World Journal of OtorhinolaryngologyHead and Neck Surgery最新文献

{"title":"Medical Malpractice in the Management of Angioedema: A Multidisciplinary Westlaw Analysis.","authors":"Emma De Ravin, Neel R Sangal, Daniel Uralov, Karthik Rajasekaran","doi":"10.1002/wjo2.70119","DOIUrl":"10.1002/wjo2.70119","url":null,"abstract":"<p><strong>Background: </strong>The management of acute angioedema is challenging and involves providers in multiple specialties. Timing of evaluation and intervention is imperative and requires effective communication between these groups, as treatment delays and improper management can lead to airway compromise and death. We aim to identify factors that contribute to malpractice litigation in the management of angioedema.</p><p><strong>Materials and methods: </strong>The Westlaw comprehensive legal database was queried for angioedema malpractice cases from 1993 to 2022. Angioedema misdiagnoses were excluded. Root cause analysis was conducted and cases were classified by defendant specialty, claimed liabilities, complication, verdict, and damage amount awarded.</p><p><strong>Results: </strong>Nine cases of angioedema malpractice were identified and met inclusion criteria. Eight cases (89%) resulted in patient death due to cardiorespiratory compromise secondary to loss of the airway, with one case resulting in long-term brain damage. Root cause analysis revealed 67% of cases involved failure to establish a timely airway, 56% delayed treatment, 33% failure to diagnose, and 33% improper treatment. Forty-five percent of the involved practitioners were emergency physicians; primary care and anesthesia were each implicated in one case. Five (56%) cases ruled in favor of the defense. Average damage amount was $3,794,000. In each case, there was significant delay in the involvement of Otolaryngologists for airway evaluation.</p><p><strong>Conclusions: </strong>Angioedema is a challenging disease for which management requires active monitoring and coordinating of care between several medical teams. This study identifies late involvement of airway experts in patient management and risk stratification as a risk factor for litigation and poor outcomes.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":"465-470"},"PeriodicalIF":1.5,"publicationDate":"2026-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perilymph Gusher in Cochlear Implantation Surgery: An Algorithm for Management.","authors":"Ahmed Abdelmoneim Teaima, Lobna El Fiky, Badr Eldin Mostafa, Mina Fayez Saleeb, Ossama Mustafa Mady","doi":"10.1002/wjo2.70122","DOIUrl":"10.1002/wjo2.70122","url":null,"abstract":"<p><strong>Objective: </strong>Perilymph leak is considered a major complication of cochlear implantation (CI) surgery and can lead to surgical difficulties and postoperative morbidities. This study is aimed to formulate an algorithm for better management of perilymph leak in cases of CI.</p><p><strong>Methods: </strong>This is a retrospective study conducted in our tertiary institute on pediatric patients with perilymph leak during CI surgery from January 2017 to January 2023. Standard facial recess approach and round window cochleostomy were used in all cases. The clinical data, imaging, details of surgery, management of perilymph leak, and outcome were revised.</p><p><strong>Results: </strong>One hundred and fourteen cases of perilymph leak out of 1035 cases of CI surgery (11.1%) were collected. In 108 cases, an oozer was encountered, while in 6 cases a severe gusher occurred. Their ages ranged between 2 and 15 years, with 74 male patients. Our algorithm for control of the leak during surgery included elevation of the head, hyperventilation, mannitol, steroids, and wait until the flow of the gusher decreases. Widening of the cochleostomy, use of an electrode with cork, and muscle packing were also helpful in control of the leak. In severe cases, subtotal petrosectomy was adopted with fat obliteration. All cases were managed properly with our algorithm. Only two cases had persistent leak postoperatively and were managed conservatively without need for revision surgery nor lumbar drain.</p><p><strong>Conclusion: </strong>In CI surgery, proper prediction, diagnosis, and systematic management of perilymph leak including nonsurgical and surgical methods are crucial for better and safe outcomes.</p><p><strong>Level of evidence: </strong>Level III.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating ChatGPT's Reliability in Analyzing Facial Asymmetry: A Comparative Study With Human Evaluators Using Cross Sectional Static Images.","authors":"Ali B Jafar, Malak Motair, Shahah Al Hajeri","doi":"10.1002/wjo2.70124","DOIUrl":"10.1002/wjo2.70124","url":null,"abstract":"<p><strong>Objective: </strong>Facial asymmetry assessment is often subjective and time intensive, thus we aim to evaluate reliability of ChatGPT in analyzing facial asymmetry compared to human raters.