Otolaryngology- Head and Neck Surgery最新文献

{"title":"Long-Term Hearing Outcome For Vestibular Schwannomas After Microsurgery And Radiotherapy: A Systematic Review and Meta-Analysis.","authors":"Antonio Daloiso, Diego Cazzador, Stefano Concheri, Giulia Tealdo, Elisabetta Zanoletti","doi":"10.1002/ohn.910","DOIUrl":"10.1002/ohn.910","url":null,"abstract":"<p><strong>Objective: </strong>Hearing loss is a common symptom associated with vestibular schwannoma (VS), either because of the tumor's effects on the cochlear nerve or due to active treatments such as surgery or stereotactic radiosurgery (SRS). Treatment decisions for VS are based on factors including tumor size, hearing status, patient symptoms, and institutional preference. The study aimed to investigate long-term auditory outcomes in VS patients undergoing active treatments with a hearing preservation intent.</p><p><strong>Data sources: </strong>A systematic literature review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, searching Scopus, Pubmed, and Web of Science databases from inception to January 2024.</p><p><strong>Review methods: </strong>Studies meeting inclusion criteria, including a minimum 5-year follow-up and assessment of pre- and posttreatment hearing outcomes, were included. Pooled prevalence estimates for serviceable hearing after SRS and microsurgery were calculated using MetaXL software. Risk of bias assessment was performed with the Risk of Bias in Non-randomized Studies of Interventions tool.</p><p><strong>Results: </strong>Nine studies met the inclusion criteria, with 356 patients included for analysis. The pooled prevalence of maintaining serviceable hearing after SRS at 10 years was 18.1% (95% confidence interval [CI]: 1.7%-43.3%), with wide prediction intervals indicating variability in outcomes. Microsurgery demonstrated a higher prevalence of maintaining long-term serviceable hearing, with a pooled estimate of 74.5% (95% CI: 63.5%-84.1%).</p><p><strong>Conclusion: </strong>This systematic review underscores the importance of long-term follow-up in evaluating auditory outcomes in VS treatment. Despite the biases inherent to pretreatment patients selection, hearing preservation microsurgery for sporadic VS removal demonstrated favorable and stable long-term serviceable hearing.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1670-1681"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141752326","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":"Rethinking Measures and Mortality Attribution in Health Care: The ENT Example.","authors":"Samip Patel, Lorenzo Olivero, Jorge Sinclair De Frias, Stephanie S Anderson, Ben D Pollock, Marian D Lee, Razvan M Chirila, Hemant S Murthy, Pramod K Guru, Richard Taylor, Pablo Moreno Franco, Terri Menser","doi":"10.1002/ohn.1015","DOIUrl":"10.1002/ohn.1015","url":null,"abstract":"<p><p>National performance metrics ultimately enhance patient decision-making and promote meaningful improvements in health care delivery, which makes having valid and reliable measures essential. This study examined US News and World Report metrics from 2019 to 2012 and used electronic health record data, combined with detailed chart review across 3 in-system hospitals, to assess the provision of care compared to the attribution of patients assigned to the ear, nose, and throat (ENT) mortality group. Of the initial 47 ENT-attributed deaths, 23 of those were verified, dimensioning the mortality rate from 1.7% to just 0.8%. These results underscore the necessity of rethinking measures and mortality attribution methodologies to be more accurate. Current methods use Medicare Severity Diagnosis Related Group billing coding to map the attribution. We suggest transitioning away from specialty ranking approaches and towards a procedure and condition \"rating\" approach to ensure that these ranking types capture data about the provision of care within a given encounter.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1925-1927"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142471791","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":"Relationship Between Voice Problems and Depression Among American Adults.","authors":"Ho Kyung Lee, Heather Shaw Bonilha, Ickpyo Hong","doi":"10.1002/ohn.946","DOIUrl":"10.1002/ohn.946","url":null,"abstract":"<p><strong>Objective: </strong>Voice problems have a large impact on quality-of-life and societal participation. It has been previously reported that persons with voice problems have a higher likelihood of depression than those without voice problems. Despite this knowledge, little has changed in clinical practice related to screening for depression or incorporating the presence of depression in treatment planning. This study aims to provide an updated analysis of the prevalence of depressive symptoms in persons with voice disorders to elucidate the current magnitude of the relationship in hopes that this will provoke greater awareness of the co-occurrence of voice problems and depression and improve clinical care.