Epidemiology and Histopathology of Cancers of the Upper Aerodigestive Tract in the ENT and Head and Neck Surgery Department of the Ignace Deen National Hospital

Introduction: Head and neck cancers represent a significant burden of cancer, collectively ranking fourth for cancer incidence and second for cancer mortality worldwide. Objective: To study the epidemiological and histopathological aspects of head and neck cancers in the ENT-CCF department of Ignace Deen National Hospital. Materials and Methods: This was a descriptive retrospective study covering a period of 5 years from September 1, 2016, to September 30, 2021. Results: We collected 43 cases of head and neck cancers, representing a hospital frequency of 1.85%. The mean age was 45.21 ± 13.23 years. Males predominated, accounting for 65.12%, compared to 34.88% for females, with a male-to-female ratio of 1.87. Housewives accounted for 27.90%, followed by farmers at 23.26% and traders/merchants at 18.60%, with 41.86% being uneducated. The main risk factors were tobacco (37.21%) and alcohol (34.88%). Pain (53.49%), dysphonia (51.16%), and dyspnea (39.53%) were the main presenting symptoms. Squamous cell carcinoma (74.42%) and large cell lymphoma (18.60%) were the most commonly cited histological types. Conclusion: Head and neck cancers remain relatively common in our country. Improving prognosis depends on early diagnosis of the condition, resuscitation resources, and prompt management.

Suggestions on the prevention of COVID-19 for health care workers in department of otorhinolaryngology head and neck surgery

The epidemic of the Coronavirus Disease 2019(COVID-19)has presented as a grim and complex situation recently.More than 77,000 cases of COVID-19 has been confirmed in China until February 25th,2020,which are causing great impact on economy and society,as well as seriously interfering with ordinary medical practice in the department of otorhinolar-yngology head and neck surgery.This article discussed medical precautions required in the clinic,inpatient ward and operation room of otorhinolaryngology head and neck department,which aims to protect health care workers from COVID-19.

Inhibitory effect of saffron on head and neck squamous cell carcinoma via targeting of ESR1 and CCND1 by its active compound crocetin

Background:Traditional Chinese medicine is promising for managing challenging and complex disorders,including cancer,and in particular,saffron is applied in treating various cancer types.However,its potential therapeutic efficacy and active components in managing squamous cell carcinoma of the head and neck(HNSCC)remain unclear yet.Methods:Using network pharmacology approaches,active ingredients of saffron,their target genes,and HNSCC-related genes were identified.Enrichment analyses were conducted for determining molecular functions and pathways enriched by genes that overlapped between the saffron target gene set and the HNSCC gene set.Among the four known active ingredients of saffron,crocetin was found to have the strongest inhibitory impact on HNSCC,based on the findings of cell viability and migration assays.Therefore,the potential target genes of crocetin in HNSCC cells were examined using molecular docking experiments and were confirmed by qPCR.Result s:Four active ingredients of saffron and 184 of their target genes were identified.Further,a total of 34 overlapping saffron-/HNSCC-associated targets related to the four active ingredients were screened,and crocetin was chosen for further investigation because it had the strongest inhibitory effect on HNSCC cells.Molecular docking experiments indicated that ESR1 and CCND1 were the target genes of crocetin.These results were confirmed through qPCR analysis,in which crocetin was found to lower the expression of the ESR1 and CCND1 genes in AMC-HN-8 and FaDu cells.Conclusion:According to our results,crocetin is a primary active anti-cancer component of saffron that may have potential in the development of novel HNSCC-treating medications.However,more thorough molecular research is necessary for confirming these results and elucidating the anti-cancer mechanism underlying saffron.

