Laryngoscope最新文献

{"title":"Treatment Patterns in Obstructive Sleep Apnea With Complete Concentric Collapse on Sleep Endoscopy.","authors":"Justin Thomas Cole, Emma Ryan, Tian Yue Song, Sveta Karelsky","doi":"10.1002/lary.32078","DOIUrl":"https://doi.org/10.1002/lary.32078","url":null,"abstract":"<p><strong>Objective(s): </strong>To describe outcomes in patients with obstructive sleep apnea (OSA) and intolerance of positive airway pressure (PAP) therapy who undergo drug-induced sleep endoscopy (DISE) with findings of complete concentric collapse (CCC) at the velum.</p><p><strong>Methods: </strong>This is a single-institution, retrospective review of all patients undergoing DISE by the senior author between January 2013 and March 2023. Inclusion criteria were moderate to severe OSA, PAP intolerance or failure, and adequate records to determine OSA treatment status.</p><p><strong>Results: </strong>Six hundred and eighty-nine patients underwent DISE between the above dates. 118 patients (17%) had CCC at the velum, and 103 were included. 23 patients (22%) were successfully treated, while 80 patients (78%) remained inadequately treated. This is significantly lower than the successful treatment rate of 48% at our institution in patients without CCC at the velum (p < 0.0001). Patients with CCC pursuing surgery to either improve PAP compliance, achieve primary surgical cure, or convert to a favorable DISE collapse pattern achieved adequate treatment in 40% of cases (12 of 30, p = 0.006 vs. patients not pursuing surgery). The remainder of CCC patients continued PAP therapy alone, employed a mandibular advancement device, or did not treat their sleep apnea.</p><p><strong>Conclusion: </strong>Patients with OSA, PAP intolerance, and CCC of the velum on DISE are more likely to remain unsuccessfully treated than those without CCC. Surgical intervention appears to confer a treatment advantage in CCC patients over continued PAP management or oral appliance therapy. Further research is needed to determine the optimal treatment for this patient population.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469799","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 Significance of Subperiosteal Abscess Volume in Acute Mastoiditis.","authors":"Rani Abu-Eta, Ramez Salameh, Yahav Oron, Ophir Handzel, Nidal Muhanna, Omer Jacob Ungar","doi":"10.1002/lary.32083","DOIUrl":"https://doi.org/10.1002/lary.32083","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the subperiosteal abscess (SPA) volume in acute coalescent mastoiditis (ACM) as measured in imaging studies, should influence the decision-making process between performing mastoidectomy versus needle aspiration or incision and drainage (I&D) as the initial treatment of SPA.</p><p><strong>Setting: </strong>Single tertiary referral center.</p><p><strong>Patients and methods: </strong>The records of all pediatric patients admitted with ACM between 1/2012 and 12/2023 were retrospectively reviewed. Baseline abscess volumes were measured on dedicated segmentation software for analyzing imaging findings. SPA volumes of needle aspirations were compared with those following I&D. Outcomes were compared.</p><p><strong>Results: </strong>In total, 99 patients (median [interquartile range] age 26 [11-35] months) were enrolled. The mean ± standard deviation white blood cell (WBC) counts and C-reactive protein (CRP) levels were 14.5 ± 7.0 K/μL and 112 ± 42 mg/dL, respectively. Fifty-seven patients were treated by needle aspiration and 42 by I&D. Age, WBC counts, and CRP levels were similar for both groups, as were SPA volumes as seen on imaging studies 2.0 ± 1.0 cm³ for the former group and 2.0 ± 0.9 cm³ for the latter group (p = 0.955). Resolution rates were 75.4% and 76.2%, respectively (p = 0.931). Resolved SPAs after needle aspiration and I&D had similar volumes 1.7 ± 0.9 and 1.7 ± 0.7 cm³, respectively, p = 0.931.</p><p><strong>Conclusion: </strong>Both needle aspiration and I&D are safe methods to reduce the infective and inflammatory load and provide pus for culture. Higher volumes (~3 cm³ and more) should be managed initially with cortical mastoidectomy since the risk of no improvement following needle aspiration or I&D is higher.