Journal of Otolaryngology - Head & Neck Surgery最新文献

{"title":"Quality Indicators in Otolaryngology-Head and Neck Surgery: A Scoping Review.","authors":"Phillip Staibano, Shireen Samargandy, Justin Cottrell, Lily Wang, Michael Au, Michael K Gupta, Han Zhang, Doron D Sommer, Christopher Walsh, Eric Monteiro","doi":"10.1177/19160216251330627","DOIUrl":"https://doi.org/10.1177/19160216251330627","url":null,"abstract":"<p><p>ImportanceQuality indicators are used to evaluate the quality of healthcare delivery and as a speciality, otolaryngology-head and neck surgery (OHNS) is beginning to transition toward this empirical understanding of healthcare quality and delivery.ObjectiveTo describe the number and quality of studies that have developed novel quality indicators for any subdiscipline in OHNS.DesignWe performed a database search of MEDLINE (Ovid), EMBASE (Ovid), Web of Science, and Cochrane Database of Systematic Reviews. We did not employ language or study-type restrictions and included studies published from database inception to October 2024.Study SelectionFollowing abstract screening, 184 articles underwent full-text screen. Eligible studies developed quality indicators in any subdiscipline within OHNS. Article screening and full-text review was performed in duplicate.Data Extraction and SynthesisWe extracted study-specific and methodological data in duplicate. Quality appraisal was assessed using the Appraisal of Indicators through Research and Evaluation instrument.ResultsWe identified 10,592 studies, of which 25 studies developed new quality indicators. Quality indicator development studies primarily focused on otology/neurotology, pediatric OHNS, and head and neck surgery. Few studies investigated facial plastics, rhinology and skull base surgery, and laryngology. Most studies employed Delphi consensus methods and patient engagement was rare. Consensus methodology reporting was poor and indicators were often not validated. Outcome indicators were often measured with fewer studies investigation structure or process indicators.ConclusionsQuality indicators may help standardize and improve patient care in OHNS. Future research should focus on structure and process indicators, while improving reporting, optimizing panel composition, and validating quality indicators.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251330627"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012346","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":"Coblation-Assisted Transoral Endoscopic Excision of Lingual Thyroglossal Duct Cysts.","authors":"Yanyan Niu, Tingting Cui, Wuyi Li, Xiaofeng Jin, Hong Huo, Jian Wang","doi":"10.1177/19160216251333351","DOIUrl":"https://doi.org/10.1177/19160216251333351","url":null,"abstract":"<p><p>ImportanceLingual thyroglossal duct cysts (LTGDCs) are rare congenital anomalies that necessitate proactive surgical intervention due to their potential for life-threatening airway obstruction. The challenging anatomical location of LTGDCs complicates their surgical management, and there are currently no standardized surgical modalities in place.ObjectiveTo analyze the clinical features of LTGDCs and evaluate the feasibility, safety, and efficacy of coblation-assisted transoral endoscopic excision of LTGDCs.DesignRetrospective case series (2009-2022) analyzing preoperative, intraoperative, and postoperative data.SettingTertiary academic center.ParticipantsTwenty-nine patients (20 males, 9 females; ages 3-70, with a median age of 34 years) were diagnosed with LTGDCs, including 7 (24.1%) with recurrent LTGDCs following prior surgeries at other institutions.InterventionCoblation-assisted transoral endoscopic excision of LTGDC using FK retractors and a 30° Hopkins telescope for optimal visualization and manipulation.Main Outcome MeasuresComplete cyst excision, postoperative recovery, recurrence rates, complications, and surgical feasibility.ResultsAll LTGDCs were completely excised. During the procedure, it was found that the LTGDCs abutted but did not adhere to the hyoid bone, which allowed for their dissection from the periosteum of the hyoid bone using coblation. Postoperative recovery was uneventful, with an average postoperative stay of 3.1 days (range 1-5 days). No complications, such as bleeding, infection, or airway obstruction, occurred. The mean follow-up period was 5.3 years (range 6 months to 12.4 years), with no recurrences observed during this time.ConclusionsCoblation-assisted transoral endoscopic excision is a reliable, effective, and minimally invasive approach for managing LTGDCs. It ensures complete removal with low recurrence and complication rates, aided by superior visualization and manipulation space provided by FK retractors and a 30° Hopkins telescope.RelevanceThis technique offers a safe alternative to traditional surgeries, reducing trauma and enhancing recovery. Future studies should explore comparisons with other surgical modalities to validate their broader applicability.