Otolaryngology- Head and Neck Surgery最新文献

{"title":"Trends in the Extent of Surgical Management for Low-Grade Parotid Malignancies: A SEER Analysis.","authors":"Katelyn S Rourk, Gabriela A Calcano, Hawa M Ali, Amy E Glasgow, Elizabeth B Habermann, Daniel L Price, Kendall K Tasche, Kathryn M Van Abel, Eric J Moore, Linda X Yin","doi":"10.1002/ohn.1305","DOIUrl":"https://doi.org/10.1002/ohn.1305","url":null,"abstract":"<p><strong>Objective: </strong>Low-grade parotid malignancies have high overall survival rates; however, controversy remains about the appropriate extent of surgery. We aim to explore the trends in the extent of parotidectomy performed over time in low-grade parotid malignancies in the United States, with a hypothesis that there has been a trend towards less aggressive surgery.</p><p><strong>Study design: </strong>Retrospective cohort study of all low-grade (grade I) acinic cell carcinoma (ACC) and mucoepidermoid carcinoma (MEC) in the Surveillance, Epidemiology, and End Results (SEER) from 2004 to 2020.</p><p><strong>Setting: </strong>Geographic areas served by SEER.</p><p><strong>Methods: </strong>Trends were assessed using Cochran-Armitage tests and logistic regression; Kaplan-Meier survival curves were used to analyze overall and cancer-specific survival, and chi-square tests were used to analyze patient characteristics.</p><p><strong>Results: </strong>In total, 1288 patients were identified (916 MEC; 372 ACC). Most patients (n = 772, 60%) were non-Hispanic white, with an average age of 50.6 years and had a slight female predominance (1.58:1). Most of the cohort presented with tumor stage T1 or T2 (84%), N0 (90.1%), and M0 (96.9%). Treatment with total parotidectomy decreased significantly (34.6 vs 17.7%, P = .02) whereas sacrificing the facial nerve (FN) slightly decreased (20 vs 15.7%, P = .1). A significant increase in N0 patients (71%-94%, P < .0001) was observed, whereas T staging remained stable (61%-64%, P = .3). Overall, both ACC and MEC had excellent cancer-specific survival.</p><p><strong>Conclusion: </strong>Over the last 17 years, there has been a significant de-escalation in the extent of parotidectomy for low-grade parotid malignancy in the United States.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111531","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":"Comparing the 7th and 8th Editions of AJCC Staging System for Hypopharyngeal Cancer Undergoing Surgery.","authors":"Heng-Yu Haley Lin, Chia-Fan Chang, Tsung-Lun Lee, Yen-Bin Hsu, Shyh-Kuan Tai, Muh-Hwa Yang, Ling-Wei Wang, Pen-Yuan Chu","doi":"10.1002/ohn.1311","DOIUrl":"https://doi.org/10.1002/ohn.1311","url":null,"abstract":"<p><strong>Objective: </strong>The prognostic accuracy of the American Joint Committee on Cancer (AJCC) 8th staging system for hypopharyngeal cancer remains uncertain. We aim to assess its survival prediction accuracy and compare it with the 7th edition.</p><p><strong>Study design: </strong>Retrospective investigation of prospective data.</p><p><strong>Setting: </strong>Single-institution tertiary referral center.</p><p><strong>Methods: </strong>A cohort of 200 patients with hypopharyngeal squamous cell carcinoma who underwent surgical intervention as primary treatment between 2007 and 2019 was analyzed. We evaluated overall survival (OS) and disease-specific survival (DSS) using the Kaplan-Meier method and the log-rank test for each AJCC edition. The Akaike information criterion (AIC) was used to assess prognostic prediction performance.</p><p><strong>Results: </strong>The median follow-up was 67 months (29-100 months). In total, 93% of the patients (N = 186) underwent at least one side of neck dissection. In total, 41% of patients (N = 82) were upstaged as per the AJCC 8th, all resulting from the redistribution of N stage. Survival curves for DSS were better distinguished for stages I, II, and IVb in the AJCC 8th edition, yet an overlap was observed between stages III and IVa. The combination of extranodal extension (ENE) and cervical metastasis level well-differentiated the survival curves for OS and DSS. The AJCC 8th system outperformed the 7th, with lower AIC values for OS (1092 vs 1098) and DSS (654 vs 666).