Laryngoscope Investigative Otolaryngology最新文献

{"title":"Safety and Effectiveness of a Bioabsorbable Septal Implant for Cartilaginous Nasal Septal Deviation.","authors":"Thomas S Higgins, Henry P Barham, Greg E Davis, Steven E Davis, Adil Fatakia, Nora W Perkins, Michael Sillers, David M Yen","doi":"10.1002/lio2.70579","DOIUrl":"https://doi.org/10.1002/lio2.70579","url":null,"abstract":"<p><strong>Objective: </strong>Nasal airway obstruction (NAO) can be due to deviation of the cartilaginous and bony nasal septum. Correcting the caudal cartilaginous septum can be technically challenging. This study aims to evaluate the safety and effectiveness of a bioabsorbable submucosal septal implant (SeptAlign; Spirair Inc.) for minimally invasive correction of cartilaginous nasal septal deviation (NSD).</p><p><strong>Methods: </strong>This was a prospective cohort study conducted at nine otolaryngology clinics in the USA. Subjects underwent placement of the implant alone or with concurrent inferior turbinate reduction (ITR). Percentage reductions relative to baseline in the mean Nasal Obstruction Symptom Evaluation (NOSE) score were calculated at 3 and 6 months postprocedure.</p><p><strong>Results: </strong>In 80 subjects (92.5% with moderate-to-severe NSD), NOSE scores decreased by 63.2% (from 67.5 at baseline to 26.0 at 3 months and 23.6 at 6 months; <i>p</i> values < 0.0001). Overall, 85.9% of subjects at 3 months and 89.9% at 6 months were considered responders. The sub-group with concurrent turbinate reduction had 88.2% responders and the sub-group with the implant alone had 91.4% responders at 6 months. Subjects returned to work a median of 1 day after the procedure, which was performed in-office under local anesthesia in 46.3% of cases.</p><p><strong>Conclusion: </strong>The septal implant was an effective treatment for NAO symptoms via NSD repair and was generally safe and well tolerated. It straightens cartilaginous NSD via mechanical traction without the need for resection and may be an attractive alternative to conventional septoplasty.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70579"},"PeriodicalIF":1.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116908","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 Role of Cochlear Anatomy in Hearing Preservation After Cochlear Implantation in Adults: A Systematic Review.","authors":"Bo Uzeel, Freya Swinnen, Veroniek Van Driessche, Dorien Ceuleers, Ingeborg Dhooge","doi":"10.1002/lio2.70571","DOIUrl":"https://doi.org/10.1002/lio2.70571","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between cochlear anatomical parameters and postoperative hearing preservation (HP) following cochlear implantation in adults with preoperative residual hearing (RH).</p><p><strong>Methods: </strong>This systematic review followed PRISMA guidelines (PROSPERO: CRD420250630915). Embase, MEDLINE, PubMed, Scopus, and Web of Science were searched for studies published between 2010 and 2026. Eligible studies included adults (≥ 18 years) with preoperative RH undergoing cochlear implantation, assessed cochlear anatomy using computed tomography or magnetic resonance imaging, reported HP within 6 months postoperatively, and examined the relationship between cochlear anatomy parameter(s) and HP. Risk of bias was evaluated using the QUIPS tool. Data were synthesized narratively; where possible, a meta-analysis using a random-effects model was performed. Certainty of evidence was assessed using GRADE.</p><p><strong>Results: </strong>Ten studies (487 implants) were included. Risk of bias was highest for study participation and confounding. Longer cochlear duct length and larger cochlear volume were suggested to be associated with better HP, though findings were inconsistent. Six studies examined angular insertion depth; four were pooled. Meta-analysis indicated a small positive correlation (pooled <i>r</i> = 0.23; <i>p</i> = 0.004; 95% confidence interval: -0.14 to 0.54), suggesting poorer HP with deeper insertion, with moderate heterogeneity (<i>I</i> ² = 48.5%). Certainty of evidence for all outcomes was rated very low.</p><p><strong>Conclusion: </strong>Cochlear anatomy may influence hearing preservation following cochlear implantation, with longer cochlear duct length and larger cochlear volume showing the most consistent associations with favorable outcomes. However, the certainty of evidence was very low, precluding firm conclusions regarding the predictive value of anatomical factors.