Otolaryngology- Head and Neck Surgery最新文献

{"title":"Endoscopic Versus Microscopic Stapedotomy: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Ebraheem Albazee, Hamad Alajmi, Ali Aldoukhi, Abeer Waleed Alali","doi":"10.1002/ohn.1109","DOIUrl":"10.1002/ohn.1109","url":null,"abstract":"<p><strong>Objective: </strong>To compare the safety and efficacy of endoscopic versus microscopic stapedotomy in patients with otosclerosis.</p><p><strong>Data sources: </strong>PubMed, Embase, Web of Science, Scopus, Google Scholar, and CENTRAL.</p><p><strong>Review methods: </strong>Eligible randomized controlled trials (RCTs) were assessed for bias using Cochrane's instrument. The specific outcomes included the mean duration of surgery, the mean gain in air-bone gap (ABG), and the rates of chorda tympani nerve (CTN) injury, CTN manipulation, facial nerve (FN) injury, tympanic membrane (TM) perforation, dysgeusia, dizziness, and pain score. Continuous data were analyzed using mean difference (MD) or standardized mean difference (SMD), and dichotomous data with risk ratio (RR), with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Eleven RCTs with 515 patients were analyzed. There was no significant difference between both groups in the mean duration of surgery (MD = -10.42, 95% CI [-26.26, 5.43]), mean gain in ABG (MD = 1.04, 95% CI [-0.48, 2.57]), CTN injury (RR = 0.46, 95% CI [0.20, 1.04]), FN injury (RR = 1.00, 95% CI [0.11, 9.27]), TM perforation (RR = 0.99, 95% CI [0.23, 4.25]), and dizziness (RR = 0.79, 95% CI [0.41, 1.53]). However, endoscopic stapedotomy significantly reduced the need for CTN manipulation (RR = 0.58, 95% CI [0.35, 0.96]), dysgeusia (RR = 0.33, 95% CI [0.19, 0.57]), and pain score (SMD = -1.59, 95% CI [-2.22, -0.97]).</p><p><strong>Conclusion: </strong>Endoscopic stapedotomy significantly reduces dysgeusia, CTN manipulation, and pain compared to microscopic stapedotomy, with similar surgery durations, audiometric gains, and comparable risks of CTN injury, TM perforation, FN injury, and dizziness.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1164-1176"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922324","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":"Iliac Crest Bone Graft and Fascia Lata Free Flap for Rescue of Mandibular Osteoradionecrosis.","authors":"Derek J Vos, Sara W Liu, Khashayar Arianpour, Peter J Ciolek, Brandon L Prendes, Michael A Fritz","doi":"10.1002/ohn.1125","DOIUrl":"10.1002/ohn.1125","url":null,"abstract":"<p><strong>Objective: </strong>Describe the use, indications, and outcomes of iliac crest bone graft (ICBG) with concomitant anterolateral thigh fascia lata (ALTFL) rescue flap for the management of mandibular osteoradionecrosis (ORN).</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Single institution.</p><p><strong>Methods: </strong>Retrospective chart review of patients who underwent ICBG with ALTFL rescue flap for mandibular ORN between 2011 and 2023.</p><p><strong>Results: </strong>Twenty-three patients (mean age 66.5 years, 73.9% male) with mandibular ORN underwent ICBG at the time of ATLFL. Patients failed prior antibiotic therapy (78.3%), hyperbaric oxygen therapy (39.1%), and/or pentoxifylline/tocopherol (34.8%). The most common mandibular subsites included the body (91.3%) and the angle (60.9%). All patients underwent concurrent ICBG with ALTFL to augment cortical height of retained mandible (<1 cm following debridement of ORN to healthy, bleeding bone). Following the ALTFL rescue flap with ICBG, the median length of stay was 3 days. There was 1 episode of flap failure noted at follow-up, requiring additional ALTFL procedure. No other major complications were reported at the reconstructed site. There were no complications associated with ICBG harvest, with all patients ambulating at the time of discharge. The mean clinical follow-up length was 20 months. Mandibular stability, based on radiographic features and clinical symptoms, was maintained in the majority of patients. Mandibular height was restored to an average of 1.9 cm, with a mean radiographic follow-up length of 16.8 months. A subset of patients (n = 4, 17.4%) experienced a flare in ORN symptoms following this procedure and required additional mandibular debridement with antibiotic therapy. One such patient required segmental mandibulectomy with osteocutaneous free flap reconstruction; however, all other patients exhibited radiographic and clinical arrest of symptoms for the follow-up period of 6.5 to 61.7 months.