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1.
Luiz Felipe Palma Fernanda Aurora Stabile Gonnelli Marcelo Marcucci Adelmo José Giordani Rodrigo Souza Dias Roberto Araújo Segreto Helena Regina Comodo Segreto 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(2):227-231
Introduction
The procedure used to evaluate salivary flow rate is called sialometry. It can be performed through several techniques, but none appears to be really efficient for post-radiotherapy patients.Objective
To adequate sialometry tests for head and neck cancer patients submitted to radiotherapy.Methods
22 xerostomic patients post-radiotherapy (total radiation dose ranging from 60 to 70 Gy) were included in this study. Ten patients were evaluated using sialometries originally proposed by the Radiation Therapy Oncology Group and twelve were assessed by our modified methods. Unstimulated and stimulated sialometries were performed and the results were classified according a grading scale and compared between both groups.Results
There was no statistically significant difference between the salivary evaluations of both groups (p = 0.4487 and p = 0.5615). Also, most of these rates were classified as very low and low.Conclusion
This novel method seems to be suitable for patients submitted to radiotherapy. 相似文献2.
Tilman Huppertz Jessica Freiherr Bernhard Olzowy Ulrich Kisser Jutta Stephan Gunther Fesl Kathrin Haegler Berend Feddersen Rainald Fischer Klaus Mees Sven Becker 《Auris, nasus, larynx》2018,45(4):747-752
Objective
Acute mountain sickness (AMS) is caused by a low partial pressure of oxygen and may occur above 2500 m. The aim of this research was to evaluate olfactory and gustatory abilities of healthy subjects during baseline conditions and after seven hours of normobaric hypoxia.Methods
Sixteen healthy subjects were assessed using the Sniffin’ Sticks, as well as intensity and pleasantness ratings. Gustatory function was evaluated utilizing the Taste Strips. Experiments were carried out under baseline conditions (518 m altitude) followed by a second testing session after seven hours of normobaric hypoxia exposure (comparable to 4000 m altitude).Results
During normobaric hypoxia olfactory sensitivity and intensity estimates were significantly reduced.Conclusions
We conclude that normobaric hypoxia leads to a significant decrease of olfactory sensitivity and intensity ratings. 相似文献3.
Sanjana Vijay Nemade Kiran Jaywant Shinde Chetana Shivadas Naik Haris Qadri 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(3):318-323
Introduction
Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.Objective
To describe and evaluate the modified sandwich graft (mediolateral graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.Methods
A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay technique. We assessed the healing and hearing results.Results
Successful graft take up was accomplished in 47 patients (97.9%) in Group A and in 40 patients (83.3%) Group B. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB while in Group B; it was 22.5 ± 3.5 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.Conclusion
Double layered graft with drum-malleus as a ‘meat’ of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity. 相似文献4.
Vincenzo Landolfo Carmine Fernando Gervasio Giuseppe Riva Massimiliano Garzaro Rita Audisio Giancarlo Pecorari Roberto Albera 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(1):74-81
Introduction
Cordectomy by laringofissure and transoral laser surgery has been proposed for the treatment of early glottic cancer.Objectives
The aim of this retrospective study was to evaluate the prognostic value of margin status in 162 consecutive cases of early glottic carcinoma (Tis–T1) treated with CO2 laser endoscopic surgery (Group A) or laryngofissure cordectomy (Group B), and to compare the oncologic and functional results.Methods
Clinical prognostic factors, local recurrence rate according to margin status, overall survival and disease-free survival were analyzed.Results
Margin status is related to recurrence rate in both groups (p < 0.05) without significant differences between open and laser cordectomy (p > 0.05). The 5 years overall survival and disease-free survival were respectively 90.48% and 85.71% in Group A; 88.14% and 86.44% in Group B (p > 0.05). Lower tracheostomy rate, earlier recovery of swallowing function and shorter hospital stay were observed in Group A (p < 0.05).Conclusions
Margin status has a prognostic role in T1a–T1b glottic cancer. Transoral laser surgery showed similar oncologic results of open cordectomy, with better functional outcomes. 相似文献5.