</p><p><strong>Study design: </strong>Cross-sectional design with a national survey.</p><p><strong>Setting: </strong>None.</p><p><strong>Methods: </strong>The study examined the 23,706 adults from the 2022 National Health Interview Survey database. A series of logistic regression models with propensity score matching approaches were used to examine the association between voice problems and depression by accounting for demographics and health conditions.</p><p><strong>Results: </strong>When comparing persons with and without voice problems, there were statistical differences in demographics and health conditions (all P < .05); however, those differences were balanced by propensity score matching methods (all P > .05). The balanced samples revealed that those with voice problems were approximately twice as likely to experience depressive symptoms (odds ratios ranged from 1.532 to 2.024, all P < .05) compared to those without voice problems. Depressive symptoms increased with the severity (P < .0001) and duration of the voice problem (P = .0328).</p><p><strong>Conclusion: </strong>The study found robust associations between voice problems and depression within the current American adult population in 2022. To achieve optimal treatment outcomes, it is critical that the co-occurrence of voice problems and depression is understood, and that treatment planning addressed both conditions, when applicable.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1798-1807"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142351443","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":"Chimeric Versus Multiple Simultaneous Free Flaps for Head and Neck Reconstruction.","authors":"Johnny Wang, Theresa Tharakan, Ryan S Jackson, Sidharth V Puram, Patrik Pipkorn","doi":"10.1002/ohn.922","DOIUrl":"10.1002/ohn.922","url":null,"abstract":"<p><strong>Objective: </strong>To describe our experience with chimeric flaps and to assess the surgical outcomes and postoperative complications associated with chimeric flaps compared to multiple flaps.</p><p><strong>Study design/methods: </strong>Patients undergoing chimeric and multiple simultaneous free tissue transfer between June 2016 and October 2023 were retrospectively reviewed. The primary outcome of interest was the complication rate. Major complications required takeback to the operating room, hospital readmission, or transfer to the intensive care unit. Minor complications were managed conservatively. Secondary outcomes included operative time, length of hospitalization, and flap survival.</p><p><strong>Setting: </strong>Academic tertiary care center.</p><p><strong>Results: </strong>Our analysis included 113 patients (chimeric n = 38, multiple n = 75). We found no significant difference in operative times or minor complications. Chimeric flaps were associated with a shorter length of hospitalization. The major complication rate was higher for chimeric flaps (42.1% vs 22.7%, P = .03), but each cohort only had 1 instance of total flap loss.</p><p><strong>Conclusion: </strong>The complexity of large head and neck defects poses a reconstructive challenge for microvascular surgeons. Our findings suggest that chimeric and multiple flaps both produce acceptable complication rates when used appropriately. Differences in complication rates may reflect differences in utilization. The chimeric flap remains a valuable option for those with prior radiation or radical resection, but it remains unclear the degree to which they lessen the inherent risk of postoperative complications within this population. Each technique must be weighed in context of the patient's reconstructive profile and the institution's surgical capabilities to optimize long-term outcomes.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1697-1704"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141902574","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":"Virtually Augmented Surgical Navigation in Endoscopic Sinus Surgery Simulation Training: A Prospective Trial of Repeated Measures.","authors":"Mackenzie Latour, Ivan Alvarez, Mark Knackstedt, Michael Yim","doi":"10.1002/ohn.945","DOIUrl":"10.1002/ohn.945","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to explore the educational utility of virtually augmented surgical navigation (VASN) in simulation training for endoscopic sinus surgery.