European Archives of Oto-Rhino-Laryngology最新文献

{"title":"Methodological considerations in evaluating long-term outcomes of cochlear implantation.","authors":"Jie Wang, Tuochen Lv","doi":"10.1007/s00405-025-09373-1","DOIUrl":"10.1007/s00405-025-09373-1","url":null,"abstract":"","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3815-3816"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic annular chondroperichondrial tympanoplasty, technical description.","authors":"M Ihsan Gülmez, Şemsettin Okuyucu","doi":"10.1007/s00405-025-09238-7","DOIUrl":"10.1007/s00405-025-09238-7","url":null,"abstract":"<p><strong>Purpose: </strong>Tympanoplasty is a surgical procedure performed to cure middle ear infections and restore normal middle ear function. It is one of the most common procedures in otological surgery. Since Wullstein described tympanoplasty, the microscope has been a widely used surgical tool in otological surgery. Transcanal endoscopic ear surgery (TEES) has come to the forefront as an alternative option due to the various limitations of microscopic surgery and the development of otological surgical techniques. When reviewing the types and tecniques of grafts used in tympanoplasty in the current literature, it is clear that the ideal graft material and tecnique to meet all needs has not yet been found. The objective of this study is to describe a novel graft technique, a modification of the cartilage-perichondrium graft obtained from tragal cartilage, which is believed to represent an optimal solution for the desired graft technique at the highest level.</p><p><strong>Material&method: </strong>The study included 40 patients who underwent endoscopic annular chondroperichondrial tympanoplasty at Hatay Mustafa Kemal University Hospital between 2015 and 2022. All patients underwent clinical otological examination and pure tone audiometry before and after surgery. Hearing results were expressed as pure tone mean air-bone gap (ABG) at 4 frequencies (500,1000,2000,4000 Hz). For all operations, the primary surgeon was the second author. Patients with inadequate follow-up, revision surgery, inflammatory middle ear mucosa, perforation etiology other than chronic otitis media were not included in the study.</p><p><strong>Results: </strong>No complications were observed in the patients included in the study. Accordingly, the graft was intact at the end of the 6th month in 38 of the 40 patients operated on. The graft success rate was 95%. The mean preoperative PTA-ABG was 22.1. The mean post-operative PTA-ABG was 5.7. Mean closed PTA-ABG was 16.4.</p><p><strong>Conclusion: </strong>In parallel with the development of otological surgical technologies, endoscopy is becoming increasingly important in tympanoplasty. We believe that our technique, endoscopic annular chondroperichondrial tympanoplasty, will be an important step in the search for the ideal grafting technique.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3465-3471"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321655/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cochlear implantation with Slim Modiolar Electrode carriers enables hearing preservation.","authors":"Kenan Dennis Sakmen, Christian Issing, Caterina Vazzana, Tobias Weißgerber, Albrecht Linke, Timo Stöver, Silke Helbig","doi":"10.1007/s00405-025-09267-2","DOIUrl":"10.1007/s00405-025-09267-2","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate hearing preservation in patients who received a cochlear implant with a preformed electrode carrier, namely the Slim Modiolar (SM).</p><p><strong>Methods: </strong>A monocentric, retrospective study was conducted. A total of 51 adult patients (24 females, 27 males), representing 60 ears, were included in the final evaluation. The mean age was 60.9 ± 15.2 years (range 17.5-89.7 years). All patients had some degree of residual hearing. Frequency-specific pure-tone audiometry was performed at three time points: preoperatively (T0), within 30 days postoperatively (T1), and at a later time point during follow-up (T2; 20.7 ± 17.6 months). Low frequency pure tone average and the HEARRING group formula were used to facilitate comparison of hearing preservation rates with other results published so far.