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333351"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009780","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":"Etiology, Clinical Presentation, and Management of Retrograde Cricopharyngeus Dysfunction: A Systematic Review.","authors":"Jérôme R Lechien, Marie Mailly, Stephane Hans, Lee M Akst","doi":"10.1177/19160216251329012","DOIUrl":"10.1177/19160216251329012","url":null,"abstract":"<p><p>ImportanceThe retrograde cricopharyngeus dysfunction (R-CPD) is an emerging topic in otolaryngology, gastroenterology, and primary care.ObjectiveTo review the current literature about the etiology, clinical presentation, and management of retrograde cricopharyngeus dysfunction (R-CPD).DesignSystematic review.SettingThree investigators conducted the PubMED, Scopus, and Cochrane Library review of the literature related to the etiologies and management of patients with R-CPD through the PRISMA statements.ParticipantsStudies that incorporated R-CPD patients.InterventionsIn-office, or operating room botulinum toxin injection, or no treatment.Main outcome measuresEtiology, clinical presentation, and therapeutic outcomes.ResultsSeventeen studies met the inclusion criteria (826 patients). A family history was reported in 28.0% of cases with most patients developing R-CDP symptoms in childhood (55.5%). In addition to the cardinal symptom of the inability to belch, associated complaints of bloating and chest pain, gurgling noises, and excessive flatulence were found in 95.7%, 86%, and 80.2% of cases, respectively.The diagnosis was recognized by patients themselves in 78.9% of cases. The immediate success rate of botulinum toxin injection into the cricopharyngeal sphincter in facilitating burping was 92.5%. Recurrence occurred in the first month of follow-up in 9.5% of cases, whereas 12.6% and 27.9% of patients had recurrence during the 1-5 months and more than 6 months posttreatment, respectively. Transient dysphagia is the most prevalent complication after botulinum toxin injection (31.1%). The heterogeneity was high across studies, limiting the establishment of further combined analyses.Conclusion and relevanceR-CPD is a recently-recognized and likely-underdiagnosed condition associated with severe symptoms affecting the quality of life of patients. Future studies are needed to elucidate the etiology of this condition, develop adequate patient-reported outcome questionnaires for the baseline and follow-up evaluations of symptoms, and propose therapeutic consensus.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251329012"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144136208","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":"Level IIb Metastases in cN0 Oral Squamous Cell Carcinoma: Multicenter Retrospective Study.","authors":"Takuma Kugimoto, Takumi Hasegawa, Takashi Niiyama, Masaya Akashi, Michihiro Ueda, Hiroyuki Harada","doi":"10.1177/19160216251349446","DOIUrl":"10.1177/19160216251349446","url":null,"abstract":"<p><p>ImportanceNeck dissection is a common surgical treatment for patients with oral squamous cell carcinoma (OSCC). Due to the low incidence of level IIb metastases and the risk of injury to the spinal accessory nerve during level IIb dissection, the need for preventive neck dissection of this area has been discussed.ObjectiveThis study aimed to verify the incidence of level IIb metastases in patients with cN0 OSCC and to discuss the need for excision.DesignRetrospective cohort study.SettingThis study was conducted at 3 centers: the Department of Oral and Maxillofacial Surgical Oncology at the Institute of Science Tokyo Hospital, the Department of Oral and Maxillofacial