Laryngoscope Investigative Otolaryngology最新文献

{"title":"Development and Validation of a Simplified Three-Item Score for Predicting Eosinophilic Chronic Rhinosinusitis.","authors":"Kao-Tsung Lin, Yi-Chen Tsai, Te-Huei Yeh, Chih-Feng Lin, Yi-Tsen Lin","doi":"10.1002/lio2.70522","DOIUrl":"10.1002/lio2.70522","url":null,"abstract":"<p><strong>Objective: </strong>Accurate preoperative identification of eosinophilic chronic rhinosinusitis (ECRS) is essential for treatment planning and selection of biologic therapies, particularly in Asian populations where inflammatory endotypes are more heterogeneous. We aimed to develop and validate a simplified clinical scoring system using readily obtainable parameters for predicting ECRS.</p><p><strong>Methods: </strong>A total of 263 adults with chronic rhinosinusitis undergoing endoscopic sinus surgery were enrolled and divided into a training cohort (<i>n</i> = 158) and an independent validation cohort (<i>n</i> = 105). ECRS was defined histologically as ≥ 10 eosinophils per high-power field. Candidate predictors were evaluated using receiver operating characteristic analysis and multivariable logistic regression to construct a simplified 3-item ECRS prediction score. Diagnostic performance was compared with the JESREC score using DeLong's test.</p><p><strong>Results: </strong>Three independent predictors were identified: blood eosinophil count ≥ 200/μL (three points), computed tomography ethmoid-maxillary (E/M) ratio ≥ 1 (2 points), and presence of nasal polyps (one point). A total score ≥ 4 predicted ECRS. In the validation cohort, the 3-item score demonstrated good discrimination (AUC = 0.781), with sensitivity 77.3% and specificity 73.8%. Diagnostic performance was comparable to the JESREC score (AUC = 0.840; sensitivity 77.3%; specificity 72.1%), with no significant difference between models (Holm-adjusted <i>p</i> = 0.206).</p><p><strong>Conclusion: </strong>The simplified 3-item ECRS prediction score provides a practical tool for preoperative prediction of ECRS using routinely available clinical parameters. Despite requiring fewer variables, its diagnostic performance was comparable to the JESREC score, supporting its clinical utility for rapid endotype identification and improved treatment stratification in routine practice.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70522"},"PeriodicalIF":1.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714177","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":"Environmental Impact of a Novel UV-C Disinfection Machine for Non-Channel Flexible Laryngoscopes.","authors":"Abhishek Mahesh, Paul C Bryson","doi":"10.1002/lio2.70537","DOIUrl":"10.1002/lio2.70537","url":null,"abstract":"<p><strong>Objectives: </strong>Infection prevention in hospitals is a highly discussed and regulated process for endoscopy in Otolaryngology. The current standard for endoscopes involves high level disinfection (HLD). The UV-SMART D60 disinfection machine utilizes Impelux UV-C light technology. This study aimed to evaluate the environmental impact of the D60 machine within an otolaryngology department in comparison to current HLD protocols.</p><p><strong>Methods: </strong>Three equipment, materials, and disposables audits were conducted where the turnover and HLD process of a single non-channeled laryngoscope was analyzed. Every item involved in the cleaning process was documented for both standard HLD and D60 workflows. Water quantity was documented and a power meter was used to determine the wattage of the machinery used. Additionally, scope turnover time was documented and CO₂ emissions were calculated from known quantities.</p><p><strong>Results: </strong>Results demonstrated a significant reduction in material usage with the D60 including reduced PPE. The total water usage was about 45 L more per scope for traditional HLD. Power analysis demonstrated a reduction of 250 watts per scope. Additionally, the D60 reduced CO₂ emissions by over a factor of 3500. Scope turnover time was 109 min less for the D60.</p><p><strong>Conclusions: </strong>Environmental analysis demonstrates a significant amount of usage of disposables, water, and energy per non-channeled nasolaryngoscope with current HLD protocols. UV-C HLD resulted in less consumption of these resources. The marked reduction in turnover time and scope handling represents a significant opportunity for clinical efficiency, cost reduction, and resource consumption and will merit further investigation when FDA approval is granted.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70537"},"PeriodicalIF":1.9,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13454790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708106","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":"Counseling Families on Long-Term Outcomes After Supraglottoplasty for Laryngomalacia: A Single-Surgeon Patient-Reported Outcome Cohort With 15-Year Follow-Up.","authors":"Luke M O'Neil, Shyan Vijayasekaran","doi":"10.1002/lio2.70528","DOIUrl":"10.1002/lio2.70528","url":null,"abstract":"<p><strong>Objective: </strong>To provide long-term patient-reported outcome data to inform preoperative counseling for supraglottoplasty, and to determine whether any residual symptom burden reflects ongoing laryngeal dysfunction or broader health factors such as comorbidity.