Sang Hyun Kwak Ji Hoon Kim Da Hee Kim Jung Min Kim Hyung Kwon Byeon Won Shik Kim Yoon Woo Koh Se-Heon Kim Eun Chang Choi 《Auris, nasus, larynx》2018,45(3):504-507
Objectives
To report outcomes with regard to clinical aspects and medical costs of adenotonsillectomy and tonsillectomy at a single institution before and after implementation of the Diagnosis-Related Groups (DRG) payment system in Korea.Methods
We retrospectively reviewed the records of patients treated with adenotonsillectomy or tonsillectomy between July 2012 and June 2014. The Korean DRG payment system was applied to seven groups of specific diseases and surgeries including adenotonsillectomy and tonsillectomy from July 2013 at all hospitals in Korea. We divided patients into four groups according whether the fee-for-service (FFS) or DRG payment system was implemented and operation type (FFS-adenotonsillectomy (AT), DRG-AT, FFS-tonsillectomy (T), and DRG-T).Results
A total of 1402 patients were included (485 FFS-AT, 490 DRG-AT, 203 FFS-T, and 223 DRG-T). The total medical cost of the DRG-AT group was significantly lower than that of the FFS-AT group (1191 ± 404 vs. 1110 ± 279 USD, P < 0.05). There were no significant differences in length of hospital stay or postoperative complications among groups.Conclusion
The Korean DRG system for adenotonsillectomy and tonsillectomy reduced medical costs and clinical outcomes were not significantly altered by the adoption of the DRG system.Level of evidence
4. 相似文献6.
Maria Humeniuk-Arasiewicz Grażyna Stryjewska-Makuch Małgorzata A. Janik Bogdan Kolebacz 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(2):232-239
Introduction
Osteomas of the paranasal sinuses are benign bone tumours that produce clinical signs depending on their size and location. In most reported cases large tumours are excised by an external approach or in conjunction with an endoscopic technique. Endoscopic treatment of such tumours is a huge challenge for the operator.Objective
Determine the optimal surgical approach by analysing giant osteomas of the frontal and ethmoidal sinuses in the literature.Methods
Group of 37 osteomas obtained from the literature review. A group of osteomas removed only by endoscopy was compared with a group in which an external approach (lateral rhynotomy or craniotomy) or combined external and endoscopic approach was applied.Results
The authors, based on the statistical analysis of the literature data, have found that the average size of osteomas excised endoscopically and those removed by external approaches does not differ statistically, when the osteomas are located in the ethmoidal cells (p = 0.2691) and the frontal sinuses (p = 0.5891).Conclusion
The choice of surgical method appears to be independent of the osteoma size and the decision is likely to be taken based on the experience of the surgeon, available equipment and knowledge of different surgical techniques. 相似文献7.
8.
Kong Yew Liew Abu Bakar Zulkiflee 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(6):764-771
Introduction
Nasopharyngeal carcinoma is a geographically and racially variable disease which has a high incidence in Malaysia. Based on current concepts in tumour related inflammation the inflammatory marker, neutrophil–lymphocyte ratio was tested to find its relationship with prognosis in nasopharyngeal carcinoma.Objective
To investigate the effect of the neutrophil–lymphocyte ratio on prognosis in non-metastatic primary nasopharyngeal carcinoma patients and to further refine the cut off between high and low neutrophil–lymphocyte ratio values.Methods
The medical charts of patients with histologically confirmed nasopharyngeal carcinoma from 1st January 2005 until 31st December 2009 were reviewed retrospectively and theneutrophil–lymphocyte ratio was calculated to see if there was any association between their higher values with higher failure rates.Results
Records of 98 patients (n = 98) were retrieved and reviewed. Only neutrophil–lymphocyte ratio (p = 0.004) and tumor node metastasis staging (p = 0.002) were significantly different between recurrent and non-recurrent groups, with the neutrophil–lymphocyte ratio being independent of tumor node metastasis staging (p = 0.007). Treatment failure was significantly higher in the high neutrophil–lymphocyte ratio group (p = 0.001). Disease free survival was also significantly higher in this group (p = 0.000077).Conclusion
High neutrophil–lymphocyte ratio values are associated with higher rates of recurrence and worse disease free survival in non-metastatic nasopharyngeal carcinoma patients undergoing primary curative treatment. 相似文献9.
