Laryngoscope Investigative Otolaryngology最新文献

{"title":"Systematic Review of Granulomatous Invasive Fungal Sinusitis Management","authors":"Abdulsalam Baqays,&nbsp;Sarah Almutawa,&nbsp;Razan Alsabti,&nbsp;Luluh Alsughayer,&nbsp;Sandra Campbell,&nbsp;Nassr Almaflehi,&nbsp;Hussain Albaharana,&nbsp;Saad Alsaleh","doi":"10.1002/lio2.70086","DOIUrl":"10.1002/lio2.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Granulomatous invasive fungal sinusitis (GIFS) affects immunocompetent individuals. There is ongoing debate over whether surgery, antifungal medication, or a combined approach is the best treatment. This article summarizes reports about GIFS and its management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Eight search engines, gray literature, and review articles were searched. Two independent reviewer groups screened the eligibility of articles. An independent reviewer solved disagreements. Exclusion criteria included non-English language reports, papers with unavailable full-texts, reviews, publications before 1980, and studies lacking information about GIFS management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 279 identified articles, 41 studies were included (<i>n</i> = 89 patients). Sinonasal GIFS with skull-base/intracranial extension was associated with an increase in mortality (<i>p</i> = 0.002, OR = 14.083; 95% CI = 1.753–113.157). Treatment was associated with an 87.2% remission rate (<i>p</i> &lt; 0.001, OR = 7.818; 95% CI = 4.502–13.576); a combined medical and surgical approach had a 74.2% recovery rate. Of surgical interventions, the highest recovery rates were associated with endoscopic debulking (52.5%), extensive surgical debulking (32.5%), and open sinonasal approach (15%, <i>p</i> = 0.132). The utilization of voriconazole was associated with higher recovery rates, but this was not significant (76.9 vs. 56%, <i>p</i> = 0.548).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Sinonasal GIFS with skull-base/intracranial extension is associated with higher mortality rates. The superiority of the endoscopic debulking and voriconazole protocol in managing these cases warrants further investigation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048414","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":"Smartphone Thermal Imaging as an Adjunct to Identify Free Flap Perforators and Assisting Flap Design: A Pilot Study","authors":"Ahmed Saleem,&nbsp;Jonas Philteos,&nbsp;Shayanne Lajud,&nbsp;Ashok Jethwa,&nbsp;Carissa Thomas,&nbsp;Christopher M. L. K. Yao,&nbsp;David P. Goldstein,&nbsp;Kevin P. Higgins","doi":"10.1002/lio2.70081","DOIUrl":"10.1002/lio2.70081","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The main technique for identification of free flap perforator vessels is Doppler sonography, which is not always accurate, user dependent and affected by the patient's body habitus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Adult patients undergoing head and neck resection and free flap reconstruction at two academic institutions were enrolled. Doppler sonography was used to identify perforators, and were marked using a skin marker. The donor site was cooled down for 3 min using a sterile iced saline bag. FLIR-ONE (FLIR Systems Inc., Wilsonville, OR) camera was used to assess for “hot spots” during a 3–5 min period of re-warming as a surrogate for cutaneous blood flow. The distance between the Doppler signal location, and the “hot spot” was recorded. The position of the perforator was then identified intraoperatively and the distances between the surgical position, the Doppler and “hot spot” were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 28 patients were included. For all flap types, FLIR thermal imaging measurements consistently tended to be closer to the surgical site compared to Doppler ultrasound. In anterolateral thigh flaps (<i>n</i> = 20), thoracodorsal artery perforator flaps (<i>n</i> = 5), and fibula osteocutaneous flaps (<i>n</i> = 3), absolute mean differences ranged from 0.62 to 1.33 cm, with trends favoring FLIR. While paired <i>t</i>-tests did not reach statistical significance, both methods correlated with intraoperatively identified skin perforators, and distances generally ranged between 0 and 2 cm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We demonstrate that a smartphone-based thermal imaging system has the potential to serve as an adjunct for identifying flap perforators, with the possibility of reducing operative times and minimizing patient morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748207/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014038","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":"Multi-Institutional Comparison of Quality of Life Between Open Versus Endoscopic Skull Base Approaches","authors":"John R. de Almeida,&nbsp;Katrina Hueniken,&nbsp;Michael Xie,&nbsp;Eric Monteiro,&nbsp;Gelareh Zadeh,&nbsp;Aristotelis Kalyvas,&nbsp;Patrick Gullane,&nbsp;Carl Snyderman,&nbsp;Eric Wang,&nbsp;Paul Gardner,&nbsp;Dan Fliss,&nbsp;Barak Ringel,&nbsp;Ziv Gil,&nbsp;Shorook Na'ara,&nbsp;Eng Ooi,&nbsp;David Goldstein,&nbsp;Ian Witterick","doi":"10.1002/lio2.70082","DOIUrl":"10.1002/lio2.70082","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The primary objective of this prospective review was to compare quality of life between patients undergoing endoscopic and open skull base approaches.