Laryngoscope Investigative Otolaryngology最新文献

{"title":"Context-Dependent <i>TP53</i> Mutation Gain-of-Function Is Correlated With Its Contribution to Genomic Instability.","authors":"Noriaki Tanaka, Jaafar A Hadi, Mei Zhao, Lin Tang, Qi Wang, Jing Wang, Jeffrey N Myers, Ge Zhou","doi":"10.1002/lio2.70562","DOIUrl":"10.1002/lio2.70562","url":null,"abstract":"<p><strong>Objectives: </strong>Mutant p53 (mutp53) proteins can exhibit oncogenic gain-of-function (GOF) activities that promote tumor progression; however, the mechanisms underlying context-dependent mutp53 GOF remain poorly understood. We investigated the functional interactions between <i>TP53</i> mutations and PI3K activation and examined the role of genomic instability in mediating mutp53 GOF in head and neck squamous cell carcinoma (HNSCC).</p><p><strong>Methods: </strong>Isogenic UM-SCC-1 HNSCC cell lines expressing mutp53 R175H or G245D, alone or in combination with constitutively active PIK3CA H1047R, were generated. Functional assays were performed to assess invasive growth in vitro and metastatic potential in vivo. Optical genome mapping was used to characterize genomic alterations across the engineered cell lines.</p><p><strong>Results: </strong>PI3K activation (PIK3CA H1047R) alone increased primary tumor growth in vivo but did not promote invasive growth in vitro or metastasis in vivo, whereas mutp53 G245D, but not mutp53 R175H, promoted invasive growth in vitro and metastasis in vivo in addition to enhancing primary tumor growth, indicating that primary tumor growth and invasion/metastasis are separable, context-dependent GOF phenotypes in this model. Genomic analyses revealed distinct patterns of alteration among the engineered models: mutp53 R175H and PI3K activation primarily induced chromosomal number variations, whereas mutp53 G245D drove qualitative genomic alterations, including chromosomal insertions, deletions, and translocations. These qualitative genomic changes strongly correlated with the observed GOF phenotypes.</p><p><strong>Conclusion: </strong>In this isogenic UM-SCC-1 HNSCC model, mutp53 GOF was highly context-dependent, varying between the two p53 mutations examined (R175H vs. G245D), and was linked to distinct patterns of genomic instability. In particular, mutp53 G245D-associated qualitative genomic alterations may underlie its oncogenic activity, suggesting that mutp53-driven genomic instability may represent one mechanism associated with context-dependent GOF phenotypes.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70562"},"PeriodicalIF":1.9,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13669820/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extratemporal Facial Nerve: Surgical Landmarks, Risk Zones, and a Practical Framework for Safe Dissection.","authors":"Emmanouil Sagkriotis, Kostis Gyftopoulos, Anastasios Goulioumis","doi":"10.1002/lio2.70544","DOIUrl":"10.1002/lio2.70544","url":null,"abstract":"<p><strong>Purpose: </strong>To provide a clinically relevant synthesis of the extratemporal facial nerve, focusing on anatomical variability, surgical landmarks, and regions at risk of injury.</p><p><strong>Method: </strong>A narrative review of the literature was performed, examining the extratemporal facial nerve across the parotid, midface, jawline, perioral, temporal, periorbital, and frontal regions. Emphasis was placed on branching patterns, depth relative to fascial planes, and surgically relevant anatomical relationships.</p><p><strong>Findings: </strong>The extratemporal facial nerve demonstrates considerable variability in course and branching. Regions where the nerve follows a superficial or less predictable trajectory represent areas of increased surgical risk. In contrast, consistent fascial planes and defined anatomical spaces may provide relatively safer corridors for dissection.</p><p><strong>Conclusion: </strong>A region-based, plane-oriented understanding of facial nerve anatomy reflects intraoperative conditions more closely than landmark-based descriptions alone. This approach may improve surgical orientation and reduce the risk of iatrogenic injury, particularly in procedures involving the parotid and midface.</p><p><strong>Level of evidence: </strong>Level 5 (Narrative Review).