Clinical Otolaryngology最新文献

{"title":"The Usefulness of ETDQ-7 Score in Assessing ETD","authors":"Niels Højvang Holm,&nbsp;Therese Ovesen","doi":"10.1111/coa.14324","DOIUrl":"10.1111/coa.14324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The ETDQ-7 questionnaire has been validated for diagnosing Eustachian tube dysfunction (ETD) and a minimal clinically important difference (MCID) of &gt; 3.5 has been suggested. We aim to assess the use of ETDQ-7 for assessing ETD and a potential correlation between ETDQ-7 and the Sino-Nasal Outcome Test 22 (SNOT-22).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>ETD was based on relevant ear symptoms and objective signs of negative middle ear pressure in 75 consecutive adult patients. Ventilation tube insertion (VTi) was performed on affected ears. ETDQ-7 and SNOT-22 scores before and 1 month after VTi were compared to 75 healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean ETDQ-7 score decreased from 31.9 to 15.8 (<i>p</i> &lt; 0.0001), remained stable on unaffected ears, and was 9.6 in controls. MCID was achieved on all affected ears after VTi. A cut-off score of &gt; 14.5 for diagnosing ETD yielded 100% sensitivity and 94.2% specificity for ETDQ-7. Spearman's <i>ρ</i> for total score test–retest was 0.878 (<i>p</i> = 0.000). Cronbach alpha for total score varied from 0.6807 to 0.7266. SNOT-22 and ETDQ-7 were correlated at baseline (0.12, <i>p</i> = 0.012). ETD patients scored significantly higher in the nasal, otologic and sleep domains in SNOT-22 compared to controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ETDQ-7 is a very valid tool for ETD diagnostics and assessing the ear-related effects of VTi. ETDQ-7 scores reveal residual symptoms after VTi, indicating symptom relief but no cure for the underlying pathophysiology. For future investigation, we suggest assessing ETDQ-7 scores for each ear separately, higher MCID values, and integration of quality of life measures.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> ClinicalTrials.gov: NCT05055115</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 5","pages":"840-847"},"PeriodicalIF":1.5,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981214","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":"Sternocleidomastoid Omohyoid Entrapment of the Internal Jugular Vein Causing Vertigo and Headaches","authors":"Yoon-Hee Cha,&nbsp;Mahmood Gharib,&nbsp;Kayla Chan,&nbsp;Joseph Karam","doi":"10.1111/coa.14325","DOIUrl":"10.1111/coa.14325","url":null,"abstract":"&lt;p&gt;Extracranial venous compression of the internal jugular vein (IJV) from neck structures such as the sternocleidomastoid (SCM) and omohyoid (OMH) muscles can lead to vertigo and headaches [&lt;span&gt;1-4&lt;/span&gt;]. Because case reports of this mechanism have been limited, the pattern of clinical features that should lead to consideration of this mechanism for vertigo and headaches has not yet been delineated. The broader phenomenon of head-motion-induced vestibular symptoms is more typically diagnosed as either vestibular migraine or cervicogenic dizziness, though neither diagnosis has a structural model that leads to the treatment of a targeted pathology [&lt;span&gt;5, 6&lt;/span&gt;]. Patients often undergo vestibular rehabilitation to adapt to their symptoms, but treatment refractoriness is common without new treatments on the horizon [&lt;span&gt;7, 8&lt;/span&gt;]. Extracranial venous compression by muscular entrapment of the IJV in the mid-neck may be an underrecognized mechanism of head motion induced vertigo that is frequently accompanied by headache. It can be a new target for treatment.&lt;/p&gt;&lt;p&gt;We report our experience with 12 patients with entrapment of the IJV under the SCM/OMH muscles that led to vertigo and headaches, with symptoms resolving with targeted treatment of this pathology. The mechanism for vertigo was retrograde efflux of venous blood leading to dilation of the superior and inferior petrosal sinuses and shunting down the vertebral veins. We report clinical features that should alert earlier recognition of this syndrome when non-invasive methods such as physical therapy and postural education can be initiated to avoid more invasive treatments later.&lt;/p&gt;&lt;p&gt;Design: Clinical case series.&lt;/p&gt;&lt;p&gt;Setting: Tertiary university-based outpatient clinic.&lt;/p&gt;&lt;p&gt;Patients: Patients presented with intractable head motion-triggered vertigo to our team's neurotologist (Y.H.C.). Detailed history, neurological exam, vestibular function testing, audiological exams, and arterial imaging (MRA/CTA) were used to rule out primary inner ear and arterial disorders. The Academic HealthCare Information Exchange for the medical centre identified patients through an IRB-approved study who were then reviewed for availability of all diagnostic tests.&lt;/p&gt;&lt;p&gt;Outcome measures: Report of relief of vertigo by at least 70%.