OTO Open最新文献

{"title":"Opportunities to Improve Primary-Level Otolaryngology Care: A Survey of Rwandan General Practitioners.","authors":"Kamala Pullakhandam, Christian Kabongo, Mahbuba Tusty, Sarah Nuss, Gabrielle Cahill, Nina Patel, John Bukuru, Hirwa Nteyumwete, Aristote Hakizimana, Aimee Kamaliza, David A Shaye, Charles Nkurunziza, Eric Uwizeyimana, Ornella Masimbi, Mary Jue Xu, Gratien Tuyishimire","doi":"10.1002/oto2.70303","DOIUrl":"10.1002/oto2.70303","url":null,"abstract":"<p><strong>Objective: </strong>In Rwanda, 30 OHNS clinicians serve the country's population of 14 million. With low subspecialist density, primary care providers (PCPs) become the first line of otolaryngologic triage and care. However, it is unclear if Rwandan PCPs are equipped to bridge OHNS care gaps.</p><p><strong>Study design: </strong>Cross-sectional qualitative survey-based study.</p><p><strong>Setting: </strong>Rwandan PCPs were surveyed, and responses were collected between November 2024 and May.</p><p><strong>Methods: </strong>Surveys were co-developed with Rwandan OHNS clinicians and evaluated the diagnostic and management confidence of common head and neck conditions. Responses were analyzed with descriptive statistics.</p><p><strong>Results: </strong>Forty-four PCPs completed the survey. PCPs most frequently encountered sinonasal, pediatric, and ear/hearing diseases (mean of 10.5, 9.7, and 6.7 presentations/week, respectively). However, confidence in sinonasal skills was low (mean confidence score of 2.9 out of 5). Diagnostic and management confidence scores were stable across disease categories. Eighty-eight percent of PCPs identified limited training/knowledge as barriers to patient care. Ninety-seven percent of PCPs agreed that further emphasis on otolaryngology training is needed during medical school.</p><p><strong>Conclusions: </strong>This study highlights training gaps and systemic barriers affecting the Rwandan primary care workforce. Targeted hands-on training is needed to improve PCPs' skills. Furthermore, evaluation of PCP recognition and management confidence did not reveal specific areas of deficit, indicating that training topics should be comprehensive and diverse. Finally, limited training/knowledge/skills was a common barrier to care, highlighting the importance of PCP-focused continuing medical education. This survey framework could be utilized in other LMIC settings to identify areas of reduced confidence in otolaryngology provision.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70303"},"PeriodicalIF":1.6,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676033/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216606","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 an Informational Video on Parental Choice of Tonsillectomy Technique.","authors":"Amanda G Baanante, Erin M Gawel, Gaayathri Varavenkataraman, Annabella M Nilon, Michele M Carr","doi":"10.1002/oto2.70306","DOIUrl":"10.1002/oto2.70306","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether the use of an educational video explaining the differences between intracapsular and extracapsular tonsillectomy, as well as their respective risks and benefits, influences parental decision-making in a pediatric otolaryngology clinic.</p><p><strong>Methods: </strong>Flyers with a quick response (QR) code linking to a video that explained intracapsular versus extracapsular tonsillectomy techniques and associated complications were posted in exam rooms of a pediatric otolaryngology clinic in July 2024. Parents were encouraged to view the video. Data were collected for tonsillectomies performed between May 2024 and January 2025, including clinic visit date, patient age and gender, parent at the visit, indication for tonsillectomy, and procedure chosen.</p><p><strong>Results: </strong>Of 214 patients, 133 (62%) had clinic visits before flyers were posted and 81 (38%) after. Before the flyers, only 24 (18%) chose intracapsular tonsillectomy, compared to 34 (42%) afterward (<i>P</i> < .001). Obstructive sleep apnea (OSA) or sleep disordered breathing (SDB) were the most common surgical indications (N = 200, 94%). Patient age and gender, parent at visit, and surgical indication were not significantly associated with the procedure chosen.</p><p><strong>Discussion: </strong>These findings suggest educational interventions can influence parental preference for tonsillectomy type. Providing accessible, comprehensible information may support more informed decision-making, potentially improving surgical outcomes and parent satisfaction.</p><p><strong>Implications for practice: </strong>Integrating concise educational tools into clinic visits offers a practical way to enhance communication and engage families in shared surgical decision-making. These interventions may also standardize information delivery and reduce variability in how options are presented across providers.