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Background: There is increasing focus on the development of high-quality simulation models for medical education. Cadaveric models, although considered more realistic, may be difficult to obtain and costly. The advent of three-dimensional (3D) printing has offered a low-cost, reliable, and reproducible alternative. This study sought to compare the utility of 3D-printed to cadaveric models for training in transcutaneous injection laryngoplasty (TIL). Methods: A simulation course with a cross-over design was employed. Video laryngoscopes were utilized for both the 3D and cadaveric models to assess the accuracy of injection into the vocal fold. Pre-procedure and post-procedure surveys were administered to evaluate understanding and comfort level on a Likert scale of 1-10. Each model was also rated on a 1-5 Likert scale for self-efficacy, fidelity, and educational value. Results: Pre- and post-survey data were completed by 15 otolaryngology residents and medical students. Mean pre-seminar understanding and comfort level were 3.7 and 2.2, respectively, compared to 6.9 and 5.9 (p < .05) following use of the 3D model and 6.4 and 4.7 (p < .05) following use of the cadaver model. When comparing 3D and cadaveric models, no significant differences were observed regarding self-efficacy, fidelity, and educational value. Conclusion: There was a similar mean increase in understanding and comfort following use of the 3D and cadaveric models. 3D-printing can provide an excellent adjunct to, and eventually a potential replacement for hands-on cadaveric training in medical education, particularly for TIL. Level of Evidence: Level III.
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To evaluate the response capabilities, in a public healthcare system otolaryngology job competition examination, of ChatGPT 3.5 and an internet-connected GPT-4 engine (Microsoft Copilot) with the real scores of otolaryngology specialists as the control group. In September 2023, 135 questions divided into theoretical and practical parts were input into ChatGPT 3.5 and an internet-connected GPT-4. The accuracy of AI responses was compared with the official results from otolaryngologists who took the exam, and statistical analysis was conducted using Stata 14.2. Copilot (GPT-4) outperformed ChatGPT 3.5. Copilot achieved a score of 88.5 points, while ChatGPT scored 60 points. Both AIs had discrepancies in their incorrect answers. Despite ChatGPT's proficiency, Copilot displayed superior performance, ranking as the second-best score among the 108 otolaryngologists who took the exam, while ChatGPT was placed 83rd. A chat powered by GPT-4 with internet access (Copilot) demonstrates superior performance in responding to multiple-choice medical questions compared to ChatGPT 3.5.
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Objective⯠To evaluate and compare the performance of Chat Generative Pre-Trained Transformer (ChatGPT), GPT-4, and Google Bard on United States otolaryngology board-style questions to scale their ability to act as an adjunctive study tool and resource for students and doctors. Methods A 1077 text question and 60 image-based questions from the otolaryngology board exam preparation tool BoardVitals were inputted into ChatGPT, GPT-4, and Google Bard. The questions were scaled true or false, depending on whether the artificial intelligence (AI) modality provided the correct response. Data analysis was performed in R Studio. Results⯠GPT-4 scored the highest at 78.7% compared to ChatGPT and Bard at 55.3% and 61.7% (p<0.001), respectively. In terms of question difficulty, all three AI models performed best on easy questions (ChatGPT: 69.7%, GPT-4: 92.5%, and Bard: 76.4%) and worst on hard questions (ChatGPT: 42.3%, GPT-4: 61.3%, and Bard: 45.6%). Across all difficulty levels, GPT-4 did better than Bard and ChatGPT (p<0.0001). GPT-4 outperformed ChatGPT and Bard in all subspecialty sections, with significantly higher scores (p<0.05) on all sections except allergy (p>0.05). On image-based questions, GPT-4 performed better than Bard (56.7% vs 46.4%, p=0.368) and had better overall image interpretation capabilities. Conclusion This study showed that the GPT-4 model performed better than both ChatGPT and Bard on the United States otolaryngology board practice questions. Although the GPT-4 results were promising, AI should still be used with caution when being implemented in medical education or patient care settings.
