Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Evaluation of Fine Structure Coding in New Cochlear Implant Users with Tonotopic Fitting: a Prospective, Randomized, Double-Blind, Cross-Over Study.","authors":"Creff Gwenaelle, Bernard-LE Liboux Nicolas, Bourdon Hermine, Pean Vincent, Nicolas Wallaert, Tisserand Raphael, Godey Benoit","doi":"10.21053/ceo.2026-00039","DOIUrl":"https://doi.org/10.21053/ceo.2026-00039","url":null,"abstract":"<p><strong>Objectives.: </strong>Several studies have demonstrated the benefits of tonotopic fitting on speech-in-noise perception in new cochlear implant (CI) users. However, these studies used different coding strategies (CIS, HDCIS, FSP, FS4, or mixed) with different frequency spectra. The aim of this study was to assess the impact of fine structure (FS) cues on speech perception in noise and in quiet and music perception, in new CI users with a tonotopic fitting map.</p><p><strong>Methods.: </strong>A prospective, randomized, double-blind, 2-period crossover study was performed from April 2023 to June 2024. All participants had tonotopic fitting determined by using flat-panel computed tomography (CT) and reconstruction software based on the Greenwood function. 24 new CI users aged 18 years or older with either bilateral severe-to-profound sensorineural hearing loss or complete hearing loss for less than 5 years were recruited at a single tertiary referral center. Participants were randomized to FS followed by conventional coding, or the reverse sequence, for 6-week periods with speech and music assessments after each period.</p><p><strong>Results.: </strong>FS cues significantly improved speech recognition in noise for high signal-to-noise ratio (SNR = +9 dB, Mean Effect (ME) = 6.0%, Standardized effect size (SES) = 0.62, p = 0.010). A period effect was observed beyond + 6 dB of SNR (SNR = +9 dB, p = 0.010; SNR = +6 dB, p = 0.018) without a statistically significant group effect. Speech recognition and tonal audiometry in quiet were not affected by FS coding. Melodic contour identification was enhanced by FS cues (ME = 7.2%, SES = 0.51, p = 0.030), and, in an exploratory subset analysis, low-frequency pitch discrimination was also improved (ME = 8.5 Hz, SES = 0.72, p = 0.04). Over 75% of the participants retained the tonotopic map with FS coding after study completion.</p><p><strong>Conclusion.: </strong>FS coding strategies on tonotopic maps may improve speech recognition in noise at favorable SNRs, without compromising speech understanding in quiet. It may also enhance selected complex sound perception aspects, particularly pitch- and contour-related processing, while benefits for subjective music perception appear less consistent.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Practice Guidelines for the Diagnosis and Management of Pediatric Voice Disorders from the Korean Society of Laryngology, Phoniatrics and Logopedics Guideline Task Force.","authors":"Yong Tae Hong, Younmi Ryu, Ji Won Kim, Sung Joon Park, Seung Jin Lee, Min-Su Kim, Gil Joon Lee, Dong Kun Lee, Myung Jin Ban, Soo-Youn An, Hyung Kwon Byeon, Taek Kyun Kwon, Chang Hwan Ryu","doi":"10.21053/ceo.2026-00099","DOIUrl":"https://doi.org/10.21053/ceo.2026-00099","url":null,"abstract":"<p><p>Pediatric voice disorders are common conditions that may significantly affect communication, psychosocial development, and quality of life in children. Despite their clinical importance, considerable variation exists in diagnostic approaches and treatment strategies, partly due to difficulties in performing invasive examinations and limited high-quality evidence. To address these challenges, the Korean Society of Laryngology, Phoniatrics and Logopedics developed evidence-based clinical practice guidelines for the diagnosis and management of pediatric voice disorders. These guidelines were developed de novo through a systematic literature review addressing predefined key clinical questions related to pediatric vocal fold mucosal lesions and vocal fold