Laryngoscope Investigative Otolaryngology最新文献

{"title":"Insights into laryngeal Castleman disease: A comprehensive scoping review with a case study focus","authors":"Natalie Weiss MD, MBA,&nbsp;Estephania Candelo MD, MSc,&nbsp;Margaret Bridges MS,&nbsp;Amy Rutt DO, FACS","doi":"10.1002/lio2.70069","DOIUrl":"10.1002/lio2.70069","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Castleman disease (CD) refers to a heterogeneous group of lymphoproliferative disorders, which rarely involves the larynx. Our goal in this study is to elucidate the clinical presentation, diagnostic techniques, and treatment methods of laryngeal CD through a scoping review and the addition of a new case.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Due to limited existing literature, we employed a mixed methodology for review. First, we searched Google Scholar using terms related to laryngeal CD. Subsequently, we screened abstracts using Covidence, drawing from databases such as PubMed, Science Direct, ProQuest, and EMBASE. We shortlisted studies for data extraction, focusing on clinical presentations, diagnostics, and treatment methodologies. Finally, we described our additional case.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Scoping review revealed five qualifying laryngeal CD articles. Presenting symptoms included dysphagia, hoarseness, and dyspnea. Diagnosis was always established through histopathologic analysis. Management included local excision or radiotherapy. In our additional case, a 71-year-old male with known CD presented with neck swelling, dysphagia, and dysphonia. Exam revealed lymphoid laryngeal and supraglottic hyperplasia and edema. Laryngeal symptoms improved with medical management of CD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Given the rarity of laryngeal CD, its identification and management can be a challenge. Practitioners should be aware of characteristic points in a CD patient's history, physical exam, imaging, and biopsies. Local excision of obstructive lymphoid tissue and radiation are the best-supported therapies. This study aims to build toward improvements in accurate diagnosis and appropriate treatment for laryngeal CD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956952","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":"Elastic cartilage properties of the tip of the vocal process of the arytenoid cartilage","authors":"Kiminori Sato MD,&nbsp;Shun-ichi Chitose MD,&nbsp;Kiminobu Sato MD,&nbsp;Fumihiko Sato MD,&nbsp;Takeharu Ono MD,&nbsp;Hirohito Umeno MD","doi":"10.1002/lio2.70071","DOIUrl":"10.1002/lio2.70071","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to investigate the histological and ultrastructural features of the elastic cartilage at the tip of the vocal process in the arytenoid cartilage, which is essential for laryngeal biomechanics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five larynges, including the vocal folds and epiglottis, were examined using transmission electron microscopy. The elastic cartilage at the tip of the vocal process was compared to the epiglottic cartilage within the same larynx to elucidate structural differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The elastic cartilage at the vocal process tip consisted of chondrocytes, elastic fibers, collagen fibrils, and ground substances. Chondrocytes in the vocal process were smaller and not distinctly isolated in cartilage cavities (lacunae), unlike those in the epiglottis. Cytoplasmic analysis showed abundant free ribosomes and well-developed granular endoplasmic reticula, often with dilated cisternae. Amorphous materials were synthesized at the periphery of the cytoplasm and secreted through vesicles. The cartilage matrices were composed of elastic fibers, collagen fibrils, microfibrils, and proteoglycans. The density of elastic fibers was notably higher where elaunin fibers predominated. Collagen fibrils were thin, randomly oriented, and did not form thick bundles. Microfibrils formed delicate three-dimensional networks with other extracellular matrix components. And proteoglycan granules were located in the interstitial spaces among other cartilage matrix components and attached to them.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The unique structural features of the elastic cartilage at the tip of vocal process, when compared to the epiglottic cartilage, suggest a specialized functional role in maintaining the flexibility and resilience required for vocal fold adduction and abduction during phonation and other laryngeal functions.