Clinical and Experimental Otorhinolaryngology最新文献

{"title":"Feasibility and Preliminary Outcomes of a Wearable Inertial Measurement Unit-Guided Canalith Repositioning Procedure for Idiopathic Benign Paroxysmal Positional Vertigo.","authors":"Chiheon Kwon, Dae Bo Shim, Jeong Sook Joo, Youn Go, Cecilia A Callejas Pastor, Myung-Whan Suh, Yunseo Ku","doi":"10.21053/ceo.2026-00070","DOIUrl":"https://doi.org/10.21053/ceo.2026-00070","url":null,"abstract":"<p><strong>Objectives.: </strong>Self-administered canalith repositioning procedure (CRP) for benign paroxysmal positional vertigo (BPPV) is often limited by inaccurate head positioning. We evaluated the feasibility of an inertial measurement unit (IMU)-guided CRP system relative to specialist-performed CRP and explored head motion parameters associated with outcomes.</p><p><strong>Methods.: </strong>In this prospective comparative study (December 2019-June 2021), 88 patients with BPPV (74 women [84%]; mean [SD] age, 56.5 [15.7] years) underwent IMU-guided CRP with real-time audio feedback (IMU-CRP, n=44) or conventional CRP by a vestibular specialist (DOC-CRP, n=44), matched for BPPV subtype, age, and sex. The primary outcome was 24-hour treatment success, defined as resolution of positional vertigo and absence of nystagmus. Head motion parameters-rotation accuracy, holding duration, and to-and-fro error-were analyzed at one hour in the IMU-CRP group.</p><p><strong>Results.: </strong>Treatment success at 24 hours did not differ significantly between groups (Epley: 61.1% vs. 66.7%; barbecue roll: 50.0% vs. 62.5%; all P>0.05). In an exploratory 90% CI analysis (25-percentage-point margin), the lower bound did not cross the margin for the Epley and combined cohorts, but crossed it for barbecue roll. Among 34 initially resolved IMU-CRP participants, 8 (23.5%) had early recurrence by 24 hours. Longer Epley step 3 holding duration was associated with success (39.2 vs. 31.1 s; P=0.043).</p><p><strong>Conclusion.: </strong>IMU-guided CRP demonstrated technical feasibility, with CRP-naive participants achieving clinically acceptable maneuver accuracy using audio guidance alone. Treatment success did not significantly differ from specialistperformed CRP, but findings remain hypothesis-generating because the noninferiority margin was not pre-specified. HC-BPPV findings are preliminary and require further validation. Early recurrence highlights the need for post-maneuver guidance, and these findings support a future randomized non-inferiority trial.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148618742","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":"Sensory Impairment and Risk of Neurodegenerative Diseases: A Nationwide Cohort Study in Korea.","authors":"Jin Youp Kim, Hae Chan Park, Seok-Won Park, Chae-Seo Rhee","doi":"10.21053/ceo.2026-00075","DOIUrl":"https://doi.org/10.21053/ceo.2026-00075","url":null,"abstract":"<p><strong>Objectives.: </strong>Sensory impairments are common in older adults. However, their association with neurodegenerative diseases across multiple sensory domains remains unclear. This study aimed to investigate the associations between visual, hearing, and olfactory impairments and incident neurodegenerative diseases.</p><p><strong>Methods.: </strong>We analyzed data from the Korean National Health Insurance Service-Health Screening Cohort (2002-2015), excluding participants with pre-existing sensory impairment or neurodegenerative disease during a washout period (2002-2004). Sensory impairment was classified as visual, hearing, olfactory, or multisensory between 2005 and 2015. The outcomes were overall neurodegenerative diseases and their subtypes (Alzheimer's disease and related dementias, Parkinson's disease, and Huntington's and other neurodegenerative disorders). Kaplan-Meier curves and adjusted Cox models were used.