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70571"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116838","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":"Demographic Differences in Diagnosis of Eosinophilic Esophagitis: A Retrospective Analysis.","authors":"Hardeep S Tiwana, Gaayathri Varavenkataraman, Alex Bogosian, Erin M Gawel, Amanda G Baanante, Grace Maley, Osama Almadhoun, Michele M Carr","doi":"10.1002/lio2.70570","DOIUrl":"https://doi.org/10.1002/lio2.70570","url":null,"abstract":"<p><strong>Objective: </strong>To investigate trends in coded eosinophilic esophagitis (EoE) diagnosis within the TriNetX healthcare population and the association between food impaction (FI) and subsequent EoE diagnosis across demographic groups.</p><p><strong>Methods: </strong>A retrospective review (2016-2024) was conducted in the TriNetX US Network. Platform-derived annual incidence of coded EoE diagnosis (ICD-10 K20.0) in patients < 21 years was assessed and stratified by sex, race, and ethnicity. Patients presenting with FI (ICD-10 T18.12) were identified, and demographic characteristics of those with and without a subsequent coded EoE diagnosis were compared. The FI analysis did not evaluate endoscopy, biopsy, histology, referral, or other elements of the diagnostic process.</p><p><strong>Results: </strong>A total of 42,519 incident coded EoE diagnoses were identified, with TriNetX-derived diagnosis incidence increasing from 27.8 to 65.8 per 100,000 persons between 2016 and 2024 (136.6% rise). In 2024, males had nearly double the diagnosis rate of females (88.1 vs. 44.2 per 100,000). White patients had the highest diagnosis rate (84.7), compared with Black (31.5), Asian (37.7), and American Indian (62.2) patients. Non-Hispanic patients had higher rates than Hispanic patients (73.3 vs. 30.0). Among 6215 patients presenting with FI (mean age 11.9 ± 6.3 years), 1849 (29.8%) had a subsequent coded EoE diagnosis (mean age 14.7 ± 4.3). Females had lower unadjusted odds than males (OR = 0.5, 95% CI: 0.4-0.5, <i>p < 0</i>.001). Black (OR = 0.3, 95% CI: 0.2-0.4) and Asian (OR = 0.4, 95% CI: 0.2-0.6) patients had lower unadjusted odds than White patients (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>Within the TriNetX healthcare population, coded pediatric EoE diagnoses increased over time and differed by sex, race, and ethnicity. Following FI, the frequency of subsequent coded EoE diagnosis also differed across demographic groups; these descriptive findings do not establish differences in underlying disease prevalence or diagnostic care.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70570"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623539/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116878","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":"Updating Disyllabic Word Lists for Italian Speech Audiometry","authors":"Laura Biondi,&nbsp;Marco Pozzi,&nbsp;Alessandro Martini,&nbsp;Federica Di Berardino","doi":"10.1002/lio2.70572","DOIUrl":"10.1002/lio2.70572","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To describe a standardized clinical for Italian speech audiometry using new disyllabic word lists and to report preliminary validation and normative parameters in normal-hearing subjects.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In accordance with ISO 8253-3 guidelines, phonetically balanced disyllabic word lists were administered to 12 normal-hearing native Italian speakers (aged 18–25 years, pure-tone average ≤ 10 dB HL). Word Recognition Scores (WRS) were assessed across a descending intensity gradient (30–0 dB HL) to derive psychometric functions. Inter-list equivalence and 1-week test–retest reliability were evaluated in quiet and background noise (cocktail party noise). Reliability was quantified using intraclass correlation coefficients (ICC), Bland–Altman analysis, and repeated-measures ANOVA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean speech recognition threshold (SRT50%) was 5.9 ± 2.2 dB HL, with a steep, highly sensitive average slope of 4.9%/dB near threshold. Maximum intelligibility (SRT 100%) was reached at 30 dB HL, across all lists. Intrasubject test-list variability was negligible (&lt; 5% difference, ANOVA <i>p</i> &gt; 0.05). Bland–Altman showed high temporal stability (mean bias: +0.88%; Limits of Agreement: ±1.5 words/list). Test–retest reliability was excellent (ICC = 0.957, 95% CI: 0.932–0.973, <i>p</i> &lt; 