</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70544"},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posturographic Assessment of Sway Misperception Accurately Identifies Persistent Postural-Perceptual Dizziness in Neurotologic Patients.","authors":"Yukihide Maeda, Hiroe Kudo, Takumi Yamaguchi, Han Matsuda, Tomoyasu Kitahara, Masafumi Sawada, Tetsuo Ikezono","doi":"10.1002/lio2.70591","DOIUrl":"10.1002/lio2.70591","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether a posturographic assessment of sway misperception (PASM) discriminates persistent postural-perceptual dizziness (PPPD) from peripheral balance disorders.</p><p><strong>Methods: </strong>We retrospectively reviewed adults (≥ 18 years) evaluated at Saitama Medical University Hospital between September 2024 and April 2025 with PPPD (Bárány Society diagnostic criteria) or peripheral balance disorders who underwent PASM; central/psychogenic disorders were excluded. On a stabilometer, postural sway area (PSA) and velocity of path length (VPL) were recorded during eyes-closed standing. Then, with eyes open, patients completed a \"reproduction\" trial: they were asked to intentionally recreate the instability they had just perceived by deliberately swaying to match the subjective magnitude, rather than standing still. Reproduction rates (RRs) were calculated as eyes-open reproduced/eyes-closed recorded values for PSA and VPL. Groups were compared with Mann-Whitney <i>U</i> tests, and ROC analyses estimated AUCs and cutoffs.</p><p><strong>Results: </strong>Nineteen PPPD patients (11 women; 50.2 (16.4) years, mean (SD)) and 20 peripheral cases (10 women; 53.8 (13.3) years) were analyzed. Eyes-closed PSA and VPL were similar (<i>p</i> > 0.05), but PSA RR (4.0 (1.5) vs. 1.7 (0.7)) and VPL RR (1.6 (0.5) vs. 1.1 (0.4)) were higher in PPPD (<i>p</i> < 0.001 and <i>p</i> = 0.001, respectively). PSA RR discriminated PPPD with an AUC of 0.94 (95% CI, 0.87-1.00); cutoff ≥ 1.89 yielded sensitivity 1.00 and specificity 0.75. VPL RR showed an AUC of 0.81 (95% CI, 0.67-0.95); cutoff ≥ 1.55 yielded sensitivity 0.63 and specificity 0.90.</p><p><strong>Conclusions: </strong>PASM quantifies exaggerated perceived sway in PPPD. An intentional sway-reproduction task, particularly PSA RR, may provide a practical objective biomarker for diagnosis of PPPD.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70591"},"PeriodicalIF":1.9,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Eosinophil Count and Lund-Mackay Ethmoid Score as Predictors of Recurrence After Endoscopic Sinus Surgery in CRSwNP.","authors":"Zikang Xiao, Ru Gao, Yu Chen, Tiansheng Wang","doi":"10.1002/lio2.70594","DOIUrl":"https://doi.org/10.1002/lio2.70594","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the incremental prognostic value of blood eosinophil count (BEC) and Lund-Mackay (LM) ethmoid score beyond age and asthma for recurrence after endoscopic sinus surgery (ESS) in adults with chronic rhinosinusitis with nasal polyps (CRSwNP).</p><p><strong>Methods: </strong>This retrospective cohort included adults with CRSwNP undergoing ESS from January 2022 to November 2024. The outcome was endoscopically confirmed recurrence. Cox models included age and asthma, then added BEC and LM ethmoid score. Performance was evaluated at 36 months and internally validated using 1000 bootstrap resamples.</p><p><strong>Results: </strong>Among 157 patients, 51 (32.5%) experienced recurrence; 36-month recurrence-free survival was 72.5% (95% confidence interval [CI], 64.7%-78.9%). Earlier recurrence was associated with age (adjusted hazard ratio [HR] per 10 years, 1.26; 95% CI, 1.03-1.53), asthma (HR, 2.00; 95% CI, 1.03-3.90), BEC (HR per 0.1 × 10⁹/L, 1.23; 95% CI, 1.12-1.36), and LM ethmoid score (HR per point, 1.29; 95% CI, 1.13-1.47). Adding BEC and LM ethmoid score reduced the Akaike information criterion from 476.3 to 458.6 and 446.1. Apparent and optimism-corrected 36-month area under the curve values were 0.818 (bootstrap 95% interval, 0.747-0.896) and 0.804; corrected C-index and Brier score were 0.756 and 0.154.</p><p><strong>Conclusion: </strong>BEC and LM ethmoid score provided complementary information beyond age and asthma. External validation and recalibration are required before clinical use.