</p><p><strong>Results.: </strong>Among the 410,749 participants, 389,659 were controls and 21,007 had sensory impairment (hearing, 16,651; olfactory, 642; visual, 3,426; multisensory, 288). The incidence differed by sensory status (log-rank p < 0.001) and was highest in multisensory impairment. Versus controls, multisensory impairment had the largest adjusted risk for overall neurodegenerative disease (Hazard ratio [HR] 5.23, 95% confidence interval [CI] 4.20-6.52) and across major disease subtypes (Alzheimer's disease, HR 4.43; Parkinson's disease, HR 5.07; and Huntington's and other neurodegenerative disorders, HR 9.90). In post hoc analyses using multisensory impairment as a reference, all single-sensory impairment groups showed significantly lower hazards.</p><p><strong>Conclusion.: </strong>: Sensory impairment across the visual, hearing, and olfactory domains was associated with an increased risk of neurodegenerative 73 diseases, showing a graded pattern with a greater sensory burden. The sensory status may serve as an accessible early risk marker for neurodegenerative diseases in older adults.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454743","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":"Context-Dependent Prognostic Impact of Microscopic Positive Surgical Margin in Papillary Thyroid Carcinoma.","authors":"Hyungju Kwon, Ting-Chun Kuo, Michael Bouvet","doi":"10.21053/ceo.2026-00029","DOIUrl":"https://doi.org/10.21053/ceo.2026-00029","url":null,"abstract":"<p><strong>Objective.: </strong>Microscopic positive surgical margins (mPSMs) are identified in approximately 10% of patients with papillary thyroid carcinoma (PTC). Previous studies have reported conflicting.</p><p><strong>Results.: </strong>regarding the association between mPSM and recurrence risk. These discrepancies may stem, at least in part, from insufficient consideration of clinicopathological factors that modify recurrence risk.</p><p><strong>Methods.: </strong>This retrospective single-center study included 2,539 patients who underwent thyroidectomy for PTC between 2009 and 2023 at a tertiary referral center in Korea. Patients were stratified by nodal status into N0 (n = 1,705), N1a (n = 660), and N1b (n = 174) groups. Cox proportional hazards modeling, survival tree analysis, and random survival forest analysis were used to evaluate prognostic factors. The primary outcome was recurrence-free survival (RFS).</p><p><strong>Results.: </strong>mPSM was identified in 2.9% of patients in the N0 group, 4.7% in the N1a group, and 8.6% in the N1b group. During a median follow-up of 7.4 years, 74 patients (2.9%) experienced recurrence. In N0 patients, mPSM was associated with significantly reduced 5- year RFS (90.2% vs. 99.1%, p = 0.002; HR 5.513, 95% CI 1.657-18.35). However, no significant association between mPSM and recurrence was observed in either the N1a group (HR 0.960, 95% CI 0.130-7.077) or the N1b group (HR 1.466, 95% CI 0.337-6.379). Random survival forest analysis identified LN metastasis as the dominant predictor of recurrence, whereas mPSM contributed minimally to recurrence prediction overall.</p><p><strong>Conclusion.: </strong>The prognostic impact of mPSM in PTC appears to be context-dependent and clinically meaningful primarily in node-negative disease. Combined assessment of margin and nodal status may improve postoperative risk stratification and follow-up planning.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429954","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":"Central Vestibular Syndromes.","authors":"Sun-Uk Lee, Hyo-Jung Kim, Jeong-Yoon Choi, Ji-Soo Kim","doi":"10.21053/ceo.2026-00155","DOIUrl":"https://doi.org/10.21053/ceo.2026-00155","url":null,"abstract":"<p><p>Although peripheral vestibular disorders account for the most cases of dizziness or vertigo, approximately 11-15% of patients have central vestibulopathy. This remains a diagnostic challenge for neurotologists, as it can present with acute vestibular syndrome (AVS) in isolation without other obvious neurologic deficits. Despite advances in modern neuroimaging, false-negative results still occur in up to 20% of cases, further complicating the differential diagnosis. Therefore, recognition of the characteristic neurotologic signs associated with each central neural structure is important for the early detection and proper management of central AVS. In this review, we discuss the typical neurotologic findings related to the underlying neural substrates of the brainstem and cerebellum.