Laryngoscope最新文献

{"title":"An Account of Roman Surgical Treatments for Ozena: Historical Review.","authors":"Perry Hammond, Rebecca R Benefiel, Kent Lam","doi":"10.1002/lary.32096","DOIUrl":"https://doi.org/10.1002/lary.32096","url":null,"abstract":"<p><strong>Objective: </strong>To analyze a first-century Roman account of surgery for ozena-a tetrad of nasal crusting, ulceration, bony involvement, and foul odor-with a focus on historical context, etymology, and surgical management.</p><p><strong>Data sources: </strong>This historical review draws from the authors' translation of De Medicina. Primary sources detailing Roman surgical instruments from the House of the Surgeon in Pompeii, as well as secondary sources of surgical techniques, were utilized.</p><p><strong>Review methods: </strong>An in-depth review of Celsus' descriptions of surgical techniques for ozena was conducted using independent translation and exegetical analysis of primary sources. Archaeological findings were investigated to correlate surgical tools with the interventions described.</p><p><strong>Results: </strong>Proto-Indo-European and Classical interpretations of ozena revealed a unifying feature of malodor and a simultaneous relationship to nasal ulceration and suppurative lesions. Celsus detailed two procedures for ozena: closed cauterization using a heated probe and an open technique involving dissection, direct cauterization, and structural repair. These align with ancient Roman understanding of wound care and caustic applications. Three surgical instruments were identified for these procedures based on archaeological finds from the House of the Surgeon in Pompeii and other collections.</p><p><strong>Conclusion: </strong>Celsus' ancient structural interventions for ozena demonstrate an advanced understanding of anatomy and a mastery of instrumentation. This study underscores the importance of the historical contextualization of ancient medical practices, providing a foundation for the treatments of nasal pathology still in use today.</p><p><strong>Levels of evidence: </strong>Not applicable.</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":"143743819","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":"Increased Neck Visual Fixation in Children With Tracheostomies: An Eye-Tracking Study.","authors":"Dorsa Mavedatnia, Justin Levinsky, Siyu Miao, Meera Chopra, Rachel Lim, Meghan Tepsich, Evan J Propst, Nikolaus E Wolter, Jennifer M Siu","doi":"10.1002/lary.32132","DOIUrl":"https://doi.org/10.1002/lary.32132","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to objectively quantify the attentional distraction effect of a tracheostomy on visual attention and gaze using eye-tracking technology.</p><p><strong>Methods: </strong>This was a cross-sectional observational study. An eye-tracking device was used to capture eye movements of participants over 5 years of age who were shown 20 images of children with and without tracheostomies. The primary outcome was the number and duration of fixations on different mapped regions of the head and neck, including the central triangle (CT) and peripheral triangle (PT) of the face, and the anterior neck. Facial recall recognition was also assessed and compared across groups.</p><p><strong>Results: </strong>A total of 160 participants were recruited (57% female, median age 18 years, range 6-54 years). The greatest amount of time was spent viewing the CT of both children with and without tracheostomies. Participants viewed the necks of children with tracheotomies 3.7 times more frequently, spent eight times longer viewing the neck, and were more likely to incorrectly recall children with tracheotomies compared with the control group (3.33 vs. 0.85 fixations, p < 0.001; 0.15 vs. 1.12 ms, p < 0.0001; p < 0.001).</p><p><strong>Conclusion: </strong>Viewers who are looking at children with tracheostomies redirect their attention from the face toward the neck and spend a longer duration of time viewing the necks of children with tracheostomies compared to those without. Viewers are also more likely to incorrectly recall the faces of children with tracheostomies. These findings highlight a possible explanation for why social interactions may be different for children with tracheostomies beyond their underlying medical and communication problems.