Clinical Otolaryngology最新文献

{"title":"Beyond the CBC: Can Novel Markers Predict Recurrence in Chronic Rhinosinusitis With Nasal Polyposis?","authors":"Hasan Canakci,&nbsp;Hasmet Yazici,&nbsp;Salih Yayman,&nbsp;Kamil Gokce Tulaci,&nbsp;Erhan Arslan,&nbsp;Omer Hizli","doi":"10.1111/coa.70024","DOIUrl":"10.1111/coa.70024","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to investigate the potential prognostic value of eosinophil count, eosinophil-monocyte ratio (EMR), total IgE, systemic immune-inflammatory index (SII), systemic inflammation response index (SIRI), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and the presence of asthma and acetylsalicylic acid (ASA) sensitivity in predicting postoperative recurrence in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with CRSwNP were divided into two groups based on recurrence within 3 years postoperatively: Group 1 (non-recurrent) included patients with no signs of recurrence, and Group 2 (recurrent) included those with endoscopic evidence of recurrence. A control group of age- and gender-matched healthy individuals without any history of inflammation and with normal nasal endoscopy findings was also included. Eosinophil, EMR, total IgE, NLR, PLR, SII, SIRI, and the presence of asthma and ASA sensitivity were compared among the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The recurrent NP group had significantly higher median total IgE and PLR compared to the non-recurrent group (<i>p</i> = 0.036). Compared to controls, the recurrent NP group had significantly elevated eosinophil, EMR, SII, and SIRI levels (<i>p</i> &lt; 0.001, <i>p</i> = 0.022, and <i>p</i> = 0.038, respectively). No significant differences in PLR, SII, or SIRI were found between the non-recurrent and control groups (<i>p</i> = 1). Multivariate logistic regression identified asthma as an independent predictor of recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>EMR, SII, and SIRI may serve as valuable biomarkers in CRSwNP. Their elevated levels in recurrent cases support their potential role in predicting postoperative recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1096-1102"},"PeriodicalIF":1.5,"publicationDate":"2025-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144871785","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":"An Exploratory Retrospective Study of Clinical Outcomes Following Adenotonsillectomy in Children With Obstructive Sleep Disordered Breathing Living With Severe Obesity","authors":"Zoë A. Burton,&nbsp;Claire Nissenbaum,&nbsp;Manjeevan Singh,&nbsp;Camille Ball,&nbsp;Gurkirat Khokar,&nbsp;Eishaan K. Bhargava,&nbsp;Heather E. Elphick","doi":"10.1111/coa.70022","DOIUrl":"10.1111/coa.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Adenotonsillectomy (AT) to improve obstructive sleep disordered breathing (oSDB) is a common paediatric surgical procedure. Children living with obesity have both an increased risk of oSDB and a higher perioperative risk.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to establish whether AT in children with severe obesity improves clinical symptoms, and whether this correlates with quantifiable sleep studies. A secondary outcome was preoperative change in BMI <i>z</i>-score amongst children attending a specialist anaesthetic clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective electronic notes review over a 2-year period identified children 2–16 years living with ‘severe’ obesity undergoing AT for oSDB. Demographic data, BMI and BMI <i>z</i>-score were collated preoperatively and at surgery. Pre- and postoperative quantifiable sleep study data and clinical episodes were examined. Postoperative AHI &lt; 5/ODI4 &lt; 4/h or clinical symptom resolution was considered ‘curative’.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1007 tonsillectomies were performed for oSDB; 55 met inclusion criteria and 30 underwent preoperative sleep studies. Age ranged from 3 to 15 years (mean 8.7, SD 3.3) with a 2:1 ratio of males to females. Nine children (34.6%) underwent both pre- and postoperative studies with ODI4/AHI ranges of 0.5–121.2/h and 0–9.3/h, respectively. Overall ‘cure’ rate was 42.3%, with postoperative sleep studies confirming clinical findings. Preoperative mean BMI <i>z</i>-score was +3.83 (SD 1.19) with significant reduction at the time of surgery (−0.17, SD 0.29; <i>p</i> = 0.004) following lifestyle intervention (mean 6.0 months; SD 11.7 weeks).