Laryngoscope Investigative Otolaryngology最新文献

{"title":"The Association of Steroids and Pediatric Post-Tonsillectomy Recovery: A Retrospective Review","authors":"Sathvik Suryadevara,&nbsp;Henry Ideker,&nbsp;Rylee Moody,&nbsp;Lorraine De Velez,&nbsp;Ahmad Odeh,&nbsp;Matthew Simpson,&nbsp;Jason Bell,&nbsp;Adrienne Childers","doi":"10.1002/lio2.70561","DOIUrl":"10.1002/lio2.70561","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Pain, dehydration, and bleeding remain significant concerns for pediatric tonsillectomy patients. The literature is sparse on potential effects of postoperative, outpatient steroid prescribing practices among the post-tonsillectomy pediatric population. We aim to investigate the association of a postoperative oral steroid course with pain, bleeding, and dehydration while controlling for infectious indication to guide physicians for appropriate management of this population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single institution, retrospective review of pediatric patients aged 2–18 years who underwent tonsillectomy from 2019 to 2021. One group received a 4-dose course of postoperative oral dexamethasone, and the other did not. Among patients ages 2–6 and 7–18, the association of steroids with emergency department visits related to bleeding, dehydration, or uncontrolled pain was estimated while controlling for infectious indication and other factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 2054 pediatric tonsillectomy patients included. The majority were male (50.8%) and Non-Hispanic White (63.7%) with an average age of 7.0 years (SD = 3.9). About one-third (30.4%) of patients received dexamethasone, and dexamethasone was not associated with significantly lower odds of bleeding, dehydration, or uncontrolled pain/pain medication refills.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A 4-dose course of postoperative dexamethasone was not associated with a significant reduction in post-tonsillectomy bleeding, dehydration, or pain when controlling for infectious indication. However, it may be reasonable as an adjunct therapy.</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":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149076227","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 Economics of Intraoperative Parathyroid Hormone Monitoring for Parathyroid Surgery: A Scoping Review of Cost Analyses and Economic Evaluations","authors":"Phillip Staibano,&nbsp;Mohit Bhandari,&nbsp;Ankit Parmar,&nbsp;Jackie Han,&nbsp;Samyan Shahid,&nbsp;Michael Au,&nbsp;Jesse D. Pasternak,&nbsp;Catlin Yeo,&nbsp;Feng Xie,&nbsp;Martin Almquist,&nbsp;Sameer Parpia,&nbsp;Alexander Rogers,&nbsp;Jason W. Busse,&nbsp;Lisa Orloff,&nbsp;Carolyn Seib,&nbsp;Nhu-Tram Nguyen,&nbsp;Alex Thabane,&nbsp;Tyler McKechnie,&nbsp;J. E. Young,&nbsp;Han Zhang","doi":"10.1002/lio2.70577","DOIUrl":"https://doi.org/10.1002/lio2.70577","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Intraoperative PTH (IOPTH) monitoring is recommended for primary hyperparathyroidism (PHPT), but questions surround its added clinical value and financial cost. We evaluated the methodological quality of economic evaluations investigating IOPTH monitoring in surgery for PHPT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched several databases, including MEDLINE and EMBASE, from January 1990 to June 2026. All screening was performed in duplicate. We included studies that conducted economic evaluations of IOPTH monitoring. Risk of bias (ROB) and methodological quality were evaluated in duplicate using ECOBIAS and CHEERS for full economic evaluations, while other criteria were applied to all eligible studies. We conducted a narrative synthesis with descriptive analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 668 articles reviewed, 22 articles met eligibility criteria. Most studies were observational (77%) and 14% were derived from decision tree models; 82% were partial economic evaluations and 18% were full economic evaluations. CHEERS adherence for full economic evaluation ranged from 46%–81%, and there was moderate/high ROB secondary to issues with reporting the time horizon, cost discounting, sensitivity analyses, and equity consideration biases. Economic perspective (14%), cost discounting (14%), economic summary measures (9%), and sensitivity analyses (23%) were infrequently reported. 50% of studies commented on IOPTH monitoring cost-effectiveness despite not investigating incremental economic summary measures. There was a similar number of studies reporting cost reductions and cost increases from the use of IOPTH monitoring.