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Objectives: The primary aim of this study was to assess disparities in nasal nitric oxide (NO) levels between individuals diagnosed with eosinophilic chronic rhinosinusitis (ECRS) and those without ECRS. The second aim was to ascertain the comparative predictive efficacy of these nasal NO levels for the presence of ECRS. Methods: A systematic analysis was conducted on relevant studies that compared nasal NO levels in individuals with ECRS and those without. Furthermore, the discriminatory capacity of nasal NO in distinguishing ECRS from non-ECRS cohorts was quantified. The risk of bias across studies was evaluated utilizing the Newcastle-Ottawa scale. Results: The comprehensive review encompassed a total of 5 studies involving 470 participants. Findings revealed that patients diagnosed with ECRS exhibited significantly higher levels of nasal NO, as measured in parts per billion (ppb), compared to their non-ECRS patients. The mean difference was 130.03 ppb (95% confidence interval: [66.30, 193.75], I2 = 58.7%). The diagnostic odds ratio for nasal NO in identifying ECRS was 9.29 ([5.85, 14.75], I2 = 26.4%). The area under the summary receiver operating characteristic curve was 0.82. The correlation between sensitivity and false positive rate was 0.53, suggesting a lack of heterogeneity. Sensitivity, specificity, negative predictive value, and positive predictive value were 69% ([0.55, 0.79], I2= 77.0%), 83% ([0.73, 0.90], I 2 = 68.5%), 77% ([0.69, 0.83], I 2 = 50.1%), and 75% ([0.67, 0.82], I 2 = 41.5%), respectively. Conclusion: Nasal NO has the potential as a noninvasive diagnostic measure and endotype tool for ECRS. [ABSTRACT FROM AUTHOR]

Objectives: This study assessed the impact of cryoablation of the posterior nasal nerve on symptoms of rhinitis in individuals with allergic rhinitis (AR) and non‐allergic rhinitis (NAR). Data Sources: PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases for studies published up to June 2023. Review Methods: Studies that evaluated the quality of life and rhinitis‐related symptom scores before and after cryotherapy treatment, as well as sham‐controlled studies, were included. Results: In total, 368 patients from seven studies were analyzed. Patients who underwent cryoablation showed a significant improvement in rhinitis‐related symptoms in both NAR and AR. In particular, the most significant improvement was observed in symptoms of rhinorrhea and congestion. Furthermore, cryoablation improved the disease‐specific quality of life evaluated using the Rhinoconjunctivitis Quality of Life Questionnaire. The rate of clinical improvement in the total nasal symptom score (total nasal symptom score [TNSS]; >30% reduction from baseline) after cryotherapy was 74%. The change in TNSS score significantly increased over time in NAR patients (p = 0.0041). Therefore, changes in the TNSS score after 12 months of cryotherapy treatment were greater in the NAR group than in the AR group (p = 0.0020), indicating that cryoablation is effective for both types of rhinitis and has better long‐term efficacy in NAR than in AR. Conclusions: Subjective symptom scores related to rhinitis, particularly for rhinorrhea and congestion, decrease after cryoablation of the posterior nasal nerve. Furthermore, the symptom improvement was greater in NAR than AR. Laryngoscope, 134:2502–2512, 2024 [ABSTRACT FROM AUTHOR]

Objective s : To conduct a systematic review and meta‐analysis of published articles to assess the impact of inferior turbinate/meatus augmentation in patients diagnosed with empty nose syndrome (ENS). Data Sources: PubMed, Cochrane database, Embase, Web of Science, SCOPUS, and Google Scholar. Review Methods: Six databases were searched to December 2022. We retrieved studies evaluating improvements in refractory ENS‐related symptoms based on various patient‐reported outcome measures after inferior turbinate/meatus augmentation. Results: As a result of meta‐analysis, Sinonasal Outcome Test, Empty Nose Syndrome 6‐Item Questionnaire (ENS6Q), and depression scores were measured at 1 week; 1, 3, and 6 months; and later than 12 months after intervention for patients with ENS. All scores revealed significant symptom improvement. By reference to the minimal clinically important difference of the ENS6Q (6.25), inferior turbinate/meatus augmentation relieved the nasal symptoms of ENS in the long term. Although the improvements in anxiety scores at 1 week (0.4133 [−0.3366; 1.1633], 0.00, I2 = NA) and 1 month (0.4525 [−0.0529; 0.9579], I2 = 0.0%) were not statistically significant, the scores differed significantly at 3 months (0.7351 [0.4143; 1.0559], I2 = 28.4%), 6 months (0.8297 [0.6256; 1.0337], I2 = 37.2%), and longer than 12 months (0.7969 [0.4768; 1.1170], I2 = 0.0%). Conclusion: These data and analysis suggest that performing inferior turbinate/meatus augmentation on ENS patients may improve not only nasal symptom scores but also accompanying psychological problems such as anxiety and depression. Laryngoscope, 134:2005–2011, 2024 [ABSTRACT FROM AUTHOR]

