Otorhinolaryngologic Diseases

耳鼻喉疾病
  • 文章类型: Journal Article
    耳鼻喉科是外科领域的重要专业,涉及耳朵的诊断和治疗,鼻子,喉咙,气管,以及相关的解剖结构。各种耳鼻喉科疾病难以使用已建立的药理学和手术方法来治疗。分子和细胞疗法的出现导致了这方面的进一步进展。本文综述了使用干细胞的治疗策略,免疫细胞,耳鼻喉科的软骨细胞。作为最广泛认可的细胞衍生物,还系统地回顾了外泌体在头颈癌中的治疗潜力,中耳炎,和过敏性鼻炎。最后,我们总结了干细胞的局限性,软骨细胞,和外泌体,以及可能的解决方案,并对耳鼻咽喉科细胞和衍生治疗的未来方向进行了展望,为这种治疗方式的临床翻译提供理论基础。
    Otolaryngology is an important specialty in the field of surgery that deals with the diagnosis and treatment of the ear, nose, throat, trachea, as well as related anatomical structures. Various otolaryngological disorders are difficult to treat using established pharmacological and surgical approaches. The advent of molecular and cellular therapies led to further progress in this respect. This article reviews the therapeutic strategies of using stem cells, immune cells, and chondrocytes in otorhinolaryngology. As the most widely recognized cell derivatives, exosomes were also systematically reviewed for their therapeutic potential in head and neck cancer, otitis media, and allergic rhinitis. Finally, we summarize the limitations of stem cells, chondrocytes, and exosomes, as well as possible solutions, and provide an outlook on the future direction of cell- and derivative-based therapies in otorhinolaryngology, to offer a theoretical foundation for the clinical translation of this therapeutic modality.
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  • 文章类型: Journal Article
    Glucocorticoids(GC) are widely used in the clinical treatment of autoimmune inner ear diseases, sudden sensorineural hearing loss, Meniere\'s disease, sinusitis and other otolaryngology diseases. However, GC resistance remains a major factor contributing to the poor efficacy of clinical treatments. The mechanism of GC resistance is still unclear. This paper reviews the related mechanisms of GC resistance from the perspectives of GC receptor factors and non-GC receptor factors. Additionally, it summarizes the latest research progress on GC resistance in otolaryngological diseases, with the aim of identifying effective clinical alternative treatment options for reversing GC resistance in the future.
    摘要: 糖皮质激素(glucocorticoids,GC)临床上广泛应用于自身免疫性内耳病、突发性聋、梅尼埃病及鼻窦炎等耳鼻咽喉疾病的治疗,部分患者存在GC抵抗现象,但导致GC抵抗因素机制尚不清楚,本文从GC受体因素和非GC受体因素两方面阐述了GC抵抗的相关机制,并综述其在耳鼻咽喉科疾病的最新研究进展,旨在未来寻找GC抵抗生物标志物,提高GC疗效提出新策略。.
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  • 文章类型: Journal Article
    探讨耳道下壁软骨在小儿先天性第一分支裂畸形(CFBCA)手术治疗中的临床意义。
    对2018年12月至2022年6月期间在我院接受手术的20名被诊断为CFBCA的儿童进行回顾性分析,并根据其工作病变类型进行分类。通过研究手术病灶与外耳道和面神经的毗邻关系,总结下壁软骨在CFBCAs手术治疗中的指导意义。
    在20名患者中,16个被归类为I型工作,4个被归类为II型工作。所有儿童的病变均与耳道下壁软骨相邻。工作类型I的病变位于上外侧,与面神经不相邻。工作II型病变位于面神经的下内侧区域。所有患儿的病灶均完全切除。一名患者术后3个月复发,原因是软骨内瘘残留。无患者出现面瘫或其他并发症。
    耳道下壁软骨可能有助于识别CFBCA的初始病变,可视为指导解剖结构。这些病变可以完全切除。用于切除II型工作型第一分支裂隙病变,手术切口可以更窄,并且可以在内窥镜的帮助下精确定位。
    UNASSIGNED: To investigate the clinical significance of the inferior wall cartilage of the auditory meatus in surgical treatment of congenital first branchial cleft anomalies (CFBCAs) in children.
    UNASSIGNED: Twenty children diagnosed with CFBCAs who underwent surgery between December 2018 and June 2022 at our hospital were retrospectively analyzed and classified according to their Work lesion type. The guiding significance of the inferior wall cartilage in the surgical treatment of CFBCAs was summarized by investigating the adjacent relationships of the surgical lesions with the external auditory canal and facial nerve.