</p><p><strong>Conclusion: </strong>In patients undergoing ALTFL rescue flap for mandibular ORN, ICBG appears to supplement mandibular height and strength in patients with limited remaining mandibular bone height following debridement, with successful arrest of clinical and radiographic disease progression, low morbidity, and abbreviated hospital stays.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1224-1231"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932401","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":"Prospective Quantitative Laryngeal Electromyography Changes in Patients With Iatrogenic Unilateral Vocal Fold Paralysis.","authors":"Yi-Chieh Lee, Yu-Cheng Pei, Yi-An Lu, Wan-Ni Lin, Tuan-Jen Fang","doi":"10.1002/ohn.1139","DOIUrl":"10.1002/ohn.1139","url":null,"abstract":"<p><strong>Objective: </strong>To track quantitative laryngeal electromyography (LEMG) and voice outcome survey (VOS) changes over 12 months postiatrogenic unilateral vocal fold paralysis (UVFP). To explore the factors influencing these changes.</p><p><strong>Study design: </strong>Historical cohort study.</p><p><strong>Setting: </strong>Tertiary medical center.</p><p><strong>Methods: </strong>Patients who developed UVFP after surgery underwent a series of assessments, including quantitative LEMG, videolaryngostroboscopy, voice acoustic analysis, and completion of the VOS at diagnosis and at the 12-month follow-up. The subsequent data from these assessments were then compared for analysis. Bivariate analysis examined predictors of changes in VOS and LEMG data respectively, with significant factors further included in a multivariate regression model.</p><p><strong>Results: </strong>The study enrolled 99 patients. LEMG data were prospectively collected within 3.9 months (±SD: 0.2) postsurgery, followed by an average 13.2-month (±SD: 0.2) follow-up. A worse initial turn ratio of thyroarytenoid-lateral cricoarytenoid muscle correlated with more significant subsequent improvement in LEMG findings, reflecting a similar trend observed in the change of VOS scores.</p><p><strong>Conclusion: </strong>This study contributes valuable insights into the temporal change of quantitative LEMG and VOS in patients with iatrogenic UVFP. It suggests that poor initial LEMG and VOS results do not necessarily determine a worse prognosis in terms of electrical activity.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1334-1341"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066222","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":"Obstructive Sleep Apnea Surgery Practice Patterns in the United States: 2019.","authors":"Jae Hoon Cho, Christine Liu, Ido Badash, Eric J Kezirian","doi":"10.1002/ohn.1156","DOIUrl":"10.1002/ohn.1156","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the volumes and facility costs/charges for procedures used to treat the pharyngeal airway in adults with obstructive sleep apnea (OSA) in the United States in 2019, and to explore whether specific patient and facility characteristics are associated with procedure type and costs/charges.</p><p><strong>Study design: </strong>A cross-sectional study.</p><p><strong>Setting: </strong>Nationwide databases (National Inpatient Sample and the Nationwide Ambulatory Surgery Sample).</p><p><strong>Methods: </strong>OSA procedures were identified in both inpatient and outpatient settings using both databases. Chi-squared tests and regression analyses examined procedure volume, type, and facility costs/charges, with adjustments made for specific patient and facility characteristics.</p><p><strong>Results: </strong>In 2019, an estimated 18,526 discharges/encounters involving OSA surgery were performed in inpatient and outpatient settings. These included 12,938 palate surgeries, 1350 hypopharyngeal surgeries, 3054 unilateral hypoglossal nerve stimulation (HNS) system implantations, and 1840 maxillomandibular advancement procedures. The odds of undergoing HNS, as compared to almost all other categories of procedures, were generally greater for those aged 40 years or older (compared to younger patients) but generally lower for almost all non-white groups compared to white patients. Younger patients were more likely to undergo isolated palate surgery, compared to other surgical procedure types. Facility costs (inpatient) and charges (outpatient) were greater for HNS than other procedure types, and there were differences variably associated with patient and facility characteristics.</p><p><strong>Conclusion: </strong>Surgical treatment is performed in approximately 0.03% to 0.77% of all adults in the United States with OSA annually. Specific factors are associated with procedure type and facility costs/charges.