</p><p><strong>Study design: </strong>Prospective trial using within-subjects design.</p><p><strong>Setting: </strong>Single academic institution.</p><p><strong>Methods: </strong>Otolaryngology trainees (n = 15) were enrolled in a prospective trial of repeated measures. Participants performed unilateral functional endoscopic sinus surgery (FESS) on a 3-dimensional-printed sinus model without instruction. Participants then underwent educational intervention incorporating VASN tools-featuring anatomic overlay delineations, virtual planning points, proximity alerts, digital measurements, as well as artificial intelligence-generated endoscopic viewpoints. With the VASN tools activated, participants then performed FESS on the contralateral side of the model. Primary outcomes of interest included number of major complications, time to complete anterior fess, steps completed, and technical skills score. Descriptive statistics were performed to describe participant characteristics and bivariate analysis were used to evaluate differences in subjective and objective outcome measures.</p><p><strong>Results: </strong>A majority (93%) of residents strongly agreed that simulation intervention improved their confidence in surgical skills related to FESS. Complications decreased from 13 instances to 3 following interventions. Initial technical skills score of 45.2 increased to 54.4 postintervention (P < .0001) and global score also improved by 4.6 points on average (P < .001). Time to anterior FESS decreased from 1356 to 915 seconds (P = .006) and average number of completed surgical steps increased from 3.3 to 4.6 (P < .001).</p><p><strong>Conclusion: </strong>This simulation study contributes to growing evidence supporting utility of advanced technology in surgical education. Results suggest that VASN serves as a beneficial adjunct in FESS simulation training.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1897-1903"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913640","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":"Alzheimer's Disease-Related Analytes Amyloid-β and Tau in Perilymph: Correlation With Patient Age and Cognitive Score.","authors":"Amit Walia, Matthew A Shew, Nedim Durakovic, Jacques A Herzog, John R Cirrito, Carla M Yuede, Cameron C Wick, Melissa Manis, David M Holtzman, Craig A Buchman, Mark A Rutherford","doi":"10.1002/ohn.942","DOIUrl":"10.1002/ohn.942","url":null,"abstract":"<p><strong>Objective: </strong>To describe the collection methods for perilymph fluid biopsy during cochlear implantation, detect levels of amyloid β 42 and 40 (Aβ₄₂ and Aβ₄₀), and total tau (tTau) analytes with a high-precision assay, to compare these levels with patient age and Montreal Cognitive Assessment (MoCA) scores, and explore potential mechanisms and relationships with otic pathology.</p><p><strong>Study design: </strong>Prospective study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Methods: </strong>Perilymph was collected from 25 patients using polyimide tubing to avoid amyloid adherence to glass, and analyzed with a single-molecule array advanced digital enzyme-linked immunosorbent assay platform for Aβ₄₀, Aβ₄₂, and tTau. Cognition was assessed by MoCA.</p><p><strong>Results: </strong>Perilymph volumes ranged from ∼1 to 13 µL, with analyte concentrations spanning 2.67 to 1088.26 pg/mL. All samples had detectable levels of tTau, Aβ₄₀, and Aβ₄₂, with a significant positive correlation between Aβ₄₂ and Aβ₄₀ levels. Levels of Aβ₄₂, Aβ₄₀, and tTau were positively correlated with age, while MoCA scores were inversely correlated with age. tTau and Aβ₄₂/Aβ₄₀-ratios were significantly correlated with MoCA scores.</p><p><strong>Conclusion: </strong>Alzheimer's disease-associated peptides Aβ₄₂, Aβ₄₀, and tau analytes are detectable in human perilymph at levels approximately 10-fold lower than those found in cerebrospinal fluid (CSF). These species increase with age and correlate with cognitive impairment indicators, suggesting their potential utility as biomarkers for cognitive impairment in patients undergoing cochlear implantation. Future research should investigate the origin of these analytes in the perilymph and their potential links to inner ear pathologies and hearing loss, as well as their relationships to CSF and plasma levels in individuals.