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BACKGROUND: This study aimed to assess the effectiveness of the BOPPPS model (bridge-in, learning objective, pre-test, participatory learning, post-test, and summary) in otolaryngology education for five-year undergraduate students. METHODS: A non-randomized controlled trial was conducted with 167 five-year undergraduate students from Anhui Medical University, who were allocated to an experimental group and a control group. The experimental group received instruction using the BOPPPS model, while the control group underwent traditional teaching methods. The evaluation of the teaching effectiveness was performed through an anonymous questionnaire based on the course evaluation questionnaire. Students' perspectives and self-evaluations were quantified using a five-point Likert scale. Furthermore, students' comprehension of the course content was measured through a comprehensive final examination at the end of the semester. RESULTS: Students in the experimental group reported significantly higher scores in various competencies compared to the control group: planning work (4.27 ± 0.676 vs. 4.03 ± 0.581, P < 0.05), problem-solving skills (4.31 ± 0.624 vs. 4.03 ± 0.559, P < 0.01), teamwork abilities (4.19 ± 0.704 vs. 3.87 ± 0.758, P < 0.05), and analytical skills (4.31 ± 0.719 vs. 4.05 ± 0.622, P < 0.05). They also reported higher motivation for learning (4.48 ± 0.618 vs. 4.09 ± 0.582, P < 0.01). Additionally, students in the experimental group felt more confident tackling unfamiliar problems (4.21 ± 0.743 vs. 3.95 ± 0.636, P < 0.05), had a clearer understanding of teachers' expectations (4.31 ± 0.552 vs. 4.08 ± 0.555, P < 0.05), and perceived more effort from teachers to understand their difficulties (4.42 ± 0.577 vs. 4.13 ± 0.59, P < 0.01). They emphasized comprehension over memorization (3.65 ± 1.176 vs. 3.18 ± 1.065, P < 0.05) and received more helpful feedback (4.40 ± 0.574 vs. 4.08 ± 0.585, P < 0.01). Lecturers were rated better at explaining concepts (4.42 ± 0.539 vs. 4.08 ± 0.619, P < 0.01) and making subjects interesting (4.50 ± 0.546 vs. 4.08 ± 0.632, P < 0.01). Overall, the experimental group expressed higher course satisfaction (4.56 ± 0.542 vs. 4.34 ± 0.641, P < 0.05). In terms of examination performance, the experimental group scored higher on the final examination (87.7 ± 6.7 vs. 84.0 ± 7.7, P < 0.01) and in noun-interpretation (27.0 ± 1.6 vs. 26.1 ± 2.4, P < 0.01). CONCLUSION: The BOPPPS model emerged as an effective and innovative teaching method, particularly in enhancing students' competencies in otolaryngology education. Based on the findings of this study, educators and institutions were encouraged to consider incorporating the BOPPPS model into their curricula to enhance the learning experiences and outcomes of students.
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Educación de Pregrado en Medicina , Otolaringología , Humanos , Otolaringología/educación , Masculino , Femenino , Estudiantes de Medicina/psicología , Evaluación Educacional , Modelos Educacionales , Curriculum , Adulto Joven , Encuestas y Cuestionarios , Competencia Clínica , Evaluación de Programas y Proyectos de SaludRESUMEN
OBJECTIVE: To describe a quality improvement (QI) method to decrease pediatric accidental decannulation (AD) in the early postoperative period for children under age 3. METHODS: A retrospective chart review was conducted on children under age 3 who underwent tracheostomy at Duke University Health System from August 1, 2013 to May 1, 2023 (n = 104). A root cause analysis was used to assess factors associated with AD following pediatric tracheostomy. Based on the factors identified by the research team, retrospective data was collected before (8/1/13 - 1/31/22) and after (2/1/22 - 5/1/23) a single practice change was implemented: using twill neck ties, rather than foam neck ties, to secure newly-placed tracheostomy tubes. Twill ties were applied intraoperatively as a visual cue to signal a recent tracheostomy for the interdisciplinary care team. The primary outcome in the pre-intervention and post-intervention period was measured as 30-day incidence of AD per 10 tracheostomy cases. RESULTS: Prior to the intervention, a total of 11 ADs occurred in 9 patients across 93 pediatric tracheostomies (1.18 AD per 10 cases). Afterward, 0 ADs occurred across 11 pediatric tracheostomies (0 AD per 10 cases). CONCLUSION: This data suggests that the twill tie intervention may prevent AD and the associated morbidity. With the twill tie initiative, we describe 11 ADs and associated risk factors and present a QI intervention that may help prevent AD and improve patient safety in the early postoperative period.