</p><p><strong>Results: </strong>In the first month after surgery, no significant deterioration was observed for the low frequencies, but a significant deterioration was observed at follow-up. Using the HEARRING classification system, the average short-term (T0-T1) hearing preservation score was 70%, which corresponds to partial hearing preservation. During follow-up (T0-T2), the score decreased to 61% in the study group, still representing partial hearing preservation. Complete hearing loss occurred in 20% of the cases.</p><p><strong>Conclusion: </strong>Especially in the low frequency range, the utilisation of SM electrode carriers during cochlear implantation facilitates preservation of residual hearing.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3541-3548"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143500084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hearing loss secondary to novel variants of the KCNQ4 gene.","authors":"Rocío González-Aguado, Julia Fernández-Enseñat, Esther Onecha, Carmelo Morales-Angulo","doi":"10.1007/s00405-025-09288-x","DOIUrl":"10.1007/s00405-025-09288-x","url":null,"abstract":"<p><strong>Purpose: </strong>Heterozygous variants of the KCNQ4 gene are associated with isolated sensorineural hearing loss (DFNA2A). This study aimed to determine the frequency and clinical characteristics of pathogenic, likely pathogenic, and uncertain variants in the KCNQ4 gene among patients with sensorineural hearing loss of unknown origin in North Spain.</p><p><strong>Methods: </strong>We conducted a prospective observational study of patients with sensorineural hearing loss of unknown etiology at a tertiary hospital over six years. Next-generation sequencing carried out with a panel of genes was used to identify genetic variants related to both syndromic and non-syndromic hearing loss.</p><p><strong>Results: </strong>Among 370 patients, seven (1.89%) harbored pathogenic or likely pathogenic variants in the KCNQ4 gene: c.777_778delinsCC, c.626 T > G, and c.778G > C. None of these variants had been previously described. One patient also had a variant of uncertain significance (c.419 T > C). All patients exhibited progressive bilateral sensorineural hearing loss, predominantly at high frequencies, with variable onset and severity. None reported dizziness or vertigo. Five patients used hearing aids, and one received a cochlear implant with good results.</p><p><strong>Conclusions: </strong>KCNQ4 gene variants are rare in Cantabria, present in less than 2% of patients with sensorineural hearing loss of unknown origin. Although most variants identified in our study had not been previously described, the observed phenotype aligned with the typical presentation: bilateral, progressive sensorineural hearing loss with variable onset and severity. Some patients may benefit from cochlear implants.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3587-3593"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of pre-operative ultrasonic depth of invasion (DOI) with histopathological depth of invasion (DOI) in gingivobuccal sulcus squamous cell carcinoma with neck nodal metastasis.","authors":"Akshay A Byadgi, Venkatesh Anehosur, Kaveri Hallikeri, Niranjan Kumar","doi":"10.1007/s00405-025-09326-8","DOIUrl":"10.1007/s00405-025-09326-8","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Head and neck carcinomas have the highest incidence among other carcinomas in the several regions of the country with trends still rising in the third population. The tumor mass is not planar but rather grows three-dimensionally, so surgeons should have the knowledge of the third dimension, which is the depth of invasion (DOI). Nowadays advanced techniques have been introduced to measure the preoperative depth of invasion of the primary tumor, i.e., ultrasonography (USG) scans. Ultrasonography (USG) scan is still considered a preoperative gold standard to measure DOI because of its advantages of radiation-free imaging and excellent tumor visualization, economical, non-invasive, and real-time images that can be obtained spontaneously. The primary objective of the study was to evaluate and compare pre-operative ultrasonic depth of invasion (DOI) with histopathological DOI in gingivobuccal sulcus squamous cell carcinoma with neck nodal metastasis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methodology: &lt;/strong&gt;This is a single-center prospective study including 51 patients reporting to our unit from November 2019 to November 2021 who were subjected to surgery. Preoperative USG evaluation of lesion was performed on all patients which recorded DOI.Similarly, postoperatively, all the resected specimens were examined for the histopathological DOI.The value obtained preoperatively from USG examinations was then compared with histopathological DOI postoperatively. Correlation coefficient analysis was studied using a scatter diagram by Karl Pearson and a dependent t-pair test. A chi-square with Yates's correction test was used to study the statistical association between USG DOI and lymph node metastasis (LNM).