Laryngoscope最新文献_第4页

Characterizing Adenoid Cystic Carcinoma of the Middle Ear-A Rare Entity. 中耳腺样囊性癌的特征--一种罕见实体。

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-21 DOI: 10.1002/lary.32134

Masanari G Kato, Seilesh C Babu

{"title":"Characterizing Adenoid Cystic Carcinoma of the Middle Ear-A Rare Entity.","authors":"Masanari G Kato, Seilesh C Babu","doi":"10.1002/lary.32134","DOIUrl":"https://doi.org/10.1002/lary.32134","url":null,"abstract":"Objectives: To characterize patient demographics, tumor features, treatment patterns, and survival outcomes of adenoid cystic carcinoma of the middle ear.Methods: Retrospective review of the Surveillance, Epidemiology, and End Results Database of the National Cancer Institute for all cases of histopathologically confirmed adenoid cystic carcinoma of the middle ear as the primary location.Results: Twenty-one patients with adenoid cystic carcinoma of the middle ear were identified. Patients had a median age of 61 years (range 16-86) and were more commonly female (57.1%) and Caucasian (85.7%). Tumors had a median size of 11 mm (range 5-22) with disease involvement most frequently locally (70%), followed by distant (20%), then regional disease (10%). Most underwent upfront surgery (85.7%) compared to radiation therapy (14.3%). Surgery was often followed by radiation. Five- and ten-year disease-specific survival remained stable at 67.3%.Conclusion: Demographics of middle ear adenoid cystic carcinoma reflect that of other primary locations, with a predilection for middle-aged and female patients. Tumors more often present with local involvement, though distant metastasis is not uncommon. Surgery, followed by radiation, appears to be the favored treatment modality and generally portends a good prognosis, despite involvement of a complicated anatomic location. Further research is necessary to better characterize the disease and define its optimal management.Level of evidence: 4: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674194","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}

引用次数: 0

Cytological Alterations of Benign Thyroid Nodules Following Radiofrequency Ablation. 射频消融术后良性甲状腺结节的细胞学变化

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-21 DOI: 10.1002/lary.32130

Emad Kandil, Mohammad H Hussein, Kavin Sugumar, Milee Patel, Marika Russell, Gregory Randolph, Eman A Toraih

{"title":"Cytological Alterations of Benign Thyroid Nodules Following Radiofrequency Ablation.","authors":"Emad Kandil, Mohammad H Hussein, Kavin Sugumar, Milee Patel, Marika Russell, Gregory Randolph, Eman A Toraih","doi":"10.1002/lary.32130","DOIUrl":"https://doi.org/10.1002/lary.32130","url":null,"abstract":"Background: Radiofrequency ablation (RFA) has emerged as a minimally invasive treatment for benign thyroid nodules. However, concerns exist about potential cytological progression following RFA. This study investigated the incidence of progression from benign (Bethesda II) to indeterminate (Bethesda III-IV) cytology and evaluated RFA's long-term efficacy and safety.Methods: This prospective study included patients with benign thyroid nodules treated with RFA from July 2019 to December 2023. Pre- and post-ablation fine-needle aspiration (FNA) cytology results were analyzed. Treatment efficacy was assessed through nodular volume changes and thyroid function, while safety was evaluated through complication rates.Results: Among 312 benign thyroid nodules treated with RFA, post-ablation FNA showed 12 cases (3.84%) progressed to Bethesda III, all confirmed benign by Afirma Gene Sequencing Classifier. Three patients underwent surgical resection due to inadequate volume reduction, with histopathology confirming benign nature. RFA achieved sustained nodular volume reduction, with a median reduction rate of 88% at 60 months. The overall complication rate was 3.2%, with no major complications requiring hospitalization.Conclusions: RFA demonstrates low risk of cytological progression and high efficacy in treating benign thyroid nodules. The significant volume reduction and favorable safety profile support RFA as a viable surgical alternative in selected patients. Future studies with larger cohorts and longer follow-up are needed to validate these findings and identify treatment success predictors.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674530","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}

引用次数: 0

Rapid Intrathecal Fluorescein Injection During Cerebrospinal Fluid Leak Repair Is Safe and Effective.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-20 DOI: 10.1002/lary.32135

Hussein Mackie, Jacob G Eide, Abdul Yassin-Kassab, Carl Wilson, Amrita Ray, Adam M Robin, Karam Asmaro, Jack P Rock, John R Craig

