OTO Open最新文献

{"title":"Addressing Perioperative Needs in Head and Neck Cancer: Piloting a Nurse Practitioner-Led Preoperative Virtual Visit.","authors":"Rebecca W Gao, Abdullah Adil, Kaitlin Vance, Marie Leginza, Matthew E Spector, Keith A Casper","doi":"10.1002/oto2.70210","DOIUrl":"https://doi.org/10.1002/oto2.70210","url":null,"abstract":"<p><strong>Objective: </strong>To improve understanding of the postoperative care challenges of patients with head and neck cancer and to help address these care needs before surgery.</p><p><strong>Study design: </strong>Qualitative study with intervention development and process testing.</p><p><strong>Setting: </strong>Tertiary care academic medical center.</p><p><strong>Methods: </strong>To examine perioperative patient experiences, we first performed interviews of 28 adult patients with head and neck cancer undergoing resection with microvascular free flap reconstruction. We then developed a unique preoperative virtual visit focused on socioeconomic and perioperative needs. 50 visits were then conducted by advanced practice providers, and visit content was analyzed.</p><p><strong>Results: </strong>Before the new preoperative visit, 73% of patients did not plan for postoperative care preoperatively and 73% did not feel comfortable with postoperative care needs. 55% reported unaddressed socioeconomic hardship. Themes included: limited understanding of surgery and limited understanding of postoperative care needs. After the new preoperative visit, 62% of visits addressed significant care-related concerns not previously identified.</p><p><strong>Conclusion: </strong>An additional preoperative virtual visit by an advanced practice provider may help improve surgical expectations and better prepare patients and their caregivers for perioperative needs.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70210"},"PeriodicalIF":1.8,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13051977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634063","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":"Histologic Origin and Survival in Salivary Duct Carcinoma: A Retrospective Cohort Study.","authors":"Lily Gao, Sindhura Sridhar, Daniel R S Habib, Marina Aweeda, Michael C Topf, Alexander Langerman","doi":"10.1002/oto2.70224","DOIUrl":"10.1002/oto2.70224","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of histologic origin on survival in salivary duct carcinoma (SDC) and characterize its clinical and pathologic features.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single, tertiary academic medical center.</p><p><strong>Methods: </strong>This study included treatment-naïve patients diagnosed with SDC (2000-2024). Histologic origin (ex pleomorphic adenoma [PA] vs de novo) was determined pathologically or clinically. Kaplan-Meier analysis and log-rank tests assessed overall survival (OS) and disease-free survival (DFS). Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI) for 13 covariates.</p><p><strong>Results: </strong>Out of N = 85 SDC patients, 68 were treated with curative intent, including 43 de novo and 25 ex PA cases. Median follow-up was 19.8 months. OS and DFS survival were not significantly different by histologic origin (OS <i>P</i> = .28; DFS <i>P</i> = .19), though 2-year OS and DFS were numerically higher in ex PA (OS: 87% vs 81%, DFS: 63% vs 57%). Histologic origin was not associated with OS (univariate <i>P</i> = .29) or DFS (univariate <i>P</i> = .19; multivariable <i>P</i> = .23). Distant recurrence was the most common failure pattern, occurring more frequently in de novo cases (37% vs 21%, <i>P</i> = .23).</p><p><strong>Conclusion: </strong>Histologic origin was not independently associated with OS or DFS, although numerically higher 2-year survival in SDC ex PA may suggest potential biologic differences between ex PA and de novo origins that warrant further study. Distant metastasis was the primary mechanism of treatment failure for both subtypes of SDC, highlighting the need to explore novel treatments, such as neoadjuvant therapies.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70224"},"PeriodicalIF":1.