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 51 patients were included in the study of which 40(78.4%) were male patients and 11(21.6%) were female patients. DOI measured preoperatively from the USG scan in these cases ranged from 6 mm to 37 mm with an average of 19.41 mm. Histopathological DOI measured in all these patients ranged from 1.3 mm to 16 mm with an average of 7.26 mm. A statistical significance was noted between preoperatively measured DOI from the USG scan and postoperatively (histologically) measured DOI with a p-value of 0.0316. Cervical lymph node metastasis was USG positive in 15 (29.41%) patients out of 51 patients. Chi-square test with Yates's correction = 0.2721, P = 0.6020, noted association between the USG DOI and the occurrence of the cervical lymph node metastasis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;DOI is clearly a potentially useful and objectively measurable prognostic tool. USG imaging studies are used preoperatively to locate the extension of the lesion proper and to measure the area of the deepest invasion of the tumour. Preoperatively, DOI data obtained helps the surgeon to plan 3-dimensional clearance of the disease. Although USG scans lack in early detection of bone invasion in gingivo buccal sulcus","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3715-3721"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotic excision of parapharyngeal and retropharyngeal lesions.","authors":"Stephen Robertson, Philip Touska, Jack Faulkner, Alastair Fry, Aleix Rovira, Ricard Simo, Jean-Pierre Jeannon, Asit Arora","doi":"10.1007/s00405-025-09345-5","DOIUrl":"10.1007/s00405-025-09345-5","url":null,"abstract":"<p><strong>Introduction: </strong>Robotic surgery is currently transforming Head and Neck cancer surgery by providing novel approaches to previously challenging procedures, with a wide range of benefits including reduced morbidity and length of stay for patients. Currently at Guy's and St. Thomas' hospital, extended applications are constantly being evaluated to advance the scope of robotic surgery further, which includes using it for parapharyngeal (PPS) and retropharyngeal space (RPS) tumours. Literature suggests over 50% of PPS tumours are pleomorphic adenomas, whereas RPS tumours often represent nodal metastasis or soft tissue inflammatory masses(4,9). We have collated a case series of fifteen patients who had either PPS or RPS tumours excised via robotic surgery.</p><p><strong>Methods: </strong>A prospective study of fifteen patients collected between October 2018 and August 2024 with retrospective swallow assessment, for all patients with a mass in the PPS or RPS treated by trans-oral robotic surgery. Excision was performed by the Intuitive da Vinci Xi robotic surgical system.</p><p><strong>Results: </strong>The average age was 51 yrs (10 males, 5 females), with an average radiological tumour diameter of 3.79 cm and volume of 35.48 cm³. 33% of PPS cases were pleomorphic adenoma, whilst 33% of cases were malignant (carcinoma ex-pleomorphic adenoma). There was no surgical capsular breach, with complete excision in all cases and no cases required conversion to open. Close margins were seen in 40%. Median length of stay was 2 days with patients starting oral diet on day 1 post operation, however three patients later required NG-tube insertion due to wound dehiscence. There have been no recurrences with mean follow up currently at 3.32 years.</p><p><strong>Conclusions: </strong>TORS provides a safe and feasible option for excision of both PPS and RPS tumours, with no sacrifice of surgical or oncological outcomes. Given the successful results, further adoption of TORS for PPS and RPS tumours is recommended. Careful patient selection and specialist radiological input to aid three-dimensional anatomical understanding are fundamental to these outcomes.