Laryngoscope最新文献_第5页

What is Considered Adequate Surgery for Chronic Rhinosinusitis with Nasal Polyps?

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-13 DOI: 10.1002/lary.32054

Camille Duggal, Yvonne Chan, Brian W Rotenberg

引用次数: 0

Safety and Preliminary Efficacy of Posterior External Tracheal Stent Tracheopexy for Severe Tracheomalacia in Children.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-12 DOI: 10.1002/lary.32052

E' Ching Shih, Danielle B Cameron, Fouzi Benboujja, Christopher J Hartnick

{"title":"Safety and Preliminary Efficacy of Posterior External Tracheal Stent Tracheopexy for Severe Tracheomalacia in Children.","authors":"E' Ching Shih, Danielle B Cameron, Fouzi Benboujja, Christopher J Hartnick","doi":"10.1002/lary.32052","DOIUrl":"https://doi.org/10.1002/lary.32052","url":null,"abstract":"Objectives: Severe tracheomalacia in children is challenging to manage, and surgical options ranging from tracheostomy to posterior tracheopexy has been performed for treatment of posterior tracheomalacia, with their associated morbidities. The role of posterior external stent tracheopexy (PEXY) has not been established, and we report our experiences in treatment of severe posterior tracheomalacia using PEXY.Methods: A retrospective review of our case series of three pediatric patients with severe posterior tracheomalacia who underwent PEXY.Results: Between August 2024 and December 2024, three patients received PEXY. Using bioresorbable external plates as posterior stents, the posterior tracheal myomembrane was sutured to the external stent instead of the anterior longitudinal spinal ligament, minimizing the risk associated with injury of surrounding structures typically encountered during mobilization for spinal ligament access, such as the thoracic duct and esophagus. There were no reported injuries intra-operatively to the recurrent laryngeal nerves and esophagus, and all patients were discharged home within a week after their first post-operative bronchoscopy. All patients reported symptomatic improvement.Conclusion: We describe a novel procedure accessible to the pediatric otolaryngologist in treatment of severe posterior tracheomalacia using easily available bioresorbable plates molded to the airway as external posterior stents to resist airway collapsibility. Further research and longer-term outcomes are required for the role of PEXY in treatment of posterior tracheomalacia.Level of evidence: 4 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400618","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

Long-Term Follow-up of Percutaneous Dilatational Tracheostomy in the Intensive Care Unit.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-12 DOI: 10.1002/lary.32040

Ram Patel, Karan Gandhi, Agnieszka Dzioba, Halema Khan, William R Leeper, Julie E Strychowsky, Danielle MacNeil, Adrian Mendez

{"title":"Long-Term Follow-up of Percutaneous Dilatational Tracheostomy in the Intensive Care Unit.","authors":"Ram Patel, Karan Gandhi, Agnieszka Dzioba, Halema Khan, William R Leeper, Julie E Strychowsky, Danielle MacNeil, Adrian Mendez","doi":"10.1002/lary.32040","DOIUrl":"https://doi.org/10.1002/lary.32040","url":null,"abstract":"Objective: The primary objective was to analyze percutaneous dilatation tracheostomy (PDT) management in the intensive care unit (ICU) by comparison with surgical tracheostomy (ST) outside of the ICU, with respect to: (i) long-term postoperative outcomes, including rate of follow-up, return to the emergency department, and major and minor complications; (ii) timing of decannulation, including time to decannulation, decannulation after >30 days, and decannulation at discharge. The secondary objective was to compare perioperative outcomes, including major and minor complications.Methods: A retrospective study from April 2013 to 2024 at a tertiary referral center. Eligible patients included those over 18 years old without PDT contraindications who received PDT in the ICU or ST.Results: Final analysis included 250 patients (125 [50%] PDT; 125 [50%] ST). The mean (SD) age of patients was 60.05 (16.41) years, and 85 (34.0%) were female. Compared with the ST group, the PDT group experienced significantly decreased long-term follow-up (41 [39.8%] vs. 115 [95.0%], respectively, p < 0.001), increased emergency department returns (61 [64.2%] vs. 31 [26.1%], p < 0.001), longer time to decannulation (estimated median difference: 11.00 days [95% CI: 7.00 to 15.00, p < 0.001]), increased decannulation after >30 days (23 [34.8%] vs. 13 [12.7%], p < 0.001), and similar postoperative complications (8 [8.4%] vs. 8 [6.8%], p = 0.664). The PDT group experienced significantly more perioperative complications (37 [30.1%] vs. 22 [17.6%], p = 0.021).Conclusion: The decreased long-term follow-up, delayed decannulation, and increased complications after PDT highlight potential pitfalls in ICU tracheostomy management, demonstrating the need for refined protocols, appropriate consultant involvement, and improved patient selection.Level of evidence: 3 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400614","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