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Remoción de Dispositivos , Mejoramiento de la Calidad , Traqueostomía , Humanos , Estudios Retrospectivos , Femenino , Masculino , Traqueostomía/efectos adversos , Preescolar , Lactante , Análisis de Causa Raíz , Complicaciones Posoperatorias/prevención & controlRESUMEN
OBJECTIVES: Virtual Reality (VR) is a successful distraction method for reducing procedure-related pain in children, though it has never been studied during otomicroscopy. Therefore, we investigated the efficacy of VR as a distraction method during otomicroscopy. METHODS: This Randomised Control Trial (RCT) included 60 children aged 4-15 years. The patients were randomised to receive distraction by VR, tablet, or no distraction. Procedure-related pain was scored by patients and compared with previous examinations. RESULTS: Patients' experience with otomicroscopy was significantly improved with VR compared to tablet (p < 0.05) and no distraction (p < 0.01). Pain scores did not differ significantly between groups. CONCLUSION: VR did not reduce pain scores, but it improved the children's experience with otomicroscopy without causing significant adverse outcomes.
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INTRODUCTION: Children who are deaf or hard-of-hearing (DHH) are at risk for speech and language delay. Language outcomes are worse in DHH children from lower socioeconomic backgrounds, due in part to disparities in access to specialised speech-language therapy. Teletherapy may help improve access to this specialised care and close this language gap. Inclusion of diverse DHH children in prospective randomised clinical trials has been challenging but is necessary to address disparities and pursue hearing health equity. Stakeholder input regarding decisions on study design elements, including comparator groups, masking, assessments and compensation, is necessary to design inclusive studies. We have designed an inclusive, equitable comparativeness effectiveness trial to address disparities in paediatric hearing health. The specific aims of the study are to determine the effect of access to and utilisation of speech-language teletherapy in addressing language disparities in low-income children who are DHH. METHODS AND ANALYSIS: After stakeholder input and pilot data collection, we designed a randomised clinical trial and concurrent longitudinal cohort trial to be conducted at four tertiary children's hospitals in the USA. Participants will include 210 DHH children aged 0-27 months. 140 of these children will be from lower income households, who will be randomised 1:1 to receive usual care versus usual care plus access to supplemental speech-language teletherapy. 70 children from higher income households will be simultaneously recruited as a comparison cohort. Primary outcome measure will be the Preschool Language Scales Auditory Comprehension subscale standard score, with additional speech, language, hearing and quality of life validated measures as secondary outcomes. ETHICS AND DISSEMINATION: This study was approved by the Institutional Review Boards of the participating sites: the University of California, San Francisco (19-28356), Rady Children's Hospital (804651) and Seattle Children's Hospital (STUDY00003750). Parents of enrolled children will provide written informed consent for their child's participation. Professional and parent stakeholder groups that have been involved throughout the study design will facilitate dissemination and implementation of study findings via publication and through national and regional organisations. TRIAL REGISTRATION NUMBER: NCT04928209.
