Relationship between the severity of laryngopharyngeal reflux and sleep apnea: using drug-induced sleep endoscopy (DISE).

OBJECTIVES: The aim of the study is to identify the following associations: (1) severity of obstructive sleep apnea syndrome (OSAS) and laryngopharyngeal reflux (LPR)-related clinical parameters, such as reflux finding score (RFS), reflux symptom index (RSI), and LPR-health-related quality of life (LPR-HRQOL) and (2) complete obstruction on drug-induced sleep endoscopy (DISE) and LPR-related clinical parameters. MATERIALS AND METHODS: Subjects included the OSAS patients without surgery history and all patients perform the polysomnography (PSG) and DISE for their OSAS. Demographics, polysomnographic data, DISE results, and LPR-related parameters were collected prospectively. The patients were divided into age-, sex-, and BMI-matched two groups, according to numbers of complete obstruction on DISE (complete obstruction at 0-1 subsites (unilevel) vs. 2-4 subsites (multilevel). Finally, 19 patients with unilevel complete obstruction and 38 patients with multilevel complete obstruction were compared. The multiple linear regression analysis was employed to determine the predictors of LPR-related quality of life. RESULTS: Among 88 patients, 19 patients demonstrated unilevel complete obstruction, and 69 patients demonstrated multilevel complete obstruction on DISE. There were no significant correlation between OSAS severity and RFS, RSI, and scores of LPR-HRQOL. Multilevel complete obstruction on DISE did not affect the LPR-related clinical parameters (p > 0.05). The result of multiple linear regression demonstrated complete obstruction at the epiglottis had a strong influence on the high scores of LPR-HRQOL. CONCLUSION: LPR is commonly developing disease with OSAS, but the OSAS severity did not affect the LPR-related parameters. The multilevel complete obstruction on DISE was not associated with the LPR-related clinical parameters.

Isolated horizontal positional nystagmus from a posterior fossa lesion.

Isolated vertigo with horizontal positional nystagmus as an impending sign of a central lesion has rarely been reported. Here we present neuro-otologic findings of patients with these clinical signs. Lesion overlays from 6 patients with ageotropic positional nystagmus revealed that the nodulus and vermis are common areas of injury. In contrast, 2 patients with geotropic positional nystagmus had cerebellar peduncle and lateral medullary lesions. These clinical findings suggest that vertigo with horizontal positional nystagmus, even in the absence of other initial neurological signs, may indicate a posterior fossa lesion, including that in the nodulus, vermis, and deep cerebellar structures.

Analysis of Predisposing Factors for Hearing Loss in Adults.

We aimed to estimate the effects of various risk factors on hearing level in Korean adults, using data from the Korea National Health and Nutrition Examination Survey. We examined data from 13,369 participants collected between 2009 and 2011. Average hearing thresholds at low (0.5, 1, and 2 kHz) and high frequencies (3, 4, and 6 kHz), were investigated in accordance with various known risk factors via multiple regression analysis featuring complex sampling. We additionally evaluated data from 4,810 participants who completed a questionnaire concerned with different types of noise exposure. Low body mass index, absence of hyperlipidemia, history of diabetes mellitus, low incomes, low educational status, and smoking were associated with elevated low frequency hearing thresholds. In addition, male sex, low body mass index, absence of hyperlipidemia, low income, low educational status, smoking, and heavy alcohol consumption were associated with elevated high frequency hearing thresholds. Participants with a history of earphone use in noisy circumstances demonstrated hearing thresholds which were 1.024 dB (95% CI: 0.176 to 1.871; P = 0.018) higher, at low-frequencies, compared to participants without a history of earphone use. Our study suggests that low BMI, absence of hyperlipidemia, low household income, and low educational status are related with hearing loss in Korean adults. Male sex, smoking, and heavy alcohol use are related with high frequency hearing loss. A history of earphone use in noisy circumstances is also related with hearing loss.

Comparison of sequential same-day middle ear surgeries: bilateral mastoidectomy, unilateral mastoidectomy with contralateral tympanoplasty, and bilateral tympanoplasty.

