Abstract in English:

Abstract Introduction Mismatch negativity (MMN) represents a negative component of event-related potentials, which is mentioned by guidelines as an important tool to provide measurable data regarding the functionality of the auditory system in acoustic processing. However, the literature still lacks reliable data that can support the clinical use of this potential in the complementary diagnosis of central auditory processing (CAP) disorder (CAPD). Objectives To analyze whether MMN assessment might be associated with the CAP behavioral test battery, as well as to assess the effects of auditory ability deficits on MMN responses in the pediatric population. Methods In total, 45 age-matched children participated in the study. They were submitted to the CAP behavior assessment and to MMN. The children were tested with a combination of speech contrast consisting of acoustic syllables [da] versus [ta], governed by the oddball paradigm. Results Mismatch negativity did not show a direct association with a single test but with the combination of the four tests used as a behavioral test battery to identify CAPD. The results also indicated that the auditory ability deficits influenced the measurement of MMN latency (p = 0.003*), but not the amplitude (p = 0.857) or the area (p = 0.577). Conclusion Mismatch negativity was shown to be statistically associated with the battery of tests used to identify deficits in auditory abilities in the studied sample rather than with a single behavioral test. The deficits in auditory abilities were observed in the MMN latency. Mismatch negativity can be used to assess children with CAPD.

Abstract in English:

Abstract Introduction Sinonasal inverted papilloma (SNIP) is a rare benign epithelial tumor of the nasal cavity and paranasal sinuses that accounts for 0.4% and 4.7% respectively, of all tumors of this anatomical region. Objective To analyze the outcomes after surgical resection of SNIP and identify the risk factors for recurrence in a Swiss tertiary center. Methods We conducted a retrospective review of all cases of SNIP treated at the Lausanne university hospital between 2005 and 2018. All data available on the patients and tumors were collected for analysis. We studied the recurrence rate and looked for risk factors. Results We included 57 patients with a mean age of 55.5 years. There were 46 primary cases (80.7%) and 11 recurrences (19.3%). Maxillary sinus was the most frequent location (33.3%). Approximately half of the patients (52.6%) presented with a T3 tumor according to the Krouse classification. The mean recurrence rate after surgery was of 17.5% and it was more frequent among the patients in the recurrence group (45.5%) than among the primary cases (10.9%), reaching statistical significance (odds ratio [OR] = 6.8; 95% confidence interval [95%CI]: 1.5–30.8; p = 0.0165). Most patients were treated endoscopically (94.7%). Frontal sinus location, higher Krouse stage, and combined approach seemed to increase the risk of recurrence, but without statistical significance. Conclusion Difficult surgical access, as in the case of tumors located in the frontal sinus, higher stage of the disease, and previously operated cases carry the higher risk of incomplete resection and recurrence.

Abstract in English:

Abstract Introduction Expansion sphincter pharyngoplasty has been shown to be a good alternative to continuous pressure devices in patients with moderate to severe obstructive sleep apnea. On the other hand, drug-induced sleep endoscopy provides information on the pattern of collapse in obstructive sleep apnea, although it is unclear whether this information improves the surgical outcomes. Objective To evaluate the success rate obtained when performing expansion sphincter pharyngoplasty on a group of patients diagnosed with moderate to severe obstructive sleep apnea who were not previously selected by drug-induced sleep endoscopy. Methods We present a series of patients with moderate to severe obstructive sleep apnea who underwent surgery. Pre- and postoperative home sleep apnea tests were performed. The success rate was calculated, and we assessed whether there were statistically significant pre- and postoperative differences in the apnea-hypopnea index and oximetry values. Results In total, 20 patients were included, and the surgical success rate was of 80%. Statistically significant improvements were demonstrated in the mean apnea-hypopnea index (from 40.25 ± 15.18 events/hour to 13.14 ± 13.82 events/hour; p < 0. 0001), the mean oximetric data (from 26.3 ± 12.97 desaturations/hour to 13.57 ± 15.02 desaturations/hour; p = 0.034), and in the mean percentage of total sleep time in which the patient had less than 90% of saturation (from 8.64 ± 9.25% to 4.4 ± 7.76%; p = 0.028). Conclusion The results showed significant improvements in the apnea-hypopnea index and in the oximetric data, with a surgical success rate of 80%, despite the lack of prior drug-induced sleep endoscopy screening.