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Sordera , Humanos , Preescolar , Lactante , Personas con Deficiencia Auditiva , Recién Nacido , Trastornos del Desarrollo del Lenguaje/terapia , Disparidades en Atención de Salud , Ensayos Clínicos Controlados Aleatorios como Asunto , Femenino , Logopedia/métodos , Estudios Multicéntricos como Asunto , Terapia del Lenguaje/métodos , Masculino , Estudios Prospectivos , Proyectos de Investigación , Accesibilidad a los Servicios de Salud , Calidad de VidaRESUMEN
Objectives: To analyze trends in error publication in the top Otolaryngology-Head and Neck Surgery (OHNS) journals. Methods: A retrospective bibliometric analysis utilizing journal-specific search engines of the top 30 OHNS journals (by impact factor) were queried for "errata OR erratum OR corrigenda OR corrigendum OR correction OR corrections," utilizing errors published between 2000 and 2023. Corrections were classified into "erratum" for errors originating from the journal and "corrigendum" for errors originating from the author. Error severity was categorized as trivial, minor, or major, based on the magnitude of their impact on outcomes or their interpretation by the reader. Results: Of the 739 analyzed errors, 62.5% (n = 462) were errata and 37.5% (n = 277) corrigenda, averaging 26.39 (±27.5) errors per journal. There was no correlation between impact factor and error occurrence (P = .979). Trends demonstrated growing numbers of errors published over the years. Mean duration between the publication date of the original article and the error was 10.8 months (±19.4 months), but there was no significant correlation between impact factor and this duration (P = .953). Most corrected articles were original research articles (n = 568, 76.9%), predominantly with the first author from the United States (n = 262, 36.1%). Most errors involved authorship (n = 273, 36.9%) and were "Trivial" in severity (n = 544, 73.6%). However, 72 (9.7%) errors were "Major" and altered the article's findings or interpretation significantly. Conclusion: A multitude of errors exist in the otolaryngology field. Despite most being insignificant and affecting authorship, roughly 10% significantly affect an article's conclusions/outcomes.Level of Evidence: 4.
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A female in her 50s developed a headache, collapsed and was noted to have an acute atraumatic subdural haemorrhage (SDH) requiring surgical evacuation and intracranial pressure-directed therapy. Her background included recurrent epistaxis, severe generalised bone pain and multiple insufficiency fractures and an undifferentiated autoimmune connective tissue disease. Chronic hypophosphataemia, elevated alkaline phosphatase and raised fibroblast growth factor 23 (FGF23) were also noted. An MRI head and subsequent 68Ga CT/positron emission tomography scan demonstrated an intensely avid tumour in the right ethmoid sinus, extending intracranially. Phosphate was aggressively replaced, and alfacalcidol was initiated to circumvent the effects of FGF23 on her kidneys and bone minerals. The tumour was biopsied and then definitively resected via combined endonasal and craniotomy approaches, resulting in good clinical improvement. FGF23 titre and serum phosphate both normalised leaving the diagnosis of a phosphaturic mesenchymal tumour-secreting FGF23, leading to tumour-induced osteomalacia.