{"title":"Rapid Intrathecal Fluorescein Injection During Cerebrospinal Fluid Leak Repair Is Safe and Effective.","authors":"Hussein Mackie, Jacob G Eide, Abdul Yassin-Kassab, Carl Wilson, Amrita Ray, Adam M Robin, Karam Asmaro, Jack P Rock, John R Craig","doi":"10.1002/lary.32135","DOIUrl":"https://doi.org/10.1002/lary.32135","url":null,"abstract":"Objective: Intrathecal fluorescein (IF) is effective for localizing nasal cerebrospinal fluid (CSF) leaks along the skull base during endoscopic exploration, with largest studies reporting sensitivities ranging from 66%-93%. Due to reports of intraoperative and postoperative neurologic complications such as seizures and paralysis, surgeons often dilute the fluorescein and inject it intrathecally slowly over a variable amount of time. However, no study has assessed whether rapid IF administration causes the aforementioned risks or whether it affects its accuracy in identifying CSF leaks intraoperatively.Methods: A prospective study was conducted from 2015 to 2024, where all patients undergoing endoscopic exploration and/or repair of CSF rhinorrhea had 0.1 mL of 10% fluorescein (10 mg) mixed with 3-5 mL of patients' CSF injected rapidly via the lumbar drain over a few seconds.Results: Of the 82 included patients, the mean age was 53.8 ± 15.2 years, and 84% were female. Sixty-nine patients underwent successful endoscopic CSF leak repairs, and 13 had negative endoscopic explorations. Rapid IF injection was 80% sensitive (20% false negative rate) and 100% specific for identifying CSF leaks, and it caused no seizures, paralysis, or other neurologic complications.Conclusion: Compared to prior reports of slow low-dose IF injection for CSF leak localization, rapid IF injection yielded similar efficacy (80% sensitivity) with no IF-related complications. Rapid IF injection was safe and effective but should be corroborated by future studies.Level of evidence: 4: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665204","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}

引用次数: 0

Cost Savings Analysis for Otolaryngologic Medications Using Direct-to-Consumer Models.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-19 DOI: 10.1002/lary.32097

Om B Tripathi, Aman M Patel, Hassaam S Choudhry, David W Wassef, Paul T Cowan, Richard Chan Woo Park, Andrey Filimonov

引用次数: 0

Contrast Agent Uptake in Endolymphatic Sac and Duct: Inverse Relation to Endolymphatic Hydrops.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-19 DOI: 10.1002/lary.32127

Johannes Gerb, Emilie Kierig, Valerie Kirsch, Sandra Becker-Bense, Rainer Boegle, Thomas Brandt, Marianne Dieterich

{"title":"Contrast Agent Uptake in Endolymphatic Sac and Duct: Inverse Relation to Endolymphatic Hydrops.","authors":"Johannes Gerb, Emilie Kierig, Valerie Kirsch, Sandra Becker-Bense, Rainer Boegle, Thomas Brandt, Marianne Dieterich","doi":"10.1002/lary.32127","DOIUrl":"https://doi.org/10.1002/lary.32127","url":null,"abstract":"Objectives: Ménière's disease (MD) and vestibular migraine (VM) can be associated with endolymphatic hydrops (ELH). The differential role of the endolymphatic sac and duct (ES/ED) system for the development of ELH is poorly understood.Methods: On 251 delayed, contrast-enhanced inner ear MRI (iMRI) datasets from neurotological patients and healthy control participants, we evaluated (1) the visibility of the ES/ED system using a novel semi-quantitative scale, and (2) the dimensions of ELH, calculated using volumetric local thresholding (VOLT). Afterwards, statistical analysis of ES/ED radiologic visibility in relation to the grade of ELH, the degree of clinical symptoms, and audiometric findings was performed.Results: Patients were divided into an MD cohort (n = 68, 34 females, mean age 54.5 ± 14.8 years) and a VM cohort (n = 67, 42 females, 45.9 ± 15.5 years). The remaining datasets did not fulfill diagnostic criteria for definite diagnoses (n = 64, 27 females, mean age 51.3 ± 16.6) or were from healthy controls (HC; n = 52, 27 females, 49.0 ± 18.1 years). MD patients showed the lowest ES/ED-visibility scores on the affected side (ANOVA F(172,2): 20.60, p < 0.001), while the ES/ED-visibility on the non-affected side in MD patients was still significantly lower than in VM and HC (ANOVA F(172,2): 6.80, p 1.44 × 10-3). The ES/ED-visibility score and ELH volume (determined by VOLT, in mm3) correlated inversely (Spearman's rho: -0.32, Fisher's z -0.34, p < 0.001).Conclusion: ES/ED radiologic visibility in iMRI is inversely associated with ELH volumes. Patients with MD show substantially decreased ES/ED visibility on the affected ear and (less pronounced) on the unaffected ear, while VM and HC exhibit normal ES/ED visibility.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659480","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}

引用次数: 0

Defining the Appropriate Length of Antimicrobial Therapy for Skull Base Osteomyelitis.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-19 DOI: 10.1002/lary.32113

Monica Trent, Kathleen M Kelly, Donald Tan, Jonathan Korpon, Jacob B Hunter, Hamid R Djalilian, Edward C Kuan, Ashleigh A Halderman

