Clinical Otolaryngology最新文献

{"title":"Dynamic Inspiratory Oropharyngeal Obstruction in Children With Obstructive Sleep-Disordered Breathing: A Cross-Sectional Study.","authors":"Amani Kais, Ruifeng Cui, Ryan S Ziltzer, Christopher Deskins, Hussein Jaffal","doi":"10.1111/coa.70113","DOIUrl":"10.1111/coa.70113","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":"784-787"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764576","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":"Oxymetazoline Can Shorten the Time Required for a Bronchoscope to Reach the Vocal Cords in Patients With Turbinate Hypertrophy.","authors":"Jie Zhang, Fanliang Meng","doi":"10.1111/coa.70118","DOIUrl":"10.1111/coa.70118","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the effects of oxymetazoline on the time required for the bronchoscope to reach the vocal cords, nasal manipulation difficulty during bronchoscopy, nasal mucosal injury, and patient-reported pain in individuals with turbinate hypertrophy undergoing bronchoscopic examination.</p><p><strong>Materials and methods: </strong>This prospective, double-blinded, randomised controlled trial enrolled 240 patients with turbinate hypertrophy (November 2023 to July 2024), randomised into oxymetazoline, saline, and blank control groups (n = 80 each). The primary outcome was bronchoscope-to-vocal-cords time. Secondary outcomes included operator-assessed nasal passage ease (negotiation visual analog scale [VAS]), assistant-evaluated facial pain (Facial Pain Scale), patient-reported nasal pain (Pain VAS), operator-rated mucosal trauma (Trauma VAS) and hemodynamic parameters.</p><p><strong>Results: </strong>The oxymetazoline group demonstrated significantly shorter bronchoscope-to-vocal-cords time compared to the saline group (44.00 s [41.00-47.00] vs. 52.00 s [50.00-58.00], p < 0.001), improved nasal passage ease (negotiation VAS: 3.00 [2.00-4.00] vs. 5.00 [4.00-6.00], p < 0.001), and reduced mucosal trauma (Trauma VAS: 7.00 [6.00-8.00] vs. 9.00 [8.00-9.00], p < 0.001). Patients receiving oxymetazoline reported lower nasal pain scores (assistant-assessed: 4.00 [3.00-5.00] vs. 5.00 [5.00-6.00]; patient-reported: 4.00 [3.00-4.75] vs. 5.50 [5.00-6.00], both p < 0.001).</p><p><strong>Conclusion: </strong>Oxymetazoline optimises bronchoscopy in turbinate hypertrophy patients by shortening procedural time, easing nasal passage, mitigating mucosal injury, and alleviating pain. This trial is registered at chictr.org.cn (ChiCTR2300077642).</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":"770-775"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338156","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":"Pathologies Detected Using In-Office Transnasal Oesophagoscopy: Our Cohort of 234 Cases.","authors":"Paraskevi Karamitsou, Ismail Sherwani, Ahmad Moinie, Panagiotis A Dimitriadis, Ananth Vijendren","doi":"10.1111/coa.70131","DOIUrl":"10.1111/coa.70131","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":"795-800"},"PeriodicalIF":1.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13432571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148204340","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":"Survey of National Approaches to Practice in Local Anaesthetic Rhinology Surgery (SNAP-LARS): A United Kingdom National Cross-Sectional Collaborative Survey.","authors":"Dhruv Patel, Behrad Barmayehvar, Shayan Shahidi, Tharsika Myuran, Ding Yang, Vikas Acharya, Miran Pankhania, Raj K Bhalla, Ashok Rokade","doi":"10.1111/coa.70162","DOIUrl":"https://doi.org/10.1111/coa.70162","url":null,"abstract":"<p><strong>Introduction: </strong>Local anaesthetic rhinology surgery (LARS) offers a safe and cost-effective alternative to procedures traditionally performed under general anaesthesia. Despite publication of British Rhinological Society guidance in 2022, the landscape of LARS provision in the United Kingdom (UK) remains unclear. This study aimed to characterise current practice, whilst highlighting variations and perceived barriers to LARS.</p><p><strong>Methods: </strong>A cross-sectional national multi-centre collaborative survey was conducted between October 2025 and February 2026. The protocol followed the CROSS reporting checklist for survey studies. Only endonasal procedures were included. Each response captured a consultant's typical LARS practice over the preceding 12 months. Free-text responses underwent thematic analysis.</p><p><strong>Results: </strong>Sixty-three consultant responses from 39 sites were analysed. The most frequently performed procedures were endonasal biopsy (n = 60, 95.2%), septal button insertion (n = 46, 73.0%) and nasal polypectomy (n = 35, 55.6%). Most consultants performed ≤ 30 cases annually (76.2%) and typically ran one LARS session per month (76.2%). Most cases (76.6%) were performed in operating theatres. Sedation was offered by 19.0% (n = 12), and most patients were discharged within 2 h (n = 57, 90.5%). Routine PROM collection was only reported by 49.2% (n = 31). Utilisation of reusable equipment varied widely, with 47.6% (n = 30) using ≤ 50% reusable equipment. Barriers to service expansion included space, equipment, staffing and funding.