Serum nutritional predictive biomarkers and risk assessment for anastomotic leakage after laparoscopic surgery in rectal cancer patients

BACKGROUND Anastomotic leakage(AL)is one of the severest complications after laparoscopic surgery for middle/low rectal cancer,significantly impacting patient outcomes.Identifying reliable predictive factors for AL remains a clinical challenge.Serum nutritional biomarkers have been implicated in surgical outcomes but are un-derexplored as predictive tools for AL in this setting.Our study hypothesizes that preoperative serum levels of prealbumin(PA),albumin(ALB),and transferrin(TRF),along with surgical factors,can accurately predict AL risk.AIM To determine the predictive value of preoperative serum nutritional biomarkers for rectal cancer AL following laparoscopic surgery.METHODS In the retrospective cohort study carried out at a tertiary cancer center,we examined 560 individuals who underwent laparoscopic procedures for rectal cancer from 2018 to 2022.Preoperative serum levels of PA,ALB,and TRF were measured.We employed multivariate logistic regression to determine the independent risk factors for AL,and a predictive model was constructed and evaluated using receiver operating characteristic curve analysis.RESULTS AL occurred in 11.96%of cases,affecting 67 out of 560 patients.Multivariate analysis identified PA,ALB,and TRF as the independent risk factor,each with an odds ratio of 2.621[95%confidence interval(CI):1.582-3.812,P=0.012],3.982(95%CI:1.927-4.887,P=0.024),and 2.109(95%CI:1.162-2.981,P=0.031),respectively.Tumor location(<7 cm from anal verge)and intraoperative bleeding≥300 mL also increased AL risk.The predictive model demonstrated an excellent accuracy,achieving an area under the receiver operating characteristic curve of 0.942,a sensitivity of 0.844,and a specificity of 0.922,demonstrating an excellent ability to discriminate.CONCLUSION Preoperative serum nutritional biomarkers,combined with surgical factors,reliably predict anastomotic leakage risk after rectal cancer surgery,highlighting their importance in preoperative assessment.

Enumeration and molecular characterization of circulating tumor cell using an in vivo capture system in squamous cell carcinoma of head and neck

Objective: Detection rate and isolation yield of circulating tumor cell (CTC) are low in squamous cell carcinoma of head and neck (SCCHN) with in vitro approaches due to limited sample volumes. In this study, we applied the CellCollector to capture CTC in vivo from peripheral blood. Methods: In total, the study included 22 cases with 37 times of detection. All of the patients were newly diagnosed with locally advanced or metastatic SCCHN, including laryngocarcinoma (40.9%, 9/22) and hypopharyngeal carcinoma (59.1%, 13/22). All patients received CTC analysis before treatment. Three patients received induction chemotherapy. Sixteen patients received surgical therapy, of which 13 patients received postoperative detection. Two patients received both induction chemotherapy and surgery treatment. Patients underwent two successive CellCollector applications 24 h before and 7 d after surgical therapy. Nine healthy volunteers were enrolled as the control group. Epidermal growth factor receptor variant type III (EGFRVIII) expression was analyzed with fluorescent dye labeled antibody. Results: With CellCollector isolation, 72.7% (16/22) of the patients were positive for >= 1 CTC (CTC; range, 1-17 cells) before treatments and 46.7% (7/15) of patients were CTC positive for >= 1 CTC (CTC; range, 1-29 cells) after surgical therapy. Moreover, the detection rate of CellCollector (82.4%, 14/17; CTC count range, 0-17) in advanced SCCHN (stage III-IV) was much higher than that in early stages (stage I-II, 40.0%, 2/5; CTC count range, 0-2) (P<0.05). EGFRVIII expression of CTC was also analyzed with fluorescence staining. One CTCEGFRVIII-positive patient was detected from six CTC-positive patients, and the positive expression of EGFRVIII was also found in the tumor tissue of this patient. Conclusions: In vivo detection of CTCs had high sensitivity in SCCHN, which might improve CTC application in clinic.