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429950","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":"High-Frequency Pseudo-Cohort Threshold Change and Severity-Dependent Sex Disparity in 4-kHz Audiometric Notching in Korean Adults.","authors":"Ho Yun Lee, Seung-Ho Shin, Sung Wan Byun","doi":"10.21053/ceo.2026-00150","DOIUrl":"https://doi.org/10.21053/ceo.2026-00150","url":null,"abstract":"<p><strong>Objectives.: </strong>Using contemporary 2019-2023 Korea National Health and Nutrition Examination Survey (KNHANES) audiometry, this study estimated population-level pseudo-cohort hearing-threshold change and the prevalence and correlates of 4-kHz audiometric notching in Korean adults aged ≥40 years.</p><p><strong>Methods.: </strong>We included 12,576 adults aged ≥40 years with valid harmonized otolaryngologic/audiometry examination weights and sufficient audiometric data. Survey-weighted regression estimated pseudo-cohort hearing-threshold slopes within seven reconstructed five-year birth-cohort groups (1944-1978), after excluding the oldest reconstructed group affected by age top-coding at 80 years. A 4-kHz notch was defined when the 4-kHz threshold exceeded both the 2-kHz and 8-kHz thresholds by ≥ 10 dB in either ear; notch analyses were restricted to participants with classifiable person-level status. Survey-weighted multivariable regression identified notch- associated factors.</p><p><strong>Results.: </strong>High-frequency (4-8 kHz) pseudo-cohort slopes were approximately 1.7-9 times larger than low-frequency (0.5-1 kHz) slopes. In the youngest reconstructed birthcohort group (1974-1978, aged 41-49 years), high-frequency change was detectable (+0.97 dB/year) despite minimal low-frequency change (+0.11 dB/year). Among participants with classifiable notch status, the survey-weighted 4-kHz notch prevalence was 17.9%, corresponding to approximately 5.4 million adults. The male-to-female prevalence ratio increased from 3.0:1 at ≥10 dB to 4.5:1 at ≥15 dB and 7.3:1 at ≥20 dB, indicating severity-dependent sex disparity. In the primary model, male sex (OR 3.45), occupational noise exposure (OR 1.60), education level (OR 0.89 per level), and rural residence (OR 1.18) were associated with the notch. The apparent age-related decline in notch prevalence was consistent with presbycusis-related masking.</p><p><strong>Conclusion.: </strong>High-frequency threshold change was detectable in midlife and showed steeper population-level pseudo-cohort slopes than speech-frequency PTA. The 4-kHz notch was concentrated in midlife men, showed severity-dependent male predominance, and became less detectable with advancing age, consistent with presbycusis-related masking of notch geometry.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148430016","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":"Longitudinal Trajectories of Hematologic Inflammatory Markers and Their Prognostic and Mediating Roles in Nasopharyngeal Carcinoma: A Multi-institutional Cohort Study.","authors":"Jia-Ching Lin, Chung-Feng Hwang, Wei-Chih Chen, Sheng-Dean Luo, Yu-Ming Wang, Tai-Jan Chiu, Yao-Hsu Yang, Wei-Chun Cheng, Ching-Nung Wu","doi":"10.21053/ceo.2026-00083","DOIUrl":"https://doi.org/10.21053/ceo.2026-00083","url":null,"abstract":"<p><strong>Objective.: </strong>To examine the longitudinal trajectories of hematologic inflammatory markers and their prognostic and mediating roles in nasopharyngeal carcinoma (NPC).</p><p><strong>Methods.: </strong>This retrospective cohort study used group-based trajectory modeling (GBTM) on 1,867 NPC patients in Taiwan across three time points during radiotherapy.</p><p><strong>Results.: </strong>A high-inflammation systemic immune-inflammation index (SII), calculated from platelet, neutrophil, and lymphocyte counts on routine blood tests (platelet × neutrophil / lymphocyte), trajectory (3.4% of patients) independently predicted poorer overall survival (adjusted HR, 1.89) and greater odds of disease persistence (adjusted OR, 2.09). Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) trajectories were not significantly associated with outcomes. Disease persistence mediated 14.7% of the total survival effect of SII.</p><p><strong>Conclusion.: </strong>In this exploratory analysis, high-inflammation SII trajectories were associated with inferior survival and increased residual disease risk in NPC. However, as SII was not associated with recurrence and disease persistence explained only a small proportion of the survival association, the pathway linking SII to survival remains unclear and warrants prospective investigation.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403968","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":"Spatial mapping of nasal polyp distribution in an ovalbumin and Staphylococcal enterotoxin B-induced murine model of chronic rhinosinusitis.","authors":"Roza Khalmuratova, Suha Lim, Yi Sook Kim, Younghoon Na, Yoongeol Lee, Dae Woo Kim, Ji-Hun Mo, Hyun-Woo Shin","doi":"10.21053/ceo.2026-00183","DOIUrl":"https://doi.org/10.21053/ceo.2026-00183","url":null,"abstract":"<p><strong>Objectives.: </strong>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory disease of the sinonasal mucosa. Although murine models provide a valuable platform for investigating disease mechanisms, variability among models limits reproducibility, in part due to the lack of standardized anatomical assessment. This study aimed to define the anatomical distribution of nasal polyps (NPs) using a five-level coronal anatomical framework and to characterize their morphological features.</p><p><strong>Methods.: </strong>A murine NP model was established using ovalbumin (OVA) and Staphylococcus aureus enterotoxin B (SEB). Nasal tissues were systematically analyzed across predefined coronal levels of the murine nasal cavity. Histological, immunohistochemical, and immunofluorescence analyses were performed to identify polypoid lesions, characterize their morphology, and assess inflammatory cell infiltration.</p><p><strong>Results.: </strong>Polypoid lesions were predominantly localized to coronal levels III and IV, indicating a preferential anatomical distribution. Epithelial remodeling was evident, including epithelial thickening and basal cell hyperplasia, accompanied by subepithelial fibrosis and basement membrane thickening. A type 2-skewed inflammatory profile was observed, characterized by eosinophilic infiltration, increased IL-13-positive cells, and the presence of Charcot-Leyden- like crystals.</p><p><strong>Conclusion.: </strong>: Application of a five-level coronal anatomical framework enabled systematic spatial mapping of NPs within the murine CRSwNP model. This approach identified preferential localization of polypoid lesions to the mid-to-posterior nasal cavity and provides a structured method for regional anatomical assessment in future studies of murine NPs.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396153","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 Guideline for the Diagnosis and Management of Tinnitus in Korea.","authors":"Euyhyun Park, Ho Yun Lee, Hyun Jung Kim, Jeon Mi Lee, Yong-Hwi An, Ah Rang Cho, Woojae Han, Jae Ho Chung, Jae Sang Han, Da Jung Jung, Kyu-Yup Lee","doi":"10.21053/ceo.2026-00130","DOIUrl":"https://doi.org/10.21053/ceo.2026-00130","url":null,"abstract":"<p><p>Standardized, evidence-based guideline for tinnitus management is currently lacking in Korea. This guideline aims to provide evidence-based recommendations for the diagnosis and management of tinnitus in Korean adults, adapted to the Korean healthcare system. A multidisciplinary panel (eight otorhinolaryngologists, one neurologist, one psychiatrist, and one audiologist) conducted systematic literature searches up to 2025 using PubMed, Embase, Cochrane Library, KoreaMed, and KMBASE. Evidence quality was assessed using the GRADE methodology. Nine key clinical questions (KQs) were developed in PICO format, and recommendations were finalized through a modified Delphi process (≥80% agreement threshold). Imaging is recommended for the evaluation of patients with pulsatile tinnitus or asymmetric hearing loss (Grade B). Tinnitus retraining therapy (TRT) and cognitive behavioral