We evaluated the advantages and outcomes of performing bilateral simultaneous middle ear surgery for chronic otitis media. For comprehensive analysis, we compared three subgroups, bilateral mastoidectomy (MM), unilateral mastoidectomy with contralateral tympanoplasty (MT), and bilateral tympanoplasty (TT). A total of 176 ears of 85 patients with chronic otitis media or cholesteatoma underwent bilateral same-day surgery. The side with worse hearing was chosen for the first operation. In the absence of any intra-operative complications, the contralateral operation was then performed. Results of hearing tests did not differ significantly among the three groups except for gained decibels in the TT versus MT groups (P = 0.033). The correlation between pre-operative sound-field audiometry (SFA) and postoperative SFA was statistically significant. These results indicate that low frequency hearing was recovered immediately, but middle and high frequencies recovered later. Temporary taste change differed statistically among the three groups (P = 0.006). There were significantly more revision cases during the postoperative period in the groups that included mastoidectomy (MM group, MT group) (P = 0.035). Bilateral simultaneous middle ear surgery provides good hearing outcomes, reduces costs and operation times, and has a low incidence of complications. The results of our study may be helpful in guiding the otologist's decision when performing bilateral middle ear surgery.

Analysis of various risk factors predisposing subjects to allergic rhinitis.

BACKGROUND: In Korea, the prevalence of allergic rhinitis (AR) is increasing, as in other industrialized countries. However, no large population-based study defining risk factors for AR has yet been conducted. OBJECTIVE: The purpose of this study was to evaluate the prevalence and risk factors of AR in large population-based study. METHODS: A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey. We evaluated data from 31,217 subjects who were interviewed between 2008 and 2011. RESULTS: The prevalence of AR decreased with age (adjusted odds ratio [AOR] = 0.985; 95% CI = 0.984-0.987). Higher-level stress (AOR for severe stress = 1.470; 95% CI = 1.209-1.788); asthma (AOR = 1.868; 95% CI = 1.582-2.205); atopic dermatitis (AOR = 1.552; 95% CI = 1.309-1.841); pulmonary tuberculosis (AOR = 1.320; 95% CI = 1.119-1.555); depression (AOR = 1.250; 95% CI = 1.117-1.400); and thyroid disease (AOR = 1.328; 95% CI = 1.104-1.597) increased the risk of AR. Participants whose parents had a history of AR also had higher AORs (father, AOR = 1.566; 95% CI = 1.130-2.172; mother, AOR = 1.546; 95% CI = 1.190-2.008). Marriage (AOR = 0.846; 95% CI = 0.741-0.966) decreased the risk of AR. Farmers, fishers, laborers, and soldiers were at lower risk of AR. Although high BMI, a high educational level, living in a large household, specific types of daily living, and a history of diabetes mellitus have been reported as risk factors for AR; none of these factors attained statistical significance in the present study. CONCLUSION: Our study revealed that age, stress level, marriage, occupation, asthma, atopic dermatitis, pulmonary tuberculosis, depression, thyroid disease, and parental AR history, all affected the prevalence of AR. We believe that defining the influence of various factors on AR will help to prevent development of the condition in the future.

Comparative Olfactory Profiles in Parkinson's Disease and Drug-Induced Parkinsonism.

OBJECTIVE: Drug-induced parkinsonism (DIP) is a frequently encountered diagnostic possibility when considering Parkinson's disease (PD). While olfactory dysfunction is a common clinical feature in PD, the comparison of olfactory function between the two conditions remains insufficient. This study aimed to compare olfactory function, including threshold, discrimination, and identification (TDI) profiles, between PD and DIP. METHODS: Consecutive patients with drug-naïve PD (n = 78) or DIP (n = 31) confirmed through dopamine transporter imaging were enrolled in this study. The YSK olfactory function (YOF) test, composed of TDI domains culturally familiar odorants to Koreans, was administered to all patients. RESULTS: In the study population, patients with DIP were significantly older than patients with PD. Over 70% of patients in each group had hyposmia or anosmia, and there was no significant difference in the occurrence of olfactory dysfunction between the two groups. In addition, there were no differences in the total YOF score and threshold score between the two groups. Meanwhile, the PD group had a significantly lower discrimination and identification score than the DIP group after adjusting for age, sex, the existence of diabetes, disease duration, and cognitive function. CONCLUSION: This study demonstrated that detailed olfactory profiles are different in PD and DIP, even though olfactory dysfunction can be observed in both conditions.

