Clinical Otolaryngology最新文献

{"title":"How Does the Morbidity of Sore Throat in Recurrent Tonsillitis Correlate With the Tonsillitis Outcome Inventory-14 (TOI-14)?","authors":"Pavithran Maniam,&nbsp;Catriona M. Douglas,&nbsp;Tony Fouweather,&nbsp;M. Dawn Teare,&nbsp;Janet Wilson,&nbsp;James O'Hara","doi":"10.1111/coa.70116","DOIUrl":"10.1111/coa.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The National Trial of Tonsillectomy in Adults (NATTINA) demonstrated that tonsillectomy is clinically and cost-effective; however, the generalizability of the results to a real-world population remains uncertain. The number of episodes of tonsillitis is used to assess candidacy for tonsillectomy. An alternative approach could be to utilise a patient-reported outcome measure such as the Tonsillectomy Outcome Inventory-14 (TOI-14).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare the TOI-14 scores in a real-world clinical cohort with the NATTINA cohort. To assess the relationship between the TOI-14 and the number of sore throat days. To assess the role of socioeconomic status in recurrent tonsillitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Baseline TOI-14 scores, the relationship between the number of sore throat days and TOI-14 scores, and socioeconomic deprivation were compared between a real-world clinical cohort and the NATTINA population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Individuals declining entry into NATTINA (<i>n</i> = 609) had the highest TOI-14 score (48.3 (SD 9.9)), followed by the clinical cohort (<i>n</i> = 422) (43.9 (SD 13.3)) and then the randomised NATTINA population (<i>n</i> = 452) (43.1 (SD 12.0), <i>p</i> &lt; 0.001). The correlation between the number of sore throat days and baseline TOI-14 score in all participants was very weak, 0.114, <i>p</i> = 0.001. Approximately 50% of participants with recurrent tonsilitis reside in areas ranked from deciles 1 to 3 on the Scottish/English Index of Multiple Deprivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings from NATTINA can be applied to general clinical practice. The use of a patient-reported outcome measurement instead of sore throat episodes as a criterion for tonsillectomy candidacy requires further research and should consider the impact of socioeconomic status on tonsillitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"672-677"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147867072","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 Analysis of Patients With N1 Nasopharyngeal Carcinoma With Different Lymph Node Characteristics","authors":"Jie Yang,&nbsp;Ying Lu,&nbsp;Hui Yang,&nbsp;Zhuo-hua Xu,&nbsp;Zhou Jiang,&nbsp;Xi-yan Tan,&nbsp;Xi-shan Chen","doi":"10.1111/coa.70124","DOIUrl":"10.1111/coa.70124","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Prognosis in patients with N1 nasopharyngeal carcinoma (NPC) remains heterogeneous, partly due to variations in lymph node involvement. This study evaluated the prognostic significance of different lymph node characteristics in N1 NPC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analysed 160 newly diagnosed non-metastatic N1 NPC patients treated at Liuzhou Worker's Hospital from January 2017 to May 2023. Kaplan–Meier curves were used to estimate survival outcomes, and Cox regression analysis was performed to identify independent prognostic factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 160 patients, 57 had retropharyngeal lymph nodes (RLNs) only, 24 had cervical lymph nodes (CLNs) only, and 79 had concurrent CLNs and RLNs involvement. The 5-year overall survival (OS), progression-free survival (PFS), locoregional relapse-free survival (LRRFS), and distant metastasis-free survival (DMFS) rates were 94.7%, 80.1%, 89.6%, and 88.8%, respectively. Patients with concurrent CLNs and RLNs involvement had worse OS than those with single-region involvement (5-year OS: 90.2% vs. 98.4%, <i>p</i> = 0.0238). Subgroup analysis showed that in T1-2 patients, combined nodal involvement was associated with inferior OS, PFS, and LRRFS, whereas no significant survival differences were observed in T3-4 patients. Multivariate analysis identified lymph node necrosis (LNN) as an independent adverse prognostic factor for LRRFS (HR = 4.056; 95% CI: 1.262–13.035; <i>p</i> = 0.019).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Lymph node characteristics further refine prognostic stratification in N1 NPC. Concurrent CLNs and RLNs involvement was associated with poorer survival, particularly in early T-stage disease, while LNN was associated with an increased risk of locoregional recurrence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"714-721"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148052943","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":"Enhanced Recovery After Surgery Protocol in Transoral Robotic Surgery: A Case–Control Study","authors":"Jonathan Daniel,&nbsp;Raguwinder Bindy Sahota,&nbsp;Mark David Wilkie,&nbsp;Lee Pryor,&nbsp;Ahmed Bassiouni,&nbsp;Jake Jervis-Bardy,&nbsp;Arun Takhar,&nbsp;Bora Jeong,&nbsp;Oladejo Olaleye,&nbsp;Suren Krishnan,&nbsp;J. C. Hodge,&nbsp;Andrew Foreman","doi":"10.1111/coa.70126","DOIUrl":"10.1111/coa.