therapy (CBT) are conditionally recommended for patients with tinnitus (Grade B). Hearing aids are conditionally recommended for patients with tinnitus and coexisting hearing loss (Grade B). Sound therapy is conditionally recommended to reduce tinnitus-related distress (Grade B). Neuromodulation (transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS)) is conditionally recommended as an adjunctive treatment (Grade B). Routine zinc and vitamin supplementation are strongly recommended against for tinnitus symptom improvement (Grade D†), whereas Ginkgo biloba may be considered for patients with subjective tinnitus (Grade B). Most available evidence was predominantly of low or very low certainty. This guideline provides the first comprehensive evidence-based framework for tinnitus management in Korea. Behavioral and rehabilitative interventions provided the strongest evidence for reducing tinnitus-related distress. Considerations of Korean National Health Insurance coverage, regional accessibility, and patient preferences were integrated throughout the guideline development process. The primary therapeutic goal is to reduce tinnitus-related distress and improve functional outcomes, thereby enhancing overall quality of life.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396132","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":"A Retrospective Review of Drug-Induced Sleep Endoscopy Evaluating Upper Airway Dynamics in Patients with Vagus Nerve Stimulator-Induced Obstructive Sleep Apnea.","authors":"Raisa O Tikhtman, Soraya Abdul-Hadi, Kathleen M Sarber, Christopher M Carosella, Wei K Liu, Jesse Skoch, Michele Turner, Thomas J Dye, David F Smith","doi":"10.21053/ceo.2026-00017","DOIUrl":"https://doi.org/10.21053/ceo.2026-00017","url":null,"abstract":"","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396127","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":"Prognostic Significance of Microscopic Positive Margin in Differentiated Thyroid Carcinoma: A Systematic Review and Meta-Analysis.","authors":"Jeongshin An, Hyeonuk Hwang, Hyeji Kim, Hyungju Kwon, Byung-In Moon","doi":"10.21053/ceo.2026-00028","DOIUrl":"https://doi.org/10.21053/ceo.2026-00028","url":null,"abstract":"<p><strong>Objective.: </strong>Microscopic positive surgical margin (mPSM) is found in around 10% of thyroid cancer cases, but it is controversial whether mPSM is associated with recurrence. This systematic review and meta-analysis integrated available evidence to clarify the association between mPSM and recurrence in differentiated thyroid carcinoma.</p><p><strong>Methods.: </strong>Cochrane Database of Systematic Reviews, MEDLINE/ PubMed, Web of Science Core Collection, and EMBASE were systematically searched from their inception through December 31, 2024. Three reviewers independently extracted study characteristics and hazard ratio (HR) of mPSM from included studies. The primary endpoint was cancer recurrence. Subgroup analysis of the primary outcome was conducted on the basis of margin location.</p><p><strong>Results.: </strong>Eleven studies comprising 20,446 patients were included in the analysis. Patients with mPSM had significantly higher recurrence rates than those with clear margins (pooled HR 1.78, 95% CI 1.43-2.20). This finding was replicated and validated when we examined 7 studies with 14,701 patients with only papillary thyroid carcinoma (pooled HR 1.87, 95% CI 1.34-2.60). Subgroup analysis revealed a markedly increased risk in cases with posterior mPSM (pooled HR 5.23, 95% CI 1.41-19.46), while anterior mPSM showed a nonsignificant association (pooled HR 1.22, 95% CI 0.82-1.82; P = 0.32).</p><p><strong>Conclusion.: </strong>This systematic review and meta-analysis suggests that mPSM may be associated with an increased risk of recurrence in differentiated thyroid carcinoma. Margin location may be an important factor to consider when evaluating the impact of mPSM on recurrence.</p>","PeriodicalId":10318,"journal":{"name":"Clinical and Experimental Otorhinolaryngology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142790","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}