Laryngoscope Investigative Otolaryngology最新文献

{"title":"Adverse Events of Tracheobronchial Stents: A MAUDE Database Study With Focus on Metallic Stents.","authors":"Janvi J Shukla, Nicholas S Hamilton, Sraavya Anne, Kenneth Yan, Rachel Kaye","doi":"10.1002/lio2.70523","DOIUrl":"10.1002/lio2.70523","url":null,"abstract":"<p><strong>Objectives: </strong>Tracheobronchial stents treat conditions that reduce airflow such as malignancy, tracheomalacia, and stenosis, but may fail and cause complications. This study aims to use the US Food and Drug Administration Manufacturer and User Facility Device Experience (MAUDE) database to understand adverse events related to tracheobronchial stent use to reduce future complications.</p><p><strong>Methods: </strong>The MAUDE database was searched for \"Prosthesis, Tracheal, Expandable,\" \"Prosthesis, Tracheal, Expandable, Polymeric,\" and \"Prosthesis, Tracheal, Preformed/Molded\" from January 2014 to December 2023. Reports were analyzed and complications were categorized.</p><p><strong>Results: </strong>We identified 525 reports. 405 (77.1%) reports listed indications including airway stenosis (<i>n</i> = 312, 51.0%), malignancy-related airway stricture (<i>n</i> = 258, 42.2%), tracheoesophageal fistula (<i>n</i> = 26, 4.2%), and tracheobronchomalacia (<i>n</i> = 16, 2.6%). A total of 768 different adverse events were cataloged. The most common device-related complication was stent deployment failure (<i>N</i> = 236, 30.7%). 94 patient injuries occurred; the most common patient injury was airway occlusion/collapse (<i>n</i> = 26, 28.6%), followed by airway bleeding/exsanguination (<i>N</i> = 12, 13.6%), and intubation/ICU care (<i>N</i> = 11, 12.5%). Six cases led to death (0.7%). Stents placed due to tracheobronchomalacia had more cases of airway occlusion/collapse, pneumonia, and intubation/ICU care than all other indications (all <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>Most adverse events were related to technical failure while severe complications such as airway obstruction were few, and mortality was rare. These risks are important to note when utilizing tracheobronchial stents.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70523"},"PeriodicalIF":1.9,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13417722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621996","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":"Regional Impedance Patterns in Cochlear Implantation: Influence of Demographic and Early Activation.","authors":"Eman Hajr, Rahma Sweedy, Mohammad F Alzahrani, Yassin Abdelsamad, Abdulrahman Hagr","doi":"10.1002/lio2.70512","DOIUrl":"10.1002/lio2.70512","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of age and gender on electrode impedance during cochlear implant surgery and at 6 months after implantation, and to determine whether activation timing modifies these relationships across cochlear regions.</p><p><strong>Methods: </strong>This retrospective longitudinal cohort study included cochlear implant recipients with normal cochlea implanted with the MED-EL FLEX28. All electrodes were fully inserted via the round window approach. Participants underwent early activation (1 day postoperatively) or classical activation (within approximately 1 month). Electrode impedance was measured intraoperatively and at ≥ 6 months. Associations between age, gender, activation timing, and impedance were analyzed across apical, middle, basal, and overall regions.</p><p><strong>Results: </strong>A total of 360 implanted ears were analyzed. Gender was not significantly associated with impedance. Implantation age demonstrated region-specific associations with impedance behavior, with the strongest findings observed in activation-stratified analyses of the apical electrodes. Mean apical impedance increased from 6.1 ± 2.1 kΩ intraoperatively to 6.9 ± 1.8 kΩ at 6 months. Younger recipients exhibited higher intraoperative apical impedance with a negative age-impedance association (<i>β</i> ≈ -0.01 to -0.02 per year, <i>p</i> < 0.001), which reversed at 6 months to a positive association (<i>β</i> ≈ +0.03 to +0.05 per year, <i>p</i> < 0.001). Age-related associations were less pronounced in the middle and basal regions.</p><p><strong>Conclusions: </strong>Implantation age demonstrated a dynamic and region-specific association with impedance behavior, particularly in apical electrodes. Early activation modified postoperative impedance trajectories and attenuated midterm impedance elevation.