European Annals of Otorhinolaryngology-Head and Neck Diseases最新文献

{"title":"Evaluating the interpretation of neck CT/MRI scans by ChatGPT-4V for detecting primary oropharyngeal squamous cell carcinoma: An exploratory study.","authors":"B Schmidl, R Walter, C C Hoch, T Huetten, S Pigorsch, F Stögbauer, T Hussain, B Wollenberg, M Wirth","doi":"10.1016/j.anorl.2026.02.012","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.02.012","url":null,"abstract":"<p><strong>Objectives: </strong>Early and accurate detection of head and neck squamous cell carcinoma and the subset of oropharyngeal squamous cell carcinoma (OPSCC) is essential for the therapy and the prognosis of patients. Computer tomography (CT) is the primary imaging modality and is currently evaluated manually by radiologists and head and neck oncologists. Since image recognition in the form of artificial intelligence (AI) was introduced recently with the large language model (LLM) ChatGPT-4V, this exploratory study for the first time evaluates the application of image recognition by ChatGPT in interpreting neck CT and MRI scans for OPSCC detection, and corresponding images without any oropharyngeal lesion.</p><p><strong>Materials and methods: </strong>The most likely diagnosis based on the CT images for 100 CT cases (50 OPSCC, 50 without lesion) and the available corresponding 62 MRI cases (31 OPSCC, 31 without an oropharyngeal lesion) by ChatGPT-4V was rated by two independent reviewers and the overall performance was evaluated in terms of accuracy, sensitivity, and specificity.</p><p><strong>Results: </strong>In this study, ChatGPT-4V reached a sensitivity of 72% and a specificity of 78% in identifying OPSCC from CT images. For MRI scans, sensitivity was 80.6% and specificity 83.9%. Human papillomavirus-positive and more advanced lesions were detected more reliably.</p><p><strong>Discussion: </strong>In this exploratory study of CT and MRI neck scans of the oropharynx, ChatGPT-4V demonstrated a mediocre performance for detecting OPSCC. Continued research and advancements in AI are essential to improve the reliability and clinical utility of LLMs for the interpretation of neck scans.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laryngeal mask in patients undergoing adenotonsillectomies.","authors":"B Friedrichsen Marques, A Mendes Figueiredo, S Catherine Quispe Rohling Gómez, G Vaz Teixeira","doi":"10.1016/j.anorl.2026.03.007","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.03.007","url":null,"abstract":"<p><strong>Background: </strong>Adenotonsillectomy is the treatment of choice for pediatric obstructive sleep apnea. Although tracheal intubation remains the standard method of airway management, the laryngeal mask (LM) has been proposed as an effective alternative for reducing operative time, despite longstanding controversy. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of LM use compared to tracheal intubation in adenotonsillectomies.</p><p><strong>Methods: </strong>The search was performed in PubMed, Embase, and Cochrane up until January 14, 2025, for RCTs comparing LM with tracheal tube (TT) in patients undergoing adenotonsillectomies. Adverse events (bronchospasm, laryngospasm, desaturation, and coughing), conversion, blood aspiration and surgical time were the researched outcomes. The analysis included risk of bias assessment, publication bias, and Harbord regression test.</p><p><strong>Results: </strong>Six studies totaling 765 participants undergoing adenotonsillectomies were included. The LM was associated with a longer surgical time (MD 3.35minutes; P<0.01), a smaller blood aspiration rate (LM 3.6% vs. TT 17.1%) and a conversion from LM to intubation of 4.7%. There was no difference between the two ventilation types regarding total adverse events (RR 0.98; P=0.96). Results of the individual outcomes, related to adverse events for the use of the LM, were bronchospasm (RR 0.89; P=0.80), laryngospasm (RR 0.68; P=0.40), desaturation (RR 1.40; P=0.35), and coughing (RR 1.08; P=0.92).</p><p><strong>Conclusion: </strong>For adenotonsillectomies, the LM is an alternative to the TT, without differences concerning adverse events associated to both methods, although it is associated with a prolonged operation time.