OTO Open最新文献

{"title":"Evaluation of Nebulized Tranexamic Acid for Acute Secondary Posttonsillectomy Hemorrhage.","authors":"Chloe M Jones, Donald H Solomon, Bailey Balouch, Lucia D Garcia, Yekaterina Shapiro","doi":"10.1002/oto2.70296","DOIUrl":"10.1002/oto2.70296","url":null,"abstract":"<p><strong>Objectives: </strong>Determine the efficacy of nebulized TXA for secondary posttonsillectomy hemorrhage.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary care medical center.</p><p><strong>Methods: </strong>All adult and pediatric patients who presented with active posttonsillectomy hemorrhage >24 hours posttonsillectomy treated at our tertiary care institution between December 2014 and July 2025 were included. Patients who were not actively bleeding on presentation were excluded. Outcomes were compared between patients who received nebulized TXA and those who did not. Outcomes included need for operative intervention, length of hospital stay, and recurrent hemorrhage rate. Univariate statistical analysis was performed using SPSS.</p><p><strong>Results: </strong>There were 101 patients included and 57 received nebulized TXA. All included patients were actively bleeding at the time of initial presentation. Hemostasis was achieved in 84.2% of the 57 patients following administration of nebulized TXA. Patients who received nebulized TXA were significantly less likely to require operative intervention (OR = 0.370 [0.157-0.873]). If operative intervention was required following administration of nebulized TXA (54.9%), the time from presentation to operative intervention was significantly longer (408 ± 324 minutes vs 249 ± 293 minutes, <i>P</i> = .045). Neither hospital length of stay (1.2 ± 1.1 vs 1.5 ± 1.4 days, <i>P</i> = .148) or readmission rate for recurrent posttonsillectomy hemorrhage (7.0% vs 13.6%, <i>P</i> = .283) differed significantly between groups. No adverse effects of nebulized TXA were identified.</p><p><strong>Conclusion: </strong>Administration of nebulized TXA is a safe and effective strategy for acute stabilization of secondary posttonsillectomy hemorrhage. Nebulized TXA reduced the rate of operative intervention for secondary posttonsillectomy hemorrhage and increased the time until intervention was required.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70296"},"PeriodicalIF":1.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521568/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Nasal Obstruction and Mouth Taping on Sleep Apnea Indicators: Systematic Review and Meta-Analysis.","authors":"Nawaf A Alshehri, Nada F Alsaif, Abdullah N Abdulrazaq, Raaoum M Jabor, Ahmed A Al-Sayed","doi":"10.1002/oto2.70294","DOIUrl":"10.1002/oto2.70294","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of nasal obstruction on obstructive sleep apnea (OSA) indicators and summarize the limited available data on mouth taping during sleep.</p><p><strong>Data sources: </strong>A systematic search was conducted in October 2024, encompassing 5 electronic databases: PubMed, MEDLINE, Web of Science, Cochrane, and CINAHL, to evaluate the impact of breathing routes on OSA indicators.</p><p><strong>Review methods: </strong>Eligible studies included those that induced nasal obstruction either non-surgically (eg, experimental studies or postintervention for epistaxis) or surgically (eg, postseptoturbinoplasty) and their impact on reported sleep apnea indicators, such as Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), mean and nadir oxygen saturation. A Meta-analysis was conducted on studies of nasal obstruction. Due to limited data, no meta-analysis was performed for mouth taping; only 2 studies were narratively reviewed.</p><p><strong>Results: </strong>Nasal obstruction was associated with a clinically significant increase in AHI (+13.78 events/h) and ODI (+7.45 events/h), alongside a modest nonclinically significant decrease in the average (-0.70%) and nadir (-1.75%) SpO₂. Conversely, a narrative review of two studies on mouth taping found it reduced AHI in patients with mild OSA. The heterogeneity among studies limits the generalizability of these data.</p><p><strong>Conclusion: </strong>Nasal obstruction, whether induced non-surgically or in surgical settings, was associated with worsening of OSA indicators and may precipitate OSA-like abnormalities in previously healthy individuals. These findings underscore the importance of nasal breathing and support further investigation into the breathing route as a modifiable factor in sleep-disordered breathing.