Abstract Objectives: Vestibular migraine is a neurological disorder characterized by the association of vertigo and headache, affecting up to 1% of the population. Among its differential diagnoses is endolymphatic hydrops. The aim of this study was to investigate the role of cervical vestibularevoked myogenic potential and electrocochleography in the diagnosis of vestibular migraine. Method: Thirteen women with clinical diagnosis of vestibular migraine (mean age 44 years) and 13 healthy volunteers without auditory and/or vestibular complaints matched for sex and age were evaluated by performing hydrops examinations of cervical vestibular-evoked myogenic potential and electrocochleography. Results: The presence of vertigo and headache was reported by all members of the group with vestibular migraine, associated with symptoms such as nausea, photophobia, and phonophobia. Tinnitus was the most frequent auditory complaint. A significant increase in P1 and N1 latencies was observed in the test group. There was no significant difference in the occurrence of asymmetry and decreased amplitude of the cervical vestibular-evoked myogenic potential. Electrocochleography showed an increase in amplitude of the summation potential. The altered SP/AP ratio was double in the group with vestibular migration, without statistical significance. Conclusions: Changes in latency increase of cervical vestibular-evoked myogenic potential suggests a central lesion. Patients with vestibular migraine may present electrocochleography compatible with endolymphatic hydrops. Level of evidence: Level 4. Objectives 1 population Method mean 4 years andor or evoked Results nausea photophobia phonophobia complaint P N SPAP SP AP migration significance Conclusions lesion evidence

Abstract Objective: To evaluate the ability of the variables Muscle Mass percentage (%MM), Body Fat percentage (%BF), Phase Angle (PhA), and Standardized Phase Angle (SPhA) to predict overall survival rates in individuals with surgically treated HNC. Methods: A prospective cohort study of surgically treated HNC patients was carried out between 2017 and 2022 at a cancer referral center in Feira de Santana, Bahia. All subjects were seen by an experienced dietitian the week before surgery. During this visit, patients had their sociodemographic and clinical data collected, as well as anthropometric measurements (weight and height) and BIA variables. In this study, postoperative overall 5-year survival was defined as the time in months between the date of surgery and the date of death, regardless of the cause of death. Patients were followed up after surgery until death. Results: Seventy-eight older adult patients were consecutively included. Patients had a median age of 65.5-years, were mostly men (83.3%), and most had low education levels (62.3%) and low household income, ranging from zero (19.2%) to the minimum wage (60.2%). They were mostly alcohol drinkers (91%) and tobacco smokers (87.2%). Glottic cancer was diagnosed in 48.7% of patients, with 44.8% of cases with stage-IV disease. Forty (51.2%) deaths were recorded in the follow-up period, with a median survival time of 39 months. Variables %MM, %BF, and SPhA were not significantly different between groups (alive vs. dead patients). PhA was considered an independent predictor of overall survival, with an accuracy of 69% (95% CI 0.57 - 0.80). When comparing survival curves, patients with a preoperative PhA < 6.8° were more than twice as likely to die during follow-up (HR = 2.38; p = 0.02; 95% CI 1.14 - 4.97). Conclusion: Out of the assessed BIA variables, preoperative PhA was considered a good predictor of overall survival after HNC surgery. Level of evidence: 3. Objective MM %MM , (%MM) BF %BF (%BF) PhA, (PhA) (SPhA Methods 201 202 Santana Bahia visit collected weight height 5year year 5 death Results Seventyeight Seventy eight included 65.5years, 655years years 65.5 years, 65 65.5-years 83.3%, 833 83.3% 83 3 (83.3%) 62.3% 623 62 (62.3% income 19.2% 192 19 2 (19.2% 60.2%. 