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3729-3738"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiological relations of sigmoid sinus with oto-neuro-surgical landmarks with its surgical risk-stratification indicating classification.","authors":"Manu Malhotra, Abhishek Bhardwaj, Madhu Priya, Pankaj Sharma, Sofia Doomra, P S Suji, Rajneesh Arora, Rashmi Malhotra","doi":"10.1007/s00405-025-09239-6","DOIUrl":"10.1007/s00405-025-09239-6","url":null,"abstract":"<p><strong>Objective: </strong>Detailed pre-operative HRCT scan-based measurement of the distance between surgical landmarks with lateral or sigmoid sinus (SS) and classification of its relations with surgical landmarks.</p><p><strong>Study design: </strong>Observational Study.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients: </strong>Patient volunteers above 18 years of age undergoing scans for various reasons.</p><p><strong>Interventions: </strong>Axial Sections of HRCT of 260 temporal bones obtained from patient volunteers were studied with the help of RadiAnt DICOM Viewer (version 2023.1).</p><p><strong>Main outcome measures: </strong>Closest distance of the SS from the posterior wall of the external auditory canal wall (CW), the vertical portion of the facial nerve (VPFN), the short process of incus (SPI), lateral (LC), and posterior semi-circular canal (PC), was measured. The SS relation with the mastoid was classified as type 1-4 depending upon the shortest distance of the sinus from the posterior canal wall millimeters.</p><p><strong>Results: </strong>The mean distance of the SS from surgical landmarks was 14.6 ± 2.7 mm for SPI, 11.1 ± 3.1 for CW, 11.4 ± 2.9 for VPFN, 10.1 ± 2.8 for PC, and 11.9 ± 2.7 LC. All measured distances were significantly more on the left side (p < 0.05, Z test), except the difference in distance from LC. The greatest range of variation (5.2 to 21.8 mm) was seen in the distance between SS and VPFN. The most common type of relationship between SS and CW was type 3, present in 64% of subjects, while the least common group was type 1, with nearly 1% of subjects.</p><p><strong>Conclusion: </strong>The assessment of distances and relations of various surgical landmarks with SS, with the proposed novel classification based on SS-CW distance, can be essential for preoperative planning and risk mitigation.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3473-3478"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intratympanic steroid as salvage therapy for sudden sensorineural hearing loss: an overview of systematic reviews and meta-analyses.","authors":"Dongdong Li, Kai Wang, Yan Shi, Weiping Li, Yushan Cheng, Maiergena Nurtai, Jingyuan Ma, Rong Yu","doi":"10.1007/s00405-025-09252-9","DOIUrl":"10.1007/s00405-025-09252-9","url":null,"abstract":"<p><strong>Objective: </strong>To re-evaluate the published systematic reviews and meta-analyses on the efficacy and safety of intratympanic steroid therapy as a salvage treatment for sudden sensorineural hearing loss (SSNHL).</p><p><strong>Methods: </strong>Systematic reviews and meta-analyses related to intratympanic steroid therapy for SSNHL were identified by searching both English and Chinese language databases, including OVID, The Cochrane Library, PubMed, Web of Science, Embase, CBM, WanFang, CNKI, and CSTJ. For each included study, the AMSTAR 2 appraisal tool was used to assess methodological quality, the PRISMA statement evaluated reporting quality, and the GRADE system was applied to assess the strength of evidence for primary study outcomes.</p><p><strong>Results: </strong>A total of 16 studies that met the inclusion criteria were included in the analysis. The AMSTAR 2 evaluation identified 2 studies as having low credibility and 14 as having very low credibility. The PRISMA statement ratings for the studies ranged from 10 to 23 (mean score: 17.6), with 4 studies classified as high quality, 8 as medium quality, and 4 as low quality. The GRADE assessment included 53 outcome indicators, with 2 considered as having intermediate evidence, 12 as low-level evidence, and 39 as very low-level evidence.</p><p><strong>Conclusion: </strong>Based on the AMSTAR 2, PRISMA, and GRADE evaluations, this study provides evidence in favor of intratympanic steroid therapy as a salvage treatment for sudden deafness. However, the systematic reviews and meta-analyses included in this study generally exhibit low methodological quality and inconsistent reporting. Future clinical trials and systematic reviews/meta-analyses should aim to improve the quality of their design, execution, and reporting to provide more reliable evidence that can guide clinical decision-making.