</p><p><strong>Methods: </strong>Retrospective cohort study with cross-sectional long-term follow-up at a tertiary pediatric hospital in Perth, WA. Patients who underwent supraglottoplasty for severe laryngomalacia between 2006 and 2011 by a single surgeon were administered the Laryngomalacia Quality-of-Life Questionnaire (LQQ) via electronic survey. Descriptive statistics, internal consistency (Cronbach <i>α</i>) and Mann-Whitney <i>U</i> testing were performed.</p><p><strong>Results: </strong>Twenty-eight of 63 families completed the survey (44.4%). Median age at surgery was 3.8 months; median follow-up from surgery was 15 years. The median total LQQ score was 43 (IQR 36.5-58), corresponding to a median item score of 1.48/5 (mean 1.65/5). Airway and Feeding/Swallowing domains demonstrated low patient-reported symptom burden. Six patients (21.4%) reported higher total scores (> 60 points), predominantly within the general quality-of-life domain. Patients with comorbidities had significantly higher general quality-of-life domain scores (<i>p</i> = 0.022, <i>r</i> = 0.55); airway and feeding/swallowing domains did not differ by comorbidity status.</p><p><strong>Conclusion: </strong>At a median of 15 years following supraglottoplasty, patients reported minimal laryngeal symptom burden. Symptoms were largely confined to the general quality-of-life domain and may reflect comorbid conditions rather than laryngeal pathology. These long-term data may support preoperative counseling.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70528"},"PeriodicalIF":1.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13449689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698168","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 as Health Information Tools: Patient Use and Trust in Otolaryngology.","authors":"Beverly J Fu, Itzel Rubio-Jimenez, Alexander Ellman, Samridhi Semwal, Reza Vaezeafshar, Noel F Ayoub","doi":"10.1002/lio2.70503","DOIUrl":"10.1002/lio2.70503","url":null,"abstract":"<p><strong>Objectives: </strong>Patients increasingly use large language models (LLMs) for health information, yet their use patterns, perceptions, and impact on clinical communication in otolaryngology remain poorly characterized.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of adult patients at an academic otolaryngology clinic. The survey assessed demographics, LLM use for general or health-related questions, and perceptions of LLM-generated information, including usefulness, trust, and communication with clinicians. Primary outcomes were LLM use for health information overall and prior to the clinic visit. Secondary outcomes included perceived helpfulness, concordance with clinician information, preparedness, disclosure, and concerns.</p><p><strong>Results: </strong>Among 59 respondents (mean age 50.1 years; 53.4% female), 71.2% reported prior LLM use, and 28.6% used an LLM to learn about their condition before the visit. All participants reported LLM information as helpful (50.0% very, 50.0% somewhat), that LLM information mostly (62.5%) or partially (25.0%) aligned with clinician explanations. Most felt more prepared for the visit (46.7% much more, 40.0% somewhat more), yet trust remained moderate: 32.7% reported mostly or complete distrust. While concerns about accuracy (82.7%) and privacy (50.0%) were common, 46.2% were likely to use LLMs again. Most users (93.8%) did not disclose LLM use, although 56.2% believed clinicians should be aware. Exploratory analyzes showed no significant differences in LLM use or perceptions by education, income, or social vulnerability index.</p><p><strong>Conclusions: </strong>LLM use for health information is common among otolaryngology patients and associated with perceived benefit despite moderate trust and concerns. Engagement may be driven by factors beyond accuracy, including accessibility and perceived empathy.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70503"},"PeriodicalIF":1.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451343/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697831","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":"Olfactory-Related Quality of Life After Endoscopic Transsphenoidal Surgery.","authors":"Yeong Ju Lee, Jeong Heon Kim, Chang-Ki Hong, Young-Hoon Kim, Ji Heui Kim","doi":"10.1002/lio2.70529","DOIUrl":"10.1002/lio2.70529","url":null,"abstract":"<p><strong>Background: </strong>To analyze olfactory-related quality of life (QOL), assess subjective and psychophysical olfactory dysfunction, and identify factors associated with changes in olfactory-related QOL following endoscopic endonasal transsphenoidal approach (EETSA).