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634155","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":"Prognostic Determinants in De Novo Sinonasal Squamous Cell Carcinoma: A Retrospective Study.","authors":"Yue Li, Lili Cao, Jing Zhou, Hongbo Xu, Xiaohong Chen","doi":"10.1002/oto2.70226","DOIUrl":"https://doi.org/10.1002/oto2.70226","url":null,"abstract":"<p><strong>Objective: </strong>Patients diagnosed with de novo sinonasal squamous cell carcinoma (DN-SSCC) generally present at an advanced stage and have a poor prognosis. The study aimed to summarize and analyze the outcomes of DN-SSCC patients.</p><p><strong>Study design: </strong>Retrospective cross-sectional study.</p><p><strong>Setting: </strong>Single-center clinical database.</p><p><strong>Methods: </strong>Overall survival was assessed with Kaplan-Meier analyses and Cox proportional hazard regression analyses for patients diagnosed with DN-SSCC between 2010 and 2018.</p><p><strong>Results: </strong>Long-term follow-up was completed for 85 out of 112 patients. The distribution of cancer stages was as follows: 1.8% in stage Ⅰ, 7.1% in stage Ⅱ, 23.2% in stage Ⅲ, and 67.9% in stage Ⅳ. Ocular invasion was present in 50.9% and intracranial invasion in 23.2%. Significant intergroup differences in T-stage (<i>P</i> = .009) and clinical stages (<i>P</i> = .028) across therapeutic modalities. The 1-year and 5-year overall survival (OS) rates were 83.5% and 51.4%, respectively. Factors significantly associated with prognosis included age (<i>P</i> = .048), lymph node classification (<i>P</i> = .003), clinical stages (<i>P</i> = .002), ocular invasion (<i>P</i> = .035), therapeutic modalities (<i>P</i> < .001), and resection margin status (<i>P</i> = .005). Surgery followed by adjuvant chemotherapy or/and radiotherapy (Surgery + CT/RT) demonstrated best prognosis, with a 5-year OS rate of 71.9%. Margin status significantly impacted survival outcomes (5-year OS: 56.0% negative margin versus 29.0% positive margin) (log-rank <i>P</i> = .005). Lymph node classification (HR 4.927, 95% CI 1.296-18.733; <i>P</i> = .019) and preoperative induction chemotherapy combined with surgery (ICT + Surgery) (HR 0.048, 95% CI 0.004-0.574; <i>P</i> = .017) were independent prognostic factors for DN-SSCC.</p><p><strong>Conclusions: </strong>Patients receiving Surgery + CT/RT had better prognoses. This therapeutic modality is recommended for advanced-stage patients, especially those with positive resection margins.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70226"},"PeriodicalIF":1.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634118","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":"Ergonomic Trends in Endoscopic Skull-Base Surgeons: A Survey to the North American Skull Base Society.","authors":"Shreya Mandloi, Alexander Duffy, Praneet Kaki, Elina M Toskala, Marc Rosen, Christopher Farrell, James Evans, Gurston G Nyquist, Mindy Rabinowitz","doi":"10.1002/oto2.70220","DOIUrl":"https://doi.org/10.1002/oto2.70220","url":null,"abstract":"<p><strong>Objective: </strong>Lack of ergonomic practices in the operating room results in significant musculoskeletal strain. This study obtains a current assessment of self-reported musculoskeletal strain associated with endoscopic endonasal and open skull base surgery as reported by members of the North American Skull Base Society (NASBS).</p><p><strong>Study design: </strong>Online Survey.</p><p><strong>Setting: </strong>Online.</p><p><strong>Methods: </strong>A survey assessing current symptoms in endoscopic skull base surgery was distributed to members of the NASBS.</p><p><strong>Results: </strong>Sixty-six responses were completed and analyzed. 95% of respondents indicated they had musculoskeletal strain at the neck and C-spine. There was no significant difference in average operating time per week and musculoskeletal strain. Prolonged standing during endoscopic cases increased neck/C-spine musculoskeletal strain (OR: 3.96; CI: 1.26, 14.2; <i>P</i> = .024). Dominant hand, operating with 1 versus multiple gloves, switching holding the endoscope with other physicians, foot pedal position, monitor, position, and manipulation of endoscopic instruments did not impact musculoskeletal strain (<i>P</i> > .05). Endoscopic endonasal skull base surgeons (EESBs) that operate on the same side of the table had significantly less L-spine pain than EESBs that operate on the opposite side of the table (OR: 0.25; CI: 0.07, 0.82; <i>P</i> = .026).