LOH-profiling by SNP-mapping in a case of multifocal head and neck cancer

AIM: To introduce an approach for the detection of putative genetic host factors that predispose patients to develop head and neck squamous cell carcinomas(HNSCC).METHODS: HNSCC most often result from the accumulation of somatic gene alterations found in tumor cells. A cancer-predisposing genetic background must be expected in individuals who develop multiple cancers, starting at an unexpectedly young age or with little carcinogen exposure. Genome-wide loss of heterozygosity(LOH) profiling by single nucleotide polymorphism microarray mapping was performed in a patient with a remarkable history of multifocal HNSCC.RESULTS: Regions of genomic deletions in germline DNA were identified on several chromosomes with a remarkable size between 1.6 Mb and 8.1 Mb(mega base-pair). No LOH was detected at the genomic location of the tumor suppressor gene P53.CONCLUSION: Specific patterns of germline DNA deletions may be responsible for susceptibility to HNSCC and should be further analyzed.

The Survival of Head and Neck Carcinoma Patients Depends on Secondary Causes of Death

Purpose: The study aimed to analyse causes of death and differential survival after multimodal treatment of head and neck carcinoma patients. Methods and Materials: Between September 2000 and December 2015, 935 patients received a multimodal treatment of head and neck carcinoma. Of these, 562 patients (60.1%) underwent a resection of the primary tumour and a postoperative radio- or radiochemotherapy and 373 patients (39.9%) received definitive radio- or radiochemotherapy. The median follow-up was 21.0 months (0.5 - 175.4 months). Results: At the endpoint of the investigation, 465 patients (49.7%) were alive. The median survival of all patients was 44.8 months (0.5 - 164.3 months). A total of 470 patients (50.3%) died. The causes of death were divided into five groups: 22 patients (2.4%) died of therapy-associated complications with a median of 2.2 months (1.6 - 3.3 months). The 160 patients (17.1%) with intercurrent death, 117 patients (12.5%) with deaths from locoregional progression with or without metastasis, and 86 patients (9.2%) with deaths from metastasis without locoregional recurrence showed comparable survival curves with a median survival of 13.3 months, 13.6 months, and 14.4 months. Eighty-five patients (9.1%) died from second malignant diseases and controlled treated head and neck carcinomas with a median survival of 34.5 months (P < 0.001). Conclusion: Despite a locoregional control and metastasis-free survival of 78.3% patients, only 49.7% of the patients were alive, due to a high rate of intercurrent and second malignant diseases. The short median survival rate is mainly due to the tumours (locoregional and or distant progression) and intercurrent causes of death, with the second malignant diseases leading to death later on.

Adenoid Cystic Carcinoma of the Head and Neck:Epidemiology and Predictors of Prognosis

Objectives: The biologic behavior of the adenoid cystic carcinoma (ACC) and the factors predicting outcome for these tumors are still poorly understood. Our objective is to analyze the predicting factors and the value of different treatment possibilities, since none sole treatment has been standardized. Methods: A retrospective analysis of the epidemiologic, clinical and histologic aspects of ACC, as well as treatment options and other prognostic factors of all the cases of ACC of the head and neck treated at this Institution were analyzed. From 1974 until 2011, 152 patients were diagnosed with ACC and treated at the Portuguese Institute of Oncology (Porto Centre). Main outcome measures: overall survival, local recurrence and distant metastasis were calculated by the Kaplan-Meier method. Factors predictive of outcome were identified by univariate and multivariate analysis. Results: The mean age at diagnosis was 55.8 years (range, 19-83 years). Incidence was higher in the female population, with a female to male ratio of 1.7:1 respectively. The primary tumor location was hard palate and submandibular region in 56 cases, 28 in each location (24.6%), parotid gland (17 cases, 14.9%) and oral cavity excluding palate (16 cases, 14%).Distributions according to T stage were: T1 (29.8%);T2 (30.7%);T3 (17.5%);T4 (22%). The overall 1-year, 5-year and 10-year survival for all patients were 94.6%, 60.5%, 41.6%, respectively. Conclusions: Univariate survival analysis revealed that age older than 60 years (p = 0.002), solid histologic subtype (p = 0.042), advanced clinical stage (p p = 0.036) were correlated with a poor survival. Multivariate analysis confirmed that age and advanced clinical stage were worst independent predicators of overall survival as well as perineural invasion for local recurrence and distant metastasis. In our analysis, radiotherapy did not have a relevant impact on survival, except in cases of solid histologic subtype. To analyze distant metastatic capacity, long term follow-up was necessary, since distant metastasis way occurs even after 10 years, which has the case with 4 patients.

