Laryngoscope Investigative Otolaryngology最新文献

{"title":"Ability to Adjust Head Position in a 3D-Printed Flexible Nasolaryngoscopy Model Improves Fidelity and Trainee Experience","authors":"Felix E. Fernández-Penny,&nbsp;Anna Christina Clements,&nbsp;Michael Bindschadler,&nbsp;Ezgi Mercan,&nbsp;Huy Le,&nbsp;Tanya K. Meyer,&nbsp;Seth D. Friedman,&nbsp;Maya G. Sardesai","doi":"10.1002/lio2.70332","DOIUrl":"https://doi.org/10.1002/lio2.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the utility of a novel 3D-printed model incorporating user-directed head position adjustments for flexible fiberoptic nasolaryngoscopy (FNL) training and simulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This proof-of-concept study utilized a CT-based, 3D-printed airway model permitting adjustments in head protrusion, flexion, and extension, with associated anatomical changes in oropharyngeal shape. Cervical flexion and atlantoaxial extension (“sniffing position”) represented the optimal head position (OHP) for laryngeal visualization, as determined by attending faculty otolaryngologists. During FNL trials, trainees simulated patient instruction for head adjustment and were asked to indicate their perceived OHP. Standardized photographs of trainees' OHP were taken and compared by training level using fiducial marker-based image analysis. Surveys evaluated trainee experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 26 medical students and residents (PGY-1 to PGY-4), completed FNL trials. Senior residents (R3+) showed little variability in their chosen OHP. While intermediate learners (R1–R2) showed the greatest variability in OHP there were no significant differences in final OHP among participants. Trainees rated the helpfulness of positional adjustments 8 ± 1.80 on a 10-point Likert scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Head position maneuverability improves fidelity and the FNL training experience. Using the model, participants at all training levels were able to achieve OHPs comparable with experienced practitioners. Greater OHP variability among those with moderate experience suggests this model feature may be used by trainees to optimize technique. This novel model presents an affordable, portable, and easily replicable tool to enhance FNL simulation and training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145824689","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":"Introducing the Modified Cobb Angle for Measuring Cervical Spine Curvature During Swallowing","authors":"Catriona M. Steele,&nbsp;Makaya O' Grady,&nbsp;Sima Farpour,&nbsp;Melanie Peladeau-Pigeon,&nbsp;Sophia Werden Abrams,&nbsp;Maureen Folsom,&nbsp;Emily K. Plowman,&nbsp;Ashwini M. Namasivayam-MacDonald","doi":"10.1002/lio2.70333","DOIUrl":"10.1002/lio2.70333","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective (s).</h3>\u0000 \u0000 <p>The C2–C7 Cobb angle is used to measure cervical spine curvature, an anatomical parameter that may be associated with swallowing difficulties in some patients. Challenges in visualizing lower cervical vertebrae on videofluoroscopic swallow study images led to the proposal of the C2–C4 modified Cobb angle (MCA) for use in swallowing research. Despite its initial promise, less than optimal reliability and validity suggested a need for improvement and further research. In this study, we aimed to explore the measurement properties of the MCA and a C2–C4 revised-MCA across key timepoints in healthy swallowing of thin liquid boluses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This exploratory analysis examined inter- and intra-rater reliability, as well as criterion validity of the C2–C4 MCA and C2–C4 revised-MCA in comparison to other measures of cervical spine curvature and head extension (C0–C2, C2–C6, and C2–C7 Cobb angles). Videofluoroscopic images from 35 healthy participants were analyzed using frames from still positioning, bolus passing the mandible, maximum pharyngeal constriction, and swallow rest. Data were analyzed using intraclass correlation coefficients (ICCs), Pearson correlations, and mixed model analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The C2–C4 revised-MCA showed superior intra- and inter-rater reliability and moderate positive correlation with the C2–C6 Cobb angle, demonstrating criterion validity. No differences in C2–C4 revised-MCA were found across swallowing frames, or as a function of participant age, sex, or head extension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The findings suggest that the C2–C4 revised-MCA has stronger psychometric properties than the MCA, confirming