Abstract in English:

Abstract Introduction The use of functional near-infrared light spectroscopy (fNIRS) may be applied to study cortical responses in children and could offer insight into auditory and speech perception during the early stages of life. Some literature suggests that babies are already able to identify familiar voices at birth, and fNIRS is a non-invasive technique that can be used to study this population. Objective To characterize the cortical responses of infants during their first trimester of life to infant-directed speech using near-infrared light spectroscopy and to verify whether there is a difference in responses when infant-directed speech is performed by their mother compared with an unknown person. Methods Twenty-three children between 0 and 3 months, healthy, without risk indicators for hearing loss, and with results considered normal in the audiological evaluation were tested with near-infrared spectroscopy using infant-directed speech as an auditory stimulus produced by their own mother and by an unknown source. Results Bilateral cortical activation was observed. The responses were present in the temporal, frontal, and parietal regions. Regarding the familiarity aspect, no significant difference was observed for the mother's voice compared with an unknown voice. Conclusion Infant-directed speech has prosodic characteristics capable of activating several cortical regions in the infant's first trimester of life, especially the temporal region. The familiarity effect needs to be better defined for this type of stimulus during this period.

Abstract in English:

Abstract Introduction The advent of the video head impulse test (vHIT) enables the study of each one of the six semicircular canals. In the present study, certain patients present disorders related only to the vertical semicircular canals, and they were carefully evaluated. Objective To investigate vestibular disorders limited to the vertical semicircular canals. Methods In total, 9,891 patients were submitted to the vHIT in our clinic; 26 (2.63%) of them, 11 men and 15 women, showed reduced vestibulo-ocular reflex (VOR) limited to the vertical canals. All of these patients had vestibular symptoms. Results These patients presented different disorders of the vestibular system, and ten of them presented vestibular neuritis. Conclusion Now, vestibular disorders limited the vertical canals can be evaluated through the vHIT. These disorders, however, may relate do different labyrinthine diseases.

Abstract in English:

Abstract Introduction The coronavirus disease 2019 (COVID-19) pandemic has prompted a transformation in medical practice, including the adoption of telemedicine in Brazil and globally. Otorhinolaryngology, a field at high risk of viral transmission, has witnessed an increasing use of telemedicine tools. However, the extent and challenges of telemedicine in this field in Brazil are not well understood. In the present study, we applied a questionnaire to Brazilian otorhinolaryngologists during the pandemic to assess telemedicine's advantages and challenges, shedding light on its integration and persistent issues in the field. Objective To assess the usage profile of telemedicine in the clinical practice of otolaryngology in Brazil. Methods The present was a cross-sectional observational study with convenience sampling. It was conducted as a web-based questionnaire distributed and advertised to Brazilian otorhinolaryngologists through social media posts on WhatsApp (Meta Platforms, Inc., Menlo Park, CA, USA), Instagram (Meta Platforms, Inc.), Facebook (Meta Platforms, Inc.), as well as direct messaging and email. Results The sample size was 186 participants. A total of 69% of them had already provided or were currently providing telemedicine services, and 34% considered it a frequent or very frequent form of work at the time of data collection. In total, 90% of the respondents considered the lack of physical examination a problem in otolaryngological teleconsultations, while 64% reported frequently or very frequently resolving patient problems through teleconsultations. Conclusion Telemedicine emerged in the context of the COVID-19 pandemic as a promising tool for remote patient care. More studies are needed to elucidate its role in the context of limited physical examination.

Abstract in English:

Abstract Introduction The coronavirus disease 2019 (COVID-19), also referred to as the 2019 novel coronavirus, is caused by a single-stranded positive-sense RNA virus. This infectious agent spreads through respiratory routes, primarily utilizing aerosols. In our study, we shed light on ear, nose, and throat (ENT) manifestations, which can be considered as prognostic clinical biomarkers to reduce forthcoming complications among such critically ill patients. This makes it feasible for researchers to investigate or fetch early diagnosis in such cases with ease without the use of large, extensive hospital-base setups. Objective To study the otorhinolaryngological (ENT) manifestations in symptomatic COVID-19 patients. Methods From January to December 2021, a cross-sectional observational study was conducted at the Department of ENT of a tertiary care hospital in central India. All eligible symptomatic COVID-19 patients admitted to this institution during the study period were consecutively enrolled. The Institutional Ethics Committee gave its permission for the project. Results Out of the total of 1,375 patients, 78% of the patients diagnosed with COVID exhibited symptoms related to the ENT, while the remaining 22% did not display any ENT manifestations. Anosmia (71.2%), sore throat (55.62%), headache (44.3%), and loss of taste (66.3%) were among the most common ENT symptoms. Conclusion The present study highlights ENT manifestations, which play a crucial role in the early diagnosis of COVID-19 patients, ensuring faster treatment and isolation for better containment of the disease. Symptomatic treatment has shown efficacy, but objective tests are needed to prevent overestimation, understand pathogenesis, and enhance treatment.