Migrating fish bone piercing the common carotid artery,thyroid gland and causing deep neck abscess

Foreign body(FB) ingestion is very common in Malaysian population.The most commonly ingested FB is fish bone.Common presenting symptoms include FB sensation,odynophagia and or sharp pricking pain during swallowing.A careful history and physical examination is very important.Despite negative laryngoscopy and rigid esophagoscopy,persistent symptoms warrants further radiographic imaging studies.The FB can migrate extraluminally and involve other important adjacent structures of the neck and along the digestive tract.We report 3 cases of extraluminal migration of fish bone and their complications,which were successfully managed.One case with vascular complication which involve common carotid artery and the other two cases with neck abscess formation involving thyroid gland,retropharyngeal and parapharyngeal abscess.

Characteristics and utility of combined duplex color-coded ultrasonography in the cervical rotational position with head MRI and MRA in the differential diagnosis of apogeotropic direction-changing positional nystagmus

Objective:To determine whether cervical ultrasonography,magnetic resonance imaging(MRI),and magnetic resonance angiography(MRA)are useful in the differential diagnosis of etiology and understanding the pathophysiology in cases of apogeotropic direction-changing positional nystagmus(DCPN).Methods:Thirty patients with apogeotropic DCPN were classified into 11 cases of central disease,seven cases of mixed central and peripheral disease,and 12 cases of peripheral disease by differential diagnosis based on various balance function,neuro-otological,and imaging tests.Cervical ultrasonography using the cervical rotation method and MRI and MRA of the head and neck were performed in most patients with apogeotropic DCPN.We reviewed the presence of abnormal imaging findings according to the disease etiology.Results:Of the 30 patients with apogeotropic DCPN,23 showed vascular abnormalities or central lesions on imaging.Vascular lesions were found in six of the 12 patients with peripheral disease.Cervical ultrasonography with cervical rotation detected blood flow disturbance in the vertebral artery in eight patients in whom the disturbance could not be detected by MRI or MRA of the head and neck.Discussion:We hypothesize that the causative disease of apogeotropic DCPN may be strongly associated with circulatory insufficiency of the vertebrobasilar and carotid arteries,and that impaired blood flow in these vessels may affect peripheral vestibular and central function.In patients with apogeotropic DCPN,examinations of vestibular function,central nervous system symptoms,and brain hemodynamics are valuable for differential diagnosis.

Postoperative surgical site infection in cholesteatoma surgery with and without mastoid obliteration, what can we learn?

Introduction:This study aims to describe the occurrence of postoperative complications related to cholesteatoma surgery and to determine factors influencing the most common complication,i.e.postoperative surgical site infection(SSI)in cases with and without mastoid obliteration.Materials and methods:Retrospective analyses were performed on surgically treated cholesteatomas in our hospital between 2013 and 2019.Patient characteristics,peri-and postoperative management and complications were reviewed.The cases were divided into two groups based on whether mastoid obliteration was performed or not.Results:A total of 336 cholesteatoma operations were performed,of which 248 cases received mastoid obliteration.In total 21 complications were observed,of which SSI was the most common(15/21).No difference in occurrence of any postoperative complication was seen between the obliteration and noobliteration group(p=0.798),especially not in the number of SSI(p=0.520).Perioperative and/or postoperative prophylactic antibiotics were not associated to the development of an SSI in both groups.In the no-obliteration group a younger age(p=0.015),as well as primary surgery(p=0.022)increased the risk for SSI.In the obliteration group the use of bioactive glass(BAG)S53P4 was identified as independent predictor of SSI(p=0.008,OR 5.940).Discussion:SSI is the most common postoperative complication in cholesteatoma surgery.The causes of SSI are multifactorial,therefore further prospective research is needed to answer which factors can prevent the development of an SSI in cholesteatoma surgery.