Early Assessment of Voice Problems in Post-Thyroidectomy Syndrome Using Cepstral Analysis.

Post-thyroidectomy syndrome (PTS), characterized by voice issues after thyroidectomy without recurrent laryngeal nerve injury, was investigated in this study. The Voice Fatigue Index (VFI) and cepstral analysis were employed for subjective and objective voice evaluation. Retrospective analysis involved 96 patients (37 males, 59 females) who underwent thyroidectomy without nerve injury from April 2018 to June 2022. Assessments pre- and post-thyroidectomy included the Voice Handicap Index (VHI) and VFI, along with auditory perceptual, acoustic (including cepstral), aerodynamic, and glottal vibration analyses. In females, although the GRBAS scale showed no significant change, both VHI and VFI increased post-thyroidectomy. Significant correlations were observed between the VHI and VFI in females. Acoustic analysis indicated a decrease in the cepstral peak prominence (CPP) of vowels (/a/) and sentences in females, with significant correlations between changes in the CPP/a/ and VHI/VFI. The maximum fundamental frequency (F0max) exhibited a significant decrease, correlating with the VHI and VFI changes. The VFI demonstrated effectiveness in subjective PTS voice evaluation, comparable to the VHI. The present study highlights the potential of cepstral analysis as an index reflecting subjective voice discomfort, suggesting its promise for a comprehensive PTS voice evaluation.

Association between Chronic Kidney Disease and Chronic Rhinosinusitis: A Longitudinal Follow-Up Study Using a National Health Screening Cohort.

Chronic kidney disease (CKD) is a leading cause of global mortality. While recent reports suggest potential connections between CKD and chronic rhinosinusitis (CRS), further research is needed to elucidate the direct association between CKD and CRS. This study investigated the association between CKD and CRS using data from the Korean National Health Insurance Service Health Screening Cohort. Participants were recruited according to medical claim codes, and individuals with CKD were matched in a 1:4 ratio with the control group. Covariates, such as demographics, health-related data, and medical history were used. The incidence rates and hazard ratio of CRS were analyzed. A further analysis was performed based on the presence of nasal polyps. Among the 514,866 participants, 16,644 patients with CKD and 66,576 matched controls were included in the analysis. The CKD group demonstrated a higher incidence of CRS than the controls: 18.30 versus 13.10 per 10,000 person-years. The CKD group demonstrated a higher risk of CRS than the control group (1.28 adjusted hazard ratio). In additional analyses, the CKD group did not exhibit a statistically significant correlation for the development of CRS with nasal polyps. This study suggests that CKD is associated with an increased risk for CRS.

Does the Necrotic Portion of Metastatic Lymphadenopathy from Squamous Cell Carcinoma Still Have Tumoral Oncologic Information? Differential Diagnosis of Benign Necrotic Lymphadenopathy Using microRNA.

Neck necrotic lymph nodes commonly correspond to metastasis or benign inflammatory conditions such as Kikuchi disease and tuberculosis. Ultrasound-guided biopsy can be used for differential diagnosis, but results may be unclear. Therefore, this study aimed to identify target microRNAs (miRNAs) and genes for the differential diagnosis of inflammatory and malignant necrotic lymph nodes. We selected six inflammatory lymphadenitis formalin-fixed paraffin-embedded (FFPE) samples that showed internal necrosis and five cancer necrotic FFPE samples. Tissue microarray (TMA) was performed to separate the necrotic and cancerous portions. Total RNA was extracted from six pairs of separated inflammatory necrosis, five pairs of cancer necrosis, and cancer portions. Differentially expressed miRNAs were analyzed by comparing inflammatory necrosis, cancer, and cancer necrosis. Seventeen miRNAs were upregulated in cancer necrosis compared to inflammatory necrosis, and two miRNAs (hsa-miR-155-5p and hsa-miR-146b-5p) showed lower expression in cancer necrotic cells. Nineteen miRNAs that were differentially expressed between inflammatory and cancer necrosis were analyzed for target gene expression; these transcripts demonstrated a clear relationship with cancer. The differentially expressed miRNAs in inflammatory and tumor necrosis were associated with cancer-related pathways. These preliminary results might help in the differential diagnosis of cervical metastatic necrotic lymphadenopathy and avoiding unnecessary excisional biopsies.

