Otolaryngology- Head and Neck Surgery最新文献

{"title":"A Randomized Controlled Trial of Ergonomic Risk in Pediatric Adenotonsillectomy.","authors":"David Barkyoumb, Zainab Sandhu, Sukaina Hasnie, Daniel Zhao, Vikram Ramjee, Jack Calvin Borders, Colin Fuller","doi":"10.1002/ohn.1190","DOIUrl":"10.1002/ohn.1190","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to compare the intraoperative ergonomics of tonsillectomies and adenoidectomies performed in seated versus standing positions for pediatric otolaryngology residents and attending physicians.</p><p><strong>Study design: </strong>A randomized controlled trial.</p><p><strong>Setting: </strong>A tertiary care center.</p><p><strong>Methods: </strong>Intraoperative data were collected for 2 attending physicians and 13 residents as they performed adenoidectomies and tonsillectomies. Each tonsillectomy was randomized to either first tonsil sitting/second tonsil standing or vice versa. Adenoidectomies performed during the same anesthesia were performed in the second of the 2 positions, and thus also randomized. Isolated adenoidectomies were randomized to either the sitting or standing position. The rapid upper limb assessment (RULA) was used to quantify ergonomic risk for each operation on a 0 to 7 scale.</p><p><strong>Results: </strong>Univariate analysis demonstrated a significant difference between sitting and standing positions (P < .001), with the sitting position exhibiting lower mean total RULA scores (mean = 3.26, median = 3.00) compared to standing (mean = 3.76, median = 4.00). This was confirmed using a multi-variable analysis adjusting for demographic variables. Univariate analysis showed that PGY1 residents had the lowest total RULA scores, whereas attending physicians had the highest total RULA scores. However, this was not confirmed by multi-variable analysis. Upper arm, lower arm, and trunk body region scores were higher in the sitting position, while wrist and neck scores were higher in the standing position. These conclusions were drawn from both univariate and multi-variable analysis.</p><p><strong>Conclusion: </strong>Sitting during adenotonsillectomy may mitigate ergonomic risk. Further research is needed to identify ways in which intraoperative ergonomics can be optimized. This study may also have implications for similar intraoral procedures.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1927-1933"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573548","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":"Characterizing the Cellular Constituents of Proximal Airway Disease in Granulomatosis With Polyangiitis.","authors":"Wenda Ye, Evan Clark, Edward Talatala, Ruth Davis, Marisol Ramirez-Solano, Quanhu Sheng, Jing Yang, Sam Collins, Alexander Hillel, Alexander Gelbard","doi":"10.1002/ohn.1197","DOIUrl":"10.1002/ohn.1197","url":null,"abstract":"<p><strong>Objective: </strong>Granulomatosis with polyangiitis (GPA) is a rare multisystem autoimmune vasculitis. 10-20% of patients suffer life-threatening obstruction of their proximal airways. Although progress has been made in the treatment of systemic disease, ameliorating airway disease in GPA remains an unmet need arising from limited understanding of disease pathogenesis. We sought to characterize the cellular constituents of the affected proximal airway mucosa in GPA airway scar.</p><p><strong>Study design: </strong>Basic/translational study.</p><p><strong>Setting: </strong>Single tertiary care center.</p><p><strong>Methods: </strong>Using single-cell RNA sequencing, we profiled the cellular constituents of proximal airway samples from GPA and disease comparators (GPA; n = 9, idiopathic subglottic stenosis: iSGS; n = 7, post-intubation proximal stenosis: PIPS; n = 5, and control; n = 10). We report transcriptomes for subglottic epithelial, immune, endothelial, and stromal cell types and map expression of GPA risk genes to tissue types present in the proximal airway. We compared differential gene expression across immune cell populations and performed pseudotime analysis using Monocle 3.</p><p><strong>Results: </strong>Similar to iSGS and PIPS, the subglottic mucosa of GPA patients demonstrated an abundant immune infiltrate. 71% of the established GPA risk genes (10 of 14) localized to T cells and macrophages. Differential gene expression and pseudotime analysis revealed a sub-population of CD4-/CD8- inflammatory T cells that only originated from GPA.</p><p><strong>Conclusion: </strong>We characterized the cellular composition of GPA airway disease and demonstrated that the expression of GPA risk alleles is predominantly localized to immune cell populations. We also identified a subset of inflammatory T cells that is unique to GPA.