602 60.2% . 60 (60.2%) 91% 91 (91% 87.2%. 872 87.2% 87 (87.2%) 487 48 7 48.7 448 44 8 44.8 stageIV stage IV disease 51.2% 512 51 (51.2% followup follow period alive vs patients. patients) 69 95 (95 057 0 57 0.5 0.80. 080 0.80 80 0.80) curves 68 6 6.8 HR 2.38 238 38 0.02 002 02 114 1 14 1.1 4.97. 497 4.97 4 97 4.97) Conclusion evidence (%MM (%BF (PhA 20 5years 65.5years 655 65. 83.3 (83.3% 62.3 (62.3 19.2 (19.2 60.2 (60.2% 9 (91 87.2 (87.2% 48. 44. 51.2 (51.2 (9 05 0. 08 0.8 6. 2.3 23 0.0 00 11 1. 49 4.9 83. (83.3 62. (62. 19. (19. 60. (60.2 87. (87.2 51. (51. ( 2. 4. (83. (62 (19 (60. (87. (51 (83 (6 (1 (60 (87 (5 (8

Abstract Objectives: Upper respiratory tract infections, including COVID-19, are associated with olfactory dysfunction and there is a need for novel therapeutic approaches. The aim of study was evaluating the effectiveness of adding melatonin, multivitamin and sodium citrate to olfactory training for the treatment of olfactory loss caused by COVID-19. Methods: We evaluated olfactory function using University of Pennsylvania Smell Identification Test (UPSIT ®) scores and self-reported patient outcomes in post-infectious smell loss cases. We investigated the effectiveness involved olfactory training combined with sodium citrate, melatonin, and multivitamin supplements with zinc over a three-month period compared to an olfactory training alone. Results: A total of 66 patients were included, with 33 in each group. There was no significant difference in the proportion of participants who showed improvement in UPSIT scores between the groups (OR=1.43, 95% CI 0.43-4.8, p= 0.56). Both groups showed improvement in average test scores, but there were no significant differences in self-reported olfactory ability or discomfort with olfactory loss. Qualitative symptoms, such as parosmia and phantosmia, were reported by a similar proportion in both groups before and after the treatment (p= 0.11, p = 1, respectively). Conclusions: Olfactory training alone and olfactory training with associated with melatonin, multivitamins and topical sodium citrate did not show significant differences in improving olfactory function in post-COVID-19 patients. Level of evidence: 3. Objectives infections COVID19, COVID19 COVID 19, 19 COVID-19 approaches melatonin COVID19. 19. Methods ® selfreported self postinfectious post infectious cases threemonth three month Results 6 included 3 group OR=1.43, OR143 OR 1 43 (OR=1.43 95 0.434.8, 04348 0.43 4.8, 0 4 8 0.43-4.8 0.56. 056 0.56 . 56 0.56) symptoms phantosmia (p 011 11 0.11 respectively. respectively respectively) Conclusions postCOVID19 postCOVID post-COVID-1 evidence COVID1 COVID-1 OR=1.43 OR14 (OR=1.4 9 434 0.434.8 0434 043 0.4 48 4.8 0.43-4. 05 0.5 5 01 0.1 postCOVID1 post-COVID- COVID- OR=1.4 OR1 (OR=1. 0.434. 04 0. 4. 0.43-4 post-COVID OR=1. (OR=1 0.434 0.43- OR=1 (OR= OR= (OR

Abstract Objectives: To determine whether routinary walking activity and the derived neutrophil-to-lymphocyte ratio are associated with outcomes in patients with recurrent and/or metastatic squamous cell carcinoma of head and neck. Methods: This multicenter retrospective cohort study included 64 patients diagnosed with recurrent and/or metastatic squamous cell carcinoma of head and neck and treated with immunotherapy (Programmed Death-1 and Programmed Death-ligand-1 proteins inhibitors) at two tertiary centers. We compared a group that performed uninterrupted physical activity for 1 h per day and controls who performed no activity. The derived neutrophil-to-lymphocyte ratio was calculated as follows: [neutrophils / (leukocytes - neutrophils)]. Progression-free survival and overall survival were evaluated. Results: We included 28 (44%) and 36 (56%) patients in the activity and non-activity groups, respectively. Patient