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70306"},"PeriodicalIF":1.6,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216563","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":"Assessment of Educational Components of a Short-Term Surgical Trip Partnership: Feasibility and Preliminary Outcomes.","authors":"Alicia B Yang, Cody L Messick, Ariana S Rincon, Mateo Useche, Naomi Tesema, Weston Niermeyer, Brhanu H Asgedom, Selamawit Gebrezgabiher, Zaid M Yehala, Myra A Zaheer, Daniel G Eyassu, Tekleweini A Hailu, Joshua P Wiedermann","doi":"10.1002/oto2.70313","DOIUrl":"https://doi.org/10.1002/oto2.70313","url":null,"abstract":"<p><strong>Objective: </strong>Assess a longitudinal, education-centered short-term surgical trip partnership's impact on knowledge, technical skill, and learner attitudes among otolaryngology residents.</p><p><strong>Study design: </strong>Prospective, pre-post interventional study.</p><p><strong>Setting: </strong>Single institution in Mekele, Ethiopia.</p><p><strong>Methods: </strong>In May 2024, 12 otolaryngology residents participated in a 4-week curriculum of didactics and skills sessions on suture and parotidectomy techniques at Ayder Comprehensive Specialized Hospital. The visiting surgical team administered precurriculum and postcurriculum self-assessments of confidence rated on Likert scales, multiple choice exams (MCE), and Objective Structured Clinical Examinations (OSCE). To assess long-term retention of knowledge and skills, the assessments were also administered 9 months after the initial STST. <i>T</i>-tests and Wilcoxon signed-rank tests were used to compare precurriculum and postcurriculum outcomes.</p><p><strong>Results: </strong>The study cohort included 3 PGY1, 4 PGY2, and 5 PGY3 who engaged in an average of 2 parotidectomies, 18 hours of study, and 3 hours of skills practice. Participants had significantly greater postcurriculum confidence in using nylon (<i>P</i> = .048), prolene (<i>P</i> < .01), monocryl (<i>P</i> < .01), and PDS (<i>P</i> < .01) and performing drain stitches (<i>P</i> = .035) and parotidectomy (<i>P</i> = .046) at the end of the first STST. After 9 months, there were no significant changes in assessment scores. All participants reported improved suture skills and strongly agreed that the curriculum was manageable along with clinical tasks.</p><p><strong>Conclusion: </strong>This study provides a framework for building sustainable partnerships across institutions. The education and assessment formats were feasible and improved subjective and objective knowledge and clinical skills. Continued longitudinal tracking of outcomes and their application towards guiding STST partnerships are warranted.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70313"},"PeriodicalIF":1.6,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13663867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195827","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":"Thyroid Involvement in Laryngeal Squamous Cell Carcinoma-Should it be Spared?","authors":"Francisco J Garratón-Gutiérrez, Bianca Bonafont-Reyes, Javier A Vilá Ortiz, Antonio Burés-Rodríguez, Mario Corona-Ruíz, Jeamarie Pascual-Marrero","doi":"10.1002/oto2.70312","DOIUrl":"10.1002/oto2.70312","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence and predictors of thyroid gland invasion in Hispanic patients with laryngeal squamous cell carcinoma undergoing total laryngectomy and to assess thyroidectomy-associated comorbidities.</p><p><strong>Study design: </strong>Retrospective cross-sectional review.</p><p><strong>Setting: </strong>University District Hospital, Puerto Rico Medical Center, San Juan, PR.</p><p><strong>Methods: </strong>Records of adults with laryngeal squamous cell carcinoma who underwent total laryngectomy from 2009 to 2022 were reviewed. Tumor characteristics were correlated with histopathologic thyroid gland invasion, and postoperative hypocalcemia was documented. Categorical variables were compared using Fisher's exact or Pearson's chi-square tests, with effect size reported by Cramér's <i>V</i>; continuous variables were analyzed with the Wilcoxon-Mann-Whitney test.</p><p><strong>Results: </strong>Of 105 patients, 8 (7.6%) had thyroid gland invasion. Tumors with invasion were larger (5.0 ± 1.3 vs 3.3 ± 1.4 cm; <i>P</i> = .003) and were associated with thyroid cartilage invasion (100% vs 54.6%; <i>P</i> = .020). Patients with invasion underwent total thyroidectomy more often (75.0% vs 28.9%; <i>P</i> = .013). Postoperative hypocalcemia occurred in 41.9% (44/105) of patients overall and was more frequent after total than after partial thyroidectomy (79.4% vs 23.9%; <i>P</i> < .001). Intravenous calcium replacement was required in 19.0% (20/105) of patients, more often after total thyroidectomy (47.1% vs 5.6%; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Thyroid gland invasion was uncommon but associated with larger tumors and thyroid cartilage invasion. Total thyroidectomy carried a higher risk and greater severity of hypocalcemia. These findings support selective thyroid management during total laryngectomy and provide evidence from an underrepresented Hispanic population.