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"2009-2017"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120036/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586652","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":"Disclosure of Industry Relationships by Otolaryngologists.","authors":"Madeline M Nottoli, Cynthia Tsang, Zoe Hsiao, Arjun Sharma, Sina J Torabi, Khodayar Goshtasbi, Sunil P Verma, William B Armstrong, Yarah M Haidar, Tjoson Tjoa, Harrison W Lin, Edward C Kuan","doi":"10.1002/ohn.1223","DOIUrl":"10.1002/ohn.1223","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to characterize how often otolaryngologists disclose relevant industry payments in publications and identify characteristics of these industry relationships.</p><p><strong>Study design: </strong>A cross-sectional database and bibliometric analysis.</p><p><strong>Setting: </strong>Open Payments Database and PubMed.</p><p><strong>Methods: </strong>Publications by the 10 highest-compensated otolaryngologists from each of 12 representative medical device and drug companies from 2018 to 2020 were assessed for disclosure of potential conflicts of interest in the years following payment through 2023.</p><p><strong>Results: </strong>After excluding 52 physicians who did not publish in this period, 102 individuals received a combined $8,473,091.68, with an individual median of 15 payments (interquartile range [IQR] = 47) and median compensation of $18,522.77 (IQR = $53,965.52) from 1 or more of the 12 companies analyzed. The median number of publications per author was 10 (IQR = 25), and the median h-index of the authors was 16 (IQR = 28). Of the 1735 publications, 114 were classified as relevant, either because the study involved the evaluation of a device manufactured by one of the analyzed companies or because one of the companies funded the study. Of these, 23 (20.1%) were missing personal disclosure by the author. Of the physicians analyzed, the most represented subspecialty was rhinology (n = 47, 31%) followed by otology (n = 18, 11.8%).</p><p><strong>Conclusion: </strong>Although most publications in the years following payments from device companies were not deemed to have potential conflicts of interest, a notable proportion of those with authors who received payments lacked relevant financial disclosure. As transparency of relevant industry relationships has received increased attention, appropriate disclosure is recommended.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1911-1918"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658097","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":"Trends in Complications of Pediatric Rhinosinusitis Before and During the COVID-19 Era.","authors":"Amrita N Bhat, Johnny Wang, Anna Yang, David Molter, Katherine A Dunsky, Maithilee Menezes, Judith E C Lieu","doi":"10.1002/ohn.1196","DOIUrl":"10.1002/ohn.1196","url":null,"abstract":"<p><strong>Objective: </strong>To examine changes in trends of the incidence and characteristics of pediatric complicated rhinosinusitis with respect to the coronavirus disease 2019 (COVID-19) pandemic.</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Single tertiary-care center.</p><p><strong>Methods: </strong>A review of patients who presented to St. Louis Children's Hospital (SLCH) with complicated rhinosinusitis from 2017 to 2022 was performed. Clinical and follow-up data were analyzed in association with COVID-19.</p><p><strong>Results: </strong>Eighty-three patients with complicated rhinosinusitis were identified and analyzed according to hospitalization before or after March 2020. No differences in demographic variables were found between the two groups. More patients had developmental comorbidities in the COVID-19 group (7 vs 1, P = .049). More patients with intracranial complications (55% vs 45%, P = .48) and Pott's puffy tumor (78% vs 22%, P = .13) were observed in the COVID-19 era group; however, this difference was not statistically significant. In the COVID-19 group, more patients were found to have Streptococcus anginosus growth in their surgical cultures (67% vs 33%, P = .03). The incidence of complicated sinusitis correlated with the incidence of all viral cases at SLCH, particularly in 2021 and 2022, and increased following COVID-19.</p><p><strong>Conclusion: </strong>Trends in complicated sinusitis vary before and after the onset of the COVID-19 pandemic. There was an increase in complications of sinusitis due to S. anginosus species in the COVID-19 era and trends towards increased intracranial complications and Pott's puffy tumor. After an initial decrease, the incidence of complicated sinusitis per year increased following COVID-19.