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>‘Enhanced Recovery After Surgery’ (ERAS) protocols have been developed for multiple surgical procedures with favourable outcome measures including Length of Stay (LoS). Trans-Oral Robotic Surgery (TORS) has similarly facilitated earlier patient discharges, particularly in comparison to open head and neck surgical techniques. There is a dearth of literature on the effect of ERAS protocols in TORS. We sought to comprehensively examine the effect of a TORS ERAS protocol across several key metrics, with a focus on LoS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective cohort study following implementation of a TORS ERAS protocol. This protocol was developed at our institution and implemented in 2021; it included key features such as pharyngocutaneous risk stratification and thorough perioperative assessments. Patients managed prior to (p-ERAS) and post implementation (w-ERAS) were separated into two groups, with key outcomes, including LoS, estimated cost per patient, return to swallow, and complication rate, compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 40 TORS cases were included. Patients managed w-ERAS had a mean adherence rate to protocol of 90%. The w-ERAS group showed a statistically significant reduction in median length of stay by 3.5 days (<i>p</i> = 0.03) when compared to the p-ERAS group. There was also a trend towards decreased median cost per patient as well as decreased median time to oral intake.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our study demonstrates an easily implementable protocol for the perioperative management of TORS oncological surgery. The use of this ERAS protocol demonstrated a significant reduction in patient length of stay in a small sample size.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"752-760"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210446","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 Multiple Interventions for Moderate to Large Traumatic Tympanic Membrane Perforations: A Systematic Review and Network Meta-Analysis","authors":"Yueyue Cai,&nbsp;Rui Lai,&nbsp;Tingting Zhu,&nbsp;Qiang Li","doi":"10.1111/coa.70121","DOIUrl":"10.1111/coa.70121","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the comparative efficacy of various therapeutic interventions for moderate to large traumatic tympanic membrane perforations (TTMP) through a network meta-analysis. Different treatment strategies were compared with respect to tympanic membrane healing rate, healing time, hearing improvement and incidence of otorrhea, providing evidence-based support for clinical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of multiple databases, including PubMed, Web of Science and Embase, was conducted to identify randomised controlled trials (RCTs) involving patients with moderate to large TTMP. A Bayesian hierarchical model was utilised to perform the network meta-analysis, assessing the relative effects of different interventions. Effect sizes, including relative risk (RR) and mean difference (MD), were computed for each intervention, with all analyses reported alongside 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 13 studies involving 1285 patients were included in the analysis. The findings suggested that fibroblast growth factor-2 (FGF-2) demonstrated the highest efficacy in enhancing tympanic membrane healing rates and reducing healing times, particularly when combined with gelfoam patching. Additionally, ofloxacin otic solution appeared to have positive effects on healing rates. Conversely, edge approximation ranked lowest among all interventions, suggesting limited effectiveness in treating moderate to large perforations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This network meta-analysis provides hypothesis-generating evidence that active intervention may be superior to watchful waiting for moderate to large TTMPs. FGF-2-based strategies, particularly when combined with physical scaffolds, show promise in improving healing outcomes. Additionally, ofloxacin otic solution may offer benefits in controlling local infections and optimising the middle ear microenvironment. In contrast, edge approximation appears less effective in this population. However, given the geographic homogeneity, limited number of studies and methodological constraints, these findings should be considered exploratory and require confirmation in large-scale, multicentre RCTs with standardised protocols and robust blinding procedures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 5","pages":"644-659"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013841","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":"Platelet-Rich Fibrin Can Improve Septoplasty Results: A Prospective Randomised Controlled Trial","authors":"Emre