</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":"143743977","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":"Olfaction, Eating Preference, and Quality of Life in Cystic Fibrosis Chronic Rhinosinusitis.","authors":"Christine M Liu, Jakob L Fischer, Michelle J Lee, Jess C Mace, Adam J Kimple, Karolin Markarian, Jeremiah A Alt, Todd E Bodner, Naweed I Chowdhury, Sei Y Chung, Patricia H Eshaghian, Yuqing A Gao, Anne E Getz, Peter H Hwang, Ashoke Khanwalkar, Jivianne T Lee, Douglas A Li, Meghan Norris, Jayakar V Nayak, Jonathan B Overdevest, Cameran Owens, Zara M Patel, Lindsay E Pappas, Katie Poch, Rodney J Schlosser, Kristine A Smith, Timothy L Smith, Zachary M Soler, Jeffrey D Suh, Grant A Turner, Marilene B Wang, Jennifer L Taylor-Cousar, Milene T Saavedra, Daniel M Beswick","doi":"10.1002/lary.32155","DOIUrl":"https://doi.org/10.1002/lary.32155","url":null,"abstract":"<p><strong>Objectives: </strong>Olfactory dysfunction (OD) is common among people with cystic fibrosis (PwCF) and chronic rhinosinusitis (CRS). OD is associated with impaired quality of life (QOL) and dietary alterations in certain non-CF populations. This study explored relationships between OD, QOL, and modulator use in PwCF.</p><p><strong>Methods: </strong>This is a cross-sectional analysis of an ongoing multicenter, prospective study (2019-2023) investigating PwCF with comorbid CRS. Participants completed the 40-Question Smell Identification Test (SIT-40), 22-question SinoNasal Outcome Test-(SNOT-22), Questionnaire of Olfactory Disorders (QOD-NS), and Cystic Fibrosis Questionnaire-Revised (CFQ-R). Clinical and sinus CT data were collected. After stratification by SIT-40 score, data was analyzed by chi-square, Kruskal-Wallis, Spearman correlation, and logistic regression to identify factors associated with OD.</p><p><strong>Results: </strong>Of 59 participants, those with anosmia (n = 12) had worse eating-related QOL (CFQ-R eating) compared to individuals with normosmia (n = 16) and hyposmia (n = 31). Participants with anosmia had worse sinus CT scores than those with hyposmia. Although PwCF treated with highly effective modulator therapy (HEMT; n = 30) had better CT scores vs. non-HEMT individuals (n = 23), rates of OD in both groups were comparable. Higher SNOT-22 total scores were associated with increased odds of hyposmia or anosmia. In an eating-related QOD-NS subscore, those with worse CFQ-R eating had 2.38 times higher odds of having OD. Each point decrease in CFQ-R eating domain score was associated with 10% increased odds of OD.</p><p><strong>Conclusion: </strong>In PwCF, OD was associated with increased CRS severity, impaired olfactory QOL, and decreased CFQ-R eating. There were no differences in SIT-40 or QOD-NS scores based on HEMT status.</p><p><strong>Level of evidence: 3: </strong></p><p><strong>Trial registration: </strong>NCT04469439.</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":"143743922","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":"Dupilumab Monthly Dose De-Escalation Maintains Efficacy in CRSwNP: A Two-Year Real-World Study.","authors":"Eugenio De Corso, Claudio Montuori, Gabriele De Maio, Leandro Maria D'Auria, Alberta Rizzuti, Maria Clara Pacilli, Giuseppe D'Agostino, Rodolfo Mastrapasqua, Dario Antonio Mele, Jacopo Galli","doi":"10.1002/lary.32162","DOIUrl":"https://doi.org/10.1002/lary.32162","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to evaluate if dupilumab interval dose de-escalation to every 4 weeks negatively impacts treatment outcomes in real-life practice for severe uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) during the first 2 years of treatment.</p><p><strong>Methods: </strong>We enrolled 148 patients who completed 2 years of follow-up. We compared two homogenous groups in terms of severity: group A included 77 patients who never modified the interval of administration during follow-up; group B included 71 patients who extended the dosing interval to monthly administration. We compared the treatment outcomes and differences in safety.