Laryngoscope Investigative Otolaryngology最新文献

{"title":"Comparative Outcomes of Surgical vs. Non-Surgical Interventions in Advanced Oropharyngeal Cancer: A Large-Scale Retrospective Cohort Study","authors":"Khang Win Vu,&nbsp;Martha Watson,&nbsp;Abdallah Attia,&nbsp;Ahmed Abdelmaksoud,&nbsp;Manal S. Fawzy,&nbsp;Eman A. Toraih","doi":"10.1002/lio2.70279","DOIUrl":"https://doi.org/10.1002/lio2.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare short-term complications and long-term survival outcomes between surgical and non-surgical treatments for oropharyngeal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a large-scale retrospective cohort study using the TriNetX Global Collaborative Network, analyzing data from 154,494,403 patients across 128 healthcare organizations. After applying inclusion criteria and propensity score matching, we compared 2413 surgical patients with 2413 non-surgical patients. Primary outcomes included short-term complications at 6 months (dysphagia, gastrostomy tube placement, tracheostomy, respiratory complications) and 5-year all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 6 months post-treatment, surgical patients showed higher rates of dysphagia (46.83% vs. 40.61%, RR = 1.15, 95% CI: 1.08–1.23) and respiratory complications (6.30% vs. 3.69%, RR = 1.71, 95% CI: 1.32–2.21). Non-surgical patients experienced increased rates of gastrostomy tube placement (17.86% vs. 6.09%, RR = 0.34, 95% CI: 0.29–0.41) and tracheostomy (7.34% vs. 3.61%, RR = 0.49, 95% CI: 0.38–0.63). Similarly, subgroup analysis of the advanced-stage cohort showed that non-surgical patients had higher rates of gastrostomy tube placement (5.5% vs. 17.5%, RR = 0.31, CI: 0.19–0.52) and tracheostomy (3.1% vs. 6.4%, RR = 0.48, CI: 0.23–0.99). At 5-year follow-up, surgical intervention was associated with significantly lower all-cause mortality (9.9% vs. 25.3%, HR = 0.43, 95% CI: 0.37–0.49). This survival benefit persisted in the advanced-stage subgroup (14.1% vs. 25.5%, HR = 0.53, 95% CI: 0.37–0.76) (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While surgical treatment for oropharyngeal cancer was associated with higher rates of certain short-term complications, it demonstrated superior long-term survival outcomes compared to non-surgical interventions, including in patients with advanced disease. These findings provide valuable evidence to inform treatment selection and patient counseling in oropharyngeal cancer management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2b.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272500","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":"Missed Adjuvant Therapy Following Upfront Laryngectomy for Laryngeal Squamous Cell Carcinoma","authors":"Aman M. Patel,&nbsp;Afash Haleem,&nbsp;Praneet C. Kaki,&nbsp;Rohini Bahethi,&nbsp;Soly Baredes,&nbsp;Richard Chan Woo Park","doi":"10.1002/lio2.70276","DOIUrl":"https://doi.org/10.1002/lio2.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate adjuvant therapy considerations, utilization, and associated overall survival (OS) following upfront laryngectomy for laryngeal squamous cell carcinoma (LSCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2010 to 2017 National Cancer Database was retrospectively reviewed for patients undergoing upfront laryngectomy (<i>N</i> = 3360). Kaplan–Meier, multivariable binary logistic, and Cox proportional hazards regression models were implemented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2997 patients with consideration(s) for adjuvant radiotherapy (aRT) (i.e., pT3-4, pN2-3 classification, lymphovascular invasion, pathologic extranodal extension (pENE), and/or positive surgical margins [PSM]), 1176 (39.2%) did not undergo adjuvant therapy and were considered to have missed aRT. Among 992 patients with consideration(s) for adjuvant chemoradiotherapy (aCRT) (i.e., pENE and/or PSM), 169 (17.0%) underwent aRT alone and were considered to have missed aCRT. Older age and increased distance to the reporting facility were associated with higher adjusted odds of both missed aRT (<i>p</i> &lt; 0.001) and missed aCRT (<i>p</i> &lt; 0.025). Patients with pENE only (<i>N</i> = 343, 57.6%) and pENE and PSM (<i>N</i> = 96, 56.8%) underwent aCRT more frequently than those with PSM only (<i>N</i> = 97, 42.5%) (<i>p</i> &lt; 0.001). Missed aRT was associated with worse OS among 2005 patients with consideration(s) for aRT alone (i.e., pT3-4, pN2-3 classification, and/or LVI without pENE or PSM) (aHR 1.23, 95% CI 1.05–1.44, <i>p</i> = 0.011) and among 992 patients with consideration(s) for aCRT (aHR 1.85, 95% CI 1.52–2.24, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Missed aRT following upfront laryngectomy for LSCC occurs frequently and portends worse OS. Identifying patients at risk of off-guideline management may create opportunities for quality improvement in the multidisciplinary care of patients undergoing upfront laryngectomy for LSCC.