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70594"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13656787/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low Serum Albumin, Body Mass Index, and Feeding Route Predict Treatment Interruptions During Concurrent Chemoradiotherapy in Head and Neck Cancer: A Retrospective Cohort Study.","authors":"Kitti Jantharapattana, Nattarin Nilrat","doi":"10.1002/lio2.70595","DOIUrl":"https://doi.org/10.1002/lio2.70595","url":null,"abstract":"<p><strong>Objective: </strong>To identify nutrition-related predictors of treatment interruption during concurrent chemoradiotherapy (CCRT), the primary outcome and to determine the secondary impact of interruption on 5-year overall survival (OS).</p><p><strong>Methods: </strong>This retrospective cohort study analyzed 440 head and neck cancer (HNC) patients receiving definitive CCRT (January 2013 to December 2016) at a tertiary academic center. Treatment interruption was defined as radiotherapy total treatment time > 56 days or cumulative delay > 7 days, and as chemotherapy delay > 7 days or premature discontinuation. Multivariable logistic regression identified independent predictors; Kaplan-Meier analysis compared 5-year OS by interruption status and tumor site.</p><p><strong>Results: </strong>Among 440 patients (mean age 55 years; 81.7% male), 52.3% experienced chemotherapy interruptions and 14.4% radiotherapy interruptions. Independent nutritional predictors of chemotherapy interruption were: serum albumin < 3.5 g/dL (adjusted OR 2.54, 95% CI 1.19-5.43, <i>p</i> = 0.016), pretreatment BMI category (overall <i>p</i> = 0.032, driven mainly by a protective trend for BMI > 25 kg/m² [adjusted OR 0.55, 95% CI 0.30-1.00, <i>p</i> = 0.051]; the < 18.5 kg/m² subgroup showed a nonsignificant increase in risk: adjusted OR 1.41, 95% CI 0.84-2.35, <i>p</i> = 0.196), and oral feeding (vs. feeding tube as reference) (adjusted OR 2.27, 95% CI 1.07-4.76, <i>p</i> = 0.030). In non-nasopharyngeal cancer, radiotherapy interruption significantly reduced 5-year OS (14.3% vs. 29.9%, <i>p</i> = 0.03). Chemotherapy interruptions did not significantly affect survival.</p><p><strong>Conclusions: </strong>Hypoalbuminemia (< 3.5 g/dL), pretreatment BMI category, and feeding route independently predict chemotherapy interruptions in HNC. Radiotherapy interruptions significantly impair survival in non-nasopharyngeal cancers. These readily available markers should guide pretreatment nutritional optimization and feeding tube consideration in high-risk patients.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70595"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Defibrinogenation Therapy for Sudden Sensorineural Hearing Loss: A Systematic Review and Meta-Analysis.","authors":"Jieun Shin, Jaekwang Lee, Jong Dai Kim, Young Hwa Song, Taeho Greg Rhee, Sung Ryul Shim, Jong-Yeup Kim","doi":"10.1002/lio2.70599","DOIUrl":"https://doi.org/10.1002/lio2.70599","url":null,"abstract":"<p><strong>Background: </strong>Sudden sensorineural hearing loss (SSNHL) is a perplexing medical condition characterized by rapid hearing decline, often accompanied by symptoms such as tinnitus and vertigo. Effectiveness of batroxobin treatment is not clearly known.</p><p><strong>Objective: </strong>To systematically review and meta-synthesize the effectiveness of Batroxobin treatment on SSNHL.</p><p><strong>Materials and methods: </strong>PubMed, Embase, and the Cochrane Library were searched from the inception date through October 31, 2025. The inclusion criteria were as follows: (1) patients with a clinical diagnosis of SSNHL, (2) interventions included prescription of defibrinogenation therapy (DT), such as venombin A, ancrod, and/or batroxobin, and (3) comparisons were controls who did not receive DT. Two researchers independently reviewed the literature according to the PRISMA guideline. The outcomes were improvement for proportional rate, and the effect size was measured using odds ratios (ORs) and corresponding 95% confidence intervals (CIs).</p><p><strong>Results: </strong>A total of 7 studies with 837 participants (i.e., 561 in the treatment group and 276 controls) were included in the final meta-analysis. DT was not statistically significant for improving hearing when compared to controls. Although the overall SSNHL improvement between DT and control groups improved, the overall effect size, as measured by the pooled OR, 1.897 (95% CI, 0.84 to 4.27), was not statistically significant. The pooled improvement rate for overall SSNHL without a comparison group was 62.1% (95% CI, 55.7% to 68.5%).