Otolaryngology- Head and Neck Surgery最新文献

{"title":"Outcomes Following Single-Stage Laryngotracheal Reconstruction Using a \"No Look\" Extubation Philosophy.","authors":"Andrew R Scott, David O Danis, Andrea B Clinch, Lindsey Greenlund, Brianne B Roby","doi":"10.1002/ohn.1159","DOIUrl":"https://doi.org/10.1002/ohn.1159","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to examine outcomes following single-stage laryngotracheal reconstruction (SSLTR) using a \"no look\" philosophy.</p><p><strong>Study design: </strong>Case series with chart review.</p><p><strong>Setting: </strong>Two urban, tertiary, children's hospitals.</p><p><strong>Methods: </strong>Patients underwent primary or revision open SSLTR by 1 of 3 surgeons at 2 institutions. After a period of planned postoperative intubation, patients were extubated in the pediatric intensive care unit (PICU), with operative inspection of the airway deferred for 6 weeks unless symptoms of stridor or distress developed postoperatively. Short-term and long-term clinical outcome metrics were examined.</p><p><strong>Results: </strong>From 2011 to 2021, 47 consecutive SSLTRs were completed, following which patients were extubated in the PICU without antecedent inspection of the airway. The mean age was 30.8 months (range: 3-130 months), and the mean preoperative stenosis grade was 2.1. There were 17 anterior grafts, 1 isolated posterior graft, and 29 A/P graft procedures; 19% of surgeries were revisions of prior open procedures. The mean PICU and hospital length of stay were 10.1 and 12.5 days, respectively. The failure rate following extubation was 4% (0% primary and 22% revision, P < .003), and 23% of patients had an unplanned return to the operating room for airway symptoms (21% primary and 33% revision, P = .44). Secondary endoscopic interventions were performed in 47% of cases; when required, the mean number of dilations was 2.2 (1.6 primary and 3.7 revision, P < .05). Long-term outcomes compared favorably with historical standards.</p><p><strong>Conclusion: </strong>In select patients undergoing SSLTR, a \"no look\" philosophy may eliminate unnecessary surgical procedures without compromising short-term or long-term clinical outcomes.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657168","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":"Physical Features Contributing to Gender Dysphoria: The Role of Voice.","authors":"Serena Pu, Leanne Goldberg, Jennifer Ren, A C Goldberg, Mark Courey","doi":"10.1002/ohn.1207","DOIUrl":"https://doi.org/10.1002/ohn.1207","url":null,"abstract":"<p><strong>Objective: </strong>Features that cause gender incongruence (gender identity not aligning with assumptions based on sex assigned at birth) in transgender individuals often motivate them to seek out gender-affirming treatments. Voice has rarely been included as a major contributor to gender dysphoria. The primary objective of this study is to understand the significance of dysphoria related to voice compared to dysphoria secondary to other features.</p><p><strong>Study design: </strong>Prospective population-based survey study.</p><p><strong>Setting: </strong>Social media.</p><p><strong>Methods: </strong>The survey requested a ranking of features that contribute to gender dysphoria, whether the features were bothersome due to external or internal perception, and self-reported ideal order for pursuing gender-affirming treatments. The categories of features that were ranked included upper body, lower body, face, neck, voice, and height.</p><p><strong>Results: </strong>In total, 79% of respondents experience gender incongruence secondary to their voice. Voice was the second most important feature contributing to gender dysphoria, only after upper body. In transgender men (29.4%) and transgender women (25%), voice was both the second most important feature contributing to gender dysphoria and the second most important intervention to alleviate gender dysphoria. Specifically, vocal incongruence is largely due to perception by others, as opposed to lower body which contributes to incongruence due to perception by self.</p><p><strong>Conclusion: </strong>Voice is the second most common contributor to gender dysphoria after upper body. Due to self-rated importance of voice to gender incongruence, health care providers must be aware that voice interventions are critical to improve gender dysphoria experienced by transgender individuals.