1.Efficacy and Safety of Fat Graft Myringoplasty Combined With Platelet-Rich Plasma for Managing Chronic Tympanic Membrane Perforations: A Systematic Review and Meta-Analysis
Yun Jin KANG ; Gulnaz STYBAYEVA ; Se Hwan HWANG
Clinical and Experimental Otorhinolaryngology 2026;19(1):70-78
Objectives:
Platelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP has been shown to be safe and effective in promoting natural wound healing processes. This study assessed the efficacy of fat graft myringoplasty combined with PRP in tympanic membrane (TM) healing in dry TM perforation due to chronic otitis media and compared it to that of fat graft myringoplasty.
Methods:
A systematic review and meta-analysis of prospective or retrospective studies was conducted, with database searches (PubMed, Cochrane Library, Embase, Web of Science, Scopus, and Google Scholar) performed through April 2025. The outcomes included the success rate (complete closure of the TM postoperatively) and changes in air-bone conduction gap (ABG) (preoperatively and postoperatively) in the audiogram.
Results:
Five studies (n=522) were included. Fat myringoplasty with PRP resulted in greater improvement in ABGs (standardized mean difference [SMD], 0.329; 95% CI, 0.132 to 0.527) and higher success rates (odds ratio [OR], 3.129; 95% CI, 1.882 to 5.203) compared to fat myringoplasty alone. In medium-sized perforations, combination therapy demonstrated superior outcomes in both success rate (OR, 3.179; 95% CI, 1.891 to 5.343) and ABG (SMD, 0.357; 95% CI, 0.128 to 0.586). However, no significant differences were observed in cases involving small and medium-sized perforations (success rate: OR, 2.154; 95% CI, 0.174 to 26.672 and changes in ABG: SMD, 0.249; 95% CI, –0.141 to 0.638). Both liquid and gel PRP significantly improved ABGs and TM closure rates, with no significant difference between types.
Conclusion
This study demonstrated a higher success rate and greater hearing improvement with PRP-assisted fat myringoplasty, especially in medium-sized perforations. Both liquid and gel PRP forms were effective, with no significant difference between them.
2.Efficacy of Montelukast–Antihistamine Combination Therapy Versus Antihistamine Monotherapy in Allergic Rhinitis: A Systematic Review and Meta-Analysis
Ji-Sun KIM ; Gulnaz STYBAYEVA ; Se Hwan HWANG
Clinical and Experimental Otorhinolaryngology 2026;19(2):164-176
Objectives:
. Allergic rhinitis (AR) can substantially compromise daily functioning and well-being, and many patients require more than a single agent to obtain satisfactory symptom control. This study examined whether adding montelukast to antihistamine could manage AR symptoms and quality-of-life outcomes effectively.
Methods:
. A review was performed in PubMed, Embase, Medline, Scopus, the Cochrane Library, and Google Scholar to identify eligible studies reported through April 2025. Eligible studies compared combination therapy with montelukast plus antihistamine against antihistamine monotherapy and reported nasal symptoms or rhinoconjunctivitis quality of life questionnaire (RQLQ) scores. Treatment effects were further examined by antihistamine class.
Results:
. Fifteen studies including 2,882 subjects were analyzed. Combination therapy significantly improved daytime nasal symptoms (standardized mean difference [SMD] [95% CI], 0.44 [0.21–0.67]), nighttime nasal symptoms (0.12 [0.01–0.23]), and RQLQ scores (0.14 [0.00–0.27]) versus monotherapy. Individual nasal or ocular symptoms, sneezing, nasal obstruction, and rhinorrhea improved significantly, while nasal itching and ocular symptoms did not. Combinations with desloratadine and levocetirizine showed greater benefits than those with loratadine or fexofenadine.
Conclusion
. Montelukast–antihistamine combination therapy reduced overall symptoms and improved quality of life versus antihistamine monotherapy. The magnitude of benefit appears to vary depending on the specific antihistamine used, highlighting the possible value of individualized treatment strategies in the treatments of AR.
3.Perinatal Risk Factors for Asthma and Allergic Rhinitis in Children and Adolescents
Se Hwan HWANG ; Hyesoo SHIN ; Gulnaz STYBAYEVA ; Do Hyun KIM
Clinical and Experimental Otorhinolaryngology 2024;17(2):168-176
Objectives:
. In this study, we evaluated the associations between birth-related exposures, postnatal factors, and the risk of allergic rhinitis and asthma in children and adolescents.
Methods:
. We performed a comprehensive search of five literature databases up to May 2023. To quantify the associations of birth-related exposures (birth weight, delivery mode, prematurity, sex, maternal age, and parental allergy history) and postnatal factors (birth order, number of siblings, breastfeeding exclusivity, and breastfeeding duration) with allergic disease, we calculated pooled odds ratios and 95% confidence intervals. We conducted subgroup analyses for allergic disease type, birth order, number of siblings, and parental allergy history. The methodological quality of the identified studies was evaluated using the Newcastle-Ottawa Scale.
Results:
. This meta-analysis included 31 studies, encompassing 218,899 patients in total. The birth-related exposures of low birth weight, maternal age, and prematurity (less than 37 weeks gestation) were not significantly associated with the risk of asthma or allergic rhinitis during childhood or adolescence. Male sex, family history of allergy, and cesarean delivery were linked to an elevated risk of asthma or allergic rhinitis. Among postnatal factors, exclusive breastfeeding, breastfeeding for longer than 6 months, second or later birth order, and having siblings exhibited protective effects against allergic diseases in offspring.
Conclusion
. The risks of allergic rhinitis and asthma were elevated in male patients, those delivered by cesarean section, and those with a family history of allergy. Conversely, exclusive breastfeeding, breastfeeding for longer than 6 months, and having siblings corresponded to a reduced risk of respiratory allergic diseases.