</p><p><strong>Conclusion: </strong>The AJCC 8th edition improves survival prediction in hypopharyngeal cancer compared to the 7th, especially with the inclusion of ENE status and nodal metastasis classification revisions.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111379","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":"Opioid Analgesia Following Pediatric Adenotonsillectomy: A Randomized Clinical Trial.","authors":"Rachel L Whelan, Jennifer L McCoy, Leonid Mirson, Raymond C Maguire, Noel Jabbour, Jeffrey P Simons, Joseph E Dohar, Dennis J Kitsko, Amanda L Stapleton, Allison B J Tobey, Cuneyt M Alper, Amber D Shaffer, Zachary R Bennett, David H Chi","doi":"10.1002/ohn.1280","DOIUrl":"https://doi.org/10.1002/ohn.1280","url":null,"abstract":"<p><strong>Objective: </strong>To compare the safety and efficacy of nonopioid versus opioid pain management following adenotonsillectomy (AT) among pediatric patients.</p><p><strong>Study design: </strong>An open-label randomized controlled trial.</p><p><strong>Setting: </strong>Tertiary care children's hospital.</p><p><strong>Methods: </strong>Patients aged 3 to 17 years undergoing AT were eligible. Participants were randomly assigned to receive either acetaminophen and ibuprofen (nonopioid group) or acetaminophen, ibuprofen, and oxycodone (opioid group). Pain scores and prevalence of emergency department (ED) visits, hospital readmission, and posttonsillectomy hemorrhage (PTH) were compared between groups.</p><p><strong>Results: </strong>From January 2019 to March 2020, 267 patients were enrolled and randomly assigned; 144 completed a postoperative pain diary. Of the 144, 69 (48%) patients received an opioid prescription, and 75 (52%) did not. Mean pain scores before (opioid: 5.78, 95% CI: 5.29-6.27 vs nonopioid: 5.66, 95% CI: 5.20-6.12) and after (opioid: 2.33, 95% CI: 1.89-2.78 vs nonopioid: 2.24, 95% CI: 1.82-2.66) analgesics were not significantly different between opioid and nonopioid groups. Although 7/75 (9%) from the nonopioid group crossed over and requested opioids, only 43/69 (62%) randomly assigned to receive opioid prescription consumed opioids. The rate of opioid consumption increased with increasing age: 18/71 (25%) patients aged 3 to 7 years, 22/57 (39%) 8 to 12 years, and 10/16 (63%) 13 to 17 years, P = .015. Differences in ED visits, hospital readmissions, and PTH between opioid and nonopioid groups were not significant.</p><p><strong>Conclusion: </strong>Many children do not require opioid analgesics following AT, particularly children less than 8 years of age. Postoperative pain scores and outcomes were similar in opioid versus nonopioid groups. Opioid prescriptions should be limited or avoided altogether after pediatric AT.</p><p><strong>Trial registration: </strong>Title: Nonopioids for analgesia after adenotonsillectomy in children; ID: NCT03618823, Clinicaltrials.gov.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111527","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":"Reducing Surgery for Pediatric Posttonsillectomy Hemorrhage Using Tranexamic Acid: A Quality Improvement Initiative.","authors":"Laura A Petrauskas, Janavi Sethurathnam, Ansley J Kunnath, Rahul K Sharma, John Ceremsak, Ryan H Belcher, James D Phillips, Jay A Werkhaven, Amy S Whigham, Lyndy J Wilcox, Christopher T Wootten, Frank W Virgin, Jason S Park","doi":"10.1002/ohn.1300","DOIUrl":"https://doi.org/10.1002/ohn.1300","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the use of tranexamic acid (TXA) and observation as a management option for pediatric patients presenting with posttonsillectomy hemorrhage (PTH).</p><p><strong>Study design: </strong>Retrospective analysis of a prospectively implemented quality improvement initiative with a historical control comparison group.</p><p><strong>Setting: </strong>Tertiary children's hospital.