&lt;/p&gt;&lt;p&gt;Screening measures: IJV entrapment was based on dynamic quantitative Doppler ultrasound (qDUS), CT venogram (CTV) of the head and neck, a trial of physical therapy, and then ultrasound-guided (US) intramuscular onabotulinumtoxin A (BoNT-A) injections (M.G.). Digital subtraction venography was performed in all patients, and surgical decompression was performed (J.K.) if non-invasive treatment was not sufficient. Descriptions of each step are included below.&lt;/p&gt;&lt;p&gt;Ten of 12 patients were female with a median age of 44 years (range 31–74 years) and a median duration of vertigo of 1.8 years before presentation. All 12 patients had vertigo triggered by leftward head ro","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 5","pages":"918-923"},"PeriodicalIF":1.5,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981720","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":"Circulating Tumour DNA as a Complementary Tool for Treatment Evaluation in HPV-Associated Head and Neck Squamous Cell Carcinoma: An Observational Cohort Study","authors":"Anna Oldaeus Almerén,&nbsp;Max Waenerlund,&nbsp;Fredrik Landström,&nbsp;Mathias von Beckerath,&nbsp;Alvida Qvick,&nbsp;Jessica Carlsson,&nbsp;Gisela Helenius","doi":"10.1111/coa.14317","DOIUrl":"10.1111/coa.14317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>HPV-positive oropharyngeal squamous cell carcinoma (OPSCC) and head and neck carcinoma of unknown primary (HNCUP) are increasing. Despite good prognosis, recurrence rates range from 10% to 25%. Surveillance with clinical controls and imaging is not always reliable. Circulating tumour human papillomavirus DNA (ctHPV-DNA) has emerged as a potential biomarker for treatment evaluation and detection of recurrence. We aimed to investigate the correlation between ctHPV-DNA in HPV+ OPSCC/HNCUP and radiologic tumour burden. Additionally, we sought to assess whether ctHPV-DNA could serve as a tool in treatment evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A prospective observational cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This multicenter study involved three otolaryngology units located in central Sweden. We utilised HPV genotype-specific assays for droplet digital PCR (ddPCR) to detect ctHPV-DNA in plasma at diagnosis and follow-up. ctHPV-DNA levels were correlated to radiological tumour burden and radiological response using the Kendall Rank correlation coefficient and the Kruskal–Wallis test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients with HPV+ OPSCC/HNCUP undergoing definitive (chemo)radiotherapy and enrolled in the CIRCOS study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 54 patients, 51 were eligible for analyses. At baseline, ctHPV-DNA was detectable in 88%. A majority of patients with a favourable radiological evaluation according to RECIST had a corresponding undetectable ctHPV-DNA at follow-up. The levels of ctHPV-DNA at baseline correlated with total tumour volume and nodal volume (<i>rτ</i> = 0.39, <i>p</i> &lt; 0.01, respectively <i>rτ</i> = 0.26, <i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ctHPV-DNA shows correlation with tumour burden. This study strengthens the role of ctHPV-DNA as a promising biomarker for treatment evaluation in HPV-related OPC/HNCUP. With further research on serial plasma sampling, ctHPV-DNA could complement radiological treatment evaluation in HPV+ OPSCC/HNCUP.</p>\u0000 \u0000 <p>\u0000 <b>Trial Registration:</b> NCT05904327 [ClinicalTrials.gov]</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 5","pages":"831-839"},"PeriodicalIF":1.5,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14317","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964868","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":"Evaluation of Sleep Stages During Drug-Induced Sleep Endoscopy in Pediatric Patients with Obstructive Sleep Apnea: A Pilot Study","authors":"Audrey Abend,&nbsp;Chase Hintelmann,&nbsp;Katherine H. Dinh,&nbsp;Darius Uknuis,&nbsp;Usman Shah,&nbsp;Maya Ramagopal,&nbsp;Kelvin Kwong","doi":"10.1111/coa.14321","DOIUrl":"10.1111/coa.14321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Drug-induced sleep endoscopy (DISE) is a valuable tool for the assessment of the upper airway in paediatric obstructive sleep apnoea (OSA). General anaesthesia induces sleep-like conditions during DISE; however, there is limited understanding of the neurophysiological aspects of this sleep. We conducted a prospective cohort pilot study recording electroencephalogram (EEG), electrooculogram (EOG) and electromyogram (EMG) data in paediatric OSA patients during DISE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Demonstrate the safety and feasibility of collecting sleep stages during DISE in paediatric patients with OSA. Characterise sleep stages of paediatric OSA patients undergoing DISE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Prospective cohort pilot study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Academic medical centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Patients between two (2) and 18 years old (inclusive) with a history of OSA and preoperative polysomnography (PSG) were recruited. Patients with known craniofacial abnormalities were excluded. Non-English or non-Spanish speaking subjects were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We recruited 13 subjects aged 3 to 13 years old. EEG, EOG, and EMG data was collected during the DISE procedure. Raw data was scored by a board-certified sleep medicine physician. Six subjects experienced N1 sleep, 12 subjects experienced N2 sleep, and 5 subjects experienced N3 sleep. Most subjects spent the majority of their time in N2 sleep. No subjects experienced REM sleep. The primary intravenous sedative agent used was dexmedetomidine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This pilot study gives the first insight into sleep stages of paediatric OSA patients undergoing DISE. Additional investigation of the neurophysiology and the effects of different intravenous anaesthetics during the DISE procedure is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 4","pages":"758-764"},"PeriodicalIF":1.7,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14321","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964869","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":"The Safe Use of Coblation Intracapsular Tonsillectomy and Adenoidectomy in Children With Cardiac Pacemakers, Vagal Nerve Stimulators and Cochlear Implants: A Retrospective Case Series of Five Patients","authors":"Alexander Scott North,&nbsp;Nikul Amin,&nbsp;Shradha Sharma,&nbsp;Daniel John Tweedie","doi":"10.1111/coa.14322","DOIUrl":"10.1111/coa.14322","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 5","pages":"913-917"},"PeriodicalIF":1.5,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974372","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":"Clinical Profile and Referral Pathways in Late Radiation-Associated Dysphagia (Late-RAD): A Consecutive Case Series","authors":"Diane Sellstrom,&nbsp;James O'Hara,&nbsp;Catherine Haighton,&nbsp;Tracy Finch,&nbsp;Joanne M. Patterson","doi":"10.1111/coa.14319","DOIUrl":"10.1111/coa.14319","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 4","pages":"785-789"},"PeriodicalIF":1.7,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981700","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":"Evaluation and Outcomes of Iatrogenic Oropharyngeal Dysphagia","authors":"Shorook Naara,&nbsp;Shadi Shinnawi,&nbsp;Nadeem Habashi,&nbsp;Eli Rimmer,&nbsp;Salem Billan,&nbsp;Jacob T. Cohen","doi":"10.1111/coa.14315","DOIUrl":"10.1111/coa.14315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the outcomes of iatrogenic oropharyngeal dysphagia and compare them with outcomes from different types of dysphagia aetiologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Retrospective analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study was conducted on patients evaluated at a tertiary hospital's Swallowing Disorder Center using physical examination and fibreoptic endoscopic evaluation of swallowing (FEES) between January 2015 and October 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were divided into six groups according to the potential cause of dysphagia: (1) Post head and neck cancers (HNCs) treatment; (2) Post-surgery for non-cancerous aetiology; (3) Neurological; (4) Intracranial; (5) Head and neck pathology; and (6) Others. Of these, the first and second groups comprise dysphagia caused by treatment (iatrogenic dysphagia). FEES results were analysed using the Swallowing Performance Status Scale (SPSS) and the Penetration Aspiration Scale (PAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 507 patients included, 146 (28.8%) had iatrogenic dysphagia, and 361 (71.2%) had non-iatrogenic dysphagia. After swallowing therapy, 138 patients underwent a follow-up FEES examination (47 patients with iatrogenic dysphagia and 91 patients with non-iatrogenic dysphagia). After swallowing intervention (compensatory technique and food consistency changes), the follow-up FEES examination revealed significant improvement in the non-iatrogenic group (<i>p</i> &lt; 0.001), while the iatrogenic group showed no significant improvement after intervention. PAS and SPSS scores also demonstrated greater improvement in the non-iatrogenic group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study emphasises that iatrogenic dysphagia is a common entity in the swallowing disorders outpatient ENT clinic. It is more likely to persist and resist conventional swallowing therapy, leading to worse outcomes compared to non-iatrogenic dysphagia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 4","pages":"751-757"},"PeriodicalIF":1.7,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986044","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":"Non-Recurrent Laryngeal Nerve: Surgical Risk of Injury in Comparison With the Normal Recurrent