Otolaryngology- Head and Neck Surgery最新文献

{"title":"Eye Tracking to Determine Noticeability of Pediatric Facial Scar Characteristics to Adult Observers.","authors":"Lydia Weykamp, Scott Lunos, Bridget Ebert, Brianne Barnett Roby, Sivakumar Chinnadurai","doi":"10.1002/ohn.1134","DOIUrl":"10.1002/ohn.1134","url":null,"abstract":"<p><strong>Objective: </strong>Determine objectively noticeable features of pediatric facial scars using eye-tracking software and explore how skin tone impacts scar perception.</p><p><strong>Study design: </strong>Cross-sectional analysis.</p><p><strong>Setting: </strong>Tertiary care pediatric hospital.</p><p><strong>Methods: </strong>Ninety-seven naïve adult participants viewed 12 randomized photos using an eye-tracking device. Photos of 4 children with different Fitzpatrick (FP) tones were used to digitally create 3 images each: a scarless control, a hypertrophic scar, and a dyspigmented scar. Scar size and location were consistent. Gaze metrics were compared between skin tones and scar types.</p><p><strong>Results: </strong>Hypertrophic and dyspigmented scars had greater total fixation duration and fixation count than controls across all skin tones (P < .01). The dyspigmented scar of the FP2 child had greater total fixation duration (P = .01) and fixation count (P = .04) than the hypertrophic scar. The dyspigmented scar of the FP2 child had greater total fixation duration and fixation count than the dyspigmented scars of the FP6 and FP4 children (P < .01). The hypertrophic scar of the FP1 child had a longer total fixation duration than the hypertrophic scar of the FP6 child (P = .04). There were lower times to first fixation for both hypertrophic and dyspigmented scars in the FP1, FP4, and FP6 children (P < .04), and the dyspigmented scar in the FP2 child (P = .049).</p><p><strong>Conclusion: </strong>Dyspigmented and hyperpigmented scars were viewed differently on children's faces with various skin tones. This highlights the importance of evaluating and accounting for both scar type and skin tone when counseling patients and families who experience facial scarring.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1748-1755"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143009252","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":"Nasal Corticosteroid Delivery Methods in Chronic Rhinosinusitis With Polyps: A Systematic Review.","authors":"Robert E Gurevich, Ajibola B Bakare, Dylan A Levy, Edward D McCoul","doi":"10.1002/ohn.1147","DOIUrl":"10.1002/ohn.1147","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review evaluates and compares the efficacy and safety of different intranasal corticosteroid delivery methods for treating chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Data sources: </strong>Embase, Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Web of Science were systematically searched from January 1, 1980 to January 9, 2024.</p><p><strong>Review methods: </strong>Two independent reviewers searched 4 databases for English-language, prospective randomized controlled trials (RCT), comparing different delivery methods of corticosteroids for the treatment of CRSwNP. Studies were excluded for specific reasons (wrong comparisons, wrong intervention, wrong patient population, and wrong route of administration).</p><p><strong>Results: </strong>The data search identified 2282 studies. After removing duplicates, 1503 studies were screened by title and abstract, with 1479 excluded for not meeting criteria. Eighteen full-text articles were assessed for eligibility, and 5 RCTs were included in the review. Both short- and long-term treatments with nebulizer, aerosol spray, and nasal drop methods demonstrated similar efficacy to oral corticosteroids (OCS) but with a better safety profile. Long-term use of aqueous sprays showed clinical improvement but was less effective than other non-aqueous delivery methods.</p><p><strong>Conclusion: </strong>Non-aqueous delivery methods, including nebulizers, aerosol sprays, and nasal drops offer a safe alternative to OCS without systemic side effects. Patients using aqueous formulations should be advised on the importance of long-term adherence to achieve symptom improvement.