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1850-1858"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11606756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073507","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":"Taste Disorders After Middle Ear Surgery: Chorda Tympani Nerve Injury and Quality of Life.","authors":"Blandine Lafargue, Grégoire D'Andréa, Roxane Fabre, Abdallah Alshukry, Clair Vandersteen, Nicolas Guevara","doi":"10.1002/ohn.920","DOIUrl":"10.1002/ohn.920","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate taste disorders after middle ear surgery, their modifying factors especially chorda tympani nerve injury or underlying otologic disease. We investigated consequences of taste disorders on quality of life.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Monocentric study in tertiary care center.</p><p><strong>Methods: </strong>A total of 214 patients who underwent middle ear surgery were included. Data regarding taste disorders were collected by questionnaires over a 1-year follow-up period.</p><p><strong>Results: </strong>Taste disorders were reported in 42.7% at 10 days, in 23.3% at 4 months, and in 9.2% 1 year postoperatively. When the chorda tympani nerve was initially healthy, taste disorders were more frequent after its transection throughout the follow-up period. When it was involved in a cholesteatoma or inflammatory process, postoperative taste disorders were more frequent after nerve stretching. Postoperative discomfort in daily life was rated on the Likert scale at 3.5 out of 10. Dietary modifications were reported by 25.8% of patients, and mood alterations by 15% of patients.</p><p><strong>Conclusion: </strong>Taste disorders are frequent after middle ear surgery although they mostly improve in the first months. When the CTN is healthy, cutting it leads to more taste disorders than stretching it, thus advocating its preservation to prevent these symptoms. However, in cases of pathological CTN, cutting this nerve, which is sometimes necessary to control the disease, is less likely to cause taste disorders than stretching it. These taste disorders are a source of discomfort and may present risks of dietary modifications and emotional impact.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1834-1841"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141860516","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":"Vocal Cord Paralysis in Pediatric Chiari Malformation: A Systematic Review and Meta-analysis.","authors":"Brandon J Vilarello, Sarah Maurrasse, Eli Grunstein, Minyoung Jang","doi":"10.1002/ohn.884","DOIUrl":"10.1002/ohn.884","url":null,"abstract":"<p><strong>Objective: </strong>Arnold-Chiari Malformation is one possible cause of congenital vocal cord paralysis (VCP). The natural history of VCP in children with Chiari malformation has previously been limited to small case studies. This systematic review seeks to better characterize the prognostic factors that may predict symptom severity and resolution of congenital VCP in children with Arnold-Chiari malformation. We hypothesized that the onset of stridor or VCP at a younger age would be associated with a poorer prognosis and earlier intervention with posterior fossa decompression would be associated with better outcomes.</p><p><strong>Data sources: </strong>PubMed, Web of Science, Cochrane Library, and bibliographic review.</p><p><strong>Review methods: </strong>A systematic review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Database search yielded 866 articles. Study abstracts were reviewed by 2 independent examiners. One hundred and seventy-six studies underwent full-text review. The following were extracted: age at onset of stridor or VCP, Chiari malformation type, laryngoscopy findings, type and timing of neurosurgical intervention, and tracheostomy history. Statistical analyses utilized χ² tests.</p><p><strong>Results: </strong>Younger age at symptom onset showed statistically significant associations with decreased likelihood for symptom resolution and tracheostomy decannulation. The shorter time interval from symptom onset to neurosurgical intervention was not significantly associated with better outcomes.</p><p><strong>Conclusion: </strong>This meta-analysis suggests poorer prognosis in those with earlier-onset symptoms, reinforcing prior case series findings. Additional prospective studies are needed to elucidate the natural history and utility of early intervention in children with vocal cord paralysis secondary to Chiari malformation.