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Type and Design</h3>\u0000 \u0000 <p>Prospective Review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five centers recruited consecutive patients treated surgically for skull base neoplasms between 2012 to 2018. The Skull Base Inventory (SBI), Anterior Skull Base (ASB), and Sinonasal Outcome Test (SNOT-22) were administered up to 12 months post-operatively. Mean change from baseline scores were compared with univariable and multivariable analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 180 patients were included: 108 (60%) F and 72 (40%) M, of whom 126 (70%) underwent endoscopic and 54 (30%) underwent open approaches. Patients undergoing endoscopic approaches were more likely to have sellar or clival pathology (68 vs. 15%, <i>p</i> &lt; 0.001). Those undergoing endoscopic approaches had better disease-specific quality of life at one year using the SBI and ASB (mean change from baseline = 7.2 vs. 0.69, <i>p</i> = 0.004; 5.8 vs. −1.1, <i>p</i> = 0.002), respectively. On multivariable analysis, endoscopic approach was associated with greater improvement in overall quality of life (mean difference in change scores from baseline = 6.5, <i>p</i> = 0.009), as well as endocrine (mean difference = 8.3, <i>p</i> = 0.011), neurologic (mean difference = 8.3, <i>p</i> = 0.012), visual (mean difference = 7.9; <i>p</i> = 0.032), financial (mean difference = 9.7, <i>p</i> = 0.03), and spiritual domain scores (mean difference = 4.0, <i>p</i> = 0.035). Subgroup analyses of pituitary and non-pituitary histopathologies demonstrated trends towards greater quality of life at 1-year compared to baseline in the endoscopic approach compared to the open group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Endoscopic approaches are associated with better quality of life compared to open approaches. However, baseline differences in histopathology between the group limit the direct comparison of the open and endoscopic approaches. Future studies with larger and more homogenous samples are required.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV evidence.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014392","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 Qualitative Study of Attitudes Toward HPV Vaccine Recommendation in Otolaryngology Clinics","authors":"Emily A. Janio,&nbsp;Cori Walker,&nbsp;Eliza Steere,&nbsp;Aaron T. Seaman,&nbsp;Natoshia Askelson,&nbsp;Nitin A. Pagedar","doi":"10.1002/lio2.70085","DOIUrl":"10.1002/lio2.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The incidence of human papillomavirus (HPV)-related oropharyngeal cancers has increased such that they are now the most prevalent HPV-related cancer. In 2020, the Food and Drug Administration (FDA) expanded the indication for Gardasil-9 to include the prevention of oropharyngeal and other head and neck cancers caused by selected HPV types, but uptake remains low. Otolaryngology office interactions may provide opportunities to increase uptake, given the relevance of HPV to clinical practice. This study explored the feasibility of recommending HPV vaccination in otolaryngology clinics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants were recruited between February to June of 2022 from the alumni of the residency and fellowship training programs at the University of Iowa Hospitals and Clinics. Participant interviews comprised open-ended questions pertaining to otolaryngologists' attitudes toward HPV vaccination recommendation. Interview recordings were transcribed, coded, and analyzed for themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants were willing to respond if patients asked about the HPV vaccine, although a common attitude toward vaccine discussions was that they were a pediatrician's responsibility. One barrier to recommending HPV vaccination was providers' concern that discussing the vaccine when not directly relevant to the patient's chief complaint could result in patient frustration. Nevertheless, participants