LaryngoscopePub Date : 2026-09-05DOI: 10.1002/lary.70896
Vincent M Desiato, Raven T Dunn, Rushil R Dang, John R Craig
{"title":"How I Do It: Nasoseptal Flap for Reconstruction of Isolated Soft Palate Defect.","authors":"Vincent M Desiato, Raven T Dunn, Rushil R Dang, John R Craig","doi":"10.1002/lary.70896","DOIUrl":"https://doi.org/10.1002/lary.70896","url":null,"abstract":"<p><p>A vascularized nasoseptal flap (NSF) provides a novel transnasal option for repairing soft palatal fistulas when traditional transoral flaps have failed or are unavailable, potentially avoiding the morbidity of regional or free tissue transfer. In the current patient who had an 8 × 6 mm soft palatal fistula, the NSF was harvested from the septum and nasal floor, rotated through the nasopharynx to cover the fistula, and was suture-fixated transorally to the mobile soft palate to promote stable adherence and healing. Closure was successful, which resolved her nasal regurgitation, partially improved her velopharyngeal function, and did not cause Eustachian tube dysfunction.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148898332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-04DOI: 10.1002/lary.70834
Ari D Schuman, Jacqui Allen, Mekibib Altaye, Milan R Amin, Semirra L Bayan, Peter C Belafsky, Brad W DeSilva, Shumon Dhar, Dale C Ekbom, Aaron D Friedman, Mark Fritz, Glendon M Gardner, John Paul Gilberto, Elizabeth A Guardiani, Christopher Johnson, Jan Kasperbauer, Brandon Kim, Brittany N Krekeler, Maggie Kuhn, Yue Ma, Lyndsay L Madden, Laura Matrka, Ross M Mayerhoff, Cyrus Piraka, Apoorva Ramaswamy, Clark Rosen, Haley C Sibley, Meredith Tabangin, Carter Wright, Z Mike Yang, Vyvy N Young, Gregory Postma, Rebecca J Howell
{"title":"Differentiating Persistent and Recurrent Dysphagia in Zenker Diverticulum: A POuCH Study.","authors":"Ari D Schuman, Jacqui Allen, Mekibib Altaye, Milan R Amin, Semirra L Bayan, Peter C Belafsky, Brad W DeSilva, Shumon Dhar, Dale C Ekbom, Aaron D Friedman, Mark Fritz, Glendon M Gardner, John Paul Gilberto, Elizabeth A Guardiani, Christopher Johnson, Jan Kasperbauer, Brandon Kim, Brittany N Krekeler, Maggie Kuhn, Yue Ma, Lyndsay L Madden, Laura Matrka, Ross M Mayerhoff, Cyrus Piraka, Apoorva Ramaswamy, Clark Rosen, Haley C Sibley, Meredith Tabangin, Carter Wright, Z Mike Yang, Vyvy N Young, Gregory Postma, Rebecca J Howell","doi":"10.1002/lary.70834","DOIUrl":"https://doi.org/10.1002/lary.70834","url":null,"abstract":"<p><strong>Objectives: </strong>To define persistent and recurrent dysphagia after surgery for CPMD with and without diverticula.</p><p><strong>Methods: </strong>Patients with CPMD with and without diverticula enrolled in the Prospective Outcomes of Cricopharyngeus Hypertonicity (POuCH) multicenter study who underwent surgery from November 2014 to August 2024 with at least 12 months of follow up were included. Surgical outcomes were evaluated using a validated patient reported dysphagia marker, Eating Assessment Tool 10 (EAT10), where normal is characterized as < 3. Persistent dysphagia is defined as patients with < 50% improvement in EAT-10 or EAT-10 score ≥ 3 at first follow up. Recurrent dysphagia is an initial surgical responder with a delayed worsening in EAT-10 scores during follow-up.</p><p><strong>Results: </strong>A total of 160 patients were included. Six patients (3.7%) had recurrent dysphagia, with 5 undergoing re-operation. A total of 23 patients (14.3%) had persistent dysphagia immediately post-operatively; one underwent re-operation. Preoperative EAT-10 scores were higher in the persistent group (median 23.5, interquartile interval (IQR) 12.0-28.5) compared to responders (14.0, 8-24) (p = 0.05). Median first post-operative EAT-10 in the persistent dysphagia group was 14 (IQR 8-21) compared to 0 in the responders (0-2; p < 0.0001). There was no difference in esophageal pathology. There was no difference in rates of response to endoscopic versus open surgery.</p><p><strong>Conclusion: </strong>Patients with recurrent dysphagia are less common than persistent dysphagia, and there are no clear markers to predict surgical responders from persistent dysphagia (e.g., non-responders), however all non-responders occurred in the first 12 months after surgery.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-04DOI: 10.1002/lary.70881
