Laryngoscope Investigative Otolaryngology最新文献

{"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}

{"title":"Impact of Topical Steroid Nasal Irrigation Adherence on Chronic Rhinosinusitis and Allergic Rhinitis Patient Outcomes.","authors":"Clifford Jiajun He, Omer Baker, Olivia LaMonte, Philipp Verpukhovskiy, Haoze Wang, Yuhang Chen, Shengjia Tu, Adam S DeConde, Carol H Yan","doi":"10.1002/lio2.70518","DOIUrl":"10.1002/lio2.70518","url":null,"abstract":"<p><strong>Objective: </strong>High volume steroid nasal rinses are often prescribed for chronic rhinosinusitis and allergic rhinitis. Although the general importance of medication adherence is well established, the specific relationship between objectively measured adherence to topical steroid irrigation and patient-reported clinical outcomes has not been previously demonstrated. This study aims to investigate the effect of topical steroid nasal rinse adherence on patient outcomes.</p><p><strong>Methods: </strong>This prospective longitudinal study recruited 97 patients with chronic rhinosinusitis or allergic rhinitis. All patients were prescribed twice-daily high-volume budesonide isotonic saline sinus rinses. Objective adherence data through quantified medication usage were collected over 8 weeks. Patient outcomes were assessed via the 22-item Sino-Nasal Outcome Test (SNOT-22), a sinus discomfort visual analog scale (VAS, 0-100), and patient-perceived surgery need. Generalized estimating equations were used to analyze the impact of adherence on symptom outcomes.</p><p><strong>Results: </strong>Higher adherence was significantly associated with improvement in both VAS (<i>β</i> = -0.18, <i>p</i> < 0.001) and SNOT-22 (<i>β</i> = -0.10, <i>p</i> = 0.024) but was not associated with increased surgery desire. Median adherence was overall 47.5%, higher in patients with recent sinus surgery (< 3 months: 55.6%) and higher baseline symptom severity (SNOT-22 ≥ 20: 51.6%), with correspondingly larger improvements in clinical outcomes.</p><p><strong>Conclusion: </strong>Objective adherence to budesonide sinus irrigation significantly associates with improved patient-reported outcomes, with the strongest benefit seen in patients with higher baseline symptoms and in the early postoperative period. Targeting adherence interventions may yield clinically meaningful improvements in sinonasal quality of life.</p><p><strong>Level of evidence: </strong>2.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70518"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13434439/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674443","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":"Advances in Pharmacological Therapy of Benign Tracheal Stenosis: A Meta-Analysis of Preclinical Studies.","authors":"Dengyuan Li, Jie Zeng, Rufang Li, Rong Wang, Danxiong Sun","doi":"10.1002/lio2.70497","DOIUrl":"10.1002/lio2.70497","url":null,"abstract":"<p><strong>Background: </strong>Benign tracheal stenosis, characterized by granulation hyperplasia, is a rare and serious disease threatening human health. Interventional bronchoscopy demonstrates limited therapeutic efficacy and poses a risk of re-injury to the airway. The objective of this meta-analysis is to evaluate the efficacy of pharmacological therapy in preclinical models of tracheal stenosis.</p><p><strong>Method: </strong>We conducted an extensive literature search across PubMed, EMBASE, Web of Science, and Cochrane Library from inception to January 31, 2024. Studies evaluated the efficacy of various pharmacological agents in treating tracheal stenosis. The SYRCLE bias risk tool was utilized to evaluate potential bias, and the GRADE approach was used to assess the quality of evidence for each outcome. Primary outcomes included the stenosis index (SI) and the degree of tracheal stenosis (SD). Secondary outcomes comprised additional indicators relevant to evaluation of tracheal stenosis, such as the fibrosis indexes, the ratio of the lamina propria thickness to the cartilage (LCR), and the severity of inflammation. Meta-analysis was conducted via Cochrane Collaboration Review Manager (version 5.4).</p><p><strong>Results: </strong>A total of 7554 studies related to pharmacological therapies for benign airway stenosis were reviewed, of which 34 articles met inclusion criteria for this meta-analysis following study selection. Of these, five studies evaluated SI, 17 studies evaluated SD, and six studies evaluated the fibrosis indexes. Compared to the control group, pharmacological therapy was associated with a significant reduction in SI (weighted mean difference (WMD) -0.21, 95% CI: -0.33 to -0.10, <i>p</i> < 0.001, <i>I</i> ² = 82%), SD (WMD = -0.26; 95% CI: -0.34 to -0.18; <i>p</i> < 0.001, <i>I</i> ² = 93%), and the fibrosis indexes (WMD = -3.15; 95% CI: -4.4 to -1.9; <i>p</i> < 0.001, <i>I</i> ² = 82%).</p><p><strong>Conclusion: </strong>Various pharmacological agents exhibited different efficacies in alleviating tracheal stenosis symptoms. These findings provide valuable insights into prospective therapeutic strategies.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70497"},"PeriodicalIF":1.9,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13436614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674384","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":"Inpatient and Postacute Care After Head and Neck Surgery Among Beneficiaries.","authors":"Mengda Yu, Joshua Brown, Songzhu Zhao, Nolan B Seim, Catherine T Haring, Stephen Y Kang, Amit Agrawal, Enver Ozer, Matthew O Old, Lauren E Miller","doi":"10.1002/lio2.70525","DOIUrl":"10.1002/lio2.70525","url":null,"abstract":"<p><strong>Introduction: </strong>Medicare Advantage (MA) enrollment has grown rapidly, yet its implications for resource use in complex head and neck cancer (HNC) surgery remain unclear.</p><p><strong>Methods: </strong>Using 2019-2023 Medicare Provider Analysis and Review data, we identified adults admitted with an HNC diagnosis who underwent a qualifying head and neck surgical procedure. We used 1:1 propensity score matching to balance MA and traditional fee-for-service (FFS) beneficiaries on demographics, comorbidity, region, and admitting diagnosis. Outcomes included index length of stay (LOS) and discharge destination (home, home with home health, skilled nursing facility/rehabilitation, or hospice). Negative binomial and multinomial logistic regression models were used to estimate associations between insurance type and LOS or discharge disposition.</p><p><strong>Results: </strong>The matched cohort included 4618 admissions (2309 MA; 2309 FFS). Mean LOS was similar for MA and FFS patients (7.1 vs. 7.3 days), and discharge destination distributions were not significantly different. MA admissions had lower observed frequencies of selected complex procedure categories, including reconstructive surgery, neck dissection, laryngectomy, and mandibulectomy. In procedure-adjusted sensitivity models, MA enrollment was not associated with LOS (rate ratio 0.99, 95% CI 0.94-1.03) or discharge destination.</p><p><strong>Conclusions: </strong>Among Medicare beneficiaries hospitalized for HNC surgery, short-term inpatient utilization during the index admission was similar for MA and FFS enrollees. MA admissions had lower observed frequencies of selected complex procedure categories; however, this finding should be interpreted as a difference in observed operative mix rather than direct evidence of reduced access. Further studies linking claims to tumor registry and hospital-level data are needed to determine whether these patterns reflect case mix, treatment selection, hospital networks, or access barriers.</p><p><strong>Level of evidence: </strong>3.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 4","pages":"e70525"},"PeriodicalIF":1.9,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13433145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674438","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}