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"2090-2097"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573365","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":"The Stigma of Hearing Loss: A Scoping Review of the Literature Across Age and Gender.","authors":"Caroline Liu, Maria M Mavrommatis, Aparna Govindan, Maura K Cosetti","doi":"10.1002/ohn.1246","DOIUrl":"10.1002/ohn.1246","url":null,"abstract":"<p><strong>Objective: </strong>Stigma is a human construct that guides community standards and opinions, often characterized by negative beliefs about a particular circumstance, quality, or person. This study reviews the literature for stigma related to hearing loss and hearing device use.</p><p><strong>Data sources: </strong>PubMed, Scopus, and Embase.</p><p><strong>Review methods: </strong>Databases were searched from inception to April 28, 2024. Two independent researchers screened articles and performed full-text reviews. Grounded theory was used to identify and analyze positive and negative themes across disparate qualitative data.</p><p><strong>Results: </strong>After screening 1096 abstracts, 45 full-texts and 4 conference abstracts were included including 17 studies in pediatric populations, 19 studies in adults of working age, and 14 studies in older adult populations. In pediatric populations, stigma is primarily tied to bullying and poor classmate perceptions, with school-based supports offering mixed results in minimizing perceived stigma. Among working and older age adults, common positive themes included improved quality of life and self-empowerment among hearing aid (HA) users. All working age studies refer to the role of HAs in creating a visible disability. The pervasive theme among older adults was being perceived as old or senile. Although studies were largely equal in gender representation, differential gender effects of stigma and HA decisions were identified.</p><p><strong>Conclusion: </strong>Hearing loss stigma appears to be pervasive across age and gender with distinctions that have implications for intervention development. Future studies are needed to parse further nuances related to the stigma of hearing loss.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1874-1881"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812077","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":"Type III Thyroplasty for Patients With High-Pitched Voice Disorders: A Systematic Review and Meta-analysis.","authors":"Bruno Dalla Vecchia Vendramini, Lucas Marinho Siqueira Campos, Bruno Teixeira de Moraes, Silvio José de Vasconcelos, Mateus Morais Aires","doi":"10.1002/ohn.1185","DOIUrl":"10.1002/ohn.1185","url":null,"abstract":"<p><strong>Objective: </strong>High-pitched voice disorders can present notable social and professional obstacles for cisgender and transgender men. Our study aims to conduct a comprehensive meta-analysis assessing the efficacy of type III thyroplasty, also known as relaxation thyroplasty, for different populations with high-pitched voice disorders.</p><p><strong>Data sources: </strong>A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching Medline/Pubmed, Embase, Cochrane, Science Direct, Scielo, LILACS, and Google Scholar databases from inception to April 2024.</p><p><strong>Review methods: </strong>Studies included patients undergoing type III thyroplasty for high-pitched voice disorders. The primary outcome was the change in fundamental frequency postintervention. Subgroup analyses compared the following: (1) cisgender versus transgender populations, (2) primary versus secondary causes of high-pitched voice disorders, and (3) unilateral versus bilateral vertical stripe resection techniques.</p><p><strong>Results: </strong>The initial search yielded 284 articles, 9 studies, including 69 unique patients, were included in the analysis. All studies provided level 4 evidence. Most patients were cisgender men with primary mutational dysphonia (66.7%, n = 46). The meta-analysis showed a significant reduction in fundamental frequency after surgery, with a mean difference of -75.9 Hz (95% confidence interval [CI]: -91.5 to -60.3). Cisgender men and patients submitted to unilateral resection had higher preoperative fundamental frequency and showed a more pronounced reduction in fundamental frequency. There were no significant differences between primary and secondary mutational dysphonia.</p><p><strong>Conclusion: </strong>Type III thyroplasty effectively lowers vocal pitch in patients with high-pitched voice disorders. The procedure is viable for both cisgender and transgender men, as well as for primary and secondary voice disorders.