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469796","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":"AI-Powered Laryngoscopy: Exploring the Future With Google Gemini.","authors":"Sean A Setzen, Katerina Andreadis, Olivier Elemento, Anaïs Rameau","doi":"10.1002/lary.32089","DOIUrl":"https://doi.org/10.1002/lary.32089","url":null,"abstract":"<p><p>Foundation models (FMs) are general-purpose artificial intelligence (AI) neural networks trained on massive datasets, including code, text, audio, images, and video, to handle myriad tasks from generating texts to analyzing images or composing music. We evaluated Google Gemini 1.5 Pro, currently the largest token context window multimodal FM and best-performing commercial model for video analysis, for interpreting laryngoscopy frames and videos from Google Images and YouTube. Gemini recognized the procedure as laryngoscopy in 87/88 frames (98.9%) and in 15/15 video-laryngoscopies (100%), accurately diagnosed a pathology in 55/88 frames (62.5%) and 3/15 videos (20.0%), identified lesion sides in 58/88 frames (65.9%) and 6/15 videos (40%) and narrated two operative video-laryngoscopies without fine-tuning. Findings suggest that Gemini 1.5 Pro shows significant potential for analyzing laryngoscopy, demonstrating the potential for FMs as clinical decision support tools in complex expert tasks in otolaryngology. LEVEL OF EVIDENCE: 3.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460234","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":"Eustachian Tube Characteristics in Patients With Turner Syndrome: A CT-Based Radiological Analysis.","authors":"Yan Huang, Liyang Liang, Lina Zhang, Wei Liu, Jia Guo, Zhigang Zhang, Yu Si","doi":"10.1002/lary.32086","DOIUrl":"https://doi.org/10.1002/lary.32086","url":null,"abstract":"<p><strong>Background: </strong>Patients with Turner syndrome (TS) commonly experience acute otitis media and Eustachian tube dysfunction (ETD). Comparison of the anatomical features of the Eustachian tube (ET) between TS patients and age-matched controls may provide insights into the high prevalence of ETD in TS.</p><p><strong>Methods: </strong>This study compared the ET angle, length, and diameters of the bone segment, bone-cartilage (BC) junction, and pharyngeal opening between TS patients and control children. A subgroup analysis was also conducted to explore potential risk factors for ETD in TS patients.</p><p><strong>Results: </strong>The ET angle in the TS group was significantly smaller (31.57°; 95% confidence interval [95% CI]: 30.05-33.09) compared with the control group (33.72°; 95% CI: 32.68-34.75; p = 0.019). No significant difference in ET length was observed between the two groups. However, the TS group exhibited significantly narrower diameters at the bony segment of the ET (0.30 cm; 95% CI: 0.29-0.32; p = 0.001), the BC junction (0.15 cm; 95% CI: 0.13-0.16; p = 0.001), and the pharyngeal orifice (0.14 cm; 95% CI: 0.13-0.16; p = 0.001) compared with the control group. Correlation analysis revealed a significant positive correlation between ET length and angle in the control group, whereas a non-significant negative correlation was observed in the TS group. In patients with TS, ET angles < 33.25°, bone segment diameters < 0.355 cm, and pharyngeal diameters < 0.15 cm were significantly associated with an increased risk of ETD.</p><p><strong>Conclusion: </strong>A more horizontal ET angle, along with narrower diameters at various ET segments, may contribute to the development of ETD in patients with TS. Consequently, heightened vigilance in monitoring hearing and early intervention strategies is recommended for children with TS (https://www.chictr.org.cn/, ChiCTR2300068063).</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460243","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":"Clinical Efficacy of Sialendoscopy-Assisted Stone Removal for Non-Palpable Hilar and Intraglandular Submandibular Sialoliths.","authors":"Han Cheol Lee, Ju Ha Park, Moon Su Kwak, Dae Hyun Kim, Young Min Park, Jae-Yol Lim","doi":"10.1002/lary.32065","DOIUrl":"https://doi.org/10.1002/lary.32065","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the efficacy of sialendoscopy in retrieving non-palpable submandibular stones located in the hilum or deeper parenchyma compared to traditional non-endoscopic transoral stone removal techniques.</p><p><strong>Methods: </strong>Seventy patients with non-palpable submandibular hilar or intraparenchymal stones underwent sialendoscopy-assisted stone removal (SASR). Seventeen patients with hilar stones treated with non-endoscopic transoral stone removal (TOSR) were the control group. Parameters evaluated included stone characteristics (size, number, location, mobility, and accessibility) as well as outcomes (success rate, operation time, complications, recurrence, and functional recovery).