{"title":"Defining the Appropriate Length of Antimicrobial Therapy for Skull Base Osteomyelitis.","authors":"Monica Trent, Kathleen M Kelly, Donald Tan, Jonathan Korpon, Jacob B Hunter, Hamid R Djalilian, Edward C Kuan, Ashleigh A Halderman","doi":"10.1002/lary.32113","DOIUrl":"https://doi.org/10.1002/lary.32113","url":null,"abstract":"Objectives: Skull base osteomyelitis (SBO) is a rare infection comprising either the lateral (LSBO), central (CSBO), or both lateral and central (BSBO) skull base. Due to its rarity, the optimal length of antimicrobial therapy (AMT) has not been well defined. Therefore, the purpose of this study was to identify factors that may influence outcomes of SBO and formulate clearer recommendations on AMT duration.Methods: A multi-institutional retrospective cohort study of SBO patients was conducted. Patient demographics, medical comorbidities, presenting symptoms, laboratory results, radiographic imaging, surgical treatment, culture results, length of follow-up, and type, length, and number of AMT courses were collected.Results: Sixty-five patients were included. The average age was 66.5 years, and the average length of symptoms (LOS) prior to diagnosis was 3.74 months. The most common pathogen was Pseudomonas aeruginosa (n = 23) followed by coagulase-negative Staphylococcus species (n = 15). The average length of IV AMT was 6.8 weeks, and the average total length of AMT (TLA) was 15.7 weeks. Positive fungal cultures were associated with longer TLA (22.6 vs. 13.7 weeks, p = 0.02) and a greater number of distinct courses of AMT (4.1 vs. 2.7, p = 0.01).Conclusion: In this series, the average length of IV AMT was 6.8 weeks. The average TLA was 15.7 weeks, indicating that a minimum of 6 weeks of IV AMT followed by a prolonged course of oral AMT is necessary to treat most cases of SBO. Fungal involvement significantly impacts the duration of AMT. Clinical guidelines are needed to better define the management of this complex disease.Level of evidence: 4: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659487","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}

引用次数: 0

The Sheep Head Versus the Pig Head as a Training Model for Sialendoscopy.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-19 DOI: 10.1002/lary.32126

Urs Borner, Samuel Tschopp, Michael Stewart, Olcay Cem Bulut, Frederic Faure, Gunther Pabst, Robert Irvine, Hila Klein, Shirish Ghan, Claudio Cernea, Zahoor Ahmad, David Eisele, Sandro de Paiva Leite, Marco Caversaccio, Lukas Anschuetz, Jean Michel Lopez, Francois Marchal, Siu-Kwan Ng, Olivier Abboud, Francis Marchal

{"title":"The Sheep Head Versus the Pig Head as a Training Model for Sialendoscopy.","authors":"Urs Borner, Samuel Tschopp, Michael Stewart, Olcay Cem Bulut, Frederic Faure, Gunther Pabst, Robert Irvine, Hila Klein, Shirish Ghan, Claudio Cernea, Zahoor Ahmad, David Eisele, Sandro de Paiva Leite, Marco Caversaccio, Lukas Anschuetz, Jean Michel Lopez, Francois Marchal, Siu-Kwan Ng, Olivier Abboud, Francis Marchal","doi":"10.1002/lary.32126","DOIUrl":"https://doi.org/10.1002/lary.32126","url":null,"abstract":"Objective: Sialendoscopy is a minimally invasive technique for treating inflammatory salivary gland diseases, requiring hands-on training due to its steep learning curve. While pig heads have been the standard training model for over two decades, sheep heads have recently emerged as an alternative. This study evaluates the efficiency of sheep heads for sialendoscopy training in newcomers.Methods: Participants of the 32nd International Sialendoscopy Hands-on Course (Geneva, 2023) performed sialendoscopies on fresh pig and sheep heads. Self-assessment questionnaires were completed pre- and post-training, with procedures rated on a Likert scale. Tutors evaluated participants using standardized assessments and recorded procedural times.Results: Among 52 participants from 27 countries, significant improvement in diagnostic sialendoscopy comfort was reported for both models post-training. Female participants demonstrated higher success rates than male participants in diagnostic (2.8 vs. 2.5, p = 0.03) and therapeutic (2.9 vs. 2.4, p = 0.03) procedures. More participants successfully cannulated the parotid duct on sheep heads, while submandibular gland performance was comparable across models. Self-assessments favored sheep for parotid (63%) and pigs for submandibular (79%). Overall, 53% preferred the pig model, while 47% preferred the sheep.Conclusion: Both models are effective for training, with sheep heads offering advantages for parotid duct procedures. Despite the pig model's broader applications, logistical, cultural, and ethical constraints make sheep heads a viable alternative for sialendoscopy training.Level of evidence: N/A.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659497","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}