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1628-1638"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141477161","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":"Efficacy of ¹⁸FDG-PET/CT in Detecting Synchronous Malignancies in Patients With Head and Neck Cancer: A Systematic Review and Meta-analysis.","authors":"Soroush Ershadifar, Jordan Larsson, Kurtis Young, Marianne Abouyared, Arnaud Bewley, Andrew C Birkeland","doi":"10.1002/ohn.879","DOIUrl":"10.1002/ohn.879","url":null,"abstract":"<p><strong>Objective: </strong>To assess the diagnostic accuracy of fluorine-18 fluorodeoxyglucose positron emission tomography and computed tomography (¹⁸FDG-PET/CT) in detecting second primary malignancies (SPMs) in patients with treatment naïve head and neck squamous cell carcinoma (HNSCC).</p><p><strong>Data sources: </strong>Medline, Embase, Cochrane Library, and Scopus searched from 1946 to December 2022.</p><p><strong>Review methods: </strong>Studies reporting the performance of ¹⁸FDG-PET/CT in patients with treatment-naïve, index HNSCC for detection of SPMs were included. The reference standard was histopathology, clinical follow-up over the duration of study, and other imaging modalities. Multiple investigators completed depth full-text analysis. Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines were followed. Methodologic and diagnostic accuracy data were abstracted independently by multiple investigators. Risk of bias assessment was conducted using the Quality Assessment of Diagnostic Accuracy Studies tool independently. Bivariate random-effects model meta-analysis and multivariable meta-regression modeling were used.</p><p><strong>Results: </strong>Seventeen studies examining 4624 patients with a total of 475 SPMs were included in the final analysis. Eleven studies were found to be at low risk for bias, while the rest were in the high-risk category. ¹⁸FDG-PET/CT demonstrated pooled sensitivity and specificity of 0.73 (95% confidence interval [CI]: 0.49-0.88) and 0.99 (95% CI: 0.98-1.00) in detecting SPMs. Further subsite analysis revealed varied diagnostic performance across different anatomical regions, with sensitivity and specificity of esophageal SPMs being 0.47 (0.30-0.64) and 0.99 (0.98-1.00), and sensitivity and specificity of 0.86 (0.73-0.94) and 0.99 (0.98-1.00) for head and neck SPMs. Finally, this imaging modality showed sensitivity and specificity of 0.92 (0.84-0.96) and 0.99 (0.98-1.00) for lung SPMs.</p><p><strong>Conclusion: </strong>The findings of this study suggest varied accuracy of ¹⁸FDG-PET/CT in detecting SPMs during initial workup for HNSCC, highlighting the importance of screening modalities such as esophagoscopy in high-risk patients.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1639-1649"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469821","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":"A Scoping Review of Pain Management After Transoral Robotic Surgery.","authors":"Vusala Snyder, Daniel O Kraft, Andrew Creamer, Matthew E Spector, Shaum S Sridharan","doi":"10.1002/ohn.871","DOIUrl":"10.1002/ohn.871","url":null,"abstract":"<p><strong>Objective: </strong>Pain following transoral robotic surgery (TORS) is a driver of adverse outcomes and can lead to readmission and treatment delays. A scoping review was conducted to characterize TORS-related pain and identify key management strategies utilized in the literature.</p><p><strong>Data sources: </strong>OVID Medline, CINAHL, Cochrane, Pubmed, and Embase databases were queried.</p><p><strong>Review methods: </strong>Two team members independently screened titles and abstracts and completed full-text reviews. Studies examining TORS for OPSCC with quantitative pain data were included. The study followed the PRISMA guidelines.</p><p><strong>Results: </strong>A total of 1467 studies were imported for screening and 25 studies were ultimately included. The average study sample size was 89 participants. 68% were conducted in a single-center academic setting. Pain was assessed on varying timelines up to 3 years using 13 different metrics. Pain peaks days-weeks postoperatively and returns to baseline thereafter. Postoperative pain is a significant cause of morbidity and limited data exist about optimal management.</p><p><strong>Conclusion: </strong>Prospective studies are needed to characterize and address TORS-related pain.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1617-1627"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731365","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}