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1847-1855"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515771","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":"Demographics, Management, and Outcomes Associated With Idiopathic Vocal Fold Paralysis: A Systematic Review.","authors":"Corinne Stonebraker, Romy Pein, Zachary A Valley, Christine Murphy Estes, David Garber","doi":"10.1002/ohn.1195","DOIUrl":"10.1002/ohn.1195","url":null,"abstract":"<p><strong>Objective: </strong>Idiopathic vocal fold paralysis (IVFP) is an enigmatic disease that results in voice, breathing, and swallowing impairments. This systematic review provides a comprehensive discussion of the demographics, management, and outcomes of IVFP.</p><p><strong>Data sources: </strong>PubMed and Embase databases.</p><p><strong>Review methods: </strong>The PubMed and Embase databases were queried with the keywords \"((vocal fold paralysis) OR (vocal cord paralysis)) AND (idiopathic).\" Articles were selected if published between 1990 and 2023 and reported data related to patients aged ≥18 years with IVFP. Case studies and reviews were excluded. Participant demographics, presenting symptoms, and spontaneous recovery data were extracted.</p><p><strong>Results: </strong>The database query identified 509 relevant abstracts, of which 29 studies met the inclusion criteria. A total of 1238 patients with IVFP were identified with a mean age of 55.8 years (range: 40.0-70.2). Patients experienced unilateral IVFP in 97.0% of cases with 67.5% affecting the left side. The most common presenting symptoms were dysphonia (n = 78), dysphagia (n = 41), sore throat (n = 16), and cough (n = 13). Five studies reported time to presentation with a mean of 114.5 days (range: 28-341). Eleven studies found a mean spontaneous recovery rate of 31.6% (range: 11.8%-87.5%) over a mean of 139.4 days (range: 68-180). Only 4.3% of patients were documented to have a viral upper respiratory infection (URI) before developing IVFP. No specific treatments were linked to spontaneous recovery.</p><p><strong>Conclusion: </strong>There is a paucity of research describing the presentation and outcomes of patients with IVFP. Viral URI may be a potential contributing factor to IVFP development; however, more research is necessary.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1856-1865"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573590","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":"Ten-Year Update: The State of Sleep Surgery Training for Otolaryngologists.","authors":"Neil S Kondamuri, Raj C Dedhia, Kathleen L Yaremchuk","doi":"10.1002/ohn.1174","DOIUrl":"10.1002/ohn.1174","url":null,"abstract":"<p><p>A decade ago, the field of sleep surgery was on the brink of extinction after changes in certification requirements. Though improving, many otolaryngology programs still do not have dedicated sleep faculty, and residents feel they have not received adequate sleep medicine experience. The field of sleep surgery can expand on a pipeline of sleep-trained otolaryngology fellows by increasing residency exposure to faculty with subcertification in sleep medicine and increasing visibility of fellowship opportunities. Mini-mentorship programs for residents without sleep programs/faculty and inclusion of sleep surgery procedures as key indicator cases during residency may increase interest and exposure to sleep procedures. Maintaining current lists of sleep medicine fellowship programs that include Otolaryngology-Head and Neck Surgery faculty is critical to ensuring accessibility and transparency. Without intervention, the field may be limited to selecting sleep surgery fellows from programs with established sleep surgeons and/or training programs, creating a narrow path for future growth.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"2141-2143"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710639","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":"Health Insurance Coverage and Hearing Aid Utilization in U.S. Older Adults: National Health Interview Survey.","authors":"Diego E Razura, Nikko D Beady, Matthew E Lin, Janet S Choi","doi":"10.1002/ohn.1201","DOIUrl":"10.1002/ohn.1201","url":null,"abstract":"<p><strong>Objective: </strong>Assess rates of hearing aid use by insurance coverage in U.S. older adults and their changes over time.</p><p><strong>Study design: </strong>Cross-sectional analysis of the National Health Interview Survey 2007-2018.