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272580","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":"Association of Life's Essential 8 With Hearing Loss and Tinnitus in U.S. Adults","authors":"Xing Lin,&nbsp;Yuxi Lin,&nbsp;Siyi Tang,&nbsp;Huimin Cai,&nbsp;Heng Xiao,&nbsp;Chang Lin,&nbsp;Shengnan Ye","doi":"10.1002/lio2.70270","DOIUrl":"https://doi.org/10.1002/lio2.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between cardiovascular health, measured by Life's Essential 8 (LE8) score, and hearing loss and tinnitus among U.S. adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis was conducted on 4624 adults (≥ 20 years) from NHANES 2005–2018 cycles. Cardiovascular health was assessed via the LE8 score, encompassing eight health behaviors and factors. Audiometry-measured speech-frequency hearing loss, defined as pure-tone average (PTA) ≥ 20 dB in the better ear at 500–4000 Hz, and subjective hearing loss and tinnitus were assessed using self-reported questionnaires. Multivariable logistic regression models adjusted for confounders examined associations between LE8 scores and auditory conditions. Additional analyses included restricted cubic spline regression, subgroup, and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher LE8 scores, indicating better cardiovascular health, were significantly associated with lower odds of audiometry-measured speech-frequency hearing loss (adjusted OR: 0.84; 95% CI: 0.77–0.92), subjective hearing loss (adjusted OR: 0.82; 95% CI: 0.77–0.88), and tinnitus (adjusted OR: 0.88; 95% CI: 0.81–0.96). Subgroup analyses showed consistent associations for audiometry-measured hearing loss and tinnitus across demographic strata, while findings for subjective hearing loss varied by sex. Sensitivity analyses confirmed the robustness of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Better cardiovascular health, as measured by LE8 score, is associated with lower odds of hearing loss and tinnitus among U.S. adults. These findings suggest that the LE8 score may serve as a valuable integrated metric for evaluating cardiovascular health in relation to auditory outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2b.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272925","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":"Extracorporeal Septoplasty for Severe Nasal Septal Deviation: A Systematic Review","authors":"Matteo Lazzeroni,&nbsp;Jèrôme René Lechien,&nbsp;Mario Lentini,&nbsp;Pasquale Capaccio,&nbsp;Alberto Maria Saibene,&nbsp;Michele Gaffuri,&nbsp;Antonio Mario Bulfamante,&nbsp;Luca Giovanni Locatello,&nbsp;Portelli Tancredi,&nbsp;Ingrassia Angelo,&nbsp;Federico Sireci,&nbsp;Antonino Maniaci","doi":"10.1002/lio2.70280","DOIUrl":"https://doi.org/10.1002/lio2.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Extracorporeal septoplasty (ECS) is a surgical technique used to address severe nasal septal deviations, especially in patients in whom in situ septoplasty (ISS) is insufficient. This systematic review assesses the efficacy, safety, and clinical outcomes of ECS techniques, including conventional and modified ECS methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>PRISMA-compliant systematic search of PubMed, Scopus, Web of Science, and Embase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies on ECS techniques were included. Eligibility criteria were established using the PICOTS framework. Study quality was assessed using the Cochrane Risk of Bias 2 tool and the Newcastle-Ottawa Scale. Functional and aesthetic improvements were primary outcomes, while complication rates represented secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two studies (retrospective, prospective, and RCTs) met the inclusion criteria. ECS was associated with significant functional improvement, as assessed by nasal obstruction scores measured by NOSE scores, acoustic rhinometry, and rhinomanometry. Aesthetic results were also satisfactory, with a significant improvement in the nasofrontal angle, nasolabial angle, and the tip projection index, as well as good patients' satisfaction. Complications were rare, with few cases of septal perforation, graft resorption, or residual nasal obstructive symptoms. Evidence strength was limited considering the majority of included studies were retrospective, with inherent bias risks, small sample sizes, and inconsistent follow-up durations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ECS may be a successful and safe method for severe septal deviation correction, providing functional and aesthetic results with a low complication rate. More high-quality, multicenter RCTs with long-term follow-up will be required for a standardization of surgical protocols and outcome measures.