Epidemiologic, radiologic, and sialendoscopic aspects in chronic obstructive sialadenitis.

PURPOSE: Chronic obstructive sialadenitis (COS) is a recurring inflammation of the salivary gland. To date, there are no known predisposing factors for COS. Given the advances seen in radiology and sialendoscopy, we must update our knowledge of COS, analyzing factors that can favor its development. METHODS: We prospectively analyzed 333 patients who underwent sialendoscopy between 2012 and 2021. Epidemiologic, radiologic, and sialendoscopy-related factors were correlated. Suspected diagnosis was established based on the clinical and radiologic data. The final diagnosis was determined on the basis of sialendoscopic findings. RESULTS: The most common etiology of COS was stricture (40.8%). Lack of papilla distensibility (LPD) was also described as an etiology. COS was related to patient gender and age. Submandibular gland involvement was significantly more associated with lithiasis and LPD, while COS of the parotid gland was most frequently caused by stricture. Radioiodine sialadenitis and Sjögren's syndrome were significantly associated with stricture. MR sialography (MR-Si) showed the best overall sensitivity and specificity. CONCLUSION: In our series, stricture was the most common cause of COS. We describe LPD as a frequent cause of COS in this series; ours is the first study to report this finding. There was a significant association between the salivary gland involved, patient sex and age, and the cause of COS. MR-Si showed the greatest diagnostic yield.

Microscopic approach for repairing nasal septal perforations using bilateral advancement flaps.

BACKGROUND: Septal perforations consist in an anatomic defect of the mucosal, cartilaginous and/or bone tissues of the nasal septum. A huge variety of approaches and techniques for nasal perforation repair have been reported. METHODOLOGY/PRINCIPAL: Between January 2008 and January 2017, 38 patients were treated for nasal septal perforation in Department of Otorhinolaryngology Head and Neck Surgery, Fundación Jiménez Díaz University Hospital, Madrid, Spain. A novel approach is presented based on microscope. Septal perforation closure was performed with endonasal bilateral advancement flaps-established technique and autologous cartilage and muscle temporal fascia grafts. We performed a retrospective review of closure rates and complications. RESULTS: A postoperative follow-up of at least 12 months was performed in 37 patients. The mean size of perforation was 1.33 cm. After the withdrawal of the silicone splints, perforations were completely closed in all cases. However, during the follow-up, four patients resulted in a reperforation, so our closure rate was 89.19%. For all cases, symptoms related to septal defect were solved. Only one case was reported of local infections that was resolved with antibiotics in a few days. CONCLUSIONS: Microscopic approach of septal perforation closure using bilateral advancement flaps can be an affordable technique with a high percent of success and low rate of complications.

Validation of a Spanish chronic obstructive sialadenitis quality of life questionnaire (CSOC).

BACKGROUND AND OBJECTIVES: Interest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility. MATERIAL AND METHODS: A prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed. RESULTS: All the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94 respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31. CONCLUSIONS: The CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis.

Prevalence of hearing protection use and subjective auditory symptoms among Spanish classical orchestral musicians.

INTRODUCTION: Sensorineural hearing loss caused by exposure to noise is one of the most frequent causes of deafness. Professional musicians have significant occupational exposure to high levels of noise. Use of hearing protection among musicians could substantially prevent hearing damage, though the rate of use is quite low. METHODS AND MATERIAL: A questionnaire on the use of protective hearing devices, hearing care, and subjective judgments of hearing difficulties was completed by a group of classical musicians from Spain. We analysed the frequency of device use by instrument based on contingency tables analysed by χ2 tests. RESULTS: One hundred and ninety-four Spanish classical orchestral musicians voluntarily completed the questionnaire. The percentage of musicians who reported using hearing protection in our survey was very low and varied with the type of instrument played. However, we found a high prevalence of subjective auditory disorders within this group. CONCLUSION: Few Spanish musicians use hearing protection. Training on hearing-loss prevention in this field and better protective devices could increase device use and improve the auditory health of this group.

Sialolithiasis: mineralogical composition, crystalline structure, calculus site, and epidemiological features.

