Clinical Otolaryngology最新文献

{"title":"Malignant Head and Neck Paraganglioma: A Comprehensive and Contemporary Database Review of a Rare Entity","authors":"Avigeet Gupta,&nbsp;Kadie M. Nausha,&nbsp;Alexander G. Bien,&nbsp;Rachad I. Mhawej","doi":"10.1111/coa.70147","DOIUrl":"10.1111/coa.70147","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>There remains an overall paucity of literature regarding malignant head and neck paragangliomas (MHNPs) and optimal treatment strategies. Our study aims to elucidate contemporary trends regarding the incidence, management modalities, and predictors of survival in a rare entity of a malignancy for which there is no well-established treatment guideline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>The Surveillance, Epidemiology, and End Results (SEER) database was queried for all cases of MHNPs from 2000 to 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The age-adjusted incidence of MHNPs has increased 56% from 2000 to 2019 (0.096–0.150 per 1 000 000). One hundred forty-two patients were included for case-listed statistical analysis, with the mean age at diagnosis being 47 years ± 18.4, presence of regional disease in 47% of cases, and distant disease in 53%. Surgery was the most common form of treatment for MHNP (90, 63.4%) followed by radiation (57, 40.1%). Two-year and 5-year disease-specific survival were noted to be 92% and 79%, respectively. Patients treated with surgery had a decreased risk of mortality (0.227 [95% CI: 0.122–0.424], <i>p</i> &lt; 0.001), whereas those with distant disease at diagnosis had an increased risk of mortality (3.47 [95% CI: 1.780–6.800], <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study represents the largest and most contemporary known cohort of patients with MHNP and provides details regarding the incidence, survival, and treatment strategies for this rare malignancy with little known treatment data. There was a statistically significant benefit for surgical management of MHNP. Distant metastasis at diagnosis was an independent predictor of increased mortality risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 6","pages":"908-913"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148520057","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":"Tympanometric Measurement of Ear Canal Volume in Children With Trisomy 21: Rate of Growth and Predictive Value for Success of Ventilation Tube Insertion","authors":"Sam Plyming,&nbsp;Haytham Kubba","doi":"10.1111/coa.70152","DOIUrl":"10.1111/coa.70152","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Children with trisomy 21 have narrow ear canals which can make ventilation tube insertion difficult or impossible. This study aimed to use ear canal volume, as routinely reported on tympanometry, to estimate the annual growth rate of the ear canal and to predict the success rate of ventilation tube insertion in children with trisomy 21.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective study on 50 children with trisomy 21 who each had tympanometric ear canal volume measurements available on 3 occasions to calculate the growth rate of the ear canal. We also conducted a separate retrospective study of 83 ventilation tube insertion attempts in 45 children with trisomy 21 to see if the tympanometric ear canal volume was predictive of success or failure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ear canal volume grows at 0.04–0.05 mL/year on average in children with trisomy 21, but at any given age the variation between children is many times larger than this. Of 83 ventilation tube insertion attempts, 66 were successful (92%) and 7 failed (8%). All failures occurred in children with ear canal volume 0.51 mL or less. Age was not predictive of success of ventilation tube insertion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Smaller ear canal volumes are predictive of failure of ventilation tube insertion. Ear canal volumes do grow over time in children with trisomy 21 but at a slow rate. Tympanometry can provide information on ear canal volume, which is useful for discussions about how best to manage otitis media with effusion in children with trisomy 21.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 6","pages":"923-928"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629849","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":"Static Otolith Signals Reflect Clinical Course in Acute Vestibular Neuritis","authors":"Seo-Young Choi,&nbsp;Jae-Hwan Choi,&nbsp;Hyun Sung Kim,&nbsp;Kwang-Dong Choi","doi":"10.1111/coa.70143","DOIUrl":"10.1111/coa.70143","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate how static and dynamic utricular functions differentially correlate with dizziness symptoms and quality of life (QoL) recovery in patients with acute vestibular neuritis (VN).