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Abstract Introduction Lactococcus lactis (L. lactis) is widely used in fermented foods and has immunomodulatory properties. However, its effects on allergic rhinitis remain unclear. Objective This study evaluated the efficacy of L. lactis 11/19-B1 in mitigating allergic rhinitis symptoms in a mouse model. Methods Female BALB/c mice were fed a diet supplemented with heat-killed L. lactis 11/19-B1, while allergic rhinitis was induced via intraperitoneal and intranasal administration of ovalbumin (OVA). The positive control group received a standard diet without L. lactis 11/19-B1. Sneezing frequency was recorded, and tissue samples were collected for analysis. Serum OVA-immunoglobulin E (IgE) levels were also measured, nasal mucosa histopathology assessed, and the interleukin 4 (IL-4), interferon gamma (IFN-γ), T helper (Th) 1/Th2 balance in cluster of differentiation (CD) 4+ T cells analyzed by flow cytometry (FCM). Results Mice receiving L. lactis 11/19-B1 showed significantly reduced sneezing frequency and decreased eosinophil infiltration in the nasal mucosa. No significant changes in serum OVA-IgE levels were observed. Flow cytometry analysis showed a significant increase in the Th1/Th2 ratio in Peyer's patches in the L. lactis 11/19-B1 group compared with the positive control group. Conclusion These findings suggest that L. lactis 11/19-B1 alleviates allergic rhinitis symptoms by modulating the Th1/Th2 balance and reducing eosinophil infiltration, independently of IgE suppression. These findings highlight its potential as a dietary supplement for allergic disease management .

Resumo em Inglês:

Abstract Introduction The aditus ad antrum is a structure located on the posterior wall of the tympanic cavity, connecting the epitympanum and mastoid antrum, playing a role in ventilating the mastoid antrum and air cells. However, there is limited in-depth research on this structure. Objective To study the anatomy and morphology of the aditus ad antrum and evaluate its correlation with mastoid pneumatization using 3D MPR-reconstructed CT scans. Methods This cross-sectional descriptive study was conducted using 101 normal temporal bone CT scans (190 ears) from individuals aged 16 years or older in Vietnam. The aditus was examined in three planes (axial, coronal, and sagittal) using 3D MPR reconstruction. Results The aditus ad antrum morphology was classified into four groups, with group 2 being the most prevalent (48.42%). There was no correlation between aditus morphology and gender or ear side. Additionally, no relationship was found between mastoid pneumatization and aditus morphology. With increasing mastoid pneumatization, aditus ad antrum dimensions change. In individuals with two normal ears (N = 89), bilateral symmetry in aditus morphology was observed in 45% of cases. No significant differences were found in aditus dimensions between ears. The mean transverse diameter of the aditus in males was significantly larger than in females (p < 0.05). The anterior-posterior diameter of the right ear was significantly greater than the left in the same individual (p < 0.05). Conclusion The aditus ad antrum may differ between the left and right ears in normal individuals and is not associated with mastoid pneumatization.

Resumo em Inglês:

Abstract Introduction Masseteric vestibular evoked myogenic potentials assess saccular-masseteric pathway function using air-conducted or bone-conducted stimuli. Objective This study investigated whether simulated bilateral conductive hearing loss differentially affects mVEMP response characteristics under air- and bone-conducted stimulation in young adults. Methods Fifty healthy participants were included in the study. Conductive hearing loss was simulated in 25 individuals using silicone-blocked foam ear tips to create controlled bilateral attenuation. Masseteric vestibular evoked myogenic potentials were elicited using 500 Hz tone bursts delivered to the right ear through air and bone-conducted methods. Responses were recorded using a two-channel zygomatic electrode placement and analyzed for P1 and N1 latencies and P1-N1 peak-to-peak amplitude. Results In the simulated conductive hearing loss group, air-conducted masseteric vestibular evoked myogenic potential responses showed decreased response rate, delayed latency, and reduced amplitude compared with normal hearing participants. In contrast, bone-conducted masseteric vestibular evoked myogenic potentials were consistently recorded in both groups, demonstrating significantly higher amplitudes and earlier latencies than air-conducted responses in the simulated conductive hearing loss group. Spectral analysis revealed a consistent peak around 100 Hz for all conditions except air-conducted stimulation in the simulated conductive hearing loss group, which showed no distinct peak. Conclusion Simulated conductive hearing loss significantly affects air-conducted masseteric vestibular evoked myogenic potential responses, often rendering them absent or diminished. However, bone-conducted responses remain robust and reliable in normal and simulated conductive hearing loss conditions, highlighting their diagnostic value when conductive pathologies compromise air-conducted responses.