its utility as a cervical spine curvature measurement during swallowing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806063","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":"Predictive Value of Sleep Architecture and Arousal Index for Surgical Outcomes in Obstructive Sleep Apnea","authors":"Dong Yun Lee,&nbsp;Hyun Jung Kim,&nbsp;Jayoung Oh,&nbsp;Siyeon Jin,&nbsp;Dongyoung Kim,&nbsp;Doo Hee Han,&nbsp;Hyun Jik Kim","doi":"10.1002/lio2.70331","DOIUrl":"10.1002/lio2.70331","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>While palatal surgery is an established treatment for obstructive sleep apnea (OSA), variability in outcomes has prompted investigation into factors predicting surgical success. This study aimed to evaluate whether preoperative polysomnographic (PSG) parameters, along with drug-induced sleep endoscopy (DISE) findings, can predict surgical outcomes in patients with OSA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 56 adult patients with OSA who completed both pre- and postoperative PSG and DISE assessments. Patients were classified into a successful outcome group (SG; ≥ 20 events/h reduction in apnea–hypopnea index [AHI]) or a worse outcome group (WG; ≥ 20 events/h increase in AHI). Baseline PSG and DISE findings were compared between groups, and multivariate regression analysis was used to identify independent predictors of surgical success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the SG exhibited significantly higher preoperative AHI and larger tonsil size compared to those in the WG. While DISE collapse patterns did not differ significantly between groups, key differences emerged in PSG metrics. SG patients had a significantly greater proportion of non-REM stage N3 sleep within non-REM sleep and a lower arousal index, both of which were independently associated with improved surgical outcomes. Additionally, respiratory events were more prominent during non-rapid eye movement sleep in SG patients. Multivariate analysis confirmed that a greater proportion of non-REM stage N3 sleep and lower arousal index were strong predictors of postoperative AHI reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings may offer more reliable predictors of which OSA patients will benefit from sleep surgery and underscore the importance of incorporating detailed PSG analysis into preoperative evaluations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806090","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":"Heart Rate as a Predictor of 6-Month Pneumonia Risk in Patients With Dysphagia","authors":"Yuval Nachalon,&nbsp;Nogah Nativ-Zeltzer,&nbsp;Yosef Kula,&nbsp;Anne Tran,&nbsp;Stephanie Reshma Warrior,&nbsp;Peter C. Belafsky","doi":"10.1002/lio2.70321","DOIUrl":"10.1002/lio2.70321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether resting heart rate (HR) or heart rate variability (HRV) derived from finger photoplethysmography (PPG) predicts 6-month pneumonia risk in patients with dysphagia. HRV reflects autonomic regulation of inflammation which may predispose to respiratory complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 301 patients who underwent a videofluoroscopic swallow study (VFSS) in 2020–2021 were enrolled. Prior to VFSS, resting HR was measured using the CorSense HRV finger sensor (ELITE HRV). Additional HRV metrics, including the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences (RMSSD) were collected from a subset of 153 participants. Pneumonia incidence was assessed at 3 and 6 months through phone interviews and medical record review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 66.3 ± 12.5 years, and 38% were female. Twenty patients (7%) developed pneumonia, with 75% of cases occurring within 3 months. Patients who developed pneumonia had higher resting HR than those who did not (83.4 vs. 74.3 bpm, <i>p</i> &lt; 0.01). This association remained significant after adjusting for age (<i>p</i> = 0.01). Pneumonia risk increased stepwise with higher HR thresholds, with a 2.4-fold greater risk observed at HR ≥ 82 bpm and a 2.8-fold risk at HR ≥ 90 bpm. HRV metrics were not significantly associated with pneumonia incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated resting HR, though within the normal range, was associated with increased pneumonia risk in patients with dysphagia. This may reflect underlying inflammation or autonomic dysfunction. Because comorbidities, medications, and VFSS severity were not accounted for, these findings should be interpreted as preliminary. Resting HR may represent a simple, non-invasive tool for pneumonia risk stratification in this