</p><p><strong>Conclusion: </strong>LARS is delivered through heterogeneous models, and responses showed skew towards England. There is considerable opportunity to expand outpatient procedure-room delivery, standardise care pathways and outcome measurement, and address organisational barriers. These could enhance efficiency, reduce costs, minimise environmental impact, and ultimately improve patient experience.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825558","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":"Xylitol-Containing Nasal Irrigation or Nebulization in Postoperative Sinonasal Care: A Systematic Review and Meta-Analysis With GRADE Assessment.","authors":"Mohamed Saad Rakab, Yasir Majhud S Alzahrani, Abdulaziz Muhayya Alotaibi, Nourah Almarri, Lamyaa Hamdan Almutairi, Rakan Y Alsuwayyid, Aasheq Mamdouh W Alanazi, Abdullah O Almutairi, Turki Nashi Alharbi, Abdullah Mohammed Alghaith, Talal Dhifallah A Alanazi, Saad Hamdi Alenzi","doi":"10.1111/coa.70155","DOIUrl":"https://doi.org/10.1111/coa.70155","url":null,"abstract":"<p><strong>Background: </strong>Xylitol, a five-carbon polyol with antibiofilm effects, is increasingly added to postoperative sinonasal irrigations, yet its advantage over saline remains uncertain.</p><p><strong>Methods: </strong>We systematically reviewed comparative studies evaluating xylitol-containing nasal solutions after ESS, septoplasty, or turbinate surgery. Searches spanned PubMed, Scopus, Web of Science, and CENTRAL from inception to 18 June 2026. Outcomes included patient-reported symptoms (SNOT-20/22, NOSE, VAS), endoscopic healing, and safety. Random-effects meta-analysis pooled effects as mean differences (MD) or standardized mean differences (SMD); certainty was appraised with GRADE.</p><p><strong>Results: </strong>Eight studies met eligibility. Xylitol showed no clear overall advantage on SNOT-20/22 (SMD -0.49, 95% CI -1.12 to 0.14; p = 0.107; I² = 72.9%). The effect was larger yet heterogeneous post-ESS (SMD -0.79, 95% CI -1.99 to 0.41), while non-ESS effects centred on no difference (SMD -0.09, 95% CI -0.45 to 0.26). Excluding Lin 2017 resolved most heterogeneity and significantly favoured xylitol (SMD -0.27, 95% CI -0.47 to -0.06; p = 0.0098; I² = 24.2%). VAS score showed modest yet statistically significant improvement with xylitol (MD -1.16 points, 95% CI -2.30 to -0.03; p = 0.045). NOSE showed no overall benefit (MD -4.18, 95% CI -13.04 to 4.68; p = 0.2299); non-ESS improved slightly (MD -1.17, 95% CI -2.08 to -0.26; p = 0.0387), while ESS was heterogeneous and uncertain. Endoscopic scores were not significantly different (SMD -0.21, 95% CI -0.51 to 0.08; p = 0.1157).</p><p><strong>Conclusions: </strong>Xylitol-containing postoperative irrigations may provide modest symptomatic benefit in selected postoperative populations, but the evidence remains low to very low certainty and does not establish a reliable clinically important SNOT-22 benefit. Larger, multicentre RCTs with standardized dosing/delivery and head-to-head comparators are needed to define candidates, optimal regimens, and durability of benefit.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825573","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":"Treatment Outcomes of Total Versus Superficial Parotidectomy With Postoperative Radiotherapy for High-Grade Parotid Carcinoma Confined to the Superficial Lobe: A Propensity Score–Adjusted Analysis","authors":"Wisarut Samuckkeethum,&nbsp;Yosita Muenkaew,&nbsp;Narin Ratanaprasert,&nbsp;Thanapat Supakmontri,&nbsp;Tapanut Ariyanon,&nbsp;Jakkree Naruekon,&nbsp;Pasawat Supanimitjaroenporn,&nbsp;Wirut Iamsahakiat,&nbsp;Stephen J. Kerr,&nbsp;Kornkiat Snidvongs","doi":"10.1111/coa.70115","DOIUrl":"10.1111/coa.70115","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The optimal surgical management of high-grade parotid carcinoma confined to the superficial lobe remains controversial, with limited evidence comparing total and superficial parotidectomy in this setting.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To compare oncologic outcomes and complications between total parotidectomy with postoperative radiotherapy (TP + PORT) and superficial parotidectomy with postoperative radiotherapy (SP + PORT).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Study Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Multicentre retrospective cohort study.&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;Adult patients (&gt; 18 years) with high-grade parotid carcinoma confined to the superficial lobe treated between 2011 and 2023 were identified at tertiary centres. Exclusion criteria included preoperative facial nerve palsy, metastatic disease to the parotid gland, prior head and neck radiotherapy, receipt of concurrent chemoradiation and follow-up &lt; 12 months.&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;A total of 108 patients were included (TP + PORT, &lt;i&gt;n&lt;/i&gt; = 63; SP + PORT, &lt;i&gt;n&lt;/i&gt; = 45) with a median follow-up of 53 months. Baseline characteristics were comparable except for older age and a higher proportion of Milan category VI cytology in the TP + PORT group (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). Local, regional and distant recurrence rates and mortality did not differ significantly between groups (&lt;i&gt;p&lt;/i&gt; = 0.55, 0.26, 1.00 and 0.36, respectively). All local recurrences occurred within 24 months (mean: 7.2 months). Age and positive resection margins were independent predictors of mortality (&lt;i&gt;p&lt;/i&gt; &lt; 0.01). Five-year overall survival was 73.0% in the TP + PORT group and 81.5% in the SP + PORT group. IPTW-adjusted analyses confirmed no significant differences in recurrence or mortality between groups (hazard ratio for mortality, 0.78; 95% CI: 0.32–1.90; &lt;i&gt;p&lt;/i&gt; = 0.59). Permanent facial nerve palsy was significantly more common after TP + PORT (14.3% vs. 2.2%, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), while other complications were similar.