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective observational study with 1-week and 1-month follow-up assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Tertiary referral centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twenty-six patients diagnosed with acute VN were enrolled and evaluated at baseline, 1 week and 1 month after symptom onset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Static utricular function was assessed using subjective visual vertical (SVV), and dynamic function via ocular vestibular-evoked myogenic potentials (oVEMP). Dizziness symptoms and QoL were evaluated using the Dizziness Handicap Inventory (DHI), Visual Analogue Scale (VAS) and the EQ-5D-5L questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with normalised SVV tilt at 1 week showed significantly greater improvement in DHI scores compared to those with persistent abnormal SVV (<i>p</i> = 0.046). By 1 month, these patients demonstrated further significant improvement in both DHI (<i>p</i> = 0.012) and EQ-5D-5L (<i>p</i> = 0.035) scores. Furthermore, early improvement in SVV tilt correlated significantly with DHI improvement at 1 week (<i>p</i> = 0.048, Spearman's rho = 0.392). In contrast, dynamic utricular function as measured by oVEMP did not correlate with clinical recovery at any time point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In acute VN, static utricular function correlates with early symptom relief and QoL recovery, whereas dynamic function does not. These findings suggest that central adaptive mechanisms may act more selectively on static utricular signals or recover dynamic pathways more rapidly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 6","pages":"861-866"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70143","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396205","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":"Nocturnal Hypoxemia Burden Correlates With Vestibular Dysfunction in Obstructive Sleep Apnea","authors":"Dachan Kim,&nbsp;Seong Hoon Bae,&nbsp;Hyung-Ju Cho","doi":"10.1111/coa.70146","DOIUrl":"10.1111/coa.70146","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Introduction&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Obstructive sleep apnea (OSA) is a potential contributor to vestibular dysfunction, though specific correlating parameters remain unclear. This study aimed to determine whether hypoxemia severity indices correlate quantitatively with caloric slow-phase eye velocity (SPV), a marker of vestibular function.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In a retrospective cohort of 82 adults undergoing both full-night PSG and bithermal caloric testing, the primary outcome was total caloric SPV (°/s; sum of four irrigations). Fifteen prespecified predictors were evaluated, including hypoxemia burden (apnea–hypopnea index [AHI], oxygen desaturation index [ODI], cumulative time with SpO&lt;sub&gt;2&lt;/sub&gt; &lt; 90% [CT90], nadir SpO&lt;sub&gt;2&lt;/sub&gt;), sleep fragmentation (total arousal index), sleep architecture (N1, N2, N3, rapid eye movement [REM] proportions and sleep efficiency) and ancillary measures (snoring index, pulse rate, age, sex and body mass index [BMI]). Unadjusted associations were calculated using Pearson's correlations. For adjusted inference, ordinary least squares with backward Akaike information criterion (AIC) reduction were employed. Feature importance was quantified without prespecifying functional form by training a random-forest regressor and computing TreeSHAP values.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;SPV was inversely correlated with AHI (&lt;i&gt;r&lt;/i&gt; = −0.295, &lt;i&gt;p&lt;/i&gt; = 0.007), ODI (&lt;i&gt;r&lt;/i&gt; = −0.261, &lt;i&gt;p&lt;/i&gt; = 0.018) and CT90 (&lt;i&gt;r&lt;/i&gt; = −0.254, &lt;i&gt;p&lt;/i&gt; = 0.021). Sleep efficiency, snoring index, pulse rate, nadir SpO&lt;sub&gt;2&lt;/sub&gt;, and sleep stage proportions showed no significant associations. In the adjusted linear model, AHI and sex were retained; each 10-event/h AHI increase corresponded to a 3.16°/s lower SPV (95% CI: −6.05 to −0.28; &lt;i&gt;p&lt;/i&gt; = 0.032). The random forest model achieved a pooled fivefold &lt;i&gt;R&lt;/i&gt;\u0000 &lt;sup&gt;2&lt;/sup&gt; of 0.065, indicating low explained variance. Regarding mean absolute SHAP values, hypoxemia-domain metrics ranked highest (ODI, AHI, CT90), followed by BMI, while other features had minimal impact.