paralysis. Searches were conducted in Medline, Embase, the Cochrane Library, and KoreaMed for studies published up to May 31, 2025. Evidence was critically appraised using standardized tools according to study design, and the certainty of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Recommendations were formulated by considering the balance of benefits and harms, quality of evidence, patient values and preferences, clinical feasibility, and resource implications. A total of nine key clinical questions were addressed, covering diagnostic strategies, voice assessment, noninvasive imaging, voice therapy, surgical intervention, and postoperative management in children with voice disorders. Most recommendations were conditional due to low or very low certainty of evidence, reflecting current limitations in pediatric voice research. These guidelines aim to support consistent, patient-centered clinical decision-making, reduce unwarranted practice variation, and promote optimal outcomes in the care of children with voice disorders.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tinnitus Practice Patterns in Korean University Hospitals: Findings from a 2025 Nationwide Survey and Comparison with 2013.","authors":"Jeon Mi Lee, Ho Yun Lee, In Seok Moon","doi":"10.21053/ceo.2026-00159","DOIUrl":"https://doi.org/10.21053/ceo.2026-00159","url":null,"abstract":"<p><strong>Objectives.: </strong>A 2013 nationwide survey described tinnitus management in Korean university hospitals. Since then, conceptual frameworks have broadened, and new therapies have emerged. We aimed to investigate tinnitus practice patterns among Korean university hospital otologists in 2025 and compared them with the findings in 2013.</p><p><strong>Methods.: </strong>A cross-sectional electronic survey was distributed in October 2025 to otologists registered with the Tinnitus Study Group of the Korean Otologic Society. We assessed classification, diagnostic work-up, treatment strategies, hearing-aid fitting, and perceived barriers. Comparisons with 2013 used a predefined item-level mapping; formal hypothesis testing was not performed because individual-level 2013 data were unavailable and several items were not directly comparable.</p><p><strong>Results.: </strong>Thirty-four otologists from 28 of 45 university hospitals responded. Compared with 2013, 2025 practice more often involved broader classification, psychological assessment, and structured questionnaires. Pharmacotherapy, tinnitus retraining therapy, and hearing-aid-based rehabilitation remained the main treatments. Cognitive behavioral therapy-related approaches, digital therapeutics, and neuromodulation were more widely represented but showed limited routine use. Auditory rehabilitation expanded to include CROS/BiCROS and cochlear implantation. Barriers included a lack of effective treatments, online misinformation, unrealistic expectations, and reimbursement limitations.</p><p><strong>Conclusion.: </strong>: Korean university hospital tinnitus care appears more structured and diversified than in 2013, emphasizing psychological assessment and auditory rehabilitation. However, universal pharmacotherapy, frequent intratympanic steroid use, heterogeneous minimal clinically important difference criteria, low real-ear measurement adoption, and limited routine use of newer modalities indicate persistent evidence-practice and outcome-standardization gaps. These findings underscore the need for stronger evidence, standardized outcomes, and health-system support for patient-centered care.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Cochlear Implantation for Single-Sided Deafness and Asymmetric Hearing Loss: Quality of Life, Tinnitus, and the Effect of Deafness Duration.","authors":"Yujin Heo, Young Sang Cho, Il Joon Moon","doi":"10.21053/ceo.2026-00144","DOIUrl":"https://doi.org/10.21053/ceo.2026-00144","url":null,"abstract":"<p><strong>Objectives.: </strong>To evaluate multidimensional outcomes of cochlear implantation (CI) in adults with single-sided deafness (SSD) or asymmetric hearing loss (AHL), and to examine how duration of deafness influences speech perception, tinnitus severity, and hearing-related quality of life.