Otolaryngology- Head and Neck Surgery最新文献

{"title":"Microtia Reconstruction Practices Among Otolaryngologists in the United States.","authors":"Arianna Winchester, Michele Santacatterina, Wenqing Yang, Zahrah Taufique, Danielle F Eytan","doi":"10.1002/ohn.1245","DOIUrl":"https://doi.org/10.1002/ohn.1245","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to describe current practices among otolaryngology-trained microtia surgeons in the United States.</p><p><strong>Study design: </strong>Survey.</p><p><strong>Setting: </strong>A tertiary care center.</p><p><strong>Methods: </strong>A 22-question anonymous digital survey of practice patterns and surgical methods was distributed to all members of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) and the American Society of Pediatric Otolaryngology (ASPO). Responses were analyzed using descriptive statistics and linear regression models.</p><p><strong>Results: </strong>Of 1730 eligible members, 83 (4.8%) responses were collected. Forty-three (51.8%) were AAFPRS members, 39 (47.0%) were ASPO members, and 1 (1.2%) reported dual membership. Respondents had multiple practice settings, were at different stages in their experience, and were well-distributed geographically. Forty (48.2%) don't perform microtia repair and half (52.5%) refer to an FPRS-trained colleague. Among microtia surgeons, most (N = 30, 69.8%) received fellowship training. Autologous reconstruction was the most popular method for training and practice; however, most perform multiple methods (N = 33, 76.7%). Autologous rib training was positively correlated with experience of >20 years. Those with combined autologous/alloplastic practice were more frequently trained by PO fellowship. Surgical site infection was the most frequent complication and was seen more often by those trained via residency alone (OR 12.8, P < .05). Those who trained in autologous rib alone were less likely to encounter postoperative graft exposure (OR 5.0, P < .05); however, they were more likely to encounter skin and soft tissue infection (OR 0.07, P < .05).</p><p><strong>Conclusion: </strong>Otolaryngology-trained microtia surgeons come from a variety of academic backgrounds and progress to varied practices. They are trained and practice both alloplastic and autologous repair methods, although autologous methods remain the most common.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009022","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":"Endoscopic Pituitary Surgery in High-Resource Settings Versus a Public Hospital in Ghana.","authors":"Katherine Y Tai, Daniel B Spielman, Lauren H Tucker, Kafui Searyoh, Loius Armooh, Confidence K Nai, Amanda Quarshie, Divine A Kwami, Jerome K Boatey, Patrick Bankah, George K Wepeba, Rodney J Schlosser, Michael G Stewart, Jonathan B Overdevest, David A Gudis","doi":"10.1002/ohn.1263","DOIUrl":"https://doi.org/10.1002/ohn.1263","url":null,"abstract":"<p><strong>Objective: </strong>The evidence supporting endoscopic transsphenoidal pituitary adenoma resection (TSPR) is predominantly from skull base centers in high-resource settings (HRSs). This study is the first comparative analysis of TSPR performed at a low-resource setting (LRS), Korle Bu Teaching Hospital (KBTH), a public hospital in Accra, Ghana, versus HRS.</p><p><strong>Study design: </strong>Cohort study.</p><p><strong>Setting: </strong>Tertiary skull base surgery centers in Ghana, the United States, Canada, and Australia.</p><p><strong>Methods: </strong>Patients who underwent TSPR at KBTH from 2021 to 2023 were compared to a multi-institutional cohort of TSPR patients from skull base centers in the United States, Canada, and Australia. Univariate and multivariate analyses were performed controlling for available demographic characteristics and medical history.</p><p><strong>Results: </strong>The KBTH cohort included 93 patients, and the HRS cohort included 1112 patients of similar age. The HRS cohort had higher incidences of diabetes (P = .013) and cancer history (P = .012). There were two deaths in the KBTH cohort (one intracranial bleed, one meningitis) versus five in the HRS cohort (odds ratio [OR] = 8.07, 95% CI 1.28, 50.98). There were no differences in rates of other postoperative complications.</p><p><strong>Conclusion: </strong>These findings demonstrate the capacity of LRSs to perform endoscopic pituitary surgery and highlight the need for building rhinologic and skull base surgery capacity around the world. This study was unable to control for important factors including tumor size, postoperative access to health care resources, availability of adjuvant treatments such as neuro-interventional radiology and stereotactic radiation therapy, and others.