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Abstract Introduction In some patients with conductive or mixed hearing loss, or single-sided deafness, bone conduction implants (BCIs) offer an effective treatment; and scar appearance is a relevant factor in the overall outcome. Objective To compare scar appearance and alopecia between linear and curved scalp incisions in patients undergoing transcutaneous BCIs surgery. Methods An observational, cross-sectional study was conducted at a tertiary referral center in patients who underwent transcutaneous BCI. Postoperative follow-up period was between 6m to 3y. Scar evaluation was performed using the Patient and Observer Scar Assessment Scale (POSAS) and the Vancouver Scar Scale (VSS). Alopecia was defined as absence of hair follicles within 2 mm of the incision line. Statistical comparisons between linear and curved incisions groups were conducted, as well as multivariate analysis with logistic regression models. Results Eighty-four cases were analyzed: 28 underwent linear incisions and 56 underwent curved incisions. Patients reported significantly better scar appearance with linear incisions in POSAS, p = 0.035. Alopecia occurred less frequently among patients who received the Bonebridge implant (OR = 0.113; 95% CI: 0.027–0.478; p = 0.003). No statistically significant differences were found in observer assessment of POSAS or VSS scores. Conclusion Linear incisions may offer advantages in scar appearance with transcutaneous BCIs. Certain scar characteristics may also be influenced by the type of device and the surgical approach required for its placement, making it challenging to isolate this effect from that attributed solely to type of incision. These results highlight the need to consider both cosmetic factors and auditory outcomes in surgical planning.

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Abstract Introduction Decision-making is one of the most difficult and important tasks performed by surgeons. Clinical guidelines and, more recently, Artificial Intelligence (AI) have been implemented to support these decisions. However, there is a paucity of research exploring the impact of AI on surgical decision-making strategies. Objective To evaluate the accuracy of AI in informing clinical decision-making for the treatment of advanced oral cancer. Methods Structured questions based on seven selected clinical recommendations were formulated and processed through multiple large language model (LLM) platforms. Claude (Sonnet 3.5) was used to identify discrepancies between established guidelines and LLM-generated responses. Subsequently, three subject matter experts assessed the identified differences to evaluate their clinical significance. Results Analysis of the 28 generated responses revealed that 21 (75%) showed congruence between LLM outputs and established guideline recommendations. In three instances, guidelines provided significantly more comprehensive content than LLM responses. One LLM response contained additional relevant information, while three responses were contradictory to the guidelines. Conclusion The LLMs demonstrated 75% concordance with guideline recommendations and should be considered complementary tools for established clinical guidelines.

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Abstract Introduction Intrinsic laryngeal muscles (ILMs) play a fundamental role in airway protection, respiration, and phonation. Objective Knowledge of the distribution and roles of different sarcoplasmic reticulum Ca2+ ATPase (SERCA) and myosin heavy chain (MHC) isoforms in ILMs is essential for understanding their functions and associated pathophysiological changes. Methods We immunohistochemically characterized SERCA and MHC isoform expression and co-expression patterns in five ILMs of young, aged, and denervated rats. Results ILMs exhibited the predominant expression of fast fibers that would be important in airway protection. ILMs showed spatially different percentages of muscle fibers and SERCA2. Slow fibers were higher in medial thyroarytenoid (TA) muscles than lateral TA. Significant increases were observed in slow and hybrid fibers with aging. SERCA2 noticeably diminished after denervation, pointing to an increased vulnerability of the denervated muscle to fatigue. A compensatory increase in SERCA2 and hybrid fibers was observed in contralateral muscles likely reflecting adaptation to increased mechanical load. Conclusion These results indicate that ILMs, like limb muscle fibers, are subject to neural regulation. These findings may significantly advance the understanding of the Ca2+ handling system in ILMs and its role in unique laryngeal muscle functions.