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272924","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":"The Associative Impact of Recreational Cannabis Use on Sinonasal Diseases","authors":"Zain Mehdi,&nbsp;Heli Majeethia,&nbsp;Jagan M. R. Dwarampudi,&nbsp;Aatin K. Dhanda,&nbsp;Meher Gajula,&nbsp;Lexi Goehring,&nbsp;Faizaan Khan,&nbsp;Roshan Dongre,&nbsp;Franklin Wu,&nbsp;Renjie Hu,&nbsp;Michael T. Yim,&nbsp;Masayoshi Takashima,&nbsp;Omar G. Ahmed","doi":"10.1002/lio2.70261","DOIUrl":"10.1002/lio2.70261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>With growing cannabis use in the US, it is crucial to understand the impact of recreational use on sinonasal diseases like chronic rhinosinusitis (CRS), allergic rhinitis (AR), and chronic rhinitis (CR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study leveraged the NIH AllOfUs database to query patient surveys assessing cannabis usage frequency (lifetime never, monthly, weekly, or daily within the past 3 months) and consumption route (smoking or non-smoking). Cannabis users were matched to never users for demographics, healthcare visit frequency, and insurance. A stringent logistic regression model calculated odds ratios (OR) of developing AR, CRS, or CR after survey completion. Cox regression hazard ratios (HR) compared consumption routes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five thousand one hundred sixty-four cannabis users were matched with 113,418 never users. Users demonstrated significantly lower odds of AR, CRS, and CR than never users. For CRS, the ORs compared to never users are as follows: daily users 0.64 (95% CI 0.53–0.78), weekly users 0.61 (95% CI 0.48–0.77), and monthly users 0.80. For AR, the ORs were 0.64 (95% CI 0.58–0.71) for daily users, 0.62 (95% CI 0.54–0.71) for weekly users, and 0.69 (95% CI 0.58–0.80) for monthly users. For CR, the ORs were 0.61 (95% CI 0.47–0.79) for daily users, 0.64 (95% CI 0.47–0.87) for weekly users, and 0.41 (95% CI 0.26–0.65) for monthly users. There was no significant difference between smokers and non-smokers (HR 0.64, 95% CI 0.27–1.5).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is an inverse, associative relationship between cannabis use and sinonasal disease. This relationship is insufficiently understood, and there remain significant concerns about the impact of cannabis use, especially smoking, on airway pathologies.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253223","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 CI Systems for Better Recognition of Soft Speech —the Concept of Broad-Range Mapping","authors":"Matthias Hey,&nbsp;Thomas Hocke","doi":"10.1002/lio2.70273","DOIUrl":"10.1002/lio2.70273","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The individual mapping of cochlear implants (CIs) aims to optimize the user's speech understanding. Recent investigations have shown the importance of soft speech: (1) According to Datalog studies, a large proportion of speech components lies in the range below 60 dB, and (2) soft speech represents a separate category in CI outcome, in addition to supra-threshold speech and speech in noise. Soft-speech understanding can be influenced by optimizing T-values or by global parameters (loudness growth and TSPL in the Nucleus system). This study focussed on improving soft speech below 60 dB by optimizing loudness growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Speech understanding with varying loudness growth in the speech processor CP11 (Cochlear Ltd.) was compared in 20 experienced adult CI users. The mean soft-speech score based on monosyllabic words at 40 and 50 dB was introduced for quantification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Six of the 20 patients studied showed significant individual improvement for soft speech when loudness growth was optimized, while none showed a significant decrease under quiet or noisy test conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Actual CI systems offer a broad loudness range of speech understanding. In addition to suprathreshold speech understanding, additional attention should be paid to soft speech, and the result should therefore be confirmed by speech audiometry at low levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Levels of Evidence</h3>\u0000 \u0000 <p>2.