Lillian R Whipple, Maya Sardesai, Sarah N Bowe, Randall A Bly
{"title":"The Impact of a Research Year on Scholarly Output Among 2025 Otolaryngology Residency Applicants.","authors":"Lillian R Whipple, Maya Sardesai, Sarah N Bowe, Randall A Bly","doi":"10.1002/lary.70881","DOIUrl":"https://doi.org/10.1002/lary.70881","url":null,"abstract":"<p><strong>Objective: </strong>Research productivity among otolaryngology-head and neck surgery (OHNS) residency applicants has increased substantially in recent years, alongside growing participation in dedicated research years. However, the extent to which a research year contributes to meaningful scholarly output remains unclear. This study characterizes and compares research productivity among OHNS residency applicants with and without a dedicated research year.</p><p><strong>Methods: </strong>We retrospectively reviewed applicants to a single OHNS residency program during the 2025 application cycle. Applicants were categorized by completion of a dedicated research year. Students with ambiguous reasons for a gap in medical education (e.g., personal) were excluded. Research products listed in ERAS were categorized by type, authorship, publication status, and presentation characteristics. Outcomes were compared using the Wilcoxon rank-sum test and reported as medians with interquartile ranges (IQR).</p><p><strong>Results: </strong>The median number of total research products among all 196 applicants was 26 [IQR 17-37]. Applicants with a dedicated research year (n = 55) had more total research products than those without (n = 90) (32 [21-37] vs. 24 [15.75-37]), comprised primarily by unpublished work (5 [3-8] vs. 3 [1-5]) and oral presentations (6 [3-9] vs. 4 [2-7]). Published articles (5.5 [3-11] vs. 7 [3-12]) and first-author manuscripts (Median 1) did not differ significantly between groups.</p><p><strong>Conclusion: </strong>A dedicated research year is associated with modestly increased research productivity among OHNS applicants; however, this increase is largely driven by unpublished and middle author work. These findings suggest that volume-based metrics may incompletely capture scholarly engagement and may contribute to increased expectations without proportionate gains in research experience.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148892720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-03DOI: 10.1002/lary.70875
Leyu Li, Xiaoran Zhang, Jia Ren, Pengwei Zhao, Yuezhan Ma, Zheng Jiang, Hong Ran, Yun Zheng, Dapeng Lei, Fei Chen, Jun Liu
{"title":"Two-Stage Tracheal Repair for Well-Differentiated Thyroid Carcinoma With Tracheal Invasion.","authors":"Leyu Li, Xiaoran Zhang, Jia Ren, Pengwei Zhao, Yuezhan Ma, Zheng Jiang, Hong Ran, Yun Zheng, Dapeng Lei, Fei Chen, Jun Liu","doi":"10.1002/lary.70875","DOIUrl":"https://doi.org/10.1002/lary.70875","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a two-stage tracheal reconstruction strategy for repairing extensive tracheal defects in well-differentiated thyroid carcinoma (WDTC) with tracheal invasion.</p><p><strong>Methods: </strong>Seventy-four patients underwent tumor resection and tracheal excision, followed by staged reconstruction using a free posterior tibial flap (n = 28), pedicled thoracoacromial flap (n = 36), or pedicled supraclavicular flap (n = 10). Functional recovery, decannulation, complications, and survival were analyzed.</p><p><strong>Results: </strong>Demographic characteristics were comparable across groups. Tracheal defects were significantly larger in the free posterior tibial artery perforator flap group (9.14 ± 1.57 rings) versus the pedicled thoracoacromial (5.89 ± 2.59 rings) and supraclavicular (6.30 ± 1.49 rings) flap groups. The overall endotracheal tube removal rate was 95.9%, with no intergroup differences (p = 0.533). Functional recovery (swallowing, speech, and respiration) was comparable among groups. The 3-year survival rate was 78.4%, with no significant differences across groups (p = 0.633).