</p><p><strong>Setting: </strong>Participants (≥65 years) with complete data on insurance, hearing aid use, and self-reported hearing limitations.</p><p><strong>Methods: </strong>Rates of hearing aid use among older adults who self-reported hearing limitations and their trends were estimated using survey weights. Sixteen insurance categories were created based on exclusive and combinatorial coverage, with Medicare coverage only as a reference group. The associations between insurance coverage and hearing aid use were examined using multivariable regression analyses.</p><p><strong>Results: </strong>Hearing aid use rate among older adults who self-reported hearing limitations was 51.2% in the United States. In multivariable models adjusting for demographics, socioeconomic status, self-reported hearing loss, and comorbidities, Military insurance only and Military & Medicare groups reported higher hearing aid use rates than Medicare only (odds ratio [OR] 3.14, 95% confidence interval [CI] 1.49-6.64; OR 1.8, 95% CI 1.55-2.09, respectively). During 2007-2018, there were no significant changes in hearing aid use rates by insurance groups among private, Medicaid, and military insurance coverage.</p><p><strong>Conclusion: </strong>While hearing aid use remains low among U.S. older adults, Military-related insurance, which generally provides enhanced coverage for hearing aids, was independently associated with higher use rates compared to Medicare, which does not offer coverage. Future research should examine the direct impact of different insurance policies on hearing aid use and its downstream health benefits.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1934-1942"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586673","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":"Long-Term Outcomes After Elective Contralateral Neck Dissection for HPV-Related Oropharyngeal Cancer.","authors":"Ray Y Wang, Molly E Heft Neal, Wade L Thorstad, Hiram A Gay, Anthony J Apicelli, Michael J Moravan, Douglas R Adkins, Peter J Oppelt, Patrik Pipkorn, Jason T Rich, Paul Zolkind, Randal C Paniello, Sidharth V Puram, Ryan S Jackson","doi":"10.1002/ohn.1227","DOIUrl":"10.1002/ohn.1227","url":null,"abstract":"<p><strong>Objective: </strong>Patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC), particularly of the base of tongue, have a high rate of occult nodal disease in the contralateral neck. The risk of failure in the contralateral neck is reduced with elective treatment. The optimal treatment strategy to minimize treatment-related toxicity while preserving regional control in the contralateral neck has not been elucidated.</p><p><strong>Study design: </strong>Cross-sectional study of patients who underwent elective contralateral neck dissection as part of primary surgical treatment for HPV-related OPSCC between January 2002 and December 2018.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Methods: </strong>Patients who underwent elective contralateral neck dissection as part of primary surgical treatment for HPV-related OPSCC between January 2002 and December 2018 were selected for inclusion. Long-term patient-reported functional outcomes were assessed via telephone at the time of data collection.</p><p><strong>Results: </strong>In total, 64 patients met the criteria for inclusion with a median follow-up of 58.5 months. In total, 56 patients (88%) had a primary cancer within the base of tongue or glossotonsillar sulcus. In total, 12 patients (19%) were found to have occult nodal metastasis in the contralateral neck, of whom 9 received adjuvant contralateral neck radiation. None of the patients who had node-negative contralateral neck dissections went on to receive radiation in the contralateral neck. Two patients (3%) recurred locally, two patients (3%) developed ipsilateral regional recurrence, and four patients (6%) developed distant metastasis. There were no regional recurrences within the contralateral neck. Five-year progression-free survival was 82.0%, whereas 5-year locoregional control was 93.0%. The mean Neck-Dissection Impairment Index was 94.4 with a median interval time of 92 months after surgery.</p><p><strong>Conclusion: </strong>Elective contralateral neck dissection in patients with HPV-related OPSCC provides excellent regional control with minimal long-term functional impairment, and most patients can be spared contralateral neck radiation without compromising oncologic outcomes. This may decrease long-term toxicity related to bilateral neck irradiation.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1954-1961"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658119","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}