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1502-1511"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080701","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":"Microvascular Coupling in Venous Anastomoses for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis.","authors":"Andrea Costantino, Daniel Uralov, Bianca Maria Festa, Gian Marco Pace, Uthman Alamoudi, Bruce Haughey, Giannicola Iannella, Antonio Greco, J Scott Magnuson, Armando De Virgilio","doi":"10.1002/ohn.1167","DOIUrl":"10.1002/ohn.1167","url":null,"abstract":"<p><strong>Objective: </strong>We conducted a systematic review and meta-analysis to compare venous couplers and hand-sewn techniques for venous anastomosis in head and neck reconstruction.</p><p><strong>Data sources: </strong>PubMed/MEDLINE and Scopus, databases were searched for relevant publications. Additionally, a manual search was performed in Google Scholar and through reference lists.</p><p><strong>Review methods: </strong>Retrospective and prospective cohort studies were included. Odds ratios (ORs) and mean differences (MD) were calculated with their 95% confidence intervals (CIs) for each study comparing the 2 groups (coupler vs hand). The inverse variance method was used to combine the effect sizes from the individual studies.</p><p><strong>Results: </strong>A total of 14,053 patients undergoing 14,270 head and neck free flap reconstructions were included from 52 studies. A total of 6080 flaps were performed using a coupling device for the venous anastomoses, while 8190 flaps were performed with the hand-sewn technique. No significant difference was found for the venous thrombosis rate (OR: 1.06, 95% CI: 0.65-1.72), and reoperation rate (OR: 0.93, 95% CI: 0.51-1.70), but a significantly lower failure rate was measured for the coupler group (OR = 0.34, 95% CI: 0.20-0.58). A nonsignificant lower operative time was found for venous anastomoses (MD: -20.5, 95% CI: -51.7 to 10.7) and total surgery (MD: -23.7, 95% CI: -344.3 to 296.8) for the coupler group.</p><p><strong>Conclusion: </strong>Despite the slight advantages observed with venous couplers, the overall outcomes of both techniques are excellent, and the choice of anastomotic technique should be guided by surgeon preference.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1548-1559"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468682","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":"Representation of Women Authors in the 100 Most-Cited Facial Plastic and Reconstructive Surgery Articles.","authors":"Lindsay Fleischer, Yoo Jin Ahn, Matthew J Urban, Peter C Revenaugh, Ryan M Smith, Michael Eggerstedt","doi":"10.1002/ohn.1177","DOIUrl":"10.1002/ohn.1177","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to determine the representation of women among most-cited facial plastic and reconstructive surgery articles.</p><p><strong>Study design: </strong>A bibliometric analysis of the most-cited articles from 9 high-impact facial plastic surgery journals.</p><p><strong>Setting: </strong>Online database.</p><p><strong>Methods: </strong>A retrospective analysis of the 100 most-cited articles in facial plastic surgery was conducted using the Elsevier Scopus database. The representation of women among first, senior, and corresponding authors was assessed using the US Social Security Baby Names Database. Accredited websites were utilized for further clarification of gender, professional background, and title. A 2-tailed t-test was performed to compare the average number of citations by gender, while chi-square analysis was used to compare the relative number of women authors between 5-year intervals, citation rank, and nationalities. A significance level of 0.05 was used.</p><p><strong>Results: </strong>The top 100 most-cited articles had the highest total number of citations between 2000 and 2004. US institutions published 71% of these articles. The gender of 99% of first authors, 94% of senior authors, and 94% of corresponding authors was identified. Among these, 11% of first authors, 14% of senior authors, and 10% of corresponding authors were women. Of the 19 women authors, 11 were physicians. No statistically significant difference in the relative number of first, senior, and corresponding women authors was observed between years of publication, citation quartile, and article nationality.</p><p><strong>Conclusion: </strong>Despite increasing women facial plastic surgery trainees, women's academic contributions continue to trail. Additional efforts are needed to support and highlight academic achievements of women facial plastic surgeons.