    UNASSIGNED: Of the 20 patients, 16 were classified as Work type I and 4 as Work type II. The lesions were adjacent to the inferior wall cartilage of the auditory meatus in all children. Work type I lesions were located in the upper lateral aspect and were not adjacent to the facial nerve. Work type II lesions were located in the inferior-medial region of the facial nerve. The lesions were completely resected in all children. One patient experienced recurrence 3 months postoperatively because of a residual endochondral fistula. No patients developed facial paralysis or other complications.
    UNASSIGNED: The inferior wall cartilage of the auditory meatus may help to the identify the initial lesion of the CFBCAs and can be regarded as a guiding anatomical structure. These lesions can be completely resected. For resection of Work type II first branchial cleft lesions, the surgical incision can be narrower, and can be precisely positioned with the assistance of endoscope.
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  • 文章类型: Journal Article
    比较不同时间点静脉注射纳布啡对腺样体切除患儿术后镇痛和镇静的疗效。
    将进行腺样体扁桃体切除术的阻塞性睡眠呼吸暂停综合征患者随机分为A组(患者在麻醉诱导前静脉注射纳布啡0.2mg/kg),B组(患者在手术结束前10分钟静脉注射纳布啡0.2mg/kg),和C组(患者未接受纳布啡注射)。测量结果的时间点是麻醉诱导前(T0),拔管(T1),以及在麻醉后护理单元(PACU)中的0、15、30或45分钟(分别为T2-T5)。
    A组40例,B组41例,C组39例。B组患者FLACC明显降低(Face,腿,活动,哭吧,Consolability)疼痛评分在T2-T5时均优于C组(均p<0.05)。B组患者T2-T4时Ramsay镇静评分高于C组(均P<0.05)。A组PACU中接受补救镇痛的患者比例(17.5%,p=0.008)和B组(9.8%,p<0.001)显著低于C组(46.2%)。
    在儿童腺样体扁桃体切除术结束前10分钟静脉注射纳布啡可以降低疼痛强度,并在恢复期增加镇静水平,减少PACU的补救镇痛。试验注册号ChiCTR2200060118。
    UNASSIGNED: To compare the efficacy of intravenous administration of nalbuphine at different time points for postoperative analgesia and sedation in adenotonsillectomized children.
    UNASSIGNED: Patients with obstructive sleep apnea syndrome scheduled for adenotonsillectomy were randomly divided into group A (patients received intravenous nalbuphine 0.2 mg/kg before anesthesia induction), group B (patients received intravenous nalbuphine 0.2 mg/kg 10 min before the end of surgery), and group C (patients did not receive nalbuphine injection). The time points for measuring outcomes were before anesthesia induction (T0), extubation (T1), and 0, 15, 30, or 45 min in the postanesthesia care unit (PACU) (T2-T5, respectively).
    UNASSIGNED: There were 40 patients in group A, 41 patients in group B and 39 patients in group C. Patients in group B had significantly lower FLACC (Face, Legs, Activity, Cry, Consolability) pain scores at T2-T5 than those in group C (all p<0.05). Patients in group B had higher Ramsay Sedation Score at T2-T4 than those in group C (all p<0.05). The proportion of patients who received remedial analgesia in the PACU in group A (17.5%, p=0.008) and group B (9.8%, p<0.001) was significantly lower than that in group C (46.2%).
    UNASSIGNED: Intravenous administration of nalbuphine 10 min before the end of adenotonsillectomy in children could decrease pain intensity and increase sedation levels during the recovery period with the reduction of remedial analgesia in the PACU.Trial registration number ChiCTR2200060118.
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  • 文章类型: Journal Article
    目的:在本研究中,我们采用双向孟德尔随机化方法评估了吸烟和饮酒与11种耳鼻喉科疾病的相关性.