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Definition of severity, management, and follow-up of isolated snoring in adults: An international consensus.","authors":"H Carrichon, V Favier, G Cammaroto, H Dos Santos, A de Vito, E Zancanella, M B Cahali, A Moniri, M Carrasco-Llatas, M Ravesloot, U Alkan, R C T Cheong, J R Lechien, A Maniaci, C O'Connor, F Salamanca, O Jacobowitz, D Abedipour, A Decotte, D Schmitt, P Lestang, L Yona, J Huth, P-L Bastier, X Dufour, N De Vries, J C Winck, E Olszewska, L Allali, Q Lisan, F Carsuzaa","doi":"10.1016/j.anorl.2026.04.001","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.04.001","url":null,"abstract":"<p><strong>Introduction: </strong>Isolated snoring (IS), defined by nocturnal upper airway vibration without apneas, remains a prevalent yet underrecognized condition lacking standardized definitions for severity and management. Despite its significant impact on bed partners' sleep quality and social life, no consensus exists on severity criteria or follow-up practices. This international Delphi consensus aimed to define IS severity, address the management of nasal comorbidity, and establish follow-up protocols to support personalized patient care.</p><p><strong>Methods: </strong>A two-round Delphi process was conducted from December 2024 to April 2025, involving 35 otolaryngology experts from 16 countries. Thirty-nine initial statements were developed by a steering committee and evaluated using a 9-point Likert scale. Consensus was defined as≥75% agreement.</p><p><strong>Results: </strong>Of 58 evaluated statements, 44 reached consensus. IS severity was associated with frequency of snoring, bed partner's complaints, and impact on the couple's quality of life, while objective acoustic parameters alone were not deemed reliable indicators. Nasal obstruction was recognized as a treatable comorbidity that may be assessed before snoring management. Personalized management using validated subjective tools was strongly recommended. For follow-up, expert consensus supported a 3- to 6-month reassessment using smartphone apps or quality-of-life metrics, with distinctions made between clinical and research goals.</p><p><strong>Conclusion: </strong>This consensus supports a patient- and partner-centered approach to IS. It discourages reliance on isolated acoustic data for severity grading, promotes proactive management of nasal factors, and highlights the need for individualized treatment strategies. Future research should aim to validate objective and subjective tools to further standardize care pathways for IS.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Louis Hubert Farabeuf: A renowned anatomist, and a strong character.","authors":"C-A Righini","doi":"10.1016/j.anorl.2026.04.002","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.04.002","url":null,"abstract":"<p><p>In the 19th century, human anatomy was badly taught, in poorly suited run-down premises, by teachers with very uneven levels of knowledge. Louis Hubert Farabeuf came from a poor family, and abandoned his ambition to train as a surgeon, due to poor health. He turned his focus to anatomy, and had modern premises constructed in the Paris Medical School. He also set out the operating rules of anatomy labs that have come down to us today. He was a brilliant anatomist and an exceptional teacher of operative medicine, wrote several books and developed several surgical instruments that are still in use. His career was no bed of roses, but distinctly thorny - which by no means prevented his legacy from enduring.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and impact of a cooperation and task-sharing protocol in voice prosthesis replacement in laryngectomized patients.","authors":"A Villarmé, D Culié, G Poissonnet, C Poudenx, C Grazzi, A Bozec","doi":"10.1016/j.anorl.2026.04.005","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.04.005","url":null,"abstract":"<p><strong>Aim: </strong>Voice prostheses are one of the main vocal rehabilitation techniques following total laryngectomy. However, leakage requires frequent replacement and availability of physicians. This study explores a task delegation protocol between physicians and nurses for voice prosthesis exchange. The objective was to evaluate feasibility and impact on patient care.</p><p><strong>Methods: </strong>After validating and implementing the protocol, we conducted a prospective study from March to October 2024 to assess its impact for nurses, physicians and patients, on a satisfaction questionnaire.</p><p><strong>Results: </strong>Fifty-six of the first 60 voice prosthesis replacements were successfully performed by delegated nurses. Physicians were consulted for 4 unsuccessful procedures, mainly due to difficult access to the tracheoesophageal fistula. Three patients expressed concerns about the protocol, but overall, 93% reported high satisfaction with the care received.</p><p><strong>Conclusion: </strong>The success of this collaborative protocol helped reduce physician workload and highlighted the valuable role of nurses, while ensuring high-quality care for laryngectomized patients with voice prostheses.