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Factor-23 de Crecimiento de Fibroblastos , Factores de Crecimiento de Fibroblastos , Hematoma Subdural Agudo , Osteomalacia , Humanos , Osteomalacia/etiología , Femenino , Factores de Crecimiento de Fibroblastos/sangre , Factores de Crecimiento de Fibroblastos/metabolismo , Persona de Mediana Edad , Hematoma Subdural Agudo/etiología , Hematoma Subdural Agudo/cirugía , Hematoma Subdural Agudo/diagnóstico por imagen , Neoplasias de los Senos Paranasales/complicaciones , Neoplasias de los Senos Paranasales/cirugía , Síndromes Paraneoplásicos , Neoplasias de Tejido Conjuntivo/cirugía , Neoplasias de Tejido Conjuntivo/diagnóstico , Senos Etmoidales/cirugía , Imagen por Resonancia MagnéticaRESUMEN
Introduction Accurate and detailed documentation of surgical operation notes is crucial for post-operative care, research and academic purposes, and medico-legal clarity. Several studies have shown their defiency and inaccuracy sometimes, and some methods have been proposed to make them more objective. This study aimed to evaluate the completeness of thyroidectomy operative notes in a tertiary center and to assess the adequacy of video documentation by comparing it to the corresponding operative notes. Methods A retrospective review of thyroidectomy operative notes from 2010 to 2020 at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, was performed to ensure completeness. Subsequently, 15 thyroidectomies were video recorded, and their notes were compared to the corresponding written operative notes. The completeness score was calculated based on an item list that included items that had to be included in an operative note. An independent samples t-test was used to compare the completeness score means between the two groups. One-way analysis of variance was used to compare the completeness score means between two or more groups. Result A total of 385 thyroidectomy-operative notes were retrospectively reviewed. The completeness scores ranged between 6% and 89% for the various items that had to be documented, with a mean of 54.47%. The mean score of the video-documented operative record was 83.86%±12.84%, which was significantly higher than the corresponding written operative notes (47.53%±18.06%) (p <0.001). Conclusion Video documentation showed significant improvement compared to the corresponding written and retrospective operative notes. Video recording can also be a valuable tool when teaching anatomy and surgical skills and conducting research.
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Augmented reality (AR) technology has become widely established in otolaryngology-head and neck surgery. Over the past 20 years, numerous AR systems have been investigated and validated across the subspecialties, both in cadaveric and in live surgical studies. AR displays projected through head-mounted devices, microscopes, and endoscopes, most commonly, have demonstrated utility in preoperative planning, intraoperative guidance, and improvement of surgical decision-making. Specifically, they have demonstrated feasibility in guiding tumor margin resections, identifying critical structures intraoperatively, and displaying patient-specific virtual models derived from preoperative imaging, with millimetric accuracy. This review summarizes both established and emerging AR technologies, detailing how their systems work, what features they offer, and their clinical impact across otolaryngology subspecialties. As AR technology continues to advance, its integration holds promise for enhancing surgical precision, simulation training, and ultimately, improving patient outcomes.
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BACKGROUND: Online video hosting websites such as YouTube have been increasingly used by medical institutions to spread information about new and exciting topics. However, due to the large number of videos uploaded daily and the lack of peer review, few attempts have been made to assess the quantity and quality of information that is uploaded on YouTube. For this study, our team assessed the available content on the transoral robotic surgery (TORS) procedure. METHODS: A qualitative case study model was employed. Videos related to TORS were collected using a unified search protocol. Each video was then analyzed, and metrics of the following data points were collected: views, likes, comments, upload date, length of video, author type, author, and region of origin. Each dataset was analyzed by two distinct authors, and interrater reliability was calculated. Quantitative and qualitative statistics were curated. RESULTS: A total of 124 videos were analyzed for this review. The breakdown of videos was as follows: 15.32% (19) in the educational for patients category, 16.94% (21) in the educational for trainees category, 30.65% (38) in the procedural overview category, 8.87% (11) in the patient experience (PE) category, 10.48% (13) in the promotional category, 12.10% (15) in the other category, and 5.65% (7) in the irrelevant (IR) category. The total number of views across all videos analyzed was 2,589,561. The total number of likes was 14,827, and the total number of comments was 2,606. The average video length was 8.63 minutes. The most viewed category was the PE category at 1,014,738 and the most liked at 1,714. The least viewed category was IR at 21,082. The PE category had the most engagement based on combined comments and likes. The most watched video, with 774,916 views, was in the PE category under the "TORS for Thyroidectomy" search term and was titled "Thyroid Surgery (Thyroidectomy)." CONCLUSION: As the prevalence of online videos regarding medical devices, procedures, and treatments increases, patients and trainees alike will look toward resources such as YouTube to augment their understanding. Patients, providers, and medical education platforms should take heed of the promise and pitfalls of medical content on YouTube.