</p><p><strong>Results: </strong>The SASR group had four stones in the intraparenchymal glands, two of which were located inferior to the mylohyoid. Complete stone removal was achieved in 69 out of 70 patients (98.57%) in the SASR group. However, one patient had a sialolith measuring less than 2 mm in the intraparenchymal and inferior to mylohyoid that could not be removed. TOSR procedures were exclusively performed to remove hilar stones. Nevertheless, one patient in the TOSR group was unsuccessful in retrieving a 5-mm hilar stone, resulting in an overall success rate of 94.12%. The operation duration was much longer in the SASR group than in the TOSR group. However, the TOSR group had a significantly higher incidence of acute complications (41.18%), such as swelling, pain, or tongue numbness, compared to the SASR group (7.14%).</p><p><strong>Conclusion: </strong>Sialendoscopy is a valuable adjunct to the transoral combined approach for retrieving non-palpable submandibular stones, especially those in the hilum or deeper parenchyma. A precise preoperative assessment of stone location is crucial for determining the appropriate surgical intervention.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Two academic tertiary medical centers.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460239","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":"Predictors of Thyroglossal Duct Cyst Recurrence and Complications Following Sistrunk Procedure.","authors":"Brett A Campbell, Zachary Kelly, Hae-Young Kim, Michael Joseph Cunningham, Sukgi S Choi","doi":"10.1002/lary.32082","DOIUrl":"https://doi.org/10.1002/lary.32082","url":null,"abstract":"<p><strong>Objective: </strong>Recurrence is the primary complication of the Sistrunk procedure performed for the resection of thyroglossal duct cysts (TGDC). We aim to more confidently identify patients who may be predisposed to recurrence or other postoperative complications based on their clinical presentation and (or) perioperative course.</p><p><strong>Methods: </strong>Our institution's electronic medical record was queried over a 23-year period (2000-2023) for patients with TGDC who underwent a Sistrunk procedure. Demographics, clinical presentation, and outcomes data were collected and analyzed. The primary outcome was the factors associated with postoperative TGDC recurrence. The secondary outcomes were the factors associated with Sistrunk procedure complications.</p><p><strong>Results: </strong>A total of 357 patients underwent a Sistrunk procedure for TGDC at a mean age of 5.75 years and an average duration of follow-up of 26.5 months. Age, gender, race, cutaneous tracts, tongue base findings, pre-operative infection, number of pre-operative infections, incision and drainage, needle aspiration, placement of a post-operative drain, and the type of drain placed were unassociated with recurrence. The two factors associated with recurrence were postoperative infection (adjusted OR = 11.98 [95% CI: 3.38, 42.49], p = < 0.001) and postoperative seroma (adjusted OR = 5.03 [95% CI: 1.17, 21.62], p = -0.030). Male sex was significantly associated with postoperative complications (adjusted OR = 3.26 [95% CI: 1.55, 6.89], p = 0.002).</p><p><strong>Conclusion: </strong>Recurrence of TGDC after a Sistrunk procedure is an ongoing challenge that occurs in approximately 5% of cases. Recurrence is likely due to two factors: inadequate surgical technique and (or) histological factors like remnant arborizing microscopic ductules. Postoperative infection and seroma do not cause recurrence but may be predictors of residual disease due to one of these two factors and warrant closer surveillance.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460249","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":"Ultrasonic Vocalization Acoustics After Recurrent Laryngeal Nerve Injury and Recovery.","authors":"Robert Morrison, Arlin Khan, Adrianna C Shembel","doi":"10.1002/lary.32069","DOIUrl":"https://doi.org/10.1002/lary.32069","url":null,"abstract":"<p><strong>Objectives: </strong>The lack of well-defined functional acoustic correlates of vocal fold paralysis in animal models creates challenges for translating basic science studies of recurrent laryngeal nerve (RLN) injury to patients with vocal fold paralysis. Capitalizing on natural communicative rodent ultrasonic vocalizations (USVs), this study aimed to (1) investigate the impact of RLN injury on USV acoustics in both acute and chronic stages of RLN injury and (2) to identify USV parameters with the greatest ecological validity specific to RLN injury.