Abstract in English:

Abstract Introduction In children, obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is caused by adenotonsillar hypertrophy and is characterized by upper airway obstruction disturbing sleep. Objective We conducted this study to evaluate health-related quality of life (QoL) in children with OSA before and after adenotonsillectomy. Methods A descriptive, observational study was conducted among 43 children in the 4-to-12 years old age group who had symptoms of OSA due to adenotonsillar hypertrophy and who underwent adenotonsillectomy at a tertiary care center during the period from February 2020 to February 2021. The QoL was assessed using the OSA-18 questionnaire preoperatively and at 2 and 6 months postoperatively. Results Among the study population, males (72)%) were more affected with OSA, with a male-to-female ratio of 2.6:1. Based on the OSA-18 questionnaire assessment, the most severe and frequently observed symptoms were in the domains of sleep disturbance and physical symptoms, in which the mean score was 77 preoperatively. After adenotonsillectomy, the mean OSA-18 score decreased to 28.605 and 22.465 at 2 and 6 months, respectively. At 2 months postsurgery, more significant improvement was noticed in sleep disturbances, physical symptoms, and parent's concern while at 6 months postsurgery, all domains showed equal improvement. Therefore, following adenotonsillectomy, the QoL improved significantly. Conclusion Obstructive sleep apnea can adversely affect sleep quality as well as neurocognitive and cardiovascular functions. Adenotonsillectomy resulted in significant improvement in the QoL.

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Abstract Introduction Obstructive salivary gland disease is a frequently encountered clinical entity that can present to various health practitioners. Obstructive sialadenitis can lead to recurrent infections and debilitating quality-of-life issues. Objective There is a paucity of published data regarding obstructive salivary disorders among the multiracial Asian population. The present study aimed to determine the demographic pattern and risk factors of obstructive salivary gland disorders with the goal of better management of this condition. Methods A retrospective cross-sectional study was conducted at a tertiary institution over a period of 5 years. Results A total of 256 (9.84 for every 1,000) patients were found to have salivary disorders, 10% of who were diagnosed to have obstructive disorder. Among the obstructive salivary disorders, 76% had sialolithiasis, 19% had recurrent parotitis, and 1 patient had chronic sialadenitis. We observed a small female preponderance for obstructive salivary disorders. This study revealed that smoking is a significant risk factor (p = 0.041; prevalence ratio = 2.54, 95% confidence interval 1.12–5.78), and smokers were 2.5 times more likely to develop obstructive salivary disorders. There was no statistical correlation between the prevalence and other risk factors like infection, dehydration, intake of medications, history of diabetes mellitus, radiotherapy, and autoimmune disorders. Conclusion Our study results demonstrated that the prevalence of obstructive salivary gland disorders was 0.1%. This study provided a better understanding of the prevalence and risk factors of obstructive salivary disorders, which facilitate timely management and improves quality of life.

Abstract in English:

Abstract Introduction Fat grafts have been in used since 1962 for small central perforations, with a success rate ranging from 86 to 100%. Platelet-rich plasma (PRP) containing platelet concentrations greater than 1 million platelets/μL assist the healing process by various means. Current data suggests improved healing when tympanoplasty is performed using temporalis fascia grafts if PRP is added during surgery. Objective To assess the effect of PRP on fat grafts in small and moderate-sized central perforations. Methods The present prospective observational study was conducted with 36 patients who underwent fat graft tympanoplasty with PRP under local anesthesia. Clinical and audiological observations were carried out after 4, 8, and 12 weeks, and a statistical analysis of the observations was performed. Results We assessed 23 patients with small central perforations and 11 patients with moderate central perforations. An overall success rate of 76.4% was observed, with an 82.6% success rate among patients with small central perforations and 63.6% among those with moderate central perforations. There was no statistically significant difference in the uptake regarding the location of the perforation, but a statistically significant difference was found in terms of hearing improvement following the procedure. Conclusion The morbidity of conventional tympanoplasty in cases of small-to-moderate central perforations in patients with chronic otitis media vis a vis the results of the procedure needs to be revisited, as in the present study fat grafts placed with PRP under local anesthesia could lead to surgical and audiological outcomes that are as good as those reported in the literature.