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064317","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":"Pregnancy and Parity as Risk Factors for Recurrence in Idiopathic Subglottic Stenosis.","authors":"Andrew S Awadallah, Forrest W Fearington, Yousuf H Khalil, Andrew J Bowen, Hawa M Ali, Yan Li, David O Francis, Seth H Dailey, Eric S Edell, Matthew J Koster, Semirra L Bayan, Dale C Ekbom","doi":"10.1002/ohn.1255","DOIUrl":"https://doi.org/10.1002/ohn.1255","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the impact of parity on the severity and recurrence rates of idiopathic subglottic stenosis (iSGS) in premenopausal females.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Two tertiary care centers from 2002 to 2024.</p><p><strong>Methods: </strong>We analyzed premenopausal iSGS patients under 40 years who underwent balloon dilation or laser wedge excision. Clinical features, including demographics and pregnancy history, were examined. Recurrence rates between nulliparous and parous patients were compared using Poisson regression, adjusting for age and follow-up duration. Linear regression assessed the relationship between pregnancy and iSGS recurrence.</p><p><strong>Results: </strong>Forty-eight patients were included, with 36 parous and 12 nulliparous. Adjusting for age and follow-up, the mean recurrence rate was 2.6 times higher in parous patients (95% confidence interval [CI]: [1.5, 4.8], P = .0008). Each additional pregnancy was associated with 0.81 additional recurrences (95% CI: [0.05, 1.57], P = .0375). No significant differences in surgery-free time were observed between groups.</p><p><strong>Conclusion: </strong>Parity and pregnancy significantly increase the risk of iSGS recurrence, although they do not accelerate subsequent recurrences. Health care providers should counsel women of childbearing age about these risks in family planning discussions, emphasizing shared decision-making regarding potential surgical interventions.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009146","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":"Comparison of Socioeconomic Factors Influencing Delay and Underuse of Cochlear Implants.","authors":"Maryann Zhao, Victoria Huang, Michelle H Zhang, Jack Y Ghannam, Mary M Morcos, Jennifer J Shin, Alicia M Quesnel, Carleton E Corrales, James G Naples","doi":"10.1002/ohn.1250","DOIUrl":"https://doi.org/10.1002/ohn.1250","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare socioeconomic factors associated with underuse and prolonged time to cochlear implant (CI) surgery for qualifying candidates.</p><p><strong>Study design: </strong>Retrospective cohort study of adult patients who were CI candidates from January 1, 2018, to December 31, 2022.</p><p><strong>Setting: </strong>Three tertiary academic centers.</p><p><strong>Methods: </strong>Demographic factors (age, sex, race, zip code, insurance status, preferred language, and marital status) and speech recognition scores in quiet and distance to CI center were collected. Household income quintiles were determined based on zip code matching to US Census data. Main outcomes were decision to pursue CI surgery and time elapsed from initial candidacy to surgery.</p><p><strong>Results: </strong>A total of 382 patients were evaluated for CI candidacy and included in the analysis (191 [50%] women; median age, 70 years; interquartile range [IQR] 58-78). Of these, 306 (80%) underwent cochlear implantation. Multivariable analyses revealed that, among those who qualified, patients with non-English-speaking status (odds ratio [OR] 0.31 [95% CI: 0.13-0.71]), older age (OR 0.97 [95% CI: 0.94-0.99]), male sex (OR 0.40 [95% CI: 0.23-0.72]), and higher speech recognition scores (21%-40%: OR 0.33 [95% CI: 0.15-0.70]; >41%: OR 0.24 [95% CI: 0.076-0.74]) were less likely to receive surgery. Among those who underwent surgery, only non-English-speaking patients experienced significantly longer time to surgery relative to English-speaking patients (hazard ratio [HR] 0.64 [95% CI: 0.43-0.97]).</p><p><strong>Conclusion: </strong>Language is a potential enduring factor impacting both pursuit of and time to CI surgery. Future work should consider target strategies to account for these factors as a way to improve CI access.