endorsed the feasibility of discussing the vaccine during follow-up visits after the patient's needs had been addressed or via the distribution of educational materials to patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Otolaryngologists do not currently identify recommending HPV vaccine uptake as their clinical responsibility. While such recommendations may not be feasible in every patient encounter, there could be a role for this in the appropriate clinical scenario. These findings can be used to inform interventions aimed at recommending the vaccine in otolaryngology clinics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014391","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 Predictive Model for Secondary Posttonsillectomy Hemorrhage in Pediatric Patients: An 8-Year Retrospective Study","authors":"Yuting Ge,&nbsp;Wenchuan Chang,&nbsp;Lixiao Xie,&nbsp;Yan Gao,&nbsp;Yue Xu,&nbsp;Huie Zhu","doi":"10.1002/lio2.70080","DOIUrl":"10.1002/lio2.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Posttonsillectomy hemorrhage (PTH) is a common and potentially life-threatening complication in pediatric tonsillectomy. Early identification and prediction of PTH are of great significance. Currently, there are very few tools available for clinicians to accurately assess the risk of PTH. This study aimed to develop and validate a predictive model for secondary PTH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was conducted on 492 individuals who underwent tonsillectomy or tonsillotomy in Children's Hospital of Soochow University from July 1st, 2015 to December 31th, 2023. The study population was randomly divided into the training set and the validation set at a ratio of 7:3. Univariate logistic regression analysis was used to screen features. Multivariate logistic regression and seven machine learning algorithms were used to construct predictive models. Discrimination, calibration, and clinical utility were used to compare the predictive performance. The SHapley Additive exPlanation (SHAP) method was used to interpret the results of the best-performing model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One multivariate logistic regression model and seven machine learning models were constructed. The XGBoost model yielded the best performance in the validation set. The SHAP method ranked the features of the XGBoost model based on their importance and provided both global and local explanations of the model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study established a machine learning-based predictive model for secondary PTH, which may enable clinicians to accurately assess the risk of secondary PTH in children.</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 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014390","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":"Prognostic value of inflammation and nutritional indicators for sinonasal squamous cell carcinoma: A single-center retrospective study","authors":"Ce Wu MD,&nbsp;Zhiyu Qi MD,&nbsp;Jiahong Chen MD,&nbsp;Xudong Yan MD, PhD,&nbsp;Shunke Li MD,&nbsp;Lin Wang MD,&nbsp;Longgang Yu MD, PhD,&nbsp;Yan Jiang MD, PhD","doi":"10.1002/lio2.70046","DOIUrl":"10.1002/lio2.70046","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Systemic inflammatory and nutritional markers are associated with the prognosis of various cancers. However, their association with sinonasal squamous cell carcinoma (SNSCC) prognosis remains unclear. This study aimed to identify systemic inflammatory and nutritional markers associated with the postoperative prognosis of patients with SNSCC and to clarify the clinical value of these markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and methods</h3>\u0000 \u0000 <p>Data from 129 patients with SNSCC were included. The optimal prognostic systemic inflammatory and nutritional markers were identified using the area under the curve. The prognostic value was evaluated using COX regression and subgroup analyses; a nomogram was built based on these data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The advanced lung cancer inflammation index (ALI) and systemic immune-inflammatory index (SII) had higher prognostic values than the other indices; their cut-off values were 27.80 and 791.35, respectively. The nomogram included tumor stage, ALI, and tumor primary site; the calibration and decision curves indicated that the model had good clinical value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The ALI and SII have potential prognostic value for postoperative patients with SNSCC. The nomogram constructed in this study could be used as a tool to assist physicians in making clinical decisions.