</p>\u0000 \u0000 <p>Level of evidence: NA</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956936","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":"Evaluation of factors that impact medical student consideration of a career in otolaryngology","authors":"Mary H. Kress BS,&nbsp;Evan Thomas BS,&nbsp;Hannah Turbeville MD PhD,&nbsp;Nicholas R. Lenze MD MPH,&nbsp;Brent Williams MD,&nbsp;Terrence Pleasant MD,&nbsp;Lauren Bohm MD","doi":"10.1002/lio2.70066","DOIUrl":"10.1002/lio2.70066","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify differences in timing of exposure and demographic characteristics between medical students who did and did not consider Otolaryngology as a career choice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study involved developing and distributing a survey by an interdisciplinary team to assess exposure to Otolaryngology and individual consideration of pursuing Otolaryngology. The survey was administered electronically to third- and fourth-year medical students at a single medical school, with a small monetary incentive for completion. Descriptive statistics, Fisher's exact tests, and logistic regression models were used for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 172 survey responses were collected out of 374 third- and fourth-year medical students (46%). A total of 74 (43.0%) respondents considered Otolaryngology during medical school. Exposure to Otolaryngology prior to medical school was significantly associated with choosing Otolaryngology (71.4%) compared to those who lacked exposure (28.6%) (<i>p</i> = .048). There was no significant gender difference among students who considered Otolaryngology (<i>p</i> = .537). However, our results showed significant differences between those who considered Otolaryngology by race (<i>p</i> = .003). Black/African American (OR = 0.11, 95% CI 0.01–0.99; <i>p</i> = .049) and Hispanic or Latino (OR = 0.14, 95% CI 0.03–0.65; <i>p</i> = .012) were less likely to consider Otolaryngology when compared to those identifying as White when adjusted for exposure prior to medical school.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our results showed that early exposure and demographic background impact a student's decision to consider Otolaryngology as a career. These findings highlight the need for robust recruitment initiatives. Avenues like pipeline and mentorship programs are recommended to recruit and attract diverse applicants to Otolaryngology.</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":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956941","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":"Neuromuscular junction visualization in paraffin-embedded thyroarytenoid muscle sections: Expanding options beyond frozen section analysis","authors":"Samuel L. Kaefer BA,&nbsp;Elizabeth O. Shay MD,&nbsp;Rachel A. Morrison PhD,&nbsp;Lujuan Zhang MD,&nbsp;Sherry Voytik-Harbin PhD,&nbsp;Stacey Halum MD, FACS","doi":"10.1002/lio2.70020","DOIUrl":"10.1002/lio2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>The current gold standard for immunofluorescent (IF) visualization of neuromuscular junctions (NMJs) in muscle utilizes frozen tissue sections with fluorescent conjugated antibodies to demarcate neurons and IF alpha-bungarotoxin (α-BTX) to demarcate motor endplates. Frozen tissue sectioning comes with inherent inescapable limitations, including cryosectioning artifact and limited sample shelf-life. However, a parallel approach to identify NMJs in paraffin-embedded tissue sections has not been previously described.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Yucatan minipig thyroarytenoid (TA) muscle was harvested and prepared as 5-μm thick paraffin-embedded tissue sections. A variety of antibodies at various concentrations were selected to target nicotinic acetylcholine receptors, synaptic vesicles, and neurons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Neurofilament (NEFL, Invitrogen, 1:500) and synaptic vesicle glycoprotein (SV2, DSHB, 1:230) bound and demarcated the neurons and synaptic vesicles, respectively. Following consistent visualization of nerve tissue, rabbit anti-nicotinic acetylcholine receptor alpha-1 subunit (CHRNα₁, Abcam, 1:500) was used to identify the acetylcholine receptors within motor endplates. Complete NMJ visualization was then achieved with an optimized protocol using primary antibodies to the neurofilament light chain, nerve synaptic vesicle glycoprotein 2, and the alpha 1 subunit of the nicotinic acetylcholine receptor. Slide imaging was performed with the Echo Revolve Microscope (40×).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Herein, we describe a new methodology to visualize NMJs within paraffin-embedded TA muscle sections. Our protocol avoids the known limitations associated with cryosectioned samples and introduces a new neurolaryngologic research tool that utilizes the advantageous ability of paraffin-embedded sectioning to preserve tissue morphology. In conjunction with standard cryosectioned methods, the described paraffin-embedded protocol serves to enhance histological analysis of NMJs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>NA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705440/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956894","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":"Establishment of a survival rabbit model for laryngotracheal stenosis: A prospective randomized study","authors":"Wei Chen MD,&nbsp;Qingyu Wang MM,&nbsp;Hongming Xu MD,&nbsp;Yuhui Xie MM,&nbsp;Lina Zhang MM,&nbsp;Yao Li PhD,&nbsp;Guofeng Yan PhD,&nbsp;Yiwen Ding PhD,&nbsp;Shunkai Lu MM,&nbsp;Zhibo Xie MD,&nbsp;Jiarui Chen MD,&nbsp;Mengrou Xu MD,&nbsp;Xiaoben Liang MD,&nbsp;Juan Chen PhD,&nbsp;Penghuai Fu PhD,&nbsp;Xiaoyan Li MD, PhD,&nbsp;Liming Peng PhD","doi":"10.1002/lio2.70047","DOIUrl":"https://doi.org/10.1002/lio2.