Laryngoscope Investigative Otolaryngology最新文献

{"title":"A Machine Learning Model to Predict Complications Following Head and Neck Microvascular Surgery.","authors":"Caroline A Bonaventure, Adam Bess, Reed Smith, Supratik Mukhopadhyay, Rula Mualla, Michael DiLeo, Christopher Yao, Sagar Kansara","doi":"10.1002/lio2.70588","DOIUrl":"https://doi.org/10.1002/lio2.70588","url":null,"abstract":"<p><strong>Objectives: </strong>Microvascular free tissue transfer is the primary reconstructive method in patients with complex defects of the head and neck. Defect site complications vary; incidence ranges from 15% to 70%. The use of machine learning via mutual information analysis has recently been described in the context of head and neck cancer, but this does not distinguish between causal relationships. The current study explores the first causal machine learning model to predict surgical outcomes in patients undergoing head and neck microvascular reconstruction.</p><p><strong>Methods: </strong>A retrospective chart review was conducted at a single institution from 2022 to 2025. A causal machine learning analysis using Peter-Clark algorithmic discovery, external knowledge inputs, and large language models was performed to determine predictors of complications.</p><p><strong>Results: </strong>The dataset included 155 subjects with 116 features. These 116 features were generated from the extracted clinical variables after preprocessing, categorical encoding, numerical transformation, and derivation of model-ready analytic features. Flap failure occurred in 3.2% (<i>n</i> = 5) of patients, and defect site complications occurred in 31.6% (<i>n</i> = 49). Mutual information analysis identified osteoradionecrosis/chondroradionecrosis, preoperative albumin, and peripheral vascular disease as the most consistently informative features. Lower preoperative hemoglobin and albumin were identified as potential causal predictors in the structural model.</p><p><strong>Conclusions: </strong>Causal machine learning analysis is a powerful tool that assists in the prediction of outcomes for patients undergoing head and neck free flap reconstruction and can identify potentially modifiable preoperative factors to aid in risk assessment.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70588"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13657859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185340","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":"Evaluating the Efficacy of Chitosan-l-DOPA MAP Gel for Acute Laryngeal Injury.","authors":"Areli Rodriguez-Ayala, Ryan Stepp, Naushin Ali, Vincent Gray, Rachel Letteri, Patrick S Cottler, Donald R Griffin, James J Daniero","doi":"10.1002/lio2.70578","DOIUrl":"10.1002/lio2.70578","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate the efficacy of an innovative chitosan-l-DOPA-modified microporous annealed particle (MAP) hydrogel in reducing fibrosis and enhancing healing in the treatment of Acute Laryngeal Injury (ALgI).</p><p><strong>Methods: </strong>Four experimental treatment groups: uninjured control, sham treated control (saline), nonbioactive MAP gel (sMAP), and Chitosan-l-DOPA MAP gel (dMAP2) were evaluated in a validated rabbit model of acute laryngeal injury, consisting of posterior glottis mucosal stripping and debridement followed by treatment at 14 days postinjury. At Days 4 and 14 posttreatment, histological evaluations were performed to evaluate the posterior glottic thickness (PGT), collagen content and type within the posterior glottis via immunofluorescence staining, glycosaminoglycan (GAG) content via Alcian blue staining, and collagen fiber orientation through picrosirius red staining.</p><p><strong>Results: </strong>At Day 4, the dMAP2 treatment performed similarly to the standard MAP gel, indicating a consistent inflammatory profile. Though at Day 14, the dMAP2 treated injuries demonstrated a significant increase in PGT compared to uninjured controls (<i>p</i> < 0.001), the healing wound expressed a significant increase in collagen area, including collagen I, collagen III, and colocalized species (<i>p</i> < 0.05). The alignment of collagen fibers within the tissue was consistent with the uninjured sample compared to the untreated injury. In a similar relationship, dMAP2 treated wounds led to similar GAG expression within the cricoarytenoid joint as the uninjured tissue, compared to the untreated injury consistent with a reduced arthritic condition.</p><p><strong>Conclusions: </strong>The dMAP2 gel improved healing with organized tissue remodeling compared to untreated controls through the proliferative phase of wound healing.