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Over half of severely obese children undergoing AT had residual postoperative oSDB symptoms. Sleep studies might identify those benefitting from further intervention. Findings support the effectiveness of preoperative lifestyle intervention, but the impact on symptoms and surgical timing should be further delineated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1088-1095"},"PeriodicalIF":1.5,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854789","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":"Paediatric Nasal Septal Perforations Systematic Review: Etiologies, Symptoms, and Treatment Outcomes","authors":"Arjun Sharma,&nbsp;Lana Mamoun,&nbsp;Nihal Punjabi,&nbsp;Roy Qu,&nbsp;Joseph D. Peterson,&nbsp;Jared C. Inman","doi":"10.1111/coa.70010","DOIUrl":"10.1111/coa.70010","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To better elucidate the aetiologies, symptomatology, and surgical repair outcomes for nasal septal perforations in the paediatric population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Systematic review and meta-analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PubMed, Embase and Web of Science libraries were queried using the terms “nasal septum,” “perforation,” and “paediatric” and all relevant synonyms. All studies that included data on nasal septal perforations in patients aged 0–18 and their etiologies were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>After 498 studies were reviewed, 9 retrospective studies with 219 patients were included for the primary analysis. The most common etiologies for nasal septal perforations in the literature were iatrogenic (34.25%), traumatic (23.29%), and idiopathic (18.26%). The most reported symptoms were crusting, epistaxis, and nasal obstruction. The overall closure rate for surgical repair was 0.86 [95% CI 0.76–0.95; <i>I</i>² = 17%]. Closure rates were notably lower in patients with autoimmune, drug, and foreign body related etiologies. There was no clear relationship between perforation size and closure success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, paediatric nasal septal perforations appear to primarily be caused by iatrogenic and traumatic etiologies. Paediatric patients also experience high proportions of foreign body-related defects. Closure rates remain high for paediatric patients with nasal septal perforations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1082-1087"},"PeriodicalIF":1.5,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144834342","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 Operative Management of Cholesteatoma in the Elderly: A 15-Year Retrospective Study","authors":"Dimitrios Daskalakis,&nbsp;Emily G. Heywood,&nbsp;Rahil Mandalia,&nbsp;Anil Banerjee,&nbsp;Peter Rea,&nbsp;Paramita Baruah","doi":"10.1111/coa.70019","DOIUrl":"10.1111/coa.70019","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1114-1122"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798352","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":"Paediatric Obstructive Sleep Disordered Breathing: Cardiovascular Changes After Adenotonsillectomy","authors":"Francisco Alves de Sousa,&nbsp;Marta Rios,&nbsp;Paula Branco,&nbsp;Sara Raquel Azevedo,&nbsp;Mariline Santos,&nbsp;Manuel Ferreira de Magalhães","doi":"10.1111/coa.70018","DOIUrl":"10.1111/coa.70018","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Obstructive sleep disordered breathing (OSDB) is prevalent in children and often associated with adenotonsillar hypertrophy (ATH). This prospective study investigated the impact of adenotonsillectomy on cardiovascular parameters in children with ATH and suspected OSDB, employing a generalised estimating equation (GEE) approach to account for repeated measures and potential confounders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Children (4–14 years) with ATH and clinical OSDB undergoing adenotonsillectomy were included. Pre- and post-operative resting heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, and estimated cardiac output (COEst) were assessed. Paired t-tests and Wilcoxon signed-rank tests were used for pre-post comparisons, while GEE models examined the influence of time (surgery), age, gender, and their interactions on the outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 90 children (mean age: 6.86 ± 2.78 years) participated. Adenotonsillectomy resulted in a significant decrease in HR (<i>p</i> = 0.028) and COEst (<i>p</i> = 0.003). No significant changes were observed in SBP or DBP (<i>p</i> &gt; 0.05). A significant negative correlation was found between the change in COEst and age (Spearman's rho = −0.349, <i>p</i> &lt; 0.001), indicating a more pronounced reduction in COEst in younger children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Adenotonsillectomy in children with ATH and clinical OSDB may lead to significant variations in resting heart rate and estimated cardiac output after surgery. This suggests a potential reduction in resting sympathetic activity following the resolution of upper airway obstruction, with a possible contribution of age-related factors to the observed cardiovascular responses to adenotonsillectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1071-1081"},"PeriodicalIF":1.5,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798353","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":"Defining the Terminology for Acute Ear Discharge in Children: Systematic Review and Expert Consensus Using the Nominal Group Technique","authors":"Elliot Heward,&nbsp;James Dempsey,&nbsp;Amy McGovarin,&nbsp;John Molloy,&nbsp;Mark Wilbourn,&nbsp;Eason Sivayoham,&nbsp;Merijam Kikic,&nbsp;Jaya R. Nichani,&nbsp;Iain A. Bruce","doi":"10.1111/coa.70021","DOIUrl":"10.1111/coa.