Marina Carvalho S. Côrtes Pedro Weslley Rosario Gabriela Franco Mourão Maria Regina Calsolari 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(4):448-452
Introduction
In patients with papillary thyroid carcinoma who have negative serum thyroglobulin after initial therapy, the risk of structural disease is higher among those with elevated antithyroglobulin antibodies compared to patients without antithyroglobulin antibodies. Other studies suggest that the presence of chronic lymphocytic thyroiditis is associated with a lower risk of persistence/recurrence of papillary thyroid carcinoma.Objective
This prospective study evaluated the influence of chronic lymphocytic thyroiditis on the risk of persistence and recurrence of papillary thyroid carcinoma in patients with negative thyroglobulin but elevated antithyroglobulin antibodies after initial therapy.Methods
This was a prospective study. Patients with clinical examination showing no anomalies, basal Tg < 1 ng/mL, and elevated antithyroglobulin antibodies 8–12 months after ablation were selected. The patients were divided into two groups: Group A, with chronic lymphocytic thyroiditis on histology; Group B, without histological chronic lymphocytic thyroiditis.Results
The time of follow-up ranged from 60 to 140 months. Persistent disease was detected in 3 patients of Group A (6.6%) and in 6 of Group B (8.8%) (p = 1.0). During follow-up, recurrences were diagnosed in 2 patients of Group A (4.7%) and in 5 of Group B (8%) (p = 0.7). Considering both persistent and recurrent disease, structural disease was detected in 5 patients of Group A (11.1%) and in 11 of Group B (16.1%) (p = 0.58). There was no case of death related to the disease.Conclusion
Our results do not support the hypothesis that chronic lymphocytic thyroiditis is associated with a lower risk of persistent or recurrent disease, at least in patients with persistently elevated antithyroglobulin antibodies after initial therapy for papillary thyroid carcinoma. 相似文献10.
Rafael Denadai Anelise Sabbag Cassio Eduardo Raposo Amaral João Carlos Pereira Filho Mirian Hideko Nagae Cesar Augusto Raposo Amaral 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(6):697-707
Introduction
The interpretation of the speech results obtained with the buccinator myomucosal flap in the treatment of velopharyngeal insufficiency in patients with cleft palate has been limited by the restriction in the number of patients and the time of postoperative follow-up.Objective
To evaluate the effect of the buccinator myomucosal flap on speech hypernasality in the treatment of patients with cleft palate and velopharyngeal insufficiency.Methods
Patients with repaired cleft palate (± lip) who were submitted to surgical correction of velopharyngeal insufficiency using the bilateral buccinator myomucosal flap were assessed. Hypernasality (scores 0 [absent], 1 [mild], 2 [moderate], or 3 [severe]) was analyzed by three evaluators by measuring the audiovisual records collected in early and late preoperative and postoperative periods (3 and 12 months, respectively). The values were considered significant for a 95% Confidence Interval (p < 0.05).Results
Thirty-seven patients with cleft palate (± lip) showing moderate (16.2%) or severe (83.8%) hypernasality in the preoperative period were included. Analyses of the late postoperative period showed that hypernasality (0.5 ± 0.7) was significantly (p < 0.05) lower than the hypernasality of the preoperative and recent postoperative periods (2.8 ± 0.4 and 1.7 ± 0.9, respectively).Conclusion
The buccinator myomucosal flap is effective in reducing/eliminating hypernasality in patients with cleft palate (± lip) and velopharyngeal insufficiency. 相似文献11.