    方法:共有85,22,34和7个单核苷酸多态性被用作吸烟起始的工具变量,每天的香烟,每周的酒精饮料和酒精消费,分别。从UKBiobank和FinnGen数据集获得与11种常见耳鼻喉疾病的遗传关联。IVW,加权中位数,MR-Egger,该分析使用MR-PRESSO和留一法。
    结果:开始吸烟会增加声带和喉疾病的风险(OR1.002;95%CI1.001-1.004;P=4×10-4),头颈部肿瘤(OR1.001;95%CI0.999-1.003;P=0.027),甲状腺癌(OR1.538;95%CI1.006-2.351;P=0.047)和睡眠呼吸暂停(OR1.286;95%CI1.099-1.506;P=0.002)。每天吸烟与慢性鼻窦炎相关(OR1.152;95%CI1.002-1.324;P=0.046),慢性鼻炎和咽炎(OR1.200;95%CI1.033-1.393;P=0.017),声带和喉疾病(OR1.001;95%CI0.999-1.002;P=0.021)和头颈部癌(OR1.001;95%CI0.999-1.003;P=0.017)。每周酒精饮料仅与头颈部癌症的风险显着相关(OR1.003;95%CI1.001-1.006;P=0.014)。然而,没有证据支持基因预测的饮酒会增加耳鼻喉疾病的风险.反向MR也没有发现结果对暴露的影响。
    结论:这项研究表明,吸烟和大量饮酒会促进一些耳鼻喉疾病的发生,表明生活方式的改变可能有利于预防耳鼻喉疾病。
    OBJECTIVE: In this study, a bidirectional mendelian randomization was applied to evaluate the association of smoking and alcohol consumption with 11 otolaryngological diseases.
    METHODS: A total of 85,22,34 and 7 single nucleotide polymorphisms were used as instrumental variables for smoking initiation, cigarettes per day, alcoholic drinks per week and alcohol consumption, respectively. Genetic associations with 11 common otolaryngological diseases were obtained from the UK Biobank and FinnGen dataset. IVW, weighted median, MR-Egger, MR-PRESSO and leave-one-out method were used in this analysis.
    RESULTS: Smoking initiation increased the risk of vocal cord and larynx diseases (OR 1.002; 95% CI 1.001-1.004; P = 4 × 10-4), head and neck cancer (OR 1.001; 95% CI 0.999-1.003; P = 0.027), thyroid cancer (OR 1.538; 95% CI 1.006-2.351; P = 0.047) and sleep apnoea (OR 1.286; 95% CI 1.099-1.506; P = 0.002). Cigarettes per day was associated with chronic sinusitis (OR 1.152; 95% CI 1.002-1.324; P = 0.046), chronic rhinitis and pharyngitis (OR 1.200; 95% CI 1.033-1.393; P = 0.017), vocal cord and larynx diseases (OR 1.001; 95% CI 0.999-1.002; P = 0.021) and head and neck cancer (OR 1.001; 95% CI 0.999-1.003; P = 0.017). Alcoholic drinks per week only was significantly associated with the risk of head and neck cancer (OR 1.003; 95% CI 1.001-1.006; P = 0.014). However, there was no evidence to support that genetically predicted alcohol consumption increased the risk of otolaryngological diseases. Reverse MR also did not find outcomes effect on exposures.
    CONCLUSIONS: This study shows that smoking and heavy alcohol consumption promote the occurrence of some otolaryngological diseases indicating that lifestyle modification might be beneficial in preventing otolaryngological diseases.
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  • 文章类型: Journal Article
    UNASSIGNED:探讨三维液体衰减倒置恢复(3D-FLAIR)MRI对儿童内耳出血引起的突发性耳聋的诊断价值。
    UNASSIGNED:比较了三种不同的MRI序列在内耳检查中对32例突发性耳聋儿童的诊断效果。分析听力检查结果和3个月的随访结果。
    未经评估:32岁的突发性耳聋儿童的年龄为5至18岁。发病后1至18天进行MRI检查。6例因内耳出血引起的突发性耳聋最终得到临床诊断。对于不同的MRI序列,3D-FLAIR序列检测到5例阳性病例;常规T1加权图像序列也检测到5例阳性病例;但常规T2加权图像序列仅检测到3例阳性病例。3D-FLAIR序列诊断内耳出血的敏感度和特异度分别为83.3%(5/6)和96.2%(25/26),分别,受试者工作特性曲线的曲线下面积值为0.897。在出血组中,所有六例都有非常严重的感觉神经性听力损失,随访3个月后听力恢复无效。听力损伤的程度,3个月的短期治疗效果,3D-FLAIRMRI对内耳出血的诊断在出血组和非出血组之间有统计学意义(p=0.043,p=0.000,p=0.000)。
    UNASSIGNED:3D-FLAIRMRI有助于突发性耳聋儿童内耳出血的诊断。此外,短期治疗表明对严重听力障碍儿童的影响较差。
    UNASSIGNED: To investigate the diagnostic value of three-dimensional fluid-attenuated inversion recovery (3D-FLAIR) MRI in children with sudden deafness caused by inner ear hemorrhage.
    UNASSIGNED: The diagnostic efficacies of three different MRI sequences in the examination of the inner ear for 32 children with sudden deafness were compared. Hearing examination results and 3-month follow-up outcomes were analyzed.