Abstract in English:

Abstract Introduction Benign vocal fold lesions (BVFLs) disrupt the superficial lamina propria, impacting vocal fold pliability. Investigating the diagnostic competency of ear, nose, and throat (ENT) residents in identifying BVFLs, we hypothesize that factors such as residency year, subspecialty focus, and training center influence diagnostic accuracy. Objectives To assess the accuracy of diagnosis of BVFLs among ENT residents and to correlate diagnostic accuracy with the year of residency. Methods An observational cross-sectional study included all ENT residents in Saudi Arabia. It was performed in August and September 2021 using a self-administered online questionnaire that assessed demographic variables and included three images with open-ended questions on diagnosing vocal fold lesions. Results A total of 61 ENT residents (62.3% male) were included in this study. The images of vocal fold cyst, vocal fold polyp, and vocal fold nodule were correctly diagnosed by 60.7%, 88.5%, and 91.8% of residents, respectively. There was a correlation between the year of residency and the accuracy of diagnosing a vocal fold cyst (p = 0.029). Residents interested in laryngology correctly diagnosed all three lesions more frequently than other residents. Conclusion The ability of residents to diagnose vocal fold cysts was moderate. In particular, the senior residents were able to diagnose polyps and nodules with excellent accuracy.

Abstract in English:

Abstract Introduction Cornelia de Lange Syndrome (CdLS) is a genetic disorder in which individuals may present sensorineural and/or conductive hearing loss, and the results of behavioral auditory assessments are not accurate. Objective To characterize the audiological profile of individuals with CdLS through behavioral, electroacoustic, and electrophysiological audiological assessments. Methods The study included 13 individuals of both sexes, aged between 3 and 26 years, with diagnoses confirmed through genetic studies. The following procedures were performed: medical history survey, otoscopy (pure-tone audiometry [PTA], speech audiometry, and acoustic immittance measures), and auditory brainstem response (ABR). Results In total 62.50% of the participants who underwent PTA had abnormal results (all of which were mild), with a predominance of bilateral conductive hearing loss (60%). Regarding tympanometry, 76.93% had abnormal results, most frequently type B (85.72% on the right and 88.89% on the left ear). Acoustic reflexes showed results compatible with tympanometry changes. Changes in ABR latency values compatible with middle-ear impairment were found in 8 of them (66.66%) – 3 had bilateral (37.50%), and 5 had unilateral impairments (62.50%). Conclusion Mild hearing loss was identified in 62.5% of the individuals with CdLS who underwent the behavioral audiological assessment. In the acoustic immittance measures, 76.9% of the participants presented a tympanometry curve characteristic of middle-ear changes. Acoustic reflexes were absent in 84.6% of the subjects. In the ABR, no changes were identified in auditory pathway integrity. On the other hand, changes in the absolute latency values were found, which are characteristic of conductive hearing loss.

Abstract in English:

Abstract Introduction Tinnitus can be distressing, and it affects the quality of life (QoL) through psychological and cognitive impairments. Cognitive behavioral therapy (CBT) and notched sound therapy (NST) are tinnitus management approaches aiming to reduce symptoms and improve QoL via two different mechanisms. The CBT attains the cognitive principle, whereas the NST initiates tinnitus habituation. Objective To evaluate the effect of CBT and NST and compare their results in the management of chronic subjective tinnitus. Methods The present prospective study involved 64 adults with normal hearing and chronic subjective tinnitus. They were subjected to history taking, basic audiological evaluation, and extended high-frequency audiometry at 10 and 12.5 kHz. The participants were divided into two equal groups, the first treated with CBT and the second treated with NST. The psychoacoustic measures of tinnitus and the Arabic Questionnaire for Tinnitus Reaction (Arabic-QTR) were used to monitor the outcomes of both therapies. Results Both groups showed significant reduction in tinnitus severity according to the Arabic-QTR and tinnitus loudness matching. Improvement in the Arabic-QTR was better in the CBT group, while tinnitus loudness improvement was better in the NST group. Conclusion Both CBT and NST are effective in the management of chronic subjective tinnitus. In a comparison of the effect of the two therapies, CBT was found to be more effective in decreasing tinnitus-related distress, whereas SNT was found to be more helpful in reducing tinnitus loudness.