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1468-1479"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067207","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":"Platelet-Rich Plasma for Treating COVID-19-Related Anosmia, Hyposmia, and Parosmia: A Controlled Longitudinal Study.","authors":"Jerome R Lechien, Sven Saussez","doi":"10.1002/ohn.1149","DOIUrl":"10.1002/ohn.1149","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectiveness of platelet-rich plasma (PRP) injection into the olfactory clefts of coronavirus disease 2019 (COVID-19) patients with persistent anosmia, hyposmia, and parosmia.</p><p><strong>Study design: </strong>Controlled study.</p><p><strong>Setting: </strong>Multicenter study.</p><p><strong>Methods: </strong>From March 2022 to July 2024, 514 COVID-19 patients undergoing PRP injection and olfactory training versus olfactory training (controls) for a persistent olfactory dysfunction (OD) were consecutively recruited from two medical centers. Subjects were evaluated from pre- to 3 months post-injection with the olfactory disorder questionnaire (ODQ) and the threshold, discrimination, and identification (TDI) test. Olfactory outcomes were compared between controls and patients considering the type of OD (anosmia, hyposmia, and parosmia).</p><p><strong>Results: </strong>The PRP group was composed of 416 patients with anosmia (N = 111; 26.7%), hyposmia (N = 160; 38.5%), and parosmia (N = 145; 34.9%). The baseline ODQ of patients with parosmia was significantly higher than those of the other groups (P = .001). The increase in TDI subscores and total score was significantly higher in all PRP subgroups compared to controls (P = 0.001). The ODQ significantly reduced from pre- to post-PRP injection in hyposmia and parosmia groups (P = 0.001). Patients with parosmia showed a significantly greater reduction in ODQ scores compared to the control group. The 3-month TDI score was negatively influenced by the age of patients (r_s = -0.263; P = 0.001) and the duration of OD (r_s = -0.213; P = .001).</p><p><strong>Conclusion: </strong>Patients with parosmia experienced a stronger impact of OD on quality of life (QoL), and showed greater QoL improvement following PRP injections compared to other groups.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1450-1458"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143067209","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":"Perioperative Caregiver Education Using Animated Videos for Pediatric Tonsillectomy: A Randomized Controlled Study.","authors":"Catherine F Roy, Sena Turkdogan, Lily H P Nguyen, Tobial McHugh, Sam J Daniel, Jeffrey C Yeung","doi":"10.1002/ohn.1126","DOIUrl":"10.1002/ohn.1126","url":null,"abstract":"<p><strong>Objective: </strong>Information technologies may enhance our traditional perioperative teaching by providing more comprehensive information beyond the clinical visit. This quality improvement study aims to assess whether the implementation of an animated surgical video improves caregiver satisfaction for children undergoing adenotonsillectomy.</p><p><strong>Study design: </strong>Prospective, single-blinded randomized-controlled trial was conducted between March 1 and October 1, 2023.</p><p><strong>Setting: </strong>Tertiary care academic pediatric hospital.</p><p><strong>Methods: </strong>A consecutive series of patients and their primary caregivers were randomly allocated to either the control arm, in which they received traditional patient education, or the intervention arm, additionally gaining access to the multimedia platform summarizing the surgical pathway for an adenotonsillectomy. Outcomes included caregiver satisfaction using the Care Transitions Measures (CTM-15) questionnaire, resource utilization, and qualitative feedback analysis.</p><p><strong>Results: </strong>A total of 100 patients (50 in each arm) completed the postintervention questionnaires (mean age 5.2 ± 3.0 years, female:male: 9:10) after undergoing an adenoidectomy (N = 28), tonsillectomy (N = 3), or both (N = 69). CTM-15 scores were high in both groups, with no observed difference between the intervention and control groups 85.82 <math> <semantics> <mrow><mrow><mo>±</mo></mrow> </mrow> <annotation><math display=\"inline\" altimg=\"urn:x-wiley:01945998:media:ohn1126:ohn1126-math-0001\" xmlns=\"http://www.w3.org/1998/Math/MathML\" wiley:location=\"equation/ohn1126-math-0001.png\"><mrow><!--<semantics>--><mrow><mo>unicode{x000B1}</mo></mrow><!