Clinical Otolaryngology最新文献

{"title":"Effect of Apnoeic Oxygenation (THRIVE) on Operating Theatre Productivity in Endoscopic Pharyngolaryngeal Surgery: An Observational Study.","authors":"Neill S Aitken, Iain J Nixon, Alistair F McNarry, Patrick A Ward","doi":"10.1111/coa.70016","DOIUrl":"https://doi.org/10.1111/coa.70016","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The First 100 Patients to Undergo Elective Ethanol Ablation of Thyroid Cysts in the East of Scotland.","authors":"Rosa Bock, Iain J Nixon, Craig Hurnauth, David Summers, Helen Reid","doi":"10.1111/coa.70013","DOIUrl":"https://doi.org/10.1111/coa.70013","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid cysts are a common cause of neck lump presentation. Historically, treatment options were aspiration or surgery. Percutaneous ethanol ablation (PEA) offers a minimally invasive, low cost and effective alternative, although UK experience is limited.</p><p><strong>Methods: </strong>Hundred consecutive patients to receive elective PEA for a benign thyroid cyst between May 2017 and October 2024 in NHS Lothian were reviewed. Cyst volume reduction (CVR) and patient outcomes over a median follow-up period of 33 months were reviewed.</p><p><strong>Results: </strong>Median CVR was 79.16%. Follow-up data was available for 88 patients. 68 (77.3%) were discharged without further intervention following their first PEA. 14 (15.9%) had repeat PEA, 1 (1.1%) underwent fine needle aspiration and 5 (5.7%) were referred for consideration of surgery, of which 3 underwent a procedure. Regarding cyst characteristics, the presence of septations had the strongest influence on CVR (p = 0.003). Solid components were also significantly associated with decreased CVR (p = 0.019). Viscous cyst fluid showed a trend toward decreased CVR (p = 0.161). Further analysis demonstrated that septations (p = 0.056), solid components (p = 0.013) and viscosity (p = 0.013) were predictive of incomplete cyst resolution necessitating repeat interventions such as PEA, aspiration or surgery.</p><p><strong>Conclusion: </strong>In conclusion, we found USS-guided PEA to be an effective treatment for benign thyroid cysts, resulting in significant cyst volume reduction. It was found to be most effective in simple cysts and can avoid the need for surgical intervention in over 95% of such cases. This service should be routinely offered to patients as part of the shared decision-making process.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Carbon Footprint of Local Versus General Anaesthesia in Outpatient Turbinoplasty.","authors":"Sevasti Konstantinidou, Nefeli Konstantinidou, Mona Mozaffari, Florian Bast, Pavol Surda","doi":"10.1111/coa.70014","DOIUrl":"https://doi.org/10.1111/coa.70014","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Practical Online Dynamic Nomogram to Predict the Progression-Free Survival in Nasopharyngeal Carcinoma.","authors":"Jiayan Zhang, Jiayi Yu, Dan Zhang, Qian Liu, Qian Li, Zuhua Song, Bi Zhou, Zhuoyue Tang","doi":"10.1111/coa.70011","DOIUrl":"https://doi.org/10.1111/coa.70011","url":null,"abstract":"<p><strong>Objective: </strong>This retrospective study aimed to establish a convenient and effective online dynamic nomogram for predicting progression-free survival (PFS) in nasopharyngeal carcinoma (NPC).</p><p><strong>Methods: </strong>The clinical and imaging characteristics were retrospectively collected from 106 patients with pathologically confirmed NPC. Univariate and multivariate Cox proportional hazards regression analyses were performed to select the independent prognostic factors and construct a nomogram for predicting 1-, 3-, and 5-year PFS. The predictive effectiveness and clinical utility of the nomogram were evaluated by concordance index (C-index), calibration curves, and decision curve analysis (DCA). Patients were divided into different groups by risk score based on the nomogram, and the PFS rates of these two groups were compared by Kaplan-Meier curves.