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008596","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":"Tracheostomy Outcomes in Children With Bronchopulmonary Dysplasia.","authors":"Ada Cleary Sher, Humra Shamim, Jemma Maynard, Jacob Stack, Isaac Kistler, Megan McNutt, Hajera Afreen, Amy Manning, Audrey Miller, Prasanth Pattisapu, Tendy Chiang","doi":"10.1002/ohn.1248","DOIUrl":"https://doi.org/10.1002/ohn.1248","url":null,"abstract":"<p><strong>Objective: </strong>To quantify the tracheostomy-related morbidity and mortality, readmissions, and airway interventions in tracheostomy-dependent children with bronchopulmonary dysplasia (BPD).</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary care children's hospital.</p><p><strong>Methods: </strong>Infants with BPD who received tracheostomy by an otolaryngologist between January 2016 and December 2022 at a single institution were included. Surviving patients were followed to at least 2 years of age. Data were extracted from electronic medical records for patient characteristics, clinical encounters, and surgical visits.</p><p><strong>Results: </strong>There were 76 patients included in this study. The overall mortality was 30.3% (23/76) with one tracheostomy-related death. Tracheostomy occurred at a median 56 weeks postmenstrual age (PMA). Tracheitis was the most common short- and long-term adverse event (within the first postoperative week, 21%; after postoperative day 7, 81%). Other complications observed include stomal granuloma (77%), airway stenosis (69%), and accidental decannulation (38%). The 30-day and 2-year readmission rates were 32% and 61%, of which 61% and 76% were for tracheostomy-related causes, respectively. The most common reason for readmission over these time periods was tracheitis. Overall decannulation rate for surviving patients was 68%, and decannulation occurred at a median 3.1 years of age. Most surviving patients returned for operative airway intervention (85%); 43% required open airway reconstruction.</p><p><strong>Conclusion: </strong>Tracheostomy-related morbidity was low in this cohort despite a majority of patients experiencing multiple tracheostomy-related adverse events and readmissions. Patient comorbid conditions, BPD severity, and socioeconomic status were not significantly associated with outcomes. Larger studies are needed to assess the airway interventions and outcomes in this population.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972580","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":"Structure From Motion Reconstruction of the Pediatric Larynx: A Clinical Case Series.","authors":"Michael C Barbour, Shaunak N Amin, Hannah F Case, Seth D Friedman, Francisco A Perez, Randall A Bly, Kaalan E Johnson, Sanjay R Parikh, Clare M Richardson, John P Dahl, Alberto Aliseda","doi":"10.1002/ohn.1247","DOIUrl":"https://doi.org/10.1002/ohn.1247","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopy is the gold-standard diagnostic modality for many pediatric airway disorders but does not enable quantitative assessment of airway morphology. In a series of pediatric patients, we aim to demonstrate that structure from motion (SfM) photogrammetry, a computer-vision algorithm, can accurately reconstruct three-dimensional (3D) models of laryngeal anatomy directly from bronchoscopy videos.</p><p><strong>Study design: </strong>Prospective case series.</p><p><strong>Setting: </strong>Tertiary academic pediatric hospital.</p><p><strong>Methods: </strong>Pediatric patients undergoing direct laryngoscopy/bronchoscopy and same-day neck and chest computed tomography (CT) as a part of clinical care were recruited. Optical calibration of the imaging system occurred after each bronchoscopy. SfM was used to reconstruct 3D surfaces from bronchoscopy videos. SfM-reconstructed surfaces were compared against CT-derived geometries to determine reconstruction accuracy at glottic and subglottic levels.</p><p><strong>Results: </strong>SfM reconstruction was successfully completed for all four patients. Circular equivalent diameter (D_CE) of cross-sectional area slices measured from SfM-reconstructed airways was highly accurate compared to D_CE measured from the gold-standard CT scans, with root mean squared error of 0.1, 0.375, and 0.225 mm at the glottis, proximal subglottis, and distal subglottis subsites, respectively. This represents average percent errors of 2%, 4%, and 4%, for each site, respectively.</p><p><strong>Conclusion: </strong>We demonstrate the feasibility of reconstructing laryngeal anatomy with high fidelity from SfM photogrammetry in a clinical series of pediatric patients. This reproducible method provides highly accurate anatomic models directly from endoscopy, enabling quantitative assessment without CT scanning and radiation exposure. This approach has the potential to impact many areas of otolaryngology, including virtual surgical planning, simulation, and family counseling.