--</semantics>--></mrow></math></annotation></semantics> </math> 12.91 versus 85.41 <math> <semantics> <mrow><mrow><mo>±</mo></mrow> </mrow> <annotation><math display=\"inline\" altimg=\"urn:x-wiley:01945998:media:ohn1126:ohn1126-math-0002\" xmlns=\"http://www.w3.org/1998/Math/MathML\" wiley:location=\"equation/ohn1126-math-0002.png\"><mrow><!--<semantics>--><mrow><mo>unicode{x000B1}</mo></mrow><!--</semantics>--></mrow></math></annotation></semantics> </math> 16.21, respectively, P = .89). Unplanned postoperative visits were comparable between groups, however, caregivers in the intervention arm were less likely to call a medical professional on more than 1 occasion postoperatively (16% vs 2%, P = .042). Most caregivers within the intervention arm agreed that the animated platform was interesting (94%) and useful (98%).</p><p><strong>Conclusion: </strong>Animated surgical guides are an alluring complementary modality to standard clinician-led teaching and may help reduce perioperative resource utilization.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":"172 4","pages":"1427-1434"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720855","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":"Inpatient Audiograms: A Mixed Methods Study Examining Clinical Decision Making, Financial Analyses, and Audiologist Perspectives.","authors":"Nadine I Ibrahim, Megan M Cherry, Charles A Keilin, Obada Abdulrazzak, Chioma Anidi, Madison V Epperson, Gerilyn Jones, Renee M Banakis Hartl","doi":"10.1002/ohn.1106","DOIUrl":"10.1002/ohn.1106","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate inpatient audiometry on clinical decision-making. Assess stakeholder perspectives on the practice of inpatient audiometry and financial impact.</p><p><strong>Study design: </strong>This is a mixed methods study utilizing retrospective chart review, a focus group, and financial analyses.</p><p><strong>Setting: </strong>Academic tertiary referral center.</p><p><strong>Methods: </strong>Included subjects were adults (18+) admitted from 2015 to 2022 who received an inpatient audiogram (n = 302). A binary assessment of whether audiograms impacted inpatient clinical management was determined. Financial analyses estimated the cost of audiograms. An audiology focus group was conducted.</p><p><strong>Results: </strong>The average age was 51 years. Thirty-nine percent were female. Seventy percent of inpatient audiograms were associated with Otolaryngology consultation. Inpatient audiograms were performed an average of 3.6 days after request (0-47 days, 90th percentile 8.2 days). Forty-nine percent were performed within 1 day. Twenty-three percent were performed for acute hearing loss. Ototoxic monitoring was the most frequent indication (15%). Sixty-two percent of audiograms did not impact the initiation or withholding of treatment. Inpatient testing results in a 63% increase in cost over outpatient. Audiologists endorsed challenges with equipment, patient-level factors, and system-level challenges.</p><p><strong>Conclusion: </strong>Inpatient audiometry is resource-intensive without significant data examining the impact and clinical utility. In most cases, inpatient audiometry is not used in the decision to withhold or deliver treatment and may cost 63% more than outpatient audiograms. While inpatient audiometry has a critical role in appropriate settings, system optimization and guidelines are necessary. Outpatient audiograms may suffice for the majority of otologic consults in combination with a thorough history and physical exam. Additional study across institutions with variable practice would be beneficial to establish broader recommendations.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1254-1261"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947854/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046999","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":"The Impact of \"Close Margins\" in HPV-Associated Oropharyngeal Squamous Cell Carcinoma Treated With TORS.","authors":"Gabriela A Calcano, Katelyn S Rourk, David M Routman, Jamie J O'Byrne, Ashish V Chintakuntlawar, Joaquin J Garcia, Daniel L Price, Kendall K Tasche, Eric J Moore, Kathryn M Van Abel, Linda X Yin","doi":"10.1002/ohn.1127","DOIUrl":"https://doi.org/10.1002/ohn.1127","url":null,"abstract":"<p><strong>Objective: </strong>Margin distance is a significant prognosticator in oral cavity cancer but its role in HPV-related oropharyngeal squamous cell carcinoma [HPV(+)OPSCC] remains unclear. Here, we investigate the impact of margin distance on locoregional recurrence in HPV(+)OPSCC.