</p><p><strong>Methods.: </strong>This retrospective cohort study included 124 adults with SSD or AHL who underwent unilateral CI at a tertiary referral center (September 2019-October 2024) with at least 12 months of postoperative follow-up. The primary outcome, hearing-related quality of life, was assessed using the Speech, Spatial, and Qualities of Hearing Scale (SSQ); secondary outcomes included the Hearing Handicap Inventory for the Elderly (HHIE), Tinnitus Handicap Inventory (THI), Short Form-36 (SF-36), and open-set speech perception (n = 61). The association between duration of deafness and postoperative outcomes was evaluated using duration as a continuous predictor in linear regression.</p><p><strong>Results.: </strong>Significant postoperative improvements occurred in SSQ Speech (+0.97; d = 0.53; p < 0.001) and Spatial domains (+1.60; d = 0.88; p < 0.001), HHIE (- 13.0; d = 0.50; p < 0.001), THI (-15.8; d = 0.61; p < 0.001), and SF-36 (+4.2; d = 0.27; p = 0.031). Speech perception improved markedly under CI-only conditions (monosyllabic d = 1.98; bisyllabic d = 2.92; sentence recognition d = 3.59). Longer duration of deafness was significantly associated with smaller THI improvement (β = 1.13 points/year, 95% CI 0.43-1.84; p = 0.002; adjusted β = 0.98, 95% CI 0.18-1.78; p = 0.017), whereas quality-of-life and sentence recognition outcomes were not associated with deafness duration.</p><p><strong>Conclusion.: </strong>Unilateral CI produces clinically meaningful improvements in hearingrelated quality of life, tinnitus severity, hearing handicap, and speech perception in adults with SSD and AHL. Quality-of-life and speech outcomes were preserved regardless of deafness duration, whereas tinnitus suppression declined with increasing deaf duration. These findings support earlier CI for candidates with bothersome tinnitus.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of core needle biopsy versus fine-needle aspiration cytology in salivary gland malignancies: A systematic review and metaanalysis.","authors":"Jeong-Yeon Ji, Yeong Joon Kim, Sungryeal Kim, Hyunbum Kim, Minhyung Lee, Yong-Il Cheon, Jeon Yeob Jang, Soon-Hyun Ahn, Hanaro Park, Sung-Chan Shin","doi":"10.21053/ceo.2026-00178","DOIUrl":"https://doi.org/10.21053/ceo.2026-00178","url":null,"abstract":"<p><strong>Objectives.: </strong>Accurate preoperative differentiation of salivary gland malignancies is critical for surgical planning. This study aimed to perform an updated systematic review and meta-analysis comparing the diagnostic accuracy of ultrasound-guided core needle biopsy (CNB) and fine-needle aspiration cytology (FNAC) in detecting salivary gland malignancies.</p><p><strong>Methods.: </strong>A systematic search of electronic databases (MEDLINE, Embase, and the Cochrane Library) was conducted to update a foundational review. Studies comparing the diagnostic accuracy of CNB and FNAC for salivary gland tumors, with definitive surgical histopathology as the reference standard, were included. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-Comparative (QUADAS-C) tool. Pooled sensitivity, specificity, and diagnostic odds ratios (DOR) were estimated using random-effects models. A bivariate random-effects model was used to construct summary receiver operating characteristic (SROC) curves.</p><p><strong>Results.: </strong>Ten studies comprising 3,902 procedures (2,064 FNAC and 1,838 CNB) were included. The pooled sensitivity of CNB (0.905 [95% CI, 0.874-0.936]; I2 = 0.0%) was higher than that of FNAC (0.601 [95% CI, 0.526-0.676]; I2 = 42.7%). Pooled specificity was comparably high for both modalities (CNB: 0.979 [95% CI, 0.958-1.000]; I2 = 82.9%; FNAC: 0.970 [95% CI, 0.954-0.985], I2 = 66.6%). The pooled DOR for CNB was higher than that for FNAC (492.468 vs. 42.624). The area under the SROC curve was also higher for CNB than for FNAC (0.903 vs. 0.865). The QUADAS-C assessment indicated predominantly low risk in the comparative index-test domain, with no high-risk judgements in any domain.