The purpose of this paper was to describe the characteristics of salivary calculi and their relationship to epidemiological factors, through a cross-sectional study. We analysed 100 calculi obtained in 2017-2021. Patient data including age, time since onset of symptoms, gland involved, and site of location in the salivary system were studied. The calculi were studied to determine their morphological features using scanning electron microscopy and energy dispersive plain radiographic analysis. Most of the calculi had formed in the submandibular gland (SG) (82%). The mean age of patients at onset was 45.83 years; patients presenting parotid gland (PG) stones were somewhat older (p = 0.031). The mean time since the onset of symptoms was longer in PG calculi (p = 0.038). The most common lithiasis site was the main duct (74%), followed by the hilum (22%). Hilar stones were the largest (p < 0.05) and heaviest (p = 0.028). Octacalcium phosphate (OCP) was the most common crystalline phase (Cp) founded, followed by hydroxyapatite (HA) and whitlockite (WH). Specifically, OCP had a higher presence in PG calculi (p = 0.029) and WH was the most common phase in SG calculi (p = 0.017). The most prevalent site of lithiasis was the main duct, and the largest and heaviest calculi were found in the SG. PG stones were associated with a longer history of symptoms and older age. OCP was the most frequent Cp of the calculi studied, and the main Cp in PG stones. WH was the predominant Cp in SG stones. The Cp of the calculi was not influenced by location, patient age, or time of symptoms.

Postoperative complications after adenotonsillectomy in two paediatric groups: Obstructive sleep apnoea syndrome and recurrent tonsillitis. / Complicaciones postoperatorias tras adenoamigdalectomía en 2 grupos de pacientes pediátricos: síndrome de apnea-hipopnea del sueño e infecciones de repetición.

INTRODUCTION AND OBJECTIVES: Adenotonsillectomy is a surgery to treat recurrent tonsillitis or obstructive sleep apnoea syndrome (OSAS). It is considered a safe procedure, with few complications. Moreover, patients over 3 years and without comorbidities do not present a higher rate of respiratory adverse events after the immediate postoperative period, and do not need systematic admission to a paediatric intensive care unit (PICU), regardless of their OSAS severity. The aim of this study is to reanalyse the situation, including patients under the age of 3 years, for whom there are fewer available data, to confirm that this trend has not changed. METHODS: A retrospective observational study was performed, including all adenotonsillectomised children in our hospital over 5 years. RESULTS: 418 adenotonsillectomised children were included, 56.7% due to recurrent tonsillitis, and 43.3% because of OSAS. Only 24 patients (5%7%) experienced adverse events, of whom 1.2% had vomiting, 3.1% bleeding, and 1.4% respiratory events. All the respiratory events occurred in the operating theatre or in the post-anaesthetic unit, most frequently in children with severe OSAS, while the tonsillitis group had more bleeding (P=.046). No differences in complications were observed according to age (P=0.174), but the group of patients under three years was relatively small. CONCLUSIONS: No differences were found in the percentage of complications between the two groups. Although the OSAS group exhibited more respiratory events, these occurred in the immediate postoperative period; otherwise, there was a higher risk of bleeding in the tonsillitis group. These results support the findings indicating that routine PICU admission is not required for these patients.

Incidence and risk factors for radioactive iodine-induced sialadenitis.

BACKGROUND: Radioactive iodine (131I) is one of the treatments of hyperthyroidism and differentiated thyroid carcinoma (DTC). Swelling of salivary glands are one of the possible side effects of this treatment, known as radioactive iodine-induced sialadenitis (RAIS). The prevalence of RAIS varies widely and no specific risk ratio has been established. OBJECTIVES: To determine the incidence of RAIS, analysing the epidemiological data and tumour- and treatment-related factors that may influence the development of the disease. MATERIAL AND METHODS: 197 patients who received radioiodine treatment between 2015 and 2017 were studied (76.6% women). The variables studied were age, gender, weight, height, and body mass index; presence of high blood pressure, dyslipidemia, diabetes, and thyroid diseases; cumulative radioiodine dose, presence of sialadenitis, affected salivary gland, and the time of onset. RESULTS: 14 patients developed sialadenitis (78.6% women), all with DTC. The incidence of sialadenitis was 3.4% overall and 6.3% among DTC patients. Furthermore, we found that higher cumulative radioiodine doses confer a greater risk of developing sialadenitis, with a hazard ratio of 1.009 (p = .001). No association was found between the epidemiologic data studied and sialadenitis. CONCLUSIONS: In this series, a dose-dependent relationship was found between radioiodine treatment and sialadenitis.

p16 Influence on Laryngeal Squamous Cell Carcinoma Relapse and Survival.