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Nocturnal hypoxemia burden—reflecting the frequency and cumulative duration of oxygen desaturation—emerged as the principal predictor of reduced caloric SPV in patients with OSA. While the low explained variance of our models (&lt;i&gt;R&lt;/i&gt;\u0000 &lt;sup&gt;2&lt;/sup&gt; = 0.065) suggests these associations should be viewed as hypothesis-generating, the findings support prioritising desaturation assessment in","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 6","pages":"894-901"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148444874","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":"Time-to-Event Comparison of Two Surgical Techniques for Excision of Localised Pars Tensa Retraction","authors":"Zohaib Hussain,&nbsp;Mable T. Monachan,&nbsp;Paul H. J. Donachie,&nbsp;Maryam Nowghani,&nbsp;John Hamilton","doi":"10.1111/coa.70139","DOIUrl":"10.1111/coa.70139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We investigate whether the insertion of a ventilation tube into the tympanic membrane affects the healing of the tympanic membrane after excision of clinically significant pars tensa retraction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis of patients with pars tensa retraction who underwent surgical excision of the retracted part of their tympanic membrane without surgical repair of the defect. Time to event analysis was used to compare perforation closure of the group who underwent ancillary ventilation tube insertion to that of the group with retraction excision alone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eligible were 149 ears from 149 patients with a median age of 11 years (IQR: 8–21 years), where 47 underwent excision only and 102 underwent excision plus tube insertion. At 6 months after surgery, a higher percentage of patients who underwent excision alone healed (89%) compared to those who had excision with tube insertion (75%). The depth of the retraction pocket and the integrity of the ossicular chain were also independently associated with the tympanic membrane closure. Age, sex, side of ear surgery and location of retraction were not associated with this outcome. At 6 months, the probability that the difference between the two surgical groups is due to chance is 0.004.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our series, ancillary ventilation tube insertion had a detrimental effect on the complete spontaneous healing of the tympanic membrane after retraction pocket excision without surgical repair of the defect.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 6","pages":"875-881"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419524","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":"Predictors of Enrolment in a Transoral Surgical Trial for HPV-Related Oropharyngeal Carcinoma","authors":"Nina Gallo,&nbsp;Caroline Casey,&nbsp;Andrea Costantino,&nbsp;Shravan Kandula,&nbsp;Tarek Mekhail,&nbsp;Xiang Zhu,&nbsp;J. Scott Magnuson,&nbsp;Bruce H. Haughey","doi":"10.1111/coa.70160","DOIUrl":"10.1111/coa.70160","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated demographic, clinical and perceptual factors associated with enrolment in a Phase III transoral surgical trial for HPV-related oropharyngeal carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Single-centre, questionnaire-based cross-sectional pilot study of patients screened for PATHOS trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Tertiary cancer centre participating in the PATHOS trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients with p16-positive oropharyngeal carcinoma were eligible for the trial. Of 100 patients screened, 70 met trial eligibility and 51 completed a telephone questionnaire and were included. Inability to complete the questionnaire because of cognitive impairment or a language barrier was a prespecified survey exclusion criterion. However, no patient was excluded for either reason.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Primary outcome was the patient decision to enrol or decline participation in PATHOS (written consent). Predictor variables included demographic and clinical characteristics and responses to a 31-item Likert-scale questionnaire.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 51 eligible patients who completed the questionnaire, 29 (57%) enroled in the trial. On univariable analysis, significant predictors included perceptions of treatment quality, toxicity, quality of life, travel distance, trial comprehension, randomisation, medical terminology, trust, prior trial experience and concern about being treated as a ‘guinea pig’. On multivariable analysis, prior trial experience (<i>p</i> = 0.022) and not feeling like a ‘guinea pig’ (<i>p</i> = 0.047) remained significant, with travel distance trending (<i>p</i> = 0.087).