0.001). In background noise, stable reproducibility was maintained, showing a well-contained coefficient of variation (14.5%–14.7%) at SNR 0 dB and a perfect ceiling effect at SNR +10. Good equivalence among lists were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The new 10-item lists demonstrate robust equivalence and high test–retest reliability under ISO criteria. This validation workflow offers a time-efficient paradigm that is methodologically applicable to other languages, supporting standardized cross-linguistic clinical assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13623507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082370","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":"Adjuvant HPV Vaccination and Survival in Oropharyngeal Squamous Cell Carcinoma: An Exploratory Analysis of a Real-World Database.","authors":"Mary Elizabeth Kim, Kevin Herrera, Albert Han, Kevin Hur, Niels Kokot, Mark S Swanson","doi":"10.1002/lio2.70573","DOIUrl":"https://doi.org/10.1002/lio2.70573","url":null,"abstract":"<p><strong>Objective: </strong>Childhood HPV vaccination reduces oropharyngeal cancer (OPC) incidence, but evidence regarding vaccination after HPV exposure or OPC diagnosis remains limited. While benefits are documented in cervical dysplasia, anogenital cancers, and laryngeal papillomatosis, the impact on OPC outcomes is unknown.</p><p><strong>Methods: </strong>Using the prospective TrinetX database, OPC patients were stratified by HPV vaccination status. Vaccinated patients were divided into three cohorts: vaccinated before OPC diagnosis, within 1 year after diagnosis, and at any timepoint. Cohorts were propensity-matched with unvaccinated controls by age, race, ethnicity, sex, and cancer stage. Survival outcomes were assessed at 2, 5, and > 5 years post-diagnosis using absolute risk reduction and Kaplan-Meier analyses.</p><p><strong>Results: </strong>Propensity matching yielded 162 patients vaccinated at any time, 24 vaccinated within 1 year post-diagnosis, and 79 vaccinated pre-diagnosis, with equal matched controls showing no demographic differences. Women predominated among those vaccinated before OPC diagnosis (73%), while men comprised 80% of those vaccinated after diagnosis. HPV vaccination was associated with improved overall survival at 2 years (97% vs. 91%, <i>p</i> = 0.29), 5 years (97% vs. 89%, <i>p</i> = 0.019), and > 5 years (93% vs. 74%, <i>p</i> = 0.0003) for the vaccinated-anytime cohort versus never-vaccinated patients, translating to 5.14% absolute risk reduction at 5 years. Trends persisted but lacked statistical significance in pre- and post-diagnosis vaccination subgroups.</p><p><strong>Conclusion: </strong>HPV vaccination after HPV exposure was associated with improved survival in OPC patients. However, imperfect HPV ascertainment, small vaccinated cohorts, and potential selection bias, including a healthy vaccinee effect, preclude causal inference, and this association should not be interpreted as evidence of a therapeutic effect. Prospective and randomized clinical trials are needed to determine whether adjuvant HPV vaccination confers a true survival benefit in OPC. Given the low morbidity of therapy and high potential survival impact, a clinical trial is warranted.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70573"},"PeriodicalIF":1.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13624292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116842","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":"Classification of Odontogenic Sinusitis: A Clinical-Based Phenotyping System to Guide Multidisciplinary Surgical Management.","authors":"Lorenzo Sabatino, Simone Di Giovanni, Michelangelo Pierri, Carmen Bigliardo, Marco Mattaroccia, Matteo Valentini, Antonio Moffa, Manuele Casale, Michele Antonio Lopez","doi":"10.1002/lio2.70555","DOIUrl":"10.1002/lio2.70555","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Odontogenic sinusitis (ODS) is a condition that requires a multidisciplinary approach for successful treatment. Effective communication among the healthcare providers involved reduces the risk of errors and treatment failure. This study proposes a new ODS classification system to facilitate the communication of pivotal clinical information.