</p><p><strong>Conclusion.: </strong>Ultrasound-guided CNB demonstrates higher pooled sensitivity than FNAC, while both modalities showed high pooled specificity. Given this higher sensitivity for detecting malignancies, CNB may be considered a preferred diagnostic option within a risk-adapted approach to salivary gland cancer management, especially when malignancy is clinically suspected.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148905161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spatiotemporal Remodeling of the Tumor-Draining Lymph Node Microenvironment During Head and Neck Cancer Metastasis.","authors":"Hye Ran Lee, Jiyeon Lee, Chorong Seo, Yoo Seob Shin, Chul-Ho Kim, Jeon Yeob Jang","doi":"10.21053/ceo.2026-00186","DOIUrl":"https://doi.org/10.21053/ceo.2026-00186","url":null,"abstract":"<p><strong>Objectives.: </strong>The spatiotemporal evolution of the tumor-draining lymph node microenvironment remains incompletely characterized in head and neck squamous cell carcinoma (HNSCC). Using a reproducible buccal xenograft model with serial time-point and spatial analyses, we aimed to define stage-and region-resolved microenvironmental remodeling during cervical lymph node metastasis.</p><p><strong>Methods.: </strong>A buccal xenograft model of cervical lymph node metastasis was used, and tumor-draining lymph nodes were analyzed at serial time points using immunofluorescence staining and confocal microscopy. The lymphovascular architecture, stromal remodeling, hypoxia, and immune cell distribution were evaluated during metastatic progression.</p><p><strong>Results.: </strong>The model reproducibly induced cervical lymph node metastasis with a gradual temporal progression. Before overt tumor colonization, tumor-draining lymph nodes showed features of a pre-metastatic niche, including expansion of LYVE-1⁺ lymphatic vessels, remodeling of high endothelial venules, and increased recruitment of CD11b⁺ myeloid cells and F4/80⁺ macrophages. Confocal imaging revealed that the tumor cells were initially localized within the subcapsular sinus lymphatic vessels and subsequently expanded into the lymph node parenchyma. During invasive progression, metastatic regions showed progressive loss of CD31⁺ blood vessels and LYVE-1⁺ lymphatic vessels, accompanied by GLUT1 upregulation, fibrinogen deposition, disruption of PDGFRβ⁺ fibroreticular networks, and spatially organized myeloid cell accumulation at the invasive front.</p><p><strong>Conclusion.: </strong>This study delineated a stage- and region-resolved sequence of nodal microenvironmental remodeling during HNSCC metastasis, linking premetastatic lymphovascular changes to intralymphatic tumor colonization and subsequent invasive regional remodeling. These findings provide an integrated spatiotemporal framework for understanding the progression of the metastatic lymph node microenvironment.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non‑thermal plasma activated media induces ferroptosis in head and neck cancer through HMOX1‑mediated iron accumulation.","authors":"Quoc Khanh Nguyen, Seung-Nam Jung, Shuyu Piao, Mi Ae Lim, Sicong Zheng, Shan Shen, Shengzhe Cui, Doh Hoon Kim, Chaehyeon Park, Bin Wen, Ji Won Kim, Jae Won Chang, Young Il Kim, Bon Seok Koo","doi":"10.21053/ceo.2026-00124","DOIUrl":"https://doi.org/10.21053/ceo.2026-00124","url":null,"abstract":"<p><strong>Objectives.: </strong>To investigate the anticancer mechanisms of non-thermal plasma activated media (NTPAM) treatment in head and neck cancer (HNC) cells, with a focus on its role in oxidative stress and ferroptosis induction.