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1594-1600"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493178","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 Impact of Lovenox Prophylaxis and Other Anticoagulants on Microvascular Free Flap Outcomes.","authors":"Kavita Bhatnagar, Hannah Smith, Farshid Taghizadeh, Gavin Young, Skylar Trott, Daniel Clayburgh, Sara Yang, Mark K Wax","doi":"10.1002/ohn.1160","DOIUrl":"10.1002/ohn.1160","url":null,"abstract":"<p><strong>Objective: </strong>Microvascular free flap reconstruction for head and neck defects carries a 95% success rate. When flap compromise occurs, it is often due to vascular occlusion. This study seeks to determine what impact lovenox prophylaxis has on flap outcomes and postoperative complications.</p><p><strong>Study design: </strong>A retrospective review.</p><p><strong>Setting: </strong>A single tertiary institution.</p><p><strong>Methods: </strong>A total of 1100 patients underwent microvascular free flap reconstruction from January 2010 to May 2019. The use of lovenox prophylaxis began in 2013, and by 2015, it was routinely used. Flap outcome and postoperative complications were compared between those who received postoperative lovenox prophylaxis and those who did not, using a chi-squared analysis. Outcomes among patients on therapeutic heparin and other oral anticoagulants were similarly examined.</p><p><strong>Results: </strong>There was no difference between those with (n = 716) or without chemoprophylaxis (n = 384) in rates of flap compromise (11.46% vs 12.71%), salvage (43.19% vs 52.71%), and overall failure (6.51% vs 6.01%) (P = .45). Rates of arterial insufficiency (8.07% vs 7.82%, P = .89) and venous congestion (3.39% vs 5.73%, P= .09) were equivalent. Arterial insufficiency (23.85%, P = .0002) was highest among the therapeutic heparin group. The rate of hematoma was significantly different between those without chemoprophylaxis (2.08%), and those on lovenox (3.77%), heparin (10.55%), and other anticoagulants (14.55%) (P = 4 × 10^-8).</p><p><strong>Conclusions: </strong>Lovenox prophylaxis does not appear to impact overall flap survival but does confer a small increase in hematoma risk. There were higher rates of complications among patients on therapeutic heparin. Patients who require anticoagulation for other medical comorbidities are nearly 4 times as likely to develop hematomas and should be counseled accordingly.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1579-1584"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383054","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":"Hearing Loss and Negative Social Experiences in the All of Us Research Program.","authors":"Angela Renne, Jenny X Chen","doi":"10.1002/ohn.1176","DOIUrl":"10.1002/ohn.1176","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess the impact of demographic characteristics on negative social experiences for individuals with bilateral hearing loss.</p><p><strong>Study design: </strong>A 1:1 matched case-control study.</p><p><strong>Setting: </strong>Participants with and without bilateral hearing loss in the All of Us Research Program database.</p><p><strong>Methods: </strong>Multivariable logistic ordinal regression, controlling for various demographic and health factors, examined the association between hearing loss and self-reports of isolation, discrimination, stress, and poor health care experiences.</p><p><strong>Results: </strong>A total of 9050 participants had bilateral hearing loss. Compared to matched controls, those with hearing loss had greater odds of reporting isolation (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.09-1.21, P < .001), discrimination (OR 1.13, 95% CI 1.07-1.19, P < .001), and stress (OR 1.32, 95% CI 1.25-1.40, P < .001) but not health care experiences. Younger (18-39) and middle-aged adults (40-64) reported higher isolation (OR 2.77, 95% CI 2.41-3.24, P < .001 [18-39]; OR 1.97, 95% CI 1.82-2.15, P < .001 [40-64]), discrimination (OR 4.49, 95% CI 3.51-5.73, P < .001 [18-39]; OR 2.71, 95% CI 2.45-3.00, P < .001 [40-64]), and stress (OR 6.67, 95% CI 5.22-8.53, P < .001 [18-39]; OR 2.38, 95% CI 2.14-2.64, P < .001 [40-64]) compared to those older than 65. Females with hearing loss reported more isolation (OR 1.14, 95% CI 1.05-1.23, P < .01), discrimination (OR 1.50, 95% CI 1.38-1.63, P < .001), and stress (OR 1.86, 95% CI 1.73-1.99, P < .001). Severe hearing loss was associated with worse outcomes. Hearing aids were not protective against negative social experiences.</p><p><strong>Conclusion: </strong>Certain demographic factors were associated with negative social experiences in individuals with bilateral hearing loss. Future interventions should account for these differences.