Laryngoscope最新文献

{"title":"Impact of Nasal Pathology on Efficacy of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea.","authors":"Iman Adibi, Amala Nayak, Arman Saeedi, Katherine Yu, Mihai Bentan, Ryan S Nord","doi":"10.1002/lary.32172","DOIUrl":"https://doi.org/10.1002/lary.32172","url":null,"abstract":"<p><strong>Objectives: </strong>Hypoglossal nerve stimulation (HNS) has emerged as a treatment for obstructive sleep apnea (OSA). While current literature suggests comorbid nasal pathology can decrease quality of life (QoL) in OSA populations, its impact on HNS efficacy has been less explored. This study assesses whether the presence of nasal pathology changes HNS efficacy in improving sleep outcomes in OSA patients.</p><p><strong>Methods: </strong>A retrospective analysis evaluated 90 patients who underwent HNS implantation. Treatment efficacy and QoL were assessed preoperatively and postoperatively with apnea-hypopnea index (AHI), Epworth sleepiness scale (ESS), and functional outcomes of sleep questionnaire (FOSQ-10). Nasal exam and nasopharyngoscopy findings derived four groups: normal nasal findings (n = 44), positive anterior rhinoscopy findings (n = 32), positive nasopharyngoscopy findings (n = 36), and any positive nasal finding (n = 46). Septal deviation, septal perforation, polyps, masses, vestibular stenosis, and turbinate hypertrophy were considered positive findings. Outcomes within and across groups were analyzed using t-tests, Mann-Whitney U-tests, and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Both AHI and ESS scores significantly improved across all groups (p < 0.05) following HNS. FOSQ-10 in patients with positive anterior rhinoscopy findings did not significantly improve. Average FOSQ-10 improvement was significantly greater in the control group compared to the positive anterior rhinoscopy findings (p < 0.05). All groups met Sher15 and Sher20 criteria at similar rates.</p><p><strong>Conclusions: </strong>Comorbid nasal pathology does not diminish the effectiveness of HNS in treating OSA, with all groups showing significant improvement in AHI and ESS scores. However, impacts on broader QoL, measured by FOSQ-10, warrant further investigation.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789379","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":"The Role of Spreader Grafts in Reduction Septorhinoplasty: A Randomized Clinical Trial With Quality of Life Assessment.","authors":"Raphaella Migliavacca, Michelle Lavinsky, Eduardo Priesnitz Friedrich, Samuel Afonso de Freitas Toledo, Andreza Mariane de Azeredo, Denise Rossato Silva","doi":"10.1002/lary.32131","DOIUrl":"https://doi.org/10.1002/lary.32131","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of spreader grafts in reduction septorhinoplasty on quality of life (QOL) outcomes.</p><p><strong>Trial design: </strong>Randomized clinical trial (RCT).</p><p><strong>Methods: </strong>Individuals over 15 years old with nasal obstruction were evaluated for functional and aesthetic septorhinoplasty from October 2018 to October 2022 at a facial plastic surgery clinic of a tertiary university hospital in Brazil. Participants were randomly allocated to subjects with or without spreader grafts.</p><p><strong>Primary outcome: </strong>Relative changes in specific Nasal Obstruction Symptom Evaluation in the Portuguese language (NOSE-p). Outcomes were assessed at least 6 and 12 months postoperatively (PO ≥ 6 and PO ≥ 12 m). The participants and those assessing the outcomes were blinded to group assignment.</p><p><strong>Results: </strong>A 50 patients were included, 25 randomized to each group, mainly Caucasians with moderate/severe allergic rhinitis symptoms. Mean age was 32.89 ± 13.36 years and 68% were female. Septorhinoplasty improved specific quality-of-life scores irrespective of using spreader grafts (p < 0.001). There was no difference between subjects submitted or not to placement of spreader grafts in NOSE-p score in PO ≥ 6 m (-60.0 vs. -66.6%; p = 0.37); ROE in PO ≥ 6 m (71.83 vs. 79.56; p = 0.35), NO-VAS in PO ≥ 6 m (13.00 vs. 8.00; p = 0,35), NOSE p in PO ≥ 12 m (-53.14% vs. -68.33%; p = 0.28), ROE in PO ≥ 12 m (76.33 vs. 79.53; p = 0.645), NO-VAS in PO ≥ 12 m (13.00 vs. 11.50; p = 0.60).</p><p><strong>Conclusions: </strong>Reduction septorhinoplasty was associated with improvement in quality of life regarding nasal obstruction irrespective of using spreader grafts in a 7.88-month follow-up.</p><p><strong>Level of evidence: 2: </strong></p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: (NCT0449946).