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253210","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":"Treatment of Biopsy-Proven Laryngeal Squamous Cell Carcinoma In Situ","authors":"Praneet C. Kaki,&nbsp;Aman M. Patel,&nbsp;Lily Huang,&nbsp;Gavin Turner,&nbsp;Afash Haleem,&nbsp;Jason A. Brant,&nbsp;Robert M. Brody,&nbsp;Ryan M. Carey","doi":"10.1002/lio2.70267","DOIUrl":"10.1002/lio2.70267","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the impact of clinical surveillance, primary radiotherapy, and primary surgery on overall survival (OS) in laryngeal carcinoma in situ (Cis).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2006–2020 National Cancer Database was queried for adults with a biopsy-proven diagnosis of laryngeal Cis. Multivariable binary logistic and Cox proportional hazards regression models were implemented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 3567 unique patients satisfying inclusion criteria, 514 (14.4%) underwent clinical surveillance, 1074 (30.1%) underwent primary radiotherapy, and 1979 (55.5%) underwent primary surgery. Receiving treatment at an academic/research facility was associated with higher odds of undergoing primary surgery compared to primary radiotherapy. Among 646 patients undergoing primary surgery with known pT classification and margins, 570 (76.6%) had pTis and NSM and 174 (23.4%) had pT1 and/or PSM. 5-year OS of clinical surveillance, primary radiotherapy, and primary surgery was 73%, 81%, and 86%, respectively (<i>p</i> &lt; 0.001). Patients undergoing primary surgery with invasive or residual disease (i.e., pT1 and/or PSM) had similar 5-year OS as those without (84% vs. 88%, <i>p</i> = 0.057). Compared with primary radiotherapy, clinical surveillance (aHR 1.29, 95% CI 1.06–1.57, <i>p</i> = 0.003) was associated with worse OS, and primary surgery (aHR 0.80, 95% CI 0.69–0.92, <i>p</i> = 0.003) was associated with higher OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Primary surgery is associated with higher OS than clinical surveillance and primary radiotherapy among patients with laryngeal Cis.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253324","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":"Social Determinants of Health in Endoscopic Anterior Skull Base Surgery: A Systematic Review and Meta-Analysis","authors":"Shvetali Thatte,&nbsp;Radhika Duggal,&nbsp;Kaelan Wong,&nbsp;Mohamad R. Chaaban","doi":"10.1002/lio2.70264","DOIUrl":"10.1002/lio2.70264","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Social determinants of health (SDOH) have been extensively studied in multiple fields, but studies in endoscopic anterior skull base surgery are limited. Our systematic review examines studies analyzing SDOH and their association with endoscopic anterior skull base surgery outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This December 2023 systematic review surveyed literature via Embase, Web of Science, MEDLINE, and CENTRAL using predefined syntax analyzing SDOH in endoscopic anterior skull base surgery outcomes. Two independent authors screened the titles, abstracts, and full text for eligibility of inclusion, with a third author resolving any conflicts that arose.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 18 studies from 2015 to 2023, the most common SDOH included were insurance status (67%, <i>n</i> = 12), race and ethnicity (61%, <i>n</i> = 11), and SES (50%, <i>n</i> = 9). Common outcomes included rate of postoperative complications (67%, <i>n</i> = 12), length of stay (56%, <i>n</i> = 10), and 30-day readmissions (39%, <i>n</i> = 7). Asian patients had higher odds of 30-day readmission compared to White patients (OR = 1.30, 95% CI: 1.04–1.62, <i>p</i> = 0.02). Black patients had an increased risk of postoperative diabetes insipidus compared to White patients (RR = 1.32, 95% CI: 1.09–1.59, <i>p</i> &lt; 0.01). Medicaid patients had higher odds for 30-day readmission (OR = 1.30, 95% CI: 1.08–1.56, <i>p</i> &lt; 0.01) and greater risk of postoperative diabetes insipidus (RR = 1.25, 95% CI: 1.02–1.52, <i>p</i> = 0.03) compared to private insurance patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Several studies indicate that race and insurance status significantly influence rates for readmission and postoperative complications in endoscopic anterior skull base surgery. The heterogeneity of other SDOH suggests further research to consolidate the findings and explore potential links explaining the observed variations.