Laryngoscope最新文献

{"title":"Evaluating the Role of the CoPE in Relation to Established Laryngology PROMs.","authors":"Camryn R Marshall, James J Lappin, Tyler W Crosby, Steve D Stockton, Yue Ma, VyVy N Young, Clark A Rosen","doi":"10.1002/lary.70163","DOIUrl":"https://doi.org/10.1002/lary.70163","url":null,"abstract":"<p><strong>Objectives: </strong>Laryngology patient-reported outcome measures (PROMs) quantify symptoms related to voice, swallowing, and/or breathing. Vocal Cord Paralysis Experience (CoPE) is a PROM developed to evaluate disabilities associated with unilateral vocal fold paralysis (UVFP). The relationship between disease-specific and general symptom-based PROMs has not been previously studied in Laryngology. Correlations between CoPE and established Laryngology PROMs [e.g., Voice Handicap Index-10 (VHI-10), Eating Assessment Tool-10 (EAT-10), Dyspnea Index (DI)] assessed the role and added benefit of CoPE.</p><p><strong>Methods: </strong>Patients with UVFP at a tertiary Laryngology clinic completed CoPE, VHI-10, EAT-10, and DI during routine visits. Comparisons across PROMs were performed.</p><p><strong>Results: </strong>One hundred and eight unique data collection epochs were obtained from 80 patients (34 men, 46 women), mean age of 62.6 years. Mean scores were 43.4 ± 22 for CoPE, 21.2 ± 10.2 for VHI-10, 9.2 ± 8.5 for EAT-10, and 10.5 ± 9.9 for DI. Comparison of CoPE score to other Laryngology PROMS demonstrated statistically significant, positive correlations: CoPE versus VHI-10 (R = 0.596, p = 0.000), CoPE versus DI (R = 0.424, p = 0.000), and CoPE versus EAT-10 (R = 0.447, p = 0.000). CoPE subscale scores similarly demonstrated statistically significant, positive correlations: CoPE voice subscale versus VHI-10 (R = 0.641, p = 0.000) and CoPE swallowing subscale versus EAT-10 (R = 0.603, p = 0.000).</p><p><strong>Conclusion: </strong>PROMs are critical for assessing UVFP-related functional impairments. CoPE does not appear to capture unique aspects of the UVFP experience not already covered by VHI-10, DI, and EAT-10. Furthermore, these commonly used Laryngology PROMs have broad utility across many pathologic conditions and can be implemented prior to diagnosis, offering psychometric advantages. Clinicians and researchers can confidently employ commonly used Laryngology PROMs or CoPE to report UVFP results.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240329","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":"Infectious Complications After Oral Corticosteroid Use in Otolaryngology.","authors":"Margaret B Mitchell, Neil Bhattacharyya","doi":"10.1002/lary.70150","DOIUrl":"https://doi.org/10.1002/lary.70150","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233858","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":"Impact of Obesity on the Structured Histopathology of Chronic Rhinosinusitis Patients.","authors":"Daniel X Ma, Sushanth Neerumalla, Ali Baird, Russell A Whitehead, Peter Filip, Bobby A Tajudeen, Pete S Batra, Peter Papagiannopoulos","doi":"10.1002/lary.70177","DOIUrl":"https://doi.org/10.1002/lary.70177","url":null,"abstract":"<p><strong>Objectives: </strong>Obesity is an established risk factor for asthma, which shares common inflammatory pathways with chronic rhinosinusitis (CRS). However, the link between obesity and CRS remains poorly understood. By identifying trends in the structured histopathology (SHP) of obese patients with CRS, we aim to better understand how changes in the tissue architecture of obese patients may contribute to CRS.</p><p><strong>Methods: </strong>Retrospective chart review was conducted on 476 patients with CRS with and without nasal polyps who underwent functional endoscopic sinus surgery. Data were collected on SHP, demographics, and comorbidities. Chi-squared, logistic analyses, and multivariate analysis were performed.</p><p><strong>Results: </strong>The patient cohort was 53.8% female. Mean age was 52.01 years and mean BMI was 29.74. A total of 290 (60.9%) patients were nonobese (BMI < 30), 100 (21.0%) were Class I obese (BMI 30-34.9), 40 (8.4%) were Class II obese (BMI 35-39.9), and 46 (9.7%) were Class III obese (BMI ≥ 40). It was found that class III obesity was associated with statistically significant increases in several histopathological markers, including hyperplastic/papillary changes (17.4% vs. 5.6%, p < 0.026), Charcot-Leyden crystals (17.4% vs. 6.6%, p < 0.037), and squamous metaplasia (26.1% vs. 17.6%, p < 0.028). Multivariate analysis was performed, controlling for asthma, smoking, CRS subtype, and diabetes mellitus status. None of the variables were identified as confounders.