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657706","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":"Localized Knockout of E-Cadherin in Subglottic Mucosa Increases Fibrosis.","authors":"Raymond J So, Samuel L Collins, Yee Chan-Li, Ioan Lina, Alexander Gelbard, Kevin M Motz, Alexander T Hillel","doi":"10.1002/ohn.1226","DOIUrl":"https://doi.org/10.1002/ohn.1226","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effects of localized subglottic knockout of E-cadherin (CDH1^-/-) on survival, tracheal luminal thickness, and fibrotic gene expression in a mouse model of subglottic stenosis.</p><p><strong>Study design: </strong>Case-control in vivo mouse study.</p><p><strong>Setting: </strong>Tertiary care academic hospital.</p><p><strong>Methods: </strong>Mice with loxP sites flanking E-cadherin underwent extratracheal placement of a fibrin-plasmin gel embedded with either CRE-expressing or control adenovirus. Mice then underwent chemomechanical injury to induce laryngotracheal stenosis, with harvest of subglottis/tracheas 21 days later. Immunofluorescence and Western blotting were used to confirm E-cadherin knockout. Outcomes of interest included Kaplan-Meier survival curves (n = 40), lamina propria thickness on hematoxylin-eosin (H&E) histology (n = 8), and fibrotic gene expression (n = 3).</p><p><strong>Results: </strong>Immunofluorescence and Western blotting confirmed decreased E-cadherin expression in CDH1^-/-. On H&E, lamina propria thickness was greater in CDH1^-/- mice (mean difference [95% CI] in μm, 107.2 [74.8-139.7], P < .001). Survival was significantly shorter for knockout mice relative to control (median survival in days, 5.0 vs 8.5; P = .007). Further, fibrotic gene expression of COL1 (mean difference [95% CI] in log-fold change, 11.5 [1.9-21.0]; P = .03), COL3 (31.0 [11.5-50.5]; P = .01), COL5 (6.8 [3.1-10.4]; P = .007), and FN1 (6.9 [1.3-12.6]; P = .03) was significantly greater relative to control.</p><p><strong>Conclusion: </strong>CDH1^-/- results in greater fibrosis and increased mortality, further supporting the role of epithelial barrier dysfunction in the pathogenesis of subglottic stenosis. Therapies that restore epithelial integrity may therefore represent a rational pharmacologic target.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658117","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":"Perilymphatic Signal Changes in Vestibular Schwannoma: A Potential Biomarker of Progressive Hearing Loss?","authors":"Anne Renée Juliette Péporté, Benoît Gallix, Aïna Venkatasamy","doi":"10.1002/ohn.1228","DOIUrl":"https://doi.org/10.1002/ohn.1228","url":null,"abstract":"<p><strong>Objective: </strong>Vestibular schwannomas influence the magnetic resonance (MR) signal intensity (SI) in the vestibular cistern and cochlear perilymph. The aim of this study is to evaluate the relationship between perilymphatic signal changes on gradient-echo T2-weighted 3 T MR sequence and the clinical symptoms.</p><p><strong>Study design: </strong>Retrospective case-control study.</p><p><strong>Setting: </strong>The study was conducted at the Institute of Image-Guided Surgery in Strasbourg, France.</p><p><strong>Methods: </strong>Patients with vestibular schwannoma who underwent magnetic resonance imaging at our institution between 2008 and 2016 were retrospectively reviewed. A control group consisted of individuals without past or present otological symptoms. The vestibular schwannomas were divided into three groups, based on the degree of internal auditory canal obstruction. The SI ratios of the vestibular cistern to cerebrospinal fluid (CSF) and cochlea to CSF were compared with clinical data.</p><p><strong>Results: </strong>We included 172 patients with vestibular schwannoma and 61 controls. Vestibular schwannoma was associated with a significant decrease of the SI ratio of the vestibular cistern to CSF (0.716 ± 0.297 vs 1.06 ± 0.21, P = .004) and cochlea to CSF (0.66 ± 0.199 vs 0.903 ± 0.011, P = .004) compared to controls, with significant negative correlation between both the SI ratios of the vestibular cistern and cochlea to CSF with tumor volume (P < .001). Among all the symptoms studied, the SI ratio of the cistern normalized by CSF was significantly associated with progressive hearing loss (P = .003).</p><p><strong>Conclusion: </strong>Perilymphatic vestibular cistern and cochlear SI changes appear to be a promising noninvasive biomarker for hearing impairment in vestibular schwannoma.