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70294"},"PeriodicalIF":1.6,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13521571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health and Sleep Outcomes Among Patients Diagnosed With Chronic Cough.","authors":"Andrew Meci, Emily N Milarachi, John P Gniady","doi":"10.1002/oto2.70291","DOIUrl":"10.1002/oto2.70291","url":null,"abstract":"<p><strong>Objective: </strong>Chronic cough is a complex, multi-factorial condition. Past studies have associated chronic cough with a degraded quality of life, namely related to psychological and sleep outcomes. We investigated the association between chronic cough and later diagnosis with mental health and sleep disorders using a large database.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>TriNetX research database.</p><p><strong>Methods: </strong>A retrospective cohort analysis was conducted using the TriNetX research database. Patients aged ≥18 years with chronic cough diagnosed from 2008 to 2018 and no recent history of mental health or sleep disorders were included and compared to a matched control cohort. Primary outcomes were 5-year diagnoses with sleep disorders, depression, and anxiety. Secondary outcomes included rates of interaction with the healthcare system, other mental health diagnoses, and usage of psychological medications and sleep devices.</p><p><strong>Results: </strong>Of 65,442 included patients with chronic cough, mean age was 54.5 ± 15.3 and patients were 60.8% female, 75.2% white, and 86.5% not Hispanic/Latino. After demographic matching, patients with chronic cough had significantly higher rates of smoking, obesity, asthma, and GERD. Patients were at significantly higher risks of developing sleep disorders (RR 1.58, <i>P</i> < .01), mental health diagnoses (RR 1.33, <i>P</i> < .01), and receiving anti-reflux, antidepressant, and CPAP treatments (<i>P</i> < .01 for all).</p><p><strong>Conclusion: </strong>Chronic cough diagnosis is associated with increased risk of later development of anxiety, depression, and disordered sleep. This is the largest study to date examining the burden of chronic cough alongside associated outcomes. Future studies will further investigate these associations and investigate improved patient care models.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70291"},"PeriodicalIF":1.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Upper Extremity Outcomes in Radial Forearm Free Flap Reconstruction of the Head and Neck.","authors":"Brooke B Swain, Sindhura Sridhar, Whitney Jin, Robert J Sinard, Kyle Mannion, Alexander J Langerman, Eben L Rosenthal, Michael C Topf, Sarah L Rohde","doi":"10.1002/oto2.70283","DOIUrl":"10.1002/oto2.70283","url":null,"abstract":"<p><strong>Objective: </strong>Fasciocutaneous radial forearm free flaps (RFFF) are widely used for head and neck soft tissue reconstruction. Osteocutaneous radial forearm free flaps (OCRFFF) enable bony reconstruction, but concerns for donor site morbidity have limited their use. Long-term donor site outcomes following OCRFFF remain understudied.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Single-institution.</p><p><strong>Methods: </strong>Patients who underwent RFFF or OCRFFF between 2010 and 2023 were surveyed by phone. Upper extremity function was assessed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) survey (0-100 scale, higher scores indicate greater disability). Patients who were non-verbal or lacked follow-up after 2021 were excluded. QuickDASH scores were analyzed using Wilcoxon rank-sum test. Univariable linear regressions assessed clinical associations.</p><p><strong>Results: </strong>Survey response rate was 21.7%. The cohort included 26 RFFF, 14 OCRFFF, and 5 patients with multiple radial forearm flaps. At a median time of 3.25 years postoperatively (IQR: 2.2-5.6), OCRFFF patients had higher mean QuickDASH scores (21.6) than RFFF (10.7), suggesting greater functional limitation in OCRFFF cases (<i>P</i> = .12). Overall impairment remained low. OCRFFF patients reported greater difficulties compared to RFFF regarding jar opening (2.4 vs 1.6; <i>P</i> = 0.01), back washing (2.0 vs 1.3; <i>P</i> = .03), and recreational activities (2.5 vs 1.4; <i>P</i> = .02). History of depression was associated with higher QuickDASH scores (coef 12.7, 95% CI: 1.23-24.48).