</p><p><strong>Level of evidence: </strong>Level 3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70512"},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13416201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622144","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 Low-Cost, Easily Implementable Model for Multiskill Hands-On Training in Otolaryngology Education.","authors":"Takahiro Inoue, Shota Sakaue, Hisataka Ominato, Risa Wakisaka, Michihisa Kono, Hidekiyo Yamaki, Kenzo Ohara, Takumi Kumai, Miki Takahara","doi":"10.1002/lio2.70517","DOIUrl":"10.1002/lio2.70517","url":null,"abstract":"<p><strong>Objective: </strong>Early exposure to otolaryngology-head and neck surgery is limited in undergraduate medical education, and existing hands-on training programs are often resource-intensive or focused on single procedures, restricting their broader implementation. This study aimed to develop a low-cost, easily implementable, and reproducible multiskill hands-on training model in otolaryngology and to evaluate its educational validity.</p><p><strong>Methods: </strong>This retrospective study evaluated a structured, rotation-based hands-on seminar conducted at a single academic institution between 2024 and 2025. Participants included fourth- to sixth-year medical students and postgraduate year (PGY) 1-2 residents. The intervention was a 70-min, four-station, low-cost training model (endoscopic sinus surgery, ultrasound-guided fine-needle aspiration, otologic skills, and tracheostomy) designed for standardized, reproducible implementation. Educational validity was assessed using pre- and postseminar self-reported measures of knowledge, procedural skills, and interest in otolaryngology, as well as overall satisfaction.</p><p><strong>Results: </strong>A total of 27 participants were included. Self-assessed knowledge and procedural skills improved significantly across all domains following the seminar (all <i>p</i> < 0.001). Interest in otolaryngology also increased significantly. Participants reported high overall satisfaction with the program. During follow-up, 9 participants (33.3%) chose otolaryngology as their specialty.</p><p><strong>Conclusions: </strong>This study presents a low-cost, multiskill hands-on training model that is feasible to implement and reproducible in routine educational settings, even in time-constrained clinical environments. The findings support the educational validity of this structured approach for early procedural exposure in otolaryngology. This model may provide a practical strategy for integrating multiskill training into otolaryngology education, particularly in resource-limited settings.</p><p><strong>Level of evidence: </strong>Level V.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70517"},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13413226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622036","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":"Malta Consensus Statements on Paranasal Sinus Disorders in SCUBA Diving: Results of a Delphi Study","authors":"B. Y. Roukema,&nbsp;H. F. van Waegeningh,&nbsp;R. J. P. Briët,&nbsp;H. G. Bremer,&nbsp;S. M. Reinartz","doi":"10.1002/lio2.70499","DOIUrl":"https://doi.org/10.1002/lio2.70499","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To establish expert consensus on the diagnostic approach, treatment strategies, and fitness-to-dive assessment for divers with paranasal sinus disease, addressing the current lack of specific guidelines for this frequent diving-related disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A rapid, conference-based modified Delphi process was conducted with a panel of 14 Dutch otorhinolaryngologists, including four certified diving medicine specialists. Consensus was defined as more than 80% agreement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The panel achieved consensus on recommendations across four domains. For diagnosis, a comprehensive ENT evaluation including nasal endoscopy is recommended; low-dose CT-imaging is advised for persistent or recurrent cases to identify anatomical obstructions. Primary management is conservative, adhering to EPOS guidelines. Functional endoscopic sinus surgery (FESS) is reserved for cases refractory to medical therapy, particularly those with anatomical obstruction. Postoperatively, it is advised to refrain from diving for a minimum of 8 weeks. Return to diving requires confirmed mucosal healing via endoscopy and a test dive under controlled conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This Delphi-based consensus provides practical, evidence-informed guidance for clinicians, bridging the gap in formal guidelines and promoting uniform evaluation and treatment strategies within diving medicine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70499","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148616224","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":"Transoral Robotic Surgery Versus Traditional Lingual Tonsillectomy for Persistent Pediatric Sleep Apnea.","authors":"Mona Dabbas, Christina Zhu, Emily Clementi, Samay Sampat, Kristen Mathew, Earl Harley","doi":"10.1002/lio2.70491","DOIUrl":"10.1002/lio2.70491","url":null,"abstract":"<p><strong>Objectives: </strong>This study compares postoperative outcomes of transoral robotic surgery (TORS) and traditional lingual tonsillectomy in pediatric patients with persistent obstructive sleep apnea (OSA) following tonsillectomy and adenoidectomy (T&A).