    UNASSIGNED: The age of 32 children with sudden deafness ranged from 5 to 18 years. MRI was performed from 1 to 18 days after onset. Six cases of sudden deafness caused by inner ear hemorrhage were finally diagnosed clinically. For different MRI sequences, the 3D-FLAIR sequence detected five positive cases; the conventional T1-weighted image sequence also detected five positive cases; but the conventional T2-weighted image sequence only detected three positive cases. The sensitivity and specificity of the 3D-FLAIR sequence in the diagnosis of inner ear hemorrhage were 83.3% (5/6) and 96.2% (25/26), respectively, and the area under the curve value of the receiver operating characteristic curve was 0.897. In the hemorrhage group, all six cases had extremely severe sensorineural hearing loss, and the hearing recovery was ineffective after 3 months of follow-up. The degree of hearing impairment, 3-month short-term treatment efficacy, and 3D-FLAIR MRI in the diagnosis of inner ear hemorrhage between hemorrhage group and non-hemorrhage group were statistically significant (p=0.043, p=0.000, p=0.000).
    UNASSIGNED: 3D-FLAIR MRI is helpful for the diagnosis of inner ear hemorrhage in children with sudden deafness. Besides, short-term treatment indicates poor effects on children with severe hearing impairment.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    “2019年冠状病毒病”(COVID-19)的大流行改变了人们的生活。耳鼻喉科常见门诊和急诊病例发生了变化,因此完成了与之相关的数据分析。本研究旨在评估病毒感染疾病在耳鼻咽喉科常见疾病中的影响。本研究使用耳鼻喉科“COVID-19”大流行期间(2020年2月至4月)和过去3年同期门诊和急诊科常见疾病的数据。在“COVID-19”期间,与去年同期相比,按疾病划分的病例排名发生了变化。慢性咽炎等疾病,过敏性鼻炎,突发性耳聋,耳鸣增加,同时急性咽炎和急性咽喉炎减少(p<0.05)。病毒感染影响了人们的精神行为,因此,耳鼻喉科的精神相关疾病病例间接增加。这项研究提供了真实的数据来说明与精神有关的疾病。它还提供了经验,并显示了保持和保持心理健康的重要性。
    The pandemic of \"Corona Virus Disease 2019\" (COVID-19) has changed the lives of people. There have been changes in common outpatient and emergency cases in otolaryngology, so an analysis of data pertaining to this was completed. This study is to evaluate the impact of viral infection disease in otolaryngological common disease. This study uses the data of common diseases in the outpatient and emergency department during the \"COVID-19\" pandemic (from February to April 2020) and the same period in the past 3 years from the Department of Otolaryngology. During the \"COVID-19\" period compared with the same period last year, the ranking of cases by diseases has changed. Diseases such as chronic pharyngitis, allergic rhinitis, sudden deafness, and tinnitus increased, meanwhile acute pharyngitis and acute laryngopharyngitis decreased (p < 0.05). The viral infection has impacted the mental behaviors of people, therefore mental-related disease cases of the department of Otolaryngology have increased indirectly. This study provides real data to illustrate mental-related diseases. It also provides experience and shows the importance of keeping and maintaining mental health.
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  • 文章类型: Journal Article
    Objective:To explore the correlation between acute otitis media(AOM), acute pharyngitis(AP) and allergic rhinitis(AR) and environmental-meteorological factors in children in Lanzhou. Method:Data were collected in 2015-2017 from the outpatient department and emergency department of Otolaryngology of one hospital in Lanzhou. The association between clinical data and the environmental meteorological factors during the same period, including the air quality index(AQI), PM2.5, PM10, CO, NO₂, SO₂, O3, average temperature, average air pressure, average wind speed, average humidity in Lanzhou, was analyzed. Result:The incidence of AOM was positively correlated with AQI, PM2.5, PM10, CO, NO₂, SO₂, average air pressure, and was negatively correlated with O3, average wind speed and average air temperature, but not correlated with average humidity. The incidence of AP was positively correlated with average temperature and average humidity, and not correlated with other 9 factors. The incidence of AR was correlated with all 10 environmental meteorological factors except for O3.The number of children with AOM, AP and AR varied with different seasons. Environmental meteorological factors have single lag and cumulative lag effects on the incidence of children with AOM, AP and AR, and difference between the single lag and cumulative lag time was observed. Conclusion:There may be some correlation between the environmental meteorological factors and the incidence of AOM, AP, AR in children, and there is a lag effect. The incidence of pediatric AOM, AP and AR is affected by seasonal factors.