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Lemierre's syndrome (LS) is a rare and severe complication primarily associated with the bacteria Fusobacterium necrophorum and characterized by an oropharyngeal infection leading to bacteremia and septic thrombophlebitis. We present a case of an 89-year-old patient with a history of hypertension who initially presented with type B influenza infection and neck pain. She subsequently developed a neck abscess with thrombosis of the internal jugular vein. We believe this to be the first reported case in the literature of LS secondary to Streptococcus intermedius presenting after infection with type B influenza. As more atypical LS cases emerge, it is becoming increasingly clear that this condition can manifest in a number of ways. This unique case highlights the importance of considering LS as a differential diagnosis for patients of all ages presenting with neck pain and Streptococcus intermedius infection.
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Papillary thyroid cancer (PTC) contributes to the majority of all thyroid malignancies. In this case report, we detail two cases of occult thyroid carcinoma (OTC), which presents with thyroid metastasis to locoregional lymph nodes without having an initial primary tumor detected in the thyroid gland. OTC may be found incidentally on biopsy, surgery, or imaging. Advancements in diagnostic technology have allowed physicians to identify and treat OTC at an earlier stage. We present two patients who were found to have metastases to cervical lymph nodes without a primary identification in the thyroid gland. The first patient was a 67-year-old female who noticed an enlarging mass in her right neck at levels III and IV. Fine needle aspiration (FNA) revealed the presence of PTC. The patient underwent a total thyroidectomy, central nodal dissection, and right-modified radical neck dissection. Final pathology confirmed the presence of PTC metastasis to cervical lymph nodes, but no primary tumor was identified within the thyroid gland. The second patient was a 79-year-old male who presented with a painless mass of the left parotid gland. The FNA of the patient revealed PTC metastasis to his left parotid gland. The patient underwent a total thyroidectomy, ipsilateral central nodal dissection, ipsilateral modified radical neck dissection, and inferior superficial and deep lobe parotidectomy. No malignancy was detected within the thyroid gland or central or lateral neck lymph nodes on final pathology. Carcinoma was confined to an intra-parotid node in the deep lobe of the parotid gland. OTC is a rare phenomenon in PTC. One proposed theory for OTC includes spontaneous regression of the primary tumor and genetic mutations to the BRAF gene. Due to the fact that it is easy for this rare condition to be misdiagnosed, more studies should be conducted to standardize diagnostic and treatment plans for OTC.
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Laryngotracheal trauma is a relatively rare traumatic injury seen particularly in young male adults. Trauma due to strangulation is one of its most frequent circumstances. However rare, pneumomediastinum is a particular complication of severe blunt neck injuries leading to alveolar ruptures. This phenomenon, described as the Macklin effect, requires early diagnosis, and its management varies from conservative to surgical treatment depending on the severity of symptoms. Our aim is to describe the case of a 21-year-old male who presented with blunt neck trauma. Clinical and imaging findings revealed subcutaneous neck emphysema and pneumomediastinum. Treatment was conservative leading to complete resolution of the injuries and the patient was discharged after 2 weeks.
