Laryngoscope Investigative Otolaryngology最新文献

{"title":"Vocal cord dysfunction: Does laryngeal adduction on laryngoscopy predict disease severity and response to laryngeal retraining therapy?","authors":"David Ahmadian BS,&nbsp;Nader Wehbi BS,&nbsp;Claire M. Gleadhill MD,&nbsp;Natalie Monahan CCC-SLP,&nbsp;Charles J. Gallego BS,&nbsp;Jonathan R. Skirko MD,&nbsp;Helena T. Yip MD","doi":"10.1002/lio2.70039","DOIUrl":"https://doi.org/10.1002/lio2.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Vocal cord dysfunction (VCD) is a complex disorder characterized by episodic adduction of the vocal folds during inspiration and expiration, which can lead to dyspnea, wheezing, cough, and acute-onset respiratory distress. Currently, there is a lack of standardized criteria among treating physicians across multiple disciplines, including otolaryngologists, pulmonologists, allergists, and speech and language pathologists, for diagnosis and treatment of VCD, although laryngeal-respiratory retraining therapy (LRT) has emerged as the preferred treatment modality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In the present study, we examined the efficacy of LRT in patients presenting with a clinical diagnosis of VCD in the presence and absence of laryngeal adduction on laryngoscopy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 74.1% of the cohort showed a response to LRT, of which 62.1% were partial and 12.1% were significant responses. When comparing between patients with and without laryngeal adduction on laryngoscopy, there were no significant differences in the number of sessions of LRT undertaken, mean time to response, and overall response rate between the groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that LRT should be utilized for all patients presenting with symptoms of VCD, even in the absence of laryngeal adduction on laryngoscopy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142762439","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":"Cochlear nerve visualization in Normal anatomy and inner ear malformations","authors":"Majed Assiri MD,&nbsp;Tawfiq Khurayzi MD,&nbsp;Fida Almuhawas MD,&nbsp;Kurt Schlemmer MD,&nbsp;Abdulrahman Hagr MD,&nbsp;Anandhan Dhanasingh PhD","doi":"10.1002/lio2.70023","DOIUrl":"https://doi.org/10.1002/lio2.70023","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to qualitatively evaluate the variations in nerve bundles between patients with normal anatomy and those with inner-ear anomalies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Magnetic resonance imaging (MRI) scans of the temporal bones of candidates for cochlear implants (CIs) enrolled at a tertiary center were retrospectively reviewed from the clinical database. The 3.0-Tesla MRI scans were analyzed using a three-dimensional slicer to visualize the nerve bundles in the internal auditory canal.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 49 ears were analyzed. Twenty ears exhibited normal inner ear anatomy, whereas 29 ears had various inner-ear malformations. The cochlear nerve (CN) was visible on all 20 scans with normal inner-ear anatomy. In addition, the CN was visualized in 18 scans with inner ear malformations. Furthermore, the CN was identified in six of the eight scans with IP type I, whereas in two scans, the CN and vestibular nerve were unclear. Three scans with a common cavity showed only two nerve bundles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings of this study show that the CN can be visualized in most inner-ear anatomical types. Even in severely malformed inner ears, the common nerve bundle that represents the cochlear and vestibular nerves can be visualized. The MRI is highly recommended for CN assessment before CI surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142748881","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":"Histopathology of thermal effects in endoscopic ear surgery: An experimental animal study","authors":"İsa Kaya MD,&nbsp;Fetih Furkan Şahin MD,&nbsp;Yiğit Uyanıkgil MD,&nbsp;Canberk Tomruk MD,&nbsp;Cansın Şirin MD","doi":"10.1002/lio2.1303","DOIUrl":"10.1002/lio2.1303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The potential risk of thermal damage in the transcanal endoscopic ear surgery has been a concerning issue. This study aimed to investigate the histopathological effects of heat exposure of different durations in external auditory canal (EAC) skin and facial nerve tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted on 20 rabbits assigned equally to five groups according to the endoscope-transmitted heat exposure duration: Control group (no exposure), 2, 10, 15, and 30 min. At the end of the procedure, EAC skin and the tympanic segment of facial nerve tissue samples were taken surgically and histopathologically examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant histopathological thermal damage findings in external auditory canal skin and facial nerve tissues were observed under endoscope-transmitted heat exposure longer than 15 and 10 min, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that prolonged exposure of the endoscope-transmitted heat can cause histopathological thermal damage in EAC skin and facial nerve on rabbit subjects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11590331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733526","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":"Challenges and outcomes of airway surgery in a post-war low-resource setting: A case series from Mekelle, Ethiopia","authors":"Daniel G. Eyassu BS,&nbsp;Estephania Candelo MD, MSc,&nbsp;Brhanu H. Asgedom MD,&nbsp;Katherine P. Wallerius MD,&nbsp;Shaina W. Twardus BA,&nbsp;Weston L. Niermeyer MD,&nbsp;Katerina J. Green MB, BCh, BAO,&nbsp;Tejas S. Athni MS,&nbsp;Joshua P. Wiedermann MD, FACS","doi":"10.1002/lio2.70034","DOIUrl":"https://doi.org/10.1002/lio2.