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Knowledge gaps and methodological inadequacies impede our current understanding of the economics of IOPTH monitoring. The shortcomings identified should be addressed in future economic evaluations of intraoperative parathyroid technologies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70577","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048171","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":"UV-C LED Disinfection of Flexible Rhinolaryngoscopes: Microbiological, Economic, Environmental, and Legislative Evaluation","authors":"Camille Maeyaert,&nbsp;Sofie Claeys,&nbsp;Stien Vandendriessche,&nbsp;Hannah Siwe,&nbsp;Bjorn Delbeecke,&nbsp;Pascal Verdonck,&nbsp;Alain F. Kalmar","doi":"10.1002/lio2.70575","DOIUrl":"https://doi.org/10.1002/lio2.70575","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the microbiological efficacy of the Ray-Two ultraviolet-C (UV-C) light-emitting diode (LED) chamber for reprocessing flexible rhinolaryngoscopes in otorhinolaryngology (ORL) practice and compare its economic and ecological impacts with chemical high-level disinfection using the Tristel Trio Wipes System (TTWS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a prospective study at a tertiary ORL center, bacterial contamination was assessed on 20 flexible rhinolaryngoscopes immediately after routine posterior rhinoscopy and/or laryngoscopy. Paired swab samples were collected from the distal 10–12 cm shaft pre- and post-reprocessing: manual pre-cleaning with tap water followed by a 4-min UV-C LED cycle. Samples were cultured on TSA-5% sheep blood agar for 36 h at 35°C–37°C, with colony-forming units (CFUs) enumerated. Per-cycle costs and carbon footprints were calculated via life cycle assessment (ISO 14040/14044) and compared with TTWS, based on 5000 annual procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Pre-reprocessing median CFUs (IQR; range) were 15 (3–27; 2 to &gt; 200), reducing to 0 (0–0; 0–1) post-UV-C (<i>p</i> &lt; 0.001; &gt; 99% reduction; 19/20 samples sterile). UV-C per-cycle cost was €0.56 (vs. €8.32 for TTWS; 93% savings), with a carbon footprint of 6.81 g CO₂e (vs. 115.8 g; 94% reduction). Annual savings: €38,800 and 548 kg CO₂e.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Ray-Two UV-C LED chamber achieves near-complete bacterial elimination (100% in 19/20 samples; 1 residual CFU in 1/20 samples) on flexible rhinolaryngoscopes, with superior cost-efficiency and sustainability versus TTWS. This mercury-free, point-of-care method supports greener ORL practice amid evolving EU and US state-level regulations on mercury-containing lamps, enhancing infection control without compromising efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149048066","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":"Radiological Tumor Calcification in Sinonasal Adenocarcinoma: Prevalence and Prognostic Implications","authors":"Julia Fanchette,&nbsp;Florian Chatelet,&nbsp;Melania Bertolini,&nbsp;B. Boukebous,&nbsp;Alessandro Vinciguerra,&nbsp;Martina Conti,&nbsp;Jean Pierre Guichard,&nbsp;Khaled Al Tabaa,&nbsp;Michel Wassef,&nbsp;Homa Adle-Biassette,&nbsp;Philippe Herman,&nbsp;Benjamin Verillaud","doi":"10.1002/lio2.70565","DOIUrl":"10.1002/lio2.70565","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;Radiological intratumoral calcifications in sinonasal adenocarcinoma have been scarcely investigated. This study aimed to assess their prevalence and evaluate their potential prognostic significance and to examine its association with surgical resectability.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Materials and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;We conducted a retrospective single-center study including patients treated with curative intent for sinonasal adenocarcinoma. Clinical, pathological, treatment, and computed tomography (CT) data were reviewed. Intratumoral diffuse calcifications were assessed on preoperative CT. Associations with tumor characteristics, surgical outcomes, and survival were analyzed using appropriate statistical methods, including Cox proportional hazards models.&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;Ninety-six patients were included. Intratumoral calcifications were identified in 24 patients (25%). Compared with patients without calcifications, those with calcifications more frequently had locally advanced tumors (pT3–4: 79.2% vs. 47.2%, &lt;i&gt;p&lt;/i&gt; = 0.013; pT4: 62.5% vs. 31.9%, &lt;i&gt;p&lt;/i&gt; = 0.025), were more likely to receive induction chemotherapy (33.3% vs. 9.7%, &lt;i&gt;p&lt;/i&gt; = 0.015), and had a higher rate of incomplete resection (R2: 20.0% vs. 1.5%, &lt;i&gt;p&lt;/i&gt; = 0.007). Histological subtype and differentiation grade were similar between groups. The association with R2 resection persisted after adjustment for pT stage (penalized logistic regression: OR 7.74, 95% CI 1.26–82.61; &lt;i&gt;p&lt;/i&gt; = 0.026). In univariable analysis, calcifications were associated with worse disease-free survival (HR 2.36, 95% CI 1.23–4.54; &lt;i&gt;p&lt;/i&gt; = 0.010), but this association did not persist after adjustment for pT stage (HR 1.47, 95% CI 0.76–2.88; &lt;i&gt;p&lt;/i&gt; = 0.26) or in multivariable analysis (HR 1.41, 95% CI 0.70–2.85; &lt;i&gt;p&lt;/i&gt; = 0.34). Calcifications were not associated with overall survival.&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;Intratumoral radiological calcifications were present in 25% of sinonasal adenocarcinomas and were associated with more advanced local disease and a higher risk of incomplete resection. Although associated with poorer disease-free survival in unadjusted analyses, this effect was attenuated after adjustment for tumor stage. These findings suggest that calcifications primarily reflect local tumor extent; although not an independent survival factor, their independent association with incomplete resection may make them a useful preoperative marker of surgical difficulty.