</p><p><strong>Study design: </strong>This is a retrospective cohort study of surgically treated HPV(+)OPSCC patients. Patients received either standard of care (at least 60 Gy with or without cisplatin) or de-escalated adjuvant therapy (30-36 Gy with concurrent docetaxel). Margin distance was measured in mm from the primary specimen or in combination with separately submitted margins. Kaplan-Meier survival analysis with univariate and multivariable Cox regressions were conducted to determine the impact of margin distance on risk of local and locoregional recurrence.</p><p><strong>Setting: </strong>Setting for this is 3 tertiary centers between January 2010 and February 2024.</p><p><strong>Results: </strong>Among 1102 included patients, 33 (3.0%) had positive final margins. 374 patients had adequate margin distance data available. Margin distance was >3 mm in 73.4%, 1 to 3 mm in 24.5%, and <1 mm in 2.2% of patients. Positive final margins, pT4 disease, pN2 disease, and surgery alone as a treatment modality (P < .02 for all) was associated with higher risk of 5-year locoregional recurrence. Margin distance did not significantly impact risk of local or locoregional recurrence even after adjusting for de-escalated adjuvant therapy (P > .05).</p><p><strong>Conclusion: </strong>Positive final margins after TORS without adjuvant radiotherapy for HPV(+)OPSCC carries a high risk of local recurrence. Margin distance does not appear to significantly impact risk of local or locoregional recurrence, even after de-escalated adjuvant radiotherapy.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":"172 4","pages":"1291-1299"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143720858","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":"Author Reply to Letter by Kezirian Regarding Combination Tonsillectomy and Hypoglossal Nerve Stimulation for Sleep Apnea Patients With Oropharyngeal Lateral Wall Collapse.","authors":"Phillip Huyett, Daniel Vena","doi":"10.1002/ohn.1094","DOIUrl":"10.1002/ohn.1094","url":null,"abstract":"","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1488-1490"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142838560","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":"Butterfly Cartilage Inlay Technique for Repairing Medium-to-Large-Sized Tympanic Membrane Perforations.","authors":"Ji Min Yun, Dachan Kim, Ju Yun Nam, Eun Jin Son, In Seok Moon, Seong Hoon Bae","doi":"10.1002/ohn.1098","DOIUrl":"10.1002/ohn.1098","url":null,"abstract":"<p><strong>Objective: </strong>The butterfly cartilage inlay technique was originally developed for repairing small tympanic membrane (TM) perforations but is now increasingly used for repairing large TM perforations. Although studies have evaluated the effectiveness of butterfly tympanoplasty for repairing medium-to-large-sized TM perforations, no study has compared its effectiveness with that of the conventional underlay cartilage technique. Therefore, we aimed to evaluate the effectiveness of butterfly tympanoplasty for repairing medium-to-large-sized TM perforations compared with that of the conventional underlay cartilage.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>This retrospective study analyzed patients treated for medium-to-large-sized TM perforations at a tertiary medical center between January 2017 and July 2024.</p><p><strong>Methods: </strong>We compared the outcomes of butterfly cartilage tympanoplasty with those of the conventional underlay technique, focusing on graft success rate, postoperative hearing outcomes, perioperative complications, and operating time. TM perforation sizes were precisely measured using the ImageJ software.</p><p><strong>Results: </strong>Among a total of 52 patients, 28 underwent butterfly tympanoplasty and 24 underwent underlay tympanoplasty. Both techniques showed comparable graft success rates (butterfly technique, 92.9%; underlay technique, 83.3%) and minimal perioperative complications. The butterfly technique had a significantly shorter operating time compared with that of underlay tympanoplasty and was performed under local anesthesia. Both groups showed a significant postoperative air-bone gap (ABG) reduction, with no significant difference in the ABG improvement.</p><p><strong>Conclusion: </strong>The butterfly technique is effective for medium-to-large-sized TM perforations, offering comparable outcomes to the conventional underlay technique, with the advantages of reduced operating time and the use of only local anesthesia.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1357-1363"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142910027","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}