Abstract in English:

Abstract Introduction Endoscopic transsphenoidal surgery (ETS) is the standard practice in pituitary surgeries. The sellar exposure becomes the main factor which determines the residual disease in ETS. Not many studies can be found in the literature on the influence of anatomical variations of the sphenoid on intraoperative sella exposure. Objective The aim of the current study is to ascertain whether sphenoid sinus variations play a role in sellar exposure and residual tumor volume. Methods This is a prospective study conducted in a south Indian tertiary care center between June 2020 to June 2022, with 21 study participants who were scheduled to have ETS. The relation of preoperative computed tomography (CT) and magnetic resonance imaging (MRI) parameters with the intraoperative area of sellar exposure and residual tumor volume was evaluated. Results Sphenoid sinus dimensions, like presellar width (mean = 1.89 ± 0.51 cm), maximum width (mean = 2.94 ± 1.09 cm), presellar depth (mean = 1.14 ± 0.55 cm), suprasellar depth (mean = 1.08 ± 0.24 cm), infrasellar depth (mean = 2.36 ± 0.92 cm), presellar height (mean = 2.22 ± 0.47 cm), or the 9 internal carotid artery (ICA)-related measures, did not have any correlation with the mean intraoperative area of sellar exposure (0.57 ± 0.28 cm2). Also, the adequacy of sellar exposure did not relate to the residual tumor. Preoperative tumor volume was found to be higher (20.2 [55.3–13.2] cm3) in patients with residual tumor compared with those with no residual tumor (5.9 [6.8–5.2] cm3). Tumor extension had a significant association with the residual tumor volume. Conclusion According to the present study, anatomical variations of the sphenoid sinus do not influence the adequacy of sellar exposure. Further studies need to be undertaken concerning residual tumor volume as well as preoperative tumor volume and extension.

Abstract in English:

Abstract Introduction Sudden sensorineural hearing loss (SSNHL) is defined as a rapid sensation of hearing impairment in one or both ears. Based on its personal impact on patients, the present study advances the analysis of new treatments for the prompt recognition and management of SSNHL, with higher chances of improvements in terms of hearing recovery and quality of life of the patients. Objective To describe the intratympanic (IT) corticoid infiltration technique, to demonstrate the efficacy of betamethasone injection as a sequential treatment in patients whose initial systemic steroid treatment failed, as well as to compare its use in different treatment periods. Methods The present clinical trial was conducted with 37 patients referred to our office with the diagnosis of SSNHL, from September 2019 to May 2022, who provided informed consent to participate. Results Even dividing the analysis of increasing the pure tone average (PTA) or speech recognition threshold (SRT) between the difference into initiation of the salvage therapy in up to 15 days of the sudden deafness event, and between 15 days and 3 months of the event, we did not find any difference in hearing improvement. Conclusion Intratympanic corticosteroid therapy is prescribed when conventional therapy fails or when there is a limitation to the use of corticosteroids due to the presence of systemic disorders. As such, new drugs, such as bethametasone, are studied and show promising results.

Abstract in English:

Abstract Introduction Sleep deprivation has a great impact on the learning process in physicians in training. Therefore, inquiring on this phenomenon in the most recent investigations will facilitate the provision of evidence on the influence regarding the absence of sleep on the learning process in health personnel. Objectives The aim of this systematic review is to review, analyze and discuss the current literature that shows the impact of sleep on the learning process on doctors in training. Data Synthesis A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A search of the existing literature between the years of 2000 and 2022 was performed in the PubMed and Elsevier databases, taking into account the inclusion criteria of articles in English or Spanish and the established timeframe. As a result, 128 articles distributed in the databases were obtained and 23 articles that met the inclusion criteria were selected. Conclusion Sleep is a fundamental factor for the consolidation, processing and functioning of memory and learning. Health professionals are a population at risk of sleep deprivation, thus it is important to take into account the effects it has on patients and health personnel.