</p><p><strong>Methods.: </strong>4 HNC cell lines were treated with NTPAM, and cell sequencing data were analyzed revealed Ferroptosis as a potential cell death pathway. Intracellular ferrous iron (Fe²⁺) levels, Ferroptosis markers, and gene expression of HMOX1 and NRF2 were measured in vitro on FADU and SNU1041 cell lines. RNA silencing of HMOX1 and NRF2 were performed to assess their roles in NTP - induced ferroptosis. In vivo tumor models were examined for intra-tumor Fe²⁺ accumulation and HMOX1 expression following NTPAM treatment.</p><p><strong>Results.: </strong>NTPAM treatment induced HNC cell death via a non-canonical ferroptosis pathway, primarily through increased Fe²⁺ level. Overexpression of HMOX1, an NRF2 regulated gene, promotes NTPAM induces intracellular Fe²⁺ increase; and silencing HMOX1 rescues HNC from NTPAM induced iron accumulation and ferroptosis. NRF2 knockdown deregulates HMOX1 expression and prevents Fe²⁺ increase but do not improve cell survival or ferroptosis morphology. In vivo, NTPAM-treated tumors showed elevated intratumoral Fe²⁺ and increased HMOX1 expression, confirming their contribution to ferroptosis.</p><p><strong>Conclusion.: </strong>Our finding suggests that NTPAM directly induces ferroptosis in HNC cells by HMOX1 - mediated intracellular Fe²⁺ accumulation. This process is facilitated by increased nuclear translocation of NRF2, which upregulates HMOX1 expression and thereby drives iron dysregulation leading to ferroptotic toxicity.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Prior Sinus Surgery Influence Dupilumab Treatment Response in CRSwNP?","authors":"Karina Berbalk, Nicholas J Campion, Tina J Bartosik, Linda Liu, Minghao Pan, Dioni-Pinelopi Petsiou, Christina Morgenstern, Victoria Stanek, Aldine Tu, Slagjana Stoshikj, Julia Eckl-Dorna, Sven Schneider","doi":"10.21053/ceo.2026-00209","DOIUrl":"https://doi.org/10.21053/ceo.2026-00209","url":null,"abstract":"<p><strong>Objectives.: </strong>To investigate whether prior endoscopic sinus surgery (ESS) influences long-term treatment response to Dupilumab in patients with chronic rhinosinusitis with nasal polyps (CRSwNP), including patient-reported outcomes, nasal polyp score and olfactory function.</p><p><strong>Methods.: </strong>This retrospective, single-centre real-world study included adult CRSwNP patients treated with Dupilumab between 2019 and 2025. Patient-reported outcome measures (PROMs) to assess symptom burden (i.e., SNOT-22, TNSS, ACT, PHQ-2, EQ-5D-3L), nasal polyp score (NPS) and olfactory performance were recorded longitudinally. Linear and piecewise linear mixed-effects models were used to analyse trajectories over time and compare outcomes by surgical status.</p><p><strong>Results.: </strong>A total of 224 patients were followed for up to 4.5 years, including 146 patients who had previously undergone ESS. Surgery-naïve patients had higher baseline disease burden across all outcomes. Dupilumab led to significant improvements in 6 all groups. Except for PHQ-2, which improved significantly faster in surgery-naïve patients during the early treatment phase (=0.310.14, p-value=0.03), trajectories were comparable. No significant differences were observed according to the number of previous surgeries or N-ERD status.</p><p><strong>Conclusion.: </strong>Dupilumab provides rapid and sustained clinical benefit in CRSwNP, independent of prior sinus surgery status. However, it should be noted that the influence of surgical extent could not be assessed in this cohort.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Retention in Positive Airway Pressure Therapy: Motivation, Psychological Status, and Sleep Symptom Severity.","authors":"Jee Won Moon, Dongha Kim, Jaeman Park, Min Young Seo, Jae-Min Shin, Tae Hoon Kim, Seung Hoon Lee, Il-Ho Park","doi":"10.21053/ceo.2026-00094","DOIUrl":"10.21053/ceo.2026-00094","url":null,"abstract":"<p><strong>Objective.: </strong>To evaluate whether initial visit motivation was associated with retention throughout the obstructive sleep apnea (OSA) diagnostic and treatment pathway, including polysomnography (PSG) completion and continued follow-up after positive airway pressure (PAP) initiation, among OSA patients in South Korea.