</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789380","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":"Tracheostomy Related Adverse Events: Is There a Weight-Related Association in Pediatric Patients.","authors":"Mele Mafi, Hae-Young Kim, Reza Rahbar, Michael Cunningham, Karen Watters","doi":"10.1002/lary.32169","DOIUrl":"https://doi.org/10.1002/lary.32169","url":null,"abstract":"<p><strong>Objectives: </strong>Adults have an increased risk of tracheostomy complications as body mass increases. A similar association has not been established in pediatric patients. This study assesses the relationship between weight-for-length percentile or body mass index (BMI) and adverse tracheostomy events in infants and children, respectively.</p><p><strong>Methods: </strong>Global Tracheostomy Collaborative database was reviewed for patients < 20 years who underwent tracheostomy (2008-2023) at a tertiary center. Data collected included age, weight, height, comorbidities, tracheostomy indication, and adverse tracheostomy events. Weight-for-length percentile for patients < 2 years and BMI percentiles for patients ≥ 2 years were calculated. Logistic regression models assessed the association of weight-for-length/BMI percentiles, demographics, and comorbidities with adverse events.</p><p><strong>Results: </strong>Of 474 patients (mean [SD] age, 4.1 [5.8] years), 96 (20.2%) had at least one tracheostomy adverse event. Complications included skin-related issues 19 (19.8%), tracheostomy bleeding 17 (17.7%), suprastomal granulation tissue 17 (17.7%), accidental decannulation 14 (14.6%), and tracheostomy tube obstruction 12 (12.5%). No significant association between adverse events was identified for high versus healthy weight-for-length percentiles [OR = 1.22, 95% CI: 0.59, 2.53, p-value = 0.60], nor for high versus healthy BMI percentiles [OR = 1.43, 95% CI: 0.60, 3.37, p-value = 0.42]. Despite the lack of statistical significance, the adjusted odds ratio suggested a 22% increase in odds of adverse event from healthy to high weight-for-length classification in children under 2 years [OR = 1.22], and a 43% increased odds of adverse event from healthy to high BMI percentile for children over 2 years [OR = 1.43].</p><p><strong>Conclusions: </strong>Neither higher weight-for-length percentiles in infants nor increased BMI in children demonstrated a statistically significant increase of tracheostomy adverse events. The comparatively higher percentages of adverse events observed in overweight/obese children do, however, raise clinical concern and would benefit from additional larger-scale investigations.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781371","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":"In Response to: Is Topical Tranexamic Acid Effective in Treating Epistaxis?","authors":"Kelti M Munroe, Leigh J Sowerby, Christopher J Chin","doi":"10.1002/lary.32144","DOIUrl":"https://doi.org/10.1002/lary.32144","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765597","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":"In Reference to Is Topical Tranexamic Acid Effective in Treating Epistaxis?","authors":"Abdullah AlDaihani","doi":"10.1002/lary.32143","DOIUrl":"https://doi.org/10.1002/lary.32143","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765596","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":"Preventing Hearing Loss in Children Receiving Cisplatin: A Systematic Review and Meta-Analysis.","authors":"Ethan M Kallenberger, Erin E Briggs, Shaun A Nguyen, Peter R Dixon, Allyson V Drawdy, Robert F Labadie, Ted A Meyer, David R White","doi":"10.1002/lary.32158","DOIUrl":"https://doi.org/10.1002/lary.32158","url":null,"abstract":"<p><strong>Objective: </strong>Cisplatin-induced hearing loss leads to significant neurologic, social, and behavioral impairment in children. The goal of this study is to characterize options available to prevent cisplatin-induced hearing loss and to identify gaps in the literature.</p><p><strong>Data sources: </strong>CINAHL, Cochrane Library, PubMed, Scopus.</p><p><strong>Review methods: </strong>Literature was searched between 1990 and 2024. Studies evaluating interventions to prevent hearing loss in children receiving cisplatin were included. Audiometric data including pure tone threshold, pure tone average, and incidence of hearing loss were extracted from included studies.