</p><p><strong>Methods: </strong>This study included 112 patients who underwent an EETSA between August 2019 and June 2022. Participants completed assessments before and after surgery, including the YSK Olfactory Function (YOF) test, the Questionnaire of Olfactory Disorders (QOD; comprising QOD-LQ, QOD-S, QOD-P, and QOD-VAS subscales, with higher scores indicating greater QOL impairment), the 36-Item Short-Form Survey (SF-36), and the 22-Item Sino-Nasal Outcome Test (SNOT-22). Clinical characteristics, intraoperative events, and postoperative complications were reviewed retrospectively.</p><p><strong>Results: </strong>Post-EETSA assessment revealed significant increases in mean QOD-LQ, QOD-P, and QOD-VAS scores, while neither physical health scores (SF-36 PCS) nor mental health scores (SF-36 MCS) showed significant changes following EETSA. Twenty-seven patients (24.1%) reported subjective olfactory dysfunction through SNOT-22 with normal YOF test results. \"Decreased sense of smell\" scores in SNOT-22 demonstrated significant positive correlations with QOD-LQ, QOD-P, and QOD-VAS scores. Female patients exhibited significantly greater deterioration in QOD-LQ and QOD-VAS than males, with female sex an independent factor for both. Postoperative CSF leakage (<i>n</i> = 3) was independently associated with QOD-LQ deterioration, although the sample size was small.</p><p><strong>Conclusions: </strong>Post-EETSA evaluation should emphasize both olfactory-related QOL and subjective olfactory dysfunction rather than focusing solely on psychophysical olfactory function. Comprehensive pre- and post-operative counseling addressing these aspects is essential for optimal patient care, with particular attention given to high-risk populations.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70529"},"PeriodicalIF":1.9,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13451143/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697842","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":"Total Parotidectomy Versus Less-Than-Total Parotidectomy for Early-Stage Low Grade Parotid Cancer: A Systematic Review and Meta-Analysis.","authors":"Nayeon Choi, Hye Ran Lee, Jungirl Seok, Heejun Yi, Sung Yool Park, Ji Hye Kwak, Woori Park, Sang Hoo Park, Eun-Jae Chung, Soon-Hyun Ahn, Jeon Yeob Jang, Gil Joon Lee","doi":"10.1002/lio2.70530","DOIUrl":"10.1002/lio2.70530","url":null,"abstract":"<p><strong>Objectives: </strong>Total parotidectomy (TP) has been advocated to ensure complete tumor clearance and removal of intraparotid lymph nodes; however, less-than-total parotidectomy (LTT) may offer comparable oncologic control with superior functional outcomes. In this systematic review and meta-analysis, we compared oncologic and functional outcomes between LTT and TP for patients with T1-2 low-grade parotid malignancies.</p><p><strong>Methods: </strong>A systematic literature search was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Four retrospective cohort studies of T1-2 low-grade parotid cancer were included. Patients underwent either LTT or TP. Primary outcomes were overall survival (OS) and recurrence-free survival (RFS). Pooled hazard ratios with 95% confidence intervals were calculated using random-effects models. Heterogeneity was assessed using <i>I</i> ² statistics and the Cochran's <i>Q</i> test.</p><p><strong>Results: </strong>The pooled analysis demonstrated no significant difference in OS between LTT and TP based on three studies. Across the four studies, RFS was comparable between the two surgical approaches, and statistical heterogeneity was negligible for both OS and RFS. No evidence of publication bias was detected.</p><p><strong>Conclusion: </strong>In selected patients with T1-2 low-grade parotid malignancies confined to the superficial lobe, LTT showed no statistically significant disadvantage in OS or RFS compared with TP based on the available retrospective evidence. However, the high risk of bias across included studies limits causal interprettion. Surgical strategy should therefore be individualized and should prioritize negative margins and functional preservation when oncologically appropriate. Prospective studies with standardized oncologic and functional outcome reporting are warranted.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70530"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445257/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686118","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":"Post-Radiation Dental Care Access Among Head and Neck Cancer Survivors: A Safety Net Perspective.","authors":"Armita Norouzi, Kennedy Johnson, Kevin Avelar, Alyssa Civantos, Alonn Ilan, Megan L Durr, Yogin Patel, Alan Paciorek, Li Zhang, Yasmin Eltawil, Yousef Alqasieer, Kwang Kim, Jymie Graham, Patrick Ha, Jason Chan, Sue S Yom, Lori Ross, Su Li, Shauna Brodie, Mary Jue Xu","doi":"10.1002/lio2.70527","DOIUrl":"10.1002/lio2.70527","url":null,"abstract":"<p><strong>Objectives: </strong>This study describes dental care access among individuals with head and neck cancer (HNC) at Zuckerberg San Francisco General Hospital (ZSFG), a large, public, safety-net hospital that serves a substantial underserved population.