</p><p><strong>Methods: </strong>Patients <18 years of age who underwent adenotonsillectomy (AT) and returned to the Emergency Department for PTH were included. Patients who were stable without large volume or active bleeding were given intravenous TXA and admitted for overnight observation. Data were compared in a before-and-after analysis: preprotocol (April 2022 to March 2023) versus postprotocol (April 2023 to March 2024). For cost-effectiveness analysis, we analyzed aggregated claims data from a commercial claims database.</p><p><strong>Results: </strong>Preprotocol 1800 adenotonsillectomies were performed, and 40 procedures were performed for control of hemorrhage (2.2 per 100 AT). Postprotocol 2356 adenotonsillectomies were performed, and 30 procedures were performed to control hemorrhage (1.3 per 100 AT) showing a significant reduction in return to the operating room (relative risk [RR] = 0.59, 95% confidence interval [CI] [0.358, 0.916], P-value .020). There were no reported adverse events attributable to TXA. An estimated 21 surgeries were avoided, and 26 additional patients were observed in the hospital during the postprotocol period, for an estimated net cost savings of $174,970.</p><p><strong>Conclusion: </strong>The implementation of a standardized TXA protocol significantly reduced the need for return to the operating room for PTH in pediatric patients, without complications and with net cost savings to the health care system.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111529","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 and Safety of Lasers in Treating Head and Neck Capillary Malformations: A Systematic Review and Meta-analysis.","authors":"Soroush Farsi, Peter Eckard, Walker Bartels, Peyton Pinkus, Gresham T Richter","doi":"10.1002/ohn.1309","DOIUrl":"https://doi.org/10.1002/ohn.1309","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to comprehensively review and compare the safety and efficacy of commonly used lasers in the management of head and neck capillary malformations (CMs).</p><p><strong>Data sources: </strong>PubMed, Embase, Cochrane, and Web of Science.</p><p><strong>Review methods: </strong>Databases were searched from inception to August 2023. Study protocols adhered to the PRISMA guidelines. Cohort studies reporting CM laser treatment outcomes were included. Study validity was tested using the Newcastle-Ottawa Scale. Meta-analysis was conducted using the inverse variance method and a fixed effects model, with treatment success defined as achieving 25% to 100% clearance of the lesion.</p><p><strong>Results: </strong>A total of 725 studies were screened, and 14 full-text articles met the criteria, comprising 714 patients. Patients underwent a mean of 6.5 laser treatment sessions, consisting of 80% pulsed dye laser (PDL), 12% neodymium-doped yttrium-aluminum-garnet laser (Nd:YAG), and 8% 577 nm yellow laser treatments. Meta-analysis revealed an overall treatment success rate of 97% (95% confidence interval [CI]: 0.96-0.98). Subgroup analysis by laser type resulted a success rate of 96% (95% CI: 0.94-0.973) for PDL, 99% (95% CI: 0.979-1.008) for Nd:YAG laser, and 86% (95% CI: 0.7621-0.964) for 577 nm yellow laser. The complication rate by laser type was 9% (95% CI: 0.031-0.147) for PDL, 4% (95% CI: 0.007-0.080) for Nd:YAG laser, and no reported complication data for 577 nm yellow laser.</p><p><strong>Conclusion: </strong>The vast majority of the available data on laser treatment of head and neck CMs suggest excellent outcomes and low complication rate using PDL treatment. Centers using Nd:YAG laser reported a slightly higher rate of successful treatment with fewer complications than PDL or 577 nm yellow laser treatment.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111325","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":"Dynamic Airway CT for Morphometric Analysis of Pediatric Tracheomalacia Throughout Respiration.","authors":"Hannah F Case, Michael Bindschadler, Michael Barbour, Tanya Meyer, John P Dahl, Seth D Friedman, Alberto Aliseda, Randall A Bly","doi":"10.1002/ohn.1313","DOIUrl":"https://doi.org/10.1002/ohn.1313","url":null,"abstract":"<p><p>Dynamic airway computed topography (4D-CT) can be used to evaluate the trachea in pediatric patients with tracheomalacia. The 4D-CT enables objective and quantitative evaluation throughout all phases of respiration; however, current systems