Otolaryngology- Head and Neck Surgery最新文献

{"title":"Human Papilloma Virus Infection and Sinonasal Inverted Papilloma Recurrence: A Meta-Analysis.","authors":"Fayssal Alqudrah, Sharwani Kota, Jason Morgan, Phillip R Purnell, Justin P McCormick","doi":"10.1002/ohn.1108","DOIUrl":"10.1002/ohn.1108","url":null,"abstract":"<p><strong>Objective: </strong>Prior studies have been contradictory on the role of human papillomavirus (HPV) infection in sinonasal inverted papilloma (SNIP) recurrence. This systematic review and meta-analysis was performed to further evaluate this potential association.</p><p><strong>Data sources: </strong>PubMed, Embase, and Scopus electronic databases.</p><p><strong>Review methods: </strong>Case-control studies reporting SNIP recurrence data and HPV status identified by polymerase chain reaction (PCR) and in-situ hybridization (ISH). Meta-analysis was performed to determine pooled odds ratios (ORs) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>25 studies were identified including a total of 1116 benign SNIP tumors. A total of 267 SNIP were HPV+, 103 of which were recurrent, and 849 SNIP were HPV-, with 231 being recurrent. The pooled standard OR for recurrence in HPV+ tumors was 2.05 (95% CI: 1.31-3.19). Stratification by low-risk and high-risk HPV subtypes were not statistically significant. The standard OR for SNIP recurrence in low-risk and high-risk HPV+ subtypes were 1.57 (95% CI: 0.98-2.54) and 1.67 (95% CI: 0.98-2.80), respectively.</p><p><strong>Conclusion: </strong>Infection with HPV may be associated with an increased risk of SNIP recurrence. This increased risk seems to be independent of HPV subtype based on low-risk or high-risk status. However, this correlation was variable among recently published studies requiring additional investigation.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1155-1163"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tubomanometry-Score as Predictor of Outcome for Balloon Eustachian Tuboplasty in Patients With Eustachian Tube Dysfunction.","authors":"Niels H Holm, Alexander Mirz, Therese Ovesen, Christoph J Pfeiffer","doi":"10.1002/ohn.1145","DOIUrl":"10.1002/ohn.1145","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the predictive value of tubomanometry (TMM) in predicting subjective outcome of Balloon Eustachian Tuboplasty (BET) in patients with long-lasting Eustachian tube dysfunction (ETD).</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Single tertiary referral center.</p><p><strong>Methods: </strong>A total of 111 ETD patients undergoing 194 BET procedures were included. Demographics, TMM measurements, and tympanograms were registered before and 3 to 6 months after BET. The time ratio between the pressure increase in the nasopharynx and the outer ear canal was labelled R value.</p><p><strong>Results: </strong>At follow-up, 58.8% of the patients were satisfied with BET outcomes. The prevalence of normal R values increased significantly at 30 mbar (12%, P = .024), 40 mbar (14%, P = .0082), and 50 mbar (13%, P = .011). The prevalence of R = 0 decreased at all three pressure levels (-20%, P = .0001; -15%, P = .0013, and -16%, P = .0005, respectively). Type A tympanograms increased from 37% to 56% (P = .0002), while type B tympanograms decreased from 44% to 25% (P = .0006). Stratifying TMM measurements (R ≤ 1, R > 1, and R = 0) showed that preoperative R values were not prognostic of subjective outcome. Preoperative type B tympanogram indicated a risk of poor subjective outcome.</p><p><strong>Conclusion: </strong>BET appeared to improve Eustachian tube function with reduced prevalence of pathologic R values and tympanograms. Although preoperative R values were not prognostic, TMM remains promising for assessing Eustachian tube function. Further studies are needed to refine TMM's role in predicting BET efficacy.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1387-1393"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047418","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of IL-1 Receptor Antagonist and Dexamethasone in Noise-Induced Hearing Loss: Animal Model.","authors":"Nagihan G Yaşar, Zeynep Yiğman, Deniz Billur, Abdurrahman Tufan, Bülent Gündüz, Gurbet I Ş Kamişli, Recep Karamert","doi":"10.1002/ohn.1101","DOIUrl":"10.1002/ohn.1101","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to attenuate cochlear inflammation following noise-induced hearing loss by targeting IL-1. We evaluated the effectiveness of IL-1 inhibition through auditory and histological assessments in an animal model.