Laryngoscope最新文献

{"title":"Swallowing Kinematics in Male Patients with Total Laryngectomy.","authors":"Hakan Gölaç, Fatma E Aydınlı, Aydan B Dumbak, Önal İncebay, Necati Enver, Dilek Yapar, Mehmet Düzlü, Elif G Bulut, Nilda S Süslü, Metin Yılmaz","doi":"10.1002/lary.31825","DOIUrl":"10.1002/lary.31825","url":null,"abstract":"<p><strong>Objective: </strong>The present study aimed to investigate the symptomatic swallowing complaints in individuals with total laryngectomy (TL) and reveal how swallowing kinematics differs between those with and without symptomatic dysphagia complaints.</p><p><strong>Methods: </strong>A total of 34 subjects with TL were included in the study. Swallowing kinematics of those with symptomatic swallowing complaints (Group 1) were compared to those without (Group 2). Kinematic parameters including pharyngeal transit duration (PTD), maximum pharyngeal constriction ratio (MPCR), upper esophageal sphincter opening ratio (UESOR), upper esophageal sphincter opening duration (UESOD), and bolus clearance ratio (BCR) were investigated from Videofluoroscopic Swallowing Study (VFSS) records via ImageJ software.</p><p><strong>Results: </strong>Symptomatic swallowing complaints were determined in 47.1% of the subjects (n = 16). Difficulty while swallowing solid foods and pills, diminished pleasure of eating, food getting stuck in the throat, and increased level of stress during swallowing were among the major swallowing complaints in the present cohort. PTD, MPCR, and BCR parameters were significantly higher in subjects with symptomatic swallowing complaints than those without.</p><p><strong>Conclusion: </strong>These preliminary findings indicate that almost half of individuals with TL may have symptomatic swallowing complaints. The underlying pathophysiology of this phenomenon may be the devianced kinematic parameters including PTD, MPCR, and BCR in this population. Therefore, it is recommended to include the kinematic measurements in the dysphagia evaluation protocol in individuals with TL, most notably in those with symptomatic swallowing complaints.</p><p><strong>Level of evidence: </strong>3 Laryngoscope, 135:809-817, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"809-817"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Management of Buckled Thyroid Cartilage in the Setting of Dysphonia.","authors":"Sydney Ring, Allison Knewitz, Andrew J Bowen, David O Francis","doi":"10.1002/lary.31787","DOIUrl":"10.1002/lary.31787","url":null,"abstract":"<p><p>Buckled thyroid cartilage is a rare, but documented structural anomaly that has been found in patients who suffer from dysphonia. Outside of a known trauma, the origin of the anomaly is unknown. We present a case study of a patient who suffered from significant cartilage buckling, and associated hoarseness. While there is a single case of surgical correction documented, we present a description of a surgical approach with detailed photo documentation. With promising outcomes, this case report highlights a novel and effective approach to addressing dysphonia in the setting of buckled thyroid cartilage. Laryngoscope, 135:833-835, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"833-835"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142479115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do People Want to Know About Cochlear Implants: A Google Analytic Study.","authors":"Ezer H Benaim, Samuel P O'Rourke, Margaret T Dillon","doi":"10.1002/lary.31741","DOIUrl":"10.1002/lary.31741","url":null,"abstract":"<p><strong>Objective: </strong>Identify the questions most frequently asked online about cochlear implants (CI) and assess the readability and quality of the content.</p><p><strong>Methods: </strong>A Google search engine observational study was conducted via a search response optimization (SEO) tool. The SEO tool listed the questions generated by Google's \"People Also Ask\" (PAA) feature for the search queries \"cochlear implant\" and \"cochlear implant surgery.\" The top 50 PAA questions for each query were conceptually classified. Sourced websites were evaluated for readability, transparency and information quality, and ability to answer the question. Readability and accuracy in answering questions were also compared to the responses from ChatGPT 3.5.</p><p><strong>Results: </strong>The PAA questions were commonly related to technical details (21%), surgical factors (18%), and postoperative experiences (12%). Sourced websites mainly were from academic institutions, followed by commercial companies. Among all types of websites, readability, on average, did not meet the recommended standard for health-related patient education materials. Only two websites were at or below the 8th-grade level. Responses by ChatGPT had significantly poorer readability compared to the websites (p < 0.001). These online resources were not significantly different in the percentage of accurately answering the questions (websites: 78%, ChatGPT: 85%, p = 0.136).