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J. Otorhinolaryngol. Hear. Balance Med., Volume 5, Issue 2 (December 2024) – 6 articles

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8 pages, 417 KiB  
Article
Nasal Septal Deviation Classifications Associated with Revision Septoplasty
by Karina Bayer, Johannes Brady-Praun, Gerold Besser, Faris F. Brkic, Markus Haas, Christian A. Mueller and David T. Liu
J. Otorhinolaryngol. Hear. Balance Med. 2024, 5(2), 14; https://doi.org/10.3390/ohbm5020014 - 27 Sep 2024
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Abstract
Background: This study aimed to identify clinical characteristics and classifications of nasal septal deviations associated with revision septoplasty. Methods: The cross-sectional study design included 652 patients undergoing septoplasty at a tertiary referral center. We classified patients according to Baumann’s validated septal deviation classification [...] Read more.
Background: This study aimed to identify clinical characteristics and classifications of nasal septal deviations associated with revision septoplasty. Methods: The cross-sectional study design included 652 patients undergoing septoplasty at a tertiary referral center. We classified patients according to Baumann’s validated septal deviation classification and assessed similarities and differences regarding septal pathologies and types of nasal septal deviations in both groups. Results: The sample comprised 600 primary surgery cases and 52 revision cases. In primary surgeries, type 1 septal deviations were most common (60.3%), followed by type 5 (10.5%) and type 3 (10.0%). In revision surgeries, type 1 deviations (36.5%) were most common, followed by type 3 (25.0%) and type 2 (17.3%). Group comparisons revealed that type 2 and type 3 septal deviations, high septal deviations, and septal perforations were significantly more frequent in revision cases. Common septal pathologies included an oblique septum (98.0%), ipsilateral septal crest (76.4%), contralateral turbinal hyperplasia (42.5%), and vomeral spur (39.9%). Conclusions: This study suggests that using validated classification systems for septal deviations, which combine various pathologies, can provide a more clinically relevant assessment and improve patient counseling and treatment. Full article
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13 pages, 2802 KiB  
Article
Cerebrovascular Burden and Its Association with Ménière’s Disease: A Case-Control Study
by Francisco Alves de Sousa, João Tarrio, Bruno Moreira, Ana Nóbrega Pinto, Luís Meireles and Ângela Reis Rego
J. Otorhinolaryngol. Hear. Balance Med. 2024, 5(2), 13; https://doi.org/10.3390/ohbm5020013 - 24 Sep 2024
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Abstract
Background: Ménière’s disease (MD) lacks a universally accepted pathogenesis model. Recent research has revisited the vascular hypothesis. This study aims to compare the cerebrovascular burden in patients with MD and age-matched controls, investigating the potential role of cerebrovascular dysfunction in MD. Methods [...] Read more.
Background: Ménière’s disease (MD) lacks a universally accepted pathogenesis model. Recent research has revisited the vascular hypothesis. This study aims to compare the cerebrovascular burden in patients with MD and age-matched controls, investigating the potential role of cerebrovascular dysfunction in MD. Methods: A total of 145 patients (70 MD, 75 controls) underwent magnetic resonance imaging (MRI) assessment for small-vessel disease (SVD) markers (including Fazekas and EPVS scores), cortical strokes, and baseline comorbidities. Statistical analyses were performed to compare the cerebrovascular burden between the groups, adjusting for potential confounders. Results: The MD group exhibited significantly higher mean SVD scores across various measures compared to controls (p < 0.05). This association persisted even after adjusting for age, sex, and comorbidities (ORs ranging from 1.746 to 2.495, p < 0.05). Neither the presence of cortical strokes nor comorbidities significantly differed between groups. Conclusions: This study is the first to compare cerebrovascular burden between MD patients and controls. The findings suggest that cerebrovascular dysfunction may contribute to MD incidence. Further research is needed to elucidate the relationship between cerebrovascular disease and MD, potentially leading to novel therapeutic avenues. Full article
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9 pages, 252 KiB  
Review
The Emerging Role of Pharmacotherapy in Obstructive Sleep Apnea
by Nikhil Jaganathan, Younghoon Kwon, William J. Healy and Varsha Taskar
J. Otorhinolaryngol. Hear. Balance Med. 2024, 5(2), 12; https://doi.org/10.3390/ohbm5020012 - 7 Sep 2024
Viewed by 662
Abstract
Obstructive sleep apnea (OSA) is a prevalent pathology with current modalities of treatment including continuous positive airway pressure (CPAP), surgery, weight loss, hypoglossal nerve stimulation, and pharmacotherapy. While CPAP is the current standard treatment for OSA, lack of tolerance and side effects necessitate [...] Read more.
Obstructive sleep apnea (OSA) is a prevalent pathology with current modalities of treatment including continuous positive airway pressure (CPAP), surgery, weight loss, hypoglossal nerve stimulation, and pharmacotherapy. While CPAP is the current standard treatment for OSA, lack of tolerance and side effects necessitate alternative modalities of treatment. Various pharmacologic agents exist with mechanisms that may target OSA. Early trials have demonstrated efficacy of noradrenergic-antimuscarinic combinations to stimulate the airway, promote pharyngeal muscle tone, and prevent airway collapse. These agents, which we discuss in detail, have demonstrated significant reductions in apnea-hypopnea index (AHI) and lowest oxygen saturations based on preliminary studies. Glucagon-like peptide 1 receptor agonists (GLP-1RA), which stimulate endogenous insulin, reducing glucagon release, and decreasing gastric emptying, have shown positive results for OSA patients through weight loss with reductions in AHI. In this narrative review article, we highlight the mechanisms, current data, and future potential for multiple drug classes, including respiratory stimulants and GLP-1RAs. Full article
16 pages, 5680 KiB  
Case Report
Case Report and Literature Review on Tongue Schwannoma
by Michelangelo Pierri, Antonio Moffa, Lorenzo Sabatino, Francesco Iafrati, Simone Di Giovanni, Luigi De Benedetto and Manuele Casale
J. Otorhinolaryngol. Hear. Balance Med. 2024, 5(2), 11; https://doi.org/10.3390/ohbm5020011 - 12 Aug 2024
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Abstract
Schwannoma is a neoplasm originating from cells surrounding and insulating axons in peripheral nerves. It usually presents benign behaviour with slow growth. A significant portion of cases occur in the head and neck region but rarely in the oral cavity, where the tongue [...] Read more.