4.Comparative Effectiveness of Cryotherapy and Radiofrequency Ablation for Chronic Rhinitis: A Systematic Review and Meta-analysis
Yun Jin KANG ; Gulnaz STYBAYEVA ; Se Hwan HWANG
Clinical and Experimental Otorhinolaryngology 2023;16(4):369-379
Objectives:
. Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We conducted a systematic review and meta-analysis to evaluate the efficacy of cryotherapy and radiofrequency ablation for alleviating symptoms in patients with allergic and nonallergic rhinitis.
Methods:
. We retrieved studies from PubMed, Scopus, Embase, Web of Science, and Cochrane Database up to July 2023. Data on the impact of cryotherapy and radiofrequency ablation on quality of life and symptom ratings of rhinitis were extracted and evaluated.
Results:
. An analysis of 12 studies involving 788 patients demonstrated significant improvements in quality of life and rhinitis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) in patients treated with cryotherapy or radiofrequency ablation (symptom score at 24 months and quality of life score at 3 months). However, radiofrequency ablation had a more positive effect on nasal symptoms after 3 months than cryotherapy. Nonallergic rhinitis patients responded more favorably to posterior nerve ablation than patients with allergic rhinitis. Both techniques enhanced disease-specific quality of life during the initial 3 months of treatment (cryotherapy, 84.6%; radiofrequency, 81.6%; P=0.564). After 3 months of treatment, a clinical improvement in all nasal symptoms (minimal clinically important difference in the total nasal symptom score: >1.0 points) was seen in 81.8% and 91.9% of patients who underwent cryotherapy and radiofrequency ablation, respectively (P=0.005), suggesting that radiofrequency is more likely to lead to clinical improvement.
Conclusion
. Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy and radiofrequency ablation. Ablation was more efficacious than cryotherapy for nasal symptoms in patients with nonallergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing these two techniques are warranted.
5.Predictive Value of Olfactory and Taste Symptoms in the Diagnosis of COVID-19: A Systematic Review and Meta-Analysis
Do Hyun KIM ; Sung Won KIM ; Gulnaz STYBAYEVA ; So Yun LIM ; Se Hwan HWANG
Clinical and Experimental Otorhinolaryngology 2021;14(3):312-320
Objectives:
. This study evaluated the diagnostic value of various symptoms of coronavirus disease 2019 (COVID-19) in screening for this disease.
Methods:
. Two authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane Database, Embase, Web of Science, Scopus, and Google Scholar) from their dates of inception until November 2020. The predictive value of patient-reported symptoms, including otolaryngologic and general symptoms, was evaluated in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of the included studies was evaluated using the quality assessment of diagnostic accuracy studies tool (ver. 2).
Results:
. Twenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43–12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57; 95% CI, 0.47–0.66) but moderate negative (0.78; 95% CI, 0.69–0.85] and positive (0.78; 95% CI, 0.66–0.87) predictive values and a high specificity (0.91; 95% CI, 0.83–0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms.
Conclusion
. Among otolaryngologic symptoms, olfactory and/or taste dysfunction was the most closely associated with COVID-19 and its general symptoms, and should therefore be considered when screening for the disease.
6.Predictive Value of Olfactory and Taste Symptoms in the Diagnosis of COVID-19: A Systematic Review and Meta-Analysis
Do Hyun KIM ; Sung Won KIM ; Gulnaz STYBAYEVA ; So Yun LIM ; Se Hwan HWANG
Clinical and Experimental Otorhinolaryngology 2021;14(3):312-320
Objectives:
. This study evaluated the diagnostic value of various symptoms of coronavirus disease 2019 (COVID-19) in screening for this disease.
Methods:
. Two authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane Database, Embase, Web of Science, Scopus, and Google Scholar) from their dates of inception until November 2020. The predictive value of patient-reported symptoms, including otolaryngologic and general symptoms, was evaluated in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of the included studies was evaluated using the quality assessment of diagnostic accuracy studies tool (ver. 2).
Results:
. Twenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43–12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57; 95% CI, 0.47–0.66) but moderate negative (0.78; 95% CI, 0.69–0.85] and positive (0.78; 95% CI, 0.66–0.87) predictive values and a high specificity (0.91; 95% CI, 0.83–0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms.
Conclusion
. Among otolaryngologic symptoms, olfactory and/or taste dysfunction was the most closely associated with COVID-19 and its general symptoms, and should therefore be considered when screening for the disease.
7.Prospects and Opportunities for Microsystems and Microfluidic Devices in the Field of Otorhinolaryngology
Se Hwan HWANG ; Alan M. GONZALEZ-SUAREZ ; Gulnaz STYBAYEVA ; Alexander REVZIN
Clinical and Experimental Otorhinolaryngology 2021;14(1):29-42
Microfluidic systems can be used to control picoliter to microliter volumes in ways not possible with other methods of fluid handling. In recent years, the field of microfluidics has grown rapidly, with microfluidic devices offering possibilities to impact biology and medicine. Microfluidic devices populated with human cells have the potential to mimic the physiological functions of tissues and organs in a three-dimensional microenvironment and enable the study of mechanisms of human diseases, drug discovery and the practice of personalized medicine. In the field of otorhinolaryngology, various types of microfluidic systems have already been introduced to study organ physiology, diagnose diseases, and evaluate therapeutic efficacy. Therefore, microfluidic technologies can be implemented at all levels of otorhinolaryngology. This review is intended to promote understanding of microfluidic properties and introduce the recent literature on application of microfluidic-related devices in the field of otorhinolaryngology.

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