Dysregulated microRNA Expression Relevant to TERT Promoter Mutations in Tonsil Cancer-A Pilot Study.

Tonsillar squamous cell carcinomas (TSCCs) exhibit high rates of human papillomavirus (HPV) positivity. The expression profiles of microRNA (miRNA), which are small RNA molecules that play pivotal roles in biological processes, in TSCC in relation to the HPV status and cancer-related genetic mutations are not well investigated. Herein, we expanded our previous research, which was focused on established clinicopathological and genetic mutational data, to profile miRNA expression in TSCC, aiming to identify clinically relevant targets for early diagnosis and therapeutic intervention. The miRNA profiles were analyzed using the nCounter Nanostring miRNA Expression assay in 22 surgically resected TSCC tissues and their contralateral normal tonsil tissues. The TERT promoter (TERTp) gene was the only relevant candidate gene associated with differentially expressed miRNAs in TSCC. Hierarchical clustering analysis revealed high expression levels of hsa-miR-1285-5p, hsa-miR-1203, hsa-miR-663a, hsa-miR-1303, hsa-miR-33a-5p, and hsa-miR-3615 coupled with low expression levels of hsa-miR-3182, hsa-miR-219a-2-3p, and hsa-miR-767-3p, which were associated with HPV-positive TSCC (p = 0.009). Functional enrichment analysis revealed that these dysregulated miRNAs tended to be involved in protein binding (molecular function) and cellular components (biological processes). Therefore, hsa-miR-1285-5p and hsa-miR-663a may be associated with HPV-positive TERTp-mutated tumors and may serve as potential treatment targets and biomarkers for early detection.

Assessment of the Mutation Profile of Tonsillar Squamous Cell Carcinomas Using Targeted Next-Generation Sequencing.

Data regarding driver mutation profiles in tonsillar squamous cell carcinomas (TSCCs) remain scarce, limiting the understanding of its pathogenesis and unexpected behavior in the updated staging system. We investigated the incidence of clinically relevant mutations and their contribution in the prognosis of the condition, and their association with human papillomavirus (HPV) infection and adjuvant therapy. We subjected 43 surgically resected TSCC samples to targeted next-generation sequencing, determined their HPV status using polymerase chain reaction, and performed The Cancer Genomic Atlas and Gene Set Enrichment analyses. Thirty-five TSCC samples (81.4%) showed at least one oncogenic/likely oncogenic mutation among twenty-nine cancer-related genes. The top five mutated genes were TP53 (46.5%), PIK3CA (25.6%), PTEN (18.6%), EGFR (16.3%), and SMAD4 (14.0%). The EGFR pathway was the most frequently affected (51.2%), followed by the p53 (48.8%), PI3K (39.5%), and RTK (34.9%) pathways. The gene set enrichment analysis confirmed that the genes involved in signal transduction, such as growth factor receptors and second messengers, EGFR tyrosine kinase inhibitors, and PI3K signaling pathways, were mostly related with TSCCs. TP53 mutation was an independent prognostic factor predicting worse overall survival in the adjuvant therapy group. RTK mutations were related to survival in all patients and in the HPV-positive group, but multivariate analyses showed no significance. In conclusion, oncogenic/likely oncogenic mutations were relatively high in TSCCs, and TP53 and RTK mutations may be candidate predictors for poor prognosis in the adjuvant therapy and HPV-positive groups, respectively, under the updated staging system.

Analysis of Nasal Foreign Bodies in South Korea: Over 10-Year Experience.

