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3. Transcription factors gene expression in chronic rhinosinusitis with and without nasal polypsTanja Soklič, Matija Rijavec, Mira Šilar, Ana Koren, Izidor Kern, Irena Hočevar-Boltežar, Peter Korošec, 2019, original scientific article Abstract: Background. Chronic rhinosinusitis (CRS) current therapeutic approaches still fail in some patients with severe persistent symptoms and recurrences after surgery. We aimed to evaluate the master transcription factors gene expression levels of T cell subtypes in chronic rhinosinusitis with nasal polyps (CRSwNP) and chronic rhinosinusitis without nasal polyps (CRSsNP) that could represent new, up-stream targets for topical DNAzyme treatment. Patients and methods. Twenty-two newly diagnosed CRS patients (14 CRSwNP and 8 CRSsNP) were prospectively biopsied and examined histopathologically. Gene expression levels of T-box transcription factor (T-bet, TBX21), GATA binding protein 3 (GATA3), Retinoic acid-related orphan receptor C (RORC) and Forkhead box P3 (FOXP3) were analyzed by real-time quantitative polymerase chain reaction (RT-qPCR). Results. Eosinophilic CRSwNP was characterized by higher level of GATA3 gene expression compared to noneosinophilic CRSwNP, whereas there was no difference in T-bet, RORC and FOXP3 between eosinophilic and noneosinophilic CRSwNP. In CRSsNP, we found simultaneous upregulation of T-bet, GATA3 and RORC gene expression levels in comparison to CRSwNP; meanwhile, there was no difference in FOXP3 gene expression between CRSwNP and CRSsNP. Conclusions. In eosinophilic CRSwNP, we confirmed the type 2 inflammation by elevated GATA3 gene expression level. In CRSsNP, we unexpectedly found simultaneous upregulation of T-bet and GATA3 that is currently unexplained; however, it might originate from activated CD8+ cells, abundant in nasal mucosa of CRSsNP patients. The elevated RORC in CRSsNP could be part of homeostatic nasal immune response that might be better preserved in CRSsNP patients compared to CRSwNP patients. Further data on transcription factors expression rates in CRS phenotypes are needed.
Keywords: chronic rhinosinusitis
Published in DiRROS: 05.07.2024; Views: 56; Downloads: 36
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5. Three-dimensional ultrasound evaluation of tongue posture and its impact on articulation disorders in preschool children with anterior open biteSanda Lah Kravanja, Irena Hočevar-Boltežar, Maja Marolt-Mušič, Ana Jarc, Ivan Verdenik, Maja Ovsenik, 2018, original scientific article Abstract: Background. Tongue posture plays an important role in the etiology of anterior open bite (AOB) and articulation disorders, and is crucial for AOB treatment planning and posttreatment stability. Clinical assessment of tongue posture in children is unreliable due to anatomical limitations. The aim of the study was to present functional diagnostics using three-dimensional ultrasound (3DUS) assessment of resting tongue posture in comparison to clinical assessment, and the associations between the improper tongue posture, otorhinolaryngological characteristics, and articulation disorders in preschool children with AOB. Patients and methods. A cross-sectional study included 446 children, aged 3-7 years, 236 boys and 210 girls, ex- amined by an orthodontist to detect the prevalence of AOB. The AOB was present in 32 children. The control group consisted of 43 children randomly selected from the participants with normocclusion. An orthodontist, an ear, nose and throat (ENT) specialist and a speech therapist assessed orofacial and ENT conditions, oral habits, and articulation disorders in the AOB group and control group. Tongue posture was also assessed by an experienced radiologist, us- ing 3DUS. The 3DUS assessment of tongue posture was compared to the clinical assessment of orthodontist and ENT specialist. Results. The prevalence of AOB was 7.2%. The AOB group and the control group significantly differed regarding improper tongue posture (p < 0.001), and articulation disorders (p < 0.001). In children without articulation disorders from both groups, the improper tongue posture occured less frequently than in children with articulation disorders (p < 0.001). After age adjustment, a statistical regression model showed that the children with the improper tongue posture had higher odds ratios for the presence of AOB (OR 14.63; p < 0.001) than the others. When articulation disor- ders were included in the model, these odds ratios for the AOB became insignificant (p = 0.177). There was a strong association between the improper tongue posture and articulation disorders (p = 0.002). The 3DUS detected the high- est number of children with improper resting tongue posture, though there was no significant difference between the 3DUS and clinical assessments done by orthodontist and ENT specialist. Conclusions. The 3DUS has proved to be an objective, non-invasive, radiation free method for the assessment of tongue posture and could become an important tool in functional diagnostics and early rehabilitation in preschool children with speech irregularities and irregular tongue posture and malocclusion in order to enable optimal condi- tions for articulation development.