</p><p><strong>Conclusion: </strong>The results found that most respondents experience musculoskeletal strain and that factors including surgeon positioning and prolonged standing increase pain. Altering strategies in the operating room, including surgeon and instrument positioning, may help to decrease ergonomic strain amongst skull base surgeons.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70220"},"PeriodicalIF":1.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433645","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":"Fine-Needle Aspiration Versus Core Needle Biopsy for Malignant Cervical Lymphadenopathy: A Meta-Analysis and Systematic Review.","authors":"Sacha Moufarrej, Kavenpreet S Bal, Alexander Rivero, Miranda L Weintraub, Thomas L Haupt, Kevin H Wang","doi":"10.1002/oto2.70218","DOIUrl":"https://doi.org/10.1002/oto2.70218","url":null,"abstract":"<p><strong>Objective: </strong>Cervical lymphadenopathy is a common presentation in Otolaryngology-Head and Neck Surgery, often requiring biopsy to exclude malignancy. Fine-needle aspiration (FNA) is the standard initial diagnostic tool; however, evidence from other anatomical sites suggests that core needle biopsy (CNB) may offer superior diagnostic performance. This systematic review aims to compare the diagnostic accuracy and safety of FNA versus CNB for adult cervical lymphadenopathy.</p><p><strong>Data sources: </strong>PubMed, Embase, and Cochrane databases were systematically searched for studies published between 1995 and 2025 evaluating FNA versus CNB for adult cervical lymphadenopathy. Studies lacking extractable cervical lymphadenopathy data were excluded.</p><p><strong>Review methods: </strong>Two investigators independently screened studies and extracted data on study characteristics and diagnostic performance. A meta-analysis was performed in Stata using a random-effects model, and a quality assessment was conducted using the QUADAS-2 criteria.</p><p><strong>Results: </strong>Of 2523 abstracts identified, 6 studies met inclusion criteria, with 5 providing adequate data for meta-analysis (total n = 649 patients, 331 FNA, 318 CNB). Pooled sensitivity and specificity were higher for CNB (0.94 and 0.98, respectively) compared to FNA (0.72 and 0.96; <i>P</i> < .001). CNB was 1.32 times more sensitive than FNA in detecting malignancy (<i>P</i> < .001). Both techniques had low complication rates. Study heterogeneity was low to moderate, and risk of bias was similarly moderate.</p><p><strong>Conclusion: </strong>CNB demonstrates significantly greater diagnostic accuracy than FNA in detecting malignant cervical lymphadenopathy without increased complication risk. While further studies are warranted, these findings support greater consideration of CNB as a first-line diagnostic test to minimize inconclusive results and diagnostic delays.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70218"},"PeriodicalIF":1.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434062","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":"Intranasal Oxymetazoline and Xylometazoline Use in Patients With Deviated Nasal Septum: A Cross-Sectional Telephone Survey.","authors":"Marcin Masalski, Jakub Kurasz, Aleksandra Kosiorowska, Aleksander Mateja, Krzysztof Morawski","doi":"10.1002/oto2.70216","DOIUrl":"https://doi.org/10.1002/oto2.70216","url":null,"abstract":"<p><strong>Objective: </strong>To assess the pattern of oxymetazoline and xylometazoline (OXM) use in patients with deviated nasal septum (DNS).</p><p><strong>Study design: </strong>A retrospective Computer-Assisted Telephone Interviewing survey.</p><p><strong>Setting: </strong>Patients who underwent septoplasty in University Clinical Hospital in Opole, Poland.</p><p><strong>Methods: </strong>A retrospective Computer-Assisted Telephone Interviewing (CATI) survey was conducted among patients who underwent septoplasty between 2018 and 2024. The questionnaire included inquiries about the frequency of OXM use, awareness of the consequences of long-term OXM application, and alternative treatment options, all prior to septoplasty.</p><p><strong>Results: </strong>The study was conducted on 159 of 305 (52.1%) patients identified in the hospital database. Approximately one-third of respondents (55 of 159, 34.6%) denied using OXM, about one-third had used OXM for no more than 7 days (52 of 159, 32.7%), and the remaining one-third (52 of 159, 32.7%) admitted to OXM overuse. Lack of awareness of the consequences of chronic OXM use was associated with a 6.5-fold increased risk of addiction (OR = 6.5, 95% CI: 1.2-33.6, <i>P</i> = .02). Furthermore, 16 of 52 (30.8%) respondents were unaware of intranasal steroid therapy in the preoperative period.