OTO Open最新文献

{"title":"Does Electrical Stimulation Therapy Influence Synkinesis in Facial Paralysis? A Systematic Review.","authors":"Hänel W Eberly, Marly Aziz, F Jeffrey Lorenz, Heather K Schopper, Jessyka G Lighthall","doi":"10.1002/oto2.70231","DOIUrl":"10.1002/oto2.70231","url":null,"abstract":"<p><strong>Objective: </strong>Facial paralysis (FP) has aesthetic, social, and functional consequences. While electrical stimulation (ES) shows promise for peripheral nerve injury, its role in FP remains controversial due to concerns about increasing synkinesis.</p><p><strong>Data sources: </strong>A literature review was conducted using Medline/PubMed, Cochrane, and Web of Science databases.</p><p><strong>Review methods: </strong>Included studies evaluated the incidence or severity of synkinesis after ES in FP patients. Extracted data included demographics, ES parameters, FP etiology, synkinesis outcomes, and treatment duration.</p><p><strong>Results: </strong>Of 601 identified articles, 6 met inclusion criteria, comprising 243 patients (92 female, reported in 5 studies). Bell's palsy was the most common FP etiology (76.5%), followed by iatrogenic facial nerve injury (20.2%). Time to treatment ranged from 1 week to 7 years post-onset. Treatment durations varied from 2 weeks to 29 months, with inter-impulse gaps of 30 to 3000 milliseconds, phase durations of 10 to 700 milliseconds, and amplitudes of 0.5 to 27 mA. All ES was transcutaneous. Three of 5 studies reported no differences in synkinesis scores between ES and control groups. Two studies found no differences in synkinesis incidence. Only one study showed reduced synkinesis in the ES group.</p><p><strong>Conclusions: </strong>This study represents an up-to-date review of synkinesis in FP patients receiving ES. Evidence suggests a benefit in overall facial function for patients without significant additional risk of synkinesis. Inconsistencies in synkinesis outcomes and measurement underscore the need for further research in this area.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70231"},"PeriodicalIF":1.6,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13078372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147691144","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":"Age-Related Differences in Efficacy and Safety of Subcutaneous Immunotherapy in Allergic Rhinitis: A Real-World Study.","authors":"Jiaxin Jia, Xuan Yuan, Liyuan Liu, Shaobing Xie, Lai Meng, Wei Zhong, Hua Zhang, Weihong Jiang, Can Liao, Zhihai Xie","doi":"10.1002/oto2.70229","DOIUrl":"10.1002/oto2.70229","url":null,"abstract":"<p><strong>Objective: </strong>To investigate age-related differences in efficacy and safety of subcutaneous immunotherapy (SCIT) among patients with allergic rhinitis (AR).</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Methods: </strong>AR patients who completed a 3-year course of dust mite SCIT with a 2-year post-SCIT follow-up were categorized into pediatric and adult groups. Baseline characteristics, SCIT efficacy, and adverse reactions were compared between groups. Multivariable logistic regression was used to identify independent predictors of SCIT efficacy and adverse reaction.</p><p><strong>Results: </strong>889 patients were included, comprising 544 children and 345 adults. Adults exhibited higher baseline symptom burden, higher rates of former or current smoking and alcohol consumption, longer AR duration, more frequent dose adjustments during SCIT, and greater prevalence of comorbid asthma and urticaria. In contrast, children had higher frequencies of family history of allergy, monosensitization, food allergy, and secondary immunotherapy. Multivariable logistic regression confirmed that older age, particularly adult status, was an independent risk factor for reduced SCIT efficacy at both 1 and 2 years post-SCIT discontinuation, after adjusting for clinical confounders. Adverse reactions, including both local and systemic events, occurred more frequently in children, though the majority were mild and occurred during the maintenance phase. Notably, older or adult age was independently associated with a lower risk of SCIT-related adverse reactions.</p><p><strong>Conclusion: </strong>Pediatric patients demonstrated superior short- and long-term SCIT efficacy compared to adults, along with a higher incidence of adverse reactions. These results support age-specific strategies to maximize clinical benefits and minimize risks in SCIT for AR.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70229"},"PeriodicalIF":1.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634152","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 Limited English Proficiency on the Presentation and Management of Vestibular Schwannomas.","authors":"Christian Jung, Carly Y Yang, Keshav V Shah, Douglas C Bigelow, Michael J Ruckenstein, Tiffany Peng-Hwa","doi":"10.1002/oto2.70222","DOIUrl":"10.1002/oto2.70222","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of limited English proficiency (LEP) on the presentation, diagnosis, and management of vestibular schwannoma (VS).</p><p><strong>Study design: </strong>Retrospective matched cohort study.</p><p><strong>Setting: </strong>Single tertiary academic center.</p><p><strong>Methods: </strong>A retrospective review of patients diagnosed with VS at a tertiary academic center from 2018 to 2023 identified 29 LEP and 1350 non-LEP patients. LEP patients were matched 1:1 to non-LEP patients using propensity scores based on age, sex, insurance, and zip code-based income. Clinical variables included audiometric data, tumor characteristics, time to diagnosis and treatment, and management outcomes.</p><p><strong>Results: </strong>No significant differences were found in presenting symptoms, tumor characteristics, or treatment recommendations. LEP patients were significantly less likely to undergo word recognition testing (41% vs 97%, <i>P</i> < .001). Among those tested, bilingual LEP patients performed worse than non-LEP counterparts in word recognition testing (44.5% vs 61.9%, <i>P</i> = .1). LEP patients trended toward larger tumor volumes at diagnosis (6072.5 mm³ vs 2114 mm³, <i>P</i> = .059) and longer delays from symptom onset to diagnosis (4949 vs 2609 days), even after outlier removal. LEP patients also had higher loss to follow-up rates (34% vs 14%, <i>P</i> = .123).