</p><p><strong>Results: </strong>The monthly interval dose prolongation was started in 22/71 patients (30.99%) at 6 months, in 11/71 (15.48%) at 9 months, in 22/71 (30.99%) at 12 months, and in 16/71 (22.54%) at 18 months. The dose prolongation was to manage minor adverse events in 9 of 71 patients; persistent eosinophilia in 26/71 patients; specific request of patients who had confirmed sustained control as determined by the physician's assessment in 36/71 cases. Mean values of all outcomes of response to treatment (i.e., volume of polyps, nasal obstruction, quality of life, olfaction) significantly improved at 6, 12, and 24 months compared to baseline (p < 0.01) in both groups A and B. No significant differences were found comparing groups A and B for any of the outcomes examined over the 2 years of follow-up (p < 0.01).</p><p><strong>Conclusion: </strong>These results suggest that extending to monthly dosing of dupilumab in real life does not negatively impact outcomes in patients with severe uncontrolled CRSwNP.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732741","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":"Functional but Not Structural Brain Changes After Olfactory Training in Women With COVID-19-Associated Olfactory Dysfunction.","authors":"Zetian Li, Julia Gebler, Akshita Joshi, Xinni Xu, Divesh Thaploo, Antje Hähner, Vittoria Avaro, Federico Calegari, Thomas Hummel","doi":"10.1002/lary.32128","DOIUrl":"https://doi.org/10.1002/lary.32128","url":null,"abstract":"<p><strong>Background: </strong>Olfactory training (OT) is a recommended treatment for olfactory loss and has proven effective in clinical contexts, yet its effects on the central-nervous system remain unclear. This study aimed to investigate the functional and structural brain changes in patients with post-viral olfactory loss undergoing OT.</p><p><strong>Methods: </strong>Twenty patients with post-viral olfactory loss and 19 healthy controls underwent OT for 3 months. All participants were assessed using the Sniffin' Sticks test and magnetic resonance imaging (MRI). Voxel-based morphometry and olfactory bulb volumetry were performed on structural images. Presenting an unpleasant odor, n-butanol, in a canonical block design, functional MRI was performed using whole-brain and region of interest analyses.</p><p><strong>Results: </strong>Patients with post-viral olfactory loss showed significant improvement following OT. Enhanced functional activations were observed in the orbitofrontal cortex and parahippocampus, while OT had little or no effects on brain structures.</p><p><strong>Conclusion: </strong>The present findings suggest that OT provides early perceptual and functional benefits, with structural changes potentially emerging later with extended training duration.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732743","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":"Barriers to Care for Sleep Surgery at a Safety Net Hospital: Qualitative Patient Experiences.","authors":"Amrita N Bhat, Amritpal Singh, Philip Kurien, George Su, Jolie L Chang, Megan L Durr","doi":"10.1002/lary.32145","DOIUrl":"https://doi.org/10.1002/lary.32145","url":null,"abstract":"<p><strong>Objective(s): </strong>Understanding barriers to surgical interventions for obstructive sleep apnea (OSA) is crucial to ensuring equity of access to OSA care. This study aims to understand the experiences of patients at a safety-net hospital in getting treatment for OSA.</p><p><strong>Methods: </strong>We used semi-structured interviews of adult patients with OSA presenting to the Zuckerberg San Francisco General Hospital Otolaryngology -Head and Neck Surgery clinic. Interviews consisted of open-ended questions focusing on barriers to sleep apnea care and surgery. These interviews were recorded and transcribed. Thematic analysis using the Consensual Qualitative Review methodology was performed by two reviewers.</p><p><strong>Results: </strong>15 adult patients with OSA were interviewed. Subthemes were identified and then grouped into four major barriers to sleep surgery, which included: (1) limited knowledge about treatment options and instructions, (2) healthcare delivery delays, (3) negative perceptions of health care, and (4) financial and logistical limitations. Patients utilized various resources for their health information, including physicians, word of mouth from family or friends, Youtube, television, and Tiktok.