Laryngoscope Investigative Otolaryngology最新文献

{"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}

{"title":"Uneasy (Intractable) Head and Neck Defect Coverage With Easy and Reliable Local Flap Techniques: A Retrospective Case-Based Study of Perforator-Plus Peninsular Flap and Modified Keystone Flap","authors":"Chi Sun Yoon,&nbsp;Wooseob Kim,&nbsp;Eun A. Jang,&nbsp;Kap Sung Oh,&nbsp;Kyu Nam Kim","doi":"10.1002/lio2.70277","DOIUrl":"10.1002/lio2.70277","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Head and neck defects are challenging to reconstruct. Local flaps, preserving donor sites, offer optimal results. This study evaluated perforator-plus peninsular flaps (PPPF) and modified keystone flaps (MKF) for reconstructing “uneasy” defects lacking clear solutions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Records of patients undergoing PPPF or MKF were reviewed. Defects were defined as “uneasy” if two of three experienced plastic surgeons could not suggest a local flap within 10 min. Data on demographics, defect features, flap type, complications, and Patient and Observer Scar Assessment Scale (POSAS)-based scar outcomes were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ten patients (mean age, 50.3 years) were included. Defects involved the scalp and forehead (60%), ear (20%), cheek (10%), and neck (10%) with a mean size of 16.5 cm². All flaps (PPPF 40%, MKF 60%) survived without complications. Mean POSAS scores were 15.1 (patient) and 18.3 (observer).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PPPF and MKF offer reliable solutions for uneasy head and neck defects.</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/PMC12501763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253343","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":"Oral Diet Outcomes and Tracheostomy Avoidance After Submental Flap Reconstruction of Oral and Oropharyngeal Defects","authors":"Michael P. Wu,&nbsp;Edward S. Sim,&nbsp;Tessa Goldsmith,&nbsp;Matthew Kovoor,&nbsp;Derrick T. Lin,&nbsp;Jeremy D. Richmon,&nbsp;Daniel G. Deschler","doi":"10.1002/lio2.70271","DOIUrl":"https://doi.org/10.1002/lio2.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The submental island flap can be used to reconstruct defects of the oral cavity and oropharynx. The objective of this study is to describe functional outcomes after this reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective chart review was performed for 82 patients who underwent submental flap reconstruction of oral cavity cancer defects and 11 with oropharyngeal cancer defects. Primary outcomes were feeding tube use at last follow-up and time from surgery to first oral intake. The secondary outcome was the need for tracheostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Feeding tube use at last follow-up was 9% in the oral cavity group and 36% in the oropharynx group. Median time to oral intake was 7 days in both groups. Tracheostomy was avoided in 87% of oral cavity patients and in 46% of oropharynx patients. In regression analysis of the entire cohort, the outcomes of persistent feeding tube use at last follow-up and tracheostomy were associated with the following variables: prior irradiation, oropharyngeal primary site, and adjuvant treatment status. Among the oral cavity group, prior irradiation was associated with persistent feeding tube use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The submental flap can be used in a wide range of oral cavity and oropharyngeal defects, even in elderly patients. This flap can be performed for oral cancers with avoidance of tracheostomy in most cases and reliable resumption of oral diet.</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":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Term Outcomes of Microdebrider-Assisted Endoscopic Powered Intracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea: A Questionnaire-Based Observational Study","authors":"Ryota Koshu,&nbsp;Masao Noda,&nbsp;Haruna Nakamoto,&nbsp;Karin Kojima,&nbsp;Hisashi Sugimoto,&nbsp;Takahiro Fukuhara,&nbsp;Tomokazu Yoshizaki,&nbsp;Makoto Ito","doi":"10.1002/lio2.70274","DOIUrl":"https://doi.org/10.1002/lio2.70274","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This study aimed to evaluate the long-term efficacy and safety of microdebrider-assisted endoscopic powered intracapsular tonsillectomy and adenoidectomy (PITA) in pediatric patients with obstructive sleep apnea (OSA) using caregiver-reported retrospective assessments of pre- and post-operative symptom states.&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;This single-center retrospective observational study included 65 children aged &lt; 15 years who underwent PITA and at least 1 year of postoperative follow-up. Caregivers completed a structured postoperative questionnaire, retrospectively assessing preoperative and postoperative symptom severity using the validated Japanese version of the Obstructive Sleep Apnea Questionnaire-18 (OSA-18). The questionnaire evaluated sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns. Postoperative complications, including tonsillitis, peritonsillar abscess, and perceived symptom recurrence, were also assessed. All surgeries were performed using an endoscopic PITA technique designed to preserve the tonsillar capsules.