OBJECTIVE: (1) To identify p16 protein in laryngeal squamous cell carcinoma (LSCC) specimens and to correlate it with the presence of human papillomavirus (HPV) found in these specimens from a previous study. (2) To analyze p16 impact on 10-year overall and disease-free survival. STUDY DESIGN: Retrospective case series with oncologic database chart review. SETTING: Academic tertiary care hospital. SUBJECTS: A total of 123 samples of LSCC (taken from the glottis only) from patients treated with primary surgical resection between 1977 and 2005. METHODS: p16 protein expression was analyzed through immunohistochemistry and compared with the presence of HPV established in our previous studies. Results were compared with histologic, clinicopathologic, and survival parameters, with a 10-year follow-up. RESULTS: Of the samples, 39.02% were positive for p16, but only 11.38% were positive for both p16 and HPV. The p16+ cohort showed a significant improvement in disease-free survival ( P = .0022); statistical significance was not achieved for overall survival. p16+ cases had fewer relapses over time, with no relapses after a 2-year follow-up. Age at the time of diagnosis and tobacco consumption were the only epidemiologic factors that influenced overall survival. CONCLUSION: The expression of p16 protein was a beneficial prognostic factor for disease-free survival among patients with LSCC of the glottis, with no relapses after a 2-year follow-up.

HPV in Larynx Squamous Cell Carcinoma: New Serotypes and Survival Study within 10-Year Follow-up.

Objective To determine the presence of human papillomavirus (HPV) in head and neck squamous cell carcinoma, specifically in the larynx without the bias of other sublocations, and to describe the different serotypes of HPV and their impact on overall and disease-free survival after 10-year follow-up. Study Design Retrospective case series with chart review of ear, nose, and throat oncologic database. Setting Academic tertiary care hospital. Subjects A total of 123 samples of larynx squamous cell carcinoma were included, only from the glottis and treated only with surgery between 1977 and 2005. Methods DNA extraction was carried out by polymerase chain reaction, and subsequent visualization was performed in low-density arrays. Results were compared with histologic, clinicopathologic, and survival parameters, with a 10-year follow-up. Results HPV DNA was detected in 22.76% (n = 28) of the samples. Eleven genotypes were detected, 2 of which had never been described in the larynx (HPV43 and HPV62). No increasing trend of HPV was observed over time. HPV presence did not correlate with better survival during the follow-up. Smoking was proven as an independent factor in relation to the presence of HPV. Conclusion HPV may represent a notable factor in the development of a subset of laryngeal squamous cell carcinoma without significant influence on overall and disease-free survival. More studies, including oncogene transcription proteins, would be necessary to draw more relevant conclusions about the relevance of HPV infection in the larynx.

Validación de un cuestionario específico de calidad de vida en sialoadenitis obstructiva crónica (CSOC) / Validation of a Spanish chronic obstructive sialadenitis quality of life questionnaire (CSOC)

Antecedentes y objetivos: El interés en la sialoadenitis obstructiva crónica está aumentando con la introducción de la sialoendoscopia. Es necesario contar con un instrumento para evaluar la calidad de vida en los pacientes con sialoadenitis obstructiva crónica que permita mejorar el manejo clínico y apoyar la investigación. Los objetivos del presente trabajo son diseñar un cuestionario en español para evaluar la calidad de vida en los pacientes con sialoadenitis obstructiva crónica, denominado CSOC, y evaluar su fiabilidad, validez y viabilidad.Material y métodosEstudio prospectivo, multicéntrico, observacional, en el que se incluyeron pacientes con diagnóstico de sialoadenitis obstructiva crónica. Se realizaron una búsqueda bibliográfica y entrevistas con pacientes para la generación de las preguntas del cuestionario. A continuación, un panel de expertos evaluó la validez de contenido. La validez de constructo fue evaluada en una muestra de 120 pacientes y 100 controles. Los pacientes contestaron un CSOC, un short form-36 (SF-36) versión en español y una escala visual analógica (EVA). Se evaluó la viabilidad, la fiabilidad, la consistencia interna, la validez de constructo y la sensibilidad al cambio.ResultadosTodos los pacientes encontraron comprensible el instrumento. El tiempo requerido para completar el CSOC pre y postsialoendoscopia fue de 5,7 y 4,5min, respectivamente. El coeficiente α de Cronbach fue muy alto para el CSOC pre y postsialoendoscópico (0,90 y 0,94, respectivamente). La correlación con las dimensiones del SF-36 fue negativa y positiva con la EVA. La puntuación media del CSOC en el grupo con sialoadenitis fue de 28,63 (antes de la sialoendoscopia) y de 8,33 (después de la sialoendoscopia). En el grupo control la puntuación media del CSOC fue de 1,31.ConclusionesEl CSOC es comprensible, factible, fiable y representativo de la calidad de vida en pacientes con sialoadenitis obstructiva crónica.