</p><p><strong>Conclusions: </strong>The most searched topics were technical details about devices, surgical factors, and the postoperative experience. Unfortunately, most websites did not meet the ideal criteria of readability, quality, and credibility for patient education. These results highlight potential knowledge gaps for patients, deficits in current online education materials, and possible tools to better support CI candidate decision-making.</p><p><strong>Level of evidence: </strong>NA Laryngoscope, 135:840-847, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"840-847"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Instrumentation Considerations for Calcified Thyroid Cartilage during Chondrolaryngoplasty.","authors":"Lily A Stevenson, Phillip C Song, Ramon A Franco, Matthew R Naunheim","doi":"10.1002/lary.31790","DOIUrl":"10.1002/lary.31790","url":null,"abstract":"<p><strong>Objective: </strong>Chondrolaryngoplasty, also known as thyroid cartilage reduction, alleviates gender dysphoria by reducing the thyroid cartilage to conform to a patient's gender identity. Reduction of the thyroid cartilage prominence (\"Adam's apple\") is often performed with a scalpel, but in cases of cartilage calcification, rongeurs or drills are utilized. This study aims to characterize the success rate with scalpel-only excision and relate this to patient age and operative time.</p><p><strong>Methods: </strong>Billing records were screened for chondrolaryngoplasties performed between 2020 and 2023 by a single surgeon. Patient demographics, operative notes, and operation duration were recorded. Type of instrumentation was categorized as scalpel only, rongeur, or drill. All cases began with attempted scalpel excision of cartilage and were transitioned to rongeur or drill if there was calcification that prevented sharp excision. Descriptive statistics were used to describe patient and surgical factors.</p><p><strong>Results: </strong>52 individuals underwent chondrolaryngoplasty: 30 cases (57.7%) had soft cartilage requiring only a blade, 22 (42.3%) required use of either drill or rongeur. The average age of these groups was 25.7 (SE 1.8) and 41.3 years (SE 2.2), respectively; this difference was statistically significant (p < 0.0001). Cases requiring a drill or rongeur lasted on average 78.5 min (SE 2.3), whereas those using only a blade were shorter at 66.8 min (SE 2.7); this difference was significant (p = 0.0017).</p><p><strong>Conclusion: </strong>Cartilage calcification should be expected in a significant number of chondrolaryngoplasties, and surgeons should be prepared for this scenario. The need for alternative instrumentation is higher in older individuals and may extend procedural time.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 135:748-751, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"748-751"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299632","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}

{"title":"Primary Site Influences the Ability of Magnetic Resonance Imaging to Assess Cartilage Invasion in Advanced Laryngeal Cancer.","authors":"Justin M Hintze, Eoin Cleere, J Griffin, I O'Riordan, C Timon, J Kinsella, C Fitzgerald, P Lennon","doi":"10.1002/lary.31822","DOIUrl":"10.1002/lary.31822","url":null,"abstract":"<p><strong>Objective: </strong>Accurate staging of advanced laryngeal cancer is important, as treatment can vary significantly between larynx preservation and total laryngectomy. The purpose of this study was to evaluate the accuracy of magnetic resonance imaging (MRI) in assessing features of T4a disease in locally advanced laryngeal cancer and determine if primary site played a role in the accuracy of MRI in this setting.</p><p><strong>Methods: </strong>A retrospective cohort study of patients undergoing a total laryngectomy in a tertiary referral center for head and neck cancer over a 10-year time period was carried out. Patients met inclusion criteria if they underwent a primary total laryngectomy for squamous cell carcinoma (SCC) of the larynx during the study period. Data collected included basic demographic data, primary tumor subsite, and clinical and pathological staging. The predictive ability of MRI on outer thyroid cortex invasion, extralaryngeal extension, and overall T4a stage was analyzed with receiver operating characteristics analysis. Analysis was compared to histological data on outer thyroid cortex invasion, extralaryngeal extension, and histological T4a stage.