characteristics, treatment details, and tumor Programmed Death-ligand-1 expression were not associated with either progression-free survival or overall survival. Physical activity was an independent beneficial factor for progression-free survival (p < 0.001) and overall survival (p <0.001). By contrast, a derived neutrophil-to-lymphocyte ratio < 3.5 was an independent beneficial factor for overall survival (p = 0.013), but not for progression-free survival (p = 0.328). Conclusions: Walking one hour per day and having a high proportion of lymphocytes to neutrophiles (expressed as a low derived neutrophil-to-lymphocyte ratio) independently predict a better prognosis in patients with recurrent and/or metastatic squamous cell carcinoma of head and neck treated with immunotherapy. Level of evidence: III. Objectives neutrophiltolymphocyte neutrophil lymphocyte andor Methods 6 Death1 Death Death- Deathligand1 Deathligand ligand Death-ligand- inhibitors centers follows neutrophils leukocytes neutrophils. . neutrophils)] Progressionfree Progression free evaluated Results 2 44% 44 (44% 3 56% 56 (56% nonactivity non groups respectively characteristics details progressionfree progression p 0.001 0001 0 001 <0.001. <0.001 <0.001) contrast 35 5 3. 0.013, 0013 0.013 , 013 0.013) 0.328. 0328 0.328 328 0.328) Conclusions expressed evidence III Death-ligand neutrophils) 4 (44 (56 0.00 000 00 <0.00 0.01 01 032 0.32 32 (4 (5 0.0 <0.0 03 0.3 ( 0. <0. <0

Abstract Objectives: One of the most common sensory impairments in the elderly is age-related hearing loss, and individuals with this condition have a higher risk of mild cognitive impairment than the overall aged population. The purpose of this study was to conduct a systematic review of the literature in order to evaluate the evidence supporting the hypothesis that mild cognitive impairment may be developed in patients with age-related hearing loss. Methods: The PRISMA principles were followed when searching the databases of the China Knowledge Network, Wanfang, China Biomedical Literature Database, Pub Med, Cochrane Library, Embase, and Web of Science. Tw o investigators independently carried out the quality assessment, data extraction, and literature review of the eligible studies. Stata 17.0 was used to finish the statistical analysis and descriptive results. Results: A total of 13 articles containing 2,222,036 individuals who were evaluated for demographic traits, factors associated with age-related hearing loss, vascular neurologic factors, and psychological factors were included after 2166 search records were found in the database. In patients with age-related hearing loss, eleven factors were found to be risk factors for the development of mild cognitive impairment: age (OR=1.63; 95% CI 1.09 -2.43), male (OR=1.29; 95% CI 1.14 -1.47), degree of hearing loss (OR=1.35; 95% CI 1.03-1.75), not wearing hearing aids (OR=1.56; 95% CI 1.37-1.79), cerebrovascular disease (OR=1.41; 95% CI 1.17-1.69), cardiovascular disease (OR = 1.29; 95% CI 1.07-1.55), diabetes mellitus (OR = 1.28; 95% CI 1.20-1.35), head injury (OR= 1.22; 95% CI 1.13-1.33), alcohol consumption (OR=1.28; 95% CI 1.14-1.43), and tobacco use (OR= 1.19; 95% CI 1.14-1.25), and depression (OR= 1.63; 95% CI 1.47-1.81). Conclusion: Caregivers can customize care strategies to decrease the occurrence of mild cognitive impairment in elderly deaf patients by considering demographic traits, factors associated with age-related hearing loss, vascular-neurologic factors, and psychological factors. Objectives agerelated related population Methods Network Wanfang Database Med Library Embase Science assessment extraction studies 170 17 0 17. results Results 1 2222036 2 222 036 2,222,03 traits 216 database OR=1.63 OR163 OR 63 (OR=1.63 95 109 09 1.0 2.43, 243 2.43 , 43 -2.43) OR=1.29 OR129 29 (OR=1.29 114 14 1.1 1.47, 147 1.47 47 -1.47) OR=1.35 OR135 35 (OR=1.35 1.031.75, 103175 1.03 1.75 03 75 1.03-1.75) OR=1.56 OR156 56 (OR=1.56 1.371.79, 137179 1.37 1.79 37 79 1.37-1.79) OR=1.41 OR141 41 (OR=1.41 1.171.69, 117169 1.17 1.69 69 1.17-1.69) 1.29 129 1.071.55, 107155 1.07 1.55 07 55 1.07-1.55) 1.28 128 28 1.201.35, 120135 1.20 1.35 20 1.20-1.35) OR= 1.22 122 22 1.131.33, 113133 1.13 1.33 33 1.13-1.33) OR=1.28 OR128 (OR=1.28 1.141.43, 114143 1.43 1.14-1.43) 1.19 119 19 1.141.25, 114125 1.25 25 1.14-1.25) 1.63 163 1.471.81. 