Schwannoma is a neoplasm originating from cells surrounding and insulating axons in peripheral nerves. It usually presents benign behaviour with slow growth. A significant portion of cases occur in the head and neck region but rarely in the oral cavity, where the tongue is the most frequently affected organ. This article describes the case of a man presenting an asymptomatic mass on the dorsal aspect of the tongue that sought attention at the Integrated Therapies in Otorhinolaryngology Department of the Policlinico Campus Bio-Medico Foundation in Rome. After clinical and radiological examinations, the patient underwent surgical treatment under local anaesthesia. A literature search was conducted on PubMed and Google Scholar. Only complete case reports published in English from 1923 to 2023 were selected. A total of 183 cases were considered after the selection of relevant articles and the elimination of duplicates. The resulting data confirm that the most common presentation of this pathology consists of a painless mass in the oral tongue; usually, this lesion is removed surgically via a transoral approach, but different variations were described depending on the dimensions and position of the lesion. Full article
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12 pages, 1657 KiB  
Article
Cardiovascular Risk Profile in Ménière’s Disease and Posterior Circulation Infarction: A Comparative Study
by Francisco Alves de Sousa, João Tarrio, Rita Rodrigues, Clara Serdoura Alves, Mariline Santos, Ana Nóbrega Pinto, Luís Meireles and Ângela Reis Rego
J. Otorhinolaryngol. Hear. Balance Med. 2024, 5(2), 10; https://doi.org/10.3390/ohbm5020010 - 15 Jul 2024
Viewed by 765
Abstract
Ménière’s disease (MD) has an unclear cause. The microvascular dysregulation of the inner ear has been increasingly pointed out as a potential contributor. This study investigates the prevalence of cardiovascular risk factors (CVRFs) in MD patients compared to those with posterior circulation cerebral [...] Read more.
Ménière’s disease (MD) has an unclear cause. The microvascular dysregulation of the inner ear has been increasingly pointed out as a potential contributor. This study investigates the prevalence of cardiovascular risk factors (CVRFs) in MD patients compared to those with posterior circulation cerebral infarction (POCI). CVRFs like hypertension, diabetes, dyslipidemia, obesity, coronary heart disease, and smoking were assessed in both MD and POCI patients. Brain MRI identified POCI etiology as “small vessel occlusion” (SVO) or “other etiology” (OE). This study included 64 MD and 84 POCI patients. Compared to MD, POCI OE showed a higher prevalence of CVRFs across various age groups, including hypertension, diabetes, dyslipidemia, and smoking. Notably, the odds of having POCI OE were significantly higher for individuals with hypertension and smoking. On the other hand, POCI SVO showed a similar prevalence of CVRFs compared to MD. This study revealed no significant differences in CVRF prevalence between MD and smaller vessel POCI. However, a clear distinction emerged when comparing MD to POCI with the involvement of larger blood vessels. Further research is needed to confirm these findings and explore potential shared risk factors between POCI (SVO) and MD. Full article
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7 pages, 623 KiB  
Systematic Review
Effect of Continuous Positive Airway Pressure after Pulmonary Vein Isolation in Obstructive Sleep Apnea Patients with Atrial Fibrillation: A Systematic Review and Meta-Analysis
by Angkawipa Trongtorsak, Omar Khalil, Hussein Krayem, Mathurin Suwanwalaikorn, Kimberly R. Ding, Natchaya Polpichai, Ronpichai Chokesuwattanaskul and Narut Prasitlumkum
J. Otorhinolaryngol. Hear. Balance Med. 2024, 5(2), 9; https://doi.org/10.3390/ohbm5020009 - 4 Jul 2024
Viewed by 681
Abstract
Background: Obstructive sleep apnea (OSA) was associated with atrial fibrillation (AF) as well as the recurrence of AF after rhythm control strategy. However, the data on continuous positive airway pressure (CPAP) and recurrent AF after catheter ablation with pulmonary vein isolation (PVI) remain [...] Read more.
Background: Obstructive sleep apnea (OSA) was associated with atrial fibrillation (AF) as well as the recurrence of AF after rhythm control strategy. However, the data on continuous positive airway pressure (CPAP) and recurrent AF after catheter ablation with pulmonary vein isolation (PVI) remain unclear. We conducted this systematic review and meta-analysis to evaluate the effect of CPAP treatment in OSA patients after atrial fibrillation ablation. Methods: We searched MEDLINE and Embase databases from inception to September 2023 to identify studies that assess the effect of CPAP in OSA patients on the recurrence of AF after PVI. Data from each study were combined using the random effects model. Results: Eight studies (one randomized controlled trial and seven cohort studies) with 1487 OSA patients (660 in the CPAP group and 827 in the control group) were included. The use of CPAP in OSA patients was associated with significantly lower AF recurrence after PVI (odds ratio (OR) = 0.36, 95% conference interval (CI) 0.25–0.53, p < 0.001). The results of sensitivity analysis remain the same as the main analysis. Conclusions: Our meta-analysis demonstrated that CPAP treatment was associated with lower rates of AF recurrence after PVI. Full article
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