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040866","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":"Impact of Presurgical Second-Touch Visits on Delays in Initiating Adjuvant Radiation Therapy.","authors":"Antonio A Bon-Nieves, Naomi C Wang, Sarah F Wagoner, Rahul Alapati, Maria Feucht, Uma Ramesh, Rohit Nallani, Emma Rea, Colleen Sommer, Amelia S Lawrence, Kevin J Sykes, Kiran Kakarala, Yelizaveta Shnayder, Andrés M Bur, Chelsea S Hamill","doi":"10.1002/ohn.1194","DOIUrl":"https://doi.org/10.1002/ohn.1194","url":null,"abstract":"<p><strong>Objective: </strong>Patients with head and neck squamous cell carcinoma (HNSCC) often encounter delays in starting postoperative radiotherapy (PORT), leading to worse outcomes. We investigated whether attending second-touch visits-appointments after the initial clinic visit and before surgery to address treatment-related questions and follow-up expectations-with an advanced practice provider (APP) is associated with reduced PORT delays.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single tertiary referral center.</p><p><strong>Methods: </strong>Adult patients with HNSCC who underwent free flap surgery and PORT between 2020 and 2022 were included. All patients were offered a second-touch visit. The primary outcome was PORT delay, defined as treatment initiation >42 days after surgery. Clinicodemographic and treatment-related data were collected at baseline and at the last known follow-up.</p><p><strong>Results: </strong>Of the 104 patients included, 57.7% attended a second-touch visit. Attendance was associated with receiving radiotherapy (RT) in an academic setting (65.0% vs 40.9%, P = .015) and fewer PORT delays (56.7% vs 79.5%, P = .015). Multivariable analysis revealed a 70% reduction in odds of PORT delay for those attending second-touch visits (adjusted odds ratio [aOR] = 0.298, 95% CI 0.103-0.866, P = .026). PORT delay was more likely in patients with RT in a community setting (aOR = 3.783, 95% CI 1.284-11.146, P = .016), wound complications (aOR = 5.149, 95% CI 1.363-19.460, P = .016), and a higher comorbidity index (aOR = 1.407, 95% CI 1.012-1.957, P = .042).</p><p><strong>Conclusion: </strong>Attendance of a second-touch visit and RT at a tertiary medical center significantly reduced the likelihood of PORT delay. These findings underscore the importance of APP-driven patient navigation in improving timely care and outcomes for patients with HNSCC.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027585","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":"Temporal and Geographic Trends in HPV Testing for Oropharyngeal Cancer in the United States.","authors":"Andrea Costantino, J Scott Magnuson, Evan M Graboyes, Uthman Alamoudi, Bruce H Haughey","doi":"10.1002/ohn.1259","DOIUrl":"https://doi.org/10.1002/ohn.1259","url":null,"abstract":"<p><strong>Objective: </strong>Although human papillomavirus (HPV) testing is fundamental to staging, accurate prognosis, patient management, and clinical trial eligibility in oropharyngeal squamous cell carcinoma (OPSCC), national testing patterns remain unclear. This study investigates temporal and geographic trends in HPV DNA-RNA and/or p16 immunohistochemistry testing for OPSCC in the United States.</p><p><strong>Study design: </strong>Retrospective cohort study including patients with OPSCC between 2010 and 2021.</p><p><strong>Setting: </strong>National Cancer Database (NCDB).</p><p><strong>Methods: </strong>Logistic regression analyses were performed to characterize the association of temporal, demographic, and clinical factors with HPV testing rates.</p><p><strong>Results: </strong>Among the 146,176 patients with OPSCC and known HPV testing included in the study, the overall HPV testing rate was 88.4% (N = 129,240/146,176). Testing for HPV mediation significantly increased during the study period from 56.0% to 93.6% (adjusted odds ratio [OR]: 1.23, 95% CI: 1.22-1.24, P < .001). Significant differences were measured between geographic regions within the United States (range: 85.6%-91.2%; P < .001). Additionally, demographic, socioeconomic, and hospital-related factors were significantly associated with variations in testing rates.</p><p><strong>Conclusion: </strong>Despite significant disparities across categories, this study highlights a significant increase in HPV testing rates for OPSCC since 2010, indicating an expanded awareness of its importance in the diagnosis and management of OPSCC. Further research is warranted to address geographic and other disparities to optimize testing for refined patient outcomes.