</p><p><strong>Methods: </strong>Thirty patients with unilateral facial paralysis who underwent facial reanimation surgery were included in this study. Sixty static 2D frontal images (pre and postoperative) were obtained from our database. Facial asymmetry was assessed using the Sunnybrook resting symmetry scale and a 0-4 global asymmetry rating scale. Two human raters evaluated all images independently. ChatGPT Pro 5.0 accessed from September 2025 to October 2025, was prompted through standardized instructions to evaluate the same set. Agreement was assessed using intraclass correlation coefficient (ICC), Cohen's kappa, the Wilcoxon signed-rank test, and Bland-Altman plots.</p><p><strong>Results: </strong>ChatGPT Pro 5.0 showed no statistically significant difference compared with human raters in preoperative facial assessment (<i>p</i> = 0.701), indicating high reliability in detecting pronounced asymmetry. However, a significant difference emerged in the postoperative assessment (<i>p</i> = 0.0001), where the ChatGPT was less sensitive to subtle facial asymmetry in postoperative stage. Cluster analysis confirmed agreement in high asymmetry cases and divergence in mild cases.</p><p><strong>Conclusion: </strong>ChatGPT reliably assesses pronounced facial asymmetry but is less accurate with subtle facial asymmetry features.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Evaluation of AI Consent Forms in Otolaryngologic Surgery.","authors":"Sholem Hack, Rebecca Attal, Armin Farzad, Lilia Ann Crew, Shmuel Silverstein, Jacob E Karni, Nir Livneh, Shibli Alsleibi, Naseem Saleh, Ben Gvili, David Yogev, Eric Remer, Eran E Alon, Gil Siegal, Masayoshi Takashima, Habib G Zalzal","doi":"10.1002/wjo2.70118","DOIUrl":"10.1002/wjo2.70118","url":null,"abstract":"<p><strong>Introduction: </strong>Surgical consent documents are frequently written at reading levels exceeding average health literacy. Large language models (LLMs) may offer a scalable approach to generating clearer, procedure-specific consent forms. This study evaluated the clarity, clinical accuracy, and acceptability of consent forms generated by GPT-4 and Claude for common otolaryngologic procedures.</p><p><strong>Methods: </strong>Twenty AI-generated consent forms (10 GPT-4.0, 10 Claude-2.1) were produced using standardized prompts. In a survey-based, non-clinical setting, five board-certified otolaryngologists independently rated each form for medical accuracy, readability, comprehensibility, legal/ethical sufficiency, and usability using a 4-point scale. A cross-sectional cohort of 300 English-speaking adults (15 raters per form) evaluated perceived clarity and signing comfort on 5-point Likert scales, and perceived trust using a binary (Yes/No) item, and completed eight binary quality assessments. A blinded subgroup (<i>n</i> = 10) compared AI-generated and official national health system templates across five Likert domains. Readability was assessed using Flesch-Kincaid Grade Level (FKGL).</p><p><strong>Results: </strong>Mean lay ratings for clarity across AI-generated forms were high overall. Claude demonstrated numerically higher scores than GPT-4 for clarity (4.72 vs. 4.68), perceived trust (reported as proportions), and signing comfort (4.40 vs. 4.27). However, when analyzed at the form level, differences between models were not statistically significant for clarity (mean difference 0.04; <i>t</i>(9) = -0.80; <i>p</i> = 0.44) or signing comfort (mean difference 0.13, <i>t</i>(9) = -1.68, <i>p</i> = 0.13). Across binary domains, ≥ 95% of participants affirmed adequate explanation of risks, benefits, and alternatives. Experts rated GPT-4 more accurate than Claude (2.2 vs. 1.5, <i>p</i> = 0.034). Mean Flesch-Kincaid Grade Level was lower for AI-generated forms compared to official templates. Although prompts targeted a 6th-8th grade reading level, achieved readability scores were slightly higher (8.8-9.4).</p><p><strong>Conclusions: </strong>In a non-clinical evaluation, AI-generated consent forms were perceived as clear and clinically complete, with model-specific trade-offs between perceived clarity and clinical detail. These perception-based findings-reflecting participant ratings of clarity, perceived trust, and willingness to sign rather than objective comprehension-are hypothesis-generating, and prospective clinical and legal validation in more representative patient populations is required.