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OBJECTIVES: Research trends concerning hearing loss within teen rural populations are limited and current evidence suggests that extended high-frequency audiometry can be a sensitive tool to detect subclinical hearing loss. Moreover, current research emphasises the importance of representing different ethnic populations in science. This study aimed to determine the prevalence of acquired hearing loss through conventional pure-tone (0.25-8 kHz) and extended high frequency (EHF) (9-20 kHz) audiometry in Afro-Colombian adolescents from a rural area in Colombia. DESIGN: Observational, cross-sectional study. PARTICIPANTS: 230 Afro-Colombian adolescents aged 13-17 years who attended high school in a rural population from Cartagena, Colombia. INTERVENTIONS: Otoscopic examination, conventional (0.25-8 kHz) and EHF (9-20 kHz) audiometry tests were performed during February-March 2021. Sociodemographic and associated factor questionnaires were also applied to assess probable factors associated with EHF hearing loss. MAIN OUTCOME MEASURES: Prevalence of acquired hearing loss using conventional and EHF audiometry, and factors associated with hearing loss. RESULTS: Of 230 adolescents who met the eligibility criteria, 133 (57.82%) were female. The mean age was 15.22 years (SD: 1.62). The prevalence of hearing loss in at least one ear assessed with conventional audiometry was 21.30% and with EHF audiometry 14.78%. The main abnormal otoscopic findings included: neotympanum (1.30%), myringosclerosis (0.87%) and monomeric scars (0.43%). Factors associated with a higher probability of EHF hearing loss found through logistic regression were older age (prevalence ratio (PR): 1.45; 95% CI 1.16 to 1.80), attending the 'Picó' four or more times a month (PR: 6.63; 95% CI 2.16 to 20.30), attending bars more than three times a month (PR: 1.14; 95% CI 1.03 to 1.59) and self-reported hearing difficulties (PR: 1.24; 95% CI 1.22 to 4.05). CONCLUSIONS: Our results suggest that acquired hearing loss is already widespread among this young rural population.
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Pérdida Auditiva de Alta Frecuencia , Población Rural , Humanos , Adolescente , Colombia/epidemiología , Femenino , Estudios Transversales , Masculino , Población Rural/estadística & datos numéricos , Prevalencia , Pérdida Auditiva de Alta Frecuencia/epidemiología , Pérdida Auditiva de Alta Frecuencia/diagnóstico , Audiometría de Tonos Puros , OtoscopíaAsunto(s)
Absceso , Enfermedades Orbitales , Schizophyllum , Humanos , Absceso/microbiología , Absceso/tratamiento farmacológico , Absceso/diagnóstico por imagen , Enfermedades Orbitales/microbiología , Enfermedades Orbitales/diagnóstico , Enfermedades Orbitales/tratamiento farmacológico , Schizophyllum/aislamiento & purificación , Masculino , Micosis/diagnóstico , Micosis/tratamiento farmacológico , Micosis/microbiología , Antifúngicos/uso terapéutico , Tomografía Computarizada por Rayos X , FemeninoRESUMEN
OBJECTIVE: To investigate the platelet-rich plasma (PRP) effectiveness in patients with a long-lasting postviral olfactory dysfunction (LPOD). METHODS: Forty-three consecutive patients with a long-lasting postviral OD were prospectively recruited. The injection of 1 mL of PRP was carried out in both olfactory clefts. The pre- to 6-month post-PRP injection change in olfaction was assessed with the olfactory disorder questionnaire (ODQ) and the threshold, discrimination, and identification (TDI) tests. RESULTS: Forty-three patients received bilateral PRP injections (24 females). The mean age of patients was 58.9 ± 16.8 years. The mean duration of LPOD was 8.7 years. The pre to 6-month post-injection mean TDI significantly improved from 10.3 ± 10.2 to 20.12 ± 12.07 (p = 0.001). The mean ODQ significantly decreased from 29.8 ± 13.0 to 23.4 ± 11.3 (p = 0.013). The average change of the TDI and the ODQ were 9.8 and 6.4, respectively. Age was inversely associated with the 6-month threshold score. CONCLUSION: PRP appears to be a promising therapeutic strategy for long-lasting postviral OD. Our findings support the conduction of controlled randomized trial in this population of patients.
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Mucoceles are locally invasive but benign expansive cystic lesions that can arise within paranasal sinuses. Isolated sphenoid sinus Mucoceles (SSM) are quite rare, comprising less than 1% of all paranasal sinus mucoceles. Due to the critical position and proximity of the sphenoid sinus to vital structures, SSMs can cause a multitude of symptoms and complications. We report a case of a 53-year-old man who presented with sudden vision loss and was found to have an isolated SSM. Following surgical drainage and management of the SSM, the patient had full recovery of visual acuity upon discharge.