</p><p><strong>Methods: </strong>USVs were recorded over 2 weeks (acute) in 16 animals and over 30 weeks (chronic) in 8 animals using two USV elicitation paradigms (n = 16 non-elicited, spontaneous; n = 8 elicited, sexually paired). USV acoustic characteristics from a list of possible parameters (duration, principal frequency, complexity, power, and tonality) were compared across USV elicitation paradigms and time points (before RLN injury, 2 weeks after injury, and 30 weeks after injury).</p><p><strong>Results: </strong>The USV parameters most impacted by RLN injury were frequency, power, and tonality, with significant decreases in all three parameters in both non-elicited/spontaneous and sexually elicited USV elicitation paradigms. All USV parameters were stable across 30 weeks after RLN injury.</p><p><strong>Conclusion: </strong>USV acoustic frequency, power, and tonality best characterize RLN injury and are stable over time, demonstrating their ecological utility in characterizing RLN injury and recovery. Furthermore, their stability can ensure accurate outcome metrics for future studies. Finally, these parameters have direct translation to humans with vocal fold paralysis.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460262","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 Sesquialter (First and a Halfth) Branchial Cleft Anomaly.","authors":"Evan J Propst, Jennifer M Siu, Susan Blaser, Haiying Chen, Nikolaus E Wolter","doi":"10.1002/lary.32072","DOIUrl":"https://doi.org/10.1002/lary.32072","url":null,"abstract":"<p><p>A 6-month-old presented with a sinus in the neck coursing from below the body of the mandible, between the carotid and parotid spaces, and terminating posterior to the stylomastoid foramen on MRI. Facial nerve monitoring was used, a lacrimal probe was placed in the sinus, an elliptical incision was made in the skin, and the tract was followed to the parapharyngeal space. Pathology demonstrated a keratinous squamous epithelial lining, skin adnexae, and elastic cartilage. Because there were clinical, radiographic, and pathological features intermediate to first and second branchial anomalies, we propose calling this a sesquialter (first and a halfth) branchial anomaly.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450676","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":"Contemporary Surgical Approaches in Managing Laryngeal Chondrosarcoma: A Scoping Review.","authors":"D Alexander Cronkite, Clare Moffatt, Kenric Tam, Alice C Yu, Dinesh K Chhetri, Maie St John","doi":"10.1002/lary.32068","DOIUrl":"https://doi.org/10.1002/lary.32068","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this scoping review is to describe and evaluate current surgical management options for chondrosarcoma of the larynx, and to summarize these techniques with respect to the laryngeal subsite affected.</p><p><strong>Data sources: </strong>PubMed/MEDLINE and EMBASE databases.</p><p><strong>Review methods: </strong>The review was conducted according to the Preferred Reporting Items for Systematic Reviews extension for Scoping Reviews.</p><p><strong>Results: </strong>Forty-one articles met eligibility criteria for inclusion in the final analysis, which included a total of 149 unique surgical cases that were analyzed based on affected laryngeal subsites of cricoid, thyroid, arytenoid, and epiglottis. Management of cricoid chondrosarcoma favored transoral endoscopic resection (TER) or transcervical laryngeal preservation surgery (TPLS), which ranged from limited tumor debulking via laryngofissure to larger operations like subtotal to total cricoidectomy with laryngeal reconstruction. Nearly all cases of arytenoid and epiglottic chondrosarcoma were successfully managed with TER techniques. Thyroid chondrosarcoma primarily affected the outer cortex of the cartilage and very rarely involved the endolaryngeal mucosa, making it very amenable to transcervical approaches to remove part of or the entire affected thyroid lamina.</p><p><strong>Conclusion: </strong>Overall trends in the articles reviewed for this study suggest that more aggressive surgery and R0 resection did not lead to better overall survival, which aligns with the broader philosophical shift in treatment goals to prioritize preservation of the larynx and laryngeal function over complete oncologic resection.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450675","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":"Is There Benefit of Music Training Following Cochlear Implantation?","authors":"Rhea N Shah, Isaac L Alter, Anil K Lalwani","doi":"10.1002/lary.32071","DOIUrl":"https://doi.org/10.1002/lary.32071","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442175","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}