</p><p><strong>Study design: </strong>Experimental animal study.</p><p><strong>Setting: </strong>Gazi University Faculty of Medicine, Ankara, Turkey.</p><p><strong>Methods: </strong>Twenty-four rats were randomly assigned into 3 groups: Anakinra, dexamethasone, and control groups. All animals were exposed to broadband noise (110 dB SPL, 8 hours), auditory brainstem response (ABR) tests were conducted before noise exposure, immediately after, and on Day 14. Anakinra, dexamethasone, and saline were administered intraperitoneally, cochlear tissues were harvested for histological and immunohistochemical evaluation.</p><p><strong>Results: </strong>On Day 14, ABR thresholds in Anakinra group were better than the control group across all frequencies, with a significant difference observed at 8 kHz (P = .036). The mean number of OHC was significantly higher in Anakinra group compared to the control group (P < .05). The mean number of IHC in the Anakinra group was greater than in the dexamethasone group. IL-1β immunopositivity in the stria vascularis and spiral ganglia was significantly higher in Anakinra group compared to dexamethasone group (P = .022 and P = .013, respectively). TNF-α immunopositivity in the stria vascularis and spiral ganglia was significantly greater in control group than in Anakinra group (P = .037 and P = .01, respectively).</p><p><strong>Conclusion: </strong>The comparable efficacy of Anakinra and dexamethasone in both histological and auditory assessments suggests that Anakinra may serve as a promising therapeutic option for noise-induced hearing loss.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1364-1373"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mohs Micrographic Surgery Efficacy for Solid Organ Transplant Head and Neck Cutaneous Squamous Cell Carcinoma.","authors":"Kevin L Li, Cecelia E Schmalbach","doi":"10.1002/ohn.1129","DOIUrl":"10.1002/ohn.1129","url":null,"abstract":"<p><strong>Objective: </strong>Solid organ transplant (SOT) recipients carry a higher incidence of cutaneous squamous cell carcinoma (cSCC) with more aggressive features and worse outcomes compared to immunocompetent (IC) patients. The National Comprehensive Cancer Network advocates peripheral and deep en-face margin assessment such as Mohs micrographic surgery (MMS) for very-high-risk cSCC. We aim to assess the efficacy of MMS in the treatment of SOT immunosuppressed head and neck (HN) cSCC patients.</p><p><strong>Study design: </strong>Cohort study with planned chart review enrolling HN cSCC patients (2004-2017).</p><p><strong>Setting: </strong>Patients were enrolled from a tertiary care medical center registry.</p><p><strong>Methods: </strong>Patients with cSCC were categorized on the independent variable of immune status. The incidence of MMS was compared between IC and SOT patients. Subgroup analysis of a matched cohort of patients treated with only MMS was performed for patient demographics, tumor characteristics, recurrence rates, and survival.</p><p><strong>Results: </strong>A total Of 178 HN cSCC patients met the criteria. SOT patients were more likely to be treated with MMS, P < .001. In the subgroup analysis, 34 matched patients were treated with MMS alone. There was homogeneity between groups regarding patient demographics and tumor characteristics. One patient developed local recurrence in the SOT cohort (P = .310). Compared to IC cSCC patients, SOT patients treated with MMS did not experience worse disease-free or overall survival (OS) (P = .540).</p><p><strong>Conclusion: </strong>This study suggests that narrow-margin MMS is an appropriate treatment option for SOT cSCC patients. SOT patients were more likely to be treated with MMS and did not compromise local recurrence, disease-free, or OS.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1286-1290"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding and Improving Pediatric Hearing Care Navigation: A Human-Centered Design Approach.","authors":"Neema Rashidi, Michael M Lindeborg, Jihyun Stephans, Silvia Bellfort-Salinas, Kendyl Naugle, Michelle A Wong, Dylan K Chan","doi":"10.1002/ohn.1123","DOIUrl":"10.1002/ohn.1123","url":null,"abstract":"<p><strong>Objective: </strong>Explore the experiences of stakeholders within hearing care pathways using a human-centered design process to design a patient navigator (PN) to improve hearing health equity for deaf or hard-of-hearing children.