Otolaryngologic Side Effects of GLP-1 Receptor Agonists.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-12 DOI: 10.1002/lary.32061

Faizaan I Khan, Sebastian Guadarrama-Sistos Vazquez, Zain Mehdi, Isuru Somawardana, Roshan Dongre, Samuel Razmi, Keyvon Rashidi, Jason Shenoi, Najm Khan, Aatin Dhanda, Masayoshi Takashima, Omar G Ahmed

{"title":"Otolaryngologic Side Effects of GLP-1 Receptor Agonists.","authors":"Faizaan I Khan, Sebastian Guadarrama-Sistos Vazquez, Zain Mehdi, Isuru Somawardana, Roshan Dongre, Samuel Razmi, Keyvon Rashidi, Jason Shenoi, Najm Khan, Aatin Dhanda, Masayoshi Takashima, Omar G Ahmed","doi":"10.1002/lary.32061","DOIUrl":"https://doi.org/10.1002/lary.32061","url":null,"abstract":"Objectives: With the increasing use of GLP-1 receptor agonist (GLP-1 RA) drugs for weight loss and diabetes management, concerns have been raised regarding their potential side effects. We aim to assess the frequency of otolaryngologic adverse events (AEs).Study design: Retrospective analysis of national registry.Methods: The Food and Drug Administration's Adverse Event Reporting System (FAERS) database was queried for events related to the GLP-1 RA: exenatide, liraglutide, dulaglutide, semaglutide, and tirzepatide from 1 year after their approval until the end of 2023. AEs were collected and sub-stratified according to anatomic site. Reporting odds ratios (ROR) and proportional reporting ratios (PRR) were determined for all AEs.Results: The number of AEs reported from all drugs within this study totaled 9,746. Significant signal ratios were defined as a PRR≥2 and a lower CI ROR >1. Medullary thyroid carcinoma (MTC) and papillary thyroid carcinoma (PTC) had the highest signals and were significant in virtually all medications. This was followed by GERD which also had very high signal ratios and was significant in all drugs assessed. Semaglutide also had significant signals in anosmia, dry mouth, dysgeusia, and Bell's palsy. Liraglutide had significance in both signals in dysphonia, dysgeusia, tinnitus, and Bell's palsy. This was followed by exenatide which also included dysgeusia and hearing disability.Conclusions: GLP-1 RA were associated with various otolaryngologic AEs, with significant signals observed for semaglutide and liraglutide. GERD, MTC, and PTC were of significance in all GLP-1 RA in this study. Monitoring these AEs is recommended.Level of evidence: 4 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400616","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

Access to Cochlear Implantation: Trends in Surgeon Volume and Training.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-11 DOI: 10.1002/lary.32037

Mana Espahbodi, Patricia Trautwein, Daniel E Bestourous, Teresa A Zwolan, Ashley M Nassiri, Matthew L Carlson, Isaac D Erbele, Neil S Patel, Richard K Gurgel