&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;Among the 65 pediatric patients (median follow-up, 48.0 months; interquartile range, 25.0–65.0), significant improvements were observed across all five OSA-18 domains. The mean preoperative scores were 5.2, 4.5, 2.3, 3.4, and 4.7 for sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns, respectively. Postoperative scores improved to 1.7, 2.3, 1.7, 2.1, and 1.8, respectively (all, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). Subgroup analyses showed no significant differences in outcomes based on follow-up duration (&lt; 5 vs. ≥ 5 years) or age at surgery (≤ 4 vs. &gt; 4 years), suggesting durable and consistent long-term benefits of PITA regardless of age or time since surgery. No peritonsillar abscesses were reported; only three patients (4.6%) experienced postoperative tonsillitis. Thirteen percent of the caregivers reported a subjective recurrence of symptoms; however, none required revision surgery.&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;PITA is a potentially safe and effective long-term surgical option for pediatric OSA. Retrospective caregiver evaluation revealed sustained symptom improvement, minimal postoperative complications, and high satisfaction levels.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Level of Evidence&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Level IV.&lt;/","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223911","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":"Comprehensive Genetic Analysis of NF2 in Sporadic Vestibular Schwannoma","authors":"Takeshi Wakabayashi,&nbsp;Koichiro Wasano,&nbsp;Kohei Nakamura,&nbsp;Makoto Hosoya,&nbsp;Ryutaro Kawano,&nbsp;Reika Takamatsu,&nbsp;Masafumi Ueno,&nbsp;Marie N. Shimanuki,&nbsp;Nobuyoshi Tsuzuki,&nbsp;Takanori Nishiyama,&nbsp;Takenori Akiyama,&nbsp;Masahiro Toda,&nbsp;Hiroshi Nishihara,&nbsp;Hiroyuki Ozawa,&nbsp;Naoki Oishi","doi":"10.1002/lio2.70265","DOIUrl":"https://doi.org/10.1002/lio2.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To elucidate the genetic etiology of sporadic vestibular schwannomas (VSs) and investigate the correlation between <i>NF2</i> inactivation mechanisms and preoperative clinical characteristics, including hearing function and tumor growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nineteen patients who underwent VS resection at our otorhinolaryngology or neurosurgery department between June 2020 and March 2022 were included in this study. Whole-exome sequencing (WES) was performed to detect somatic changes in <i>NF2</i>. Additionally, <i>NF2</i> promoter methylation status and copy number changes were evaluated using methylation analysis and multiple ligation-dependent probe amplification (MLPA). Preoperative clinical data, including pure tone audiometry, speech discrimination scores, and tumor growth rates, were collected and analyzed for correlations with genetic findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>WES identified somatic alterations in both <i>NF2</i> alleles in 16 cases (84.2%). The addition of methylation analysis and MLPA confirmed biallelic <i>NF2</i> inactivation in all cases. <i>NF2</i> promoter methylation was suggested to be associated with hearing loss and tumor progression. A weak correlation between <i>NF2</i> expression levels and tumor growth rate was observed (<i>r</i> = 0.21), while no significant correlation was found between <i>NF2</i> expression and pure tone audiometry or speech discrimination scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comprehensive genetic analyses, including WES, methylation analysis, and MLPA, are essential for identifying <i>NF2</i> inactivation mechanisms in sporadic VSs. The findings suggest that <i>NF2</i> methylation may contribute to variations in clinical presentation. Further studies with larger cohorts are necessary to clarify the role of epigenetic modifications in disease progression and their potential impact on patient management strategies.</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":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146616","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":"Sound Progress? Asian Representation in Otolaryngology Residency Programs: A 5-Year Update","authors":"Amy Wang,&nbsp;Yuki Yoshiyasu,&nbsp;Brian McKinnon,&nbsp;Tyler Janz","doi":"10.1002/lio2.70252","DOIUrl":"https://doi.org/10.1002/lio2.