Keywords: anterior open bite, tongue posture, three-dimensional ultrasound
Published in DiRROS: 02.07.2024; Views: 98; Downloads: 48
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6. Higher levels of total pepsin and bile acids in the saliva as a possible risk factor for early laryngeal cancerMaja Šereg Bahar, Aleš Jerin, Irena Hočevar-Boltežar, 2015, original scientific article Abstract: Background. Gastroesophageal reflux is suspected to be an etiological factor in laryngeal and pharyngeal cancer. The aim of this study was to establish, using a non-invasive method, whether laryngopharyngeal reflux (LPR) appears more often in patients with early laryngeal cancer than in a control group. Patients and methods. We compared the pH, the level of bile acids, the total pepsin and the pepsin enzymatic activity in saliva in a group of 30 patients with T1 laryngeal carcinoma and a group of 34 healthy volunteers. Results. The groups differed significantly in terms of levels of total pepsin and bile acids in the saliva sample. Higher levels of total pepsin and bile acids were detected in the group of cancer patients. No significant impact of other known factors influencing laryngeal mucosa (e.g. smoking, alcohol consumption, and the presence of irritating substances in the workplace) on the results of saliva analysis was found. Conclusions. A higher level of typical components of LPR in the saliva of patients with early laryngeal cancer than in the controls suggests the possibility that LPR, especially biliary reflux, has a role in the development of laryngeal carcinoma.
Keywords: laryngopharyngeal reflux, gastric acid, pepsin, bile acids, laryngeal carcinoma
Published in DiRROS: 17.04.2024; Views: 239; Downloads: 131
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7. Olfaction and gustation abilities after a total laryngectomyGordana Mumović, Irena Hočevar-Boltežar, 2014, original scientific article Abstract: Background A laryngectomy affects many of a patient's functions. Besides speech and respiratory-tract problems, olfaction and gustation problems can also have an influence on the quality of life. The aim of this study was to find out how often various nasal problems and decreased gustation appear after a laryngectomy. Patients and methods. One hundred and five laryngectomized patients (9 women, 96 men, aged 45-88 years), treated in two tertiary centers, were included in the study. They completed a questionnaire about various nasal problems, olfactory and gustatory capabilities, possible allergies and irritants in their environment, and the impact of the nasal and gustation problems on their quality of life. Results Olfaction was impaired in 51.4%, and was even not possible in 30.5%, of patients. Decreased gustation abilities were reported in 26.7%, and dysgeusia in 11.4%, of patients. Almost 21% of patients were bothered by an impaired gustatory ability and 50.5% of patients were affected by their loss of olfaction. Frequent nasal discharge was reported in 20%, frequent sneezing in 58.1%, and nasal itching in 33.3% of the laryngectomized patients. There were no correlations between the age and the olfaction and gustation abilities and between the allergy and the nasal symptoms, whereas the correlation between olfaction and gustation appeared significant (p=0.025). Conclusions Various nasal and gustatory problems were reported in more than 80% of laryngectomized patients. The olfaction and gustation abilities are connected and have a substantial impact on the quality of life. Like in the case of speech, the rehabilitation of olfaction is also necessary in all laryngectomized patients and must take place soon after the completion of the treatment.