&lt;/p&gt;\u0000 &lt;/section&gt;","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041563","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":"Modeling the Relationship of Age With Hypocalcemia Following Total Thyroidectomy: A NSQIP Analysis","authors":"Cyrus W. Abrahamson,&nbsp;Daniel C. Chelius,&nbsp;Jill N. D'Souza,&nbsp;Amy L. Dimachkieh,&nbsp;Anthony M. Sheyn,&nbsp;Jeffrey C. Rastatter","doi":"10.1002/lio2.70566","DOIUrl":"10.1002/lio2.70566","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To characterize the relationship between age and hypocalcemia risk following total thyroidectomy and identify critical age-related transition points across the lifespan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The American College of Surgeons National Surgical Quality Improvement Program Thyroidectomy Targeted database was queried for 21,109 adult patients (18+) from 2016 to 2023 who underwent total thyroidectomy. Multivariate regressions utilizing age, sex, race/ethnicity, BMI, surgical specialty, ASA classification, and surgical indication were used to assess odds of hypocalcemia within 30 days of surgery. Additionally, age-stratified analyses, generalized additive modeling (GAM), and segmented regression were used to assess odds of hypocalcemia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Age was independently associated with 2% decreased odds of hypocalcemia per year older (OR, 0.98; 95% CI, 0.98–0.99; <i>p</i>-value &lt; 0.001). GAM and systematic evaluation of 1,683,217 segmented regression models identified six key inflection points at ages 26, 35, 39, 51, 54, and 71, with hypocalcemia risk characterized by sharp changes at these transition points and gradual changes between them. Inflection points in early adulthood were the most consistent across models, while those in older age showed greater variability, suggesting increasing physiological heterogeneity with advancing age. Risk stabilized after age 65 with no significant differences between consecutive age groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hypocalcemia risk following total thyroidectomy follows a nonlinear age-dependent pattern with identifiable transitions, challenging simple continuous or categorical age modeling. Risk stabilizes after the mid-sixties, though very elderly patients should not be assumed to have lower risk due to advanced age alone. These findings support development of age-tailored risk stratification tools for more personalized perioperative calcium management.</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":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13598293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149041628","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":"From Innovation to Implementation: A Scoping Review of Simulation in Otolaryngology Education","authors":"Michael T. Yim,&nbsp;Mackenzie Latour,&nbsp;Srivatsa Surya Vasudevan","doi":"10.1002/lio2.70564","DOIUrl":"10.1002/lio2.70564","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;To systematically map the otolaryngology simulation literature according to learner stage, primary educational objective, and depth of outcome measurement, and to propose a structured implementation framework for integrating emerging technologies and developing standardized, national simulation curricula.&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;A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). PubMed/MEDLINE, Embase, and Web of Science were searched for studies published from January 2010 through August 2026 describing simulation used for education, training, or assessment in otolaryngology. Included studies were charted across three domains: learner stage (medical students, residents, practicing otolaryngologists), primary educational objective (exposure, acquisition, refinement, assessment), and outcome depth (face/content validity, pre–post or construct validity, behavior/clinical correlation). Evidence from adjacent surgical specialties and emerging technologies was synthesized narratively to inform a stepwise implementation framework.&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;Of 9081 records identified, 979 unique studies met inclusion criteria, yielding 1142 learner entries. Simulation efforts were heavily concentrated in resident education (56.0% of learner entries) and skill acquisition (53.0%), with skill refinement concentrated among practicing otolaryngologists and almost no studies designed primarily for assessment. Face or content validity remained the most common highest measured outcome (53.7%); behavior-level outcomes were rare (1.1%). These distributions demonstrate insufficient alignment between learner stage, educational intent, and validation depth. Lessons from adjacent surgical specialties, together with emerging technologies such as artificial intelligence and extended reality, offer a practical pathway toward scalable, objective assessment.