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aims to document and analyze the challenges and outcomes of performing complex airway surgery in a low-resource, post-war setting in Mekelle, Ethiopia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective case series examines clinical data from five patients who underwent airway reconstruction surgeries and one patient who underwent total laryngectomy at Ayder Comprehensive Specialized Hospital in Mekelle. Data included patient demographics, airway stenosis etiology and severity, operative details, postoperative outcomes, complications, and hospital length of stay. Ethical approval was obtained from institutional review boards at Mayo Clinic and Mekelle University.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included six patients aged 9–62 years, with surgeries comprising three cricotracheal resections, two tracheal resections, and one laryngectomy. Three reconstructions were for war-related injuries. Challenges included power outages during surgeries, limitations in medical supplies and equipment, and inadequate perioperative care. Despite these, three patients requiring tracheostomies were successfully decannulated within a year. However, complications such as restenosis, infections, and the need for reintubation were common.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Airway surgeries in a low-resource, post-war setting face significant hurdles, including perioperative care quality, resource limitations, and infrastructure issues. Successful outcomes require multidisciplinary training tailored to local contexts, investments in hospital infrastructure and reliable electricity, and proper perioperative nutrition. This study highlights the need for comprehensive interventions to improve surgical care in such settings.</p>\u0000 \u0000 <p><b>Level of evidence:</b> IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142665839","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":"Automated classification of online reviews of otolaryngologists","authors":"Jake G. Stenzel MS,&nbsp;Nicholas R. Schultz MS,&nbsp;Michael J. Marino MD","doi":"10.1002/lio2.70036","DOIUrl":"10.1002/lio2.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The study aimed to extract online comments of otolaryngologists in the 20 most populated cities in the United States from healthgrades.com, develop and validate a natural language processing (NLP) logistic regression algorithm for automated text classification of reviews into 10 categories, and compare 1- and 5-star reviews in directly-physician-related and non-physician-related categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>1977 1-star and 12,682 5-star reviews were collected. The primary investigator manually categorized a training dataset of 324 1-star and 909 5-star reviews, while a validation subset of 100 5-star and 50 1-star reviews underwent dual manual categorization. Using scikit-learn, an NLP algorithm was trained and validated on the subsets, with F1 scores evaluating text classification accuracy against manual categorization. The algorithm was then applied to the entire dataset with comparison of review categorization according to 1- and 5-star reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>F1 scores for NLP validation ranged between 0.71 and 0.97. Significant associations emerged between 1-star reviews and treatment plan, accessibility, wait time, office scheduling, billing, and facilities. 5-star reviews were associated with surgery/procedure, bedside manner, and staff/mid-levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study successfully validated an NLP text classification system for categorizing online physician reviews. Positive reviews were found to have an association with directly-physician related context. 1-star reviews were related to treatment plan, accessibility, wait time, office scheduling, billing, and facilities. This method of text classification effectively discerned the nuances of human-written text, providing valuable insights into online healthcare feedback that is scalable.</p>\u0000 \u0000 <p>Level of evidence: Level 3</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630577","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":"Individualized post-operative prediction of cochlear implantation outcomes in children with prelingual deafness using functional near-infrared spectroscopy","authors":"Zhe Chen MD,&nbsp;Xue Zhao PhD,&nbsp;Haotian Liu PhD,&nbsp;Yuyang Wang PhD,&nbsp;Zhikai Zhang PhD,&nbsp;Yuxuan Zhang PhD,&nbsp;Yuhe Liu PhD","doi":"10.1002/lio2.70035","DOIUrl":"10.1002/lio2.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The goal of this study was to develop an objective measure and predictor of cochlear implantation (CI) outcomes using functional near-infrared spectroscopy (fNIRS) for young children with prelingual deafness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sound-evoked hemodynamic responses were recorded from auditory and language-related cortical regions of 47 child CI recipients (35.47 ± 17.24 months of age) using fNIRS shortly after CI activation (0.26 ± 0.30 months). There were four sound conditions (natural speech, instrumental music, multi-speaker babble noise, and speech-in-noise). Post-CI auditory and verbal communication performance was evaluated using clinical questionnaires with caretakers. Both classification and individualized regression models were constructed to predict post-CI behavioral improvement from fNIRS data