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657426","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":"Evaluating Adverse Outcomes After Myringotomy or Tube Placement in Head and Neck Cancer.","authors":"Krithika Kuppusamy, Carly Y Yang, Kevin Wong, Douglas C Bigelow, Michael J Ruckenstein, Steven J Eliades, Jason A Brant, Tiffany Hwa","doi":"10.1002/ohn.1186","DOIUrl":"https://doi.org/10.1002/ohn.1186","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate rates of adverse outcomes among patients with a history of head and neck cancer undergoing myringotomy with or without tube placement for middle ear effusion.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Academic medical center.</p><p><strong>Methods: </strong>Retrospective chart review was performed on patients undergoing myringotomy with or without tube placement for middle ear effusion between 2018 and 2022. Data reviewed included demographics, cancer history, audiometry, and clinical course.</p><p><strong>Results: </strong>In total, 578 patients (736 ears) had a mean follow-up of 36.6 months: 84 (14.53%) were in the cancer cohort. On average, cancer patients were older (62.6 vs 59.3 years, P < .05) but had similar rates of overall adverse outcomes (44.05% vs 44.13%, P = 1.0). Rates of persistent perforation were higher among cancer patients (14.29% vs 2.43%, P < .001); there was no significant difference in rates of recurrent effusion (5.95% vs 4.66%; P = .81). Postpropensity score matching, perforation rates reached statistical significance (14.29% vs 1.22%, P < .01). There was no difference in rate of adverse events for overall events (44.05% vs 47.56%, P = .77) or recurrent effusion (5.95% vs 1.22%, P = .22).</p><p><strong>Conclusion: </strong>Patients with a history of head and neck cancer or radiation have a three-to-five-fold risk of persistent tympanic membrane perforation after myringotomy with or without tube placement and a higher rate of recurrent effusion that is not significant. In multivariate analysis, perforation risk was revealed to be multifactorial.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658098","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":"Improved Pharyngeal Contraction and Oral Intake Status After Modified Central-Part Laryngectomy for Late-Stage ALS.","authors":"Rumi Ueha, Maria Angela Dealino, Misaki Koyama, Kaoru Yamakawa, Naoyuki Matsumoto, Taku Sato, Takao Goto, Aiko Mizukami, Kenji Kondo","doi":"10.1002/ohn.1229","DOIUrl":"https://doi.org/10.1002/ohn.1229","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of modified central-part laryngectomy with pharyngeal space reduction (CPL-PR) on patients with weak deglutitive pharyngeal contraction, as seen in late-stage amyotrophic lateral sclerosis (ALS).</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Single-institution academic center.</p><p><strong>Methods: </strong>Patients with late-stage ALS confined at The University of Tokyo Hospital between 2019 and March 2024 in whom CPL-PR had been performed were identified. Patients who had undergone simultaneous pharyngeal flap surgery or had no preoperative high-resolution manofluorography done were excluded. Preoperatively, penetration-aspiration scale (PAS) scores were determined via videofluoroscopic swallowing study. Functional oral intake scale (FOIS) scores and high-resolution manometric parameters were measured and compared preoperatively and postoperatively.</p><p><strong>Results: </strong>Eighteen patients were identified with a median age of 66.5 (interquartile range [IQR]: 58.0-74.8). The median preoperative PAS score was 7.5 (IQR: 5.5-8.0), indicating severe dysphagia. There was significant improvement in oral intake status with FOIS scores increasing from 1 (IQR: 1-1) to 3 (IQR: 2-3) at 3 months postoperatively (P = .0002). Significant increases in velopharyngeal closure integral (P = .024) and mesohypopharyngeal contractile integral (P = .0001) were observed. Upper esophageal sphincter (UES) resting pressure was reduced (P = .0002), and UES relaxation time was prolonged during swallowing (P < .0001).</p><p><strong>Conclusion: </strong>There were tangible improvements in pharyngeal contraction, UES bolus passage, and oral intake status following CPL-PR, which contribute to regaining oral intake in late-stage ALS. CPL-PR is an option for patients requiring tracheostomy who wish to prevent aspiration and regain their ability to take food orally.