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Otolaryngology is poised to advance simulation education beyond historically fragmented initiatives toward a deliberately designed simulation ecosystem aligned with learner level, educational intent, and outcome depth. A coordinated national framework that leverages emerging technologies while building on existing infrastructure, implemented through phased pilot programs and attentive to cost, faculty, and technical barriers, can position the field as a leader in surgical educa","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591109/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018600","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":"Impact of an Evidence-Based Emergency Department Order Set on Clinical Management of Bell's Palsy","authors":"Joyce H. Lee,&nbsp;Derek Vos,&nbsp;Margaret Parkhurst,&nbsp;Sara Liu,&nbsp;Dane Genther,&nbsp;Peter Ciolek","doi":"10.1002/lio2.70551","DOIUrl":"https://doi.org/10.1002/lio2.70551","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the impact of an evidence-based emergency department (ED) order set on the clinical management of patients presenting with Bell's palsy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included adult patients diagnosed with Bell's palsy in the ED before and after the institution of a new order set, which mirrors the AAO-HNSF Clinical Practice Guidelines. Data were extracted on demographics, steroid and antiviral prescribing, eye protection, and referrals and analyzed using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two cohorts of patients diagnosed with Bell's palsy in the ED were compared: those managed prior to the institution of the order set (<i>n</i> = 27, April 2020 to August 2023) and those managed under the new order set (<i>n</i> = 29, September 2023 to November 2025). Demographics were similar across cohorts, with median ages of 50 years in the prior group versus 54 years in the order set group. Use of a tapering steroid regimen increased with the updated order set (79.3% vs. 0%). Eye protection was provided to 89.7% of patients in the updated order set group compared to 85.2% prior. Referrals to otolaryngology increased to 89.7% with the order set compared to 0% prior.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementation of an order set in accordance with the AAO-HNSF Clinical Practice Guidelines on Bell's palsy improved adherence to best practices, particularly regarding steroid tapers, eye protection, and referral to otolaryngology. These findings suggest that structured ED order sets may enhance the quality and consistency of Bell's palsy care.</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":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70551","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148943374","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":"Gender and Perceived Racial Diversity in Academic Otolaryngology","authors":"Rachel A. Haji,&nbsp;Robin Powszok,&nbsp;Grant Primer,&nbsp;Joyce Jeong,&nbsp;Dina Simon,&nbsp;Krupa R. Patel,&nbsp;Vanessa Stubbs","doi":"10.1002/lio2.70557","DOIUrl":"10.1002/lio2.70557","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;To characterize gender and perceived racial representation among academic otolaryngology faculty in the United States and evaluate associations with academic rank, leadership roles, and research productivity.&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 cross-sectional study evaluated faculty with professorial titles across 133 Accreditation Council for Graduate Medical Education-accredited otolaryngology residency programs in the United States. Faculty rosters were collected from program websites between October 2024 and March 2025 and supplemented with publicly available sources. Variables included perceived gender, perceived race, academic rank, leadership roles, years in practice, subspecialty training, and &lt;i&gt;h&lt;/i&gt;-index. Associations were evaluated using chi-square tests and multivariable ordinal logistic regression. Because demographic variables were assigned from publicly available information rather than self-identification, perceived race was analyzed only as White versus non-White and is interpreted as a limited, socially constructed variable.&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 1697 faculty, 69.1% were male and 68.8% were perceived as White. Women were more represented in pediatric otolaryngology and laryngology, whereas men were more represented in head and neck surgery, neurotology, and comprehensive otolaryngology (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Women were more likely to be assistant professors and men professors (&lt;i&gt;p&lt;/i&gt; &lt; 0.001). Women more often held residency leadership roles (9.7% vs. 5.6%; &lt;i&gt;p&lt;/i&gt; = 0.002), whereas men more often held fellowship leadership roles (8.4% vs. 5.3%; &lt;i&gt;p&lt;/i&gt; = 0.028) and chair positions (5.0% vs. 2.7%; &lt;i&gt;p&lt;/i&gt; = 0.026). Men had more years in practice and higher &lt;i&gt;h&lt;/i&gt;-indices (both &lt;i&gt;p&lt;/i&gt; &lt; 0.001). No significant differences by perceived race were observed in academic rank, leadership, or research productivity. In multivariable analysis, years in practice and &lt;i&gt;h&lt;/i&gt;-index independently predicted higher academic rank, whereas gender and perceived race did not.