Background and objectives: Interest in chronic obstructive sialadenitis is increasing with the introduction of sialendoscopy. A self-administered instrument to assess quality of life in patients with chronic obstructive sialadenitis is needed to improve clinical management and support research. The objectives of this study are to design a Spanish questionnaire to assess quality of life in chronic obstructive sialadenitis, named CSOC and assess its reliability, validity and feasibility.Material and methodsA prospective, multicentre, observational study was conducted. Patients with diagnosis of chronic obstructive sialadenitis were included in the study. The item generation process included a review of published data as well as interviews with patients. An expert panel then tested the content validity of the instrument, and the construct validity was tested in 120 patients and 100 controls. Patients completed a self-administered CSOC questionnaire, a Short Form-36 and a Visual Analogue Scale. Feasibility, reliability, internal consistency, construct validity and responsiveness were assessed.ResultsAll the patients found the instrument understandable. Cronbach α coefficient was high (0.85). The time required to fill out was 5.7 and 4.5min for pre and postsialendoscopy CSOC respectively. Cronbach α coefficient was very high for both pre and postsialendoscopy CSOC (0.90 and 0.94, respectively). The correlation with the SF-36 dimensions was negative and positive with the VAS. The mean score of CSOC was 28.63 and 8.33 for pre and postsialendoscopy. In the control group the mean score of CSOC was 1.31.ConclusionsThe CSOC questionnaire is understandable, feasible, reliable and representative of quality of life in chronic obstructive sialadenitis. (AU)

Prevalence of hearing protection use and subjective auditory symptoms among Spanish classical orchestral musicians / Prevalencia del uso de protección auditiva y síntomas auditivos subjetivos entre los intérpretes de orquesta de música clásica españoles

Introduction: Sensorineural hearing loss caused by exposure to noise is one of the most frequent causes of deafness. Professional musicians have significant occupational exposure to high levels of noise. Use of hearing protection among musicians could substantially prevent hearing damage, though the rate of use is quite low.Methods and materialA questionnaire on the use of protective hearing devices, hearing care, and subjective judgments of hearing difficulties was completed by a group of classical musicians from Spain. We analysed the frequency of device use by instrument based on contingency tables analysed by χ2 tests.ResultsOne hundred and ninety-four Spanish classical orchestral musicians voluntarily completed the questionnaire. The percentage of musicians who reported using hearing protection in our survey was very low and varied with the type of instrument played. However, we found a high prevalence of subjective auditory disorders within this group.ConclusionFew Spanish musicians use hearing protection. Training on hearing-loss prevention in this field and better protective devices could increase device use and improve the auditory health of this group. (AU)

Introducción: La hipoacusia neurosensorial motivada por la exposición al ruido es una de las causas más frecuentes de sordera. Los músicos profesionales tienen una exposición ocupacional significativa a los altos niveles de ruido. El uso de protección auditiva entre los músicos podría prevenir sustancialmente el daño auditivo, aunque su tasa de utilización es bastante baja.Métodos y materialUn grupo de intérpretes de orquesta de música clásica españoles completó un cuestionario sobre el uso de dispositivos de protección auditiva, cuidados auditivos, y opiniones subjetivas sobre las dificultades auditivas. Analizamos la frecuencia del uso de dispositivos por instrumento basada en tablas de contingencia analizadas mediante pruebas χ2.ResultadosCiento noventa y cuatro intérpretes de orquesta de música clásica españoles completaron el cuestionario voluntariamente. El porcentaje de músicos que reportaron el uso de protección auditiva en nuestra encuesta fue muy bajo, y variable dependiendo del tipo de instrumento interpretado. Sin embargo, encontramos una alta prevalencia de trastornos auditivos subjetivos dentro de este grupo.ConclusiónPocos músicos españoles utilizan protección auditiva. La formación sobre prevención de hipoacusia en este campo y la mejora de los dispositivos protectores podría incrementar el uso y mejorar la salud auditiva de este colectivo. (AU)