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253200","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":"Endoscopic Vascular Grading Directs Stepwise Therapy in Hereditary Hemorrhagic Telangiectasia","authors":"Hong-Gang Duan,&nbsp;Fang Ji,&nbsp;Hui Yuan,&nbsp;Lin-Rong Li,&nbsp;Ke-Jia Yu,&nbsp;Zhen-Yuan Wei","doi":"10.1002/lio2.70272","DOIUrl":"10.1002/lio2.70272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To establish a nasal endoscopic vascular grading system for predicting epistaxis severity and guiding stepwise therapy in hereditary hemorrhagic telangiectasia (HHT).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort of 32 HHT patients from 22 families was classified via 1080p endoscopy into three grades: Grade I: Sparse punctate telangiectases; Grade II: Dense confluent vessels; Grade III: Protruding hemangiomas. Demographics, Epistaxis Severity Score (ESS), hemoglobin levels (Hb), systemic vascular lesions, and ENG/ACVRL1 mutations were analyzed. Treatment outcomes were compared across grades.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Grade I accounted for 18.8%, Grade II for 34.4%, and Grade III for 46.9%. Grade III patients showed the highest ESS (6.31 ± 2.13 vs. 1.21 ± 0.92 for Grade I, <i>p</i> &lt; 0.01) and the lowest Hb (97.2 ± 22.4 vs. 129.5 ± 4.9 g/L for Grade I, <i>p</i> &lt; 0.05), and had more systemic lesions (80.0% of Grade III patients had hand/oral/visceral hemangiomas vs. 16.7% in Grade I, <i>p</i> &lt; 0.01). Local therapies or tranexamic acid treatment sufficed for Grade I/II patients, who maintained stable ESS. Among Grade III patients who showed no improvement after treatment with tranexamic acid, bevacizumab (administered at a dose of 5 mg/kg every 3–6 months) improved the ESS and increased the Hb in 62.5% of the patients (5 out of 8), and no severe adverse events occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study preliminarily confirms a significant correlation between nasal endoscopic vascular morphology and HHT epistaxis severity, guiding disease assessment and treatment planning.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253237","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":"Radiologic Evaluation of Paranasal Sinuses in Sickle Cell Anemia and Thalassemia: Case–Control Study","authors":"Maha A. Alharbi,&nbsp;Ayat AlDarwish,&nbsp;Reem M. Alamier,&nbsp;Nawal E. Omer,&nbsp;Mahmoud A. Alabbad,&nbsp;Abdulmohsin M. Aljassem,&nbsp;Qasem M. ALalwan,&nbsp;Danah H. Althomaly,&nbsp;Hussain Abdullali Albaharna","doi":"10.1002/lio2.70268","DOIUrl":"10.1002/lio2.70268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Sickle cell disease and thalassemia are inherited hematological disorders that are common worldwide. These patients suffer from chronic hemolytic anemia, which can result in bone marrow dysfunction and, in rare cases, extramedullary hematopoiesis. These pathophysiological changes can predispose patients to sinus complications or misdiagnosis in imaging studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluate the maxillary sinus abnormalities in patients with β-thalassemia, sickle cell anemia, and sickle cell–beta thalassemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A multicenter, case–control study was conducted, including 212 participants, categorized into four groups: control (<i>n</i> = 100), sickle cell anemia (<i>n</i> = 51), β-thalassemia (<i>n</i> = 15), and sickle cell-beta thalassemia (<i>n</i> = 46). Demographic information, laboratory parameters (mean hemoglobin levels and hemoglobin electrophoresis), history of hydroxyurea use, and blood transfusion were recorded. Computed tomography was used to assess sinus wall thickness, extramedullary hematopoiesis, and related sinonasal abnormalities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Significant maxillary sinus wall thickening across all disease groups was found, with the β-thalassemia exhibiting the most pronounced changes (<i>p</i> &lt; 0.001). A negative correlation was observed between hemoglobin levels and sinus wall thickness in sickle cell anemia. Extramedullary hematopoiesis in the paranasal sinuses, although rare, was identified in five patients with β-thalassemia. Obstruction of the ostiomeatal complex was observed in 14.3% of the β-thalassemia, 13.7% of sickle cell anemia, and 6.5% of sickle cell–beta thalassemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings reveal significant maxillary sinus wall thickening in β-thalassemia, sickle cell anemia, and sickle cell–beta thalassemia. Recognizing these structural changes is important for radiologists and otolaryngologists, as they may resemble other pathologies and lead to diagnostic challenges if not carefully interpreted.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12501765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253216","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}