147181 1.81 . 81 1.47-1.81) Conclusion vascularneurologic 222203 2,222,0 21 OR=1.6 OR16 6 (OR=1.6 9 10 1. 24 2.4 4 -2.43 OR=1.2 OR12 (OR=1.2 11 1.4 -1.47 OR=1.3 OR13 3 (OR=1.3 031 1.031.75 10317 103 175 1.7 7 1.03-1.75 OR=1.5 OR15 5 (OR=1.5 371 1.371.79 13717 137 1.3 179 1.37-1.79 OR=1.4 OR14 (OR=1.4 171 1.171.69 11716 117 169 1.6 1.17-1.69 1.2 12 071 1.071.55 10715 107 155 1.5 1.07-1.55 201 1.201.35 12013 120 135 1.20-1.35 131 1.131.33 11313 113 133 1.13-1.33 141 1.141.43 11414 143 1.14-1.43 1.141.25 11412 125 1.14-1.25 16 471 1.471.81 14718 181 1.8 8 1.47-1.81 22220 2,222, OR=1. OR1 (OR=1. 2. -2.4 -1.4 1.031.7 1031 1.03-1.7 1.371.7 1371 1.37-1.7 1.171.6 1171 1.17-1.6 1.071.5 1071 15 1.07-1.5 1.201.3 1201 1.20-1.3 1.131.3 1131 1.13-1.3 1.141.4 1141 1.14-1.4 1.141.2 1.14-1.2 1.471.8 1471 18 1.47-1.8 2222 2,222 OR=1 (OR=1 -2. -1. 1.031. 1.03-1. 1.371. 1.37-1. 1.171. 1.17-1. 1.071. 1.07-1. 1.201. 1.20-1. 1.131. 1.13-1. 1.141. 1.14-1. 1.471. 1.47-1. 2,22 -2 -1 1.031 1.03-1 1.371 1.37-1 1.171 1.17-1 1.071 1.07-1 1.201 1.20-1 1.131 1.13-1 1.141 1.14-1 1.471 1.47-1 2,2 - 1.03- 1.37- 1.17- 1.07- 1.20- 1.13- 1.14- 1.47- 2,

Abstract Objective: To translate and validate the Facial Feminization Surgery Outcomes Evaluation in Brazilian Portuguese. Methods: A standard back-translation method was applied to obtain the final Brazilian Portuguese language version. In total, 21 Brazilian native Portuguese speakers transgender women with surgical intent and 21 Brazilian native Portuguese speakers transgender women without surgical intent were included in the study. The FFSOE was administered to both groups and all patients underwent a test-retest two weeks later. Results: The FFSOE showed a high internal consistency with Cronbach’s alpha greater than 0.8. The test-retest reliability was high with repeated measures being highly correlated in all items, except for item 3, where the difference was significant (p = 0.027). Conclusion: The FFSOE showed reliability, internal consistency and reproducibility in the evaluations. It is easy to understand and quick to apply, making it a simple tool for pre- and post-operative assessment in facial feminization surgeries. The Oxford 2011 Levels of Evidence: Level 4. Objective Methods backtranslation back translation version total 2 study testretest test retest later Results Cronbachs Cronbach s 08 0 8 0.8 items 3 p 0.027. 0027 0.027 . 027 0.027) Conclusion evaluations apply pre postoperative post operative surgeries 201 Evidence 4 0. 002 0.02 02 20 00 0.0

Abstract Objective: To analyze the Benefit of Modulated Masking (BMM) on hearing in young, adult and elderly normal-hearing individuals. Methods: The sample included 60 normal-hearing individuals aged 18-75 years who underwent behavioral assessment (sentence recognition test in the presence of steady and modulated noise) and electrophysiological assessment (cortical Auditory Evoked Potential) to investigate BMM. The results were analyzed comparatively using the paired t-test and ANOVA for repeated measures, followed by the Bonferroni post-hoc test (p-value < 0.05). Results: A decrease in latencies and an increase in amplitudes of cortical components (P1-N1-P2) was observed due to noise modulation in all age groups. Modulated noise generated better auditory threshold responses (electrophysiological and behavioral), compared to steady noise. The elderly presented a higher threshold in both hearing domains, compared to the other participants, as