</p><p><strong>Conclusion: </strong>Several SHP variables are significantly more prevalent in obese patients who underwent functional endoscopic sinus surgery. This may serve as a predictor of CRS severity and suggests CRS in Class III obese patients follows a non-type 2 inflammatory pathway.</p><p><strong>Level of evidence: 4: </strong></p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03816891.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233849","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":"Impact of Margin Assessment Method on Adjuvant Therapy and Recurrence in Early Oral Cancer.","authors":"Andrés M Bur, Jamie R Oliver, Nathan Farrokhian, Hannah Brown, Maria Feucht, Naomi Wang, Mark Varvares, Marisa Buchakjian, Andrew J Holcomb","doi":"10.1002/lary.70135","DOIUrl":"https://doi.org/10.1002/lary.70135","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of specimen-based margin (SBM) sampling versus tumor bed-based margin (TBBM) sampling on adjuvant therapy utilization and local recurrence rates in patients with early-stage oral cavity squamous cell carcinoma (OCSCC). We hypothesized that TBBM would be associated with increased use of adjuvant treatment and worse local control compared to SBM.</p><p><strong>Methods: </strong>In this retrospective, observational study, we reviewed records of patients with cT1 to T2, N0 OCSCC who underwent resection with intraoperative margin assessment at four academic centers between 2000 and 2019. Eligible cases required documentation of the margin sampling technique and at least two years of clinical follow-up. Local recurrence was the primary outcome, estimated using Aalen-Johansen cumulative incidence functions. Univariable and multivariable Fine-Gray subdistribution hazard models were used to identify associations, accounting for death as a competing risk and clustering by institution. The secondary outcome-adjuvant radiation therapy-was assessed using multivariable logistic regression.</p><p><strong>Results: </strong>Among 646 eligible patients, there were no significant differences in reported closest margin distance between techniques. TBBM was associated with a significantly higher likelihood of receiving adjuvant therapy (HR 1.82, 95% CI 1.08-3.05, p = 0.024) and an increased risk of local recurrence (HR 1.72, 95% CI 1.00-2.95, p = 0.049) compared to SBM.</p><p><strong>Conclusion: </strong>In early-stage OCSCC, TBBM is linked to increased adjuvant therapy use and higher local recurrence despite similar margin clearance on final pathology. These findings suggest SBM may offer improved clinical outcomes through more accurate margin assessment.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145233876","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":"Prospective Study of Long-Term Outcomes and the Patient Experience With Superior Laryngeal Nerve Block for Chronic Cough.","authors":"Andrew T Peachman, Zachary T Root, Mohammad Bilal Alsavaf, Brandon Kim, Brad W deSilva, Laura Matrka","doi":"10.1002/lary.70011","DOIUrl":"https://doi.org/10.1002/lary.70011","url":null,"abstract":"<p><strong>Objective: </strong>To characterize long-term response rates to the superior laryngeal nerve (SLN) block in a prospective fashion. Secondary objectives are to provide objective data to answer common pre-procedural questions and to identify factors that predict injection outcomes.</p><p><strong>Methods: </strong>Prospective study from April 2021 to August 2024 of adult patients with refractory chronic cough undergoing SLN block. Response was measured via a yes/no question about improvement, cough severity index (CSI), and a 1-10 Likert scale grading cough impact on quality of life (QoL) taken at baseline, 2 weeks, and 6-9 months post-injection.