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bibliometric analysis of global research trends in pediatric hearing impairment.","authors":"R Ravi, K Kumar, D R Gunjawate","doi":"10.1016/j.anorl.2026.03.006","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.03.006","url":null,"abstract":"<p><strong>Objectives: </strong>Bibliometric analysis provides a detailed analysis of the research trends and identify the preferred journals, patterns in collaborations, research topics. Till date, no such bibliometric analysis has been carried out in pediatric hearing impairment. The aim of the present study was to conduct a bibliometric analysis to determine the evolution of research in the area of pediatric hearing impairment including key institutions, journals and authors, collaborative links, and top research priorities areas based on author keywords.</p><p><strong>Methods: </strong>A bibliometric analysis was conducted to identify publications on pediatric hearing impairment in Scopus database. The identified studies were exported from Scopus into Microsoft Excel and VOSviewer for further analysis. Visualization and bibliometric analyses were performed using VOSviewer.</p><p><strong>Results: </strong>A total of 5996 studies were identified for detailed analysis. The results revealed a growing trend in publications over the years. In all, 118 countries being involved in research on pediatric hearing impairment with maximum papers published in the United States (33.89%) with Harvard Medical School, USA being the leading contributor. The International Journal of Pediatric Otorhinolaryngology emerged as the most common choice. The keyword co-occurrences revealed five clusters with interconnections.</p><p><strong>Conclusion: </strong>The study provides an overview of the evolution and research trends in pediatric hearing impairment. These findings provide valuable insights to plan future research in this area.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Auditory neuropathy as the first sign of leptomeningeal metastasis.","authors":"R Santarelli, F Di Paola","doi":"10.1016/j.anorl.2026.03.003","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.03.003","url":null,"abstract":"<p><strong>Introduction: </strong>Auditory neuropathy is a hearing disorder characterized by impaired temporal coding of acoustic signals in the auditory nerve fibers, resulting in abnormal auditory perceptions relying on temporal cues. We describe the case of a woman with a history of cancer who developed auditory neuropathy as the first manifestation of leptomeningeal metastasis.</p><p><strong>Case summary: </strong>A woman in her sixties complained of severe difficulties in understanding speech despite preserved sensitivity to sounds, which had begun two months before audiological assessment. Her past medical history was remarkable for an occult cancer, possibly breast cancer, diagnosed seven years earlier. Pure-tone audiometry showed mild bilateral sensorineural hearing loss associated with markedly reduced speech intelligibility. Otoacoustic emissions were normal, indicating preserved outer hair cell function, whereas auditory brainstem responses (ABRs) were absent despite preserved hearing thresholds. Contrast-enhanced brain magnetic resonance imaging (MRI) only demonstrated bilateral enhancement of the eighth cranial nerve. However, a brain MRI performed one month later revealed diffuse leptomeningeal enhancement, while cerebrospinal fluid (CSF) cytology was positive for atypical malignant cells, both findings consistent with leptomeningeal metastasis.</p><p><strong>Discussion: </strong>This case illustrates that the onset of auditory neuropathy in a patient with a clinical history of cancer may represent an early clinical sign of leptomeningeal metastasis, highlighting the importance of prompt neuroimaging and CSF analysis.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of swallowing muscle training for the treatment of patients with post-stroke dysphagia: A systematic review and meta-analysis.","authors":"B Pastor-Benavente, P Hernández-Lucas, A González-Castro, R Leirós-Rodríguez","doi":"10.1016/j.anorl.2026.03.005","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.03.005","url":null,"abstract":"<p><strong>Purpose: </strong>Strokes may cause some swallowing difficulty or associated dysphagia in 25-80% of patients, increasing morbidity and mortality associated with nutritional and respiratory disorders. Therefore, the aim of this research was to evaluate the efficacy of swallowing muscle training in patients with dysphagia in post-stroke patients.</p><p><strong>Methods: </strong>A systematic search was carried out in PubMed, Scopus, Web of Science and MEDLINE.