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70312"},"PeriodicalIF":1.6,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149183867","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":"Outcomes of Modified Sistrunk Procedure for Pediatric Thyroglossal Duct Cyst Removal: Systematic Review and Meta-Analysis.","authors":"Hashim Shaaban, Alma Sato, Annah Waqasi, Carl-Gabriel McGovern, Ismail Ozgenc, Laith Bayan, James W F Burns, Sum-Yu C Lee, Christian A Than, Hayato Nakanishi, Premjit Randhawa","doi":"10.1002/oto2.70308","DOIUrl":"10.1002/oto2.70308","url":null,"abstract":"<p><strong>Objective: </strong>This meta-analysis aims to evaluate the safety and efficacy of the modified Sistrunk procedure in pediatric patients with thyroglossal duct cyst.</p><p><strong>Data sources: </strong>A comprehensive literature search was conducted across Ovid MEDLINE, Embase, CINAHL and The Cochrane Library, from inception to April 16, 2025.</p><p><strong>Review methods: </strong>Screening and selection followed PRISMA guidelines, and the review protocol was prospectively registered with PROSPERO (CRD420251022683). Eligible studies included pediatric patients undergoing the modified Sistrunk procedure for thyroglossal duct cysts. Data extraction was performed independently by reviewers, and study quality was assessed using standardized appraisal tools. Pooled estimates for recurrence, complications, infection, postoperative drainage and operative time were calculated using a random-effects meta-analysis model to account for between-study variability.</p><p><strong>Results: </strong>Of 999 studies screened, 5 studies met the eligibility criteria, with a total of 937 pediatric patients with thyroglossal duct cyst undergoing modified Sistrunk procedure. The pooled recurrence rate was 4% (95% CI: 0.02, 0.07; <i>I</i> ² = 59%), and the complication rate was 12% (95% CI: 0.01, 0.32; <i>I</i> ² = 97%). The pooled infection rate was 6% (95% CI: 0.02, 0.10; <i>I</i> ² = 84%), whereas the postoperative drainage rate was 5% (95% CI: 0.00, 0.14; <i>I</i> ² = 91%), and operative time was 49.0 minutes (95% CI: 33.6 min, 64.5 min; <i>I</i> ² = 99%).</p><p><strong>Conclusions: </strong>The modified Sistrunk procedure appears to be a safe approach for the management of thyroglossal duct cysts for pediatric patients. However, heterogeneity in technique highlights the need for standardized definitions and high-quality studies to inform clinical guideline development.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70308"},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113100","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":"From Model to Mastery: High-Fidelity Cricothyrotomy Simulation With a 3D-Printed and Biological Tissue Model.","authors":"Lauren E Schlegel, Sruti Tekumalla, Sara Belko, Aarti Agarwal, Eva Varotsis, Julianna Rodin, Robert Pugliese, Morgan Hutchinson, Richard Goldman","doi":"10.1002/oto2.70300","DOIUrl":"10.1002/oto2.70300","url":null,"abstract":"<p><strong>Objective: </strong>Emergency cricothyroidotomy is a rare procedure utilized in the setting of patients who cannot be oxygenated or intubated. To enhance training in this critical skill, we developed and validated an immersive, high-fidelity task trainer that integrates a 3D-printed airway model with a porcine soft-tissue layer, and we assessed its impact during simulation-based training sessions.</p><p><strong>Study design: </strong>Observational.</p><p><strong>Setting: </strong>Single institution (16 otolaryngology and 30 emergency medicine trainees).</p><p><strong>Methods: </strong>Our trainer consisted of an accurate 3D-printed airway model and neck incorporating anatomical structures and a biological soft-tissue layer. A survey was administered before and after the simulation. The simulations were completed individually in a case-based scenario with vital signs monitors and supporting actors responding to the participant's management decisions. The participants debriefed with otolaryngology faculty. Differences among post graduate year were analyzed using analysis of variance (ANOVA) and two-tailed <i>t</i> tests.</p><p><strong>Results: </strong>Confidence regarding airway anatomy, management, and cricothyrotomy performance increased significantly after the simulation (<i>P</i> < .00001). Across all training levels, simulation elements such as adaptive vital signs and use of biological skin on the task trainer were rated highly, scoring an average of 8.7 and 9.7 out of 10, respectively. Participants rated the composite model, on average, 9.1 out of 10 on the post-simulation survey.</p><p><strong>Conclusion: </strong>High-quality simulation is essential for developing competence in cricothyrotomy, a procedure that is infrequent yet critical. The task trainer and simulation session described here provide a realistic, reproducible, and highly rated method for trainees to gain the skills and confidence necessary to perform emergent cricothyrotomy.