population, but larger studies are needed for validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783394","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":"Optimizing Cochlear Implant Position for Magnetic Resonance Imaging of Vestibular Schwannoma","authors":"Ji Min Yun,&nbsp;Jamol Ergashev,&nbsp;Seong Hoon Bae,&nbsp;In Seok Moon","doi":"10.1002/lio2.70319","DOIUrl":"10.1002/lio2.70319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to determine the optimal placement of the cochlear implant (CI) magnet to ensure the visibility of the inner ear and internal auditory canal (IAC) on postoperative magnetic resonance imaging (MRI) scans in patients treated for vestibular schwannoma (VS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine patients who underwent CI either simultaneously with VS resection or sequentially after gamma knife surgery between January 2021 and June 2024 were retrospectively reviewed. Three patients had the CI placed in the conventional position, while six had it positioned farther from the external auditory canal (EAC) at a more vertical angle (alternative positioning). Postoperative temporal MRI scans were analyzed for inner ear and IAC visibility. Postoperative brain computed tomography (CT) scans underwent three-dimensional reconstruction to measure the distances from the CI magnet to the EAC and IAC, and the nasion–EAC–magnet angle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the six patients in the alternative positioning group, five showed unobstructed IAC visibility, with both magnet-to-EAC and magnet-to-IAC distances exceeding 90 mm. The remaining patient in this group, whose distances were below 90 mm, showed obscured IAC structures due to artifacts. All three patients in the conventional positioning group had distances less than 90 mm and exhibited obscured IAC visibility. A strong correlation was observed between the magnet-to-EAC and magnet-to-IAC distances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Optimal positioning of the CI magnet, particularly maintaining a distance greater than 90 mm from the EAC, is crucial for achieving clear postoperative MRI visualization of the IAC in patients undergoing VS treatment.</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":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783410","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 Platelet Rich Plasma Versus Placebo for Improvement in Olfactory Function in Adults With Olfactory Dysfunction: A Systematic Review and Meta-Analysis","authors":"Ali B. Jafar,&nbsp;Ghabrielle Almeida,&nbsp;Fatima Al Mousawi,&nbsp;Eric Delgado Rendon,&nbsp;Amber U. Luong","doi":"10.1002/lio2.70317","DOIUrl":"10.1002/lio2.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Olfactory dysfunction significantly impairs quality of life. Conventional treatments such as corticosteroids and olfactory training offer limited and inconsistent efficacy. Platelet-rich plasma (PRP), a biologically active agent, has shown potential regenerative effects in olfactory neuroepithelium. This study systematically evaluates the efficacy of PRP compared to placebo in improving olfactory function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was conducted according to PRISMA guidelines and was registered in PROSPERO (CRD 420251045079). The databases searched included PubMed, Scopus, Embase, Central, and Web of Science. Seven studies (four RCTs, three non-RCTs) involving 789 patients were included. Subjective and objective outcomes were extracted and pooled using a random-effects model. Risk of bias was assessed using ROB-2 and ROBIN-I tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PRP was significantly more effective than placebo in improving subjective olfactory scores at 1 month (SMD = 1.16, 95% CI [0.29–2.03], <i>p</i> = 0.009), 3 months (SMD = 0.29, 95% CI [0.07–0.50], <i>p</i> = 0.01), and 12 months (SMD = 1.47, 95% CI [1.06–1.89], <i>p</i> = 0.00001). Objective testing also favored PRP at all timepoints, including 1 month (SMD = 1.55, 95% CI [0.36–2.73], <i>p</i> = 0.01), 3 months (SMD = 0.44, 95% CI [0.05–0.82], <i>p</i> = 0.03), and 12 months (SMD = 2.42, 95% CI [0.35–4.5], <i>p</i> = 0.02). Subgroup analysis showed younger age (&lt; 40 years old) was associated with greater improvements. The safety profile was favorable with no serious adverse events reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PRP demonstrates both short- and long-term benefits in olfactory recovery compared to placebo, especially among younger adults. Given the promising results and safety profile, PRP represents a viable treatment option