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Trial enrolment was driven primarily by prior exposure to clinical research and perceptions of vulnerability and trust, rather than by demographic or tumour factors. Addressing fears of being a ‘guinea pig’, improving trial comprehension and mitigating travel-related barriers may enhance accrual and promote more equitable participation in head and neck cancer trials.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 6","pages":"952-959"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789109","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":"Voice Fundamental Frequency Variation and Statin Therapy.","authors":"Luca Francesco Parata, Paola Andreozzi, Lydia Thaleia Tzigkie, Marco de Vincentiis, Diletta Angeletti, Massimo Fusconi","doi":"10.1111/coa.70171","DOIUrl":"https://doi.org/10.1111/coa.70171","url":null,"abstract":"<p><strong>Objectives: </strong>Statins are considered a first-line treatment for dyslipidaemia, being the most frequently prescribed medicine worldwide. However, statin therapy has been associated with several adverse effects, including statin-associated myopathy, which may manifest with symptoms such as myalgia, muscle stiffness, and cramps. Because phonation involves skeletal muscles of the larynx, statin-related muscular effects may also influence vocal function. The fundamental frequency of the voice (FFF) depends on vocal fold length, mass, and tension and may therefore reflect alterations in laryngeal muscle function.</p><p><strong>Design: </strong>In this prospective observational study, the authors analysed the FFF at the baseline (T0), before initiating statin therapy, and after 3 months of treatment (T1). To measure the FFF, we have used a sensible microphone and the Multi-Dimensional Voice Program.</p><p><strong>Participants: </strong>Thirty-six adult patients (16 men and 20 women) have been initially enrolled, 28 of whom have successfully completed the study (12 men and 16 women).</p><p><strong>Results: </strong>Among the 28 patients who have completed the 3 months' study, 20 have had a reduction of the FFF. Of these, 14 have experienced mild muscle cramps, whereas 6 of them have not experienced any symptoms.</p><p><strong>Conclusion: </strong>Changes in fundamental frequency were observed in a proportion of patients undergoing statin therapy. These findings suggest that acoustic voice analysis may potentially reflect alterations in laryngeal muscle function during statin treatment. However, given the limited sample size and the absence of a control group, further prospective studies with larger cohorts and controlled confounding factors are necessary to clarify the potential role of FFF as an objective marker of statin-associated myopathy.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149105151","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":"Trial Design, Endpoints and Results Reporting in Interventional Laryngeal Cancer Trials: A Registry-Based Analysis.","authors":"Jin Wang, Junfeng Wu, Ziqi Yang, Yihao Pei, Fance Meng, Jianmei Han","doi":"10.1111/coa.70174","DOIUrl":"https://doi.org/10.1111/coa.70174","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize trial design, endpoint emphasis and public results reporting in interventional laryngeal cancer studies.</p><p><strong>Design: </strong>Registry-based descriptive study of trial records.</p><p><strong>Setting: </strong>ClinicalTrials.gov; records were retrieved on 28 July 2025.</p><p><strong>Participants: </strong>Interventional trials retrieved using the term 'laryngeal cancer' and with a documented start date between 1988 and 2025.</p><p><strong>Main outcome measures: </strong>Trial phase, planned enrolment, design features, intervention strategies, registered endpoint domains, results posting and discontinuation.</p><p><strong>Results: </strong>We identified 404 trials. Most were early-to mid-phase with modest enrolment, and masking was recorded in 10.6%. Randomization was documented in 34.7% overall and was more frequent in 2009-2025 than in 1988-2008. Across three study eras, the proportion of trials specifying survival endpoints increased from 34.2% to 68.4%. Quality-of-life or patient-reported endpoints increased from 11.0% to 36.8%, and swallowing endpoints increased from 6.3% to 17.1%. Voice endpoints remained uncommon (3.8%-6.6%), and 21 trials (5.2%) specified an explicit larynx-preservation endpoint. Results were posted for 23.5% of trials, and 16.1% were discontinued.</p><p><strong>Conclusions: </strong>Registrations increasingly reflect survival and patient-centred priorities, although explicit larynx-preservation endpoints and publicly posted results remain uncommon. Future trials may benefit from larynx-specific designs, consistent assessment of larynx preservation and function with adequate follow-up, and timely dissemination of results.