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop a reproducible survival rabbit model for laryngotracheal stenosis (LTS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy New Zealand white (NZW) rabbits were randomly divided into experimental groups (<i>n</i> = 30) and a control group (<i>n</i> = 40). In experimental groups, a nylon brush was inserted retrograde from the tracheotomy through the subglottis and rotated until a full layer circumferential mucosal injury to cartilage exposure, assisted by fiberoptic laryngoscopy (FOL) visualization. Experimental group 1 (<i>n</i> = 10), rotated 10 times; group 2 (<i>n</i> = 20), rotated 20 times. The control group underwent tracheotomy only without nylon brush scraping. The rabbits underwent FOL at 1st, 4th, 8th, and 12th week postinjury respectively to observe the formation of LTS. They were euthanized and the larynxes and tracheas were subjected to gross and histopathological examination at 12 weeks postinjury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The control group all survived, while five cases in experimental groups died from LTS and/or mucous plug. Histological observation showed that the control group had intact laryngotracheal mucosal epithelium without any stenosis; the experimental groups showed proliferation of fibroblasts and thickening of collagen fibers. The mean stenosis in control group was 9.31 ± 0.98%, while that in experimental group 1 was 32.78 ± 7.07% and 58.25 ± 8.96% in experimental group 2. The difference between the three groups was statistically significant (<i>χ</i>² = 47.98, <i>p</i> &lt; .05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We successfully developed a reproducible survival rabbit model for LTS using a nylon brush through FOL visualization combined with tracheostomy. This model can provide a mature and stable animal model for the exploration of wound-healing pathophysiology and the effect of interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>NA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70047","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862061","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":"Herpes simplex virus presenting as an oropharyngeal mass","authors":"Evgeniya Molotkova BS,&nbsp;Anna C. Buhle BS,&nbsp;Patrick S. Rush DO,&nbsp;James E. McLean MD,&nbsp;Patrick S. Carpenter MD","doi":"10.1002/lio2.70042","DOIUrl":"https://doi.org/10.1002/lio2.70042","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective(s)</h3>\u0000 \u0000 <p>Present a clinically challenging case of an immunocompetent 74-year-old male who presented with marked dyspnea and hemoptysis. After the airway was secured, direct laryngoscopy revealed a large, fungating, hemorrhagic mass of the left lateral pharyngeal wall and surrounding structures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Chart review of a single patient. This patient provided consent for his case materials and images to be used for educational purposes and publication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The clinical appearance of the mass was suspicious for an aggressive neoplasm. Initial biopsy of the mass was nonspecific, revealing necrosis and inflammation, but was negative for malignancy. Due to concern for bacterial supraglottitis, empiric treatment with antibiotics was initiated. Cultures were positive for <i>Fusobacterium necrophorum</i>. Repeat biopsy samples showed signs of underlying human simplex virus (HSV) infection, which was confirmed with polymerase chain reaction (PCR) testing. After addition of acyclovir, the patient began to improve clinically and was eventually decannulated. There was complete resolution of the mass at his 1-month follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HSV supraglottitis is a rare, rapidly progressive, and highly morbid condition. Lack of overt patient risk factors, frequently inconclusive biopsies, and clinical appearance mimicking other etiologies make diagnosis challenging. Superimposed bacterial infection is even less common and may contribute to increased disease severity and progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70042","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142868848","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":"Worse survival and higher rates of relapse in U.S. Armenians with papillary thyroid cancer","authors":"Karen Tsai MD,&nbsp;Katerina Arca MS,&nbsp;Philip H. G. Ituarte PhD,&nbsp;Thomas Gernon MD,&nbsp;Behrouz Salehian MD,&nbsp;Diana Bell MD,&nbsp;Ellie Maghami MD","doi":"10.1002/lio2.70052","DOIUrl":"https://doi.org/10.1002/lio2.70052","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Papillary thyroid cancer (PTC) is the most frequent subtype of thyroid cancer with overall favorable survival. Currently, little is known about the PTC experience within the United States (U.S.) Armenians. We performed the first study comparing clinicopathologic variables and clinical outcomes of U.S. Armenian PTC patients to a matched control group of non-Armenians.