</p><p><strong>Methods: </strong>We identified a convenience sample of participants ≥ 18 years of age through review of routine outpatient HNC surveillance visits. Surveys were translated to Spanish and Simplified Chinese by certified medical interpreters. We used descriptive statistics to summarize findings and logistic regression to analyze predictors of dental care access, represented with odds ratios (ORs), 95% confidence intervals (CIs), and <i>p</i>-values. Statistical significance was defined as a two-sided <i>p</i>-value < 0.05.</p><p><strong>Results: </strong>Among 41 participants, the majority were male (63%) with a median age of 59 years [interquartile range (IQR) 48-64]. The most represented race/ethnicity was Asian (37%). 63% reported seeing a dentist only annually or less frequently both before and after cancer diagnosis. Prescription fluoride product use was reported by 15% of participants (<i>n</i> = 6). On univariate analysis, a non-English primary language was significantly associated with lower odds of dental visits at least twice a year pre-diagnosis (OR 0.19, 95% CI 0.05-0.78; <i>p</i> = 0.021). Participants who reported challenges finding a dentist had lower odds of dental visits at least twice a year post-diagnosis (OR 0.17, 95% CI 0.04-0.77; <i>p</i> = 0.022).</p><p><strong>Conclusion: </strong>Our findings suggest that HNC survivors in low-resource settings may experience limited access to routine dental care. Targeted interventions to support access to dental care in higher-risk populations may improve adherence to guideline-recommended care at all stages of cancer treatment.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70527"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690037","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":"Audiovestibular Outcomes After Parathyroidectomy in Primary Hyperparathyroidism.","authors":"Erdem Köroğlu, Halil Erdem Özel, Seda Erem Basmaz, Melikşah Çakır","doi":"10.1002/lio2.70533","DOIUrl":"10.1002/lio2.70533","url":null,"abstract":"<p><strong>Objective: </strong>To prospectively evaluate audiovestibular outcomes following parathyroidectomy in patients with primary hyperparathyroidism (pHPT) using a comprehensive battery of audiological, vestibular, and patient-reported outcome measures.</p><p><strong>Methods: </strong>This prospective observational study included 31 adult patients undergoing parathyroidectomy for pHPT caused by parathyroid adenoma. Assessments were performed preoperatively and at prespecified postoperative time points: audiometry at month 1; vHIT, VNG, and VDI at week 1 and month 1; and SVV on day 2, week 1, and month 1. The primary outcome was change in VDI score following surgery.</p><p><strong>Results: </strong>Hearing thresholds remained stable after surgery, with no significant changes in conventional or extended high-frequency audiometric measurements. SVV values remained within normal limits throughout follow-up, and VNG revealed no clinically significant abnormalities. vHIT gains were largely unchanged, although statistically significant differences were observed in left lateral canal gain (<i>p</i> = 0.032) and anterior canal asymmetry (<i>p</i> = 0.003); all values remained within normative ranges. Mean VDI scores improved significantly following surgery (38.1 ± 31.0 vs. 25.7 ± 26.8; <i>p</i> = 0.001), indicating reduced dizziness-related disability. None of the patients with preoperative BPPV (12.9%) reported recurrent positional vertigo symptoms during postoperative follow-up.</p><p><strong>Conclusions: </strong>Parathyroidectomy was associated with significant improvement in subjective vestibular symptoms and reduced dizziness-related disability, despite largely stable objective audiological and vestibular findings. These results suggest that metabolic correction in pHPT may improve vestibular symptom perception through mechanisms not fully captured by conventional audiovestibular testing. Further studies with larger cohorts and longer follow-up are needed to clarify the long-term effects of parathyroidectomy on vestibular function.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70533"},"PeriodicalIF":1.9,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148690064","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":"Comparing Fibula and Osteocutaneous Radial Forearm Free Flaps: A 20-Year Retrospective Review.","authors":"Erich A Mildner, J Benjamin Gordon, Kyle S Hrabovsky, Samuel B Craig, Kenneth R Feehs, Brianna R Maniscalco, Gregory B Russell, James D Browne, Hafiz S Patwa, Joshua D Waltonen, Christopher A Sullivan, Allison A Slijepcevic","doi":"10.1002/lio2.70516","DOIUrl":"10.1002/lio2.70516","url":null,"abstract":"<p><strong>Objectives: </strong>Fibula free flaps and osteocutaneous radial forearm flaps (OCRFFFs) may be used to reconstruct complex head and neck defects following cancer ablation and trauma. This study aimed to compare the reconstructive outcomes of defects rehabilitated with fibula or OCRFFFs.