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70578"},"PeriodicalIF":1.9,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185358","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":"Longitudinal Functional Outcomes After Transoral Robotic Surgery Versus Transoral Videolaryngoscopic Surgery for Oropharyngeal Cancer: A Retrospective Single-Center Study","authors":"Kazufumi Obata,&nbsp;Kenji Okami,&nbsp;Kaori Zenba,&nbsp;Takane Watanabe,&nbsp;Mayu Yamauchi,&nbsp;Hiroaki Iijima,&nbsp;Koji Ebisumoto,&nbsp;Akihiro Sakai,&nbsp;Koichiro Wasano","doi":"10.1002/lio2.70569","DOIUrl":"10.1002/lio2.70569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>Direct comparisons of functional outcomes between transoral videolaryngoscopic surgery (TOVS) and transoral robotic surgery (TORS) for oropharyngeal cancer remain limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective single-center study included 35 patients who underwent TOVS and 13 who underwent TORS. The European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-H&amp;N35, and Hyodo scores were assessed preoperatively and at 1, 3, 6, and 12 months. A linear mixed-effects model (LMM) included time, treatment, the group-by-time interaction, T stage (Tis/T1/T2 vs. T3), anatomic subsite (Tonsil vs. not Tonsil), prior cancer-directed treatment, concurrent neck dissection, sex, and age.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both groups showed transient postoperative deterioration followed by recovery. In the prespecified primary longitudinal LMM, treatment had no statistically significant main effect on pain, opening mouth, swallowing, or total Hyodo score.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this cohort, no statistically significant differences in postoperative quality of life or swallowing recovery were detected between TOVS and TORS. This design does not establish functional equivalence; however, TOVS may be a practical transoral option when robotic systems are unavailable.</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":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13655305/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170905","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":"Tympanostomy Tube Placement: The Effect of Location on Tube Retention and Risk of Perforation.","authors":"Jason G May, Eric Y Du, Jacob A Thoenen, Eliav Gov-Ari, Arnaldo L Rivera","doi":"10.1002/lio2.70590","DOIUrl":"https://doi.org/10.1002/lio2.70590","url":null,"abstract":"<p><strong>Objective: </strong>The retrospective cohort study compares tube location in the anterior-inferior quadrant versus the posterior-inferior quadrant and time of tube retention along with the risk of early extrusion and perforation. The study hypothesis holds that both anterior-inferior placement and posterior-inferior placement are equally effective and safe locations for tube placement with equal tube retention and risk for tympanic membrane perforation.</p><p><strong>Methods: </strong>An IRB-approved retrospective chart review was completed at a major Academic Center's Children's Hospital. The study included data from children who underwent tube placement between 6 months and 16 years old between February 2019-February 2021. Demographics and clinical factors were collected.</p><p><strong>Results: </strong>Of the 905 patients and 1800 ears, a total of 1584 ears had tubes placed in the anterior-inferior quadrant and 216 were placed in the posterior-inferior quadrant. Tubes remained in place for 487 days in the anterior-inferior quadrant and 456 in the posterior-inferior quadrant. The risk of perforation was 1.4% in the anterior-inferior quadrant and 0% in our study for the posterior-inferior quadrant. Univariate analysis showed a difference but was not significantly different (1.10 [0.95, 1.27]). This slight difference was confirmed by multivariate analysis HR = 1.11 [0.96, 1.30].</p><p><strong>Conclusion: </strong>This study shows that there is no difference in tube retention or risk of tympanic membrane perforation based on location of tympanostomy tube placement either in the anterior-inferior quadrant versus the posterior-inferior quadrant. Factors associated with earlier tube extrusion included older age, cleft palate, and recurrent acute otitis media as the diagnosis. T-tubes had slower extrusion, as expected.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70590"},"PeriodicalIF":1.9,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13652708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168624","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":"Concomitant Temporal and Facial Bone Fractures: Patterns, Outcomes, and Cushion Effect Hypothesis.","authors":"Bryant Wang, Bailey Balouch, Sophia Chryssofos, Luke Stanisce, Donald H Solomon","doi":"10.1002/lio2.70592","DOIUrl":"https://doi.org/10.1002/lio2.70592","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate injury patterns, clinical features and outcomes in patients with concomitant temporal bone fractures (TBFs) and facial bone fractures (FBFs). To evaluate these findings in the context of the cushion effect hypothesis.