using support vector machine (SVM) learning algorithms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Auditory cortical responses shortly after CI hearing onset yielded highly accurate prediction of behavioral development in young CI children. For classification models, optimal prediction was achieved using cortical responses to two or more sound conditions, with the highest accuracy of 98.20% (precision = 98.17%, sensitivity = 98.96%, area under the curve of the receiver operating characteristic curve = 99.61%) obtained with the combination of speech, noise, and music stimuli. Similarly, for regression models, best prediction of individual development was achieved using three (highest <i>r</i> = 0.919) or four (<i>r</i> = 0.966) sound conditions. The predictability of cortical responses far outperformed (Cohen's <i>d</i>: 18.56) that of the collection of audiological and demographic parameters (classification accuracy: 0.62) under the same SVM algorithms and could not benefit from the inclusion of the latter.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Machine learning models using auditory cortical hemodynamic responses shortly after CI activation were able to predict individualized post-CI behavioral improvement in children with prelingual deafness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 5.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11558700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630594","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":"Causes and treatment of secondary sphenoid sinus infection post-endoscopic transsphenoidal approach","authors":"Yi Dong MD,&nbsp;Bing Zhou MD,&nbsp;Shunjiu Cui MD,&nbsp;Qian Huang MD,&nbsp;Yan Sun MD,&nbsp;Zhenxiao Huang PhD, MD,&nbsp;Jingying Ma MD,&nbsp;Quanjie Yang MD,&nbsp;Na Liang MD","doi":"10.1002/lio2.70033","DOIUrl":"10.1002/lio2.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study analyzed the causes of sphenoid sinus (SS) infection (SSI) following endoscopic transsphenoidal skull base surgery and determined appropriate treatment methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 31 cases of secondary SSI following the endoscopic transsphenoidal approach (ETSA; SSI group) and 246 cases without SSI (non-SSI group). Data collected included post-ETSA pathological results, types of artificial skull base reconstruction materials, and SS patency. For the SSI group, data included time from ETSA to symptom onset, endoscopic and imaging findings, intraoperative conditions during the second surgery, and changes in visual analog scale (VAS) scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incidence of secondary SSI was 11.19%. In the SSI group, 26 patients (83.87%) reported headaches, and 24 (77.42%) had stenosis or closure of the SS ostium (SSO). The non-SSI group reported no symptoms, and 236 patients (95.93%) had well-opened SSOs. Centripetal hyperosteogeny (CHO) in the SS walls was observed in 20 patients (64.5%) in the SSI group. Absorbable materials were used in five cases (16.13%) and 215 cases (87.40%) in the SSI and non-SSI groups, respectively, while non-absorbable materials were used in 24 cases (77.42%) and 20 cases (8.13%), respectively. SSI risk was 9.42 times higher with non-absorbable synthetic materials. VAS scores for SSI symptoms and Lund–Kennedy scores significantly decreased at 3 and 12 months post-second surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Secondary SSI after ETSA can cause persistent symptoms. Non-absorbable synthetic repair materials should be avoided to prevent secondary SSI. Extended sphenoidectomy and removal of artificial materials can lead to rapid resolution of SSI symptoms.</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":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630580","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":"Prognosis of asymptomatic endolymphatic hydrops in healthy volunteers: A five-year cohort study","authors":"Takahiro Kimura MD, PhD,&nbsp;Tadashi Kitahara MD, PhD,&nbsp;Tadao Okayasu MD, PhD,&nbsp;Masaharu Sakagami MD, PhD,&nbsp;Tomoyuki Shiozaki PhD,&nbsp;Hiroshi Inui MD, PhD,&nbsp;Toshizo Koizumi MD, PhD,&nbsp;Mariko Kakudo MD, PhD","doi":"10.1002/lio2.70026","DOIUrl":"10.1002/lio2.70026","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to clarify the prognosis of asymptomatic endolymphatic hydrops (EH) in healthy volunteers via five-year follow-ups with inner ear magnetic resonance imaging (MRI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Inner ear MRI was performed on 115 participants recruited as controls in a previous study on Meniere's disease. The endolymphatic space was visualized using Naganawa's method of contrast-enhanced MRI with intravenous gadolinium injection and evaluated using Nakashima's method of 2D imaging analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Cochlear or vestibular EH was present in 7.0% of participants (<i>n</i> = 8), with all cases being unilateral (laterality), moderate (severity), and asymptomatic (onset). Only cochlear-localized EH, only vestibular-localized EH, and both EH were present in 1.7% (<i>n</i> = 2) (C group), 4.3% (<i>n</i> = 5) (V group), and 0.9% (<i>n</i> = 1) (CV group) of participants, respectively. Conducting inner ear MRI after 5 years showed that EH had almost disappeared in two participants in the C and V groups (4/8, 50.0%). EH was still present in three participants in the V group and one in the CV group (4/8, 50.0%). One participant in the V group and another in the CV group presented with residual inner ear EH and developed typical symptomatic Meniere's disease (2/8, 25.0%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Approximately 