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Objectives: To explore the prognostic factors in patients with advanced olfactory neuroblastoma (ONB) underwent endoscopic surgery. Materials and Methods: Retrospective medical records were reviewed of patients with pathologically proven ONB who underwent endoscopic surgical resection. Clinicopathological characteristics including patient demographics, treatment, complications, follow-up, and outcomes were analyzed. Kaplan–Meier overall survival (OS) and disease-free survival (DFS) curves were plotted. Univariate and multivariate Cox regression models were used to determine prognostic factors. Results: Eighty-five patients with Kadish stage C ONB were examined. According to the various staging systems used, most patients harbored modified Kadish stage C (78.8%). Twenty-six patients (30.6%) underwent bony skull base resection, 11 (12.9%) underwent dura resection, and 24 (28.2%) underwent additional intracranial resection that included the olfactory bulb and duct. Median follow-up was 39 months. Five-year OS and DFS rates were 83.7% and 74.9%, respectively. Five-year OS was 100% in patients treated with bony skull base resection and 77.5% in those who were not (P =.052). Dura resection did not improve OS. Multivariate Cox regression analysis identified perioperative complications (P =.009), gross total resection (P =.004), orbital invasion (P =.014), postoperative radiotherapy (P =.030), and bony skull base resection (P =.019) as independent prognostic predictors. Conclusion: For patients with advanced ONB, endoscopic surgery in conjunction with radiotherapy and chemotherapy is effective and safe. Dura resection should be performed with caution in selected patients to balance survival and complications. Postoperative radiotherapy is important to improve OS and DFS. [ABSTRACT FROM AUTHOR]

Objective: We aimed to develop a modified tinnitus‐relieving sound system and establish a model for predicting its treatment effects. Study Design: Retrospective study. Setting: Tinnitus Specialist Clinic of Eye & ENT Hospital, Fudan University. Methods: We recruited 107 patients undergoing modified tinnitus‐relieving sounds between August 2020 and May 2021. Patients were divided into training (n = 75) and validation (n = 32) cohorts in a 7:3 ratio. The treatment outcome was Tinnitus Handicapped Inventory scores. Features were established using a least absolute shrinkage and selection operator‐derived logistic regression model, where the selected clinical risk factors were included in the multivariate logistic regression, and a nomogram was established based on the model. The discrimination and calibration abilities of the nomogram were evaluated using the Hosmer‐Lemeshow test and calibration curves. Decision curve analysis (DCA) was used to evaluate the net benefit of predictive efficacy. Results: Multivariate logistic analysis indicated that the initial Tinnitus Handicapped Inventory score (odds ratio [OR]: 1.13 [1.07‐1.19], P <.001) and treatment duration (OR: 3.4 [1.34‐8.62], P <.001) were positive factors for improved tinnitus. The nomogram model that included baseline Tinnitus Handicapped Inventory score and treatment duration achieved a better concordance index of 0.880. DCA revealed that the nomogram model could lead to net benefits and exhibited a wider range of threshold probabilities for the prediction of therapeutic effects. Conclusion: Our study suggests that the nomogram model, including baseline Tinnitus Handicapped Inventory score and treatment duration, could achieve optimal performance in the preoperative prediction of the therapeutic effect of modified tinnitus‐relieving sound. [ABSTRACT FROM AUTHOR]

Open in new tab Download slide OBJECTIVES Oesophagectomy was always recommended after noncurative endoscopic resection (ER). And the optimal time interval from ER to oesophagectomy remains unclear. This study was to explore the effect of interval on pathologic stage and prognosis. METHODS We included 155 patients who underwent ER for cT1N0M0 oesophageal cancer and then received subsequent oesophagectomy from 2009 to 2019. Overall survival and disease-free survival (DFS) were analysed to find an optimal cut-off of interval from ER to oesophagectomy. In addition, pathologic stage after ER was compared to that of oesophagectomy. Logistic regression model was built to identify risk factors for pathological upstage. RESULTS The greatest difference of DFS was found in the groups who underwent oesophagectomy before and after 30 days (P  = 0.016). Among total 155 patients, 106 (68.39%) received oesophagectomy within 30 days, while 49 (31.61%) had interval over 30 days. Comparing the pathologic stage between ER and oesophagectomy, 26 patients had upstage and thus had worse DFS (hazard ratio = 3.780, P  = 0.042). T1b invasion, lymphovascular invasion and interval >30-day group had a higher upstage rate (P  = 0.014, P  < 0.001 and P  < 0.001, respectively). And they were independent risk factors for pathologic upstage (odds ratio = 3.782, 4.522 and 2.844, respectively). CONCLUSIONS It was the first study exploring the relationship between time interval and prognosis in oesophageal cancer. The longer interval between noncurative ER and additional oesophagectomy was associated with a worse DFS, so oesophagectomy was recommended performed within 1 month after ER. Older age, T1b stage, lymphovascular invasion and interval >30 days were significantly associated with pathologic upstage, which is related to the worse outcome too. [ABSTRACT FROM AUTHOR]