&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;Academic rank was more strongly associated with years in practice and &lt;i&gt;h&lt;/i&gt;-index than with gender or perceived race. Perceived-race findings should be interpreted cautiously because binary externally assigned categories may obscure within-group differences.&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;4&lt;/p&gt;\u0000 ","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901331","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":"Auditory Perceptions Associated With Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea","authors":"Andrew Belilos,&nbsp;Iman Adibi,&nbsp;Aaron Tucker,&nbsp;Arman Saeedi,&nbsp;Alyssa Calder,&nbsp;Lawrance Lee,&nbsp;Ryan Nord","doi":"10.1002/lio2.70550","DOIUrl":"10.1002/lio2.70550","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>Hypoglossal nerve stimulation (HNS) is an effective therapy for obstructive sleep apnea (OSA), but its potential auditory side effects are not well studied. This study aims to determine the baseline prevalence of tinnitus in Inspire recipients and assess and characterize new auditory perceptions occurring specifically during device activation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted using a scripted telephone survey to collect patient-reported outcomes from individuals who received HNS therapy for OSA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 70 HNS recipients surveyed, 17.1% (<i>n</i> = 12) reported auditory perceptions occurring specifically during device activation. Patients with preexisting tinnitus were not more likely to report device-related auditory perceptions compared with patients with no history (22.2% vs. 15.4%, <i>p</i> = 0.53), suggesting that preexisting tinnitus does not predispose patients to perceive device activation. No significant associations were found between device-related auditory perceptions and age (<i>p</i> = 0.387), BMI (<i>p</i> = 0.876), device amplitude (<i>p</i> = 0.427), or stimulation frequency (<i>p</i> = 1).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this population, patient demographics and device settings were not predictive of auditory perception onset. A notable percentage of HNS patients reported new stimulation-related auditory sensations unrelated to demographic or device factors. These findings highlight an underrecognized outcome and support increased surveillance and counseling regarding auditory symptoms after HNS implantation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 5","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13539899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888740","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":"Large Language Models Versus Multidisciplinary Tumor Board Decisions in Thyroid Cancer","authors":"Bayram Barış Büyük,&nbsp;Arzu Or Koca,&nbsp;Felat Toprak,&nbsp;Aslı Ayan,&nbsp;Tuncay Tunçcan,&nbsp;Ayça Arslan,&nbsp;ArzuBetül Duran,&nbsp;Elif Akyol Şen,&nbsp;Ömer Semih Budak,&nbsp;Alptekin Gürsoy,&nbsp;Caner Kılıç","doi":"10.1002/lio2.70547","DOIUrl":"10.1002/lio2.70547","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Large language models (LLMs) are increasingly proposed as clinical decision-support tools; however, their agreement with real-world multidisciplinary tumor board (MDT) decisions remains insufficiently investigated in thyroid oncology. To evaluate the concordance between treatment recommendations generated by ChatGPT 5.2 and Gemini 3.0 and decisions made by a tertiary multidisciplinary thyroid tumor board.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 59 consecutive patients discussed at a tertiary MDT between August and December 2025. Anonymized clinical data, including demographics, ultrasonographic findings, and Bethesda cytology, were provided to both LLMs using standardized structured prompts. MDT decisions were defined as the reference standard. Agreement was assessed using exact concordance rates and Cohen's kappa (<i>κ</i>) statistics with 95% confidence intervals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>ChatGPT 5.2 achieved a concordance rate of 71.2% (42/59), demonstrating substantial agreement (<i>κ</i> = 0.623; 95% CI 0.459–0.771). Gemini 3.0 showed a concordance rate of 64.4% (38/59), reflecting moderate agreement (<i>κ</i> = 0.527; 95% CI 0.359–0.684). Discordance increased in complex scenarios involving lateral neck dissection, radioactive iodine therapy, and active surveillance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While LLMs demonstrate promising concordance in standardized thyroid cancer management, they are best positioned as supportive decision aids—such as in MDT preparation and workflow streamlining—rather than replacements for expert multidisciplinary evaluation, particularly in complex clinical scenarios.</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":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13536480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882331","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}