Keywords: laryngectomy, olfaction, gustation, questionnaire, quality of life
Published in DiRROS: 11.04.2024; Views: 404; Downloads: 321
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8. Communication after laryngectomyIrena Hočevar-Boltežar, Miha Žargi, 2001, review article Abstract: Izhodišča. Pri bolnikih z napredovalim rakom grla in spodnjega žrela je kirurška odstranitev grla najbolj primeren način zdravljenja. To zdravljenje pa negativno vpliva na številne pomembne bolnikove funkcije in tudi na govor. Bolniki in metode dela. Po odstranitvi grla je možnih več različnih načinov tvorbe glasu, tako da se vsak laringektomirani bolnik lahko nauči katerega od teh načinov govornega sporazumevanja. Rezultati. Znanih je več različnih, tudielektronskih naprav, ki s pomočjo lastnih baterij proizvajajo zvok. Drugo možnost predstavlja ezofagalni govor, pri katerem se bolnik nauči uporabljati mišični segment na prehodu v zgornji požiralnik kot generator glasu. Kirurško možnost govorne rehabilitacije po laringektomiji pa predstavlja vstavitev proteze v kirurško narejeno fistulo med zgornjim požiralnikom in sapnikom. Proteza usmeri zrak iz pljuč v zgornji požiralnik, glas pa nastane pri prehoduzraka skozi že omenjeni mišični segment. Zaključki. Številni dejavniki vplivajo na izbiro najprimernejšega načina nadomestnega govora pri posameznem bolniku. V Sloveniji največ laringektomiranih bolnikov uporablja ezofagalni govor.
Published in DiRROS: 25.01.2024; Views: 276; Downloads: 77
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9. Factors influencing rehabilitation in patients with head and neck cancerIrena Hočevar-Boltežar, Alojz Šmid, Miha Žargi, Avgust Župevc, Igor Fajdiga, Janez Fischinger, Ana Jarc, 2000, original scientific article Abstract: Purpose. The purpose of the prospective study was to identify the factors adversely influencing the post-treatment rehabilitation in patients with head and neck cancer. Patients and methods. One hundred and ten patients with oral cavity, pharyngeal and laryngeal cancer were examined before surgical treatment in order to find unfavorable factors: hearing loss, defective teeth,impaired pulmonary function, and speech disorders. The patients evaluated the success of their rehabilitation 12 months after the treatment. The influence of possible unfavorable factors, tumor site, and type of surgeryon speech, swallowing and reintegration competence was determinated. Results. The site of the tumor and the type of surgery did not influence the quality of rehabilitation in general. Defective teeth influenced the ability of swallowing but not the speech. Hearing loss impaired the patient's reintegration in their home environment. Impaired pulmonary function did not affect patient's speech. Speech was the poorest in laryngectomized patients. However, about two thirds of the patients were satisfied with their capabilityof speech, swallowing and their rehabilitation in general. Conclusions. Early identification of unfavorable factors, and individually planned rehabilitation can ensure a suitable quality of life for patients thathave undergone surgery for head and neck cancer.
Published in DiRROS: 25.01.2024; Views: 272; Downloads: 84
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10. Voice quality after radiation therapy of early glottic cancerIrena Hočevar-Boltežar, Miha Žargi, 1997, original scientific article Abstract: Radiation therapy is generally accepted as a successful treatment modality forearly glottic cancer offering an acceptable voice quality after the treatment. In order to evaluate objectively the voice quality in irradiated patients and to eliminate the influence of decreasing voice quality as a result of normal aging, the results of the acoustic analysis of voice in 20 patients with early glottic cancer treated with radiation therapy were compared to the results of 20 age-matched volunteers. The results established worse voice quality in the irradiated group but the difference was not significant except in amplitude perturbation quotient which expresses the instability of loudness. In order to identity the factors which could influence the quality of voice after irradiation of the laryngeal carcinoma, the results of laryngoscopy and the biopsy extension, were correlated with theresults of the perceptive voice evaluation and the results of acoustic voice analysis. No significant influence of the stated factors on the voice quality of the patients was established. Only the irregular glottic gap duringphonation indicated to be connected with very hoarse voice. In conclusion, radiation therapy of early glottic cancer results in an abnormal, but still satisfactory voice quality when compared to the voice quality of normal age-matched speakers. The hoarseness is the results of instability of pitch and specifically the instability of amplitude (loudness). The voice quality after the treatment can be influenced by the tumor extension and localization, the sequels of excisional biopsy, and the radiation therapy or functional disorder. All the stated factors are very intermingled and are probably acting together.
Published in DiRROS: 16.01.2024; Views: 348; Downloads: 76
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