</p><p><strong>Conclusions: </strong>The findings suggest that defibrinogenation treatment is not more effective than other treatments for SSNHL.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70599"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Machine Learning Model to Predict Complications Following Head and Neck Microvascular Surgery.","authors":"Caroline A Bonaventure, Adam Bess, Reed Smith, Supratik Mukhopadhyay, Rula Mualla, Michael DiLeo, Christopher Yao, Sagar Kansara","doi":"10.1002/lio2.70588","DOIUrl":"https://doi.org/10.1002/lio2.70588","url":null,"abstract":"<p><strong>Objectives: </strong>Microvascular free tissue transfer is the primary reconstructive method in patients with complex defects of the head and neck. Defect site complications vary; incidence ranges from 15% to 70%. The use of machine learning via mutual information analysis has recently been described in the context of head and neck cancer, but this does not distinguish between causal relationships. The current study explores the first causal machine learning model to predict surgical outcomes in patients undergoing head and neck microvascular reconstruction.</p><p><strong>Methods: </strong>A retrospective chart review was conducted at a single institution from 2022 to 2025. A causal machine learning analysis using Peter-Clark algorithmic discovery, external knowledge inputs, and large language models was performed to determine predictors of complications.</p><p><strong>Results: </strong>The dataset included 155 subjects with 116 features. These 116 features were generated from the extracted clinical variables after preprocessing, categorical encoding, numerical transformation, and derivation of model-ready analytic features. Flap failure occurred in 3.2% (<i>n</i> = 5) of patients, and defect site complications occurred in 31.6% (<i>n</i> = 49). Mutual information analysis identified osteoradionecrosis/chondroradionecrosis, preoperative albumin, and peripheral vascular disease as the most consistently informative features. Lower preoperative hemoglobin and albumin were identified as potential causal predictors in the structural model.</p><p><strong>Conclusions: </strong>Causal machine learning analysis is a powerful tool that assists in the prediction of outcomes for patients undergoing head and neck free flap reconstruction and can identify potentially modifiable preoperative factors to aid in risk assessment.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70588"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Efficacy of Chitosan-l-DOPA MAP Gel for Acute Laryngeal Injury.","authors":"Areli Rodriguez-Ayala, Ryan Stepp, Naushin Ali, Vincent Gray, Rachel Letteri, Patrick S Cottler, Donald R Griffin, James J Daniero","doi":"10.1002/lio2.70578","DOIUrl":"10.1002/lio2.70578","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficacy of an innovative chitosan-l-DOPA-modified microporous annealed particle (MAP) hydrogel in reducing fibrosis and enhancing healing in the treatment of Acute Laryngeal Injury (ALgI).</p><p><strong>Methods: </strong>Four experimental treatment groups: uninjured control, sham treated control (saline), nonbioactive MAP gel (sMAP), and Chitosan-l-DOPA MAP gel (dMAP2) were evaluated in a validated rabbit model of acute laryngeal injury, consisting of posterior glottis mucosal stripping and debridement followed by treatment at 14 days postinjury. At Days 4 and 14 posttreatment, histological evaluations were performed to evaluate the posterior glottic thickness (PGT), collagen content and type within the posterior glottis via immunofluorescence staining, glycosaminoglycan (GAG) content via Alcian blue staining, and collagen fiber orientation through picrosirius red staining.</p><p><strong>Results: </strong>At Day 4, the dMAP2 treatment performed similarly to the standard MAP gel, indicating a consistent inflammatory profile. Though at Day 14, the dMAP2 treated injuries demonstrated a significant increase in PGT compared to uninjured controls (<i>p</i> < 0.001), the healing wound expressed a significant increase in collagen area, including collagen I, collagen III, and colocalized species (<i>p</i> < 0.05). The alignment of collagen fibers within the tissue was consistent with the uninjured sample compared to the untreated injury. In a similar relationship, dMAP2 treated wounds led to similar GAG expression within the cricoarytenoid joint as the uninjured tissue, compared to the untreated injury consistent with a reduced arthritic condition.