JAMA otolaryngology-- head & neck surgery最新文献

{"title":"A 52-Year-Old Male With Chronic Nasal Congestion.","authors":"Emily S Kwon, Pratibha S Shukla, James K Liu","doi":"10.1001/jamaoto.2026.2192","DOIUrl":"10.1001/jamaoto.2026.2192","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1001-1002"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pollutant-Specific Inflammatory Signatures in Sinonasal Tissue-Reply.","authors":"Hong-Ho Yang, Jivianne T Lee","doi":"10.1001/jamaoto.2026.2990","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2990","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Glucagon-Like Peptide-1 Receptor Agonists for Obstructive Sleep Apnea: A Review.","authors":"Alexandria Harris, Thomas Kaffenberger","doi":"10.1001/jamaoto.2026.2266","DOIUrl":"10.1001/jamaoto.2026.2266","url":null,"abstract":"<p><strong>Importance: </strong>Obstructive sleep apnea (OSA) affects nearly 1 billion adults worldwide and is independently associated with cardiovascular disease, stroke, and increased mortality. While continuous positive airway pressure (CPAP) remains the criterion standard treatment, adherence rates of only 30% to 60% limit its population-level effectiveness. Obesity is present in 60% to 70% of patients with OSA and represents the primary modifiable risk factor, yet, until recently, no pharmacological therapies specifically targeted this pathophysiological mechanism. The December 2024 US Food and Drug Administration approval of tirzepatide as the first medication indicated for moderate to severe OSA in adults with obesity represents a paradigm shift toward disease-modifying pharmacotherapy, with implications for otolaryngologic practice.</p><p><strong>Observations: </strong>Six meta-analyses demonstrated consistent apnea-hypopnea index (AHI) reductions with glucagon-like peptide-1 receptor agonists (GLP-1 RAs), ranging from -5.7 to -21.9 events per hour. The SURMOUNT-OSA phase 3 trials showed that tirzepatide reduced AHI by 20 to 24 events per hour vs placebo, with 42% to 50% of patients experiencing disease remission (AHI, <5 events per hour or <15 without symptoms). Weight loss is the primary established mechanism, with GLP-1 RAs reducing tongue fat and parapharyngeal adipose tissue that contribute to upper airway collapse. Emerging preclinical evidence has suggested potential weight-independent effects through carotid body glucagon-like peptide 1 receptor modulation of chemosensitivity (affecting loop gain), leptin pathway interactions that are associated with upper airway neuromuscular control, and NLRP3 inflammasome suppression. However, GLP-1 RAs did not match CPAP efficacy (approximately22 vs 31 events per hour of an AHI reduction), cardiovascular outcome benefits remain unproven, and weight regain commonly occurs after discontinuation.</p><p><strong>Conclusions and relevance: </strong>This review suggest that GLP-1 RAs offer otolaryngologists a disease-modifying adjunct for obesity-related OSA that is best positioned as complementary therapy alongside CPAP, preoperative optimization before upper airway surgery, or potentially to expand hypoglossal nerve stimulator candidacy. They are appropriate for patients with a body mass index (calculated as weight in kilograms divided by height in meters squared) greater than 30 who are CPAP-intolerant or have obesity-related comorbidities but are unlikely to benefit individuals without obesity or those with primarily anatomical obstruction. Critical evidence gaps include associations with pharyngeal critical closing pressure, drug-induced sleep endoscopy collapse patterns, and hypoglossal nerve stimulator combination therapy outcomes.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"992-1000"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue-Informed ctDNA Assay Performance in Head and Neck Squamous Cell Carcinoma.","authors":"Ryan M Sicard, Peter V Cooke, Alyssa Steinbaum, Diana Shaari, Alicia B Yang, Ethan Gomez, Daniel O Kraft, Michael Berger, Marita S Teng, Mohemmed N Khan, Krzystoff J Misiukiewicz, Elisabet Pujadas, Richard Bakst, Kunal Sindhu, Eric M Genden, Raymond Chai, Scott A Roof","doi":"10.1001/jamaoto.2026.2469","DOIUrl":"10.1001/jamaoto.2026.2469","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Liquid biopsy is emerging as a strong biomarker for detecting and monitoring head and neck squamous cell carcinoma (HNSCC). The strongest evidence for circulating tumor DNA (ctDNA) in HNSCC comes from studies of tissue-agnostic assays detecting human papillomavirus (HPV)-associated HNSCC. In HPV-negative HNSCC, the lack of broadly shared variational targets precludes the use of tissue-agnostic ctDNA approaches. An emerging alternative, tissue-informed assays, leverage patient-specific tumor variant profiles to enable individualized ctDNA detection in the blood.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To measure the detection characteristics of a commercially available tissue-informed assay when compared to the standard criterion for tissue biopsies, both in the pretreatment and surveillance settings of HPV-positive and HPV-negative HNSCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This was a retrospective cohort study of adults with HNSCC who received a tissue-informed ctDNA assay as part of their oncologic treatment at a large, urban tertiary care center from December 2024 to March 2026. Data analysis was conducted from March to April 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Tumor tissue specimen, collected by fine-needle aspiration or surgical biopsy, used to create an individualized ctDNA assay for subsequent ctDNA blood tests.