Otolaryngology- Head and Neck Surgery最新文献

{"title":"Stroke Risk in Head and Neck Cancer: A Meta-analysis of Reconstructed Individual Patient Survival Data.","authors":"Eda Liew, Jing Xuan Tan, Chen Ee Low, Doreen Shu Lin Goh, Esther Yanxin Gao, Yao Hao Teo, Emilie C M de Groot, Jasper Senff, Ching-Hui Sia, Leonard Leong Litt Yeo, Anna See, Benjamin Kye Jyn Tan, Benjamin Yong-Qiang Tan","doi":"10.1002/ohn.1249","DOIUrl":"https://doi.org/10.1002/ohn.1249","url":null,"abstract":"<p><strong>Objective: </strong>Although previous studies suggest an increased stroke risk in head and neck cancer (HNC) survivors, the risk with various treatment modalities, including radiotherapy, is less certain. This study investigates stroke incidence and risk in HNC patients, including how different treatments influence stroke risk.</p><p><strong>Data sources: </strong>A literature search of PubMed, Scopus, and Embase was conducted.</p><p><strong>Review methods: </strong>We included all primary studies assessing stroke as an outcome in HNC patients aged 18 and older, regardless of cancer subtype or treatment modality. Incidence rates were pooled by reconstructing individual patient time-to-event data from survival curves. Random-effects meta-analyses were employed to compare stroke risk between HNC patients, healthy controls, and treatment groups.</p><p><strong>Results: </strong>In total, 15 studies (N = 2,295,447 patients) were included in the analyses. Among surviving HNC patients, stroke occurred at a rate of 1% per year (10% at 10 years and 15% at 15 years cumulatively). Meta-analyses showed that HNC patients had a significantly higher stroke risk compared to healthy controls (hazard ratio [HR] = 1.45; 95% CI: 1.27-1.65; I²: 20%). Among HNC patients, radiotherapy alone increased stroke risk compared to surgery alone (HR = 1.66; 95% CI: 1.35-2.03; I²: 0%). Patients who received any form of radiotherapy had higher stroke risk compared to those without (HR = 1.47; 95% CI: 1.29-1.68; I²: 60%). Patients with definitive chemoradiotherapy had heightened stroke risk compared to patients who received definitive surgery (HR = 1.28; 95% CI: 1.09-1.49; I²: 86%).</p><p><strong>Conclusion: </strong>Patients with HNC face an elevated stroke incidence and risk, especially those treated with radiotherapy. This underscores the need for surveillance and tailored preventive strategies to reduce stroke risk in this vulnerable population.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795804","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":"Intermediate Grade Salivary Gland Mucoepidermoid Carcinoma: Is Neck Dissection Indicated?","authors":"Jake Langlie, Nicholas DiStefano, Carmen Gomez-Fernandez, Jaylou Velez-Torres, Jason Leibowitz, David Arnold, Donald Weed, Francisco J Civantos","doi":"10.1002/ohn.1202","DOIUrl":"https://doi.org/10.1002/ohn.1202","url":null,"abstract":"<p><strong>Objective: </strong>NCCN guidelines recommend a neck dissection addressing at least levels II-IV for high-grade mucoepidermoid carcinoma (MEC) and close observation of the lymphatic basins for low-grade MEC. However, no guidelines exist for intermediate-grade MEC with clinically and radiologically uninvolved cervical lymph nodes.</p><p><strong>Study design: </strong>Retrospective analysis.</p><p><strong>Setting: </strong>Patients with intermediate-grade MEC with a clinically N0 neck from our tertiary academic institution from 2015 to 2023.</p><p><strong>Methods: </strong>Evaluation for histologic lymphatic metastases was performed when surgeons elected to perform neck dissection. For patients who did not receive a neck dissection, review of medical records to document the results of clinical observation, and specifically regional lymphatic recurrence, on long-term follow-up.</p><p><strong>Results: </strong>Thirty-five patients with N0 intermediate grade MEC were included, composed of 26 patients who underwent primary tumor resection and neck dissection and 9 patients who received resection of the primary tumor without neck dissection. One out of 26 patients receiving neck dissection was found to have lymphatic metastasis. Watchful waiting of 9 patients demonstrated no recurrence at a mean follow up of 40 months. Thus, 1 out of 35 patients (2.9% [95% confidence interval: 2.7%-3.1%]) had documented metastatic disease in the lymphatics.</p><p><strong>Conclusions: </strong>For patients presenting with intermediate-grade MEC, there was a low chance (2.9%) of positive histologic or clinical lymphatic metastases in the neck. Given this low risk, we believe the potential benefit of neck dissection may be outweighed by the potential morbidity. Careful consideration of the clinical behavior of the lesion could be considered along with a more selective approach toward elective lymphadenectomy in intermediate-grade MEC.