</p><p><strong>Conclusions: </strong>The dMAP2 gel improved healing with organized tissue remodeling compared to untreated controls through the proliferative phase of wound healing.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70578"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal Functional Outcomes After Transoral Robotic Surgery Versus Transoral Videolaryngoscopic Surgery for Oropharyngeal Cancer: A Retrospective Single-Center Study","authors":"Kazufumi Obata,&nbsp;Kenji Okami,&nbsp;Kaori Zenba,&nbsp;Takane Watanabe,&nbsp;Mayu Yamauchi,&nbsp;Hiroaki Iijima,&nbsp;Koji Ebisumoto,&nbsp;Akihiro Sakai,&nbsp;Koichiro Wasano","doi":"10.1002/lio2.70569","DOIUrl":"10.1002/lio2.70569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>Direct comparisons of functional outcomes between transoral videolaryngoscopic surgery (TOVS) and transoral robotic surgery (TORS) for oropharyngeal cancer remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-center study included 35 patients who underwent TOVS and 13 who underwent TORS. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-H&amp;N35, and Hyodo scores were assessed preoperatively and at 1, 3, 6, and 12 months. A linear mixed-effects model (LMM) included time, treatment, the group-by-time interaction, T stage (Tis/T1/T2 vs. T3), anatomic subsite (Tonsil vs. not Tonsil), prior cancer-directed treatment, concurrent neck dissection, sex, and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both groups showed transient postoperative deterioration followed by recovery. In the prespecified primary longitudinal LMM, treatment had no statistically significant main effect on pain, opening mouth, swallowing, or total Hyodo score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this cohort, no statistically significant differences in postoperative quality of life or swallowing recovery were detected between TOVS and TORS. This design does not establish functional equivalence; however, TOVS may be a practical transoral option when robotic systems are unavailable.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tympanostomy Tube Placement: The Effect of Location on Tube Retention and Risk of Perforation.","authors":"Jason G May, Eric Y Du, Jacob A Thoenen, Eliav Gov-Ari, Arnaldo L Rivera","doi":"10.1002/lio2.70590","DOIUrl":"https://doi.org/10.1002/lio2.70590","url":null,"abstract":"<p><strong>Objective: </strong>The retrospective cohort study compares tube location in the anterior-inferior quadrant versus the posterior-inferior quadrant and time of tube retention along with the risk of early extrusion and perforation. The study hypothesis holds that both anterior-inferior placement and posterior-inferior placement are equally effective and safe locations for tube placement with equal tube retention and risk for tympanic membrane perforation.</p><p><strong>Methods: </strong>An IRB-approved retrospective chart review was completed at a major Academic Center's Children's Hospital. The study included data from children who underwent tube placement between 6 months and 16 years old between February 2019-February 2021. Demographics and clinical factors were collected.</p><p><strong>Results: </strong>Of the 905 patients and 1800 ears, a total of 1584 ears had tubes placed in the anterior-inferior quadrant and 216 were placed in the posterior-inferior quadrant. Tubes remained in place for 487 days in the anterior-inferior quadrant and 456 in the posterior-inferior quadrant. The risk of perforation was 1.4% in the anterior-inferior quadrant and 0% in our study for the posterior-inferior quadrant. Univariate analysis showed a difference but was not significantly different (1.10 [0.95, 1.27]). This slight difference was confirmed by multivariate analysis HR = 1.11 [0.96, 1.30].</p><p><strong>Conclusion: </strong>This study shows that there is no difference in tube retention or risk of tympanic membrane perforation based on location of tympanostomy tube placement either in the anterior-inferior quadrant versus the posterior-inferior quadrant. Factors associated with earlier tube extrusion included older age, cleft palate, and recurrent acute otitis media as the diagnosis. T-tubes had slower extrusion, as expected.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70590"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}