Solguntekin,&nbsp;Sedat Çağlı,&nbsp;Kerem Kökoğlu,&nbsp;Emrah Gülmez","doi":"10.1111/coa.70101","DOIUrl":"10.1111/coa.70101","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aims to assess the impact of platelet-rich fibrin (PRF) on nasal mucociliary clearance (NMC) time and post-operative pain following septoplasty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>This trial was conducted involving patients who underwent septoplasty. Participants were randomly assigned to either a control group or a PRF group. The control group underwent standard septoplasty, while in the PRF group, PRF membranes were placed and sutured between the Doyle splint and septal mucosa at the end of the surgery. NMC times were measured in both groups and in both nasal passages preoperatively and post-operatively using the saccharin test. Additionally, pain levels were assessed at the fourth post-operative hour. Changes in NMC times and pain scores were statistically analysed, with both intragroup and intergroup comparisons conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 41 participants were included in the study, with PRF applied to 20 randomly selected individuals. The groups were comparable in terms of age, gender, smoking status, and deviation side and type (<i>p</i> &gt; 0.05). A statistically significant reduction in median NMC duration was observed in the PRF group in the deviated nasal passage. Although a statistically significant increase in median NMC time was noted in the control group in the non-deviated passage (<i>p</i> &lt; 0.05), this increase was limited in the PRF group. Furthermore, post-operative pain scores were significantly lower in the PRF group compared to the control group (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The application of PRF post-operatively may enhance nasal mucociliary clearance in the deviated nasal passage and alleviate post-operative pain in patients undergoing septoplasty.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 4","pages":"548-554"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70101","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442442","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":"Paediatric Adenoidectomy: A Retrospective Cohort Study of Clinical Practice and Outcomes in NHS England (2008–2024)","authors":"Angus Lawson,&nbsp;Paola Cognigni,&nbsp;Kim Keltie,&nbsp;Ben Talks,&nbsp;Andrew Sims,&nbsp;Steven Powell,&nbsp;Michael W. Mather,&nbsp;Jason Powell","doi":"10.1111/coa.70095","DOIUrl":"10.1111/coa.70095","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To examine trends and outcomes for paediatric adenoidectomies in NHS England between 2008 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Retrospective observational cohort study using Hospital Episode Statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>NHS trusts in England.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Children (≤ 16 years) undergoing adenoidectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Adenoidectomies and concurrent procedures performed. In-hospital complications and readmissions within 28 days. All-cause mortality and revision procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2008 and 2024, 351 540 adenoidectomies were performed; 305 922 alongside ventilation tube insertion and/or tonsillectomy and 45 618 without these concurrent procedures. In-hospital complications occurred in 4422 admissions (1.3%) and 21 398 patients (6.1%) were readmitted within 28 days. Across all cases, the rate of haemorrhage was 3.4%, while in adenoidectomies occurring in the absence of concurrent ventilation tube insertion and/or tonsillectomy, the overall rate of haemorrhage was 0.7%, and 0.16% cases required return to theatre for surgical arrest of haemorrhage from the adenoid. Over the study period, emergency readmission rates rose from 3.8% to 6.7% while the proportion of day-case procedures increased from 46.3% to 81.1%. For adenoidectomies without concurrent ventilation tube insertion and/or tonsillectomy the rate of emergency admission rose from 2.07% to 2.91%, while adenoidectomies occurring concurrently alongside these procedures rose from 4.61% to 7.52%. The estimated overall revision rate was 4.52% (95% CI 4.44%–4.61%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study describes key outcomes, providing the basis for accurate preoperative counselling in paediatric adenoidectomy. However, clinical coding does not capture surgical indication or technique, limiting procedure-specific assessment. Improved coding and prospective research are critically needed to examine technique-specific outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 4","pages":"512-519"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70095","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164464","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":"Investigating the Effect of Tumour Necrosis Factor Antagonist on Olfaction","authors":"Andreas Espehana,&nbsp;George