</p><p><strong>Conclusions: </strong>OCRFFF patients reported greater difficulty in certain task-specific activities compared to RFFF, but overall donor site impairment following forearm free flap reconstruction is minimal. History of depression is associated with worse self-reported upper extremity function.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70283"},"PeriodicalIF":1.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Characteristics of Patients With Symptomatic Sigmoid Sinus Wall Anomalies.","authors":"Christopher Z Wen, Charlyn Gomez, Yunting Fu, Jae-Jin Song, Dong Woo Nam, Yue-Lin Hsieh, Wuqing Wang, David J Eisenman","doi":"10.1002/oto2.70293","DOIUrl":"10.1002/oto2.70293","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate geographic differences in clinical characteristics, including BMI, of patients with pulsatile tinnitus (PT) due to sigmoid sinus wall anomalies (SSWA).</p><p><strong>Study design: </strong>Systematic review and multi-institutional retrospective cohort study.</p><p><strong>Setting: </strong>Three tertiary care centers, one each in the United States, China, and Korea.</p><p><strong>Methods: </strong>For the systematic review, PubMed, Embase, and Scopus were queried for articles published through June 2025. The retrospective review included patients who underwent intervention for SSWA-associated PT from 2007 to 2025.</p><p><strong>Results: </strong>Of 957 articles, 11 studies were included. BMI of US patients (n = 80) was 9.9 kg/m² higher (<i>p</i> = 0.0001; CI 8.1-11.6) than East Asian patients (n = 261), but there was no difference compared to the national average BMI. The retrospective review included 111 United States, 151 Korean, and 206 Chinese patients. The BMI of US patients (33.61 kg/m²) was higher (<i>p</i> < .0001) and had greater variance (<i>p</i> < .0001) than that of Korean (25.22 kg/m²) and Chinese (23.21 kg/m²) patients. When compared to the national average BMI, US (<i>p</i> < .0001; ∆4.1 kg/m², CI 2.5-5.7) and Korean (<i>p</i> < .0001; ∆1.8 kg/m², CI 1.1-2.6) patients had higher mean BMI, but Chinese patients did not. US patients were more likely to be overweight or obese compared to Korean (odds ratio [OR] 3.17, <i>p</i> < .0001; CI 1.71-5.85) and Chinese (OR 5.75, <i>p</i> < .0001; CI 3.20-10.31) patients. Korean patients were 1.81 (<i>p</i> < .01, CI 1.18-2.79) times more likely than Chinese patients to be overweight or obese.</p><p><strong>Conclusions: </strong>BMI appears to be a more defining characteristic for American patients than East Asian patients with SSWA-associated PT. These findings have implications on the pathophysiology of SSWA and its relationship to IIH.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70293"},"PeriodicalIF":1.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing the State of Sponsorship in Academic Otolaryngology Departments.","authors":"Maeher Grewal, Caitlin Faust, Kelly Daniels, Kristine A Smith, Abigail Pulsipher, Amanda Stapleton, Jeffrey Simons, Reema Padia","doi":"10.1002/oto2.70295","DOIUrl":"10.1002/oto2.70295","url":null,"abstract":"<p><strong>Objectives: </strong>Recent studies suggest sponsorship opportunities are not equal between men and women in academic surgical medicine. We aimed to quantify the state of sponsorship in academic otolaryngology based on gender to establish a baseline by which to mark future progress.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Publicly available department roster.</p><p><strong>Methods: </strong>A cross-sectional study was performed in which academic rank, gender, and leadership role were obtained from departmental websites of all ACGME-accredited United States otolaryngology programs from June to September 2024.</p><p><strong>Results: </strong>Of 2253 academic ranks and 1113 leadership roles identified across 125 otolaryngology departments, 29.0% and 25.5% were respectively held by women (<i>P</i> < .0001). Fourteen of 99 (14.1%) department chairs, 44 of 122 (36.1%) program directors (<i>P</i> < .0001), and 54 of 301 division chief or directorship roles (17.9%, <i>P</i> < .01) were held by women. Two of 26 (4.3%) professor emeriti, 113 of 626 (18.1%) full professor, 186 of 633 (29.4%) associate professor, and 352 of 948 (37.1%) assistant professor roles were held by women (<i>P</i> < .0001). Significant differences were observed in the proportion of women in leadership roles in departments chaired by women versus men (45% vs 25%, <i>P</i> < .0005), and with female versus male program directors (43% and 15%, <i>P</i> < .0001).