focus on qualitative review of generated 4D images. Few analytic workflows are available to assist in the extraction of the quantitative geomorphic data generated. In this study, we share a protocol developed within the 3D Slicer framework that performs semi-automatic tracheal segmentation and subsequent geomorphic analysis. This methodology is applied to 4 sample cases with varying degrees of tracheal collapse throughout all phases of respiration to demonstrate output of cross-sectional area, aspect ratio (defined as the ratio between minor-to-major luminal axis lengths), and tracheal volume (bound by the subglottis and carina) metrics.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111382","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":"Lateral Axillary Approach for Placement of the Fifth-Generation Hypoglossal Nerve Stimulator Implantable Pulse Generator.","authors":"Phillip Huyett, Maria V Suurna","doi":"10.1002/ohn.1321","DOIUrl":"https://doi.org/10.1002/ohn.1321","url":null,"abstract":"<p><p>Hypoglossal nerve stimulation has become an increasingly popular treatment for obstructive sleep apnea. Some patients express concerns about the appearance of the anterior chest incision scar. Here, we describe the feasibility of the lateral axillary approach for placing the fifth-generation implantable pulse generator, which does not require a respiratory sensor. The first three patients were successfully implanted, had excellent respiratory waveforms, and had no complications. The surgical times were not substantially different than for implanting the fourth-generation or fifth-generation device through a standard anterior chest incision.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111431","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":"TI-RADS and Bethesda Classification System Correlate With Predicting Pediatric Papillary Thyroid Carcinoma.","authors":"Shaunak N Amin, Megan Branson, J Nathaniel Perkins, Xing Wang, Eric C Huang, Tyler G Ketterl, Hedieh Khalatbari, Sanjay R Parikh, Scott C Manning, John P Dahl","doi":"10.1002/ohn.1310","DOIUrl":"https://doi.org/10.1002/ohn.1310","url":null,"abstract":"<p><strong>Objective: </strong>Our study objectives were to evaluate the relationship between Thyroid Imaging Reporting and Data System (TI-RADS) and Bethesda classification and to compare both TI-RADS and Bethesda classification for the diagnosis of papillary thyroid carcinoma (PTC) within the pediatric population.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Academic pediatric hospital.</p><p><strong>Methods: </strong>A 13-year retrospective review was performed of all pediatric patients undergoing thyroid fine needle aspiration (FNA) and ultrasound at our institution. Demographics, TI-RADS scoring, FNA results, surgical history, and final pathology were collected. High-risk ultrasonography and cytopathology were defined as TI-RADS 3-5 and Bethesda 5-6, respectively. Spearman's rank correlation was determined for TI-RADS and Bethesda classification. Relative risks of high-risk TI-RADS and Bethesda classification for predicting PTC were calculated.</p><p><strong>Results: </strong>A total of 157 patients (21.7% male, median age at time of FNA 15 years, and range 2.7-21 years) underwent ultrasound and FNA during the study. The Spearman's rank correlation coefficient for TI-RADS compared with the Bethesda classification was 0.41 (P < .001). The relative risk of high-risk TI-RADS scores to predict the presence of PTC was 7.99 (95% CI 1.16-54.90). High-risk Bethesda classification demonstrated a relative risk for predicting PTC of 6.62 (95% CI 4.22-10.41).</p><p><strong>Conclusion: </strong>In our cohort, there was a moderate correlation between TI-RADS and Bethesda classifications. Patients with a TI-RADS score ≥3 and Bethesda classification 3 or 4 are at intermediate risk for harboring PTC and should be counseled accordingly.