</p><p><strong>Results: </strong>Univariate and multivariate analyses indicated that the ADC (OR 0.177, 95% CI 0.068-0.464), extranodal neoplastic spread (ENS) (OR 3.662, 95% CI 1.495-8.968), and lymphocyte-to-monocyte ratio (LMR) (OR 2.688, 95% CI 1.094-6.607) at baseline were independent prognostic factors of NPC, with all p < 0.05. The nomogram revealed favourable predictive performance (C-index = 0.795). The area under the receiver operating characteristic curve (AUC) of the nomogram for predicting 1-, 3-year, and 5-year PFS was 0.792, 0.849, and 0.822, respectively, which outperformed the AJCC 8th TNM staging system (AUC = 0.592, 0.543, and 0.575). Besides, the nomogram distinguished the PFS rates well between low-and high-risk groups (p < 0.0001).</p><p><strong>Conclusion: </strong>The online dynamic nomogram based on ADC, ENS, and LMR can divide NPC patients into different risk groups, and its prediction efficiency is better than the TNM stage system.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Radiotherapy on Vestibular Function Among Nasopharyngeal Carcinoma Patients.","authors":"Pei Fen Cheah, Jeyasakthy Saniasiaya, Po Lin Ooi, Narayanan Prepageran","doi":"10.1111/coa.70015","DOIUrl":"https://doi.org/10.1111/coa.70015","url":null,"abstract":"<p><strong>Introduction: </strong>Vestibular end-organs are deemed low-risk organs at risk (OAR) in the context of radiotherapy contouring in nasopharyngeal carcinoma (NPC) treatment. To date, existing literature on the effect of radiotherapy on vestibular function among post-irradiated NPC patients remains elusive. The main aim of this study is to determine the effect of radiotherapy on vestibular function, specifically the semicircular canal (SCC), in post-irradiated NPC patients.</p><p><strong>Methods: </strong>A total of 31 post-irradiated NPC patients (10 patients in the prospective group and 21 patients in the cross-sectional group) were assessed by using the video head impulse test (VHIT) and adult dizziness handicap inventory (DHI) and compared with 36 healthy patients (control group). The vestibular ocular reflex (VOR) gain and the presence of saccade of individual SCCs were assessed and compared with the control group. VOR gain and the presence of saccade were correlated with the mean radiation dose of the cochlea.</p><p><strong>Results: </strong>VOR gain of all SCCs among post-irradiated NPC patients was grossly reduced, significantly seen in all the right-sided semicircular canals and left anterior semicircular canal (p < 0.05), corresponding with a high DHI score. Persistently reduced VOR gain was demonstrated among subjects 3 months post-radiotherapy (p > 0.05). Right lateral SCC saccade was significantly positively correlated with mean radiation of cochlea (r = 0.667).</p><p><strong>Conclusion: </strong>Vestibular hypofunction was demonstrated in SCC among post-irradiated NPC patients and is found to be progressive as well as radiation dose-dependent.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of N0 Necks in Primary Parotid Carcinoma: A Multi-Institution Study Over Ten Years.","authors":"Harriet Cunniffe, Jeremy Wong, Richard Jackson, Belen Kornfeld, Alfred Addison, Katerina Karamali, Brian Fish, Ramez Nassif","doi":"10.1111/coa.70000","DOIUrl":"https://doi.org/10.1111/coa.70000","url":null,"abstract":"<p><strong>Aims: </strong>To determine in patients with clinical and radiological N0 necks in primary parotid carcinoma: (1) Rate of occult node positivity post-neck dissection. (2) Outcomes following elective neck dissection ± radiotherapy. (3) Factors predicting recurrence and mortality following treatment.</p><p><strong>Methods: </strong>A retrospective study on patients diagnosed with malignant neoplasm of the parotid between January 2007 and December 2018 from three UK tertiary centres.</p><p><strong>Results: </strong>One hundred and thirty-four patients were identified. 6% (4/62) of patients who underwent neck dissection for radiologically N0 neck had positive lymph nodes. There was no statistically significant feature associated with recurrence and disease-related mortality, but recurrence was associated with an increased risk of mortality (HR 1.444).</p><p><strong>Conclusion: </strong>This study has demonstrated a low rate of occult nodal disease in N0 parotid malignancy and suggests that high-grade disease has a higher risk of nodal disease and recurrence. These patients may benefit from elective neck treatment, but more prospective data is required.