</p><p><strong>Methods: </strong>A systematic search of Ovid MEDLINE, Embase, Cochrane CENTRAL, and Web of Science was conducted through January 2026. Inclusion criteria: pediatric patients (< 18 years) with persistent OSA following T&A, TORS, or traditional lingual tonsillectomy. Outcomes assessed included postoperative apnea-hypopnea index (AHI) reduction, bleeding, and non-bleeding complications.</p><p><strong>Results: </strong>A total of 17 studies were analyzed (<i>n</i> = 470; 25 TORS and 445 traditional procedures). Postoperative dysphagia was significantly higher among TORS (32%) versus traditional (1.3%; <i>p</i> < 0.001). Postoperative infection rates were greater after TORS (16% vs. 1.3%; <i>χ</i> ² = 14.88, <i>p</i> < 0.001). Meta-analysis demonstrated significantly greater postoperative bleeding with TORS (12%) versus traditional (3%, <i>χ</i> ² = 3.98, <i>p</i> = 0.046). AHI reduction was greater in TORS (mean: 16.20 events/h, 95% CI: 9.01-23.39) than in traditional (mean: 3.64 events/h, 95% CI: 2.03-5.25), with a significant subgroup difference (<i>χ</i> ² = 11.41, <i>p</i> < 0.001) indicating greater symptom resolution following TORS. No significant differences were observed in postoperative airway obstruction or bleeding requiring surgical intervention.</p><p><strong>Conclusion: </strong>Although TORS offers greater improvements in persistent pediatric OSA following T&A, its association with higher rates of postoperative dysphagia, infection, and bleeding warrants careful decision-making and further investigation in larger cohorts to refine patient selection and optimize outcomes.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70491"},"PeriodicalIF":1.9,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397471/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585794","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":"Long-Term Outcomes of Surgical Management for Submandibular Sialolithiasis: Gland Resection Versus Preservation.","authors":"Claire Orth, Edward Tannenbaum, Evgeniya Molotkova, Piper Vander Waal, Kailey Henkle, Henry Hoffman","doi":"10.1002/lio2.70515","DOIUrl":"10.1002/lio2.70515","url":null,"abstract":"<p><strong>Objective: </strong>Describe long-term outcomes of submandibular sialolithiasis treatment, comparing gland-preserving procedures to gland resection.</p><p><strong>Methods: </strong>This retrospective cohort study with prospective patient-reported outcome assessment study included all patients who underwent initial surgical management of submandibular sialolithiasis by a single surgeon from 2013 to 2018. Patients were contacted in 2024 and surveyed regarding treatment response. The primary outcome was xerostomia at long-term follow-up, measured using the Xerostomia Questionnaire (XQ). Secondary outcomes included stone recurrence, postoperative complications, and \"ultimate surgical success,\" defined as resolution of salivary symptoms without additional interventions during the 5-to-10-year interval following the initial series of procedures. Eighty-two patients were identified; 36 (43.9%) completed follow-up.</p><p><strong>Results: </strong>Of 36 respondents (median follow-up 97.4 months), 11 (30.6%) underwent initial gland resection and 25 (69.4%) underwent initial gland-preserving, sialendoscopy-assisted procedures. Among the preservation group, 1 patient required a second gland-preserving procedure, and 3 ultimately underwent gland removal due to persistent symptoms. Resolution of symptoms after the first procedure occurred in all resection patients (100%) and 18 of 25 (72%) in the preservation group. Among those with preserved glands at follow-up (<i>n</i> = 22), 6 (27.3%) reported xerostomia (mean XQ 8.0) compared to 4 of 14 (28.6%) in the resection group (mean XQ 3.4). Ultimate surgical success was achieved in 90.9% of the preservation group and 100% of the resection group.</p><p><strong>Conclusions: </strong>Both surgical approaches offer durable outcomes, though gland preservation may carry a higher risk of persistent symptoms and potential need for additional intervention. Xerostomia rates were comparable, suggesting gland preservation does not necessarily reduce long-term xerostomia risk.