Foreign bodies (FBs) in the nasal cavity are commonly encountered in otorhinolaryngology. This retrospective study was conducted between January 2009 and December 2020. The nasal FB frequencies were investigated according to age and sex. The type, shape, and location of the FBs, onset, and clinical features were obtained. In a total of 1228 cases, the average age was 3.9 ± 5.7 years. We found a higher incidence in patients 2-4 years old. The most frequent nasal FBs were beads (24.0%), toys/plastics (17.8%), and beans/corn (15.8%). However, there were some differences in the nasal FB types according to the age group. There was no difference in the location of the nasal FBs according to age group, but nasal FBs were found more frequently in the right nasal cavity in the 1-3-years-old groups. Most patients (97.5%) visited the hospital the same day when the nasal FB insertion was suspected, and most were asymptomatic. After the removal of the nasal FBs, most patients were free of complications. Of the nine cases involving button batteries, septal perforation was observed in two patients who visited the hospital one or two days after the FB insertion. There were specific age-based characteristics of the nasal FBs that may serve as a basis for specific precautions.

Three-Dimensional Digital Light-Processing Bioprinting Using Silk Fibroin-Based Bio-Ink: Recent Advancements in Biomedical Applications.

Three-dimensional (3D) bioprinting has been developed as a viable method for fabricating functional tissues and organs by precisely spatially arranging biomaterials, cells, and biochemical components in a layer-by-layer fashion. Among the various bioprinting strategies, digital light-processing (DLP) printing has gained enormous attention due to its applications in tissue engineering and biomedical fields. It allows for high spatial resolution and the rapid printing of complex structures. Although bio-ink is a critical aspect of 3D bioprinting, only a few bio-inks have been used for DLP bioprinting in contrast to the number of bio-inks employed for other bioprinters. Recently, silk fibroin (SF), as a natural bio-ink material used for DLP 3D bioprinting, has gained extensive attention with respect to biomedical applications due to its biocompatibility and mechanical properties. This review introduces DLP-based 3D bioprinting, its related technology, and the fabrication process of silk fibroin-based bio-ink. Then, we summarize the applications of DLP 3D bioprinting based on SF-based bio-ink in the tissue engineering and biomedical fields. We also discuss the current limitations and future perspectives of DLP 3D bioprinting using SF-based bio-ink.

Thyroid Diseases and Chronic Rhinosinusitis: A Nested Case-Control Study Using a National Health Screening Cohort.

This study aimed to investigate the association between thyroid diseases and chronic sinusitis (CRS) in a matched cohort in a study conducted within the Korean National Health Insurance Service-Health Screening Cohort (2002−2015). A total of 6024 patients with CRS were 1:4-matched for age, sex, household income, and region of residence with 24,096 control participants. Effects of a previous history of thyroid disease, including hypothyroidism, hyperthyroidism, thyroiditis, autoimmune thyroiditis, and Graves' disease, were investigated using conditional logistic regression. Subgroup analyses were performed in regard to the presence of nasal polyposis. A history of hypothyroidism (2.8% vs. 1.8%), hyperthyroidism (2.0% vs. 1.5%), thyroiditis (1.1% vs. 0.8%), autoimmune thyroiditis (0.4% vs. 0.3%), and Graves' disease (0.3% vs. 0.2%) was not more prevalent in the CRS group than in the control group according to univariate analysis (all p > 0.05). Hypothyroidism was associated with CRS in the multivariate-adjusted model (odds ratio [OR] 1.25, 95% confidence interval [CI] 1.00−1.57). In the subgroup analyses, thyroid diseases were not statistically significantly associated with CRS after being classified according to the presence or absence of nasal polyps. Additional studies are required to elucidate the relationship between thyroid diseases and CRS, as this may aid in screening and clinical decision making.

Identification of differentially expressed microRNAs as potential biomarkers for carcinoma ex pleomorphic adenoma.