</p><p><strong>Methods: </strong>Retrospective chart review completed over 20 years of adult patients greater than 18 years of age undergoing reconstruction of head and neck defects with fibula or OCRFFFs.</p><p><strong>Results: </strong>Total patients: 52. Reconstruction type: 26/52 (50%) fibula, 26/52 (50%) OCRFFF. Mean surgical time: 697 min fibula, 576 min OCRFFF (<i>p</i> = 0.002). Charlson Comorbidity Index: 4.6 fibula, 4.7 OCRFFF (<i>p</i> = 0.43). There was no significant difference in flap survival rate. Survival rates of both fibula and OCRFFFs: 23/26 (88%) survived, 2/26 (8%) total loss, 1/26 (4%) partial flap loss (<i>p</i> > 0.99). There was no significant difference in post-operative complications between flap types. Post-operative complications: 10/26 (38%) fibula, 9/26 (35%) OCRFFF (<i>p</i> > 0.99). There was no significant difference in post-operative infection rate. Post-operative infection rate: 7/26 (27%) fibula, 7/26 (27%) OCRFFF (<i>p</i> > 0.99). There was no significant difference in post-operative length of stay. Post-operative length of stay: 11.6 days fibula, 14.0 days OCRFFF (<i>p</i> = 0.26).</p><p><strong>Conclusion: </strong>OCRFFFs provide reconstruction of composite defects with significantly shorter operative times compared to fibula flaps. Post-operative flap survival and complication rates were similar in both fibula and OCRFFF reconstructions. Although OCRFFFs may not undergo dental implantation as the bone stock is thin, the flap may optimally reconstruct composite defects in patients unable to undergo prolonged procedures.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70516"},"PeriodicalIF":1.9,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680561","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":"Social Determinants of Preoperative Polysomnography and Surgical Outcomes in Pediatric Tonsillectomy.","authors":"Austin Bridges, Varun Pasapula, Zoe Zhang, Ron B Mitchell, Seckin Ulualp, Stephen R Chorney, Felicity Lenes-Voit, Cynthia S Wang, Yann-Fuu Kou, Kenneth Lee, Christopher Liu, Romaine F Johnson","doi":"10.1002/lio2.70532","DOIUrl":"10.1002/lio2.70532","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate how sociodemographic and neighborhood factors are associated with use of preoperative polysomnography (PSG) in children undergoing tonsillectomy, and to assess whether these factors are associated with return for postoperative PSG, surgical success, or postoperative complications.</p><p><strong>Methods: </strong>We analyzed 940 children undergoing tonsillectomy at a tertiary children's hospital (2016-2024). Multivariable logistic regression estimated associations between sociodemographic factors (race, ethnicity, insurance, language), neighborhood opportunity (Child Opportunity Index [COI]), and preoperative PSG. Sequential models examined pathways of association. Doubly robust models estimated the association between PSG and postoperative complications.</p><p><strong>Results: </strong>Preoperative PSG was performed in 389 of 940 children (41.4%). In adjusted models, Black race (adjusted odds ratio [aOR], 1.79; 95% CI, 1.18-2.72), non-English language (aOR, 2.26; 95% CI, 1.45-3.52), Medicaid insurance (aOR, 1.52; 95% CI, 1.06-2.17), and lower COI (aOR per 1-SD increase, 0.81; 95% CI, 0.67-0.99) were associated with higher odds of having preoperative PSG prior to tonsillectomy. Obesity was also strongly associated with preoperative PSG (aOR, 2.49; 95% CI, 1.77-3.51), second only to medical complexity. The association for Hispanic ethnicity attenuated by approximately 80% in sequential models. Sociodemographic and neighborhood factors were not associated with return for postoperative PSG or surgical success; those outcomes were associated with preoperative apnea-hypopnea index (AHI) and medical complexity. In doubly robust models, preoperative PSG was associated with higher complication odds (aOR, 2.07; 95% CI, 1.09-3.93), consistent with confounding by indication rather than a causal effect of testing.</p><p><strong>Conclusion: </strong>Social and neighborhood factors were associated with preoperative PSG use but not with surgical success. The critical equity question in pediatric tonsillectomy may lie upstream, in who reaches tertiary surgical evaluation at all.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70532"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437420/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680522","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}