</p><p><strong>Results: </strong>Of the 13 investigations analyzed, four evaluated the effects of Shaker exercise, tongue training and chin flexion against resistance; two investigations applied mandibular opening exercises against resistance; and only one, the effect of training with forced swallows was evaluated. Meta-analysis confirmed their significant effect on reducing the risk of penetration and aspiration.</p><p><strong>Conclusion: </strong>Swallowing muscle training has beneficial effects on swallowing function in patients with post-stroke dysphagia and reduced the risk of penetration and aspiration.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When the wall pulses: Submucosal retropharyngeal internal carotid artery as an unexpected driver of chronic cough.","authors":"A D Asimakopoulos, Y Lelonge, A Karkas","doi":"10.1016/j.anorl.2026.03.004","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>Anatomical variations of the cervical internal carotid artery (ICA), including a retropharyngeal submucosal trajectory, may mimic submucosal pharyngeal lesions and produce atypical upper aerodigestive symptoms. Failure to recognize these variants carries significant risk, as inadvertent injury during pharyngeal surgery, endoscopy, or intubation can result in catastrophic hemorrhage.</p><p><strong>Case summary: </strong>We report the case of a 73-year-old woman with several years of persistent cough and progressive dysphagia. Flexible fiber-optic nasopharyngolaryngoscopy revealed a smooth, pulsatile submucosal bulge of the posterior pharyngeal wall with associated salivary stasis. Contrast-enhanced CT confirmed a retropharyngeal course of the right cervical ICA of normal caliber. Given the absence of alarming features, conservative management with annual endoscopic follow-up was recommended.</p><p><strong>Discussion: </strong>This case represents a rare presentation in which a submucosal retropharyngeal ICA manifested predominantly as chronic cough, likely due to repetitive mechanical stimulation of supraglottic sensory pathways. Only two similar cases have been reported. The case expands the recognized symptomatic spectrum of ICA medialization and highlights the importance of targeted endoscopic examination and selective imaging when encountering unexplained chronic cough or atypical pharyngeal anatomy. Awareness of this vascular variant is essential to avoid misdiagnosis and prevent life-threatening iatrogenic injury.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147786493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamics of prognostic nutritional index before and after surgery in head and neck cancer.","authors":"T Miura, H Kessoku, T Kobayashi, M Nagaoka, H Kojima","doi":"10.1016/j.anorl.2026.03.002","DOIUrl":"https://doi.org/10.1016/j.anorl.2026.03.002","url":null,"abstract":"<p><strong>Aims: </strong>To evaluate the relationship between changes in the prognostic nutritional index (PNI), which is an indicator of nutritional status, and outcomes in patients with head and neck cancer who underwent surgery at our hospital.</p><p><strong>Material and methods: </strong>We retrospectively reviewed the medical records of 148 patients (128 men and 20 women) who underwent surgery from 2015 to 2022. The median age was 68.5 (range: 40-88) years. Overall survival (OS) was calculated using the Kaplan-Meier method. The PNI was calculated preoperatively and postoperatively. Based on changes in pre- and post-treatment, patients were categorized as having high PNI both before and after surgery (high-to-high [HTH]), low PNI before and high PNI after surgery (low-to-high [LTH]), high PNI before and low PNI after surgery (high-to-low [HTL]), and low PNI both preoperatively and postoperatively (low-to-low [LTL]).</p><p><strong>Objectives: </strong>The effects of pre- and post-treatment changes in the PNI on patient outcomes were determined using the Cox proportional hazards model.</p><p><strong>Results: </strong>The median PNI was 49 and 48 before and after surgery, respectively. In the multivariate analysis, preoperative PNI was an independent poor prognostic factor for disease-free survival (DFS) and OS (P=0.037 and P=0.039). The postoperative PNI was an independent poor prognostic factor for DFS and OS (P<0.01). In the univariate analysis, the HTL and LTL groups showed poorer patient outcomes when the HTH group was used as a reference.</p><p><strong>Conclusion: </strong>Changes in PNI could be a useful indicator of postoperative outcomes in patients with head and neck cancer.</p>","PeriodicalId":48834,"journal":{"name":"European Annals of Otorhinolaryngology-Head and Neck Diseases","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}