Carcinoma ex pleomorphic adenoma (CXPA) is a rare malignancy that transforms from PA. Early detection of the carcinoma by biopsy is difficult due to similar histopathology of the malignant and benign components. To address this, we investigated and compared the characteristic miRNA expression patterns across samples of the PA, carcinomatous portions (CA) of CXPA, as well as conventional PA. We selected 13 CXPA and 16 conventional PA FFPE samples, separated the PA and CA portions of CXPA samples and conducted miRNA profiling for each group. Among 13 transcripts that were differentially expressed between PA and CA of CXPA, eight miRNAs were up-regulated and five down-regulated in CA. Bioinformatic analysis revealed that the up-regulated miRNAs were related to cancer progression and down-regulated ones to tumor suppression. Additionally, seven miRNAs were significantly up-regulated in PA of CXPA compared to conventional PA, although they are histopathologically similar. Almost all of these transcripts interacted with TP53, a well-known tumor suppressor. In conclusion, we identified differentially expressed miRNAs in PA and CA of CXPA, which were closely associated with TP53 and various cancer-related pathways. We also identified differentially expressed miRNAs in the PA of CXPA and conventional PA which may serve as potential biomarkers.

Association between Benign Paroxysmal Positional Vertigo and Previous Proton Pump Inhibitor Use: A Nested Case-Control Study Using a National Health Screening Cohort.

The present nested case−control study evaluated the impact of previous proton pump inhibitor (PPI) prescription on the risk of benign paroxysmal positional vertigo (BPPV). A ≥40-year-old Korean population was included. A total of 34,441 patients with BPPV was matched with 137,764 comparison participants for demographic and socioeconomic factors. Previous histories of PPI use and PPI prescription dates were compared between the BPPV and comparison groups. The odds ratios (ORs) with 95% confidence intervals (CIs) of PPI use for BPPV were calculated using a logistic regression. The demographic and socioeconomic factors and comorbidities were adjusted in the adjusted model. Both current and past PPI users were associated with higher odds for BPPV than non-PPI users (adjusted OR (aOR) = 3.57, 95% CI = 3.33−3.83, and p < 0.001 for current PPI users and aOR = 1.76, 95% CI = 1.64−1.89, and p < 0.001 for past PPI users). In addition, longer dates of PPI use were related to higher odds for BPPV (aOR (95% CI) = 1.95 [1.81−2.10] for ≥1 day and <30 days of PPI prescription, <2.88 [2.68−3.10] for ≥30 days and <365 days of PPI prescription, and <3.45 [3.19−3.73] for ≥365 days of PPI prescription). PPI use was linked with an elevated risk of BPPV in the adult population. The odds for BPPV were higher in patients with a longer duration of PPI use.

Biocompatible fluorescent silk fibroin bioink for digital light processing 3D printing.

Chemically modified silk fibroin (SF) bioink has been used for three-dimensional (3D) bioprinting in tissue engineering because of its biocompatibility and printability. Also, fluorescent silk fibroin (FSF) from transgenic silkworms has been recently applied in biomedicine because of its fluorescence property. However, the fabrication of fluorescent hydrogel from FSF has not been elucidated. In this study, we showed the fabrication of a digital light processing (DLP) printable bioink from a chemically modified FSF. This bioink was fabricated by covalent conjugation of FSF and glycidyl methacrylate (GMA) and can be printed into various structures, such as the brain, ear, hand, lung, and internal organs. The physical properties of glycidyl methacrylated fluorescent silk fibroin (FSGMA) hydrogel was like the glycidyl methacrylated non-fluorescent silk fibroin (SGMA) hydrogel. The FSGMA hydrogel significantly retains its fluorescence property and has excellent biocompatibility. All these properties make FSGMA hydrogel a potent tool in encapsulated cell tracking and observing the scaffolds' degradation in vivo. This study suggested that our 3D DLP printable FSF bioink could play a promising role in the biomedical field.

Prevalence of Dysphonia in Children with Adenotonsillar Problems and the Impact of Surgery on Voice.