Mohammad Waheed El-Anwar Alaa Omar Khazbak Diaa Bakry Eldib Hesham Youssef Algazzar 《Auris, nasus, larynx》2018,45(3):487-491
Objective
This study aimed to describe the positions of the lamina papyracea (LP) in patients who had nasal polypi, by computed tomography (CT) analysis.Methods
Paranasal CT scans of patients diagnosed to have nasal polypi were included in the study. CT images were acquired with multiplanar reformates to obtain delicate details in coronal planes for all subjects. Positions of the LP were registered then analyzed in relation to nasal polypi grading.Results
Forty seven subjects (94 nasal sides) were included in the current study. Grade I lamina detected in 50% or more of all cases. Patients who had larger polypi (polyp grade 3, 4) were associated with significantly more medial LP (grade II) than smaller polypi (polyp grade 0, 1, 2) (P = 0.00386).Conclusion
The current study improves surgeons’ awareness of LP position in different grades of nasal polypi and highlights that larger polypi are significantly associated with more medial LP than smaller polypi. This may be one of the causes of the higher incidence of complication in larger polypi and can help for safer surgery. 相似文献12.
Daisuke Sano Kenichiro Yabuki Hideaki Takahashi Yasuhiro Arai Yoshihiro Chiba Teruhiko Tanabe Goshi Nishimura Nobuhiko Oridate 《Auris, nasus, larynx》2018,45(4):846-853
Objective
The purpose of this study is to validate the concept of lymph node ratio (LNR) in head and neck squamous cell carcinoma (HNSCC).Methods
A total of 63 patients with HNSCC who underwent resection of the primary tumor combined with neck dissection in our institution were analyzed in this study. LNR was defined as the number of positive lymph nodes divided by the total number of lymph nodes excised. LNR was categorized into two groups (<0.068 and ≥0.068) according to the results of receiver-operating characteristic plots for determination of the cut-off value.Results
LNR ≥ 0.068 was associated with poor overall survival (OS), progression-free survival (PFS) and locoregional recurrence-free survival (LRFS) after resection of the primary tumor combined with neck dissection in patients with HNSCC. Univariate and multivariate data analysis showed that LNR ≥ 0.068 was an independent prognostic factor for OS, PFS and LRFS. Both pathological T stage status (pT3 or 4) and ≥3 positive LNs were also an independent prognostic factors for PFS in patients with HNSCC in our univariate and multivariate analysis.Conclusion
These results suggested that LNR could be useful tools in identifying HNSCC patients with poor outcomes. 相似文献13.
Ethan I. Huang Chia-Ling Kuo Yu-Ting Chou Yu-Ching Lin Shu-Yi Huang 《Auris, nasus, larynx》2018,45(4):791-795
Objective
The meticulous two-layer closure is a step to complete the modified Z-palatoplasty, which has been reported to serve as an effective element in multilevel sleep surgery for patients with severe obstructive sleep apnea, especially with Friedman anatomical stages II and III diseases. A single layer closure—the suture closure as originally described in uvulopalatopharyngoplasty by Fujita et al., is an alternative of the two-layer closure, featured by simplicity while its efficacy has not been completely proved in patients with severe obstructive sleep apnea.Methods
By apnea–hypopnea index (AHI), we investigated 7 patients with severe obstructive sleep apnea undergoing the modified Z-palatoplasty with one-layer closure in a multilevel surgery.Results
The mean apnea–hypopnea index is reduced from 52.9 ± 17.1 (preoperative) to 18.4 ± 9.7 events/h (postoperative) without any wound dehiscence or bleeding that results in an unplanned return to the operating room. In comparison, the percentage of reduction in mean apnea–hypopnea index is 65%. The improvement of apnea–hypopnea index is statistically significant with the p-value 0.004.Conclusion
Our results support that one-layer closure remains the efficacy of modified Z-palatoplasty (with two-layer closure) in one-stage multilevel surgery for severe obstructive sleep apnea with an unfavorable anatomical stage. 相似文献14.