{"title":"Access to Cochlear Implantation: Trends in Surgeon Volume and Training.","authors":"Mana Espahbodi, Patricia Trautwein, Daniel E Bestourous, Teresa A Zwolan, Ashley M Nassiri, Matthew L Carlson, Isaac D Erbele, Neil S Patel, Richard K Gurgel","doi":"10.1002/lary.32037","DOIUrl":"https://doi.org/10.1002/lary.32037","url":null,"abstract":"Objectives: Evaluate the training background of surgeons performing high volumes of cochlear implants (CIs) and estimate the ratio of providers trained in otology/neurotology (O&N) to the number of traditional CI candidates and audiologists.Methods: A retrospective review of US surgeon registration data from a single CI manufacturer was performed to determine CI volume based on surgeon training. The prevalence of traditional candidates for CIs was estimated from US census population data and compared with the number of O&N providers. The ratio of audiologists to O&N providers was estimated from the Bureau of Labor and Statistics and American Speech-Language-Hearing Association databases.Results: From 2021 to 2023, a mean of 88% of providers performing ≥25 CIs per year and 90% performing ≥40 per year had training in O&N. All surgeons registering ≥100 implants per year were O&N providers. The mean percentage of O&N providers performing ≥25 CIs per year and ≥ 40 per year was higher than the percentage of General and Pediatric Otolaryngology providers performing the same volume: mean difference = 76%, p < 0.001 and mean difference = 79%, p < 0.001, respectively. The mean estimated prevalence of traditional CI candidates per O&N provider is 3,354 with an estimated mean of 32 audiologists (3.5 trained in CIs) per O&N provider.Conclusion: 88% of high-volume CI surgeons have fellowship training in O&N. To meet the current state of CI underutilization and anticipated growing population of CI candidates, we propose increasing the surgical capacity of O&N providers and the number of surgeons proficient in CIs.Level of evidence: NA Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392337","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

Regional Variability in Compressive Strength of the Cartilaginous Nasal Septum: Implications for Fracture Patterns.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-11 DOI: 10.1002/lary.32046

Max Feng, Nihal Punjabi, Jared C Inman

{"title":"Regional Variability in Compressive Strength of the Cartilaginous Nasal Septum: Implications for Fracture Patterns.","authors":"Max Feng, Nihal Punjabi, Jared C Inman","doi":"10.1002/lary.32046","DOIUrl":"https://doi.org/10.1002/lary.32046","url":null,"abstract":"Introduction: Septal trauma is caused by compressive forces. Defining regional variability in compressive strength (CS) may reveal areas of weakness in the septum that are more prone to fracture. The objective of this study is to determine the CS at multiple locations within the cartilaginous septum and assess if variations in strength correlate with known patterns of septal fracture.Methods: Nineteen nasal septal quadrangular cartilages were dissected from fresh human anatomic specimens. Septa were divided into 11 sections using known anatomical and relative points. Each septum was cut into multiple 5 mm × 5 mm boxes, and the CS was measured using a force gauge.Results: The CS of the anterior septal point (ASP) was 0.072 MPa, keystone area 0.132 MPa, anterior nasal spine (ANS) 0.182 MPa, and posterior septal point (PSP) 0.204 MPa. The highest mean CS was located at the PSP (0.204 MPa). The lowest value was located at the ASP (0.072 MPa). The greatest regional difference in CS was found at the transition between the caudal L-strut and the ASP (0.09 MPa; 63%), the transition between the posterior caudal septum and the PSP (0.07 MPa, 42%), and the transition between mid-septal body and the ANS (0.06 MPa, 39%).Conclusion: There is high regional variability in CS at multiple locations within the cartilaginous septum. Septal fractures often occur between areas where there is a high regional difference in CS. This data may help inform choice of optimal donor and recipient site when considering grafting of the nasal septum.Level of evidence: NA. Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392356","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

Patients With Giant Facial Basal Cell Carcinoma, Who Are They?-A Psychosocial Profile.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-11 DOI: 10.1002/lary.32049