OBJECTIVE/HYPOTHESIS: Adenotonsillar problems might affect the voices of patients with pediatric dysphonia, which is very common. This study aimed to evaluate the prevalence of dysphonia in patients with adenotonsillar problems and to demonstrate the impact of tonsillectomy and adenoidectomy (T & A) on their voice postoperatively. STUDY DESIGN: Single-institution retrospective study. METHODS: Subjects were recruited from those children admitted for the purpose of T & A, and all underwent the auditory-perceptual assessment by speech therapists preoperatively. If children demonstrated scores >2 in the G parameter, we performed subjective (pediatric voice handicap index [pVHI], severity, talkativeness scale) and objective (Multi-Dimensional Voice Program) voice analyses preoperatively and 1 and 3 months postoperatively. RESULTS: Among the 1,197 patients, 91 (7.6%) patients showed dysphonia with a score >2 in the G parameter preoperatively. The follow-up voice analysis was completed in 51 and 22 patients after 1 and 3 months, respectively. Although there were no significant differences in the amount of speech preoperatively and postoperatively, the average visual analog scale score for dysphonia severity was significantly decreased at postoperative 1 month and postoperative 3 months. The average total pVHI score, jitter, shimmer, noise-to-harmonic ratio, and soft phonation index were significantly decreased at 1 and 3 months postoperatively. Subjective scores given by parents did not correlate with the acoustic parameters; however, the postoperative subjective parameters were significantly correlated with objective parameters. CONCLUSIONS: Voice problems were significantly improved after T & A in the short term and long term. In those with pediatric dysphonia, decreased mouth breathing and compliance with vocal hygiene would be helpful for voice improvement. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:2369-2375, 2021.

Impact of Coffee/Green Tea/Soft Drink Consumption on the Risk of Hyperuricemia: A Cross-Sectional Study.

This cross-sectional study aimed to investigate the association between hyperuricemia and the frequency of coffee, tea, and soft drink consumption, based on data from the Korean Genome and Epidemiology Study (KoGES) (2004-2016). We used the KoGES health examinee data, obtained from urban residents aged ≥ 40 years. Information on the participants' medical history, nutrition (total calorie, protein, fat, and carbohydrate intake), frequency of alcohol consumption, smoking status, household income, and frequency of coffee/green tea/soft drink intake was collected. A logistic regression model was used to analyze the data. Subgroup analyses were performed according to the participant's age and sex. Among 173,209 participants, there were 11,750 and 156,002 individuals with hyperuricemia and non-hyperuricemia controls, respectively. In an adjusted model, frequent coffee and green tea consumption did not increase the risk of hyperuricemia, compared to the "no intake" reference group. However, an adjusted odds ratio of hyperuricemia was 1.23 (95% confidence interval, 1.11-1.35, p < 0.001) for participants who reported consuming soft drinks ≥ 3 times per day, compared to the respective "no drink" reference group. Even after adjusting for nutritional and sociodemographic factors, frequent soft drink intake was associated with an increased risk of hyperuricemia. Meanwhile, neither coffee nor green tea intake was associated with an increased risk of hyperuricemia.

Microbiome of Unilateral Chronic Rhinosinusitis: A Controlled Paired Analysis.

The sinonasal microbiota in human upper airway may play an important role in chronic rhinosinusitis (CRS). Thus, this study aimed to investigate the human upper airway microbiome in patients with unilateral CRS, and compare the sinonasal microbiome of the unilateral diseased site with that of a contralateral healthy site. Thirty samples, 15 each from the diseased and healthy sites, were collected from the middle meatus and/or anterior ethmoid region of 15 patients with unilateral CRS during endoscopic sinus surgery. DNA extraction and bacterial microbiome analysis via 16S rRNA gene sequencing were then performed. Corynebacterium showed the highest relative abundance, followed by Staphylococcus in samples from both the diseased and healthy sites. Further, the relative abundances of Staphylococcus and Pseudomonas were significantly lower in samples from diseased sites than in those from healthy sites. Conversely, anaerobes, including Fusobacterium, Bacteroides, and Propionibacterium, were abundantly present in samples from both sites, more so in samples from diseased sites. However, the sites showed no significant difference with respect to richness or diversity (p > 0.05). Our results indicate that CRS might be a polymicrobial infection, and also suggest that Corynebacterium and Staphylococcus may exist as commensals on the sinus mucosal surface in the upper respiratory tract.