    目的:探讨兰州地区儿童急性中耳炎(AOM)、急性咽喉炎(AP)、变应性鼻炎(AR)与环境气象因素的相关性。 方法:收集20l5—2017年期间解放军第940医院AOM、AP、AR患儿的临床资料,结合同期兰州市空气质量指数(AQI)及环境气象数据(PM2.5、PM10、CO、NO₂、SO₂、O3、平均气温、平均气压、平均风速、平均湿度),分析环境气象因素与儿童AOM、AP、AR就诊人数的相关性。 结果:儿童AOM日就诊人数与AQI、PM2.5、PM10、CO、NO₂、SO₂、平均气压均呈正相关,与O3、平均气温、平均风速均呈负相关,而与平均湿度无相关性;儿童AP日就诊人数与平均温度、平均湿度呈正相关,与其他9项因子无相关性;儿童AR日就诊人数除与O3无相关性外,与其他10项因子存在相关。不同季节对儿童AOM、AP、AR日就诊人数的影响因素不同,环境气象因素对儿童AOM、AP、AR的发病具有单滞后和累积滞后效应,但单滞后和累积滞后时间具有一定的差异。 结论:环境气象因素对儿童AOM、AP、AR的发病可能存在一定的相关性,且有滞后性,儿童AOM、AP、AR发病受季节因素的影响。.
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  • 文章类型: Journal Article
    Objective.描述2019年冠状病毒病(COVID-19)需要耳鼻喉科咨询的患者介绍,并根据耳朵的经验提供保护措施建议,鼻子,在COVID-19大流行期间,4家中国医院的喉部(ENT)。研究设计。回顾性病例系列。设置。多中心。主题和方法。20例住院的COVID-19患者需要武汉3家指定的COVID-19医院进行耳鼻喉科咨询,上海,深圳被确认。人口统计数据,合并症,COVID-19症状和严重程度,咨询理由,治疗,收集和分析了个人防护装备(PPE)的使用情况。报告了复旦大学附属眼科和耳鼻喉科医院耳鼻喉科门诊和急诊室就诊的感染控制策略。结果。中位年龄为63岁,55%是男性,95%处于严重或危急状态。进行了六次气管切开术。气管切开术后结果混合(2例死亡,2名患者昏迷,所有仍住院的患者)。其他咨询包括鼻出血,咽炎,鼻塞,失足,鼻炎,外耳道炎,头晕,还有耳鸣.在所有医院,动力供气过滤呼吸器(PAPRs)用于气管切开术或出血控制.PAPR或N95等效口罩以及全套防护服用于其他投诉。没有住院的耳鼻喉科提供者被感染。在门诊实施感染控制策略后,紧急访问,和手术,复旦大学眼科和耳鼻喉科医院没有提供者被感染.结论和相关性。COVID-19患者因多种原因需要耳鼻喉科咨询,包括气管切开术.耳鼻喉科医师在COVID-19患者的治疗中起着不可或缺的作用,但是,由于他们的工作,暴露的风险很高。适当的保护策略可以预防耳鼻喉科医师的感染。
    Objective. To describe coronavirus disease 2019 (COVID-19) patient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ear, nose, and throat (ENT) departments in 4 Chinese hospitals during the COVID-19 pandemic. Study Design. Retrospective case series. Setting. Multicenter. Subjects and Methods. Twenty hospitalized COVID-19 patients requiring ENT consultation from 3 designated COVID-19 hospitals in Wuhan, Shanghai, and Shenzhen were identified. Data on demographics, comorbidities, COVID-19 symptoms and severity, consult reason, treatment, and personal protective equipment (PPE) use were collected and analyzed. Infection control strategies implemented for ENT outpatients and emergency room visits at the Eye and ENT Hospital of Fudan University were reported. Results. Median age was 63 years, 55% were male, and 95% were in severe or critical condition. Six tracheotomies were performed. Posttracheotomy outcomes were mixed (2 deaths, 2 patients comatose, all living patients still hospitalized). Other consults included epistaxis, pharyngitis, nasal congestion, hyposmia, rhinitis, otitis externa, dizziness, and tinnitus. At all hospitals, powered air-supply filter respirators (PAPRs) were used for tracheotomy or bleeding control. PAPR or N95-equivalent masks plus full protective clothing were used for other complaints. No inpatient ENT providers were infected. After implementation of infection control strategies for outpatient clinics, emergency visits, and surgeries, no providers were infected at the Eye and ENT Hospital of Fudan University. Conclusions and Relevance. COVID-19 patients require ENT consultation for many reasons, including tracheotomy. Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection of otolaryngologists.
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