</p><p><strong>Results: </strong>A total of 112 patients met inclusion criteria. The mean age of the cohort was 65.1. Glottic primary subsite was associated with a statistically significant elevated risk for histological outer cortex erosion (p = 0.006), but MRI demonstrated worse sensitivity in detecting this outer cortex invasion in glottic primaries(p = 0.002).</p><p><strong>Conclusion: </strong>Glottic primaries tumors display an increased likelihood of thyroid cartilage invasion, however, MRI demonstrates a poorer sensitivity for detecting these features.</p><p><strong>Level of evidence: </strong>3 Laryngoscope, 135:723-728, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"723-728"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microvascular Regeneration and Perfusion of Partially Decellularized Tracheal Grafts.","authors":"Ada C Sher, Lumei Liu, Melwan Izem, Jazmin Calyeca, Molly O Meeker, Tendy Chiang","doi":"10.1002/lary.31801","DOIUrl":"10.1002/lary.31801","url":null,"abstract":"<p><strong>Objectives: </strong>A critical barrier to successful tracheal transplantation is poor vascularization. Despite its importance, little is known about microvascular regeneration in tissue-engineered grafts. We have demonstrated that partially decellularized tracheal grafts (PDTG) support neotissue formation including new submucosal microvasculature (CD31+). However, the perfusion of this neovasculature is unknown. In this study, we used a mouse model of tracheal replacement to measure the microvascular regeneration and perfusion of PDTG.</p><p><strong>Methods: </strong>PDTG and syngeneic tracheal grafts (STG, surgical control) (n = 5 for each group) were orthotopically transplanted into C5BL/6 J mice. We quantified vascularity of STG and PDTG samples at 1 and 3 months with conventional histology (N = 3 ~ 10/group). At 1, 3, and 6 months, animals were injected with fluorescein isothiocyanate (FITC) tomato lectin into the left ventricle. After perfusion, tracheas were fixed, harvested, mounted, stained for CD31 expression, and imaged with resonant scanning confocal microscopy. Percent CD31+, FITC area was compared between groups and endpoints compared with native trachea. Microvascular intersections were quantified using Sholl analysis.</p><p><strong>Results: </strong>Functional microvasculature was seen in both groups. Although percent vascularization (CD31) in PDTG was restored by 3 months, microvascular pattern in PDTG displayed a unique morphology compared with control. Surgery alone appeared to globally change microvascular pattern and perfusion. PDTG demonstrated equivalent perfusion to surgical control by 6 months. Sholl analysis revealed a reduction of microvessel intersectionality that persisted in PDTG and was not seen in surgical or native controls.</p><p><strong>Conclusions: </strong>PDTG exhibited microvascular regeneration. Perfusion was present in PDTG, improved, and persisted over long-term time points.</p><p><strong>Level of evidence: </strong>NA Laryngoscope, 135:614-621, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"614-621"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11729461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meticulous Approach to Medial Palpebral Ligament in Lateral Rhinotomy: Avoiding Canthus Malposition.","authors":"Kenya Kobayashi, Yuki Saito, Shimpei Miyamoto, Satoru Miyawaki, Yusuke Ito, Koji Yamamura, Kenji Kondo","doi":"10.1002/lary.31859","DOIUrl":"10.1002/lary.31859","url":null,"abstract":"<p><p>The positional stability of the inner canthus is mainly provided by the anterior limb of the medial palpable ligament (MPL). Proper repair of the anterior limb of the MPL is extremely important to prevent postoperative canthus malposition. This video presents proven techniques and technical tips for MPL management in medial maxillectomy via a lateral rhinotomy. Laryngoscope, 135:622-625, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"622-625"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Single Nucleotide Polymorphisms on CRS Outcomes: A Preliminary Observational Study.","authors":"Antonino Maniaci, Paolo Bonacci, Stefania Stefani, Salvatore Cocuzza, Federico Merlino, Alberto Maria Saibene, Giuseppe Sangiorgio, Juan Maza-Solano, Jerome R Lechien, Ignazio La Mantia, Nicolo' Musso","doi":"10.1002/lary.31719","DOIUrl":"10.1002/lary.31719","url":null,"abstract":"<p><strong>Objective(s): </strong>To conduct a preliminary investigation into the relationship between specific SNP variants, type II inflammation, and the effectiveness of dupilumab therapy and surgery in patients with CRS.