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Therapeutic Efficacy of Endoscope-Guided Coblation for Tongue Base Reduction as Part of Multilevel Surgery in Moderate to Severe OSA Patients.","authors":"Minju Kim, Siyeon Jin, Eun Hyun Cho, Dongyoung Kim, Doo Hee Han, Hyun Jik Kim","doi":"10.1002/wjo2.70116","DOIUrl":"10.1002/wjo2.70116","url":null,"abstract":"<p><strong>Objective: </strong>Obstructive sleep apnea (OSA) frequently results from multilevel upper airway obstruction involving the palate, lateral walls, and tongue base. Among various techniques, endoscope-guided coblation for tongue base reduction (TBR) provides precise resection with excellent hemostasis and minimal morbidity. This study aimed to evaluate the therapeutic efficacy and safety of endoscope-guided coblation for TBR as a component of multilevel surgery in patients with moderate to severe OSA.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Setting: </strong>Single-institution academic tertiary medical center.</p><p><strong>Subjects and methods: </strong>The study included 92 OSA patients (85 males and 7 females) with identified tongue base (TB) narrowing in a single tertiary center. Patient demographics, subjective symptoms, polysomnography parameters, drug-induced sleep endoscopy findings, positive airway pressure data, and postoperative complications following endoscopic coblation TBR were retrospectively reviewed.</p><p><strong>Results: </strong>The mean age of the patients was 40.8 ± 12.8 years, and the mean body-mass index was 26.8 ± 4.0 kg/m². The success rate of endoscopic coblation TBR was 56.1% in moderate or severe OSA patients, with 66.7% showing significant improvement in sleep parameters. The preoperative apnea-hypopnea index (AHI) was 47.3 ± 22.2 events/hr, which decreased to 27.8 ± 23.8 events/hr postoperatively at 6 months. Supine AHI, apnea index (AI), and lowest oxygen saturation (SpO₂) were also significantly improved. Sleep efficiency and REM percentage increased substantially. Postoperative complications were minimal, with pain being the most common complaint, which rarely lasted longer than a week.</p><p><strong>Conclusion: </strong>Endoscope-guided coblation TBR, when incorporated into multilevel sleep surgery, significantly improves polysomnographic outcomes, including AHI, oxygen saturation, and sleep efficiency, while maintaining a favorable safety profile. This approach offers a practical, cost-effective, and minimally invasive alternative, broadening access to effective upper airway surgery for OSA patients.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Blood Lipids, Coagulation Indexes, Blood Homocysteine and Sudden Deafness: A Retrospective Study and Mendelian Randomization Analysis.","authors":"Feng-Xin Yang, Yu-Wan Song, Yan Wang, Kun Zhao, Hu-Hui-Fen He, Jing-Jing Qiu, Da-Wei Liu, Bo Li, Yan Sun","doi":"10.1002/wjo2.70107","DOIUrl":"10.1002/wjo2.70107","url":null,"abstract":"<p><strong>Background: </strong>Certain blood components, including blood lipids, coagulation parameters, and homocysteine, have been suggested to correlate with the incidence and prognosis of sudden sensorineural hearing loss (SSNHL). However, the nature of these associations remains controversial.</p><p><strong>Methods: </strong>A retrospective study was conducted between January 2020 and December 2024. A total of 308 patients with SSNHL who received short-term combined therapy and 169 healthy controls were included from our hospital. Initially, baseline clinical indicators were compared between the patient group and the control group. Subsequently, patients were further stratified into four subgroups according to their hearing recovery outcomes for more detailed inter-group comparisons, and the impact of these indicators on SSNHL incidence and prognosis was assessed. To further investigate potential causality, Mendelian randomization (MR) analysis was performed to examine the relationship between genetically predicted blood components and SSNHL.</p><p><strong>Results: </strong>Our retrospective analysis revealed significant differences between the patient and control groups in the following parameters at admission: plasma fibrinogen at admission (PRE-FIB), activated partial thromboplastin time (APTT), thrombin time (TT), prothrombin time (PT), total cholesterol (CHOL), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG). Among the four groups stratified by hearing recovery, differences were observed in admission hearing level (dB), the change in plasma fibrinogen after the first batroxobin injection relative to baseline (DIFF-FIB), and CHOL. MR analysis using the random-effects inverse-variance weighted (IVW) method indicated a significant causal relationship between genetically predicted lipid levels and SSNHL. Additionally, genetically predicted S-adenosylhomocysteine and fibrinogen were identified as potential risk factors for SSNHL.