Surgery at Kobe University Graduate School of Medicine, and the Department of Clinical Oral Oncology, Hokkaido Cancer Center.ParticipantsIn total, 222 patients with cN0 OSCC underwent supraomohyoid neck dissection (SOHND) between 2013 and 2021.Main Outcome MeasuresIncidence of level IIb metastases in patients with cN0 OSCC.ResultsLymph node metastasis was confirmed in 57 patients (25.7%). Two patients (0.9%) had level IIb metastasis. The primary site in these cases was the tongue in 1 case and the lower gingiva in the other, both with advanced cT4 primary tumors. Isolated level IIb metastasis was observed in tongue OSCC samples. Both patients with level IIb metastases experienced primary recurrence. The 5 year overall survival rates for pN(-) and pN(+) patients were 80.6% and 74.3%, respectively (<i>P</i> = .229). The 5 year disease-specific survival rates for the pN(-) and pN(+) patients were 89.6% and 77.2%, respectively (<i>P</i> = .057).Conclusions and RelevanceLevel IIb lymph node involvement in clinical N0 neck cancers is rare. Thus, SOHND may be adequate for most patients with OSCC. Therefore, level IIb dissection may be omitted in patients with cN0 in early-stage OSCC.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251349446"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333327","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":"The Critical Role of Otolaryngologists in Managing Lassa Fever Sequelae: A Call for Action.","authors":"Sulymon A Saka","doi":"10.1177/19160216251326559","DOIUrl":"10.1177/19160216251326559","url":null,"abstract":"","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251326559"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625164","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":"The Multidimensional Approach to Assessing Factors Influencing Type I Tympanoplasty Outcomes in Chronic Otitis Media.","authors":"Arnavaz Hajizadeh Barfejani","doi":"10.1177/19160216241307623","DOIUrl":"10.1177/19160216241307623","url":null,"abstract":"","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216241307623"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374367","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":"Mentorship in Otolaryngology Head and Neck Surgery: A Scoping Review.","authors":"Norbert Banyi, Dianne Valenzuela, M Elise Graham, Amanda C Hu","doi":"10.1177/19160216241307548","DOIUrl":"10.1177/19160216241307548","url":null,"abstract":"<p><strong>Importance: </strong>Mentorship is increasingly recognized as a critical part of training across the spectrum of trainees. While explored more in-depth in the literature of other medical specialties, mentorship remains a nascent topic in the Otolaryngology Head and Neck Surgery (OHNS) literature.</p><p><strong>Objective: </strong>The objective of this study was to assess the current literature on mentorship in OHNS.</p><p><strong>Design: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was used and the methodology was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/X5FQ7). The Medline, EMBASE, and Web of Science databases were searched. Two authors independently selected studies, with the senior author resolving discrepancies. Study quality was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence.</p><p><strong>Setting and participants: </strong>English language studies employing any methodology that involved mentorship of medical trainees and staff in OHNS were included from the inception of the database up to September 20, 2023.</p><p><strong>Intervention or exposures: </strong>Any form of mentorship.</p><p><strong>Main outcome measure: </strong>The primary outcome was the benefits of mentorship afforded to the mentee.</p><p><strong>Results: </strong>From 415 unique articles identified, 45 studies were included. The median publication year was 2020 (IQR 6.5, range 1999-2023). The major themes of benefits from mentorship include improving residency uptake (n = 22), clinical competency and professionalism (n = 20), diversity and equity (n = 19), research productivity (n = 17), career planning and advancement (n = 17), and quality of life (n = 11). Other common themes included active mentorship (n = 29), near-peer mentorship (n = 13), and utilizing digital tools for mentorship (n = 6).