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Gains in Asian representation have been reported across otolaryngology residency programs over the previous decade. We provide an update on otolaryngology resident demographics from 2018 to 2024 to determine how Asian representation has changed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Demographic data from annual reports by the Journal of the American Medical Association (JAMA) and Association of American Medical Colleges (AAMC). Otolaryngology resident reports were compared to other medical specialties. Asian representation was assessed and compared to that of other reported races/ethnicities. Trends were compared between 2018 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2018 and 2024, Asian representation in Otolaryngology remained stable, showing a small decline from 2018 to 2023 that was followed by rebound growth in 2023–2024 observed across multiple specialties. The total proportion of Asian, Black, and Hispanic residents rose significantly (<i>p</i> &lt; 0.05), while the percent of White residents declined. At 24.48%, Asian otolaryngology resident levels for the period were only 0.34% higher than the Asian medical student graduate level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>From 2018 to 2024, Asian representation in Otolaryngology remained stable, with limited but insignificant growth overall. Sustained increases in the proportion of Asian otolaryngology residents have yet to be seen, but there remain promising levels of Asian resident representation, especially compared to other minority groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>5</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146615","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":"Pediatric Hairy Polyp of the Naso-Oropharynx: A Case Report and Systematic Literature Review","authors":"Diana Hallak,&nbsp;Logan F. McColl,&nbsp;Meredith M. Lind,&nbsp;Kris R. Jatana","doi":"10.1002/lio2.70262","DOIUrl":"10.1002/lio2.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hairy polyps (HPs), also known as bigerminal choristoma, are rare tumors most often occurring within the nasopharynx and oropharynx, linked to the development of the first and second pharyngeal arches. Commonly, HPs present in female neonates and are left-sided. This case report and systematic literature review provide a comprehensive overview of HPs' presentation, management, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Description</h3>\u0000 \u0000 <p>A female neonate demonstrated persistent rightward head positioning and gagging at 1 day of life. Oral examination revealed a protuberant tubular soft-tissue mass appearing to originate from the posterior pharynx or nasopharynx. Neck MRI with and without contrast revealed a lobular, exophytic, and pedunculated soft-tissue mass arising from the left soft palate and extending to the oropharynx with minimal post-contrast enhancement. At 3 days of life, she underwent transoral mass resection. Final operative findings revealed a 6-cm mass based on the posterior aspect of the left soft palate near the superior left tonsillar pillar. Histopathological evaluation revealed skin-like epidermis with hair follicles and adnexa surrounding a cartilage core, muscle bundles, fat, and vascular channels consistent with bigerminal choristoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Literature Review</h3>\u0000 \u0000 <p>Systematic review, conducted according to PRISMA guidelines using PubMed database, yielded 106 published reports with 147 HP cases with a female and childhood-onset predominance. Respiratory distress, feeding difficulties, or a combination of both was the most commonly reported presenting symptoms occurring in 63.9% of cases. Surgical excision is the standard treatment across published reports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HPs commonly present with respiratory symptoms and a visible mass. Timely diagnosis and surgical intervention are critical to avoid significant complications to the airway and aerodigestive function.</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":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139017","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":"Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study","authors":"Mirabelle Sajisevi,&nbsp;Kenny Nguyen,&nbsp;Peter Callas,&nbsp;Andrew J. Holcomb,&nbsp;Emre Vural,&nbsp;Kyle P. Davis,&nbsp;Carissa M. Thomas,&nbsp;John S. Stein,&nbsp;Ameya Asarkar,&nbsp;Ricardo Aulet,&nbsp;Rebecca K. Bell,&nbsp;Michael A. Blasco,&nbsp;Vanessa B. Bowmaster,&nbsp;Clayton P. Burruss,&nbsp;Jeffson Chung,&nbsp;Kimberly Chan,&nbsp;Brent A. Chang,&nbsp;Charles S. Coffey,&nbsp;David M. Cognetti,&nbsp;Dylan J. Cooper,&nbsp;Joehassin Cordero,&nbsp;John Donovan,&nbsp;Yue Jennifer Du,&nbsp;Yusuf Dundar,&nbsp;Rogerio Dedivitis,&nbsp;Heather Edwards,&nbsp;Boban M. Erovic,&nbsp;Antoine Eskander,&nbsp;Philip A. Feinberg,&nbsp;Emily A. Garvey,&nbsp;David Goldstein,&nbsp;Joseph F. Goodman,&nbsp;Rafael N. Goulart,&nbsp;Neerav Goyal,&nbsp;Stefan Grasl,&nbsp;Jonathan Giurintano,&nbsp;Nikita Gupta,&nbsp;Andy Habib,&nbsp;Trevor Hackman,&nbsp;Jared H. Hara,&nbsp;Christina Henson,&nbsp;Michael L. Hinni,&nbsp;Nadia Hua,&nbsp;Stephanie Johnson-Obaseki,&nbsp;Aditya Juloori,&nbsp;Noah S. Kalman,&nbsp;Alexandra Kejner,&nbsp;Sobia