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3415-3429"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faster recovery in patients with facial nerve palsy treated with contralateral botulinum toxin injection: a case-control study.","authors":"Jung Mee Park, Ji Hyung Lim, Jae Sang Han, Shi Nae Park","doi":"10.1007/s00405-025-09247-6","DOIUrl":"10.1007/s00405-025-09247-6","url":null,"abstract":"<p><strong>Purpose: </strong>Botulinum toxin (BTX, Botox) is increasingly used as an adjunct therapy to oral steroids in the management of facial paralysis, with positive outcomes. This study aimed to evaluate the additive effect of BTX injection on the non-paralyzed side and propose optimal injection timing for recovery time.</p><p><strong>Methods: </strong>A total of 48 atraumatic facial paralysis patients who visited Seoul St. Mary's hospital for facial palsy between June 2015 and May 2021 were retrospectively reviewed. Patients were divided into 2 groups: the BTX injection group (BG) and the non-BTX injection group (NBG). We analyzed the recovery rate of facial palsy to H-B grade II or lower in each group, and conducted telephone surveys to collect subjective satisfaction data after BTX injection.</p><p><strong>Results: </strong>Days of recovery to H-B grade II from symptom onset were 93.0 ± 62 and 68.7 ± 66.6 in NBG and BG, respectively. Early BTX injection (less than 17.5 days from symptom onset) was a prognostic factor for recovery to H-B grade II in less than 1 month (R² = 0.935, B = 1.738, p < 0.001). Telephone survey showed subjective satisfaction in all aspects 1 month after BTX injection: function (83.3%), cosmetic (70.9%), and recovery (54.2%).</p><p><strong>Conclusion: </strong>Early contralateral facial BTX injection can shorten the recovery period of atraumatic facial palsy.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3499-3505"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survival outcomes and optimal candidates for primary tumor resection in head and neck squamous cell carcinoma with distant metastasis at initial diagnosis.","authors":"Runqiu Zhu, Yan Zhang, Haonan Yang, Jiayi Zhang, Leitao Zhang, Zhifeng Chen, Xiqiang Liu","doi":"10.1007/s00405-025-09305-z","DOIUrl":"10.1007/s00405-025-09305-z","url":null,"abstract":"<p><strong>Introduction: </strong>The incidence of distant metastasis for head and neck squamous cell carcinoma (HNSCC) is low, and there is scant evidence to prove the prognostic value of primary tumor resection (PTR) in these cases. This study aimed to assess the survival outcomes and identify optimal candidates for PTR in HNSCC with distant metastasis at initial diagnosis.</p><p><strong>Materials and methods: </strong>Patients initially diagnosed with metastatic HNSCC between 2010 and 2021 were collected from the Surveillance, Epidemiology, and End Results (SEER) database. A Cox proportional hazards regression model was used to assess prognostic factors for survival. Survival outcomes were calculated with the Kaplan-Meier method and compared by the log-rank tests.</p><p><strong>Results: </strong>A total of 2740 patients with newly metastatic HNSCC were extracted, among whom 403 (14.7%) received PTR. Lung, distant lymph node (DLN), and bone were the most common sites of metastasis. PTR was associated with improved overall survival (OS) and cancer-specific survival (CSS) in the whole cohort (HR = 0.653, 95%CI 0.551-0.774 for OS; HR = 0.621, 95%CI 0.515-0.748 for CSS). When focusing on different metastatic patterns, PTR conferred a significant survival benefit for patients with bone, lung, liver and DLN involvement (all p < 0.05). Among patients with single-organ metastases, those who underwent surgical resection showed substantially favorable OS and CSS (both p < 0.001). Furthermore, subgroup analyses suggested that patients with younger age (< 65 years), low histological grade (grade I-II), and stage N0-2 disease might benefit from PTR.</p><p><strong>Conclusion: </strong>This study demonstrated that PTR exhibited a favorable prognostic value and held promise for the intervention of carefully-selected patients with metastatic HNSCC, although long-term prospective studies were warranted.</p>","PeriodicalId":11952,"journal":{"name":"European Archives of Oto-Rhino-Laryngology","volume":" ","pages":"3669-3681"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}