well as a lower BMM magnitude. Conclusion: It was possible to conclude that the modulated noise generated less interference in the magnitude of the neural response (smaller latencies) and in the neural processing time (larger amplitudes) for the speech stimulus in all participants. The higher auditory thresholds (electrophysiological and behavioral) and the lower BMM magnitude observed in the elderly group, even in the face of noise modulation, suggest a lower temporal auditory performance in this population, and may indicate a deficit in the temporal resolution capacity, associated with the process of aging. Level of evidence: 3. Objective (BMM young normalhearing normal Methods 6 1875 18 75 18-7 sentence Potential ttest t measures posthoc post hoc pvalue p value 0.05. 005 0.05 . 0 05 0.05) Results P1N1P2 PNP P1 N1 P2 P N (P1-N1-P2 groups behavioral, , domains participants Conclusion smaller larger group population capacity aging evidence 3 187 1 7 18- 00 0.0 P1N1P (P1-N1-P 0.

Abstract Objectives: Allergic diseases and Meniere’s disease found to have a possible link in observational study. However, the potential causal relationship between the two is unclear. Therefore, we aimed to explore the causal relationship between allergic diseases and Meniere’s disease using a new data analysis technique called bidirectional Mendelian randomization study. Method: Summary-level statistics for Meniere’s disease and three allergic diseases (asthma, allergic rhinitis, eczema/dermatitis) were obtained from large-scale genome-wide association studies. The inverse variance weighted method was used as the primary measure, supplemented by MR-Egger regression and the weighted median method. To ensure the reliability of the conclusions, Cochran’s Q, MR-Egger intercept, MR-PRESSO test, leave-one-out test, and MR Steiger test were used. Results: Inverse-variance weighted method showed asthma (p = 0.008, OR = 3.908, 95% CI 1.424 − 10.724, adjust p = 0.024), allergic rhinitis (p = 0.026, OR = 24.714, 95% CI 1.479 − 412.827, adjust_p = 0.026) and eczema/dermatitis (p = 0.019, OR = 3725.954, 95% CI 3.795 to 3,658,399.580, adjust_p = 0.029) all had a significant effect on Meniere’s disease. Reverse Mendelian randomization studies have shown that Meniere’s disease does not increase the risk of three allergic diseases. Sensitivity analysis showed no horizontal pleiotropy and heterogeneity for each trait. Conclusion: Our Mendelian randomization analysis supports a positive causal relationship between three allergic diseases (asthma, allergic rhinitis, eczema/dermatitis) and Meniere’s disease. This suggests that physicians should pay more attention to the Meniere’s patient’s allergy history and consider allergy avoidance as part of their treatment plan. Level of evidence: Mendelian Randomized (MR) studies are second only to randomized controlled trials in terms of the level of evidence. Objectives Menieres Meniere s study However unclear Therefore Method Summarylevel Summary asthma, (asthma eczemadermatitis eczema dermatitis largescale large scale genomewide genome wide measure MREgger Egger conclusions Cochrans Cochran Q intercept MRPRESSO PRESSO leaveoneout leave one out Results Inversevariance Inverse 0008 0 008 0.008 3908 3 908 3.908 95 1424 1 424 1.42 10724 10 724 10.724 0.024, 0024 0.024 , 024 0.024) 0026 026 0.026 24714 24 714 24.714 1479 479 1.47 412827 412 827 412.827 adjustp 0019 019 0.019 3725954 3725 954 3725.954 3795 795 3.79 3658399580 658 399 580 3,658,399.580 0.029 0029 029 trait Conclusion patients patient plan evidence (MR 000 00 0.00 390 90 3.90 9 142 42 1.4 1072 72 10.72 002 0.02 02 2471 2 71 24.71 147 47 41282 41 82 412.82 001 01 0.01 372595 372 3725.95 379 79 3.7 365839958 65 39 58 3,658,399.58 0.0 3.9 14 4 1. 107 7 10.7 247 24.7 4128 8 412.8 37259 37 3725.9 3. 36583995 6 5 3,658,399.5 0. 10. 24. 412. 3725. 3658399 3,658,399. 365839 3,658,399 36583 3,658,39 3658 3,658,3 365 3,658, 36 3,658 3,65 3,6 3,