</p><p><strong>Conclusions: </strong>Two-stage tracheal reconstruction is a safe and effective approach for long-segment tracheal defects in WDTC patients, offering satisfactory functional recovery. Further studies with larger cohorts and longer follow-up are warranted to confirm long-term efficacy.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-03DOI: 10.1002/lary.70888
Akari Kimura, Meena Easwaran, Patrick Timothy Kiessling, Amirbahador Golchin, Elizabeth Erickson-DiRenzo
{"title":"Impact of E-Cigarette Exposure on Wound Healing After Surgical Vocal Fold Injury in Mice.","authors":"Akari Kimura, Meena Easwaran, Patrick Timothy Kiessling, Amirbahador Golchin, Elizabeth Erickson-DiRenzo","doi":"10.1002/lary.70888","DOIUrl":"https://doi.org/10.1002/lary.70888","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical manipulation of the vocal folds carries a risk of mucosal injury. We used an established unilateral mouse vocal fold injury model to determine whether electronic cigarette (E-cig) exposure after injury induces remodeling and inflammatory responses in the vocal fold mucosa that differ from injury alone.</p><p><strong>Methods: </strong>Adult mice underwent unilateral vocal fold injury using a wire brush under microscopy and were assigned to an Injury or Injury + E-cig group. The Injury + E-cig group received daily E-cig aerosol exposure after injury. Mice were sacrificed at 3, 14, and 28 days. A room air-exposed group served as Control. We quantified epithelial (EP) thickness and lamina propria (LP) area, measured expression of genes related to EP junctions, extracellular matrix (ECM) remodeling, and inflammation, and performed immunostaining to corroborate gene expression findings.</p><p><strong>Results: </strong>Injury + E-cig mice exhibited blunted post-injury weight gain versus Controls. EP thickness and EP junction gene expression recovered similarly in Injury and Injury + E-cig groups. In contrast, early LP expansion and acute increases in TNF-α, F4/80, and Col3α1 were attenuated with E-cig exposure, indicating selective disruption of acute macrophage-associated inflammatory and ECM responses.</p><p><strong>Conclusion: </strong>This is the first study to examine the effects of E-cig exposure on vocal fold wound healing. Clinically, these findings raise concern about postoperative E-cig use after vocal fold surgery. Although often viewed as safer than smoking, E-cig use may alter early wound healing responses that are essential for restoring vocal fold structure and function.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-03DOI: 10.1002/lary.70884
James H Clark, Stanley L Marks, Lee Akst, Maie St John, Peter C Belafsky
{"title":"What Is the Clinical Significance of Histamine 2 Receptor Antagonists Tachyphylaxis?","authors":"James H Clark, Stanley L Marks, Lee Akst, Maie St John, Peter C Belafsky","doi":"10.1002/lary.70884","DOIUrl":"https://doi.org/10.1002/lary.70884","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-02DOI: 10.1002/lary.70833
Thamiris D D Cabral, Marcela Mafra, Jaime Plane, Matheus Sewastjanow-Silva, Isadora Martins Nascimento, Asitha D L Jayawardena, Abby Meyer, Andrew Redmann, Luke Jakubowski