</p><p><strong>Study design: </strong>A qualitative, prospective, observational study utilizing the Empathize, Define, and Ideate phases of Human-Centered Design.</p><p><strong>Setting: </strong>Academic tertiary children's hospital with interviews over Zoom.</p><p><strong>Methods: </strong>We interviewed 12 hearing care providers, diverse in role and education across the United States, and 10 parents of deaf or hard-of-hearing children, diverse in preferred language and delays in care (mean age at diagnosis of 4.7 months, mean age at intervention of 10.5 months). The main outcomes were themes and subsequent insights that arose from the thematic analysis of interviews, which were used within a design synthesis session.</p><p><strong>Results: </strong>Qualitative analysis revealed 3 themes: Intrinsic Barriers, Extrinsic Barriers, and Areas of Opportunity. Within Intrinsic Barriers, a majority of providers and parents described a grieving process that led to delays. Within Extrinsic Barriers, interviewees expressed challenges navigating multiple deaf or hard-of-hearing care pathways. Within Areas of Opportunity, providers and parents agreed on connecting parents of new hearing loss diagnoses with mentor families to improve the care-seeking experience. Intercoder reliability was achieved (Cohen's κ = 0.73). Findings from the qualitative analysis were incorporated in a synthesis session with diverse stakeholders to design a PN role.</p><p><strong>Conclusion: </strong>Providers and parents agree that the deaf or hard-of-hearing care pathway is difficult to navigate at baseline with delays in accessing care further exacerbated by barriers intrinsic to the family unit.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1418-1426"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143047424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maxillomandibular Advancement Safety and Effectiveness in Obstructive Sleep Apnea: Systematic Review and Meta-Analysis.","authors":"Angelica Walker, Mohamed F Kassir, Vineeth Sama, Shaun A Nguyen, Mohamed Abdelwahab","doi":"10.1002/ohn.1114","DOIUrl":"https://doi.org/10.1002/ohn.1114","url":null,"abstract":"<p><strong>Objective: </strong>To provide an updated evaluation of clinical effectiveness and sequelae of maxillomandibular advancement surgery in obstructive sleep apnea.</p><p><strong>Data sources: </strong>PubMed, Scopus, CINAHL.</p><p><strong>Review methods: </strong>Included studies described patients with obstructive sleep apnea that completed maxillomandibular advancement with any reported sequelae. Meta-analysis of proportions, regressions, and single means with 95% confidence interval were calculated using random and fixed effects models.</p><p><strong>Results: </strong>Of 380 unique abstracts reviewed, a total of 31 studies (n = 1597) were included in meta-analysis. Maxillomandibular advancement patients showed significant improvements in apnea-hypopnea index (AHI), respiratory disturbance index (RDI), SpO₂ Nadir, Epworth sleepiness scale (ESS), and body-mass index (BMI) by -41.87/h [-49.86 to -33.89], -46.24/h [-62.18 to -30.29], 6.29% [3.42 to 12.08], -8.69 [-11.54 to -5.83], and -0.74 kg/m² [-1.35 to -0.12], respectively. Sequelae with the greatest incidence were early lower facial numbness (83.40%), late lower facial numbness at less and greater than 1 year follow-up (66.51%, 32.73% respectively), and hardware removal (21.99%). There was a positive correlation between both preoperative BMI and length of hospital stay (r = 0.81, P = .052) and age and lower facial numbness (r = 0.42, P = .196). A negative correlation was found between Change in AHI and time to follow up (r = 0.75, P = .087). No major complications nor mortality were reported.</p><p><strong>Conclusion: </strong>Maxillomandibular advancement has the highest success rate for obstructive sleep apnea among current surgical treatments, with most sequelae being transient. Early lower facial numbness should be highlighted preoperatively to ensure informed decision-making. Further research should be geared towards reducing this risk.