Laryngopharyngeal reflux disease:Updated examination of mechanisms,pathophysiology,treatment,and association with gastroesophageal reflux disease

Laryngopharyngeal reflux disease(LPRD)is an inflammatory condition in the laryngopharynx and upper aerodigestive tract mucosa caused by reflux of stomach contents beyond the esophagus.LPRD commonly presents with symptoms such as hoarseness,cough,sore throat,a feeling of throat obstruction,excessive throat mucus.This complex condition is thought to involve both reflux and reflex mechanisms,but a clear understanding of its molecular mechanisms is still lacking.Currently,there is no standardized diagnosis or treatment protocol.Therapeutic strategies for LPRD mainly include lifestyle modifications,proton pump inhibitors and endoscopic surgery.This paper seeks to provide a comprehensive overview of the existing literature regarding the mechanisms,pathophysiology and treatment of LPRD.We also provide an in-depth exploration of the association between LPRD and gastroesophageal reflux disease.

Lamb's head: The model for novice education in endoscopic sinus surgery

Structured training in endonasal endoscopic sinus surgery(EESS) and skull base surgery is essential considering serious potential complications. We have developed a detailed concept on training these surgical skills on the lamb's head. This simple and extremely cheap model offers the possibility of training even more demanding and advanced procedures in human endonasal endoscopic surgery such as: frontal sinus surgery, orbital decompression, cerebrospinal fluid-leak repair followed also by the naso-septal flap, etc. Unfortunately, the sphenoid sinus surgery cannot be practiced since quadrupeds do not have this sinus. Still, despite this anatomical limitation, it seems that the lamb's head can be very useful even for the surgeons already practicing EESS, but in a limited edition because of a lack of the experience and dexterity. Only after gaining the essential surgical skills of this demanding field it makes sense to go for the expensive trainings on the human cadaveric model.

Primary and revision myringoplasty in children: Long-term outcome and analysis of the factors influencing the results

Objective:Assess the long-term outcome of pediatric myringoplasty.Methods:Tympanoplasty type I,myringoplasty,was performed on 85 children(91 consecutive operations,74 primary and 17 revisions)under 16 years of age.The perforations were sequela either to acute or chronic inflammatory middle ear disease.Medial grafting technique was employed with temporalis fascia.Adenoidectomy was performed earlier on all but five children.The preoperative observation period exceeded one year for all patients.The mean follow-up was 5.4(SD 3.6)years.Results:The long-term graft take rate was 84%for primary myringoplasty,and 53%for revision operations.The re-perforations were associated with postoperative discharge,subtotal or total perforation and revision surgery.In the cohort,sixty ears(66%)were completely healthy(intact tympanic membrane in normal position without adhesions and with good mobility)after follow-up.Spontaneous healing took place in 37%after re-perforation.The preoperative ventilation tube treatment did not affect the outcome and there were no differences between age groups.Preoperative sonotubometry or Valsalva test results did not correlate with outcome.Four ears needed a ventilation tube during the follow-up due to poor ventilation.The mean pure tone thresholds improved significantly after operation.Conclusions:Myringoplasty in children is a reliable procedure without age restrictions.One year of preoperative observation excludes most unstable ears,and high tendency of spontaneous healing after re-perforation suggests the need for a lengthy follow-up before revision surgery.