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1640-1648"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493233","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":"Flexed-Neck Flexible Nasolaryngoscopy for Evaluation of the Subglottis and Trachea in Children.","authors":"Jennifer M Siu, Nikolaus E Wolter, Meghan E Tepsich, Alexander M Treble, Samantha Goh, Alex J Osborn, Evan J Propst","doi":"10.1002/ohn.1132","DOIUrl":"10.1002/ohn.1132","url":null,"abstract":"<p><strong>Objective: </strong>Determine if a flexed-neck posture during flexible nasolaryngoscopy (FNL) improves visualization of the subglottis.</p><p><strong>Study design: </strong>Retrospective review of children undergoing FNL in the neutral (FNL) and flexed-neck (FN-FNL) positions.</p><p><strong>Setting: </strong>Tertiary children's hospital.</p><p><strong>Methods: </strong>FNL was performed with each child's head in neutral and flexed-neck positions. Videos in each posture were captured and randomized. The most distal view of the subglottis in each position was evaluated with 4 rating scales: (1) subjective view (SV); of the subglottis and trachea, (2) airway grade (AG); most distal anatomical structure visualized, (3) airway area (AA); percentage of the subglottis visualized; and (4) modified Cormack-Lehane grade.</p><p><strong>Results: </strong>Twenty children had 80 FNL views blindly evaluated by 5 pediatric otolaryngologists. The SV, AG, and AA were all significantly better with the neck flexed compared to a neutral position (7.3 vs 3.0, interquartile range [IQR]: 2.0-6.8, P < .001; 2.3 vs 1.5, IQR: 1.0-2.0, P < .001; 3.4 vs 1.7, IQR: 2.3-3.8, P = .001). There was no difference in the modified Cormack-Lehane grade between positions. Interrater reliability was excellent or strong (0.93-0.94, confidence interval: 0.91-0.93).</p><p><strong>Conclusion: </strong>FN-FNL is a simple maneuver performed in children undergoing FNL that partially improves the subjective visualization of the subglottis.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1735-1740"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142952695","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 Video Ocular Counter-Roll Test: Validation for Vestibular Dysfunction Diagnosis in Clinical Practice.","authors":"Idit Tessler, Amit Wolfovitz, Nir Abraham Gecel, Tomer Hazan, Nir Livneh, Shibli Alsleibi, Yoav Gimmon","doi":"10.1002/ohn.1164","DOIUrl":"10.1002/ohn.1164","url":null,"abstract":"<p><strong>Objective: </strong>The video ocular counter-roll (vOCR) test is a novel method that uses video-oculography (VOG) goggles to detect vestibular dysfunction, potentially offering a simpler alternative to current vestibular function tests. In this study, we aim to compare the vOCR test with the caloric test for diagnosing vestibular dysfunction and to assess its clinical applicability.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>A tertiary academic referral center.</p><p><strong>Methods: </strong>This retrospective study included all patients who underwent both vOCR and caloric tests during the same visit between 2021 and 2023. The patients were divided into 3 groups based upon caloric response: unilateral vestibular hypofunction (UVH), bilateral vestibular hypofunction (BVH), and normal. The vOCR test was performed with a 30° head tilt to both sides. Sensitivity, specificity, and area under the curve (AUC) were calculated for vOCR performance. The 2-step approach employed for utilizing the vOCR test included the average vOCR measurement for diagnosing BVH followed by the vOCR asymmetry ratio (AR) to UVH.</p><p><strong>Results: </strong>In total, 134 patients were included in the study, with 14 (10.5%) diagnosed with bilateral vestibular hypofunction (BVH), 44 (32.8%) with unilateral vestibular hypofunction (UVH), and 76 (56.7%) exhibiting normal vestibular function based on caloric testing. A vOCR cutoff value of 3.2° demonstrated sensitivity and specificity of 92.5% and 85.7%, respectively, for detecting BVH (AUC 95.1%, P < .001). An AR of 0.12 showed sensitivity and specificity of 97.7% and 63.2%, respectively, for detecting UVH (AUC 79.2%, P < .001). vOCR measurements differed significantly across all 3 groups (P < .001). In the UVH group, the vOCR angles were consistently smaller on the hypofunction side, suggesting laterality.</p><p><strong>Conclusion: </strong>vOCR diagnoses vestibular dysfunction with high sensitivity and specificity compared to the caloric test. Incorporating vOCR into the vestibular testing battery could enhance diagnostic efficiency and patient comfort.