</p><p><strong>Conclusion: </strong>Though not statistically significant, several trends suggest LEP patients may face potential barriers to timely diagnosis and follow-up for VS. The relative underrepresentation of LEP patients may also reflect underlying disparities. These findings underscore the need for targeted efforts to improve access and outcomes for LEP patients in neurotologic care.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70222"},"PeriodicalIF":1.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13052497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634125","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":"Predicting Behavior of Cutaneous Head and Neck Squamous Cell Carcinoma in Transplant Recipients.","authors":"Meghana C Bhaskara, Mikayla G Hubbard, Jessica A Yesensky, Janice L Farlow","doi":"10.1002/oto2.70230","DOIUrl":"10.1002/oto2.70230","url":null,"abstract":"<p><strong>Objective: </strong>Head/neck location and immunosuppression are independent risk factors related to cutaneous head and neck squamous cell carcinomas (cHNSCCs) in solid organ transplant recipients (SOTRs). Traditional staging criteria underperform in risk stratification. We aim to identify the utility of clinicopathologic factors for risk stratification of cHNSCCs in SOTRs.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single tertiary center.</p><p><strong>Methods: </strong>SOTRs with surgically resected cHNSCCs between 2009 and 2019 were reviewed. Deeply invasive cHNSCCs extended deep to the subcutis. Data were extracted from electronic records. Overall survival was analyzed by level of invasion and transplant type using Mantel-Cox test and by age at transplant and age at first posttransplant cHNSCC using univariate Cox regression. Level of invasion was evaluated using unpaired <i>t</i>-tests for age at transplant, age at first posttransplant cHNSCC, and overall lifespan; ANOVA for transplant type; and chi-square test for sex and ethnicity.</p><p><strong>Results: </strong>Of 77 identified patients, 44 (100% White, 97.7% non-Hispanic, 81.8% male) met criteria. Sixteen developed deep invasion. Deep invasion correlated with decreased overall survival (<i>P</i> = .0021) and shorter overall lifespan (<i>P</i> = .02). Age at first cHNSCC (HR = 1.00, 95% CI = 0.96-1.04), age at transplant (HR = 1.02, 95% CI = 0.98-1.07), and transplant type (<i>P</i> = .83) were unrelated to overall survival. Age at transplant approached significance (<i>P</i> = .07) for deep invasion. There was no difference in level of invasion by sex (<i>P</i> = .12), ethnicity (<i>P</i> = .18), or transplant type (<i>P</i> = .21).</p><p><strong>Conclusion: </strong>Deeply invasive cHNSCCs are associated with decreased overall survival in SOTRs. Age at transplant approaches significance for deep invasion. Data on immunosuppression and genetic analysis may further enhance prognostication.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 2","pages":"e70230"},"PeriodicalIF":1.6,"publicationDate":"2026-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13053138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634115","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":"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":"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":1.6,"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":1.6,"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":"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":1.6,"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":"Hyperparathyroidism and Dizziness: An Epidemiological Assessment.","authors":"Mohsin Mirza, Heather M McClure, Kourosh Parham","doi":"10.1002/oto2.70209","DOIUrl":"https://doi.org/10.1002/oto2.70209","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence and odds ratios for benign paroxysmal positional vertigo and other dizziness conditions in hyperparathyroidism.</p><p><strong>Study design: </strong>Analytical cross-sectional study from January 1, 2018, through December 31, 2023.</p><p><strong>Setting: </strong>Single-institution tertiary care center.</p><p><strong>Methods: </strong>Adults with primary or secondary hyperparathyroidism were analyzed through a population-based sample using ICD-10 diagnostic codes. The primary outcome included prevalence rates for benign paroxysmal positional vertigo and other dizziness conditions in primary and secondary hyperparathyroidism. Secondary outcomes consisted of odds ratios for benign paroxysmal positional vertigo and other dizziness conditions in primary versus secondary hyperparathyroidism, and with further systemic calcium dysregulation in the setting of vitamin D deficiency.</p><p><strong>Results: </strong>839 primary hyperparathyroidism and 1418 secondary hyperparathyroidism subjects were included. The prevalence of benign paroxysmal positional vertigo was 35.76 per 100 individuals in primary hyperparathyroidism, higher than in the general population (<i>P</i> = .01). Collectively, dizziness conditions were diagnosed as frequently in hyperparathyroidism as nephrolithiasis. The prevalence of benign paroxysmal positional vertigo did not statistically vary in secondary hyperparathyroidism from the general population, however, unspecified dizziness diagnoses were far more common than in primary hyperparathyroidism (<i>P</i> = .006). Benign paroxysmal positional vertigo and other dizziness conditions were more likely in subjects with vitamin D deficiency diagnosis.</p><p><strong>Conclusion: </strong>Primary hyperparathyroidism is a risk factor for vertigo/benign paroxysmal positional vertigo. Hyperparathyroidism, both in primary and secondary disease, may be disruptive to otoconia. Further research is needed to understand this relationship. Improved understanding of risk factors for benign paroxysmal positional vertigo offers additional insight into the pathophysiologic mechanisms.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"10 1","pages":"e70209"},"PeriodicalIF":1.6,"publicationDate":"2026-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13580814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990953","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":"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":1.6,"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":"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":1.6,"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}