</p><p><strong>Methods: </strong>In this prospective study, 48 subjects were enrolled, comprising 32 CRS patients and 16 healthy controls. The CRS patients were subjected to either dupilumab therapy or endoscopic surgery according to EPOS guidelines. SNP variants were identified using the TaqMan SNP genotyping technique. The identified SNP profiles were compared between the control group and CRS patients, and their potential influence on treatment outcomes was evaluated. Treatment responses were assessed based on symptom scores, such as SS-I, SNOT-22, disease progression using the NPS findings, and SNP profiles at a 6-month follow-up. The primary measures included the Nasal Polyp Score, Smell Identification Test (SIT) score, and SNOT-22 outcomes.</p><p><strong>Results: </strong>Dupilumab therapy and surgery significantly decreased NPS, with the last showing superior results. However, dupilumab therapy resulted in a significantly improved SIT score. Significant differences were observed in SNP profiles, particularly with rs1800629 (TNFA), rs2856838 (IL1a), rs17561 (IL1a), and rs1805011 (IL4R). In particular, the expression of rs2856838 and rs1805011 variants in the dupilumab group was associated with significantly better SIT and SNOT-22 outcomes than non-expressors. Also, the surgery group patients expressing the rs2856838 variant reported significant improvements in SNOT-22 scores.</p><p><strong>Conclusion: </strong>These preliminary findings suggest that SNP genotypes may guide personalized treatment strategies for CRS. Further larger prospective studies are required to confirm these initial observations.</p><p><strong>Level of evidence: </strong>2 Laryngoscope, 135:570-578, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"570-578"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019341","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}

{"title":"Quality-of-Life Outcomes Following Endoscopic Resection of Sinonasal Inverted Papilloma.","authors":"Arash Abiri, Ellen M Hong, Katelyn K Dilley, Theodore V Nguyen, Mandy K Salmon, Elysia M Grose, Siddhant H Tripathi, Sanjena Venkatesh, Yohan Kim, Daniel J Lee, Jennifer E Douglas, Jacob G Eide, Rijul S Kshirsagar, Katie M Phillips, Ahmad R Sedaghat, John M Lee, Charles C L Tong, Nithin D Adappa, James N Palmer, Edward C Kuan","doi":"10.1002/lary.31725","DOIUrl":"10.1002/lary.31725","url":null,"abstract":"<p><strong>Objectives: </strong>There is growing interest in assessing patient quality of life (QOL) following treatment of sinonasal tumors, including inverted papilloma (IP). We aimed to elucidate the natural history of postoperative QOL outcomes in IP patients treated with surgery.</p><p><strong>Methods: </strong>Cases of sinonasal IP treated surgically at 4 tertiary academic rhinology centers were retrospectively reviewed. SNOT-22 scores were used to evaluate QOL preoperatively and postoperatively (1, 3, 6, 12 months). Repeated-measures ANOVA assessed for differences in mean scores over time. Linear regression identified factors associated with QOL longitudinally.</p><p><strong>Results: </strong>373 patients were analyzed. Mean preoperative SNOT-22 score was 20.6 ± 20.4, which decreased to 16.3 ± 18.8 (p = 0.041) and 11.8 ± 15.0 (p < 0.001) at 1 and 3 months postoperatively, respectively. No further changes in SNOT-22 scores occurred beyond 3 months postoperatively (p > 0.05). When analyzed by SNOT-22 subdomains, nasal, sleep, and otologic/facial subdomain scores (all p < 0.05) demonstrated improvement at 12-month follow-up compared with preoperative scores; this was not observed for the emotional subdomain score (p = 0.800). Recurrent cases were associated with higher long-term SNOT-22 scores (β = 7.08; p = 0.017). Age, sex, degree of dysplasia, prior surgery, primary site, and smoking history did not correlate with symptoms (all p > 0.05).</p><p><strong>Conclusions: </strong>QOL outcomes related to IP resection are largely driven by nasal, sleep, and otologic/facial subdomains, though patients appear to experience enduring improvement as early as 3 months postoperatively. Recurrent disease is a major driver of negative QOL.</p><p><strong>Level of evidence: </strong>4 Laryngoscope, 135:579-585, 2025.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"579-585"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142047381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Topical Tranexamic Acid Effective in Treating Epistaxis?","authors":"Kelti M Munroe, Leigh J Sowerby, Christopher J Chin","doi":"10.1002/lary.31900","DOIUrl":"10.1002/lary.31900","url":null,"abstract":"<p><p>Topical tranexamic acid is used to treat epistaxis. We reviewed the evidence for this practice, and found based on the current literature, it may be a useful adjunct in managing epistaxis.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"488-490"},"PeriodicalIF":2.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11725680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}