Sanjana Vijay Nemade Kiran Jaywant Shinde Pratibha Bharat Sampate 《Auris, nasus, larynx》2018,45(3):440-446
Introduction
Surgical repair of the tympanic membrane, termed a type one tympanoplasty is a tried and tested treatment modality. Overlay or underlay technique of tympanoplasty is common. Sandwich Tympanoplasty is the combined overlay and underlay grafting of tympanic membrane.Objective
To describe and evaluate the modified sandwich graft (mediolateral double layer graft) tympanoplasty using temporalis fascia and areolar fascia. To compare the clinical and audiological outcome of modified sandwich tympanoplasty with underlay tympanoplasty.Methods
A total of 88 patients of chronic otitis media were studied. 48 patients (Group A) underwent type one tympanoplasty with modified sandwich graft. Temporalis fascia was underlaid and the areolar fascia was overlaid. 48 patients (Group B) underwent type one tympanoplasty with underlay fascia technique. 48 patients (Group C) underwent type one tympanoplasty with underlay cartilage technique. We assessed the healing and hearing results.Results
Successful graft take up was accomplished in 47 patients (97.9%) in Group A, in 40 patients (83.3%) Group B, and in 46 (95.8%) patients in Group C. The average Air-Bone gap closure achieved in Group A was 24.4 ± 1.7 dB, in Group B, it was 22.5 ± 3.5 dB and in group C, it was 19.8 ± 2.6 dB. Statistically significant difference was found in graft healing rate. Difference in hearing improvement was not statistically significant.Conclusion
Double layered graft with drum-malleus as a ‘meat’ of sandwich maintains a perfect balance between sufficient stability and adequate acoustic sensitivity. 相似文献15.
Introduction
The presence of cervical lymph node metastases in patients with oral cavity squamous cell carcinoma reduces survival by up to 50%.Objective
The aims of this study are to assess the accuracy of clinical N staging versus pathological N staging and its impact on survival in order to identify predictive factors associated with the presence of occult neck metastases.Methods
Outcomes of 105 patients with oral cavity squamous cell carcinoma who underwent surgical treatment of the primary tumor and neck were retrospectively evaluated.Results
For pN0 and pN+ patients 5-year overall survival was respectively 53% and 27%; disease specific survival was 66% for pN0 and 33% for pN+. Patients with clinical negative lymph nodes were pathologically upstaged in 62% of cases. Disease specific survival according to staging discrepancy had statistically significant impact on survival (p = 0.009).Conclusion
Clinical staging usually underestimates the presence of nodal disease. Neck dissection should be performed in cN0 oral cavity squamous cell carcinoma. 相似文献16.
Objective
Eosinophilic chronic rhinosinusitis (ECRS) is frequently complicated by asthma, and recognized as refractory and persistent rhinosinusitis. However, the detailed pathophysiology of ECRS has not been elucidated yet. In this study, we investigated the association between recurrent ECRS and intradermal testing to multi-antigens including Candida albicans.Methods
The subjects were 49 cases of bilateral chronic rhinosinusitis including 24 ECRS cases. They underwent endoscopic sinus surgery and submitted to pathological examination. Prior to surgery, peripheral blood eosinophil count, total and antigen-specific IgE levels (11 categories), and intradermal tests (5 categories) were carried out in all patients. These patients were followed-up for longer than 3 months. We compared the results of preoperative and postoperative clinical examination data between ECRS and non-ECRS (NECRS) cases.Results
Positive reaction of the delayed type of intradermal testing to C. albicans was significantly more often observed in ECRS than NECRS cases. (P < 0.01) Additionally, these positive reaction cases exhibited significantly higher recurrence of nasal polyps and symptoms of ECRS (P < 0.05).Conclusion
These results suggest the involvement of (Coombs) type IV allergic reaction to C. albicans in the pathophysiology of ECRS. 相似文献17.
Bo Hae Kim Yung Jin Jeon Young Ju Jin Woo-jin Jeong Sung Joon Park Soon-Hyun Ahn 《Auris, nasus, larynx》2018,45(5):1061-1065
Objective
This study describes the clinical characteristics and course of conservative treatment using anti-Tb medication and dressing in patients with tuberculous cervical fistula resulting from abscess formation, and to investigate factors prognostic of dressing and treatment duration.Methods
The medical records of patients with tuberculous cervical lymphadenitis were reviewed, and 38 of these patients who presented with cutaneous fistula that resulted from abscess formation were included in the study.Results
The mean duration of dressing until fistula closure was 3.7 ± 2.0 months (range 0.2–8.5), and the mean duration of treatment with anti-Tb medication was 10.6 ± 2.6 months (range 6.0–16.0). Patients with concomitant Tb, beyond the cervical lymph nodes showed significantly prolonged duration of dressing (4.6 months vs. 3.2 months, p = 0.025) and anti-Tb medication (11.8 months vs. 9.8 months, p = 0.015).Conclusion
Our results indicate that about 3.7 months of dressing was required for fistula closure. Tuberculous cervical lymphadenitis patients with fistula who had Tb beyond the cervical lymph nodes could be expected to require dressing for 4.6 months and prolonged and anti-Tb medication treatment. 相似文献18.