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1703-1710"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399608","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":"Mapping the Mentorship Landscape in Otolaryngology-Head and Neck Surgery Training Programs: A Cross-Canadian Survey.","authors":"Tanya Chen, Jennifer A Silver, Hadi Seikaly, Lily H P Nguyen, Yvonne Chan","doi":"10.1002/ohn.1166","DOIUrl":"10.1002/ohn.1166","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to explore the current landscape of mentorship within Canadian Otolaryngology-Head and Neck Surgery (OHNS) programs by investigating the experiences and perspectives of OHNS trainees and program directors (PDs).</p><p><strong>Study design: </strong>A cross-sectional survey study.</p><p><strong>Methods: </strong>Anonymized online questionnaires were sent to all residents and PDs of the 13 accredited OHNS residency programs across Canada. The questionnaires collected qualitative and quantitative information about the type of mentorship (formal vs informal) programs implemented, as well as individuals' experiences and opinions on mentorship.</p><p><strong>Results: </strong>Of residents, 57.1% (92/161) completed the survey, whereas 84.6% (11/13) of PDs completed the survey. Of residents, 45.7% (42/92) participated in formal mentorship programs and 72.8% (67/92) participated in informal mentorship programs. The PDs perceived the importance of formal mentorship at 3.0/5. Residents reported greater satisfaction with informal mentorship relationships compared to formal mentorship (4.4/5 vs 3.7/5, P < .01) due to a more organic initiation of relationship and a better personality match. The main areas for improvement of current mentorship programs included the availability of mentors, networking opportunities, and protected time for encounters.</p><p><strong>Conclusion: </strong>Surgical residents found informal mentorship to be more beneficial than formal mentorship. However, residency programs should provide more guidance and structure to optimize hybrid mentorship opportunities and mentor selection/availability. Mentorship training or development resources for attending physicians and feedback opportunities are essential for efficient relationships.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1617-1624"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493173","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":"Return to Vocal Performance After Vocal Fold Hemorrhage.","authors":"Christine M Clark, Yeo Eun Kim, Rachel Coleman, Paul J Christos, Lucian Sulica","doi":"10.1002/ohn.1181","DOIUrl":"10.1002/ohn.1181","url":null,"abstract":"<p><strong>Objective: </strong>Although vocal fold hemorrhage (VFH) is a common injury among vocal performers, no evidence exists to guide safe return to performance (RTP). This study assesses VFH recurrence following RTP.</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Academic institution.</p><p><strong>Methods: </strong>Adult vocal performers with clearly documented dates of VFH and of RTP were retrospectively studied. Clinicodemographics, interventions, and recurrence of VFH within 30 days of RTP were noted. Cohorts with and without recurrence were compared.</p><p><strong>Results: </strong>Thirty-two patients (median age: 36 years, 49% female, 76% musical theater performers) with 33 unique occurrences of VFH were included. Most hemorrhages (31; 94%) were unilateral. Twelve patients (36%) had varices, all of which were ipsilateral to the hemorrhage. Overall, median time from initial VFH to RTP was 12.0 days (range 3-29). Two patients (6%) had a recurrence within 30 days of RTP. Median time to RTP was 10 days for those with recurrence and 12 days for those without recurrence (P = .6398). There were no differences in age (37 vs 34 years; P = .8206), sex (0 vs 16 [49%] female; P = .4848), extent of hemorrhage (P = .1728), or presence of associated varices (1 [50%] vs 11 [35.5%]; P > .9999) between groups.</p><p><strong>Conclusion: </strong>Rate of VFH recurrence following RTP at a median of 12 days after initial injury was 6%, regardless of age, sex, hemorrhage extent, or associated varices. Although the interval between VFH and RTP was shorter in patients with recurrence, this was not statistically significant. These findings guide counseling and set expectations among vocal performers faced with VFH.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1676-1681"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143516534","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}