引用次数: 0

Nasopharyngeal Endoscopic Submucosal Dissection (NESD) for Stage I Nasopharyngeal Carcinoma.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-19 DOI: 10.1002/lary.32066

You-Ping Liu, Zheng-Kai Feng, Hai-Qiong Huang, Wen-Bin Wu, Rui You, Ming-Yuan Chen

引用次数: 0

Feasibility of Laryngeal Joint Replacement: A Proof of Concept Study in Cadavers.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-19 DOI: 10.1002/lary.32120

Robert C Wang, Suparna Shah, Jeffrey Moxley, Erik Kubiak, Muhammed F Shand

{"title":"Feasibility of Laryngeal Joint Replacement: A Proof of Concept Study in Cadavers.","authors":"Robert C Wang, Suparna Shah, Jeffrey Moxley, Erik Kubiak, Muhammed F Shand","doi":"10.1002/lary.32120","DOIUrl":"https://doi.org/10.1002/lary.32120","url":null,"abstract":"Objective: Posterior laryngeal stenosis is a vexing problem despite efforts at early tracheostomy in those intubated on ventilatory support. Treatment in advanced cases relies on permanent tracheostomy or irreversible arytenoidectomy/cordectomy, which are compromises between voice, swallowing, and airway. While having intact laryngeal neuromuscular function, there is immobility of the vocal cord due to scarring and ankylosis of the cricoarytenoid joint. In this proof of concept study, we explore the feasibility of repairing cricoarytenoid joint function with joint replacement in the fresh cadaver model.Study design: Fresh human cadaver dissection to expose the cricoarytenoid joint.Setting: Academic Medical Center, Cadaver Dissection Lab.Methods: Two laryngeal surgeons attempted to expose the cricoarytenoid joint posterolaterally from an external cervical approach in five fresh human cadavers.Results: One surgeon familiar with the joint anatomy was able to reproducibly expose the joint by exposing and opening the joint capsule without disruption of the surrounding intrinsic laryngeal neuromuscular or cricoarytenoid joint ligamentous structures in five joints, and the other surgeon was able to as well after observing the first surgeon's approach in three consecutive approaches after an initial failed attempt. It was also demonstrated that a 4 mm titanium implant screw was able to be placed into the posterior cricoid joint facet, onto which a 3-D printed or milled joint surface can be mounted. Joint abduction and adduction forces were measured to determine endpoints for the joint scar release.Conclusion: We demonstrate that it is feasible to expose the cricoarytenoid joint without neuromuscular or joint ligamentous injury from an external approach and insert an anchor for a hemiarthroplasty system.Level of evidence: N/A.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659491","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}

引用次数: 0

Update on Gardasil Vaccination in Recurrent Respiratory Papillomatosis Patients Aged 45 or Older.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-18 DOI: 10.1002/lary.32123

Molly O Meeker, Ryan Ivancic, Brad de Silva, Laura A Matrka

{"title":"Update on Gardasil Vaccination in Recurrent Respiratory Papillomatosis Patients Aged 45 or Older.","authors":"Molly O Meeker, Ryan Ivancic, Brad de Silva, Laura A Matrka","doi":"10.1002/lary.32123","DOIUrl":"https://doi.org/10.1002/lary.32123","url":null,"abstract":"Objective: Gardasil vaccination has been effective as primary prevention and adjuvant therapy for recurrent respiratory papillomatosis (RRP). We present an update to our previous research reporting a significant increase in the intersurgical interval (ISI) after adjuvant Gardasil vaccination. Our objectives were: (1) to assess the durability of Gardasil as an adjuvant in RRP with longer-term follow-up and an expanded cohort, and (2) to better control for the use of other non-Gardasil adjuvant therapies.Methods: A retrospective chart review of adult patients > 45 years diagnosed with RRP from 2008 to 2022 was conducted. Patients were considered vaccinated if they received at least two Gardasil doses.Results: There were 51 total patients, 14 vaccinated and 37 unvaccinated. There was a significant increase in the ISI for the vaccinated group from 126 to 304 days (p = 0.0039), with 100.1 ± 47.3 months follow-up. Our previous study, performed at 49.7 ± 30.3 months follow-up, found an ISI of 494 days in the vaccinated group. Non-Gardasil adjuvant use was greater in the vaccinated group, but we found no significant effect of non-Gardasil adjuvant use on ISI in the unvaccinated group (p = 0.34).Conclusions: Adjuvant Gardasil use in RRP patients > 45 years significantly increases the ISI, which supports findings from our previous study. However, the magnitude of this effect may wane with time, with the ISI remaining significant but downtrending from 494 to 304 days. This data raise the question of whether booster Gardasil dosing warrants investigation.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651643","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}

引用次数: 0