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658116","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":"Comparative Analysis of Information Quality in Pediatric Otorhinolaryngology: Clinicians, Residents, and Large Language Models.","authors":"Eleonora M C Trecca, Vito Carlo Alberto Caponio, Mario Turri-Zanoni, Antonella Miriam di Lullo, Michele Gaffuri, Jérôme R Lechien, Antonino Maniaci, Giuseppe Maruccio, Marella Reale, Irene Claudia Visconti, Virginia Dallari","doi":"10.1002/ohn.1225","DOIUrl":"https://doi.org/10.1002/ohn.1225","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric otorhinolaryngology (ORL) addresses complex conditions in children, requiring a tailored approach for patients and families. With artificial intelligence (AI) gaining traction in medical applications, this study evaluates the quality of information provided by large language models (LLMs) in comparison to clinicians, identifying strengths and limitations in the field of pediatric ORL.</p><p><strong>Study design: </strong>Comparative blinded study.</p><p><strong>Setting: </strong>Controlled research environment using LLMs.</p><p><strong>Methods: </strong>Fifty-four items of increasing difficulty, namely 18 theoretical questions, 18 clinical scenarios, and 18 patient questions, were posed to ChatGPT-3.5, -4.0, -4o, Claude-3, Gemini, Perplexity, Copilot, a second-year resident, and an expert in the field of pediatric ORL. The Quality Analysis of Medical Artificial Intelligence (QAMAI) tool was used for blinded evaluation of the quality of medical information by a panel of expert members from the Young Otolaryngologists Group of the Italian Society of ORL and the International Federation of ORL Societies.</p><p><strong>Results: </strong>LLMs performed comparably to specialist in theoretical and standardized clinical scenarios, with Bing Copilot achieving the highest QAMAI scores. However, AI responses lacked transparency in citing reliable sources and were less effective in addressing patient-centered questions. Poor interrater agreement among reviewers highlighted challenges in distinguishing human-generated from AI-generated responses. Rhinology topics received the highest scores, whereas laryngology and patient-centered questions showed lower agreement and performance.</p><p><strong>Conclusion: </strong>LLMs show promise as supportive resources in pediatric ORL, particularly in theoretical learning and standardized cases. However, significant limitations remain, including source transparency and contextual communication in patient interactions. Human oversight is essential to mitigate risks. Future developments should focus on refining AI capabilities for evidence-based and empathetic communication to support both clinicians and families.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658095","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":"Minimal to Mean Airway Area Ratio of the Pharynx: A Novel Predictor of Pediatric Obstructive Sleep Apnea in Three-Dimensional Imaging.","authors":"Kun-Tai Kang, Yunn-Jy Chen, Wen-Chin Weng, Hung-Ta Hsiao, Pei-Lin Lee, Wei-Chung Hsu","doi":"10.1002/ohn.1234","DOIUrl":"https://doi.org/10.1002/ohn.1234","url":null,"abstract":"<p><strong>Objective: </strong>Reliable variables for detecting pediatric obstructive sleep apnea (OSA) using three-dimensional (3D) imaging are currently lacking. This study aimed to develop a novel predictor of OSA in children.</p><p><strong>Study design: </strong>Prospective study.</p><p><strong>Setting: </strong>Tertiary care children's hospital.</p><p><strong>Methods: </strong>Pediatric patients (<18 years) with symptoms suggestive of OSA were enrolled. Polysomnography was used to categorize disease severities as primary snoring (apnea-hypopnea index, AHI < 1), mild OSA (AHI = 1-5), moderate OSA (AHI = 5-10), and severe OSA (AHI > 10). Cone-beam computed tomography was used to obtain 3D images. The minimal to mean airway area (AA) ratio was measured across the entire pharynx and its segment (nasopharynx, oropharynx, and hypopharynx).</p><p><strong>Results: </strong>The study included 104 children. For the entire pharynx, the minimal to mean AA ratio was 0.41, 0.36, 0.35, and 0.25 in the primary snoring, mild OSA, moderate OSA, and severe OSA groups, respectively (P = .001). Pearson's correlation revealed an inverse relationship between the minimal to mean AA ratio and OSA severity. The receiver operating characteristic curve identified the optimal cutoff point for predicting AHI ≥ 1 as 0.34 in the oropharynx (area under the curve [AUC] = 71%) and 0.39 in the entire pharynx (AUC = 67%). The minimal to mean AA ratio in the nasopharynx or hypopharynx indicated no significant difference between OSA severities.</p><p><strong>Conclusion: </strong>A minimal to mean airway AA ratio of less than one-third in the pharynx serves as a novel predictor of pediatric OSA in 3D imaging.