Summary: Continuous positive airway pressure (CPAP) is the primary therapeutic modality for obstructive sleep apnea (OSA) management. However, despite efforts to encourage patients to comply with CPAP usage, long‐term adherence remains low. Consequently, surgical intervention for OSA is considered a secondary option for patients who exhibit non‐compliance with CPAP. Therefore, we conducted systematic review and meta‐analysis assessed the relative effectiveness of hypoglossal nerve stimulation (HNS) treatment and alternative surgical interventions for managing OSA. Five databases were searched. Studies were included if they measured polysomnography parameters and assessed sleep apnea‐related quality of life (Epworth Sleepiness Scale [ESS]) both before and after HNS, and compared these outcomes with control, CPAP, or airway surgery (uvulopalatopharyngoplasty, expansion sphincter pharyngoplasty, or tongue base surgery) groups. A total of 10 studies (2209 patients) met the inclusion criteria. Compared to other airway surgeries, the rates of post‐treatment apnea–hypopnea index (AHI) < 10 and < 15 events/h were significantly lower in the HNS group (odds ratio [OR] 5.33, 95% confidence interval [CI] 1.21–23.42; and 2.73, 95% CI 1.30–5.71, respectively). Additionally, postoperative AHI was significantly lower in the HNS group than in all other airway surgery groups (AHI: mean difference [MD] −8.00, 95% CI −12.03 to−3.97 events/h). However, there were no significant differences in the rate of post‐treatment AHI < 5 events/h (OR 1.93, 95% CI 0.74–5.06) or postoperative ESS score (MD 0.40, 95% CI−1.52 to 2.32) between the two groups. HNS is an effective option for selected patients with moderate‐to‐severe OSA and CPAP intolerance. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the efficacy of hypoglossal nerve stimulation (HGS) in the treatment of obstructive sleep apnea. Data Sources: PubMed, Cochrane database, Embase, Web of Science, SCOPUS, and Google Scholar. Review Methods: Five databases were reviewed to identify relevant studies that measured polysomnography parameters such as the apnea‐hypopnea index (AHI) and oxygen desaturation index, as well as quality of life and functional outcomes of sleep questionnaire scores, before and after HGS. Results: In total, 44 studies involving 8670 patients met the inclusion criteria. At 12 months after treatment, approximately 47%, 72%, and 82% of patients achieved AHI values of <5, < 10, and <15, respectively. The reported clinical success rates according to Sher criteria were 80% within 12 months and 73% between 12 and 36 months. While the favorable effects exhibited a gradual reduction up to 12 months postimplantation, they generally maintained a consistent level between the 12th and 36th months, as assessed by AHI < 5, <15, and success rate according to Sher criteria. Conclusion: HGS can enhance quality of life scores and polysomnography outcomes in obstructive sleep apnea patients. Although the positive effects gradually decreased until 12 months after implantation, they generally remained consistent between 12 and 36 months. [ABSTRACT FROM AUTHOR]