</p><p><strong>Conclusion: </strong>Lack of knowledge of sleep surgical options and referral delays pose major challenges to sleep surgery care in underserved populations. Future interventions should include accessible educational videos or tools to improve health literacy on OSA treatments and multidisciplinary programs across several sleep-related specialties to facilitate timely discussion of CPAP alternatives.</p><p><strong>Level of evidence: </strong>NA.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722304","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":"Parathyroidectomy With Local Anesthesia in Primary Hyperparathyroidism During Pregnancy.","authors":"Seda Erem Basmaz, Bayram Sahin, Ozhan Aydın, İsa Cam, Ozge Telci Caklili","doi":"10.1002/lary.32141","DOIUrl":"https://doi.org/10.1002/lary.32141","url":null,"abstract":"<p><p>Although surgery in the second trimester is preferred in pregnant patients with severe primary hyperparathyroidism, once that window is missed, surgical interventions may cause morbidity. Here we present a twin pregnancy in which a successful parathyroidectomy was performed under only local anesthesia.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722306","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":"Adjuvant Radiotherapy in pT1-2N0M0 Head and Neck Adenoid Cystic Carcinoma.","authors":"Praneet C Kaki, Aman M Patel, Afash Haleem, Akash R Patel, Rohini Bahethi, David W Wassef, Paul T Cowan, Richard Chan Woo Park","doi":"10.1002/lary.32156","DOIUrl":"https://doi.org/10.1002/lary.32156","url":null,"abstract":"<p><strong>Background: </strong>Evidence regarding the indications and survival benefit of adjuvant radiotherapy (aRT) in pT1-2N0M0 head and neck adenoid cystic carcinoma (HNAdCC) is inconclusive. Lower-staged, node-negative HNAdCC therefore represents a rare, moderate-risk disease category with high variation in adjuvant management depending on patient and physician preferences. Our study investigates the impact of aRT on overall survival (OS) in this rare, moderate-risk disease category.</p><p><strong>Methods: </strong>The 2006 to 2018 National Cancer Database was retrospectively reviewed for patients with pT1-2N0M0 HNAdCC. Multivariable binary logistic and Cox regression models were implemented.</p><p><strong>Results: </strong>Of 738 patients satisfying inclusion criteria, 379 (51.4%) underwent aRT. Oral cavity primary site (aOR 0.64, 95% CI 0.43-0.96) was associated with lower odds of undergoing aRT (p < 0.05); neck dissection (aOR 1.58, 95% CI 1.09-2.28) and PSM (aOR 1.84, 95% CI 1.30-2.60) were associated with higher odds of undergoing aRT (p < 0.025). Patients undergoing aRT had higher 5-year (94% vs. 86%) and 10-year OS (85% vs. 73%) than those not undergoing aRT (p < 0.001). Adjusting for patient demographics, pathologic features, and treatment, age at diagnosis (aHR 1.05, 95% CI 1.02-1.08, p < 0.001) was associated with worse OS; aRT (aHR 0.30, 95% CI 0.13-0.69, p = 0.005) was associated with higher OS.</p><p><strong>Conclusion: </strong>Approximately half of patients with pT1-2N0M0 HNAdCC did not undergo aRT, highlighting a possible deviation from evidence-based recommendations and an opportunity for quality improvement in the multidisciplinary care of patients. aRT was associated with higher 5-year and 10-year OS, suggesting that patients with lower-staged, node-negative HNAdCC should be offered aRT to optimize long-term survival.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722291","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":"Social Vulnerability Index as a Tool to Evaluate the Distribution of Head and Neck Oncology Surgeons.","authors":"Asher C Park, Milan P Fehrenbach, Ryan J Davis, Oluwatobiloba Ayo-Ajibola, James C Wang, Urjeet A Patel, Sandeep Samant, Katelyn O Stepan","doi":"10.1002/lary.32136","DOIUrl":"https://doi.org/10.1002/lary.32136","url":null,"abstract":"<p><strong>Objective: </strong>To assess the geographic distribution of head and neck oncology surgeons (HNS) in the U.S. and to evaluate the association of this distribution with neighborhood-level social determinants of health as measured by the Social Vulnerability Index (SVI).