</p><p><strong>Conclusions: </strong>Women held higher proportions of leadership positions within departments chaired and residency programs run by women. Research efforts to determine the factors associated with these trends, including surveys of personal experiences with sponsorship, are ongoing.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70295"},"PeriodicalIF":1.6,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13512048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148831321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should H2-Blockers Be Used for the Treatment of Laryngopharyngeal Reflux?","authors":"Sophia Linguiti, W Jack Palmer, Janvi J Shukla, Kathleen Tibbetts, Colin Huntley, Joseph Spiegel","doi":"10.1002/oto2.70278","DOIUrl":"https://doi.org/10.1002/oto2.70278","url":null,"abstract":"<p><p>Laryngopharyngeal reflux (LPR) is a highly prevalent condition in otolaryngology practice, characterized by reflux of gastric contents into the pharynx and larynx. Although proton pump inhibitors (PPIs) remain first-line therapy, many patients report persistent symptoms. In refractory cases, histamine-2 receptor antagonists (H2RAs) are often employed as adjunctive or standalone therapy due to their rapid onset and accessibility. However, their utility as daily therapy is limited by tachyphylaxis, with significant loss of acid suppression within days of continuous use. Despite longstanding evidence from gastroenterology literature discouraging daily H2RA therapy, these agents remain frequently prescribed in otolaryngology practice. Contemporary ear, nose, and throat (ENT)-specific guidance on their role in LPR is lacking. In patients with ongoing laryngopharyngeal symptoms despite optimized PPI therapy, a systematic, phenotype-driven approach is recommended, incorporating objective testing with hypopharyngeal-esophageal pH-impedance monitoring, alternative agents including alginates, and consideration of surgical or endoscopic interventions. Greater adherence to evidence-based recommendations may improve outcomes.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70278"},"PeriodicalIF":1.6,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492577/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Use and Infection Patterns in Pediatric Tracheostomy Patients During Index Hospitalization.","authors":"Romaine F Johnson, Saudamini Lele, Alyssa C Chapel, Cynthia S Wang, Yann-Fuu Kou, Stephen R Chorney","doi":"10.1002/oto2.70290","DOIUrl":"https://doi.org/10.1002/oto2.70290","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate antibiotic utilization as a process measure in pediatric tracheostomy patients, establishing baseline variation across diagnostic categories to inform quality improvement and stewardship initiatives.</p><p><strong>Methods: </strong>We retrospectively studied pediatric tracheostomy patients at a tertiary children's hospital (2015-2024). Antibiotic use was quantified across diagnostic categories, with prophylactic courses defined as 2 days or less. Cultures were reviewed to distinguish true bacterial infections from viral detections and colonization. Mixed-effects logistic regression modeled infection risk, accounting for patient clustering. Sensitivity analyses excluded patients hospitalized over 365 days.</p><p><strong>Results: </strong>Of 429 patients (6.8 months [IQR 4.3-55.9]), respiratory conditions were most common (43.8%), followed by cardiac (19.3%). Cardiac patients had the highest antibiotic exposure (mean 52.1 days) despite low infection rates (17.8%), while trauma patients had the highest infection rates (31.5%). Diagnostic category did not significantly affect infection risk after accounting for clustering. Only 19.6% of 38,030 cultures showed true bacterial infection (median time 14.1 days posttracheostomy). Viral detection cascades triggered 11.4% of bacterial cultures within 48 hours.</p><p><strong>Discussion: </strong>Antibiotic prescribing patterns often reflect institutional preferences rather than true infection risk. Individual patient factors more strongly predict infection than diagnostic category. This highlights the need for personalized stewardship and standardized viral detection protocols.