Simple Summary: We compared the diagnostic accuracy of conventional smears and liquid-based preparations for detecting thyroid lesions using fine-needle aspiration cytology. We reviewed 15,861 samples from 17 studies. There was no significant difference between conventional smears and liquid-based preparations in terms of diagnostic accuracy or the proportion of inadequate smears. SurePath outperformed ThinPrep in terms of diagnostic accuracy among the liquid-based preparations. Recommendations for one method over another should take cost, feasibility, and accuracy into account, necessitating additional research. Background: To compare conventional smears (CSs) and liquid-based preparations (LBPs) for diagnosing thyroid malignant or suspicious lesions. Methods: Studies in the PubMed, SCOPUS, Embase, Web of Science, and Cochrane database published up to December 2023. We reviewed 17 studies, including 15,861 samples. Results: The diagnostic odds ratio (DOR) for CS was 23.6674. The area under the summary receiver operating characteristic curve (AUC) was 0.879, with sensitivity, specificity, negative predictive value, and positive predictive value of 0.8266, 0.8668, 0.8969, and 0.7841, respectively. The rate of inadequate specimens was 0.1280. For LBP, the DOR was 25.3587, with an AUC of 0.865. The sensitivity, specificity, negative predictive value, and positive predictive value were 0.8190, 0.8833, 0.8515, and 0.8562. The rate of inadequate specimens was 0.1729. For CS plus LBP, the AUC was 0.813, with a lower DOR of 9.4557 compared to individual methods. Diagnostic accuracy did not significantly differ among CS, LBP, and CS plus LBP. Subgroup analysis was used to compare ThinPrep and SurePath. The DORs were 29.1494 and 19.7734. SurePath had a significantly higher AUC. Conclusions: There was no significant difference in diagnostic accuracy or proportion of inadequate smears between CS and LBP. SurePath demonstrated higher diagnostic accuracy than ThinPrep. Recommendations for fine-needle aspiration cytology should consider cost, feasibility, and accuracy. [ABSTRACT FROM AUTHOR]

Objective: Internal nasal valve dysfunction is a prevalent cause of nasal obstruction. This systematic review, along with a Meta‐analysis, evaluated the efficacy of temperature‐controlled radiofrequency device (RFD) treatment in alleviating nasal obstruction by rectifying nasal valve collapse. Data Sources: A comprehensive review of studies retrieved from PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases (up to December 2022) was conducted. Review Methods: We included studies that evaluated the quality of life and nasal obstruction scores before and after RFD treatment. In addition, sham‐controlled studies were analyzed. Results: In total, 451 patients across 8 studies were included in the analysis. Patients who underwent RFD treatment reported a significantly enhanced quality of life 24 months after treatment compared to pretreatment scores. The rates of clinically improved states and positive responses regarding quality of life after treatment were 82% and 91%, respectively. Moreover, the disease‐specific quality of life, as assessed by the Nasal Obstruction Symptom Evaluation score, significantly improved. Conclusion: RFD may help improve nasal obstruction symptoms. Further randomized clinical studies on larger cohorts are essential to substantiate its efficacy in enhancing nasal valve function. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy of topically applied tramadol in peritonsillar area for pain control and induction of perioperative morbidity in children undergoing adenotonsillectomy. Methods: Two authors independently searched the databases (MEDLINE, SCOPUS, and Cochrane databases) up to April 2022 for randomized controlled trials comparing the efficacy of an intraoperative peritonsillar administered tramadol with placebo or other agents only in pediatric patients. The outcomes were postoperative pain scores, time to take the first pain reducing drugs, and postoperative nausea/vomiting. Results: Our analysis was based on 17 trials. Peritonsillar administered tramadol significantly reduced postoperative pain at less than 20 minutes (SMD −1.5852, 95% CI [−2.3900; −0.7804]), 1 hour (SMD −1.5811, 95% CI [−2.3400; −0.8222]), 8 hours (SMD −1.0258, 95% CI [−1.8792; −0.1724]), 16 hours (SMD −0.8397, 95% CI [−1.4266; −0.2529]), and 1 day (SMD −1.0110, 95% CI [−1.5213; −0.5007]) and the time to take the first analgesic drug (SMD 1.6565, 95% CI [0.2838; 3.0293]) compared with the placebo. However, tramadol showed no significant difference on postoperative pain relief effects and the time to take the first analgesic drug compared to the other topical agents (bupivacaine, lidocaine, ketamine, and dexamethasone). Tramadol did not cause significant postoperative nausea and vomiting. Conclusions: This study demonstrated that intraoperatively applied topical tramadol could control postoperative pain and reduce the analgesic uptake compared with a control. However, the efficacy of tramadol in pain control was similar to other agents in pediatric adenotonsillectomy. [ABSTRACT FROM AUTHOR]