</p><p><strong>Conclusions: </strong>DNS may increase the risk of OXM dependence; however, further controlled studies are needed. Increasing awareness about the risks of OXM overuse substantially reduces this risk.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70216"},"PeriodicalIF":1.8,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12969495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434091","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":"Technique for Difficult Wharton's Duct Cannulation.","authors":"Evgeniya Molotkova, Henry Hoffman","doi":"10.1002/oto2.70211","DOIUrl":"10.1002/oto2.70211","url":null,"abstract":"<p><p>The comparative ease of cannulating Stensen's duct is contrasted by the acknowledged difficulty in cannulating Wharton's duct. Although access to Wharton's duct can be facilitated with a floor-of-mouth incision, it is desirable to avoid this open approach. We present a technique emphasizing the use of a tapered 4-0 Prolene suture to cannulate Wharton's duct. This guide directs placement of a 26-gauge angiocatheter through a modified Seldinger technique. The suture guide is then removed to permit infusion of saline with expansion of the duct to allow for passage of a 0.38-mm guidewire and progressive dilation with a 24- and 22-gauge angiocatheter over the larger guidewire. This technique was successful in all 4 patients who had difficult access to Wharton's duct. One of these patients also underwent successful cannulation of Bartholin's duct. This novel technique for cannulation of Wharton's duct offers an alternative approach for patients with challenging anatomy.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70211"},"PeriodicalIF":1.8,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12963782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378356","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":"Tongue Reduction for Pediatric Obstructive Sleep Apnea: A Systematic Review.","authors":"Adrian Williamson, Rohit Nallani, Jason R Brown","doi":"10.1002/oto2.70215","DOIUrl":"https://doi.org/10.1002/oto2.70215","url":null,"abstract":"<p><strong>Objective: </strong>Obstructive sleep apnea (OSA) is a prevalent pediatric disorder that, if untreated, can result in substantial developmental and health consequences. Tongue reduction procedures, such as midline posterior glossectomy (MPG), are increasingly used to address tongue base obstruction. This systematic review evaluates the effectiveness and safety of tongue reduction procedures for pediatric OSA.</p><p><strong>Data sources: </strong>Embase, PubMed, and Web of Science databases were queried for studies from inception to September 20, 2023.</p><p><strong>Review methods: </strong>Studies reporting on outcomes of pediatric patients (≤21 years) undergoing tongue reduction surgery for OSA were included.</p><p><strong>Results: </strong>From 477 abstracts, 9 studies met the inclusion criteria, representing 146 pediatric patients. Surgical techniques included MPG, transoral robotic-assisted tongue base resection, and keyhole partial glossectomy. Primary outcomes assessed were apnea-hypopnea index (AHI), minimum oxygen saturation, and adverse events. All studies reported a reduction in AHI and increased minimum oxygen saturation following tongue reduction despite the method. Adverse events appear to be rare but included postoperative bleeding, need for reintubation, and wound dehiscence.</p><p><strong>Conclusion: </strong>Tongue reduction procedures appear to be safe and effective for managing pediatric OSA, improving key clinical outcomes. However, long-term results, comparative studies of surgical techniques, and refined patient selection criteria are needed. Future research should also identify risk factors for persistent OSA following tongue base reduction. These findings suggest that tongue reduction is a valuable addition to the treatment arsenal for pediatric OSA.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70215"},"PeriodicalIF":1.