&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;Superficial parotidectomy with adequate margins followed by PORT achieves comparable oncologic outcomes with significantly fewer complications and may be preferred for high-grade parotid carcinoma confined to the superficial lobe.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;2d (JBI).&lt;/p&gt;\u0000 ","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"678-686"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147873413","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":"Treatment-Related Adverse Event Claims in Otorhinolaryngology—Head and Neck Surgery: A Nationwide Finnish Review (2012–2023)","authors":"Alexander Westerholm,&nbsp;Satu Lamminmäki,&nbsp;Lasse Rämö,&nbsp;Leena-Maija Aaltonen,&nbsp;Paula Virkkula,&nbsp;Antti Mäkitie,&nbsp;Morag Tolvi","doi":"10.1111/coa.70114","DOIUrl":"10.1111/coa.70114","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigated the frequency and characteristics of patient injuries related to Otorhinolaryngology—head and neck surgery (ORL-HNS) in Finland from 2012 to 2023, with a focus on common complications, trends in injury frequency and comparisons with previous studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were obtained from the Patient Insurance Centre (PIC) of Finland, encompassing all ORL-HNS-related patient injury cases from 2012 to 2023. The study reviewed 1153 claims, of which 317 (27.5%) were compensated. The analysed variables included patient demographics, procedure types, complications and healthcare settings. Descriptive statistics were used to summarise the data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Most compensated injuries (66.6%) were due to surgical or procedural complications, followed by inadequate management (24.3%). Most cases occurred at university hospitals (40.1%) or regional hospitals (38.8%) and were handled by specialists (69.7%). Endoscopic sinus surgery and septoplasty had compensation ratios of 0.7 and 0.72 per 1000 procedures, respectively. The likelihood of compensation decreased with patient age but was not correlated with hospital type. Among subspecialties, rhinology (31%) and head and neck surgery (30%) had the highest frequency of compensated claims.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study corroborates previous findings that ORL-HNS patient injuries are relatively rare, with many occurring during routine surgeries performed by specialists. These results challenge the assumption that surgical errors stem primarily from inexperience. The greater number of reported complications in university hospitals may reflect the trend towards centralising complex procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"666-671"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728792","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 Platelet-Rich Plasma in Post-Tonsillectomy Wound Healing and Pain Management: A Randomized Controlled Study","authors":"Nilnetre Mahathanaruk,&nbsp;Chattarin Jongkittipong,&nbsp;Vipa Rath Marpukdee","doi":"10.1111/coa.70128","DOIUrl":"10.1111/coa.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tonsillectomy is one of the most common surgical procedures in otolaryngology, but the healing process remains unknown in individual patients. Several interventions, including platelet-rich plasma, have been investigated to improve healing and pain control due to their regenerative properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the effect of platelet-rich plasma injection during tonsillectomy on postoperative results especially on epithelization stage and postoperative pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A prospective randomized controlled trial was conducted between January 2023 and December 2024, including 19 patients with platelet-rich plasma randomly injected in one of the fossae [treatment group] and normal saline in the other fossa [control group]. The endpoints were the epithelialization stage and pain score on days 1–7 after tonsillectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were no statistically significant differences between groups in the postoperative epithelization stage. At the treatment sites, grade III wound epithelization was 21.1%, compared with the control site, where none had grade III wound epithelization. The <i>p</i>-values for wound epithelization (0.903) and pain score (0.222) indicate no difference between groups. Both groups' pain scores improved over time (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intraoperative injection of platelet-rich plasma into the tonsillar beds was effective in stimulating tonsillar wound healing. Because of its properties, the treatment group appeared to have faster wound recovery than the control group. However, the differences were not statistically significant. Further studies with larger sample sizes are warranted to elucidate the potential benefits of platelet-rich plasma in post-tonsillectomy healing.