{"title":"Treatment of Congenital Cytomegalovirus Beyond the Neonatal Period: A Single-Arm Meta-Analysis.","authors":"Thamiris D D Cabral, Marcela Mafra, Jaime Plane, Matheus Sewastjanow-Silva, Isadora Martins Nascimento, Asitha D L Jayawardena, Abby Meyer, Andrew Redmann, Luke Jakubowski","doi":"10.1002/lary.70833","DOIUrl":"https://doi.org/10.1002/lary.70833","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate hearing outcomes in postneonatal treatment of congenital cytomegalovirus (cCMV) infection and assess the effect of treatment initiated after the first month of life.</p><p><strong>Data sources: </strong>PubMed, Embase, Web of Science, and Cochrane Library were systematically searched.</p><p><strong>Review methods: </strong>Articles reporting antiviral treatment of cCMV, with Ganciclovir (GCV) or Valganciclovir (VGCV) in the postneonatal period were included. Outcomes of interest included viral load (urine and plasma), neutropenia, and hearing outcomes (return to normal hearing, improvement, deterioration, and no change). Mean difference (MD) was used for continuous outcomes and proportions for binary endpoints, with 95% confidence intervals (CI).</p><p><strong>Results: </strong>Eight studies with 192 patients met inclusion criteria. Oral VGCV was associated with a reduction in viral load during the first 2 months. At 2 months, pooled MD for urine viral load was -3.67 (95% CI -4.33 to -3.02, I<sup>2</sup> = 75.4%), and for plasma was -0.80 (95% CI -1.08 to -0.52, I<sup>2</sup> = 31.6%). Among patients with hearing loss, normalization occurred in 42.29% (95% CI 13.48 to 77.51, I<sup>2</sup> = 84.3%) and improvement in 38.48% (95% CI 16.77 to 66.00, I<sup>2</sup> = 88.2%) of total ears. Hearing deterioration was uncommon, affecting 5.47% of total ears (95% CI 2.15 to 13.25, I<sup>2</sup> = 60.9%). Neutropenia was infrequent, with 9.09% experiencing grade 1-2 and 3.67% grade 3-4.</p><p><strong>Conclusion: </strong>Postneonatal antiviral treatment for cCMV may reduce viral load and improve hearing in a substantial proportion of patients, with low rates of adverse events. However, long-term outcomes remain unclear, and larger prospective studies are needed to confirm efficacy.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
LaryngoscopePub Date : 2026-09-02DOI: 10.1002/lary.70883
Nour Awad, Alexander D Karabachev, Ramair Colmon, Camilo A Mora-Navarro, Donald O Freytes, Gregory R Dion
{"title":"Nebulized ECM Rescue Device (NERD) for Targeted Therapy in Vocal Fold Injuries.","authors":"Nour Awad, Alexander D Karabachev, Ramair Colmon, Camilo A Mora-Navarro, Donald O Freytes, Gregory R Dion","doi":"10.1002/lary.70883","DOIUrl":"https://doi.org/10.1002/lary.70883","url":null,"abstract":"<p><strong>Objectives: </strong>Extracellular matrix (ECM)-based scaffolds and gels demonstrate promise for vocal fold scar treatment; however, these injectables necessitate invasive procedures and repeated dosing. Multiple injections to the folds can damage the tissue, leading to fibrotic outcomes. We hypothesize that a nebulized vocal fold lamina propria ECM (VFLP-ECM) formulation can provide an effective regenerative treatment for upper airway delivery in a novel delivery approach.</p><p><strong>Methods: </strong>A porcine-derived, nebulized formulation of VFLP-ECM was synthesized for targeted VF delivery. Bilateral vocal fold injuries were induced in Sprague Dawley rats using micro forceps. Forty-eight hours postinjury, animals were assigned to a (1) injury alone/control group or a nebulized treatment group receiving (2) phosphate buffer saline (PBS), (3) collagen type I (COLI), or (4) extracellular matrix (VFLP-ECM), with six animals in each group. Larynges were harvested 14 days postinjury and histologically analyzed using Hematoxylin and Eosin and Masson's trichrome staining.</p><p><strong>Results: </strong>Histological analysis demonstrated reduced collagen deposition and lower myofibroblast density in the VFLP-ECM treated group compared to PBS and injury alone controls. Additionally, treated tissues exhibited increased lamina propria thickness and improved extracellular matrix organization, indicative of regenerative rather than fibrotic remodeling.</p><p><strong>Conclusion: </strong>Nebulized delivery of VFLP-ECM improved VF tissue characteristics. This study suggests a potential application for nebulized decellularized ECM in supporting vocal fold tissue regeneration during the acute phase of wound healing, with long-term effects warranting further investigation.</p><p><strong>Level of evidence: </strong>NA.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}