Macfarlane,&nbsp;Elizabeth Mairenn Garden,&nbsp;Liam Lee,&nbsp;Gabija Klyvyte,&nbsp;Lavandan Jegatheeswaran,&nbsp;Rebecca Davies,&nbsp;Carl Philpott","doi":"10.1111/coa.70093","DOIUrl":"10.1111/coa.70093","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Tumour Necrosis factor antagonists is a potent anti-inflammatory medication and has shown to improve olfactory function in murine models. The primary aim was to determine the effect of TNF antagonists on olfactory performance in humans. Secondary aim is to generate pilot data on the suitability of TNF for a randomised controlled trial in patients with smell disorders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>This study is a single centre observatory prospective proof of concept cohort study. Adult patients are recruited from a tertiary rheumatology centre, who are to be initiated on TNF antagonists therapy (adalimumab biosimilar) for the first time. Participants were assessed with a simple questionnaire and a baseline olfactory assessment with the extended Sniffin’ Stick Test. Participants were then brought back after 3 months of treatment for a repeat questionnaire and Sniffin’ Sticks Test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>The primary outcome <i>was</i> to determine the difference between smell test scores in the Sniffin’ Sticks TDI score before and after 3-months of treatment. Secondary outcomes include changes in visual analogue score from baseline to follow-up (questionnaire).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-three participants were recruited in the study; 21 were lost to follow up and two had stopped taking their medication, hence 40 were included in the analysis. There was no statistically significant improvement in TDI score of all participants at 3 months after treatment (<i>p</i> value = 0.08). However, analysis of participants who had olfactory dysfunction at baseline (<i>n</i> = 20, TDI &lt; 31 or 30.5 if aged 20–30) showed a statistically significant improvement in TDI score after 3 months (<i>p</i> value = 0.012).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TNF antagonists have the potential to improve olfactory function in those with olfactory dysfunction and should be subjected to further study in a selected group of patients with olfactory dysfunction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 4","pages":"504-511"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70093","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146164451","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":"Longitudinal Analysis of Sleep-Disordered Breathing and Cognitive Outcomes in Children Living With Sickle Cell Anaemia","authors":"Shifa Hamdule,&nbsp;Melanie Koelbel,&nbsp;Johanna C. Gavlak,&nbsp;Sati Sahota,&nbsp;Fenella J. Kirkham,&nbsp;Anna M. Hood","doi":"10.1111/coa.70051","DOIUrl":"10.1111/coa.70051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Sleep-disordered breathing (SDB) and cognitive challenges are commonly observed in children living with sickle cell anaemia (SCA). This study investigated the longitudinal change in polysomnographic outcomes and the association with cognitive functions in children living with SCA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Data from the Sleep Asthma Cohort (SAC 1, 2 and 3) included participants living with SCA (aged 4–18 years) who were initially recruited between 2006 and 2009, with follow-up studies conducted through until 2019. Polysomnographic indices (PSG indices), that is, obstructive apnoea hypopnoea index (OAHI), central apnoea index (CAI), mean overnight oxygen saturation and total sleep time, were assessed over two visits. Additional analyses assessed the impact of PSG indices on cognitive outcomes collected at Visit 3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-two participants (91 HbSS, 1HbSβ) completed a PSG at Visit 1 and 56 participants returned for Visit 2, 40 of whom returned for the Visit 3 cognitive assessment; mean ages were 9.9 (3.8), 14.7 (3.69) and 17.7 (4.64) years, respectively. Total sleep time significantly decreased between the two visits, while overall PSG indices remained stable. Mean overnight oxygen saturation at Visit 1 significantly predicted working memory at Visit 3. In addition, CAI at Visit 2 was associated with lower scores on the verbal comprehension index and self or caregiver-reported measures of executive function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>PSG indices did not change significantly over time; however, at least one PSG screening is recommended, given the complexity of sickle pathology. Overnight oxygen saturation levels and central apnoea influence cognitive outcomes for children living with SCA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 4","pages":"520-528"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70051","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147270011","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":"Oncological Outcomes for Primary Head and Neck Squamous Cell Carcinoma in the United Kingdom: Results From a National Cross-Sectional Cohort Study","authors":"Frederick R. Green,&nbsp;Andrew Williamson,&nbsp;Alison E. Lim,&nbsp;Ying Ki Lee,&nbsp;Lucy Li,&nbsp;Christy Moen,&nbsp;Rishi Vasanthan,&nbsp;Olivia Wharf,&nbsp;Jeremy Wong,&nbsp;Vinidh Paleri,&nbsp;INTEGRATE Collaborators","doi":"10.1111/coa.70103","DOIUrl":"10.1111/coa.70103","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To investigate overall survival outcomes from primary head and neck squamous cell carcinoma (HNSCC) in the UK.