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079407","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":"Safe Use of High-Flow Oxygenation During Transoral Laser Microsurgery Without Airway Fire: A Review of 369 Consecutive Cases.","authors":"Nathaniel S Neptune, Jeanne L Hatcher, Jeremy S Collins, Andrew Tkaczuk, Anupriya Rao, Jay A Sanford","doi":"10.1002/ohn.1293","DOIUrl":"https://doi.org/10.1002/ohn.1293","url":null,"abstract":"<p><strong>Objective: </strong>Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) is often avoided during intraoral laser use due to the concern for an airway fire with the addition of high-flow oxygen. We aim to demonstrate that THRIVE can be safely used during transoral laser microsurgery (TLM) without causing an airway fire or other major complications.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Emory University Hospital Midtown between January 2020 and April 2024.</p><p><strong>Methods: </strong>A retrospective chart review of all patients who underwent TLM with the use of THRIVE was performed. A standardized laser safety protocol was followed, and either a carbon dioxide or potassium titanyl phosphate laser was used for all cases.</p><p><strong>Results: </strong>In total, 369 cases were examined, and no fire, ignition, flash, or major complication occurred. In total, 270 (73.2%) patients were Caucasian females and 271 (73.4%) patients had a primary diagnosis of idiopathic subglottic stenosis. A total of 110 (29.8%) cases were completed with the use of THRIVE alone, 238 (64.5%) required the addition of jet ventilation, and 21 (5.7%) required intubation for the completion of the case. Increased body mass index was positively associated with the need for jet ventilation or intubation and reached statistical significance for the type of airway management employed during the case (P-value < .001).</p><p><strong>Conclusion: </strong>Airway fire and other major complications are preventable with the use of THRIVE during TLM if standardized laser safety practices are implemented.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079406","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":"Pain, Safety, and Image Quality of Magnetic Resonance Imaging With Cochlear Implants: A Prospective Trial.","authors":"Evan J Patel, Xin Wu, Joel McLouth, Daniel Q Sun, Bryan K Ward, Jeffrey D Sharon","doi":"10.1002/ohn.1301","DOIUrl":"https://doi.org/10.1002/ohn.1301","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether rotating cochlear implant (CI) magnets improve patient comfort and preserve scan usability during magnetic resonance imaging (MRI).</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Two tertiary academic centers.</p><p><strong>Methods: </strong>Adult patients with CIs who underwent MRI of any body region were included. The primary outcome was the mean change in pain score from baseline (before any study procedure) to the highest reported pain level during MRI with a CI magnet in place. Secondary outcomes included patient-reported survey responses regarding their MRI experience and the interpretability of the brain MRI scans involving rotating magnets, as assessed by two independent, blinded neuroradiologists.</p><p><strong>Results: </strong>Twenty-three MRI scans (21 patients) with CIs were analyzed. Eleven scans (47.8%) involved implants containing internal magnets designed to self-align with the magnetic field. The mean pain-score difference unrelated to headwrap use was significantly lower for rotating magnet devices than fixed magnets (0.7 vs 4.0, P = .02). No magnet displacement or depolarization occurred. In six MRI brain sequences, the mean maximal signal-loss artifact measured 6.1 cm (SD 1.2 cm) on axial images for rotating magnet devices. When assessing if the MRI could answer the question for which the scan was ordered, 100% of responses (n = 12) ranged from slightly agree to strongly agree. The majority of patients (70.0%) indicated they would undergo another MRI if medically necessary.</p><p><strong>Conclusion: </strong>CIs containing rotatable magnets reduce MRI-related pain compared to those with fixed magnets. Although the magnets produce a measurable artifact, it does not substantially compromise scan utility in the majority of cases.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144079396","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}