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656875","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":"Evaluating Outcomes in Septorhinoplasty Procedures Using Serum Cotinine as a Measure for Tobacco Use.","authors":"Kimberly Chan, Shivam Patel, Allison Keane, Tonya S King, Jessyka G Lighthall","doi":"10.1002/ohn.1212","DOIUrl":"https://doi.org/10.1002/ohn.1212","url":null,"abstract":"<p><strong>Objective: </strong>Perioperative tobacco use is associated with poor wound healing postoperative complications. The purpose of this study is to use serum cotinine as a measure of tobacco consumption to evaluate complication rates and outcomes in patients undergoing septorhinoplasty procedures.</p><p><strong>Study design: </strong>Prospective study.</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Methods: </strong>Patients >18 years old undergoing septorhinoplasty from December 2017 to January 2023 were included. Serum cotinine levels were obtained on the day of surgery. Preoperative and postoperative nasal obstruction and septoplasty effectiveness (NOSE) scores were assessed. Postoperative wound complications were categorized as mild, moderate, and severe. Chi-square, Fisher exact, and Kruskal-Wallis tests were used to analyze the data.</p><p><strong>Results: </strong>Sixty-seven patients met inclusion criteria. Average age was 46 years, 31 patients were male, and 36 were female. Seven patients reported current tobacco use and 20 reported former use. Thirteen patients (19%) were cotinine-positive, with a median level of 190 ng/mL. None of the cotinine-positive patients had postoperative wound complications, whereas four of the cotinine-negative patients did. There was no significant difference in the change in NOSE scores between the cotinine-positive (-44.0) and cotinine-negative (-45.3) groups (P = .70). Of the cotinine-positive patients, the change in NOSE scores in patients who reported current tobacco use was -33.1 compared to -56.7 in patients who reported former tobacco use (P = .07).</p><p><strong>Conclusion: </strong>Serum cotinine levels can be used for biochemical verification for tobacco use. Reported perioperative tobacco use may not be as predictive for effects on postoperative complications and functional outcomes in patients undergoing septorhinoplasty procedures.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658099","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 Hearing Outcomes Following Cochlear Implantation in Far Advanced Otosclerosis.","authors":"Raphaële Quatre, Martin Eklöf, Jeremy Wales, Åsa Bonnard","doi":"10.1002/ohn.1224","DOIUrl":"https://doi.org/10.1002/ohn.1224","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the long-term auditory performance at 5 years in patients with far advanced otosclerosis (FAO) after cochlear implantation compared to controls.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>This study was conducted at a single tertiary medical center.</p><p><strong>Methods: </strong>Patients with FAO were compared to a control group of postlingually deafened patients, selected from the same cochlear implant database. The following data were collected from medical records: age, sex, etiology, duration of hearing deprivation, prior stapes surgery, age at implantation, side of implantation, computed tomography scan findings, surgery details, postoperative complications, and hearing test results.</p><p><strong>Results: </strong>A total of 41 patients with otosclerosis and 73 control cases were included in this study. The mean speech comprehension score at 5 years was 48.63% ± 24.66 in the otosclerosis group compared to 48.17% ± 23.08 in the control group (P = .76). Cochleostomy (P = .01), scala vestibuli insertion (P < .001), and postoperative dizziness (P < .01) were more common in the otosclerosis group. Facial nerve stimulation was observed in both groups: otosclerosis group 4 cases (9.8%) and control group 4 cases (5.48%) (P = .39). In the otosclerosis group, at 5 years, the average speech comprehension in patients with a previous stapedotomy was 39.3% ± 23.9 and 57.52% ± 22.45 in patients without a previous stapedotomy (P = .02).</p><p><strong>Conclusion: </strong>Cochlear-implanted patients with otosclerosis achieve satisfactory long-term audiometric outcomes, although with higher surgical challenges and complication rates compared to other etiologies. Notably, we found that a history of stapedotomy can negatively impact long-term auditory outcomes after cochlear implantation.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658118","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}