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a single-center, retrospective, case–control study of adult Armenian PTC patients who received care at COH from 2005 to 2022. Armenian ethnicity was determined by surnames ending in “-ian” and “-yan”. We report and compare clinicopathologic presentation and disease outcomes with a gender- and age-matched control non-Armenian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty-eight Armenian patients comprised our study cohort. Positive margin status (<i>p</i> = .038), angioinvasion (<i>p</i> = .006), and extrathyroidal extension (<i>p</i> = .014) were more prevalent in the Armenian population. Higher rates of both persistent disease and death due to disease were seen in the Armenians regardless of age groupings. Multivariable analysis revealed significant impact of Armenian status on outcomes. Calculated 5- and 10- year disease-specific survival rates in the Armenian cohort were 88% and 73.2%, respectively, compared with 100% and 94.6% in the non-Armenian group (<i>p</i> &lt; .002). The 5- and 10- year progression-free survival was worse in the Armenian group at 61.8% and 50.1%, respectively, compared with 87.5% and 87.5% in the non-Armenian group (<i>p</i> &lt; .001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Armenian PTC patients displayed more aggressive disease than non-Armenians. In addition, Armenian PTC patients had higher incidence of disease relapse and worse clinical outcomes.</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":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70052","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862062","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":"Comparison between intratympanic injection of dexamethasone and methylprednisolone in idiopathic sudden sensorineural hearing loss: A randomized clinical trial","authors":"Kourosh Eftekharian MD, MPH,&nbsp;Elnaz Najafi MD,&nbsp;Maryam Amizadeh MD,&nbsp;Noosheen Mokari MS,&nbsp;Mohammad Faramarzi MD,&nbsp;Yalda Izadparast MD,&nbsp;Yalda Jabbari Moghadam MD,&nbsp;Ali Eftekharian MD","doi":"10.1002/lio2.70054","DOIUrl":"10.1002/lio2.70054","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare the hearing outcomes of patients with idiopathic sudden sensorineural hearing loss after intratympanic (IT) injection of methylprednisolone and dexamethasone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study design</h3>\u0000 \u0000 <p>Randomized case-controlled clinical trial.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Seventy-five patients diagnosed with idiopathic sensorineural hearing loss were randomly divided into two groups based on therapy. Both groups received oral prednisolone (10 mg/kg; maximum of 60 mg) for 10 days without tapering and received IT injections two times a week for 2 weeks (four injections in total). One group received an IT injection of a 40 mg/mL solution of methylprednisolone, and the other one, 4 mg/mL dexamethasone. Three comparisons between the initial and third-month hearing tests were made to assess the degree of hearing change: (1) pure tone improvement in each individual tone (0.5, 1, 2, 3, and 4 kHz); (2) word-recognition score improvement; and (3) complete, partial, and no recovery of hearing calculated (as defined by American Academy of Otolaryngology-Head and Neck Surgery Clinical Practice Guidelines).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study was completed with 69 of the 75 patients—34 in the methylprednisolone group and 35 in the dexamethasone group. The groups' differences in frequency-specific hearing improvement were not statistically significant. There was no statistically significant difference in the word recognition score improvement between the two groups. Additionally, there was no discernible difference between the two groups' hearing recovery rates.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Methylprednisolone and dexamethasone IT injection therapy had similar hearing outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of evidence</h3>\u0000 \u0000 <p>2.