Abstract in English:

Abstract Introduction The prevalence of moderate to severe sleep-disordered breathing is of 17% among men aged between 50 and 70-years, and of 9% among women in the same age group. In Brazil, obstructive sleep apnea (OSA) is also highly prevalent, and it is associated with metabolic and cardiovascular impacts, excessive daytime sleepiness, and increasing risk of traffic accidents. Laboratory-based polysomnography is the gold standard test for OSA diagnosis. However, its complexity has led to the search for alternatives to simplify the diagnosis, such as the out-of-center sleep test (OCST). Objectives To discusses the minimum OCST recording time and the potential effects of the supine position on this parameter. Data Synthesis We conducted a search on the PubMed, Web of Science, Scopus, and Embase databases to identify relevant studies on OCST recording time and a possible association with body position. We used a combination of terms, including Obstructive Sleep Apnea and Home Monitoring OR Home Care Services OR Portable Monitoring AND Supine OR Position OR Recording Time OR Positional Obstructive Sleep Apnea. The references of the selected articles were also reviewed to find other relevant studies. Through our approach, eighteen articles were retrieved and included in the present study. Conclusion Since OCSTs are conducted in an unattended environment, with potential signal loss during the night, it is crucial to determine the minimum recording time to validate the test and assess how the time spent in the supine position affects this parameter. After reviewing the literature, this topic remains to be clarified, and additional studies should focus on that matter.

Abstract in English:

Abstract Introduction Universal newborn hearing screening (UNHS) has been widely and strongly advocated as an early detection strategy for hearing loss in children. This intervention aims to prevent delays in speech and language development, which, in turn, has long-term beneficial effects on the social and emotional development and quality of life of individuals. However, the implementation of UNHS programs is circumstantial in different settings, for different reasons. Objectives The present systematic review aimed to identify whether the implementation of UNHS programs are cost-effective, as well as their variations by localities. Data Synthesis A search was conducted in seven databases: PubMed (Medline), Scopus, Web of Science, Embase, CINAHL, Lilacs, and Cochrane Library. Studies that included a cost analysis of UNHS programs were eligible for inclusion. Studies on evaluations of preschool or school-based programs only were excluded, among others. A total of 1,291 records were found. Of these, 23 articles were analyzed in full. All articles identified the cost-effectiveness of the UNHS programs implemented. Regarding the UNHS protocols, a wide variation was observed in all aspects: tests used, period established between tests and retests, professionals responsible for screening, environment, and criteria for defining hearing loss, limiting the generalization of this information. All studies presented values related to the expenses with the program, but none of them showed statistical elements for the described analyzes or any theoretical basis for such. Conclusion It is necessary to estimate local specific issues, as well as the accuracy of the chosen tests and the NHS protocols used, so that more accurate analyzes on cost-effectiveness are possible.

Abstract in English:

Abstract Introduction Long coronavirus disease (COVID) refers to the persistence of symptoms long after the recovery from the acute phase of the illness, and it is due to the interplay of various inflammatory mechanisms. This has led to emergence of new deficits, including otorhinolaryngological symptoms, in patients wo have recovered from COVID. The plethora of otorhinolaryngological symptoms associated with long COVID are tinnitus, sensorineural hearing loss (SNHL), vertigo, nasal congestion, sinonasal discomfort, hyposmia/anosmia, dysgeusia, sore throat, dry cough, dyspnea, dysphagia, and hoarseness of voice. Objective To evaluate the possible ENT symptoms in patients wo have recovered from COVID and to combine those findings with our experience. Data Synthesis We conducted a search on the PubMed, ENT Cochrane, Web of Science, and Google Scholar databases, and a total of 44 studies were selected for the present review. Conclusion Otorhinolaryngological complications such as tinnitus, SNHL, vertigo, nasal congestion, sinonasal discomfort, hyposmia/anosmia, dysgeusia, sore throat, dry cough, dyspnea, dysphagia, and hoarseness of voice have been widely reported among in long-COVID patients.

Abstract in English:

Abstract Introduction The harmonic scalpel (HS) is a technique introduced to reduce blood loss and intraoperative time during neck dissection (ND). Objective To compare the results of HS with traditional hemostasis in ND through a systematic review and metanalysis. Methods A computer-based strategy of systematic literature survey included research in the MEDLINE, EMBASE, and Cochrane Library databases from January 2007 up to August 2022. The survey strategy employed was [harmonic scalpel OR ultrasonic scalpel] AND neck dissection. Results There were 61 articles identified that addressed the use of HS in patients undergoing ND. From those, 10 randomized clinical trials were selected, comprising 264 cases of ND using HS and 262 cases of ND without HS. Conclusion The use of HS for ND significantly reduces the operative time, intraoperative bleeding, volume of draining fluid, and the number of ligatures.