Background The 2016–17 epidemic of human infections with avian influenza A(H7N9) virus was alarming, due to the surge in reported cases across a wide geographic area and the emergence of highly-pathogenic A(H7N9) viruses. Our study aimed to assess whether the human-to-human transmission risk of A(H7N9) virus has changed across the 5 waves since 2013. Methods Data on human cases and clusters of A(H7N9) virus infection were collected from the World Health Organization, open access national and provincial reports, informal online sources, and published literature. We compared the epidemiological characteristics of sporadic and cluster cases, estimated the relative risk (RR) of infection in blood relatives and non–blood relatives, and estimated the bounds on the effective reproductive number (R e ) across waves from 2013 through September 2017. Results We identified 40 human clusters of A(H7N9) virus infection, with a median cluster size of 2 (range 2–3). The overall RR of infection in blood relatives versus non–blood relatives was 1.65 (95% confidence interval [CI]: 0.88, 3.09), and was not significantly different across waves (χ2 = 2.66, P =.617). The upper limit of R e for A(H7N9) virus was 0.12 (95% CI: 0.10, 0.14) and was not significantly different across waves (χ2 = 1.52, P =.822). Conclusions The small cluster size and low R e suggest that human-to-human transmissibility of A(H7N9) virus has not changed over time and remains limited to date. Continuous assessment of A(H7N9) virus infections and human case clusters is of crucial importance for public health. [ABSTRACT FROM AUTHOR]

Objectives: Providing insight for pediatric ear surgery via investigations on the development patterns of ossicles, mastoid, and external auditory canal (EAC)., Methods: This retrospective study analyzed high-resolution computed tomography (HRCT) scans of 191 healthy temporal bones ranging from infants to adults. Subjects were grouped by 1-year intervals for developmental regression models and 3-year intervals for stage comparisons using t-tests or Mann-Whitney U tests., Results: The size of auditory ossicles and tympanic cavity (TC) remained stable during development, while the minimum diameter of the tympanic sinus (TS) entrance was reduced. Regarding mastoid pneumatization, the air cells can be observed at birth, became pronounced at 2 years old, and were fully developed around the age of 5, with subsequent growth primarily involving radial expansion. Furthermore, the EAC demonstrated significant growth with age: the width of EAC increased linearly ( y ̂ $$ \hat{y} $$  = 0.12x + 4.01, R 2  = 0.85), while the length of EAC followed a polynomial growth pattern ( y ̂ $$ \hat{y} $$  = -0.03x 2  + 1.15x + 6.25, R 2  = 0.96)., Conclusions: Ossicles and TC remain stable during development. Furthermore, mastoid air cells may have developed in the early stages of life, while their diameter increases synchronously with EAC. All in all, ossicular chain reconstruction surgery and endoscopic ear surgery can be performed in babies., Level of Evidence: NA Laryngoscope, 2024., (© 2024 The American Laryngological, Rhinological and Otological Society, Inc.)

Purpose: Spectacle lenses with highly aspherical lenslets (HAL) have been shown to effectively retard myopia progression in myopic children. This study aimed to investigate the impact of spectacle lenses with HAL on refractive and axial length (AL) changes in Chinese children with low amount of hyperopia., Design: Randomized controlled trial., Methods: A total of 108 Chinese children aged 6.0 to 9.9 years and spherical equivalent refractive error (SERE) from 0.00 to +2.00 D were randomly allocated into two groups: the HAL group and the single vision spectacle lens (SVL) group. Cycloplegic refraction, AL, and uncorrected visual acuity were measured at baseline, 6 and 12 months after lens dispensing. The duration of spectacle lens wear was monitored using a wearable device attached to the spectacle frame and by questionnaire logs provided by participants at each follow-up visit., Results: The 1-year SERE change was -0.19 (-0.32, 0.03) D and -0.23 (-0.36, 0.05) D in the SVL and HAL groups (P = .883). The 1-year AL elongation was 0.24 (0.18, 0.34) mm and 0.19 (0.12, 0.27) mm in the SVL and HAL groups (P = .057). In the HAL group, changes in AL and SERE were significantly correlated to lens wearing time (P < .001 and P = .024, respectively). Participants in the HAL group who wore their lenses for more than 30 hours per week had significantly slower AL elongation (0.11 [0.05, 0.17] mm) compared to their SVL counterparts (0.27 [0.21, 0.33] mm) (P < .001)., Conclusions: Spectacle lenses with HAL significantly reduced AL elongation in low hyperopic children who wore lenses for over 30 hours per week. A dose-response relationship was evident with longer lens wearing time associated with less AL change., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)