</p><p><strong>Conclusions: </strong>PRE-FIB, APTT, TT, PT, CHOL, HDL-C, LDL-C, and TG may be associated with the onset of SSNHL. Admission hearing level (dB), DIFF-FIB, and CHOL could play a role in predicting hearing recovery after SSNHL. MR analysis provides causal evidence supporting lipids, fibrinogen, and S-adenosylhomocysteine as potential risk factors for SSNHL.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Experimental Study on the Protective Effect of Memantine in Noise-Induced Hearing Loss.","authors":"Begüm Arda, Selis Gülseven Güven, Erdoğan Bulut, Murat Arslan, Özlem Tuğce Çilingir-Kaya, Abdullah Taş, Recep Yağız","doi":"10.1002/wjo2.70108","DOIUrl":"10.1002/wjo2.70108","url":null,"abstract":"<p><strong>Objective: </strong>This study examined the potential protective effects of memantine, an N-methyl-D-aspartate (NMDA) receptor antagonist, against acoustic trauma (AT) in guinea pigs, using electrophysiological and histopathological analyses.</p><p><strong>Methods: </strong>Thirty guinea pigs with normal hearing were divided into six groups (<i>n</i> = 5 per group): Group 1 (control), Group 2 (AT, early), Group 3 (AT, late), Group 4 (AT + steroid), Group 5 (AT + saline), and Group 6 (AT + memantine). AT was induced using 6-10 kHz broadband noise at 115-120 dB for 1.5-2.0 h. Animals received intraperitoneal injections of memantine, steroid, or saline 1.5 h before AT. Measurements were obtained at baseline, 2 h, 7 days, 14 days, and 21 days post-AT. Distortion product otoacoustic emissions (DPOAE) signal-to-noise ratios (SNRs) were measured from 1 to 32 kHz, and auditory brainstem response (ABR) from 8 to 32 kHz. Group 2 animals were euthanized within 2 h after AT; others after the 21-day evaluation. Cochlear histopathology was evaluated postmortem.</p><p><strong>Results: </strong>Baseline ABR thresholds were < 30 dB SPL, and DPOAE SNRs were ≥ 6 dB. Group 6 showed improved DPOAE SNRs at 1.5 and 24 kHz compared to Groups 3 and 5. ABR thresholds in Group 6 were lower than those in Group 3 (16, 24 kHz) and Group 5 (32 kHz). Group 4 showed lower thresholds than Group 3 at 12-24 kHz. Histology revealed milder cochlear damage in Group 6 compared to Groups 2, 3, and 5.</p><p><strong>Conclusion: </strong>Memantine demonstrated protective effects against noise-induced hearing loss. Further studies are needed to clarify its molecular mechanisms.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Induced Sleep Endoscopy in Children Predicts OSA Severity.","authors":"Neemias Santos Carneiro, Antônio Carlos Marão, Renato Battistel Santana, Camila de Castro Corrêa, Silke Anna Theresa Weber","doi":"10.1002/wjo2.70098","DOIUrl":"10.1002/wjo2.70098","url":null,"abstract":"<p><strong>Background: </strong>While adenotonsillectomy (AT) is first line for pediatric obstructive sleep apnea (OSA), treatment failure is common. Drug-induced sleep endoscopy (DISE) provides dynamic airway assessment, but its role in predicting OSA severity requires clarification. This study correlates DISE findings with polysomnographic severity.</p><p><strong>Objective: </strong>To determine the association between DISE-based obstruction patterns and OSA severity in children.</p><p><strong>Methods: </strong>This prospective study included 95 children with adenotonsillar hypertrophy. All underwent preoperative Level III polysomnography followed by DISE before AT. Two blinded otolaryngologists independently reviewed DISE recordings, classifying obstruction via the VOTE system (degree 0-2; pattern: concentric, lateral, or anteroposterior). Statistical analysis employed non-parametric tests, relative risk calculation, and ROC curves.</p><p><strong>Results: </strong>Severe OSA (AHI > 10) was significantly associated with Brodsky grade IV tonsils (40.7% vs. 16.7%) and severe adenoid hypertrophy (44.1% vs. 16.7%). DISE identified severe obstruction at the velopharynx (<i>p</i> = 0.003) and tongue base (<i>p</i> = 0.036) as specific predictors of severe OSA, with high specificities (91% and 97.1%) and positive predictive values (87.7% and 90.9%). Concentric collapse was the most frequent velopharyngeal pattern (54.2%). Obesity was significantly linked to severe tongue base obstruction (38.9% vs. 5.4%, <i>p</i> = 0.001) and higher AHI. ROC analysis for tongue base obstruction combined with the Obstructive Apnea Index (OAI) showed high diagnostic accuracy (AUC = 0.811).