Abstract Objective: To investigate the efficacy of cluster nursing intervention based on Enhanced Recovery After Surgery (ERAS) for xerostomia in chronic rhinosinusitis after nasal endoscopic surgery. Methods: A total of 80 patients with chronic rhinosinusitis who underwent functional nasal endoscopic surgery between January 2020 and December 2021 were selected and randomly divided into a control group (n = 40) and an experimental group (n = 40). Patients in the control group were treated with general nursing, while ERAS-based cluster nursing intervention was adopted for the experimental group, in addition to general nursing. Xerostomia stage and comfort level were observed at 2h, 6h, 24h and 48h after surgery; negative emotions before and after nursing were also observed. Results: After the intervention, the xerostomia stage and comfort level at 6, 24 and 48 after surgery were higher in the experimental group (p < 0.05). Negative emotions in the experimental group were lower after nursing (p < 0.001). The self-rating depression scale and self-rating anxiety scale scores increased after nursing in both two groups (p < 0.05). Conclusion: Enhanced recovery after surgery-based cluster nursing intervention can alleviate xerostomia, improve patients’ comfort levels, reduce their negative emotions and accelerate postoperative recovery. Level of evidence: 2. Objective ERAS (ERAS Methods 8 202 n 40 40. . ERASbased 2h h 6h Results 6 2 4 p 0.05. 005 0.05 0 05 0.05) 0.001. 0001 0.001 001 0.001) selfrating self rating Conclusion surgerybased levels evidence 20 00 0.0 000 0.00 0.

Abstract Objective: To describe pulmonary function, muscle strength and functional performance in the different qualities of sleep and the impact of this on the number of physiotherapeutic assistances. Methods: This is an observational study. In the pre and post operative period, sleep behavior was evaluated using the Pittsburgh questionnaire. Patients were divided into three groups: Good Sleep Quality (GSQ), Poor Sleep Quality (PSQ) and Sleep Disordered (SDB). At this time, other tests were also performed, such as: 6-Minute Walk Test (6MWT), Sit and Stand Test (SST), gait speed test and Timed Up to Go (TUG), Medical Research Council (MRC), maximal inspiratory pressure and maximal expiratory, vital capacity and peak expiratory flow. The functional performance and lung function of each group were compared. Results: A total of 105 people, undergoing cardiac surgery and admitted to hospital were evaluated, 33 with GSQ, 41 with PSQ and 31 with SD. Patients who were in the SDB group had a lower functional performance than the other groups. 6MWT (meters) in the GSQ was 499±87, versus 487±91 in the PSQ and 430±78 in the SD (p = 0.02). In the SST (seconds) it was 10.4±1.1 in the GQS, 11.1±2.3 in the PSQ and 15.4±2.1 in the SD (p = 0.04). Lung function and muscle strength did not differ between groups. Regarding the refusal to perform physical therapy, the SD group was more incident, the main reason being drowsiness. Conclusion: Based on the results, we found that sleep quality interferes with functional performance and physical therapy assistance during the hospital stay in patients undergoing cardiac surgery. Objective assistances Methods study period questionnaire groups , (GSQ) (PSQ SDB. . (SDB) time performed as 6Minute Minute 6 6MWT, MWT (6MWT) SST, (SST) TUG, TUG (TUG) MRC, MRC (MRC) flow compared Results 10 people 3 4 meters (meters 49987 499 87 499±87 48791 487 91 487±9 43078 430 78 430±7 p 0.02. 002 0.02 0 02 0.02) seconds (seconds 10411 1 10.4±1. GQS 11123 11 2 11.1±2. 15421 15 15.4±2. 0.04. 004 0.04 04 0.04) incident drowsiness Conclusion results (GSQ (SDB (6MWT (SST (TUG (MRC 4998 49 8 499±8 4879 48 9 487± 4307 43 7 430± 00 0.0 1041 10.4±1 1112 11.1±2 1542 15.4±2 499± 0. 104 10.4± 111 11.1± 154 15.4± 10.4 11.1 15.4 10. 11. 15.