</p><p><strong>Results: </strong>One hundredtwenty-two patients were injected for cough, representing 249 injections. At 2 weeks after injection, 63.1% endorsed improvement on yes/no questioning (\"initial improvers\"), with significant improvement in both CSI and QoL scores (p < 0.001 for each). Of the initial improvers, 53.2% reported ongoing symptom improvement at long-term follow-up (6-9 months). Improvement occurred at an average of 4.3 days after injection and averaged 4.1 months in duration. 72.1% of improvers reported their degree of improvement as \"a lot\" or \"completely.\" Side effects occurred in 44.2% of injections and were typically mild. No cough feature or clinical factor significantly predicted a positive response to the SLN block.</p><p><strong>Conclusion: </strong>This prospective assessment indicates that nearly 2 in 3 refractory chronic cough patients respond positively to SLN block, with ~50% of these initial improvers endorsing ongoing improvement at long-term follow-up. Average duration of benefit is 4 months, and side effects are common. Predictive factors of a positive response to SLN block remain undefined.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240502","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 Effects of Parental Anxiety on the Postoperative Pain and Complications of Children Undergoing Adenotonsillectomy.","authors":"Noor Zahid","doi":"10.1002/lary.70186","DOIUrl":"https://doi.org/10.1002/lary.70186","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226247","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 Impact of Velopharyngeal Insufficiency: The Role of Social Determinants of Health.","authors":"Wesley P Allen, J B Eyring, Brandon M Hemeyer, Reema Padia, Quinn T Orb, Jeremy D Meier","doi":"10.1002/lary.70189","DOIUrl":"https://doi.org/10.1002/lary.70189","url":null,"abstract":"<p><strong>Objectives: </strong>The impact of velopharyngeal insufficiency (VPI) on patient and caregiver quality of life (QOL) is well documented. The social determinants of health (SDOH) that affect this relationship remain unclear. This study aimed to evaluate these associations to better understand how social context impacts patients and caregivers at risk of VPI due to congenital cleft and craniofacial deformities.</p><p><strong>Methods: </strong>Retrospective review of caregiver-reported Velopharyngeal Insufficiency Effects on Life Outcome (VELO) questionnaire responses was conducted for patients seen in a multidisciplinary cleft and craniofacial clinic from 2020 to 2023. Scores were matched to census data regarding educational opportunities, health/environmental factors, and socioeconomic factors using the Childhood Opportunity Index (COI). Associations between QOL and SDOH were evaluated via linear regression, with higher scores representing better values.</p><p><strong>Results: </strong>Among the cohort (N = 161), multiple SDOH categories significantly predicted the QOL impacts of VPI (p < 0.05). Socioeconomic factors were positively correlated with speech limitations, situational difficulty, emotional impact, and caregiver impact (β = 0.23-0.36, p < 0.05). Contrary to our hypothesis, health/environmental factors exhibited a significant negative correlation across the same VELO domains in addition to swallowing problems (β = -0.29 to -0.12, p < 0.05). Educational opportunities showed no significant association with any VELO subcategory (β = -0.11 to -0.03, p > 0.1).</p><p><strong>Conclusion: </strong>Higher socioeconomic status was associated with better VELO scores, underscoring the protective role of resources in health outcomes and caregiver perceptions. In contrast, caregivers with better health/environmental conditions reported worse outcomes, suggesting that higher health standards may influence perceptions of VPI severity.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226167","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 Effects of Parental Anxiety on the Postoperative Pain and Complications of Children Undergoing Adenotonsillectomy.","authors":"Sumeyra Doluoglu","doi":"10.1002/lary.70185","DOIUrl":"https://doi.org/10.1002/lary.70185","url":null,"abstract":"","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226195","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":"Long-Term Cost Utility Analysis of Endoscopic Sinus Surgery: Analysis of 5-Year Outcomes.","authors":"Dara R Adams, Katherine Tashman, Eric H Holbrook, Stacey T Gray, Ralph Metson, George Scangas","doi":"10.1002/lary.70176","DOIUrl":"https://doi.org/10.1002/lary.70176","url":null,"abstract":"<p><strong>Objective: </strong>Both endoscopic sinus surgery (ESS) and medical management have shown effectiveness for treatment of chronic rhinosinusitis (CRS); however, the majority of such analyses have relied on short-term surgical outcomes. We aimed to evaluate the long-term (5-year) cost-effectiveness of ESS versus medical management for patients with CRS.