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;For the pretreatment analysis: test detection rate, miss rate, and insufficient tissue rate. In the surveillance setting: sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) on a per-test and per-patient basis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The pretreatment cohort comprised 77 patients (mean [SD] age, 65.0 [12.6] years; 28 female [36%] and 49 male [64%] individuals) and the surveillance cohort, 107 patients (mean [SD] age, 65.0 [12.1] years; 28 female [26%] and 79 male [74%] male individuals). The median (IQR) time since treatment conclusion for patients in the surveillance cohort was 18 (11-39) months. Tissue-informed ctDNA was detected in 71 of 77 patients (92.2%) in the initial pretreatment setting. In the surveillance setting, the assay demonstrated a per-test sensitivity of 95.2% (20 of 21 patients; 95% CI, 83.3%-100%), specificity of 100% (157 of 157 patients; 95% CI, 100%-100%), PPV of 100% (20 of 20 patients; 95% CI, 100%-100%), and a NPV of 99.4% (157 of 158 patients; 95% CI, 97.9%-100%). On a per-patient level, the sensitivity was 94.4% (17 of 18 patients; 95% CI, 72.7%-99.9%), specificity was 100% (89 of 89 patients; 95% CI, 95.9%-100%), PPV was 100% (17 of 17 patients; 95% CI, 80.5%-100%), and NPV was 98.9% (89 of 90 patients; 95% CI, 93.0%-99.8%).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this cohort study, tissue-informed ctDNA assay showed excellent test creation ability in the pretreatment setting and performance metrics in the surveillance setting. Reasons for","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"962-969"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Title and Results.","authors":"","doi":"10.1001/jamaoto.2026.3188","DOIUrl":"10.1001/jamaoto.2026.3188","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":"152 10","pages":"1013"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologic Response After Neoadjuvant Chemoimmunotherapy in Head and Neck Squamous Cell Carcinoma.","authors":"Ethan A Gomez, Daniel O Kraft, Yehia Elkersh, Peter V Cooke, Ryan M Sicard, Thomas F Barrett, Lara Shemtob, Seungjun Ahn, Michael H Berger, Marita S Teng, Diana N Kirke, Mark Urken, Mohemmed Khan, Raymond L Chai, Azita Khorsandi, Richard L Bakst, Kunal K Sindhu, Jerry T Liu, Krzysztof J Misiukiewicz, Brandon Veremis, Soo Yeon Sohn, Margaret S Brandwein, Elisabet Pujadas, Eric M Genden, Scott A Roof","doi":"10.1001/jamaoto.2026.2259","DOIUrl":"10.1001/jamaoto.2026.2259","url":null,"abstract":"<p><strong>Importance: </strong>Treatment outcomes for locally advanced head and neck squamous cell carcinoma (HNSCC) remain suboptimal, and strategies to improve response to therapy are needed. Neoadjuvant immunotherapy has shown promise, but pathologic response rates remain modest with single-agent regimens.</p><p><strong>Objective: </strong>To compare rates of pathologic response between neoadjuvant immunotherapy (NAI) and neoadjuvant chemoimmunotherapy (NACI) in patients with resectable HNSCC treated in an off-trial setting.</p><p><strong>Design, setting, and participants: </strong>This was a single-center retrospective cohort study of adult patients with pathologically confirmed HNSCC of the aerodigestive tract who received at least 1 cycle of NAI or NACI followed by definitive surgery at a large, urban tertiary academic referral center from July 19, 2024, to March 4, 2026. Patients with locoregional recurrence were included if treated with curative intent. Propensity score-adjusted analyses were performed to account for baseline differences between treatment groups. Data were analyzed from March 5 to June 17, 2026.</p><p><strong>Exposure: </strong>NAI and NACI, typically administered over 2 cycles, before surgery.</p><p><strong>Main outcomes and measures: </strong>Pathologic response in the surgical specimen, categorized as pathologic complete response (pCR), major pathologic response (MPR; ≤10% viable tumor), or partial response. Deep pathologic response was defined as pCR or MPR.</p><p><strong>Results: </strong>Among 86 participants (mean [SD] age, 63 [12] years; 27 female [31%] and 59 male [69%]), 25 (29%; 95% CI, 21%-39%) achieved pCR and 15 (17%; 95% CI, 11%-27%) achieved MPR. pCR or MPR occurred in 39 of 58 NACI recipients (67%; 95% CI, 54%-78%) compared with 1 of 28 NAI recipients (3.6%; 95% CI, 0.6%-17.7%). In propensity score-adjusted analysis, NACI was associated with higher odds of pCR or MPR (odds ratio [OR], 29.1; 95% CI, 6.7-274.7). Treatment was generally well tolerated, with few adverse event-related delays to surgery.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, neoadjuvant chemoimmunotherapy was associated with substantially higher rates of pCR and MPR compared with immunotherapy alone in resectable HNSCC. These findings support the potential role of combination regimens in improving tumor response, although prospective trials are needed to determine effects on survival.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"944-951"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine Postdissection Vagal Nerve Stimulation.","authors":"Tam-Lin Chow","doi":"10.1001/jamaoto.2026.2285","DOIUrl":"10.1001/jamaoto.2026.2285","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1011-1012"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thyroid Lobectomy vs Total Thyroidectomy in Intermediate Molecular Risk Thyroid Cancer: A Randomized Clinical Trial.","authors":"Young-Ji Seo, Elena G Hughes, James X Wu, Michael W Yeh, Masha J Livhits","doi":"10.1001/jamaoto.2026.2258","DOIUrl":"10.1001/jamaoto.2026.2258","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1007-1010"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13494793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Routine Postdissection Vagal Nerve Stimulation-Reply.","authors":"Nadia H Van Den Berg, James Griffin, Patrick Sheahan","doi":"10.1001/jamaoto.2026.2288","DOIUrl":"10.1001/jamaoto.2026.2288","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1012-1013"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change in Open Access License.","authors":"","doi":"10.1001/jamaoto.2026.2511","DOIUrl":"10.1001/jamaoto.2026.2511","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1013"},"PeriodicalIF":7.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13474093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}