</p><p><strong>Methods: </strong>U.S.-based HNSs and their practice addresses were obtained from publicly available sources. The geographic distribution of HNSs was analyzed at the state, county, and metropolitan statistical area levels. U.S. census tracts were scored on a continuous scale of increasing social vulnerability (0-1) across Overall SVI and four subthemes: Socioeconomic Status, Household Composition-Disability Status, Racial-Ethnic Minority Status, and Housing-Transportation Status. The distance from each census tract to the nearest HNS was calculated, and univariable linear regression analyses assessed associations between SVI scores and distances.</p><p><strong>Results: </strong>This study included 609 HNSs that were disproportionately distributed at the state, county, and MSA levels. Higher vulnerability scores in Overall SVI (β = 12.9 [95% CI: 11.05, 14.69]), Socioeconomic Status (β = 11.5 [95% CI: 9.67, 13.32]), Household Composition-Disability Status (β = 10.4 [95% CI: 8.61, 12.27]), and Housing-Transportation Status (β = 18.2 [95% CI: 16.42, 20.06]) were associated with significantly increased distance to the nearest HNS, while higher vulnerability scores among Racial-Ethnic Minority Status were associated with significantly decreased distance to the nearest HNS (β = -25.8 [95% CI: -27.64, -24.01]).</p><p><strong>Conclusion: </strong>Inequities in the distribution of HNSs highlight the need for targeted strategies to improve access to head and neck cancer care. SVI may help identify especially vulnerable areas lacking access to this care.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712013","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":"Upper Airway Collapse in Patients With Severe Acquired Brain Injury Who Underwent Tracheostomy.","authors":"Lu Song, Yong Wang, Hai Dong Li, Zheng Li, Su Juan Liu","doi":"10.1002/lary.32138","DOIUrl":"https://doi.org/10.1002/lary.32138","url":null,"abstract":"<p><strong>Objective: </strong>To characterize upper airway collapse (UAC) in tracheostomized patients with severe acquired brain injury (sABI) and to explore its pathophysiology.</p><p><strong>Methods: </strong>This study involved adult patients with sABI who underwent tracheostomy and were consecutively admitted to the neurorehabilitation department of a tertiary teaching hospital from March 1, 2020, to March 1, 2023. Medical records and fiberoptic laryngobronchoscopy recordings of enrolled patients were reviewed retrospectively. The diagnosis of UAC was confirmed with the collapse of upper airway structures during inspiration when the tracheostomy was occluded. Baseline information of the enrolled patients and prognosis of the patients with UAC were collected. Logistic regression and bivariate comparisons were performed.</p><p><strong>Results: </strong>Of 180 patients identified, 38 (21.1%) had UAC: 30 experienced complete airway obstruction, whereas 8 had partial obstruction with a loss of airway patency exceeding 50%. Collapse sites included the velopharynx, oropharynx, epiglottis, and arytenoid area. Spontaneous resolution of UAC (n = 16) correlated with improved consciousness (p = 0.003), higher functional outcomes (p < 0.001), better oral intake ability (p = 0.004), and secretion management ability (p = 0.001). Fourteen patients were successfully decannulated after spontaneous resolution. Associated factors with UAC were minimally conscious state (OR: 13.80; p < 0.001), unresponsive wakefulness syndrome (OR: 28.43; p < 0.001), brainstem involvement (OR: 7.54; p < 0.001), and diabetes history (OR: 4.53; p = 0.002).</p><p><strong>Conclusions: </strong>UAC following severe brain injury presents a significant barrier to decannulation, particularly among those with decreased consciousness, brainstem involvement, and a history of diabetes. The resolution of UAC correlates with a favorable prognosis. These findings enhance our understanding of this condition and will aid in patient management.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712015","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}