</p><p><strong>Conclusion and relevance: </strong>Mentorship in OHNS has seen a sharp increase in publications in recent years. There are numerous benefits to mentorship including improving residency uptake, diversity initiatives, clinical competency and professionalism, research productivity, career planning and advancement, as well as quality of life.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216241307548"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915100","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":"Pooled Analysis of 2 Randomized Clinical Trials to Evaluate the Efficacy and Safety of Clotrimazole 1% Otic Solution for the Treatment of Otomycosis in Adults.","authors":"Ansley J F, Bernal-Sprekelsen M, Butehorn H F, Todorov S, Tzvetkov V, Douglis F, Georgiev K, Moreira da Silva F","doi":"10.1177/19160216251330629","DOIUrl":"https://doi.org/10.1177/19160216251330629","url":null,"abstract":"<p><p>ImportanceThere is no antifungal otic drug for the treatment of otomycosis approved in the United States. Some current clotrimazole formulations in the market are used off-label.ObjectiveTo evaluate the efficacy and safety of clotrimazole 1% otic solution compared to placebo in treating otomycosis in adults.DesignTwo independent twin multicenter, randomized (2:1), double-blind, controlled clinical trials with identical designs were conducted from February 2020 to October 2021.SettingFifty-three sites located in the United States, Mexico, and Europe.ParticipantsAdults with uncomplicated otomycosis presented with symptoms, debris, and drainage clinically consistent with fungal infection.InterventionPatients received clotrimazole or placebo twice daily for 14 days and were evaluated on visit 1 (day 1), visit 2 (day 8-10), visit 3 (day 15), and follow-up visit 4 (day 24-26).Main Outcome MeasuresAt each visit, pruritus, otalgia, otorrhea, and ear fullness were assessed. Ear exudate was taken for a mycological and microbiological evaluation at baseline and, if present, at subsequent visits. The primary endpoint was a therapeutic cure (mycological and clinical) at visit 4 in the randomized population with positive fungal culture at baseline [mycological intent-to-treat (MITT)].ResultsThree hundred ninety-three patients received study medication (261 clotrimazole and 132 placebo). Efficacy data from the 228 patients (157 clotrimazole and 71 placebo) included in the MITT were analyzed. The clotrimazole group achieved a higher proportion for the primary endpoint than those with the placebo group (68.2% vs 25.4%; <i>P</i> < .0001), with a 42.8 difference in response rate (95% confidence interval: 30.3, 55.3). The treatment was safe and well tolerated, with 2.7% of related adverse events in the clotrimazole versus 1.5% in the placebo group.ConclusionsClotrimazole 1% otic solution has demonstrated its superiority over the placebo in each study and the pooled analysis. These are the results of the first international, multicenter clinical trials in which clotrimazole 1% otic solution demonstrates efficacy for the treatment of otomycosis.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251330629"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023634","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":"Oncocytes in Thyroid Aspirates-Implications of Clinical Parameters and Cytologic Diagnosis.","authors":"Joanna K M Ng, Joshua J X Li, Matrix M H Fung, Philip P C Ip, Karen K W Yuen, Philippe Vielh","doi":"10.1177/19160216251333358","DOIUrl":"10.1177/19160216251333358","url":null,"abstract":"<p><p>ImportanceThe clinical significance of oncocytes in thyroid aspirate is uncertain, leading to inconsistent and possible over-treatment.ObjectiveTo determine the predictive significance of clinico-radiological parameters and cytologic diagnosis on the risks of malignancy (ROM) and neoplasia.DesignData of thyroid aspirates with the presence of oncocytes were reviewed for outcomes and clinical-radiological-pathological parameters.SettingThree regional institutes performing thyroid surgery and investigations.ParticipantsFrom a population base of 1.3 million across a 9-year period, totaling 371 aspirates with oncocytes with an 85.0-month average follow-up.InterventionFine-needle aspiration of thyroid.ResultsOn clinical follow-up, the ROM for Bethesda categories C1-C6 was 15.4%/2.7%/9.2%/6.9%/37.5%/100%, while the risk of neoplasm (considering thyroidectomy follow-up) was 45.5%/23.8%/56.3%/61.9%/50%/100%, including 52 oncocytic follicular lesions (4 carcinomas and 48 adenomas) and 26 other carcinomas/malignancies. C5+ diagnoses were associated with malignancy (<i>P</i> = .003), and C3+ was associated with neoplasm on thyroidectomy (<i>P</i> = .006). Malignant/neoplastic outcomes did not correlate with sex or age (<i>P</i> > .05). High free triiodothyronine/free thyroxine levels were associated with a benign clinical outcome (<i>P</i> = .001). Cystic change on ultrasound was associated with a lower malignancy (<i>P</i> = .012) and neoplasm risk (<i>P</i> = .041). Lesion size, echogenicity, vascularity, multinodularity, lymphadenopathy, and solid areas on ultrasound were not significant in predicting malignancy or neoplasm (<i>P</i> > .05).ConclusionThe presence of oncocytes in thyroid aspirates does not increase malignancy risk. Most malignant oncocytic thyroid aspirates are not attributable to oncocytic carcinomas but papillary thyroid carcinomas. Ultrasound and thyroid function tests are helpful in the risk assessment of these cases.RelevanceFor treatment or follow-up decisions in patients with oncocytes in thyroid aspirates.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333358"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078835","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":"Preoperative Radiotherapy Does Not Increase the Risk for Early Complications Following Surgery for Oral Cancer: A Study on Data From the Randomized ARTSCAN 2 Trial.","authors":"Kristin Carlwig, Maria Gebre-Medhin, Lennart Greiff, Peter Hällman, Per Nilsson, Johan Wennerberg, Björn Zackrisson, Johanna Sjövall","doi":"10.1177/19160216251345473","DOIUrl":"10.1177/19160216251345473","url":null,"abstract":"<p><p>ImportanceThe management of complications following oral cavity squamous cell carcinoma (OCSCC) surgery can be challenging. Previous studies show conflicting results on complication risks after preoperative radiotherapy (RT), necessitating a randomized controlled trial (RCT).ObjectiveTo compare early complications during hospitalization for OCSCC surgery between patients receiving preoperative accelerated fractionated RT and those planned for but not yet exposed to RT.DesignA part of the ARTSCAN 2 RCT comparing preoperative accelerated RT with postoperative conventionally fractionated RT for OCSCC.SettingA multicentre trial in 6 tertiary care hospitals in Sweden.ParticipantsUntreated and resectable OCSCC patients of all stages recommended combination treatment by the local multidisciplinary board.InterventionPreoperative accelerated RT was administered twice daily to a total dose of 68 Gy, completed 4 to 6 weeks before surgery.Main Outcome MeasuresComplications during hospitalization included wound infection, neck flap necrosis, chyle leakage, oro/pharyngocutaneous fistula, free flap necrosis, tracheostomy, revision surgery, and medical complications. Length of surgery, perioperative blood loss, and transfusions were also monitored.ResultsTwo hundred and twenty-one patients were eligible for analysis: 103 in the preoperative RT group and 118 not yet exposed to RT. Complication rates were low, with no statistically significant differences between groups. Patients receiving preoperative RT had similar wound infection rates (12/103; 11.7%) to those not exposed (9/118; 7.6%) (<i>P</i> = .31). Among free flap patients, 1/40 (2.5%) in the preoperative RT group and 3/52 (5.8%) in the unirradiated group had free flap necrosis (<i>P</i> = .63). No differences were found in oro/pharyngocutaneous fistula frequency (3/103; 2.9% vs 3/118; 2.5%) (<i>P</i> = 1.00).Conclusion and RelevancePreoperative accelerated RT at 68 Gy, administered 4 to 6 weeks before surgery, does not increase early complications. Although survival rates, morbidities, quality of life, and societal costs need consideration in the ARTSCAN 2 assessment, our findings show that early postoperative complication risks remain unchanged by preoperative RT.Trial RegistrationISRCTN, ISRCTN00608410, Registered 20 March 2008-Retrospectively registered, https://www.isrctn.com/ISRCTN00608410.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251345473"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293877","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}