</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 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013603","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":"Validity and Reliability of the Arabic Cough Severity Index","authors":"Hamad F. Alrabiah,&nbsp;Nawaf Alqarni,&nbsp;Nuha Alrajhi,&nbsp;Aban Basfar,&nbsp;Tamer A. Mesallam,&nbsp;Mohamed Farahat,&nbsp;Khalid H. Malki","doi":"10.1002/lio2.70074","DOIUrl":"10.1002/lio2.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to translate and validate the Cough Severity Index (CSI) into Arabic (A-CSI) and to evaluate its validity and reliability among patients with chronic cough.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional descriptive questionnaire-based validation study was conducted at two tertiary hospitals in Riyadh, Saudi Arabia, between December 2023 and August 2024. The CSI was translated from English into Arabic using the forward-backward method. Its reliability was assessed using Cronbach's alpha and test–retest reliability. Its construct validity was assessed using exploratory factor analysis (EFA), and its internal consistency was assessed using Cronbach's alpha. Its discriminant validity was determined using the Mann–Whitney <i>U</i> test, and its reproducibility was evaluated using the intraclass correlation coefficient (ICC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data were collected from 100 participants, 50 with chronic cough and 50 healthy controls. The mean age was 41.56 ± 14.28 years in the chronic cough group and 35.48 ± 10.02 years in the healthy control group. The A-CSI exhibited high reproducibility (ICC = 0.896) and excellent internal consistency (Cronbach's alpha = 0.966). EFA identified three factors explaining 66.41% of the variance, with all items having communalities &gt; 0.3. The A-CSI exhibited significant discriminant validity between the chronic cough and healthy control groups (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The A-CSI is a reliable and valid tool for assessing chronic cough in Arabic-speaking patients, making it suitable for both clinical practice and research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014160","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":"Polysomnographic features of hypoglossal nerve stimulation efficacy: Looking deeper than the apnea-hypopnea index","authors":"Raymond J. So AB,&nbsp;Luu V. Pham MD,&nbsp;David W. Eisele MD,&nbsp;Kevin Motz MD","doi":"10.1002/lio2.70068","DOIUrl":"10.1002/lio2.70068","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Hypoglossal nerve stimulation (HGNS) is a promising surgical option for patients with obstructive sleep apnea (OSA) who are intolerant of continuous positive airway pressure therapy (CPAP). Efficacy studies for HGNS stimulation largely focus on the apnea–hypopnea index and/or oxygen desaturation index. This study's objective was to show the physiological effects of HGNS stimulation on upper airway patency, airflow, and treatment effect during polysomnography (PSG) testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>PSG tracings from patients implanted with an Inspire© HGNS device were reviewed for this study. Nasal pressure was utilized as a surrogate for respiratory flow and chin electromyography was used to detect HGNS stimulation, allowing for breath-to-breath analysis. Per our sleep laboratory protocol, the HGNS device was turned on and off at different periods of the night. Respiratory tracings during these periods were visually analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis of on–off periods of HGNS therapy during PSG allows for a concise assessment of HGNS efficacy. The presence of inspiratory flow limitation and subsequent apneas or hypopneas upon turning off HGNS stimulation with restoration of stable, unobstructed breathing upon resuming HGNS stimulation indicates a positive treatment effect related to HGNS therapy. Despite the respiratory-sensing capacity of the Inspire HGNS device, desynchrony of stimulation and inspiration is observed. Desynchrony yields partially captured inspiratory cycles, allowing for assessment of HGNS effect on an individual breath.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Night-to-night and intranight variability in OSA severity makes assessing the effect of HGNS complex. Strategic testing protocols during postoperative PSG can provide critical insight into the effect of this therapy on upper airway obstruction during sleep. On–off periods of stimulation provide a concise assessment of the effect of HGNS on preventing upper airway collapse and help to account for night-to-night and intranight variability. Respiratory desynchrony associated with HGNS therapy exists. Observing partially-stimulated inspiratory cycles allow for assessment of HGNS's effect on a single breath.