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080013","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 Value of Systemic Immune-Inflammation Index in the Occurrence and Prognosis of Sudden Sensorineural Hearing Loss: A Meta-Analysis.","authors":"Feifei Sun, Jun Bai, Xinyuan Liu, Mingjun Zhao","doi":"10.1111/coa.70169","DOIUrl":"https://doi.org/10.1111/coa.70169","url":null,"abstract":"<p><strong>Objectives: </strong>Sudden sensorineural hearing loss (SSNHL) is a common otolaryngology emergency. This study aimed to evaluate the association of the systemic immune-inflammation index (SII) with the occurrence and prognosis of SSNHL.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Setting: </strong>Databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, Wanfang, VIP, and SinoMed.</p><p><strong>Participants: </strong>A total of 1263 participants from 11 studies, comprising 716 SSNHL patients and 547 healthy controls.</p><p><strong>Main outcome measures: </strong>Weighted mean difference (WMD) and 95% confidence interval (CI) for SII levels.</p><p><strong>Results: </strong>This meta-analysis included 11 studies involving 1263 participants, of whom 716 were SSNHL patients and 547 were healthy controls. The pooled results showed that SII was significantly higher in SSNHL patients than in healthy controls (WMD = 393.46, 95% CI: 222.02-564.91, p < 0.001). In addition, SII was significantly lower in the hearing recovery group than in the non-recovery group (WMD = -208.36, 95% CI: -412.27 to -4.34, p = 0.045).</p><p><strong>Conclusion: </strong>Elevated SII is associated with SSNHL occurrence and poorer hearing recovery. However, further prospective studies with adequate adjustment for confounders are required to clarify its independent prognostic value and clinical utility.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016093","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":"Persistent Postural-Perceptual Dizziness in Older Adults: Associations With Intrinsic Capacity Decline, Probable Sarcopenia and Geriatric Syndromes.","authors":"Nagihan Sözen Gencer, Sibel Cavdar, Mehmet Fatih Özhan, Omer Hizli","doi":"10.1111/coa.70170","DOIUrl":"https://doi.org/10.1111/coa.70170","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent postural-perceptual dizziness (PPPD) is a chronic dizziness disorder in older adults, characterized by persistent non-vertiginous dizziness and postural instability. This study aimed to investigate the associations of intrinsic capacity, sarcopenia and geriatric syndromes with PPPD in older adults.</p><p><strong>Methods: </strong>This cross-sectional study included 263 individuals aged over 65 years (128 with PPPD and 135 without PPPD) attending geriatric and otorhinolaryngology outpatient clinics. PPPD was diagnosed according to Bárány Society criteria. Comprehensive geriatric assessment included intrinsic capacity domains, frailty (FRAIL scale), handgrip strength (HGS), sarcopenia parameters and history of falls. Multiple logistic regression models were constructed to evaluate independent associations while avoiding collinearity between overlapping variables. Separate models were used to assess physical performance, intrinsic capacity, sarcopenia and geriatric syndromes.</p><p><strong>Results: </strong>Participants with PPPD had significantly lower intrinsic capacity, slower gait speed, lower handgrip strength, higher depressive symptoms, higher frailty and more frequent falls (all p ≤ 0.005). In locomotion-based models, slower gait speed (OR = 0.121, 95% CI: 0.031-0.474; p = 0.002), higher GDS-15 scores (OR = 1.131, 95% CI: 1.021-1.252; p = 0.018) and fall history (OR = 2.660, 95% CI: 1.502-4.711; p = 0.001) were independently associated with PPPD. In muscle strength models, lower handgrip strength was also associated with PPPD (OR = 0.927, 95% CI: 0.879-0.978; p = 0.006). Domain-based analysis showed that locomotor and psychological impairments were independently associated with PPPD. Lower intrinsic capacity was strongly associated with PPPD (OR = 0.497, 95% CI: 0.377-0.656; p < 0.001). In clinically oriented models, probable sarcopenia (OR = 2.185, 95% CI: 1.188-4.018; p = 0.012), frailty (OR = 2.381, 95% CI: 1.323-4.285; p = 0.004) and depression (OR = 2.558, 95% CI: 1.387-4.717; p = 0.003) were independently associated with PPPD, while malnutrition did not show a significant association.</p><p><strong>Conclusion: </strong>PPPD in older adults extends beyond a purely vestibular disorder, encompassing geriatric dimensions such as frailty, muscle weakness and depressive symptoms. An integrated otolaryngology-geriatrics care model is warranted, and longitudinal studies evaluating the impact of geriatric interventions on PPPD's natural history are needed.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012093","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}