F. Khaja,&nbsp;Jamie A. Ku,&nbsp;Arnaud Lambert,&nbsp;Bao K. Luu,&nbsp;Kelly R. Magliocca,&nbsp;Luiz R. Medina dos Santos,&nbsp;Cara Michael,&nbsp;Brett Miles,&nbsp;Giulianno Molina de Melo,&nbsp;Michael G. Moore,&nbsp;Gregoire B. Morand,&nbsp;Kauê Moura,&nbsp;Hesameddin Noroozi,&nbsp;Rusha Patel,&nbsp;Joseph Paydarfar,&nbsp;Karolina A. Plonowska-Hirschfeld,&nbsp;Nader Sadeghi,&nbsp;Fabrice Savaria,&nbsp;Nicole C. Schmitt,&nbsp;Justin Shapiro,&nbsp;Timothy B. Shaver,&nbsp;Sandro J. Stoeckli,&nbsp;William Alvo Stokes,&nbsp;Anita Sulibhavi,&nbsp;Jason Tasoulas,&nbsp;Varun Vendra,&nbsp;Daniel B. Vinh,&nbsp;Celina G. Virgen,&nbsp;Neil M. Woody,&nbsp;Geoffrey D. Young,&nbsp;Kiran Kakarala,&nbsp;Danny J. Enepekides,&nbsp;Michael P. Hier,&nbsp;Louise Davies,&nbsp;William R. Ryan","doi":"10.1002/lio2.70246","DOIUrl":"10.1002/lio2.70246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (<i>n</i> = 384, 53%) or total (<i>n</i> = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, <i>p</i> &lt; 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, <i>p</i> &lt; 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, <i>p</i> &lt; 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, <i>p</i> = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, <i>p</i> = 0.58).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials.</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":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139022","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":"CMS Exclusion of Global Period Visits From E/M Payment Reform: Estimated Payment Loss for Pediatric Otolaryngologists","authors":"Ashley L. Miller,&nbsp;Vinay K. Rathi,&nbsp;Molly O. Meeker,&nbsp;Lauren E. Miller,&nbsp;Jason Pedicini,&nbsp;Charles E. Elmaraghy","doi":"10.1002/lio2.70254","DOIUrl":"https://doi.org/10.1002/lio2.70254","url":null,"abstract":"<p>In an effort enhance reimbursement for cognitive specialties, the Centers for Medicare and Medicaid Services (CMS) increased the payment for outpatient and inpatient E&amp;M services in 2021 and 2023, respectively. Notably, visits during the postoperative global period were excluded from this increase. It is well-established that pediatric subspecialties, including pediatric otolaryngology, are less well-compensated than their adult counterparts. In this study, we estimated the potential annual revenue increase per academic pediatric otolaryngologist had CMS included global period visits in its revaluation.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111188","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":"Other Than Complete Response in Oropharyngeal Carcinoma: Patient and Tumor-Related Factors","authors":"Francesco Mattioli,&nbsp;Matteo Miglio,&nbsp;Edoardo Serafini,&nbsp;Roberto Tonelli,&nbsp;Edoardo Meneguzzi,&nbsp;Elisa D'Angelo,&nbsp;Roberta Depenni,&nbsp;Martina Napolitano,&nbsp;Massimo Dominici,&nbsp;Daniele Marchioni,&nbsp;Federica Bertolini","doi":"10.1002/lio2.70258","DOIUrl":"10.1002/lio2.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Oropharyngeal carcinoma represents a tumor with an increased concern in human health and treatment strategy. This study aims to identify any tumor or patient-related characteristics capable of predicting response to non-surgical curative treatment in a cohort of oropharyngeal squamous cell carcinoma and define oncological outcomes of overall survival and progression-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A monocentric retrospective cohort study was performed, including 223 patients with non-metastatic oropharyngeal squamous cell carcinoma treated with curative intent with a non-surgical strategy. Patients were treated at the University Hospital of Modena (Italy) after a multidisciplinary evaluation between January 2010 and December 2021. The treatment response was assessed by using the RECIST 1.1 Criteria on imaging performed 3 months after treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tonsil subsite and stage I were independently associated with a complete treatment response (OR = 0.53, <i>p</i> = 0.05, and OR = 0.32, <i>p</i> = 0.01, respectively). The association between smoking and p16− status resulted in a higher probability of a not-complete response (OR = 1.72, <i>p</i> = 0.05). Similar results were found for soft palate subsite, cT4, N2 in the p16+ group, and stage IVb in the p16− group. Conversely, cT1 was associated with a higher probability of complete response. Age and the extension to nearby structures did not influence the response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This retrospective study shows a possible stratification of patients with oropharyngeal squamous cell carcinoma based on factors that influence treatment response rate. The identification of a phenotype of a non-responding tumor could better define therapeutic and follow-up programs.</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":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087949","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}