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70300"},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113039","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":"Survival and Recurrence Patterns After Total Laryngectomy in Young Laryngeal Squamous Cell Carcinoma Patients.","authors":"Clara D Si, Whitney Jin, Brooke Swain, Jean-Nicolas Gallant, Robert J Sinard, Eben L Rosenthal, Sarah L Rohde, Kyle Mannion, Alexander J Langerman, Michael C Topf","doi":"10.1002/oto2.70314","DOIUrl":"10.1002/oto2.70314","url":null,"abstract":"<p><strong>Objective: </strong>The prognostic role of age in laryngeal squamous cell carcinoma (LSCC) remains unclear, particularly regarding recurrence after total laryngectomy (TL). This study evaluated the impact of age on LSCC outcomes following TL.</p><p><strong>Study design: </strong>Retrospective single-institution cohort study.</p><p><strong>Setting: </strong>Academic tertiary medical center.</p><p><strong>Methods: </strong>We reviewed LSCC patients who underwent TL between 1999 and 2024 grouped by age at surgery: <45 versus ≥45 years. Overall survival (OS) and disease-free survival (DFS) were assessed using Kaplan-Meier and log-rank tests. Site-specific recurrence was analyzed using cumulative incidence functions with Gray's test. Multivariable competing risk regressions with the Fine-Gray model evaluated the association of age with recurrence.</p><p><strong>Results: </strong>Among 646 TL patients, 17 were <45 years. Five-year OS was 82.0% for <45 versus 54.3% for ≥45 (<i>P</i> = .023); 5-year DFS was 70.2% versus 42.9% (<i>P</i> = .023). There was no significant difference in overall recurrence between age groups. Competing risk analysis showed no significant difference in cumulative incidence of local, regional, or distant recurrence. In multivariable analysis adjusting for T stage, N stage, laryngectomy indication, and adjuvant therapy, younger age was not independently associated with recurrence (sHR 0.55, 95% CI 0.18-1.63, <i>P</i> = .28).</p><p><strong>Conclusions: </strong>Younger LSCC TL patients demonstrated improved OS and DFS despite comparable recurrence risk. Age was not independently associated with recurrence, suggesting that improved survival in younger patients does not reflect differences in oncologic control. These findings highlight the importance of distinguishing survival from recurrence outcomes and underscore the need for larger studies evaluating survival differences in younger patients.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 4","pages":"e70314"},"PeriodicalIF":1.6,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13640527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149113042","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":"Steroid Injection in Patients With Benign Vocal Fold Lesions: A Meta-Analysis and Meta-Regression.","authors":"Yousef M Al-Shammari, Bisher Albesher, Sarah M Murad, Dhari Altaher, Nourah H AlGhurair, Ahmad S Alawadhi, Hasan Alshemari","doi":"10.1002/oto2.70307","DOIUrl":"10.1002/oto2.70307","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to assess the efficacy and safety of steroid injections in patients with benign vocal fold lesions.</p><p><strong>Data sources: </strong>PubMed, Scopus, and Embase were searched from January 2000 through December 2025 using predefined terms for benign vocal fold pathology and steroid injection.</p><p><strong>Review methods: </strong>We conducted a PRISMA-guided systematic review and meta-analysis of studies evaluating steroid injections for benign vocal fold lesions. Study selection and data extraction were performed independently by two reviewers. Study quality was assessed using NIH (cohort studies), JBI (case series), and RoB 2 (RCTs). Random-effects meta-analysis (DerSimonian-Laird) was performed in OpenMeta[Analyst], with Freeman-Tukey double arcsine transformation for proportional outcomes.</p><p><strong>Results: </strong>Fourteen studies were included. Posttreatment VHI pooled mean was 17.585 (95% CI 10.61-24.55; <i>I</i> ² = 97%), while VHI change was not statistically significant (-6.948; 95% CI -16.06 to 2.16; <i>I</i> ² = 98%), indicating substantial between-study heterogeneity and limited certainty in pooled VHI effect estimates. MPT improved, with post-treatment pooled mean 13.24 seconds (95% CI 12.54-13.94; <i>I</i> ² = 73%) and pooled change 1.81 seconds (95% CI 1.10-2.52; <i>I</i> ² = 71%). Complications were uncommon (1.5%; <i>I</i> ² = 0%). Overall improvement was 92%, recurrence 15.2%, complete remission 42.5%, partial remission 39.6%, and no response 9.4%.