Abstract Objectives: This study aims to review the current role of various ultrasonographic methods in the evaluation of the upper airway in patients with obstructive sleep apnea. Methods: A literature review was performed on the medical databases: Pubmed, Web of Science, Scopus and Embase. After analyzing the available studies, six of them were selected for data extraction. Results: All selected studies demonstrated that it is possible to use ultrasonography as a method of evaluating the upper airway. Studies with gray-scale ultrasound concluded that the lateral pharyngeal wall and tongue are thicker in patients with obstructive sleep apnea compared to non-apneic patients. Moreover, studies with tissue characterization ultrasound, nowadays called quantitative ultrasound, have identified unique features in obstructive sleep apnea patients: standardized backscatter ultrasonography demonstrated that this particular sound wave analysis is associated with the severity of obstructive sleep apnea. Ultrasonography with elastography shows that the electrical stimulus generated in the hypoglossal nerve results in greater stiffness on the side of the tongue that is stimulated; whereas studies show conflicting results regarding the evaluation of baseline tongue stiffness in obstructive sleep apnea patients compared to non-apneic subjects. Conclusion: There is feasibility of different methods of ultrasonographic evaluation of the upper airway, with emphasis on ultrasonographic methods of tissue characterization, such as elastography, which proved to be a promising method of evaluating the mechanical properties of the muscles involved in the pathogenesis of obstructive sleep apnea and which require further studies for a better elucidation of its applicability. Objectives Methods databases Pubmed Science Embase extraction Results grayscale gray scale nonapneic non apneic Moreover stimulated subjects Conclusion applicability

Abstract Objective: This study aimed to investigate the potential reduction of cardiovascular stress response caused by suspension laryngoscopic surgery through the application of lidocaine spray on the larynx and trachea. Methods: A total of 68 patients scheduled for elective suspension laryngoscopic surgery were randomly assigned to either the lidocaine group (Group L, n = 34) or the control group (Group C, n = 33). In Group L, patients received a sprayed lidocaine dose of 2mg/kg on the larynx and trachea after anesthesia induction, prior to intubation. In Group C, equal volumes of saline solution were administered. MAP and HR were recorded at various time points: before anesthesia (T0), 1-minute after intubation (T1), 1 and 3min after suspension laryngoscopy (T2 and T3), at the end of the operation (T4), and at 1, 5, and 30min after extubation (T5, T6, and T7). Arterial blood glucose, epinephrine, and norepinephrine levels were measured at T0, T2, T5, and T7. The occurrence of severe cough and sore throat at T6 and T7 after extubation was compared between the two groups. Results: At T0 and T1, there were no statistically significant differences in mean arterial pressures, heart rate, and blood catecholamine levels between the two groups. However, from T2 to T7, the blood pressure and heart rate in Group L were lower compared to Group C, with significant differences observed at T2-T6 (p < 0.05). Group L also showed less elevation in blood glucose at T2, T5, and T7 (p < 0.05). The changes in epinephrine and norepinephrine levels between the two groups were statistically significant at T2 and T5 (p < 0.05). Conclusions: Administering lidocaine spray on the larynx and trachea during intubation for suspension laryngoscopic surgery can effectively alleviate the stress response. Level 1 evidence: Patients in this study are randomly assigned to the treatment or control group and are followed prospectively. Objective Methods 6 34 C 33. 33 . 33) 2mgkg mgkg 2mg kg mg induction administered points T , (T0) 1minute minute T1 (T1) min (T T3, T3 T3) T4, T4 (T4) 5 (T5 T7) Results pressures However T2T6 TT T2-T p 0.05. 005 0.05 0 05 0.05) Conclusions evidence prospectively 3 (T0 (T1 (T4 T2T 00 0.0 0.