</p><p><strong>Methods: </strong>Retrospective cohort analysis of patients with radiographically confirmed TBFs at a tertiary care medical center. Patients were grouped by presence or absence of concomitant FBFs. Characteristics including trauma mechanism, findings on evaluation, and TBF complications were compared at presentation and follow-up. Multivariate logistic regression analysis was performed controlling for age, gender, and trauma mechanism.</p><p><strong>Results: </strong>Of 219 TBF patients from February 2011 to November 2023, 61 had concomitant FBFs. Motor vehicle collision was the most common trauma mechanism in the TBF/FBF group (50.82%) and fall was predominant in the TBF alone group (43.67%). Concomitant FBFs were associated with a reduced rate of hemotympanum (OR = 0.338, <i>p</i> = 0.001) and subjective hearing loss on follow-up evaluation (OR = 0.284, <i>p</i> = 0.001). Specifically, mandibular fractures in the TBF/FBF cohort were associated with a decreased risk of intracranial hemorrhage (ICH) (OR = 0.127, <i>p</i> = 0.005). No differences were observed for other TBF complications.</p><p><strong>Conclusion: </strong>TBF patients presenting with concomitant FBFs sustained more severe initial trauma, but had lower rates of hemotympanum and hearing loss. Mandibular fractures in the TBF/FBF cohort were independently associated with lower rates of ICH. These findings are compatible with the cushion effect hypothesis; however, causality cannot be inferred. Further prospective and biomechanical studies are warranted to clarify these relationships.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70592"},"PeriodicalIF":1.9,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13650180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171802","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":"Cross-Cultural Adaptation, Validity, and Reliability of the Dysphonia Risk Screening Protocol-General for Turkish-Speaking Individuals.","authors":"Asude Beyza Savaş, Eren Balo","doi":"10.1002/lio2.70586","DOIUrl":"10.1002/lio2.70586","url":null,"abstract":"<p><strong>Background: </strong>Screening is a critical first step in the early identification and prevention of voice disorders, particularly among at-risk populations. The Dysphonia Risk Screening Protocol-General (DRSP-G) is a comprehensive screening tool that also functions as a standardized patient history; however, no equivalent instrument has previously been available for Turkish-speaking individuals. This study aimed to translate and culturally adapt the DRSP-G into Turkish (DRTP-TR) and to examine its validity and reliability.</p><p><strong>Methods and procedures: </strong>The DRSP-G was translated following the Scientific Advisory Committee of the Medical Outcomes Trust (SAC) guidelines, which comprise forward and backward translation, expert review, and a pilot study. A total of 140 participants (70 dysphonic, 70 healthy) across three groups: women, men, and children completed the DRSP-G. Validity was assessed using known-groups comparisons and correlations with the Voice Handicap Index, Pediatric Voice Handicap Index, auditory-perceptual (GRBAS) ratings, and acoustic measures. Receiver operating characteristic (ROC) analysis was used to determine cutoff scores. Reliability was evaluated via test-retest and inter-rater analyses.</p><p><strong>Outcomes and results: </strong>DRTP-TR scores significantly differentiated dysphonic from healthy participants across all groups (<i>p</i> < 0.001). The DRTP-TR demonstrated excellent discriminatory power in women (AUC = 0.96) and children (AUC = 1.00), and very good discriminatory power in men (AUC = 0.85). Cutoff scores were 39, 32.5, and 19.5 for women, men, and children, respectively. Test-retest reliability was strong (<i>r</i> = 0.95).</p><p><strong>Conclusion and implication: </strong>The DRTP-TR is a valid and reliable screening instrument for dysphonia risk among Turkish-speaking individuals across age and gender groups.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70586"},"PeriodicalIF":1.9,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13645492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149138821","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":"Airflow Characteristics of Empty Nose Syndrome: Insights From Patient-Specific Computational Modeling of Airflow Distribution Patterns and Nasal Air-Conditioning","authors":"Yang Na,&nbsp;Kyung Won Kwon,&nbsp;Yong Ju Jang","doi":"10.1002/lio2.70567","DOIUrl":"10.1002/lio2.70567","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Computational fluid dynamics (CFD) is increasingly used to investigate the complex pathophysiology of empty nose syndrome (ENS). Although previous CFD studies reported middle-meatus–dominant airflow and reduced air–mucosal interaction in ENS, whether airflow distribution alone explains symptoms or impaired nasal physiology remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient-specific CFD simulations were performed in 14 ENS patients using nasal cavity models reconstructed from