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144642001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CAMERA: A Consensus Study to Ascertain Minimum Datasets for Ear Remote Assessments.","authors":"Jonathan Lee, Joseph Cowling, Matthew E Smith, Nishchay Mehta, Dimitrios Spinos, Christopher Coulson, Jameel Muzaffar","doi":"10.1111/coa.70008","DOIUrl":"https://doi.org/10.1111/coa.70008","url":null,"abstract":"<p><strong>Introduction: </strong>Remote healthcare has demonstrated benefits in providing high quality care, improving patient access, and reducing morbidity. In ear, nose, and throat surgery, there has been a recent surge in remote care driven by advancements including endoscopic otoscopy and boothless audiometry, as well as the coronavirus pandemic, but uncertainty exists regarding the minimum data needed for accurate remote diagnosis.</p><p><strong>Methods: </strong>A panel of otology, audiology, general practice, and audiovestibular physicians was invited, and a literature review was undertaken to populate candidate dataset items for Round 1 of the Delphi process using the web-based software, Welphi. This was followed by two further Rounds, with controlled anonymised item-rating and qualitative feedback between rounds. Finally, a consensus meeting analysed and organised the results for dissemination of the final consensus outcomes.</p><p><strong>Results: </strong>Seventy studies were used to populate the questionnaire in Round 1. Thirty-four multi-disciplinary expert panellists determined the final data items across the 3 Delphi Rounds. Experts worked at over 16 different centres across the United Kingdom. There was an average response rate of 94% across all rounds.</p><p><strong>Discussion: </strong>This study highlights a multidisciplinary team's consensus essential dataset for effective remote ear assessment. With NHS waiting lists at an all-time high, remote assessment capacity could alleviate strain and enhance patient care. This initiative will facilitate novel service and pathway redesign with the aim of ensuring all patients have access to high-quality ear assessments, regardless of location. We are also hopeful that this standardised dataset will also facilitate research and audit of remote ear services.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Personal Listening Device on Postural Stability Among Healthy Adolescents and Young Adult: A Pilot Study.","authors":"Jeyasakthy Saniasiaya, Jeyanthi Kulasegarah, Kumar Seluakumaran, Prepageran Narayanan","doi":"10.1111/coa.70005","DOIUrl":"https://doi.org/10.1111/coa.70005","url":null,"abstract":"<p><strong>Objective: </strong>The effect of noise on the postural control process is of ongoing interest. This exploratory study aims to determine the effect of personal listening devices (PLD) on postural stability among adolescents and young adults.</p><p><strong>Methods: </strong>Participants aged between 13 and 25 with a history of PLD usage were included. The study was carried out in two parts. The first part involved determining the PLD listening level and the preferred sound level. In the second part, postural stability was assessed using the modified Clinical Test for Sensory Interaction in Balance (mCTSIB) and dynamic postural stability.</p><p><strong>Results: </strong>64 participants were recruited with a mean age of 18.78 (SD: 3.11). The majority were female (62.5%) and of Chinese ethnicity (38.1%). The reported mean PLD listening level and preferred volume levels were 57.50 dB (SD: 6.15) and 46.48% (SD: 15.98), respectively. Male PLD users had higher listening levels and preferred volume levels. Adolescents were found to have a higher listening level than young adults. Female PLD users revealed a higher sway and postural stability index than male PLD users. Young adults were found to have a higher sway and postural stability index. Statistical significance is demonstrated between the age of PLD users and mCTSIB sway index (coef: 0.367; p = 0.003).</p><p><strong>Conclusion: </strong>The current study suggests that the younger generation is susceptible to postural instability following PLD exposure. Yet, the provided data is inadequate to draw a conclusion, and future randomised controlled studies with large sample sizes are warranted.