</p><p><strong>Implications for practice: </strong>High variability in antibiotic utilization across diagnostic categories represents a measurable stewardship target. Reducing unnecessary exposure may decrease length of stay, healthcare costs, and antibiotic-associated complications.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70290"},"PeriodicalIF":1.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The T Stage of Papillary Thyroid Cancer and Its Effect on Regional Complications of Thyroidectomy.","authors":"Fahad Rind, Songzhu Zhao, Stephen Kang, Catherine T Haring, Amit Agrawal, Enver Ozer, Matthew O Old, Ricardo L Carrau, Nolan B Seim","doi":"10.1002/oto2.70213","DOIUrl":"https://doi.org/10.1002/oto2.70213","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of increasing AJCC T stage on postoperative morbidity in patients undergoing thyroidectomy for papillary thyroid cancer.</p><p><strong>Study design: </strong>Retrospective cross-sectional database study.</p><p><strong>Setting: </strong>The American College of Surgeons National Surgical Quality Improvement Program (NSQIP), which collects surgical outcomes data from ~700 US hospitals.</p><p><strong>Methods: </strong>NSQIP Participant User Files were queried for thyroidectomy procedures (CPT codes 60210, 60212, 60220, 60225, 60240, 60252, 60254, 60260) from 2016 to 2020 with a pathology-confirmed diagnosis of papillary thyroid cancer. Primary exposure was T stage and outcomes included hoarseness, hypocalcemia, and hematoma formation. Multivariate analysis controlled for N stage, total thyroidectomy, multifocality, and neck dissection.</p><p><strong>Results: </strong>A total of 10,901 cases were identified (74.2% female; mean age 50.1 ± 15.1 years). Compared to early-stage tumors, T3 cancers were associated with increased risk of hoarseness (OR 1.614, 95% CI 1.260-2.074, <i>P</i> < .01) and 30-day hypocalcemia (OR 1.296, 95% CI 1.022-1.645, <i>P</i> = .03). Upstaging to T4 further increased risks of hoarseness (OR 2.971, 95% CI 2.039-4.282, <i>P</i> < .01), hematoma (OR 2.266, 95% CI 1.027-4.999, <i>P</i> = .04), and hypocalcemia (OR 1.542, 95% CI 1.007-2.364, <i>P</i> < .05). No significant morbidity difference was observed between T1 and T2 tumors.</p><p><strong>Conclusion: </strong>Increasing T stage is associated with significantly higher postoperative morbidity in patients with papillary thyroid cancer, particularly when advancing to T3 or T4. These findings highlight the importance of preoperative risk assessment and surgical planning in advanced disease.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70213"},"PeriodicalIF":1.6,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479466/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796316","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Formal Career Goal Advising Program for Otolaryngology, the UNC Experience.","authors":"Makayla R Matthews, Todd H Lambert, Robert A Buckmire, Rupali N Shah, Christine E DeMason","doi":"10.1002/oto2.70289","DOIUrl":"10.1002/oto2.70289","url":null,"abstract":"<p><p>Career goal advising (CGA) is critical to medical student success in the increasingly competitive field of otolaryngology. Otolaryngology is underrepresented in the preclinical curriculum; therefore, early exposure and guidance are limited. At the University of North Carolina (UNC), a formal CGA program was created in 2018 to provide direct access to faculty mentorship. Advisors provide early exposure to otolaryngology, advise the interest group, and meet regularly with students throughout medical school training. All participating students were surveyed. Since inception, the match rate of students applying to otolaryngology from UNC has been 95%. The majority of these students matched at top 25 residency programs. Students reported high satisfaction with access, responsiveness to concerns, preparedness for the match, and confidence in specialty choice. Our program offers a sustainable response to the challenge of exposure and competitiveness in otolaryngology and may provide a template for medical schools to improve faculty mentorship within otolaryngology.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70289"},"PeriodicalIF":1.6,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}