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Materials and methods: &lt;/strong&gt;In this observational study the authors considered 124 consecutive patients with ODS treated in the Campus Bio-Medico of Rome Foundation Hospital. The main elements influencing the treatment of this condition resulted as: timing, etiology, presence of foreign body, maxillary obstruction of the ostiomeatal complex, and presence of oroantral fistula (OAF); these elements were organized in the acronym TEBOF. Each patient received a TEBOF classification. The \"T\" was categorized in \"T&lt;sub&gt;c&lt;/sub&gt;\" for patients diagnosed with chronic sinusitis, \"T&lt;sub&gt;a&lt;/sub&gt;\" for of acute sinusitis, and \"T&lt;sub&gt;0&lt;/sub&gt;\" for patients with maxillary sinus foreign body without sinusitis. The \"E\" was differentiated in \"E&lt;sub&gt;c&lt;/sub&gt;\" when the condition was a side effect of a primary dental pathology, \"E&lt;sub&gt;p&lt;/sub&gt;\" when the initial cause was not a dental implant, and \"E&lt;sub&gt;a&lt;/sub&gt;\" for when the initial cause was having a dental implant placed. \"B\" was reported as \"B&lt;sub&gt;1&lt;/sub&gt;\" when there was a maxillary sinus foreign body and \"B&lt;sub&gt;0&lt;/sub&gt;\" when there was not. \"O\" was reported as \"O&lt;sub&gt;1&lt;/sub&gt;\" when the ostiomeatal complex resulted closed and \"O&lt;sub&gt;0&lt;/sub&gt;\" when it was clear. \"F\" was used as \"F&lt;sub&gt;1&lt;/sub&gt;\" when there was a communication, and \"F&lt;sub&gt;0&lt;/sub&gt;\" when there was not. A preliminary assessment was performed considering the change in the classification in the groups of patients that underwent different therapeutic approaches. This classification provides a concise and easy-to-understand combination facilitating communication between the various healthcare providers who are essential for the appropriate treatment of this condition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among the 124 patients included (64 women, 51.6%; mean age 57.2 ± 13 years), chronic sinusitis (T&lt;sub&gt;c&lt;/sub&gt;) was the most frequent timing category (96 patients, 77.4%), while classical dental pathology represented the predominant etiology (E&lt;sub&gt;c&lt;/sub&gt;, 88 patients, 70.9%). Foreign body was detected in 39 patients (31.5%), ostiomeatal complex obstruction in 80 patients (64.5%), and oroantral fistula in 52 patients (41.9%). Combined surgical treatment (ESS + oral surgery) was the most frequently adopted approach (70 patients, 57%), followed by dental treatment alone (34 patients, 27%) and ESS alone (20 patients, 16%). The overall success rate was 97%, only four patients required second surgical procedure.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The TEBOF classification provides a concise, reproducible, and clinically intuitive tool for the characterization of odontogenic sinusitis. By inte","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70555"},"PeriodicalIF":1.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologic Sarcopenia and Charlson Comorbidity Index in the Head and Neck Free Flap Population.","authors":"Alexandra Vacaru, Roy W Qu, Jacob Hauser, Elaine Sun, Kyler Barnett, Justin Kim, Jared C Inman","doi":"10.1002/lio2.70580","DOIUrl":"10.1002/lio2.70580","url":null,"abstract":"<p><strong>Objective: </strong>Determining operative risk in patients undergoing head and neck free flap surgery has traditionally been difficult. Psoas muscle mass, a proven frailty marker in abdominal surgery, has not been evaluated in this population. This study demonstrates that radiologic sarcopenia and comorbidity burden may identify patients at higher risk for non-home discharge.</p><p><strong>Methods: </strong>A retrospective review was performed on 308 patients who underwent head and neck free flap surgery and had preoperative abdominal CT scans between 2014 and 2024. Inverse Psoas Muscle Index (PMI) and Charlson Comorbidity Index (CCI) were analyzed to assess the impact of radiologic sarcopenia and comorbidity on discharge disposition.</p><p><strong>Results: </strong>Higher inverse PMI had increased odds of discharge non-home (OR 1.37, 95% CI 1.05-1.77, <i>p</i> = 0.019). Non-home discharge varied across CCI groups (<i>p</i> < 0.05), occurring in 7.4% of patients with mild comorbidity, 39.5% with moderate comorbidity, and 55.7% with high comorbidity. Higher CCI increased odds of discharge non-home (OR 1.30, 95% CI 1.13-1.49, <i>p</i> < 0.001). Highest PMI quartile and mild comorbidity resulted in a 100% PPV for discharge home, corresponding to a 0% non-home discharge rate.