Objective
Several studies have demonstrated that abnormal glutathione peroxidases 1 (Gpx1) expression can influence the biological behavior of malignant cells. However, the roles of Gpx1 in laryngeal squamous cell carcinoma (LSCC) remain unknown. The purpose of this study is to analyze the Gpx1 expression and prognostic significance in LSCC patients.Methods
Gpx1 mRNA levels in laryngeal tissues were determined by qRT-PCR. Meanwhile, We examined the expression levels of Gpx1 protein in 140 primary tumor tissues and 28 cases of normal tissues by immunohistochemistry (IHC) analysis on tissue microarrays (TMA).Results
Our results revealed that the frequency of high Gpx1 was significantly higher in cancer tissue compared to normal surgical margins; Gpx1 expression correlated with clinical features and overall survival (OS). Gpx1 overexpression was significantly associated with lymph node metastasis (P = 0.023) and TNM stage (P = 0.008); Kaplan–Meier survival curves revealed that patients with high Gpx1 expression had worse prognoses than patients with low Gpx1 expression; By multivariate analysis, we revealed that high Gpx1 expression level (HR 2.101, 95%CI 1.011–4.367; P = 0.047) was an independent prognostic factor of survival in LSCC patients.Conclusion
We speculate that Gpx1 can be applied to predict the prognosis in LSCC patients. 相似文献19.
Filiz Gülüstan Zahide Mine Yazıcı Wesam M.E. Alakhras Omer Erdur Harun Acipayam Levent Kufeciler Fatma Tulin Kayhan 《Revista brasileira de otorrinolaringologia (English ed.)》2018,84(1):28-33
Introduction
Controversy surrounds the use of salvage therapies to treat sudden sensorineural hearing loss (SSNHL), with no consensus on recommendations. While several studies have demonstrated the effectiveness of intratympanic administration of steroids (ITS) and hyperbaric oxygen (HBO) treatment, few have compared the efficacy of ITS and HBO therapy in patients with refractory SSNHL.Objective
We evaluated the efficiency of ITS and HBO therapy in patients with refractory SSNHL.Methods
Patients who did not adequately benefit from systemic treatment were evaluated retrospectively. Refractory patients were defined as those who gained less than 20 dB in hearing after initial treatment. All refractory patients were informed about salvage therapy options: ITS or HBO therapy, the advantages and disadvantages of which were explained briefly. ITS involved 4 mg/mL dexamethasone administered through a 25 gauge needle. Patients underwent HBO therapy in a hyperbaric chamber where they breathed 100% oxygen for 120 min at 2.5 atmospheric pressure. The hearing levels of both groups were evaluated before the salvage therapy and at 3 months after treatment. Improvements in hearing were evaluated according to the Furahashi criteria. We also compared the two therapies in terms of speech discrimination scores (SDSs) and the recovery of all frequencies.Results
The salvage therapies generated similar results. Changes in pure tone averages and SDSs were similar for ITS and HBO therapy (p = 0.364 and p = 0.113). Comparison of SDSs and hearing thresholds at all frequencies showed similar levels of improvement.Conclusion
ITS and HBO therapy produced similar improvements in SSNHL patients, but the sample size was too small to draw definitive conclusions. Further randomized controlled studies are needed to identify the best therapy for patients with refractory sudden hearing loss. 相似文献20.
Yolanda Rebeca Peñaloza López Xóchitl Daisy Orozco Peña Santiago Jesús Pérez Ruiz 《Acta otorrinolaringologica espanola》2018,69(6):325-330