</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 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013635","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 Long-Term Effect of Childhood Otitis Media on Speech-in-Noise Testing at Ages 9 and 13","authors":"Stefanie N. H. Reijers,&nbsp;Jantien L. Vroegop,&nbsp;Bernd Kremer,&nbsp;Marc P. van der Schroeff","doi":"10.1002/lio2.70077","DOIUrl":"10.1002/lio2.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the relationship between a history of otitis media (OM) in early childhood and speech reception thresholds (SRT) in later childhood, using the Dutch digits-in-noise (DIN) test at ages 9 and 13 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted within the Generation R study, a prospective birth cohort in Rotterdam, the Netherlands. Children underwent pure-tone audiometry and DIN testing at ages 9 (2011–2015) and 13 (2016–2020) years. Regression analyses and a linear mixed model were used to examine associations between OM history and SRT in noise, accounting for repeated measurements within individuals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline (age 9 years), 2063 children were included with a mean SRT of −5.6 (SD = 2.0). At follow-up (age 13 years), 3382 children were included with a mean SRT of −7.4 (SD = 1.4). A positive association was found between recurrent acute OM (RAOM) and DIN test outcomes, with an estimated coefficient of 0.55 (95% CI = 0.26, 0.84; <i>t</i>-value = 3.70). Socioeconomic status and multilingualism did not significantly predict DIN test performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A history of RAOM may potentially influence SRT outcomes in later childhood, with higher DIN scores observed in the RAOM group. While the effect sizes between the groups are small to moderate, these findings highlight the importance of considering the potential long-term effects of OM in both clinical practice and future research. Further studies are needed to better understand these relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2 (cohort study).</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of neck dissections in the management of carotid body tumors","authors":"Gizelle Francis BSc,&nbsp;Gwynedd Pickett MD, FRCSC,&nbsp;S. Mark Taylor MD, FRCSC","doi":"10.1002/lio2.70056","DOIUrl":"10.1002/lio2.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Carotid body tumors (CBTs) are rare neoplasms of the paraganglia at the carotid bifurcation. While typically benign, CBTs occasionally exhibit malignancy, metastasizing to nearby lymph nodes. Histopathologic analysis alone is insufficient to confirm malignancy, requiring metastases to non-neuroendocrine tissue for a definitive diagnosis. The role of selective neck dissections (SNDs) in detecting malignancy and guiding subsequent management remains uncertain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>A retrospective case series through electronic chart review was performed on 21 patients undergoing CBT surgeries between 2002 and 2022 at a Canadian institution. SNDs were performed on all 21 patients. Data collection included patient demographics, genetic and laboratory testing results, preoperative imaging, intraoperative and postoperative complications, histologic analysis of neck SND and tumor specimen, and follow-up results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 21 surgical resections, there were three cases (14.3%) of carotid artery injuries and six cases (28.6%) of nerve injuries. One patient (4.8%) experienced three intraoperative strokes. Three patients (14.3%) were found to have lymph node involvement, confirming malignancy, and underwent further treatment with radiotherapy. Interestingly, two patients with carotid injuries had malignant tumors, demonstrating a statistical significance between carotid injury and malignancy (OR 34.00, 95% CI: 1.48, 781.83, <i>p</i> = .041).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SNDs are a useful adjunct in detecting malignancy during CBT surgeries. The incidence of malignancy in CBT is low but not negligible, and SND should be considered in patients to prevent inadvertent underdetection of metastatic disease. This study's 14.3% incidence of malignancy suggests that there may be a rationale for considering the universal implementation of SND during CBT resections.</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 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734182/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013620","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}