</p><p><strong>Conclusion: </strong>Lower psoas muscle mass, reflected by higher inverse PMI, independently predicts non-home discharge, supporting its role as a frailty marker in head and neck free flap patients. Patients with higher comorbidity burden, as measured by CCI, have higher odds of non-home discharge. Combining radiologic muscle assessment (inverse PMI) with comorbidity indices demonstrates strong predictive potential for non-home discharge.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70580"},"PeriodicalIF":1.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13620296/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082388","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":"Antibiotic Prescribing Patterns and Stewardship Opportunities in Pediatric Facial Trauma: A Five-Year Retrospective Analysis.","authors":"Jacob LaMar, Jenna Schaefer, Garrett Henkle, Aamr Hasanjee, Vikram Ramjee, Mark Mims","doi":"10.1002/lio2.70574","DOIUrl":"10.1002/lio2.70574","url":null,"abstract":"<p><strong>Objectives: </strong>To assess antibiotic prescribing practices in pediatric facial trauma at a tertiary academic center, examine their association with infection outcomes, and identify stewardship opportunities to inform future larger-scale evaluation of antibiotic use in pediatric facial fractures.</p><p><strong>Methods: </strong>This retrospective chart review included pediatric patients (< 18 years) presenting via trauma activation with facial trauma to a tertiary academic medical system over 5 years. Patients were identified through the institutional data warehouse. Data collected included demographics, injury patterns, antibiotic prescribing details (route, duration, timing), surgical interventions, and clinical outcomes. The primary outcome was infection development; secondary outcomes included antibiotic-related complications. Descriptive statistics characterized prescribing patterns, and univariate tests evaluated associations between antibiotic use and outcomes. Multivariable modeling was not performed due to only two infection events. Statistical significance was set at <i>p</i> < 0.05.</p><p><strong>Results: </strong>Among 223 pediatric patients with facial fractures, the infection rate was low (< 1%). Despite this, 46.2% received antibiotics, though only 32.3% received systemic therapy. Among treated patients, 68.9% received courses exceeding 5 days (median 8 days), and over 70% received intravenous antibiotics. Surgical intervention was most strongly associated with antibiotic use, with surgical patients receiving antibiotics significantly more often than non-surgical patients. Open fractures were associated with higher utilization and longer durations compared with closed fractures. Both documented infections occurred in antibiotic recipients, though this association was not statistically significant. Notably, 51% of antibiotic recipients were candidates for shorter courses or oral conversion.</p><p><strong>Conclusion: </strong>These findings suggest potential antibiotic overutilization and highlight substantial opportunities to optimize stewardship in pediatric facial trauma, including limiting prophylactic duration, favoring oral therapy when appropriate, and better targeting antibiotics to high-risk patients. Prospective, multicenter studies are needed to guide evidence-based guideline development.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70574"},"PeriodicalIF":1.9,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070293","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 Impact of Surgical Technique on Post-Tonsillectomy Hemorrhage—A Registry-Based Cohort Study","authors":"Sverre Morten Zahl,&nbsp;Vegard Bugten,&nbsp;Tor Åge Myklebust,&nbsp;Anker Stubberud","doi":"10.1002/lio2.70587","DOIUrl":"10.1002/lio2.70587","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The objective was to estimate the impact of surgical technique on the risk of post-tonsillectomy hemorrhage (PTH).