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Acute otitis media (AOM) is one of the most frequent paediatric infections. In approximately 15% of children with AOM, the tympanic membrane perforates, leading to ear discharge. This subset of children is usually more unwell and may need different treatment than those without a perforation. Therefore, terminology is required to differentiate this population from AOM without perforation. Using a consensus exercise, we aimed to standardise disease terminology for this patient group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review was performed using OVID Embase to identify the terminology used within the current published literature. The RAND version of the Nominal Group Technique was then used to gain consensus using an expert panel.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The systematic review identified 2012 abstracts which were reviewed, of which 29 manuscripts were included. A total of nine different definitions were identified within the literature. The expert panel concluded that the terminology ‘acute otitis media with discharge (AOMd)’ should be used when diagnosing a child with an acutely discharging ear of up to 6 weeks duration. Recurrent disease should be diagnosed when four or greater episodes occur per year. Within this disease context, the panel determined the optimal research question was to identify the best management option.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This consensus process has proposed the terminology that should be applied for children with acute ear discharge secondary to AOM. The use of standardised terminology is essential to improve patient care and ensure homogeneity across future research.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"951-960"},"PeriodicalIF":1.5,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complications and Economic Burden of Surgery in Chronic Rhinosinusitis With Nasal Polyps: An Observational Cohort Study Using Swedish Register Data","authors":"Petter Olsson,&nbsp;Christoph Abé,&nbsp;Maija Wolf,&nbsp;Mathias Lilja,&nbsp;Tina Maio-Twofoot,&nbsp;Ola Sunnergren,&nbsp;Pernilla Sahlstrand-Johnson","doi":"10.1111/coa.70009","DOIUrl":"10.1111/coa.70009","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is a lack of comprehensive data on complications following sinus surgery (SS) in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to estimate the prevalence of SS-related complications in CRSwNP patients and examine patient characteristics, predictors of revision surgery, healthcare use, and associated costs using secondary care data from Swedish registers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational cohort study used Swedish administrative register data to report patient characteristics and estimate the prevalence and incidence of SS-related complications among CRSwNP patients. Healthcare resource use (HCRU) and associated costs, the probability of and predictors for revision surgery were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 9178 CRSwNP patients who underwent SS, 8.5% experienced complications to SS. Asthma was the most frequently observed comorbidity. The probability of revision surgery within 4 years was 12%. Factors such as younger age at index, complications to first surgery, earlier index year, and comorbid asthma were significant predictors for future surgery. Within 4 years of follow-up, patients undergoing SS showed more HCRU and higher related costs compared to matched general population controls (€13 865 vs. €7088 per person; <i>p</i> &lt; 0.001). Asthma comorbidity, the occurrence of complications, and undergone revision surgery were associated with higher costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, this study provides valuable clinical insights into patient characteristics, complications to SS, resource use, and factors related to revision surgery in patients with CRSwNP.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1061-1070"},"PeriodicalIF":1.5,"publicationDate":"2025-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70009","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Respiratory Training in Elderly Patients With Dysphagia: A Systematic Review and Meta-Analysis","authors":"Yi Su,&nbsp;Bo Liu,&nbsp;Jing Zhang","doi":"10.1111/coa.70002","DOIUrl":"10.1111/coa.70002","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the efficacy of respiratory training in elderly patients with dysphagia through a systematic review and meta-analysis of existing research data and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Databases including PubMed, EMBASE, Web of Science, Cochrane Library, CNKI, and Wanfang were searched for studies from their inception