for olfactory dysfunction. Standardization of PRP protocols and further high-quality RCTs need to be further explored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775969","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":"Multidisciplinary Tracheostomy Teams Reduce Emergency Department Utilization in Pediatric Patients: A Retrospective Cohort Study","authors":"Basir S. Mansoor,&nbsp;Matthew Zhang,&nbsp;Stephen Chorney,&nbsp;Yann-Fuu Kou,&nbsp;Cynthia S. Wang,&nbsp;Rebecca Brooks,&nbsp;Romaine F. Johnson","doi":"10.1002/lio2.70327","DOIUrl":"10.1002/lio2.70327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effect of multidisciplinary tracheostomy team (MDT) interventions on emergency department utilization in pediatric patients with tracheostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analyzed a prospective registry of 364 children who underwent tracheostomy from 2015 to 2023 at a single tertiary pediatric center. The study period encompassed pre-intervention, post-intervention pre-COVID, COVID-19, and post-COVID recovery phases. Primary outcomes were time to ED visits and ED visit frequency, analyzed using parametric survival analysis and mixed-effects negative binomial regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 364 patients (mean age 3.5 ± 5.4 years; 53% male), MDT implementation was associated with a 50% reduction in ED visit rates (incidence rate ratio 0.50, 95% CI: 0.43–0.57, <i>p</i> &lt; 0.001) during the post-intervention, pre-COVID period. Benefits sustained through COVID (65% reduction) and post-COVID recovery (91% reduction). Time to first ED visit increased significantly across post-intervention periods (post-intervention, pre-COVID: time ratio 1.22, 95% CI: 1.12–1.32, <i>p</i> &lt; 0.001; post-COVID recovery: time ratio 1.25, 95% CI: 1.11–1.40, <i>p</i> &lt; 0.001). During median follow-up of 2.8 years, 1056 of 1842 total encounters (57%) involved ED visits. Respiratory conditions accounted for 34% of ED visits. Hispanic ethnicity (time ratio 0.88, <i>p</i> = 0.003) and respiratory-related visits (time ratio 0.78, <i>p</i> &lt; 0.001) were associated with shorter return intervals but did not affect overall visit frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MDTs were associated with sustained 50% reductions in pediatric ED utilization, with reductions continuing through the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Levels of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769697","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":"Role of Pain in Adults Undergoing Soft Tissue and Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea","authors":"Ghedak Ansari,&nbsp;Jeanne A. Darbinian,&nbsp;Samuel A. Collazo,&nbsp;Nikolas R. Block-Wheeler,&nbsp;Megan L. Durr","doi":"10.1002/lio2.70322","DOIUrl":"10.1002/lio2.70322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In adult patients who undergo soft tissue and maxillomandibular advancement (MMA) sleep surgery for obstructive sleep apnea (OSA), we identify preoperative pain diagnoses and postoperative pain medication dispensing patterns by surgery type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort chart review study examines adults who underwent sleep surgery for OSA at an integrated healthcare delivery system (2009–2017). Data obtained from electronic sources included demographics, surgery type, presentation to the emergency department, hospital readmission, and postoperative medication dispensings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2287 adult patients were identified. The average age at surgery was 40.8 ± 12.5 years. Surgeries performed included (<i>n</i>, %) uvulopalatopharyngoplasty (1312, 57.3%) tonsillectomy (577, 25.2%), genioglossus muscle advancement (GA) alone or combined with MMA (108, 4.7%) and MMA alone (170, 7.4%), adenoidectomy (60, 2.6%), tongue and palate surgery (54, 2.4%), and tongue reduction (6, 0.3%). A total of 811 (35.5%) had a preoperative pain-related diagnosis, and 336 (14.7%) had a preoperative diagnosis of depression. Of the total cohort, 912 (39.9%) had a preoperative opioid prescription. In our cohort, 91.7% were prescribed outpatient opioid medication postoperatively. This varied by surgery type, with the highest proportion of opioid prescription dispensings observed in the soft tissue surgery group (non-MMA ± GA) and the lowest in the maxillofacial surgery group (MMA ± GA). In contrast, the maxillofacial surgery group had the highest proportion of nonopioid prescriptions dispensed, while the soft tissue surgery group had the lowest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Non-hypoglossal