</p><p><strong>Conclusion: </strong>Steroid injection was associated with high clinical improvement and low complication rates. However, VHI demonstrated substantial heterogeneity and inconsistent statistical significance across studies, limiting the robustness and generalizability of pooled quality-of-life estimates. These findings support steroid injection as a minimally invasive option in selected patients but highlight the need for standardized protocols and higher-quality comparative trials to better define its effect on patient-reported voice outcomes.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70307"},"PeriodicalIF":1.6,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621230/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081187","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":"Preclinical Simulation of Transoral Robotic Thyroidectomy Using a Training Box and the Versius Robotic Platform.","authors":"Guilherme R Agne, Valdenor N Feitosa, Antonio Bertelli, Rafael de Cicco, Luiza H C da Silva, Leandro L Matos, Bruno M Murara, Renan B Lira, Everson L de Almeida Artifon, Luiz P Kowalski","doi":"10.1002/oto2.70309","DOIUrl":"10.1002/oto2.70309","url":null,"abstract":"<p><p>Transoral robotic thyroidectomy (TORT) represents an alternative to open surgery, offering favorable cosmetic outcomes and comparable oncologic results. However, standardized training pathways and validated simulation models replicating standardized setups for emerging robotic platforms remain limited. An experimental simulation of total thyroidectomy and central (recurrent) neck dissection was performed with the Versius robotic system in a validated synthetic training box. Optimal robotic positioning and docking were determined, and a standardized procedural sequence was followed to ensure optimal results. Simulation was successful only with a C-shaped configuration of the robotic arms and a posteriorly positioned camera in a Z-shaped layout, matching prior cadaveric findings. All thyroidectomy steps proceeded smoothly. However, during central neck dissection, instrument collisions limited access to deeper spaces, restricting maneuverability. The training box allowed successful simulation of TORT with the Versius system in this proof-of-concept study, providing a platform for evaluating robotic positioning and docking configurations and supporting further investigation of its potential applications in training and preclinical assessment.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70309"},"PeriodicalIF":1.6,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13618370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075575","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":"Histopathological Patterns of Metastatic Cutaneous Squamous Cell Carcinoma to Intra-Parotid Lymph Nodes and Correlation With Outcomes.","authors":"Mayuri Yasuda, Aayushma Regmi, Maitri Mehta, Cullen M Lilley, Eric Thorpe, Swati Mehrotra, Andrea Ziegler, Vijayalakshmi Ananthanarayanan","doi":"10.1002/oto2.70284","DOIUrl":"10.1002/oto2.70284","url":null,"abstract":"<p><strong>Objective: </strong>Metastatic cutaneous squamous cell carcinoma (cSCC) to the parotid gland is an uncommon but serious disease process. This study evaluates the histopathological patterns of cSCC metastases to the parotid and correlates with recurrence rates and other clinical outcomes.</p><p><strong>Study design: </strong>This was a retrospective cohort study.</p><p><strong>Setting: </strong>The study was conducted at a single tertiary care center.</p><p><strong>Methods: </strong>Cases of cSCC with metastasis to the parotid between 2016 and 2022 were included. The histological slides from the parotidectomy were reviewed to determine the WPOI. The patient's history, operative and surgical pathology reports, and postoperative clinic notes were also reviewed.</p><p><strong>Results: </strong>There was a total of 46 primary tumors. Most cases were located on the pinna, followed by temple and scalp. Patients with WPOI 4/5 were more likely to have received prior adjuvant treatment after initial excision of their primary (<i>P</i> = .035).These tumors were clinically aggressive. 54.3% had perineural invasion (PNI). Histologically, 71.1% were infiltrative with a median WPOI of 3. PNI was the only statistically significant histological factor associated with a higher risk of postparotidectomy recurrence (<i>P</i> = .036). Univariate logistic regression showed that patients with PNI were more likely to have recurrence (OR 8.33, <i>P</i> = .023).</p><p><strong>Conclusion: </strong>There were no statistically significant differences in outcomes when comparing WPOI groups. However, PNI, even at a metastatic site, was noted to be a significant risk factor for recurrence in these tumors, supporting prior evidence that PNI is an important factor to consider when determining treatment options in these clinically aggressive malignancies.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 3","pages":"e70284"},"PeriodicalIF":1.6,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149063122","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}