to 2024. Included studies were randomised controlled trials involving elderly patients (aged ≥ 65 years) with diagnosed dysphagia who underwent respiratory training, such as expiratory muscle strength training or inspiratory muscle training, with a follow-up period of at least 6 months. The quality of the included studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions, and meta-analysis was conducted using RevMan 5.3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten RCTs were included, with five rated as high quality (Grade A), four as moderate quality (Grade B) and one as low quality (Grade C). The meta-analysis revealed significant improvements in the respiratory training group compared with the control group: forced expiratory volume in the first second (relative risk = 0.07, 95% confidence interval [CI; 0.05, 0.08], <i>p</i> &lt; 0.000), peak expiratory flow (mean difference [MD] = −3.99, 95% CI [−4.88, −3.11], <i>p</i> &lt; 0.000) and Penetration–Aspiration Scale score (MD = −2.16, 95% CI [−2.35, −1.98], <i>p</i> &lt; 0.000).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Respiratory training substantially improves respiratory and swallowing function in elderly patients with dysphagia and reduces the risk of aspiration, demonstrating greater efficacy than conventional care. These findings suggest a broad potential for the application of respiratory training in dysphagia rehabilitation for elderly patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1053-1060"},"PeriodicalIF":1.5,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741405","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 Survival Prognosis Prediction Model for Locally Advanced Laryngeal Cancer Based on Feature Selection Through Machine Learning","authors":"Jiangmiao Li,&nbsp;Feng Zhao,&nbsp;Junkun He,&nbsp;Ying Zhou,&nbsp;Qiyun Li,&nbsp;Jiping Su","doi":"10.1111/coa.70012","DOIUrl":"10.1111/coa.70012","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to explore the high-risk factors associated with survival outcomes in patients with locally advanced laryngeal cancer (LALC) and to develop and validate a prognostic prediction model. This model aims to identify high-risk patients, assisting in the selection of appropriate treatment options for each individual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included 283 patients who were diagnosed with LALC. The LASSO method, XGBoost algorithm, and random forests (RF) were used to screen essential features associated with the prognosis of LALC. A nomogram was then developed based on the COX regression model. Model validation was conducted internally using the bootstrap method. Receiver operating characteristic (ROC), the area under the ROC curve (AUC), the concordance index (C-index), and decision curve analysis (DCA) were used to evaluate model performance. Kaplan–Meier curves compared survival outcomes between different groups and the effectiveness of different treatment methods. All statistical analyses were performed using R statistical software (version 4.3.1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 484 patients with LALC were followed up. The mean follow-up time was (39.07 ± 30.85) months. The 1-, 3-, and 5-year survival rates of LALC were 79.13%, 62.82%, and 54.34%, respectively. After applying inclusion and exclusion criteria, 283 patients with LALC were finally included. Seven significant variables were identified, and the nomogram incorporating these predictors demonstrated favourable discrimination and calibration. Additionally, the nomogram successfully distinguished patients into low- and high-risk groups. The AUC values for predicting 1-, 3-, and 5-year OS rates were 0.852, 0.850, and 0.829. DCA indicated that the nomogram was clinically useful. The COX model, based on seven features, demonstrated superior performance in predicting 5-year survival outcomes compared to models based on AJCC 8th TNM stage, with NRI as 0.914 and IDI as 0.24.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The Cox regression model developed based on seven independent factors, including ‘Age’, ‘Treatment’, ‘Surgery’, ‘DAA’, ‘K+’, ‘LNR’, and ‘TCIS’, can effectively predict OS in LALC patients. For LALC patients, especially those in the high-risk group, surgery or surgery combined with adjuvant radiotherapy may offer improved survival benefits.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1040-1052"},"PeriodicalIF":1.5,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728429","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 Apnoeic Oxygenation (THRIVE) on Operating Theatre Productivity in Endoscopic Pharyngolaryngeal Surgery: An Observational Study","authors":"Neill S. Aitken,&nbsp;Iain J. Nixon,&nbsp;Alistair F. McNarry,&nbsp;Patrick A. Ward","doi":"10.1111/coa.70016","DOIUrl":"10.1111/coa.70016","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 6","pages":"1109-1113"},"PeriodicalIF":1.5,"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}