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A retrospective national observational cohort study with consecutive participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>UK-wide head and neck cancer centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>All patients with HNSCC who received a definitive treatment decision between 01/09/2021 and 30/11/2021. Subgroup analysis of patients was stratified by head and neck subsites.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Two-year overall (OS), disease-free (DFS), disease-specific (DSS), and local-recurrence-free-survival (LRFS) from primary HNSCC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data from 1488 patients was submitted by 50 centres, of which 1286 were primary HNSCC. Median age was 65.5 years (IQR 57–74), and 911 (71.0%) were male. The most common subsites were oropharynx (37.6%), oral cavity (28.3%), larynx (22.0%), and hypopharynx (6.8%). Treatment intent was curative in 79.9% of cases. Of treatment modalities, 529 (41.3%) underwent surgery, 874 (68.4%) underwent radiotherapy, and 391 (30.7%) underwent chemotherapy. Two-year OS, DFS, DSS and LRFS were 79.7%, 72.2%, 84.8%, and 75.1%, respectively. Two-year OS was 83.5%, 55.4%, 73.9% and 84.6% for laryngeal, hypopharyngeal, oral cavity and oropharyngeal subsites, respectively. On multivariate analysis, clinical T staging, age, ECOG performance status, and p16 status were independent prognostic factors for survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>UK survival variations according to disease subsite reflect larger studies. Broader data over larger periods will reveal whether long-term improvements in the diagnosis, biological understanding, and treatments of HNSCC have translated into improvements in UK survival outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 4","pages":"574-584"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580805","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":"Happiness and Smell: Overlooked Factors in Endoscopic Sinus Surgery?","authors":"Tuğba Tulacı,&nbsp;Omer Hizli,&nbsp;Hasan Çanakçı,&nbsp;Mustafa Utku Akbaş,&nbsp;Kamil Gökçe Tulacı","doi":"10.1111/coa.70106","DOIUrl":"10.1111/coa.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigates the impact of functional endoscopic sinus surgery (FESS) on happiness levels in patients with chronic rhinosinusitis with nasal polyps (CRSwNP) and examines the factors influencing postoperative happiness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 55 patients (34 males, 21 females; mean age, 41.2 ± 14.7 years) who underwent FESS for CRSwNP. Preoperative and postoperative evaluations included the Sinonasal Outcome Test-22 (SNOT-22), Oxford Happiness Scale (OHS), Visual Analog Scale (VAS) for olfactory function, and saccharin clearance test for mucociliary clearance. Radiological and endoscopic disease severity was assessed preoperatively using the Lund–Mackay (LM) and Mackay–Lund Endoscopic Polyp Scores (MLEPS). A linear regression model was used to identify predictors of postoperative happiness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Postoperatively, SNOT-22 scores significantly decreased (<i>p</i> = 0.005), while OHS and olfactory VAS scores significantly increased (<i>p</i> &lt; 0.001). Mucociliary clearance times were significantly shorter after surgery (<i>p</i> = 0.025). Regression analysis revealed that both the improvement in olfactory VAS scores (<i>p</i> = 0.006) and lower preoperative MLEPS values (<i>p</i> = 0.01) were independent predictors of increased OHS scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FESS not only alleviates symptoms and enhances QoL in CRSwNP patients but also is associated with increased happiness at 1 month postoperatively. Improvement in olfactory function emerged as the strongest determinant of postoperative happiness, while patients with less extensive polyp disease experienced more favorable emotional recovery. Therefore, efforts aimed at optimizing olfactory outcomes, preserving existing olfactory function, and performing surgical intervention before widespread polyp formation may contribute to more favorable psychological outcomes after FESS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"51 4","pages":"585-590"},"PeriodicalIF":1.5,"publicationDate":"2026-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147580761","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}