Effects of traditional Chinese medicine on symptoms of patients with spleen and stomach deficiency-related tinnitus

BACKGROUND Tinnitus affects 10%-30%of the population.Recent evidence suggests that tinnitus is associated with spleen deficiency.However,compared with kidney deficiency-related tinnitus,less research has been conducted on the impact of spleen defi-ciency-related tinnitus.AIM To investigate the clinical efficacy of using Guipi Wan and dietary and lifestyle modification based on traditional Chinese medicine for treatment of patients with spleen and stomach deficiency-related tinnitus.METHODS We enrolled 110 patients with spleen and stomach deficiency-related tinnitus who were distributed into treatment(58 cases)and control(52 cases)groups.Tinnitus severity,sleep quality and emotional state were assessed by questionnaires[Tinnitus Evaluation Questionnaire(TEQ);Pittsburgh Sleep Quality Index(PSQI);Depression-Anxiety-Stress Scale-21(DASS-21)]that were used for analysis in the two groups during the initial and intervention and after.In the treatment group,patients were treated with oral administration of Guipi Wan and consulted for healthy dietary and lifestyle modification.In the control group,patients were only assessed and not treated.RESULTS At the end of the 6-months,TEQ scores decreased significantly in the treatment group(P=0.021)but not in the Control group.Significant effects in the treatment group were noted for PSQI total score(P=0.043)and several PSQI component scores in the treatment group(P<0.05).After treatment,the DASS-21 scores were significantly reduced in the treatment group(P<0.05).CONCLUSION Guipi Wan combined with dietary and lifestyle modification based on regulating the spleen and stomach can be considered core to the treatment of tinnitus related to spleen and stomach deficiency.

Endoscopic push through tragal cartilage tympanoplasty: A 10-year retrospective review of our technique and outcomes

BACKGROUND Endoscopic ear surgery(EES)provides a magnified,high-definition view of the otological surgical field.EES allows otologists to avoid surgical incisions and associated postoperative complications.It is an ideal technique for the perfor-mance and teaching of tympanoplasty.AIM To examine the efficacy of total Endoscopic Push Through Tragal Cartilage Tympanoplasty(EPTTCT),at our institution over a 10-year period.METHODS A retrospective analysis of 168 cases of EPTTCT for closure of small to medium tympanic membrane perforations from 2013-2023 was conducted.Patient sex,age range(pediatric vs adult),etiology of injury,success rate,complications,and postoperative hearing status were collected.RESULTS Graft uptake results indicated success in 94%of patients,with less than a 2%complication rate.Postoperative pure tone audiometry demonstrated hearing status improvement in 69%of patients.CONCLUSION EPTTCT has been shown to be effective in tympanic membrane perforation closures with minimal complications.This study further demonstrates the efficacy and safety of these procedures in a single-center review.

When the Combination of a Chinese Flap and Dufourmentel Makes It Possible to Treat a Hopeless Case of Squamous Cell Carcinoma of the Upper Lip

Cancers of the lip are the leading cause of labial defects, and treatment is essentially surgical. The success of a repair is assessed by two essential criteria: The functional character of the lip (restoration of continence allowing feeding) and the aesthetic quality of the repair. However, for many patients from countries whose medical infrastructure does not allow them to undertake complex reconstructions locally, medical transfers represent their only chance of treatment. The aim of this article is to share with you an extreme clinical case of labial reconstruction, the management of which was a real challenge, using two major flaps: the free ante-brachial flap and the DUFOURMENTEL-type bi-pediculated scalp flap.

Analysis of the Influence of Sound Source Position and Electrode Placement on the Stimulation Pattern of the Cochlear Implant under Noise Conditions: Optimization of Auditory Perceptual Effects