</p><p><strong>Level of evidence: </strong>OCEBM Level 4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70515"},"PeriodicalIF":1.9,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13395574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585751","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":"Facial Retaining Ligaments Influence Basal Cell Carcinoma Growth in the Midface and Periorbital Region.","authors":"Margareta Morrissette, Jin Hua Li, Nandita Varma Vegesna, Kira Minkis, Anthony P Sclafani","doi":"10.1002/lio2.70480","DOIUrl":"10.1002/lio2.70480","url":null,"abstract":"<p><strong>Objectives: </strong>Facial retaining ligaments (RLs) are well-characterized for their role in soft-tissue support and in rhytidectomy. This study investigates whether RLs also act as anatomical barriers that influence the spread of basal cell carcinoma (BCC). We hypothesized that the dermal insertion of RLs impedes the dermal spread pattern of BCCs, specifically causing them to grow along the RL.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 163 patients who underwent Mohs micrographic surgery (MMS) for BCC. Post-MMS defects were used as a proxy for the BCC size and shape. The defects were categorized as \"near,\" \"far,\" or \"crossing\" based on their proximity to the RL. Defect symmetry was quantified using the perpendicular-to-parallel ratio of the defect relative to the RL. A relative proximity ratio (RPR) was used for continuous linear regression analysis.</p><p><strong>Results: </strong>Analysis revealed significant defect asymmetry in lesions near RLs. The \"near\" group demonstrated a growth pattern parallel to the RL (ratio of 0.73) compared to the \"far\" group (ratio of 0.98, <i>p</i> < 0.0001). Linear regression confirmed that RPR was a predictor of tumor growth parallel to the RL (<i>B</i> = 0.099, <i>p</i> < 0.0001). Only 5.5% of lesions breached the RL.</p><p><strong>Conclusion: </strong>RLs correlate with an eccentric, oblong BCC growth pattern parallel to the direction of the ligament. Recognizing lesions within these zones may improve preoperative counseling and reconstructive planning.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70480"},"PeriodicalIF":1.9,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13390181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563347","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":"Nasal Alar Subunit Reconstruction: A Review of Data","authors":"Deanna C. Menapace,&nbsp;William W. Shockley,&nbsp;Matthew Miller,&nbsp;J. Madison Clark","doi":"10.1002/lio2.70494","DOIUrl":"10.1002/lio2.70494","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Alar reconstruction is common, yet high-quality outcomes data are limited. This review synthesizes the available literature to guide evidence-informed reconstructive choices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review identified 35 eligible studies reporting defect characteristics, techniques, and aesthetic, functional, and graft/flap outcomes. Single-patient case reports, purely technical papers, and studies without outcome data were excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Full-thickness skin grafts (FTSG), FTSG with cartilage, and composite grafts have been used with acceptable aesthetic outcomes for small defects. Local flaps are most common for small to intermediate defects, while regional flaps, particularly melolabial (MLF) and paramedian forehead flaps (PMFF), are the primary options for larger defects. PMFFs have higher reported cosmetic satisfaction but may require more secondary procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Standard data and evidence reporting for alar subunit reconstruction is very limited, with a predominance of retrospective and technique-driven studies and gestalt-based outcomes. Standardized reporting of defect size, functional outcomes, and validated patient-reported measures is needed. Until higher-quality data is available, reconstructive decisions should be individualized.