</p><p><strong>Discussion and conclusion: </strong>DISE is a valuable tool for predicting pediatric OSA severity. Obstruction at the velopharynx and tongue base, particularly concentric collapse and in the context of obesity, are key risk factors. Integrating DISE findings with PSG enhances preoperative risk stratification, aiding in the selection of candidates who may benefit from personalized, multilevel surgical interventions.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13399433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Cat Sensitization With Comorbid Asthma in Patients With Allergic Rhinitis: A Real-World Study.","authors":"Wei-Hao Wang, Xin Luo, Zhen-Hao Xiao, Hong-Kai Wang, Ya-Na Zhang, Qin-Tai Yang","doi":"10.1002/wjo2.70113","DOIUrl":"10.1002/wjo2.70113","url":null,"abstract":"<p><strong>Background: </strong>The prevalence of allergic rhinitis (AR) and asthma (AS) comorbidity (AR + AS) is increasing and is associated with severe allergic symptoms. The impact of cat dander sensitization on AR + AS remains unclear.</p><p><strong>Methods: </strong>In this retrospective study, 1154 patients with AR alone and 213 patients with AR + AS were enrolled at the Third Affiliated Hospital of Sun Yat-Sen University from January 2021 to February 2024. Allergens in serum were measured using UniCAP system. Multivariate logistic regression was performed to assess risk factors of AR + AS.</p><p><strong>Results: </strong>Although family history of AR and AS, VAS (> 3), polysensitization, cat ownership, cat sIgE level, and age < 18 were associated with AR + AS, cat dander sensitization remained the prominent factor (OR = 3.743, <i>p</i> < 0.001). The positive rate of cat dander was higher in AR + AS group than AR alone group (25.4% vs. 10.5%, <i>p</i> < 0.001). The prevalence of AR + AS was the highest in the HDM+Cat+ group (33.8%). Moreover, the prevalence of cat-sensitized AR + AS increased from 14.3% to 37.3% with elevated HDM sIgE levels. Co-sensitization of HDM and cat dander (OR = 3.244, <i>p</i> = 0.036) and the cat ownership among cat-sensitized patients (OR = 5.531, <i>p</i> < 0.001) were associated with AR + AS. However, in children, cat sensitization without ownership was associated with AR + AS, whereas this was not observed in adults.</p><p><strong>Conclusions: </strong>Cat sensitization is associated with AR + AS. Co-sensitization to HDM and cat dander and cat ownership further increase the prevalence of AR + AS among the cat-sensitized patients. Early detection of cat dander component sensitization may help identify at-risk individuals and optimize management of AR + AS.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Correlation Between Surgical Depth and Postoperative Voice Rest Duration in a Rabbit Phonomicrosurgery Model.","authors":"Lin-Lin Lan, Qiu-Rong Yang, Pei-Yun Zhuang","doi":"10.1002/wjo2.70106","DOIUrl":"10.1002/wjo2.70106","url":null,"abstract":"<p><strong>Objective: </strong>The optimal duration of voice rest after phonomicrosurgery remains a subject of debate, as clinical studies on its effect on vocal fold wound healing have yielded conflicting results, and a controlled animal model for investigating voice rest is currently unavailable. This study aimed to determine the optimal postoperative voice rest duration using a controlled rabbit model.</p><p><strong>Methods: </strong>Building on our established rabbit model for graded voice rest, we created two distinct phonomicrosurgery injury models: one involving the superficial lamina propria (SLP) and another extending to the mid-deep lamina propria (MDLP). The effects of different voice rest durations on wound healing were systematically evaluated through ex vivo laryngeal phonatory vibration experiments, histopathological examinations (hematoxylin-eosin, Alcian Blue, and Elastica van Gieson staining), and Gray Level Co-occurrence Matrix texture analysis.</p><p><strong>Results: </strong>The optimal voice rest duration was dependent on surgical depth. In the SLP surgery model, a 1-day voice rest period resulted in the most favorable outcomes, characterized by superior voice quality and histological organization. In contrast, for the MDLP surgery model, a 3-day voice rest duration promoted optimal wound healing, yielding better vocal function, improved vibration, and reduced tissue fibrosis.</p><p><strong>Conclusion: </strong>Voice rest requirements differ based on surgical depth.</p>","PeriodicalId":32097,"journal":{"name":"World Journal of OtorhinolaryngologyHead and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":1.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}