7% of healthy participants showed asymptomatic EH. Therefore, EH is not the definitive marker for making a diagnosis of Meniere's disease or the suitable predictor for the development of Meniere's disease. Among these participants, 25% maintained EH and subsequently developed typical Meniere's disease within the next 5 years. Schellong-positive participants maintained persistent EH in the inner ear, and participants with higher scores on the self-rating depression scale developed Meniere's symptoms after 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>2a</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630600","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":"Reflux disease and congenital laryngomalacia in neonates: A Kids' Inpatient Database analysis","authors":"Vraj P. Shah MD,&nbsp;Aman M. Patel BS,&nbsp;Praneet C. Kaki BS,&nbsp;Arsany Yassa BA,&nbsp;Andrey Filimonov MD, PharmD","doi":"10.1002/lio2.70031","DOIUrl":"10.1002/lio2.70031","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Congenital laryngomalacia (CLM) is the most common cause of stridor in neonates and is commonly associated with reflux disease (RD) such as gastroesophageal reflux and newborn esophageal reflux. This study investigates the impact of RD on the management and outcomes of neonates with CLM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2016 Kids' Inpatient Database (KID) was queried for neonates with CLM (ICD-10: Q31.5). RD status, procedures, and complications were identified with ICD-10 codes. Univariate and multivariable analyses were implemented to determine statistical associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 2212 neonates identified with CLM, 585 (26.45%) had RD. Patients with RD were more often female (<i>p</i> = .038) and premature (<i>p</i> &lt; .001). Upon multivariable analysis, patients with RD had greater total charges (Mean $457,810.87 vs. $259,020.90, <i>p</i> &lt; .001) and longer length of stay (Mean 46.03 vs. 26.44 days, <i>p</i> &lt; .001). Those with RD had more diagnoses recorded (Mean 14.15 vs. 9.66, <i>p</i> &lt; .001), underwent more procedures (Mean 5.47 vs. 3.49, <i>p</i> &lt; .001), and had a longer wait until their first procedure (Mean 13.27 vs. 7.02 days, <i>p</i> &lt; .001). Patients with RD had increased odds for undergoing laryngoscopy (OR 1.799, 95% CI 1.382–2.321, <i>p</i> &lt; .001), bronchoscopy (OR 2.179, 95% CI 1.598–2.801, <i>p</i> &lt; .001), and ventilator use (OR 1.526, 95% CI 1.197–1.886, <i>p</i> &lt; .001) on multivariable regression adjusting for patient demographics, hospital characteristics, and comorbidities. Patients with and without RD had similar odds for undergoing tracheotomy (OR 1.540, 95% CI 0.934–2.522, <i>p</i> = .088) and mortality (OR 1.084, 95% CI 0.397–2.646, <i>p</i> = .874).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CLM is a common diagnosis in neonates that is associated with RD. In our cohort of neonates with CLM, those with RD had overall poorer outcomes.</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":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630614","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":"Parotid sialolithiasis – Long term follow-up analyzing surgical approaches","authors":"Zachary Tanenbaum MD, MS,&nbsp;Piper Wenzel BS,&nbsp;Evgeniya Molotkova BS,&nbsp;Ben Fick MD,&nbsp;Kailey Henkle MS,&nbsp;Henry Hoffman MD","doi":"10.1002/lio2.70030","DOIUrl":"10.1002/lio2.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Present follow-up data comparing transoral and transfacial parotid gland procedures for stone removal to offer insight addressing technical considerations and complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective study of a consecutive series of surgical treatments for parotid sialolithiasis from 2013 to 2018 at an academic institution by one surgeon provided review of 16 transoral and 10 transfacial procedures supplemented by long-term follow-up through telephone or mail. Clinical and radiographic parameters, additional treatment, and persistence of symptoms were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four of 10 patients treated with the transfacial approach had parotid-cutaneous fistulas addressed with transdermal scopolamine patches and pressure dressings (one also with intraductal steroid infusion) with closure at a median of 12.5 days. A fifth fistula failed to resolve at 23 days and was addressed with parotidectomy. All 8 patients who were contacted (median: 106 months) reported complete resolution of symptoms. None had facial weakness.</p>\u0000 \u0000 <p>Six of 16 patients treated by a transoral approach had persistent stone fragments at the conclusion of operation. Four of these 6 patients underwent subsequent procedures (two transoral, one transfacial, one parotidectomy). Among the 11 patients who responded to long-term follow-up (median: 107 months), one reported mild symptoms insufficient to request treatment. Larger stone size coupled with proximal location correlated with the conversion from transoral to include transfacial approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with retained stone remnants at the conclusion of transoral stone removal are more likely to require additional procedures that result in long-term favorable results. The transfacial approach to stone removal offers long-term favorable results following the common short-term complication of salivary fistula.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>OCEBM Level 4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11541602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630598","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}