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388029/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563371","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":"Patient Perspectives on Systemic Bevacizumab Treatment for Recurrent Respiratory Papillomatosis","authors":"Sarah Gao,&nbsp;Jada Jones,&nbsp;Vasiliki Triantafillou,&nbsp;Lee M. Akst,&nbsp;Alexander T. Hillel,&nbsp;Kevin M. Motz,&nbsp;Adam M. Klein,&nbsp;Simon R. Best","doi":"10.1002/lio2.70500","DOIUrl":"10.1002/lio2.70500","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Systemic bevacizumab has been shown to reduce the surgical burden of recurrent respiratory papillomatosis (RRP). However, no previous studies have examined specific patient-reported differences in quality-of-life (QoL) between systemic bevacizumab and surgical treatment. This study aimed to assess patient perspectives across two academic medical centers to inform clinical practice and shared decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-institutional survey was distributed to patients who previously underwent both systemic bevacizumab and surgical treatment for RRP. Participants rated their experiences with each treatment across four domains: QoL, adverse effects, economics, and mental health. Paired responses were compared using the Wilcoxon signed-rank test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 24 patients (mean age 48.3 years) who completed the survey, 18 (75%) were actively receiving systemic bevacizumab treatment. Mean age at RRP diagnosis was 17.1 years, and patients had undergone an average of 91.4 surgeries and 25.1 bevacizumab infusions. Compared with surgery, bevacizumab was associated with significantly improved self-reported voice (<i>p</i> &lt; 0.001), breathing (<i>p</i> &lt; 0.001), and swallowing (<i>p</i> &lt; 0.001), with longer-lasting vocal improvement (<i>p</i> = 0.031), lower pain (<i>p</i> &lt; 0.001), shorter vocal rest (<i>p</i> &lt; 0.001), and fewer side effects (<i>p</i> = 0.002) with each treatment. Although expenditure (<i>p</i> = 0.649) and travel time (<i>p</i> = 0.288) did not differ significantly, patients reported missing fewer days of work (<i>p</i> &lt; 0.001) during bevacizumab infusions. Moreover, optimism (<i>p</i> &lt; 0.001) was greater with decreased fear (<i>p</i> = 0.002) during bevacizumab therapy. Overall, 79% wished to continue receiving bevacizumab treatment, and 83% believed it offered a better QoL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Systemic bevacizumab improves patient QoL across multiple domains compared with surgical treatment and represents an important step toward more patient-centered care in RRP.</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":"11 4","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608799","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 Aspirin Usage in Free Flap Reconstruction of the Head and Neck.","authors":"Robert E Africa, Brian J McKinnon, Felix Maldonado-Chapa, Viran J Ranasinghe","doi":"10.1002/lio2.70508","DOIUrl":"10.1002/lio2.70508","url":null,"abstract":"<p><strong>Objective: </strong>To compare head and neck free flap outcomes and complications following aspirin administration.</p><p><strong>Methods: </strong>This is a multicenter, retrospective cohort study using data from the 107 healthcare organizations in the United States. Adult patients (≥ 18 years) with a history of head and neck cancer who received non-bony or bony free flap reconstruction were included. They were grouped by receiving 81 mg of aspirin (ASA81), 325 mg of aspirin (ASA325), or no aspirin on the same day of surgery or postoperatively. Primary outcomes included free flap failure, blood vessel repair, and need for flap revision. Relative risks (RR) with 95% confidence intervals (95% CI) were evaluated. Subgroup analysis was conducted between ASA81 and ASA325.</p><p><strong>Results: </strong>No differences in primary outcomes were observed for same day administration of aspirin. Postoperatively, ASA81 reduced the risk of flap failure and needing a blood vessel repair procedure (RR: 0.65[0.49-0.86]; 0.52[0.42-0.65]). ASA325 was also associated with a decreased risk of flap failure, need for blood vessel repair, and the need for flap revision procedures (RR: 0.10[0.08-0.13]; 0.57[0.46-0.71]; 0.37[0.32-0.41]) for all flap types. For non-bony reconstruction, all primary outcomes were lower in the ASA81 group (RR: 0.72[0.53-0.98]; 0.53[0.41-0.68]; 0.73[0.59-0.89]). ASA325 for non-bony flaps was also associated with lower rates of all three primary outcomes (RR: 0.47[0.34-0.64]; 0.63[0.49-0.80]; 0.80[0.68-0.94]). Aspirin use in bony flaps was associated with similar outcomes. ASA81 compared to ASA325 for non-bony reconstruction was associated with higher flap failure (RR: 1.69[1.16-2.46]).</p><p><strong>Conclusion: </strong>For non-bony and bony free flap reconstruction, aspirin was associated with decreased risks of free flap failure, blood vessel repair, and flap revision.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70508"},"PeriodicalIF":1.9,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13382363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148608771","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}