computed tomography. Airflow distribution, nasal resistance, air temperature, relative humidity, and surface area-to-volume ratio (SAVR) were analyzed. Ten non-ENS subjects with nasal septal deviation (NSD) without prior nasal surgery and five normal subjects were analyzed for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Airflow distributions in ENS were heterogeneous, consisting of middle-meatus-dominant (9/14), inferior-meatus–dominant (4/14), and mixed (1/14) patterns. ENS6Q scores tended to be higher in the inferior-meatus–dominant group, whereas other variables did not differ between patterns. NSD subjects showed similarly diverse distributions (3/10, 3/10, and 4/10, respectively), indicating that skewed airflow distribution is not unique to ENS, although middle-meatus–dominant airflow was more frequent in ENS. All normal subjects exhibited mixed distributions. ENS subjects showed lower and more variable choanal relative humidity than normal subjects, and relative humidity correlated positively with SAVR in ENS and NSD, suggesting that nasal air-conditioning may be related to residual mucosal surface geometry. No parameter differed significantly between ENS and NSD or correlated with ENS6Q scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ENS is not characterized by a single airflow pattern but represents a heterogeneous spectrum of airflow characteristics, with similar phenotypes also occurring in non-ENS subjects. Airflow distribution pattern alone was insufficient to explain ENS symptoms, and none of the evaluated global CFD parameters correlated significantly with ENS6Q scores, although the small sample precludes firm exclusion of clinically relevant associations. Preservation of mucosal surface area may nevertheless play an important role in nasal air-conditioning. These findings support a physiology-based and patient-specific understanding of ENS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638262/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116855","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":"Transcervical Epiglottic Suspension for Severe Type III Laryngomalacia in Infants: Feasibility, Safety, and Effectiveness.","authors":"Weiguang Yang, Qingchuan Duan, Fei Zhang, Lan Jiang, Dongjie Seng, Ying Xu, Jie Zhang","doi":"10.1002/lio2.70584","DOIUrl":"https://doi.org/10.1002/lio2.70584","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility, safety, and clinical outcomes of transcervical epiglottic suspension in respiratory support-dependent infants with Type III laryngomalacia.</p><p><strong>Methods: </strong>This retrospective case series at a single-center tertiary children's hospital included consecutive infants with endoscopically confirmed Type III laryngomalacia who were dependent on respiratory support because of upper airway obstruction. These infants underwent transcervical epiglottic suspension between January 1, 2024, and December 31, 2025. Because all eligible infants treated during the study period were included, no a priori sample size calculation was performed. Outcomes included procedural success, operative time, suture duration, perioperative complications, liberation from respiratory support, avoidance of tracheostomy, improvement in airway obstruction, feeding recovery, and catch-up growth.</p><p><strong>Results: </strong>Fifteen infants were included. Median age at surgery was 58 days. Primary procedural success was achieved in 14 of 15 infants and in all infants after revision. All infants were liberated from respiratory support, and none required tracheostomy. Airway obstruction scores improved significantly after surgery (<i>p</i> < 0.001). Median operative time was 20 min, median blood loss was 1 mL, median suture duration was 35 days, and median time to full oral feeding was 35 days. Among 10 infants with preoperative growth impairment, eight achieved normal weight-for-age status at final follow-up. Adverse events included premature suture detachment in two infants and minor cutaneous pressure injury in one infant; no severe complications occurred.</p><p><strong>Conclusion: </strong>Transcervical epiglottic suspension was feasible and was associated with rapid liberation from respiratory support and an acceptable safety profile in high-risk infants with Type III laryngomalacia.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70584"},"PeriodicalIF":1.9,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116891","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":"Feasibility of Transoral Robotic Total Laryngectomy With the Da Vinci Single Port Robotic System.","authors":"Matthias De Witte, Jolente Boulanger, George Lawson, Catherine Dick, Frederick Dochy, Tom Vauterin","doi":"10.1002/lio2.70582","DOIUrl":"https://doi.org/10.1002/lio2.70582","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility of transoral robotic total laryngectomy using the Da Vinci Single Port (SP) Robotic System, to describe the surgical technique and discuss postoperative outcomes.