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Abstract Introduction Chronic dysfunction of the Eustachian tube is a common complaint, affecting approximately 1–5% of adults and significantly reducing quality of life. This condition may give rise to various symptoms and disorders of the middle ear. To date, the diagnostic tools for this dysfunction remain inadequate. In 2012, McCoul et al. published a questionnaire for the evaluation of Eustachian tube dysfunction, known as the ETDQ-7, and demonstrated its validity and reliability. Objectives To prove an in Italian translated version of the ETDQ-7. Methods The ETDQ-7 was translated into Italian and administered to two groups: 68 patients with chronic Eustachian tube dysfunction (ETD) and 50 healthy controls. Statistical analyses included test-retest reliability, item–total score correlation, receiver operating characteristic (ROC) analysis, and assessment of internal consistency. Results Analysis of the Italian version of the ETDQ-7 confirmed the findings of McCoul et al. (2012). The Cronbach's alpha coefficient was 0.838 for the entire questionnaire. The Spearman's rho coefficient for test–retest was 0.804, indicating good temporal stability in patients' responses. Both total and item scores were significantly higher in the patient group than in the control group. Conclusion The Italian version of the ETDQ-7 demonstrates high validity and reliability. Its use is recommended for diagnosing and monitoring patients with chronic Eustachian tube dysfunction.

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Abstract Introduction There is uncertainty about whether COVID-19 is a risk factor for hearing loss. Objective To evaluate the audiometric profile of patients post-COVID-19 infection and compare it to unaffected individuals, clarifying the correlation between COVID-19 and hearing loss. Additionally, we sought correlations between reported otorhinolaryngological symptoms during COVID-19 and changes in tonal thresholds. Methods A cross-sectional study compared the pure-tone thresholds of 120 individuals with a confirmed history of COVID-19 and 120 unexposed controls, evaluated between 2021 and 2023. Results The median tonal thresholds of exposed individuals were predominantly higher than those of unexposed individuals in both ears. The rate of hearing threshold alteration was 28.3% in exposed individuals versus 15% in unexposed individuals, with an odds ratio (OR) of 2.24 (95% CI: 1.18–4.25). Comparison of thresholds between the right and left ears of each exposed individual demonstrated asymmetric hearing impairment. The distribution of otorhinolaryngological symptoms included: nasal symptoms 67.5%; cough 65.8%; loss of smell 60%; loss of taste 56.7%; sore throat 47.5%; dizziness 30.8%; hoarseness 21.7%; tinnitus 19.2%; earache 18.3%; hearing loss 18.3%; and facial paralysis 0.8%. The association between reported symptoms and changes in pure-tone thresholds was statistically significant only for hearing loss (p < 0.001; OR = 8.9) and tinnitus (p = 0.005; OR = 3.7). Conclusion Individuals exposed to COVID-19 showed worse tonal thresholds and a higher rate of hearing changes compared with non-exposed individuals.

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Abstract Objective Post-thyroidectomy hypocalcemia is a major complication following total thyroidectomy. This study aimed to evaluate early postoperative parathyroid hormone (PTH) measurement as a predictor of hypocalcemia after thyroidectomy and its impact on same-day discharge. Methods This study combined a prospective IRB-approved correlation study of 60 patients who underwent total thyroidectomy with a meta-analysis of 5 observational studies. Results Using Pearson Correlation Coefficient correlation, there was a significant positive correlation between PTH measured 1H after surgery with 4 H PTH (PCC = 0.787) and 4H Ionized Ca (PCC = 0.642). The sensitivity of early PTH measurement (cutoff < 14 pg/mL) for detecting hypocalcemia was 100%, with an AUC of 0.977 (95% CI: 0.565-1.0). Meta-analysis of previous studies confirmed a strong positive association between early PTH and late measurements. Conclusions Early PTH measurement at 1 hour after surgery is a highly sensitive tool for detecting post-thyroidectomy hypocalcemia, which may help reduce hospital stay following thyroidectomy.