nerve stimulation (non-HGNS) sleep surgery for OSA is associated with high (nearly 92%) postoperative opioid dispensings. Adult patients undergoing non-HGNS sleep surgery are likely at increased risk of opioid complications given the high prevalence of preoperative opioid use, chronic pain, and depression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769691","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":"Depression Among Patients With Laryngeal Cancer: A Retrospective Cohort Study","authors":"Sandhya Ganesan,&nbsp;Sharwani Kota,&nbsp;Sana Smaoui,&nbsp;Tyler P. Tufano,&nbsp;Leena Zitoun,&nbsp;Arjun Joshi,&nbsp;Punam Thakkar","doi":"10.1002/lio2.70325","DOIUrl":"https://doi.org/10.1002/lio2.70325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The treatment of laryngeal cancer often results in alterations of speech and swallowing, which may contribute to the development of depression in this patient population and subsequently affect treatment outcomes and survivorship. This study aims to determine the prevalence of depression in patients with laryngeal cancer and identify contributing risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with laryngeal cancer were identified using ICD-10 codes within the TriNetX Research Network. Patients were stratified by treatment type (surgical versus non-surgical), age, socioeconomic (SES) risk factors, and post-treatment side effects. The effect of these factors on the development of depression was analyzed while controlling for cancer stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Briefly, 93,018 patients with laryngeal cancer were identified. These patients had a significantly higher risk of depression compared to the overall head and neck cancer population (RR = 1.15, 95% CI: [1.12, 1.18]). Patients under 70 were more likely to develop depression than those over 70 (RR = 1.27, 95% CI: [1.22, 1.33]). SES risk factors were associated with over double the risk of depression (RR = 2.67, 95% CI: [2.42, 2.97]). Surgical treatment conferred a higher risk than non-surgical treatment modalities (RR = 1.54, 95% CI: [1.41, 1.68]). Patients who experienced long-term complications such as dysphagia, xerostomia, or malnutrition had a 7.62% increased risk of depression (<i>p</i> &lt; 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with laryngeal cancer face a uniquely high risk of developing post-treatment depression. Future studies evaluating optimal screening protocols and supportive care strategies may help improve mental health care in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739606","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":"Pyriform Plasty as an Adjunct to Septoplasty: A Double-Blind Randomized Trial in Patients With Septal Deviation","authors":"Matin Ghazizadeh,&nbsp;Behrouz Barati,&nbsp;Mohammad Moini,&nbsp;Homeira Mansurzadeh","doi":"10.1002/lio2.70324","DOIUrl":"https://doi.org/10.1002/lio2.70324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The study was designed to compare the final long-term outcomes of septoplasty with and without unilateral pyriform plasty on the concave side in patients with septal deviation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A randomized clinical trial was conducted from 2020 to 2023. Patients were randomly divided into two groups of 30. The control group underwent septoplasty alone (without pyriform plasty). Septoplasty with pyriform plasty was performed for the intervention group. The patient's subjective feelings were compared using the NOSE questionnaire pre- and post-operatively. Six months after surgery, the patients were evaluated objectively using rhinomanometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the patients was 37.07 ± 10.39 years. Based on the rhinomanometry evaluation, the amounts of airflow in the intervention and control groups were 791.23 ± 113.14 (cm³/s) and 665.44 ± 101.03 (<i>p</i> &lt; 0.001), respectively. Also, the resistance level was 0.20 ± 0.04 (Pa/cm³/s) in the intervention group and 0.23 ± 0.05 (Pa/cm³/s) in the control group (<i>p</i> = 0.036). Among evaluated symptoms, significant improvement in nasal obstruction was detected in the intervention group (<i>p</i> = 0.044).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although septoplasty improved the patient's clinical condition by increasing nasal airflow and decreasing airflow resistance, septoplasty with pyriform plasty on the concave side significantly resulted in more favorable outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739581","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}