</p><p><strong>Study design.: </strong>Retrospective observational study.</p><p><strong>Setting.: </strong>Tertiary hospital.</p><p><strong>Methods.: </strong>Adult patients presenting with suspected OSA between July 2021 and December 2023 were retrospectively reviewed. Demographic characteristics, PSG results, and questionnaire scores, including the Berlin Questionnaire, Beck Depression Inventory-II (BDI-II), Epworth Sleepiness Scale (ESS), and Insomnia Severity Index 7 (ISI), were collected. Initial visit motivation was categorized as voluntary, encouraged, both, or other based on a self-reported questionnaire completed at the first visit. Retention was analyzed using Kaplan-Meier methods and Cox proportional hazards regression.</p><p><strong>Results.: </strong>A total of 139 patients were included. Patients reporting both voluntary and encouraged motivations showed higher retention than those reporting either motivation alone (log-rank p = 0.029). Multivariable analysis identified obesity, high Berlin Questionnaire risk, combined motivation, and lower depressive symptom severity as independent predictors of retention. In a sensitivity analysis restricted to patients who completed PSG, the association between motivation and retention was attenuated but remained directionally consistent.</p><p><strong>Conclusion.: </strong>8 Initial motivation for seeking care was associated with clinic-based retention throughout the OSA care pathway. Assessment of patients' motivational profile at the initial visit may help identify those at risk of disengagement and facilitate individualized strategies to improve long-term retention.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Responses of Nasal Polyp-Derived Macrophages to Inflammatory Cues and Potential Pathological Roles in Type 2 Chronic Rhinosinusitis With Nasal Polyps.","authors":"Hyunkyung Cha, Ara Jo, Hee-Suk Lim, Kyoung Mi Eun, Jin-A Park, Seung-No Hong, Dae Woo Kim","doi":"10.21053/ceo.2025-00142","DOIUrl":"10.21053/ceo.2025-00142","url":null,"abstract":"<p><strong>Objectives: </strong>The role of highly plastic and heterogeneous macrophages in the pathogenesis of nasal polyps (NP) is not well understood. We aimed to investigate the distribution and responses of NP-derived macrophages to inflammatory cues according to endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methods: </strong>The distribution of macrophage subsets was analyzed using NP bulk RNA sequencing data with CIBERSORTx program. The cytokines and chemokines produced by NP-derived macrophages following stimulation with interleukin (IL)-4, staphylococcal enterotoxin B (SEB), and lipopolysaccharide were evaluated using a multiplex cytokine assay. Immunofluorescence staining in NP tissues was conducted to validate the findings.</p><p><strong>Results: </strong>Type 2 CRSwNP exhibited a significantly higher proportion of M2 macrophages, whereas both M1 and M2 macrophage populations were elevated in non-type 2 CRSwNP. Baseline cytokine analysis of NP-derived macrophages revealed an increase in thymic stromal lymphopoietin (TSLP) levels in CRSwNP compared to controls. Furthermore, TSLP expression was significantly upregulated from baseline levels following IL-4 or SEB stimulation in type 2 CRSwNP. Notably, IL-4 stimulation led to an increase in oncostatin M (OSM) only in type 2 CRSwNP. Additionally, the number and proportion of TSLP- and OSM-expressing cells among CD163-positive cells were significantly higher in the NP of type 2 CRSwNP patients.</p><p><strong>Conclusion: </strong>NP-derived macrophages from type 2 CRSwNP exhibit elevated expression of TSLP and OSM in response to IL-4 or SEB, potentially contributing to the pathophysiology of type 2 CRSwNP.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":"267-280"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13555248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145630871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}