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"722-728"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70128","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052961","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":"Tonsillectomy Complications in Adults: A Retrospective Observational Cohort Study of National Health Service Patients in England Using Hospital Episode Statistics","authors":"Steven Powell,&nbsp;Kim Keltie,&nbsp;Ed O'Toole,&nbsp;Rachel A. O'Leary,&nbsp;Hayley Richardson,&nbsp;Paola Cognigni,&nbsp;Rosalyn Parker,&nbsp;James O'Hara,&nbsp;Benjamin Talks,&nbsp;Adam Donne,&nbsp;Francis Stafford,&nbsp;Andrew C. Swift,&nbsp;Andrew J. Sims","doi":"10.1111/coa.70130","DOIUrl":"10.1111/coa.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterise adult tonsillectomy procedures conducted in the NHS from routine administrative data in England and investigate trends in their associated complications over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective observational cohort study using routine data from Hospital Episode Statistics (HES).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Acute NHS trusts in England are conducting adult tonsillectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Adults (&gt; 16 years old) undergoing tonsillectomy procedure with a primary diagnosis of any non-malignant indication, and with no current or historic cancer, or benign neoplasm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Number of procedures, in-hospital complications, readmissions within 28 days and trends over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 198 130 adult patients had a tonsillectomy between 1 April 2008 and 31st March 2023 in NHS trusts in England. The total number of procedures is falling over time. It is more commonly undertaken in women (68.3%), with 79.3% performed for tonsillitis. The majority (59.6%) are discharged on the same day, with 37.5% staying 1 night in hospital. 1.5% of patients had an in-hospital complication, with a total of 1967 patients having a haemorrhage or surgical arrest of post-operative bleeding from the tonsillar bed or adenoid; occurring more frequently in men (1.7% versus 0.7%, <i>p</i> &lt; 0.001). A total of 33 934 patients were readmitted as an emergency within 28 days of surgery, almost doubling between 2008/09 and 2022/23. Readmission with bleeding within 28 days has also increased from 8.8% in 2008/09 to 15.6% in 2022/23. The return to theatre rate during readmissions has been relatively stable over the study time period with a higher proportion of admissions being managed without a further operative procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tonsillectomy is a very common operation in the NHS in England. It currently has a readmission rate of 1 in 5 adults and this information is important for informed consent and local resource planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"744-751"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175558","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":"Prognostic Value of the Haemoglobin–Albumin–Lymphocyte–Platelet Score in Head and Neck Cancer: A Systematic Review and Meta-Analysis","authors":"Yu Hsin Lin,&nbsp;Hsin Yi Huang,&nbsp;Wan-Lun Hsu,&nbsp;Li-Jen Liao","doi":"10.1111/coa.70134","DOIUrl":"10.1111/coa.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The haemoglobin–albumin–lymphocyte–platelet (HALP) score is an inflammation- and nutrition-related biomarker derived from routine blood tests, but its prognostic value in head and neck cancer (HNC) has not been quantitatively synthesized. This systematic review and meta-analysis aimed to evaluate the association between pretreatment HALP and survival outcomes in HNC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PubMed, Embase and Web of Science were searched to 24 January 2026 for cohort studies reporting hazard ratios (HRs) for survival outcomes by pretreatment HALP in HNC. Reviews, case reports, conference abstracts without full text, and studies lacking survival data were excluded. Random-effects meta-analysis was performed and risk of bias was assessed using QUIPS. The review was prospectively registered in the Open Science Framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six retrospective cohort studies (1759 patients) were included. Higher pretreatment HALP was associated with improved overall survival (pooled HR 0.52, 95% CI 0.41–0.67; <i>I</i>² = 17.6%) and disease-free survival (pooled HR 0.60, 95% CI 0.47–0.76; <i>I</i>² = 0.0%). After excluding the metastatic cohort, the pooled overall survival estimate remained similar (HR 0.56, 95% CI 0.45–0.70; <i>I</i>² = 0.0%), and leave-one-out analyses showed stable estimates (HR range 0.48–0.56).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Higher pretreatment HALP is associated with favourable survival in HNC. However, reported cutoff values for HALP have been inconsistent across studies. HALP might be helpful for clinicians in evaluating the prognosis of HNC patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"635-643"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293548","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}