Laryngeal Nerve—A Systematic Review and Meta-Analysis","authors":"Jensen Tsun-Ki So,&nbsp;C. S. G. Thompson","doi":"10.1111/coa.14312","DOIUrl":"10.1111/coa.14312","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The non-recurrent laryngeal nerve (NRLN) is a known anatomical variation of the normal recurrent laryngeal nerve (RLN). Its prevalence is estimated to be &lt; 1% and has a higher risk of iatrogenic injury. The risk during thyroid surgery has been reported variably in current literature, from 0% to 12%. This study aimed to systematically review the incidence of NRLN injury and present the results through meta-analysis. The incidence of injury to NRLN and RLN was compared statistically to determine its significance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The PRISMA protocol was followed for an online search of prominent literatures. Studies were selected according to specific criteria. Quality assessment was performed before data extraction. Meta-analysis was conducted for the incidence of injury of the NRLN and its comparison to the RLN. Results were presented in the form of a systematic review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Final analysis included 17 studies. The pooled risk of NRLN injury was 7% and the risk ratio of injury in comparison to the RLN was 3.8, showing a statistically significant difference.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This is the first study to report the overall risk of NRLN injury and establish a statistically significant difference compared to the injury of the normal RLN. The NRLN is highly associated with the vascular anomaly of aberrant subclavian artery, which is radiologically predictable. The use of intra-operative nerve monitoring can significantly reduce the risk of injury to this nerve when it is identified pre-operatively, and the thyroid surgery should be performed by experienced thyroid surgeons with extra care to minimise the risk.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 4","pages":"654-663"},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964870","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":"Clinical Factors Influencing the Compliance With National Head and Neck Cancer Targets in the United Kingdom: Results From a National Cohort Study","authors":"Alison E. Lim,&nbsp;Andrew Williamson,&nbsp;Freddie Green,&nbsp;Ying Ki Lee,&nbsp;Lucy Li,&nbsp;Christy Moen,&nbsp;Rishi Vasanthan,&nbsp;Olivia Wharf,&nbsp;Jeremy Wong,&nbsp;Vinidh Paleri,&nbsp;INTEGRATE (The UK ENT Trainee Research Network)","doi":"10.1111/coa.14314","DOIUrl":"10.1111/coa.14314","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In the United Kingdom, it is the standard of care that treatment decisions in all new cases of head and neck cancer (HNC) are discussed at a multidisciplinary team meeting (MDT). The aim of this project was to gain a national perspective on the scope of current HNC treatment, compliance with national cancer pathway targets, and their influence on survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicentre, retrospective, national observational study of primary HNC patients was discussed at a specialist MDT between September and November 2021.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data on 1488 patients were included from 50 UK departments. The most common subsite was oropharynx (35.4%, 522), of which 61.7% (263) were HPV positive. Median time of referral to diagnosis, MDT decision to treatment, and referral to first definitive treatment in primary HNCs managed curatively were 37 (interquartile range [IQR] 22–57), 42 (IQR 29–65), and 74 (IQR 54–101) days, respectively. Compliance with the 28-day, 31-day, and 62-day targets were met in 32.8% (488), 33.3% (495), and 34.6% (515), respectively. On multivariate analysis, patients with urgent cancer referrals, T1–T2 stage disease, and not undergoing a general anaesthetic biopsy were associated with greater compliance with national pathway targets.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study highlights the majority of UK HNC patients are not meeting national pathway targets and delays are seen at all points in the HNC journey. Improving adherence with national best practice standards will contribute to reducing time to treatment for HNC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 4","pages":"739-750"},"PeriodicalIF":1.7,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986042","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":"Yield of Hearing Loss Gene Panel and Audiometric Findings in a Retrospective Cohort of Children With Permanent Childhood Hearing Impairment","authors":"Alpana M. Kulkarni,&nbsp;Henna Majeithia,&nbsp;Louise Busby","doi":"10.1111/coa.14316","DOIUrl":"10.1111/coa.14316","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 4","pages":"780-784"},"PeriodicalIF":1.7,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794756","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}