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a registry-based cohort study between 2017 and 2025, covering all tonsillectomies (excluding tonsillotomies) in Norway during the study period. The primary exposure variable was surgical technique, divided into three groups: cold (non-thermal technique for both dissection and hemostasis), cold + warm (thermal technique for hemostasis), and warm (thermal technique for both dissection and hemostasis). The effect of surgical technique on risk of PTH was analyzed using logistic regression, adjusting for confounding factors. Absolute risks and numbers needed to harm were also calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 25,953 patients were included (16,318 females [62.9%], median [IQR] age 20 [13] years). PTH was reported in 1946 patients (7.5%). Cold surgical technique was used in 3348 patients (12.9%), combined cold + warm technique was used in 16,284 patients (62.7%), and warm technique was used in 6321 patients (24.4%). Use of partly or fully warm technique was significantly associated with PTH compared to a purely cold technique (cold + warm: OR 2.4, 95% CI 1.9–3.1; warm: OR 3.4, 95% CI 2.5–4.6). The absolute increase in risk of PTH was 4.5% (cold + warm) and 7.5% (warm) compared to the cold technique, with corresponding numbers needed to harm of 22 and 13. The increased risk with warm technique was more pronounced for adolescents and adults compared to children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This population-based cohort study confirms that surgical technique is associated with PTH, with a significantly higher risk of PTH when using partially or fully warm technique compared to cold technique. Based on the cumulative evidence, it may be appropriate to raise the question whether one should recommend that tonsillectomies be performed with cold surgical technique, especially in adolescents and adults.</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":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070257","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":"Provox Life HMEs for Pulmonary Rehabilitation in HME-Naïve Laryngectomy Patients: A Randomized Controlled Trial.","authors":"Rafael De Cicco, Rafael Pereira de Souza, Carla Gonçalves Soares Moreira, Sandra Lopez Calcines, Victor Bandini Vieira, Daniela Maria Santos Serrano Marquezin, Marianne Yumi Nakai, Marcelo Benedito Menezes, Tabata Briaunys Milan, Francisco Araújo Dias","doi":"10.1002/lio2.70576","DOIUrl":"10.1002/lio2.70576","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether Provox Life Heat and Moisture Exchangers (HMEs) and attachments enable HME-naïve laryngectomized patients to establish a 24-h HME routine, and whether the resulting effect on pulmonary symptoms is sustained over 9 months, compared with standard care.</p><p><strong>Methods: </strong>In this prospective, randomized controlled trial, 79 HME-naïve patients post-total laryngectomy at two Brazilian centers were randomized to the Provox Life group (<i>n</i> = 41) or a control group without HMEs (<i>n</i> = 38). Data were collected at baseline and at 3, 6, and 9 months. The primary endpoint was the Cough Symptoms (COUS) domain of the validated Cough and Sputum Assessment Questionnaire (CASA-Q). Secondary endpoints included other CASA-Q domains, forced expectorations, involuntary coughs, sleep quality (JSEQ), quality of life (EQ-5D-5L), shortness of breath, skin integrity, pulmonary complications, and patient satisfaction.</p><p><strong>Results: </strong>HME adherence was near-continuous (mean 23.3-23.9 h/day). All four CASA-Q domains (COUS, COUI, SPUS, SPUI) improved significantly from baseline in the Provox Life group (all <i>p</i> ≤ 0.001 at 9 months), with changes exceeding published minimal clinically important differences; controls remained stable except for transient sputum-domain gains at T2. At 9 months, forced expectorations were significantly lower in the Provox Life group versus controls (3.3 ± 2.2 vs. 6.6 ± 6.1 per 24 h; <i>p</i> = 0.023). Sleep quality (JSEQ) improved significantly with Provox Life (<i>p</i> = 0.013), but not in controls. The EQ-5D-5L index improved at 3 and 6 months, pulmonary complications were descriptively fewer, and 89.7% rated their experience \"very good\". Skin irritation was low and comparable between groups. No device-related serious adverse events occurred.</p><p><strong>Conclusion: </strong>In HME-naïve patients after total laryngectomy, Provox Life enables near-continuous HME use and is associated with clinically meaningful improvements in pulmonary symptom burden, sputum management, and sleep quality. Skin tolerability is comparable to standard care.</p><p><strong>Level of evidence: </strong>1b <b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT06084611.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":"e70576"},"PeriodicalIF":1.9,"publicationDate":"2026-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070224","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}