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Stigma of Hearing Loss: A Scoping Review of the Literature Across Age and Gender.","authors":"Caroline Liu, Maria M Mavrommatis, Aparna Govindan, Maura K Cosetti","doi":"10.1002/ohn.1246","DOIUrl":"https://doi.org/10.1002/ohn.1246","url":null,"abstract":"<p><strong>Objective: </strong>Stigma is a human construct that guides community standards and opinions, often characterized by negative beliefs about a particular circumstance, quality, or person. This study reviews the literature for stigma related to hearing loss and hearing device use.</p><p><strong>Data sources: </strong>PubMed, Scopus, and Embase.</p><p><strong>Review methods: </strong>Databases were searched from inception to April 28, 2024. Two independent researchers screened articles and performed full-text reviews. Grounded theory was used to identify and analyze positive and negative themes across disparate qualitative data.</p><p><strong>Results: </strong>After screening 1096 abstracts, 45 full-texts and 4 conference abstracts were included including 17 studies in pediatric populations, 19 studies in adults of working age, and 14 studies in older adult populations. In pediatric populations, stigma is primarily tied to bullying and poor classmate perceptions, with school-based supports offering mixed results in minimizing perceived stigma. Among working and older age adults, common positive themes included improved quality of life and self-empowerment among hearing aid (HA) users. All working age studies refer to the role of HAs in creating a visible disability. The pervasive theme among older adults was being perceived as old or senile. Although studies were largely equal in gender representation, differential gender effects of stigma and HA decisions were identified.</p><p><strong>Conclusion: </strong>Hearing loss stigma appears to be pervasive across age and gender with distinctions that have implications for intervention development. Future studies are needed to parse further nuances related to the stigma of hearing loss.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Backscattered Ultrasonographic Imaging of the Tongue and Outcome in Hypoglossal Nerve Stimulation.","authors":"Samuel Tschopp, Vlado Janjic, Yili Lee, Argon Chen, Pei-Yu Chao, Marco Caversaccio, Urs Borner, Kurt Tschopp","doi":"10.1002/ohn.1251","DOIUrl":"https://doi.org/10.1002/ohn.1251","url":null,"abstract":"<p><strong>Objective: </strong>Hypoglossal nerve stimulation (HNS) is an increasingly used therapy. However, not all patients undergoing HNS implantation benefit from the treatment, making an improved patient selection a priority. This study investigates whether backscattered ultrasonographic imaging (BUI) can predict the response to HNS therapy.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Secondary and tertiary hospital.</p><p><strong>Methods: </strong>In this multicenter cross-sectional study, we recruited patients who had undergone HNS implantation during their scheduled follow-up consultation. HNS therapy parameters were collected. Standardized submental ultrasonographic examination and home sleep apnea testing were performed. The primary outcome was assessing the response to HNS therapy using ultrasonographic features and preoperative patient characteristics.</p><p><strong>Results: </strong>In total, 62 participants, 49 male, with a median (interquartile range [IQR]) age of 62 (55-67) and a median (IQR) body mass index of 27.6 (25.2-29.7). The follow-up was a median (IQR) of 19.5 (4.8-41.4) months after implantation. The apnea-hypopnea index (AHI) was preoperatively 40.5 (29.8-58.0) and reduced at follow-up to 21.0 (11.0-35.3). In total, 42% were responders to HNS. Preoperative AHI (34.8/hour vs 49.3/hour, r = 0.44) was significantly higher in nonresponders than in responders. The average prediction accuracy of HNS therapy based on baseline AHI alone was 71%. A lower backscatter signal, indicating less fat deposition in the tissue, was observed in the responder group. When the baseline AHI and backscatter signal were combined, the prediction accuracy of response to the HNS reached 78%.</p><p><strong>Conclusion: </strong>The combination of tissue composition analyzed using the backscattered signal and the preoperative AHI is highly predictive for determining the HNS treatment response.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier NCT06154577.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795896","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}