</p><p><strong>Methods: </strong>A cohort-style Markov decision-tree economic model with a 33-year time horizon was developed. A cohort of 96 CRS patients who underwent ESS were compared with a 2 to 1 matched cohort of 48 CRS patients who were treated with medical management at the same academic medical center. Long-term utility scores were calculated from the EuroQol 5-Dimension (EQ-5D) survey at 5-year follow up for the surgical cohort and 1-2 year follow up for the medical management cohort. Decision-tree analysis and a 10-state Markov model utilized published event probabilities and primary data to calculate long-term costs and utility. The primary outcome measure was the incremental cost-effectiveness ratio (ICER), which represents incremental cost per quality-adjusted life year (QALY).</p><p><strong>Results: </strong>The ESS strategy cost more ($63,296.10) but yielded increased QALYs (22.61). In comparison, the medical management strategy cost $26,990.27 but yielded only 13.48 QALYs. The ICER for ESS versus medical therapy alone was $4367.68 per QALY.</p><p><strong>Conclusion: </strong>This study shows ESS to be a cost-effective intervention compared to medical therapy alone for the management of patients with CRS based on analysis evaluating long-term (5-year) surgical outcomes.</p><p><strong>Level of evidence: </strong>N/A.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226198","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":"Early Initiation and Structured Education Promote Long-Term Heat and Moisture Exchanger Use After Total Laryngectomy.","authors":"Kohei Otaki, Takeshi Takahashi, Shusuke Ohshima, Yuto Takahashi, Ryoko Tanaka, Kohei Saijo, Jo Omata, Yusuke Yokoyama, Ryusuke Shodo, Yushi Ueki, Keisuke Yamazaki, Arata Horii","doi":"10.1002/lary.70191","DOIUrl":"https://doi.org/10.1002/lary.70191","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the impact of heat and moisture exchanger (HME) use on respiratory complications after total laryngectomy (TL), and to identify factors associated with continued use, with a focus on initiation timing and inpatient education.</p><p><strong>Methods: </strong>We retrospectively reviewed 118 patients who underwent TL between 2017 and 2024 at two tertiary centers. Patients were categorized by HME initiation (yes/no), timing (early ≤ 1 month postoperatively during hospitalization vs. late), and adherence (continued vs. discontinued). Respiratory infection and prolonged use of expectorants or antitussives were assessed as clinical outcomes. Logistic regression was performed to identify predictors of continued HME use.</p><p><strong>Results: </strong>Among 96 patients who initiated HME, 80 (83.3%) maintained long-term use. Compared to the non-use group (n = 38), continued users had significantly fewer respiratory infections (8.8% vs. 50%, p < 0.01) and less prolonged use of expectorants or antitussives (3.8% vs. 18.4%, p = 0.01). Early initiation and tracheoesophageal puncture use were both significantly associated with continued use (p = 0.02 each). Although peristomal skin complications were more common in the discontinued group, targeted skin care and individualized device selection enabled many patients to continue.</p><p><strong>Conclusion: </strong>Early and sustained HME use significantly reduced respiratory morbidity following TL. Initiation during hospitalization, along with structured education on device handling, skin care, and baseplate management, played a key role in supporting adherence. These findings support standardized inpatient protocols for HME introduction.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226226","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}