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":"172 4","pages":"1142-1154"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Histamine-2 Receptor Antagonists on Hypocalcemia after Thyroidectomy: A Retrospective Cohort Study and Sensitivity Analysis.","authors":"Maxwell Rossip, F Jeffrey Lorenz, Bao Sciscent, Nguyen Truong, Chaitanya Nimmagadda, Neerav Goyal, David Goldenberg","doi":"10.1002/ohn.1140","DOIUrl":"10.1002/ohn.1140","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study is to examine the risk of hypocalcemia after thyroidectomy in patients taking histamine-2 receptor antagonists.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Multicenter, single database.</p><p><strong>Methods: </strong>Thirty-four thousand two hundred eighteen patients treated with total thyroidectomy from 2011 to 2022 were identified via the TriNetX Research Network. We compared the incidence of transient (0-1 month and 1-6 months following thyroidectomy) and permanent (6-12 months following thyroidectomy) postthyroidectomy hypocalcemia in patients with and without H2 receptor antagonists. Propensity score matching and sensitivity analysis were done to control for additional risk factors.</p><p><strong>Results: </strong>Patients were divided into 2 cohorts: those with an H2 receptor antagonist prescription before surgery (n = 5108) and those without (n = 29,110). 44.9% and 11.6% of thyroidectomy patients taking H2 receptor antagonists had hypocalcemia compared to 38.3% and 8.2% of patients without H2 receptor antagonists at 0 to 1 month and 6 to 12 months, respectively. Patients taking H2 receptor antagonists had a significantly increased risk of experiencing hypocalcemia at 0 to 1 month, 1 to 6 months, and 6 to 12 months. Patients taking H2 receptor antagonists were also at increased risk for visiting the emergency department and receiving intravenous calcium replenishment at 1 and 6 months following surgery. Sensitivity analysis continued to yield significant results at all time points.</p><p><strong>Conclusion: </strong>Patients taking H2 receptor antagonists may be at increased risk of short and long-term hypocalcemia after thyroid surgery. This is the first retrospective cohort study examining the risk of hypocalcemia after thyroidectomy in patients taking H2 receptor antagonists.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1199-1207"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Time-Driven Activity-Based Costing (TDABC) in Otolaryngology: A Scoping Review.","authors":"Eric K Kim, Alice Q Liu, Hasan Abdulbaki, Peggy Tahir, Nicole T Jiam","doi":"10.1002/ohn.1099","DOIUrl":"10.1002/ohn.1099","url":null,"abstract":"<p><strong>Objective: </strong>Accurately measuring the cost of a clinical process is critical to identifying ways to increase the value of a healthcare process. The objective of this study was to review time-driven activity-based costing (TDABC) in otolaryngology and to illustrate areas where value may be increased.</p><p><strong>Data sources: </strong>PubMed, Web of Science, Embase, CINAHL Complete, and Business Source Complete from database inception to August 2024.</p><p><strong>Review methods: </strong>In accordance with Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews guidelines, peer-reviewed full-length articles analyzing an otolaryngology care process with TDABC were included. Data collected included study characteristics, objectives, method of process mapping and costing, key study findings, subspecialty focus, and limitations.</p><p><strong>Results: </strong>Nine were included in the final review. Subspecialties consisted of pediatric otolaryngology (N = 4), head and neck surgery (N = 3), and rhinology (N = 2). The primary study aims were to reduce waste (N = 4), quantify cost (N = 4), evaluate the impact of a new intervention (N = 3), and identify quality improvement opportunities (N = 3). Most articles used input from involved personnel and/or direct observation to create process maps and reviewed institutional and/or public records to obtain cost information. TDABC was primarily used to study outpatient clinics or surgeries. Common limitations included limited generalizability, susceptibility to biases, and incomplete information.</p><p><strong>Conclusion: </strong>This scoping review demonstrated that TDABC can be a powerful and versatile tool for costing and identifying opportunities to increase the value of a care process in otolaryngology. Future costing studies can use TDABC to analyze care pathways in understudied otolaryngology subspecialties.