</p><p><strong>Results: </strong>Six studies (N = 760) pertaining to cisplatin-induced hearing loss in children were included. This includes four randomized control trials (N = 652), one nonrandomized control trial (N = 97) and one prospective cohort study (N = 11). The studies examined sodium thiosulfate or amifostine, both given intravenously. The relative risk of hearing loss between intervention and control groups was 0.78 (95% CI 0.71-0.85). The proportion of patients in the treatment group categorized as grade zero on the Brock ototoxicity grading scale was significantly higher (p < 0.0001) than in the control group (36.3% vs. 15.5%). The change in pure tone average after chemotherapy was significantly higher in the control group compared to the intervention group (5.2 vs. -1.2 dB, 95% CI 5.53-7.25).</p><p><strong>Conclusions: </strong>These results show mild success in reducing the incidence of hearing loss in children undergoing chemotherapy with cisplatin. However, the literature is limited, and further investigation is warranted.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755577","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":"Artifact Reduction 3.0 T MRI in Cochlear Implantation Recipient With Diametrically Bipolar Magnets.","authors":"Xiaoqing Cen, Meng Wang, Chunxiang Zhou, Huiwen Zhuang, Jincangjian Sun, Qin Xiong, Kaitian Chen, Guanxia Xiong","doi":"10.1002/lary.32114","DOIUrl":"https://doi.org/10.1002/lary.32114","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to explore the clinical results of the MAVRIC-SL sequence in 3.0 Tesla (T) magnetic resonance imaging (MRI) examination of cochlear implant recipients with diametrically bipolar magnets.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Six consecutive patients implanted with diametrically bipolar magnets received a 3.0 T MRI for necessary reexaminations. The artifact volumes (cm³) and maximum artifact areas (cm²) were measured before and after applying the MAVRIC-SL. Adverse events, including discomfort or pain (measured using VAS), skin temperatures, and magnet displacement, were also recorded.</p><p><strong>Results: </strong>All enrolled patients completed the MRI scans. Significant reductions in artifact volumes and maximum areas were observed with the MAVRIC-SL sequence compared to others (p < 0.05 to < 0.01). Targeted disease regions, as well as the inner ear anatomy, were clearly revealed with MAVRIC-SL. One patient (aged 12) reported pain (VAS score: 8) during the scan, while others (aged 10-36) did not experience discomfort. Neither displacement nor tilt of the internal magnet was seen.</p><p><strong>Conclusion: </strong>The MAVRIC-SL sequence represents a feasible and safe solution for 3 T MRI in cochlear implanters with diametrically bipolar magnets, providing a new option to meet clinical needs.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755563","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":"The Effect of Sleep Deprivation on the Vestibulo-Ocular Reflex and Vestibular Adaptation in Healthcare Night-Shift Workers.","authors":"Nir Livneh, Hadas Ben-Rubi Shimron, Idit Tessler, Noa Rozendorn, Shibli Alsleibi, Amit Wolfovitz, Yoav Gimmon","doi":"10.1002/lary.32160","DOIUrl":"https://doi.org/10.1002/lary.32160","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the impact of sleep deprivation on the vestibulo-ocular reflex (VOR) in healthcare night-shift workers, focusing on basic VOR function and its adaptation during head movements with varying target distances.</p><p><strong>Methods: </strong>A prospective study was conducted with 14 night-shift healthcare workers, with a final analysis of 11 participants. Testing occurred under two conditions: After normal sleep and after a night shift. VOR gain was measured using the video head impulse test (vHIT) system for both active and passive head movements and for near and far targets. Participants also completed the computerized Dynamic Visual Acuity (c-DVA) test to assess gaze stability and a self-reported vigilance questionnaire.</p><p><strong>Results: </strong>Participants experienced significantly shorter sleep durations and reported lower vigilance levels on the post-night shift. VOR gain was notably reduced (7.5%) only during passive head movements toward a far target after a night shift. Other vestibular functions, such as distance modulation and other measurements including active head impulses, near-target tests, and c-DVA scores, showed no significant differences between normal sleep and sleep-deprived states.</p><p><strong>Conclusion: </strong>Sleep deprivation in healthcare night-shift workers demonstrated a complex effect on VOR, with significant impairment in only one specific condition (passive-far). Most other VOR functions, including adaptation to target distance, were maintained. This resilience may indicate an adaptive mechanism within the vestibular system under chronic sleep-deprived conditions, warranting further research into the underlying protective processes.