Abstract in English:

Abstract Introduction The study of electrophysiological auditory measures with different types of masking makes it possible to understand temporal processing skills and the processes involved in speech recognition in noise situations. The use of modulated masking in cortical measures of hearing enables the obtainment of analysis parameters of the masking release and its impact on neural auditory processing. Objective To investigate the behavior of cortical auditory evoked potentials (CAEPs) with modulated masking in the normal hearing population. Data synthesis A total of 2,159 articles were identified in the initial search; of these, 12 were selected for full reading. After excluding studies that did not meet the eligibility criteria, six articles were included in the present systematic review. The results show that the type of masking has an influence on cortical auditory behavior, indicating a different effect on neural posture rergarding CAEP responses. Modulated noise as masking in the CAEP record generated statistically higher and earlier responses compared with non-modulated/steady noise, evidenced by the results obtained in the meta-analysis with subgroup analysis. These responses may indicate an influence of the type of noise in the neural auditory coding. Conclusion Better responses were observed in modulated masking in terms of the behavior of CAEPs. Decreased latency and increased amplitude of cortical measurements with the use of modulated noise indicate a lower masking effect of this noise in cortical auditory processing, evidencing the masking release phenomenon.

Abstract in English:

Abstract Introduction Mouth breathing generates imbalances in the musculature, in craniofacial morphofunctionality, and in the stomatognathic system. Therefore, it is essential to make a diagnosis of mouth breathing through the quantitative assessment of nasal permeability, which can be performed through rhinomanometry. Objective To investigate the effectiveness of rhinomanometry in the diagnosis of mouth breathing in pediatric patients through a systematic review of the literature. Data synthesis The guiding question was: "Is the use of rhinomanometry as an assessment tool effective in the diagnosis of mouth breathing in pediatric patients?". We conducted a search on the following databases: Latin American and Caribbean Center on Health Sciences Information (BIREME), Latin American and Caribbean Health Sciences Literature (LILACS), PubMed/Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO), Web of Science, and Science Direct. The Health Sciences Descriptors (Descritores em Ciências da Saúde, DECS, in Portuguese) and Medical Subjects Headings (MESH) were combined with the Boolean operator AND in the search strategy: rhinomanometry AND mouth breathing AND diagnosis AND nasal pressure AND nasal airflow AND nasal resistance. Observational cohort and cross-sectional studies that addressed the effectiveness of rhinomanometry in the diagnosis of mouth breathing were included. The reviewers independently extracted the information and scored the review quality based on the Physiotherapy Evidence Database (PEDro) scale and the grading of evidence levels according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Of the 1,536 articles identified, only 3 were selected for the present review after the application of the eligibility criteria. Conclusion There is great concern regarding the assessment of nasal function. There was a lack of standardization of rhinomanometry to test the effectiveness of nasal resistance as an aid in the diagnosis of breathing mode.

Abstract in English:

Abstract Introduction Olfactory dysfunction (OD) has emerged as a notable symptom among coronavirus disease 2019 (COVID-19) patients, with its prevalence varying among different populations. Recognizing the need to provide therapeutic solutions for these individuals, the present study seeks to comprehensively review the current evidence on potential underlying mechanisms and treatment modalities to manage OD in COVID-19 patients. Objective To review the recent evidence on treatments for OD in COVID-19. From the beginning of the study until August 2nd, 2023, we conducted a systematic search on four electronic databases, PubMed, Scopus, Embase, and Web of Science, to find relevant publications. Data Synthesis In the present study, 37 articles were selected for data extraction and included in the final review. The total number of patients was of 3,560 (2,098 female and 1,462 male subjects). The predominant disorders reported were hyposmia, anosmia, and parosmia. In most of the studies, the pre and postintervention assessments were the same, except for one study, in which the pre-intervention assessment of the disorder was through the SST, Sniffin’ Sticks Test (SST), and the post-intervention assessment was through the Visual Analog Scale (VAS) and the 22-item Sinonasal Outcome Test (SNOT-22). The findings suggest olfactory training (OT), ivermectin, palmitoylethanolamide, luteolin, and systemic corticosteroids, in combination with topical corticosteroids, are potential therapies for COVID-19 patients with olfactory impairment. Conclusion Although the review suggested several medications for OD treatment, further research must delve into the specific impact of OT, a non-pharmacological modality, regarding the mitigation of OD. By continuing to investigate and refine these therapeutic approaches, we can better support COVID-19 patients and improve their quality of life while navigating the challenges posed by OD.