Background: Cochlear implants (CI) are widely used to restore hearing in people with severe to profound hearing loss. However, optimizing CI performance, especially in difficult listening environments with background noise, remains a major challenge. Understanding the influence of factors such as sound source position and electrode placement on CI stimulation patterns is critical to improving auditory perception. Methods: In this study, an analysis was conducted to investigate the influence of sound source position and electrode placement on CI stimulation patterns under noisy conditions. For this purpose, a special measurement setup with a CI speech processor-microphone test box was used to simulate realistic listening scenarios and measure CI performance. Results: The results show that the effectiveness of CI noise reduction systems is influenced by factors such as the position of the sound source and electrode placement. In particular, the beamforming ultra zoom mode showed significantly better noise reduction than the omnidirectional mode, especially under real listening conditions. Furthermore, differences in electrode responses indicate individual variability in the CI user experience, highlighting the importance of personalized fitting algorithms. Conclusions: The results demonstrate the importance of considering environmental factors and individual differences when optimizing CI performance. Future research efforts should focus on the development of personalized fitting algorithms and the exploration of innovative strategies, such as the integration of artificial intelligence, to improve CI functionality in different listening environments. This study contributes to our understanding of CI stimulation patterns and lays the foundation for improving auditory perception in CI users.

Development and Optimization of Universal Bone Conduction Hearing Spectacles

Background: Non-implantable bone anchored hearing devices (BCHDs) are utilized for patients with conductive or mixed hearing loss who are unsuitable for conventional hearing aids or have unresolved middle ear issues. These devices can be surgically implanted or attached using adhesive plates, dental sticks, elastic headbands, or bone conduction spectacles. Optimal fitting of bone conduction spectacles requires appropriate frame selection and contact pressure in the temporal and mastoid areas. The ANSI S3.6 and DIN EN ISO 389-3 standards recommend a contact area of approximately 1.75 cm2 and a maximum force of 5.4 N for effective sound transmission and comfort. Methods: This study aimed to evaluate the technical fit and mechanical stability of universal bone conduction hearing spectacles compared to established systems. A Sen-Pressure 02 thin-film sensor connected to an Arduino Uno R3 board measured contact force in the temporal and mastoid areas. Several BCHDs were tested, including the Bruckhoff la belle BC D50/70, Radioear B71 headset, Radioear B71 elastic headband, Cochlear Baha SoundArc M, and Cochlear Baha elastic headband, on a PVC artificial head, with data analyzed using ANOVA and LSD post hoc tests. Results: The la belle BC D50/70 spectacles showed comparable contact force to established BCHDs, ensuring adequate sound transmission and comfort. Significant differences were observed between the systems, with the Radioear B71 headset exhibiting the highest forces. The la belle BC D50/70 had similar forces to the Radioear B71 elastic headband. Conclusion: The la belle BC D50/70 universal bone conduction hearing spectacles are a technically equivalent alternative to established BCHDs, maintaining pressure below 5.4 N. Future research should explore the impact of different contact forces on performance and comfort, and the integration of force control in modified spectacles. This study indicates that the la belle BC D50/70 is a viable alternative that meets audiological practice requirements.

Effect of TSH Suppression Therapy on Sex Hormone Levels after Thyroid Cancer Surgery

Objective:To analyze the effect of thyroid-stimulating hormone(TSH)suppression therapy on sex hormone levels in patients undergoing postoperative treatment for thyroid cancer.Methods:A total of 40 patients undergoing postoperative thyroid cancer treatment were selected for data analysis.TSH suppression therapy was implemented during the postoperative period.Patients were grouped according to the TSH level:TSH<0.1,0.1≤TSH<0.5,and TSH≥0.5.Results:Among male patients,there were no significant differences in sex hormone levels at different dosing times and TSH levels(P>0.05).For female patients,testosterone levels at different dosing times showed no significant differences under the same circumstances(P>0.05).The comparison of testosterone levels at different TSH levels over 5 years of TSH suppression therapy did not yield significant differences(P>0.05).However,the comparison of testosterone levels within 5 years of TSH suppression therapy yielded significant differences(P<0.05),with the lowest levels observed at 0.1≤TSH<0.5.Conclusion:The use of TSH suppression therapy in postoperative thyroid cancer treatment minimally affects sex hormone levels in male patients.However,it has a significant impact on female patients.Therefore,preoperative sex hormone testing is recommended,and postoperative monitoring should include regular sex hormone testing.