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780927","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":"Associations With Changes in Disease-Specific Quality of Life Following Stereotactic Radiosurgery for Sporadic Vestibular Schwannoma.","authors":"Eric E Babajanian, Ghazal S Daher, James R Dornhoffer, Karl R Khandalavala, John P Marinelli, Christine M Lohse, Michael J Link, Matthew L Carlson","doi":"10.1002/ohn.1243","DOIUrl":"https://doi.org/10.1002/ohn.1243","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations with changes in quality-of-life (QOL) outcomes following treatment of vestibular schwannoma (VS) using stereotactic radiosurgery (SRS).</p><p><strong>Study design: </strong>Prospective longitudinal study.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Methods: </strong>Patients who were treated for sporadic VS using SRS from 2015 to 2022 were included. QOL outcomes were measured using the disease-specific Penn Acoustic Neuroma QOL (PANQOL) scale.</p><p><strong>Results: </strong>Seventy-nine patients with pre-SRS and at least one post-SRS PANQOL assessments were available for analysis. The mean change in total PANQOL scores was -2 (SD 13) on a 100-point scale. The mean duration between assessments was 4.6 years (SD 2.0). Age at SRS, sex, and SRS treatment doses were not significantly associated with changes in total PANQOL scores. Total PANQOL scores improved a mean of 4 points for patients with tumors confined to the internal auditory canal but declined a mean of 5 points for patients with tumors extending into the cerebellopontine angle (P = .01); however, these changes did not exceed the minimum clinically significant threshold of 11 points. The correlation coefficient between treated tumor volume at SRS and change in total PANQOL scores was -0.30 (P = .007). Changes in PANQOL total (P = .5) and hearing domain (P = .3) scores for patients who maintained serviceable hearing or progressed to nonserviceable hearing did not significantly differ.</p><p><strong>Conclusion: </strong>Tumor extent and treated volume at SRS had a statistically significant but likely not clinically important impact on total PANQOL scores. Progression to nonserviceable hearing did not have a significant impact on PANQOL total or hearing domain scores.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780923","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":"Interventions to Reduce Health Care Utilization for Non-English Language Preference Patients After Tonsillectomy.","authors":"Meredith Lind, Kristyn Moss, Thomas Javens, Kris Jatana","doi":"10.1002/ohn.1240","DOIUrl":"https://doi.org/10.1002/ohn.1240","url":null,"abstract":"<p><strong>Objective: </strong>Compared with those of English language preference (ELP), patients of non-English language preference (NELP) are at increased risk of postoperative complications and health care utilization. A series of interventions were initiated to reduce utilization and improve post-tonsillectomy outcomes for NELP patients.</p><p><strong>Methods: </strong>This quality improvement (QI) study was performed at a tertiary pediatric hospital. Data collection began in 2019 and interventions, including improving translated postoperative education materials, pain medication tracking charts, direct access to interpreters, consistent tonsillectomy technique, and routine postoperative nurse phone call for education, were initiated by December 2020. Postintervention data were collected through July 2024. The primary outcome measured was return to the emergency department (ED) or urgent care (UC) with same-day discharge within 30 days post-tonsillectomy. Additional data collected included demographics, language spoken, reason for surgery, and reason for return.</p><p><strong>Results: </strong>Between January 2019 and July 2024, a total of 14,007 patients underwent tonsillectomy: 12,830 (91.6%) ELP and 1177 (8.4%) NELP. After interventions, there was a 70.2% reduction (7.73% in 2019 to 2.30% in 2024) in NELP patients who were seen and discharged same day. In 2019, NELP patients were seen significantly more often (P = .016). In 2023, there was not a statistically significant difference between the two groups (ELP = 1.28%; NELP = 2.30%, P = .55).</p><p><strong>Discussion: </strong>In our patient population, a set of thoughtful interventions for NELP patients/caregivers reduced minor, potentially unnecessary, nonoperative returns to the ED/UC.</p><p><strong>Implications for practice: </strong>Implementation may reduce complications, improve the postoperative experience for NELP patients, and reduce overall health care costs.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780931","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":"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":"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":"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":"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":"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":"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}