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355975","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":"Radioanatomy of the Silent Sinus Syndrome.","authors":"Paula von der Lage, Adrian Dalbert, Michael Soyka","doi":"10.1002/oto2.70212","DOIUrl":"https://doi.org/10.1002/oto2.70212","url":null,"abstract":"<p><strong>Objectives: </strong>Silent sinus syndrome (SSS) arises from negative pressure in the maxillary sinus through occlusion of the ethmoidal infundibulum. Convexity of the surrounding bone towards the lumen and a hypoglobus can occur. It may endanger surrounding structures during endoscopic sinus surgery. This research identifies and quantifies radiological changes in inferoposterior anatomical structures associated with SSS.</p><p><strong>Study design: </strong>Retrospective case series study.</p><p><strong>Setting: </strong>Computed tomography and magnetic resonance imaging scans of 23 patients with SSS who were treated at the University Hospital of Zurich between 2013 and 2023 were evaluated.</p><p><strong>Methods: </strong>The volume of the maxillary sinus, the orbital floor and sinus rear wall convexity, the height of the tuber maxillae, and the pterygopalatine fossa dimension were measured. The affected side was quantitatively compared with the healthy side.</p><p><strong>Results: </strong>The extension of the pterygopalatine fossa and the height of the tuber maxillae were significantly larger on the affected side (mean difference = 2.354 mm, 4.99 mm; <i>P</i> < .01 for both). A stronger indentation of the back wall (mean difference = 3.763 mm; <i>P</i> < .01) and the orbital floor (mean difference = 2.268 mm; <i>P</i> < .01) was measured in SSS. In addition, the syndrome reduces the volume of the affected maxillary sinus (mean difference = 8.885 mL; <i>P</i> < .01).</p><p><strong>Conclusion: </strong>SSS causes a marked enlargement of the neighbouring inferoposterior anatomical spaces. Shrinking of the sinus' volume could explain this effect. These findings have direct clinical implications, as the surgeon might inadvertently enter these structures more easily in SSS.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70212"},"PeriodicalIF":1.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355712","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":"Risks of Miniplate Removal in Fibula Free Flap Oromandibular Reconstruction.","authors":"Kuo-Chung Yang, Wen-Chung Liu","doi":"10.1002/oto2.70214","DOIUrl":"https://doi.org/10.1002/oto2.70214","url":null,"abstract":"<p><strong>Objective: </strong>To identify clinical and surgical risk factors for miniplate removal after oromandibular reconstruction with fibula free flap (FFF) and evaluate the timing of this complication.</p><p><strong>Study design: </strong>This was a retrospective cohort study.</p><p><strong>Setting: </strong>This study was conducted at Kaohsiung Veterans General Hospital, a tertiary care center, from January 2015 to December 2023. Patients undergoing oromandibular reconstruction with FFF were categorized by miniplate removal status.</p><p><strong>Methods: </strong>The incidence of miniplate removal and postoperative complications were analyzed. Multivariate logistic regression identified independent risk factors, and Kaplan-Meier analysis assessed the time to miniplate removal.</p><p><strong>Results: </strong>Out of 184 patients, 30 (16.3%) experienced miniplate issue required removal. This group showed significantly higher complication rates, including abscess/fistula (53.3% vs 5.8%), osteomyelitis (43.3% vs 0.6%), and osteoradionecrosis (23.3% vs 2.6%) (<i>P</i> < .001 for all). Preoperative or postoperative radiotherapy (OR, 9.27; <i>P</i> = .046) and number of osteotomies (OR, 3.77; <i>P</i> = .038) were identified as independent risk factors. Kaplan-Meier analysis indicated a trend of higher miniplate removal rates in the radiotherapy group (<i>P</i> = .055), with the highest risk within the first 30 months.</p><p><strong>Conclusion: </strong>Radiotherapy and an increased number of osteotomies are independent risk factors for miniplate removal after FFF reconstruction. The risk is particularly high in irradiated patients within the first 30 months post-surgery, emphasizing the need for tailored surgical planning and close monitoring.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70214"},"PeriodicalIF":1.8,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355843","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}