</p><p><strong>Methods: </strong>A clinical case of a 69-year-old woman with recurrent squamous cell carcinoma of the right aryepiglottic fold was reviewed. Following prior surgical resection with positive margins and a previous history of chemoradiotherapy, salvage total laryngectomy was performed using the Da Vinci SP robotic platform. The procedure was conducted following a modified transoral robotic approach previously described for multiport systems.</p><p><strong>Results: </strong>Transoral robotic laryngectomy using the Da Vinci SP system was accomplished without needing conversion to a conventional open approach. The procedure consisted of a cervical dissection phase, transoral robotic resection, transoral pharyngeal reconstruction, and cervical closure. Total robotic console time was 51 min. Oral intake was resumed after a barium swallow 18 days postoperatively showed no signs of fistulization. At 6 months follow-up, no locoregional recurrence or delayed complications were observed.</p><p><strong>Conclusion: </strong>Transoral robotic total laryngectomy using the Da Vinci SP system appears technically feasible and may offer several advantages compared to conventional open approach and multiport robotic systems. These include improved visualization, enhanced instrument maneuverability, limited cervical dissection and favorable functional recovery. Larger studies are required to evaluate reproducibility, long-term oncologic safety, and functional outcomes.</p><p><strong>Level of evidence: </strong>5.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70582"},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13633128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116913","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":"Adolescent Hearing Loss in China and the United States: Trends, Socioeconomic Disparities, and Noise Exposure From GBD 1990–2023 and NHANES 2005–2020","authors":"Lei Zhang,&nbsp;Xiaonan Wu,&nbsp;Yang Cao,&nbsp;Jin Li,&nbsp;Jiao Zhang,&nbsp;Jing Guan,&nbsp;Qian Guo,&nbsp;Dayong Wang,&nbsp;Qiuju Wang","doi":"10.1002/lio2.70558","DOIUrl":"10.1002/lio2.70558","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective(s)&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Drawing on data from the Global Burden of Disease (GBD) 1990–2023 for China and the U.S. National Health and Nutrition Examination Survey (NHANES) 2005–2020, this study systematically analyzed the epidemiological trends and major risk factors for adolescent hearing loss, and explored the effects of sociodemographic development, noise exposure, and socioeconomic conditions on hearing health.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Data on hearing loss prevalence, disability-adjusted life years (DALYs), and occupational noise-attributable burden for Chinese aged 10–19 years were extracted from the GBD 2023 database. Joinpoint regression was used to calculate the estimated annual percentage change (EAPC) and examine the relationship between the Sociodemographic Index (SDI) and hearing loss prevalence. In parallel, weighted logistic regression models were applied to NHANES data from U.S. adolescents aged 12–19 years (2005–2020) to assess the associations of noise exposure, household income, and education level with the risk of hearing loss.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;From 1990 to 2023, the prevalence of hearing loss among Chinese adolescents showed a sustained increase (EAPC = 0.83%), with higher rates observed in males than in females. The SDI was significantly and inversely associated with hearing loss burden (&lt;i&gt;β&lt;/i&gt; = −3.231, &lt;i&gt;P&lt;/i&gt; &lt; 0.001), although the protective effect plateaued at higher SDI levels. The DALY rate attributable to occupational noise declined markedly, from 17.35 per 100,000 population in 1990 to 12.23 per 100,000 population in 2023. NHANES results indicated that daily noise exposure significantly increased the risk of hearing loss (OR = 1.24, 95% CI:1.01–1.51), whereas a higher family income-to-poverty ratio (OR = 0.87, 95% CI:0.82–0.93) and higher educational attainment (OR = 0.65, 95% CI:0.43–0.97) exerted protective effects. Sex-stratified analysis revealed that males were more susceptible to noise-induced hearing loss (male OR = 1.39; female OR = 1.05).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Adolescent hearing health is shaped by socioeconomic status, education, and noise. While occupational noise burden has fallen, recreational and environmental noise may represent emerging threats. Accordingly, strengthened surveillance, school-based education, and noise management are warranted as public health priorities.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 ","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13632770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116890","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}