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1133-1141"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National and Regional Trends in Congenital Cytomegalovirus Infection From 1998 to 2019.","authors":"Raymond J So, Kimberley S Noij, Jiangxia Wang, Jonathan Walsh, Christine G Gourin, Carolyn M Jenks","doi":"10.1002/ohn.1107","DOIUrl":"10.1002/ohn.1107","url":null,"abstract":"<p><strong>Objective: </strong>To analyze temporal changes and to assess the possible effect of newborn hearing screening (NBHS) programs on changes in congenital cytomegalovirus (cCMV) diagnostic rates in the United States.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>National Inpatient Sample (NIS) database.</p><p><strong>Methods: </strong>Neonates with cCMV infection were identified using discharge data from the NIS database from 1998 to 2019. Neonates with cCMV infection were identified via International Classification of Diseases codes and categorized as asymptomatic versus symptomatic and with or without hearing loss. Linear regression and interrupted time series analyses were conducted to analyze changes in diagnostic rates over time. Interrupted analyses were based on the timing of NBHS implementation in geographic regions.</p><p><strong>Results: </strong>Per 1,000,000 live births, the estimated total number of cCMV diagnoses increased from 109 in 1998 to 250 in 2019 (the estimated annual increase per 1,000,000 live births is 6.89 ([95% confidence interval, 5.43-8.35], P < .001). Diagnosis of cCMV with hearing loss showed a significant annual increase during this time (0.87 [0.51-1.22], P < .001), and within this group, diagnosis of both asymptomatic (0.18 [0.03-0.32], P = .02) and symptomatic (0.68 [0.37-0.99], P < .001) cases increased significantly. Compared to pre-NBHS, the rate of increase in cCMV diagnosis was significantly higher post-NBHS implementation in the Northeast (P < .001) and South (P = .008).</p><p><strong>Conclusion: </strong>Implementation of state NBHS programs correlated with increasing diagnosis rates of cCMV, though cCMV education and awareness may be contributing. cCMV continues to be underdiagnosed in a large national database.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1409-1417"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Vaccination Status on Meningitis Risk Post Cochlear Implantation.","authors":"Jamil Hayden, Emily R Youner, Ross Rosen, Chelsea N Cleveland, De'Andre A Warren, Sarah Mowry, Todd D Otteson, Maroun Semaan","doi":"10.1002/ohn.1115","DOIUrl":"10.1002/ohn.1115","url":null,"abstract":"<p><strong>Objective: </strong>To better understand the protective benefit of pneumococcal vaccines on rates of meningitis after cochlear implantation.</p><p><strong>Study design: </strong>Retrospective large database review.</p><p><strong>Setting: </strong>Several studies have shown that cochlear implantation increases the incidence of bacterial meningitis, mostly due to pneumococcal meningitis. However, there are no studies that have demonstrated that pneumococcal vaccination is associated with a decreased risk of meningitis among cochlear implant recipients.</p><p><strong>Methods: </strong>TriNetX, an electronic medical record database, was queried for incidence of meningitis after cochlear implantation, with and without pneumococcal vaccination.</p><p><strong>Results: </strong>There are a total of 35,434 patients in the TriNetX database who have received a cochlear implant. Of these patients, 9803 patients (27.7%) had coding sufficient to assess their immunization status and were included in our study. Of the patients in our study, 9264 patients (93.7%) had evidence of receiving a PCV immunization, while 539 (5.5%) were found to be under vaccinated. A total of 258 patients in our study had an episode of meningitis after cochlear implantation, translating to an overall rate of 2.6%. The vaccinated group demonstrated a significantly lower incidence of meningitis (2.5%, n = 236) compared to the under-vaccinated group (4.1%, n = 22) (relative risk: 1.60; confidence interval (1.0441, 2.4586); P < .0310).</p><p><strong>Conclusion: </strong>Our study provides evidence that pneumococcal vaccination is associated with a significantly lower rate of bacterial meningitis after cochlear implantation. Meningitis is a potentially life-threatening complication. Better adherence to pneumococcal vaccination guidelines pre- and post-CI is critical to reducing the feared risk of bacterial meningitis after cochlear implantation.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1374-1378"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}