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848090","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":"Obesity is a risk factor for prolonged mechanical ventilation after tracheotomy","authors":"Jacqueline Tucker BS,&nbsp;Nicole Ruszkay MD,&nbsp;Sara Sandifer BS,&nbsp;Tonya S. King PhD,&nbsp;Neerav Goyal MD MPH FACS,&nbsp;David Goldenberg MD FACS,&nbsp;John P. Gniady MD FACS","doi":"10.1002/lio2.70038","DOIUrl":"10.1002/lio2.70038","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare patient outcomes across body mass index (BMI) subgroups in the setting of recent tracheotomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective chart review included patients over 18 years old who underwent tracheotomy placement between February 2017 and March 2020. Patients were divided into five groups based on BMI: underweight, normal weight, overweight, obese, and morbidly obese. Data were collected from the electronic medical record (EMR). Statistical analyses were completed via Kruskal–Wallis, Chi-square, log-rank tests, and Cox proportional hazards regression. If significant differences were found between groups, then subsequent pairwise comparisons of BMI were completed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 391 patients included in the study. There were significant differences in length of stay (<i>p</i> = .015) and duration of mechanical ventilation (<i>p</i> &lt; .001) among the groups. This was mainly driven by comparisons between the normal weight and obese groups, with patients of normal weight having shorter hospital stays and shorter ventilation durations. With each increasing BMI category from normal weight, a greater proportion of patients were ventilator-dependent at the time of discharge (<i>p</i> &lt; .001). Interestingly, after adjustment for comorbidities, the rate of tracheotomy change was 0.86 times lower for every increase in BMI category (95% CI 0.77–0.96). There was a significant difference among the BMI groups with respect to time to tracheotomy collar placement according to both the log-rank test (<i>p</i> &lt; .001) and the Cox model with adjustment for the presence of heart failure (<i>p</i> = .011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among patients undergoing tracheotomy, obese and morbidly obese patients have increased lengths of hospital stays. Additionally, they are dependent on ventilators for longer and are more likely to be ventilator-dependent at the time of discharge. It is important to understand how BMI impacts the hospital course for patients undergoing tracheotomy so that patients and their families can be better informed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11651190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848094","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":"Developing a mobile application for gender-affirming voice training: A community-engaged approach","authors":"Isaac L. Alter AB,&nbsp;Keith A. Chadwick MD, MS,&nbsp;Katerina Andreadis MS,&nbsp;Rachel Coleman MS, CCC-SLP,&nbsp;Mary Pitti MS, CCC-SLP,&nbsp;Jerel M. Ezell PhD, MPH,&nbsp;Anaïs Rameau MD, MS, MPhil","doi":"10.1002/lio2.70043","DOIUrl":"10.1002/lio2.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To date, there has yet to be a rigorous exploration of voice and communication modification training (VCMT) among transgender and gender-nonconforming (TGNC) individuals using digital technology. We sought to evaluate and describe the iterative process of app development using a community-based approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An interprofessional team of voice health care professionals, application developers, designers, and TGNC community members was assembled to conceive the functionality, content, and design of a mobile app to support VCMT for TGNC people. Six TGNC individuals, identified primarily by word of mouth, joined the development team as a Community Advisory Board (CAB). The CAB provided input on app content development, design choices, and user experience, with collaboration across disciplines and integration of TGNC community members throughout app development; the applicability of CBPR principles was evaluated throughout the development process.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Iterative cycles of content creation and feedback produced multiple substantial changes during the app's development, including added functionality, improved inclusivity and accessibility, and design and branding enhancements. Several successful outcomes from our approach were identified, including the recruitment of dedicated CAB members and interprofessional collaboration that included community members. Challenges included integration of multiple different approaches and levels of expertise, navigating TGNC individuals' participation without exploitation, and creating high-quality content on a limited budget.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our process demonstrates the value of including a CAB in the design of a digital VCMT platform, and suggests a potential for community-based participatory research (CBPR) in laryngology and speech language pathology, where uptake of this framework has remained limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 5.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"9 6","pages":""},"PeriodicalIF":1.6,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11645500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830413","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}