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimising Early Intervention: A Retrospective Study on the Role of Hyperbaric Oxygen Therapy in Enhancing Hearing Recovery for Sudden Sensorineural Hearing Loss.","authors":"Bang-Yan Zhang, Tzong-Yun Tsai, Kai-Chieh Chan","doi":"10.1111/coa.70004","DOIUrl":"https://doi.org/10.1111/coa.70004","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the efficacy of hyperbaric oxygen therapy (HBOT) as an adjunct to corticosteroids in the treatment of sudden sensorineural hearing loss (SSNHL) and to determine the optimal timing for HBOT initiation, considering the severity of initial hearing loss.</p><p><strong>Methods: </strong>A retrospective review was conducted on 128 patients diagnosed with unilateral SSNHL who received corticosteroids and HBOT. The inclusion criteria were the initiation of steroid treatment within 14 days and HBOT within 30 days of SSNHL onset, with at least five HBOT sessions completed. Audiometric evaluations were performed pre- and post-treatment to assess hearing gains. Statistical analyses, including logistic regression and ROC curves, were utilised to identify factors influencing hearing recovery.</p><p><strong>Results: </strong>The results showed that 72.7% of patients experienced significant hearing improvement. Early initiation of HBOT within 12.5 days of onset was associated with better hearing outcomes. Multivariate analysis and sensitivity testing further confirmed that HBOT timing was the most robust predictor of hearing gain, independent of baseline hearing severity.</p><p><strong>Conclusion: </strong>Early HBOT initiation, particularly within 12.5 days, enhances hearing recovery in SSNHL patients. These findings support the use of HBOT as a valuable adjunctive treatment and underscore the need for standardised protocols in future studies.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Microvascular Free Flap Reconstruction With One Versus Two Primary Surgeons.","authors":"Jamison Macke, Tuleen Sawaf, Natalie Schelbar, Bryan Renslo, Heather Schopper, Kevin J Sykes, Andres Bur, Justin Bond, Yelizaveta Shnayder, Terance T Tsue, Douglas Girod, Kiran Kakarala","doi":"10.1111/coa.70006","DOIUrl":"https://doi.org/10.1111/coa.70006","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate operative efficiency and quality in head and neck free flap reconstruction with one versus two primary surgeons by comparing procedure duration, hospital length of stay, complications and readmission rates.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Single-institution tertiary care centre.</p><p><strong>Methods: </strong>A total of 583 patients who received head and neck surgery with free flap reconstruction at the University of Kansas Medical Center between November 2010 and January 2021 were stratified into two cohorts: one-surgeon cohort and two-surgeon cohort. In the two-surgeon cohort, one surgeon performed tissue resection and the second performed reconstruction (n = 329), whereas one primary surgeon performed both resection and reconstruction in the one-surgeon cohort (n = 254). Patient age, sex, American Society of Anaesthesia (ASA) status and Charlson comorbidity index (CCI) at time of surgery were collected.</p><p><strong>Results: </strong>No significant difference in baseline clinicodemographic characteristics was found between groups. A reduced mean procedure duration was found in the one-surgeon cohort (424.9 min, SD 127.6) compared to the two-surgeon cohort (552.4 min, SD 119.2) (mean difference 127.5 min, Cohen d = 1.04). A slightly greater proportion of osteocutaneous free flaps was performed in the two-surgeon cohort compared to the one-surgeon cohort (one-surgeon: 53.5%; two-surgeon 62.3%). All other secondary quality measures showed nonsignificant differences with the exception of the proportion requiring intraoperative pressors (86.2% in one-surgeon cohort vs. 74.5% in two-surgeon cohort, mean difference 11.7%, Cohen d = 0.29).</p><p><strong>Conclusions: </strong>This study demonstrates at least noninferior efficiency and quality outcomes in free flap cases led by single primary surgeons at our institution. The optimal approach to maximise operative efficiency and quality likely differs across surgeons and centres.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}