Complicaciones postoperatorias tras adenoamigdalectomía en 2 grupos de pacientes pediátricos: síndrome de apnea-hipopnea del sueño e infecciones de repetición / Postoperative complications after adenotonsillectomy in two paediatric groups: Obstructive sleep apnoea syndrome and recurrent tonsilitis

INTRODUCCIÓN Y OBJETIVOS: La adenoamigdalectomía es una cirugía indicada por amigdalitis recurrentes e igualmente por síndrome de apnea-hipopnea del sueño (SAHS). Es considerada segura y con pocas complicaciones. Así, en pacientes mayores de 3 años y sin comorbilidades no hay más complicaciones respiratorias (fuera del postoperatorio inmediato), por lo que no precisan la hospitalización rutinaria en la unidad de cuidados intensivos pediátricos, independientemente de la gravedad del SAHS. El objetivo de este estudio es reanalizar la situación, para comprobar que esta tendencia se mantiene, poniendo especial énfasis en menores de 3 años, subgrupo donde hay menos datos disponibles. MÉTODOS: Estudio retrospectivo observacional, incluyendo los niños adenoamigdalectomizados en nuestro centro durante 5 años. RESULTADOS: Se operaron 418 niños (56,7% por amigdalitis y 43,3% por SAHS). Solo 24 (5,7%) tuvieron complicaciones: un 1,2% vómitos, un 3,1% sangrados y un 1,4% complicaciones respiratorias. Estas últimas ocurrieron siempre en quirófano o recuperación postanestésica y más frecuentemente en SAHS grave, mientras que las amigdalitis tuvieron más sangrados (p = 0,046). No hay diferencias por edad (p = 0,174), aunque el subgrupo de menores de 3 años sigue siendo más pequeño. CONCLUSIONES: No encontramos diferencias en el porcentaje de complicaciones entre SAHS y amigdalitis. Las amigdalitis tienen más sangrados, y el SAHS grave más complicaciones respiratorias, pero siempre en el postoperatorio inmediato en nuestra serie. Estos datos apoyan la hipótesis previa de no ingresar rutinariamente en la unidad de cuidados intensivos pediátricos salvo en los casos anteriormente mencionados

INTRODUCTION AND OBJECTIVES: Adenotonsillectomy is a surgery to treat recurrent tonsillitis or obstructive sleep apnoea syndrome (OSAS). It is considered a safe procedure, with few complications. Moreover, patients over 3 years and without comorbidities do not present a higher rate of respiratory adverse events after the immediate postoperative period, and do not need systematic admission to a paediatric intensive care unit (PICU), regardless of their OSAS severity. The aim of this study is to reanalyse the situation, including patients under the age of 3 years, for whom there are fewer available data, to confirm that this trend has not changed. METHODS: A retrospective observational study was performed, including all adenotonsillectomised children in our hospital over 5 years. RESULTS: 418 adenotonsillectomised children were included, 56.7% due to recurrent tonsillitis, and 43.3% because of OSAS. Only 24 patients (5%7%) experienced adverse events, of whom 1.2% had vomiting, 3.1% bleeding, and 1.4% respiratory events. All the respiratory events occurred in the operating theatre or in the post-anaesthetic unit, most frequently in children with severe OSAS, while the tonsillitis group had more bleeding (P = .046). No differences in complications were observed according to age (P = 0.174), but the group of patients under three years was relatively small. CONCLUSIONS: No differences were found in the percentage of complications between the two groups. Although the OSAS group exhibited more respiratory events, these occurred in the immediate postoperative period; otherwise, there was a higher risk of bleeding in the tonsillitis group. These results support the findings indicating that routine PICU admission is not required for these patients