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755579","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":"Improving Measurement Efficiency of the Voice Handicap Index-10 With Item Response Theory.","authors":"Elliana Kirsh DeVore, Thomas L Carroll, Maria Edelen, Clark Rosen, Jennifer J Shin","doi":"10.1002/lary.32161","DOIUrl":"https://doi.org/10.1002/lary.32161","url":null,"abstract":"<p><strong>Objectives: </strong>To assess: (1) the Voice Handicap-10 (VHI) instrument with item response theory (IRT) and determine which items convey the most information, (2) the extent to which voice handicap can be measured with a subset of items for efficient information intake, and (3) whether a proposed shorter scale has differing discriminatory ability for key diagnoses made by fellowship-trained laryngologists, as compared to the 10-item instrument.</p><p><strong>Methods: </strong>Prospectively collected data from 3640 patients who completed the VHI-10 questionnaire during evaluation at a tertiary care otolaryngology clinic were utilized. IRT analysis provided discrimination and location parameters associated with each item. Residual item correlations were also assessed to assess redundant information. Based on these results, two 5-item subsets were further evaluated using item information function curves. Areas under receiver-operator characteristic curves (ROC-AUC) were also calculated to evaluate the discriminatory ability for findings from videolaryngoscopy/stroboscopy.</p><p><strong>Results: </strong>Item discrimination parameter estimates ranged from 1.55 to 4.68, with higher values indicating more information. Residual item correlations were determined within item pairs, and location parameters were calculated. Based on these data, potential 5-item subsets were proposed, which preserved the capacity to reflect underlying voice handicap assessment. ROC-AUC analyses suggested no significant difference between the 5-item subset and 10-item instrument with regard to their ability to discriminate whether findings such as vocal fold paralysis were present.</p><p><strong>Conclusions: </strong>IRT data distinguished items for a proposed 5-item subset of the 10-item instrument, with the goal of reflecting the latent trait without significant loss of discrimination and precision.</p><p><strong>Level of evidence: </strong>Level 2-Prospective validation study with reference standard.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755576","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":"Correlation of the VFSS Esophageal Screen to High-Resolution Esophageal Manometry.","authors":"Tyler W Crosby, Joseph Lebowitz, Stamatela Balou, Uche C Ezeh, Abraham Khan, Rita Knotts, Shreya Chablaney, Paul E Kwak, Milan R Amin","doi":"10.1002/lary.32157","DOIUrl":"https://doi.org/10.1002/lary.32157","url":null,"abstract":"<p><strong>Objective: </strong>The videofluoroscopic swallow study (VFSS) is an evaluation of the anatomy and physiology of swallowing, and often includes a screening evaluation of the esophagus. How the esophageal screen translates to esophageal pathology remains unknown. The purpose of this study was to determine if abnormal esophageal clearance (EC) on VFSS correlates with esophageal function on high-resolution esophageal manometry (HREM).</p><p><strong>Materials and methods: </strong>This is a retrospective review of 115 adult patients who underwent both VFSS with esophageal screen and HRM. EC on VFSS was scored with the modified barium swallow impairment profile (MBSImP) component 17. Motility was characterized using HRM metrics according to the Chicago Classification Version 4.0 (CCv4.0). Predictive metrics were calculated for the esophageal screen.</p><p><strong>Results: </strong>An EC score o greater than or equal to 1 had a sensitivity of 66%, specificity of 57%, PPV of 52%, NPV of 70%, and OR of 2.55 (p = 0.027). EC weakly correlated with incomplete bolus clearance (rho = 0.331, p = 0.0004) and did not correlate with bolus transit time (rho = 0.17, p = 0.105).</p><p><strong>Conclusions: </strong>The esophageal screen as characterized by the MBSImP is not an effective predictor of esophageal function on HREM as defined by the CCv4.0. Future work may focus on a defining a standardized VFSS protocol for the esophageal screen and potentially a more nuanced assessment of esophageal findings on VFSS that may enhance the sensitivity of the modality to motility disorders.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743877","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}