Keerthi E Kurian, Jenica Su-Ern Yong, Samuel L Oyer, Stephen S Park

{"title":"Patients With Giant Facial Basal Cell Carcinoma, Who Are They?-A Psychosocial Profile.","authors":"Keerthi E Kurian, Jenica Su-Ern Yong, Samuel L Oyer, Stephen S Park","doi":"10.1002/lary.32049","DOIUrl":"https://doi.org/10.1002/lary.32049","url":null,"abstract":"Objective: Giant basal cell carcinoma (GBCC) of the face is a rare, disfiguring entity with poorly understood psychological challenges and factors contributing to social isolation. This study evaluates the reasons for delays in care in this patient population.Methods: A retrospective review of patients with GBCC of the face (>5 cm) treated at a tertiary care academic center from January 2003 to May 2024 was conducted. The clinical course, time to presentation, insurance type, and geographic factors were analyzed to identify causes for delay. Telephone interviews assessed reasons for delays in care. The Hospital Anxiety and Depression Scale (HADS) was administered and compared with a control group.Results: A total of 39 patients with GBCC were identified; 16 patients consented to interviews. The average lesion length was 64.5 mm. Patients presented on average 6 years (range: 0.5-18 years) after noticing the lesion, citing denial or financial concerns as reasons for delay. HADS results showed increased anxiety (p = 0.01) compared with controls. Additionally, 33.3% of patients reported habitual alcohol use, and 43.8% lived alone. Geographical analysis showed lower high school graduation rates (p < 0.001). No significant socioeconomic predictors for insurance type or treatment delays were found.Conclusion: This study reveals the substantial psychosocial challenges experienced by patients with GBCC of the face. Increased anxiety, social isolation, and lower education levels contribute to delays in care. This subpopulation would benefit from targeted social support and health literacy interventions as they may be crucial to their final treatment recommendations and outcomes.Level of evidence: 4 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392342","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

Deep Learning Radiomics Based on MRI for Differentiating Benign and Malignant Parapharyngeal Space Tumors.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-11 DOI: 10.1002/lary.32043

Helei Yan, Lei Liu, Mingzhe Xie, Mengtian Sun, Jiaxin Yao, Jin Guo, Yizhen Li, Xinyi Huang, Donghai Huang, Xingwei Wang, Yuanzheng Qiu, Xin Zhang, Shanhong Lu, Yong Liu

{"title":"Deep Learning Radiomics Based on MRI for Differentiating Benign and Malignant Parapharyngeal Space Tumors.","authors":"Helei Yan, Lei Liu, Mingzhe Xie, Mengtian Sun, Jiaxin Yao, Jin Guo, Yizhen Li, Xinyi Huang, Donghai Huang, Xingwei Wang, Yuanzheng Qiu, Xin Zhang, Shanhong Lu, Yong Liu","doi":"10.1002/lary.32043","DOIUrl":"https://doi.org/10.1002/lary.32043","url":null,"abstract":"Objective: The study aims to establish a pre-academic diagnostic tool based on deep learning and conventional radiomics features to guide the clinical decision-making of parapharyngeal space (PPS) tumors.Methods: This retrospective study included 217 patients with PPS tumors, from two medical centers in China from March 1, 2011, to October 1, 2023. The study cohort was divided into a training set (n = 145) and a test set (n = 72). A deep learning (DL) model and conventional radiomics (Rad) model based on neck MRI were constructed to distinguish malignant tumors (MTs) and benign tumors (BTs) of PPS tumors. The deep learning radiomics (DLR) model which integrates deep learning and radiomics features was further developed. The area under the receiver operating characteristic curve (AUC), specificity, and sensitivity were used to evaluate model performance. Decision curve analysis (DCA) was applied to assess the clinical utility.Results: Compared with the Rad and DL models, the DLR model showed excellent performance in this study, with the highest AUC of 0.899 and 0.821 in the training set and test set, respectively. The DCA curve confirmed the clinical utility of the DLR model in distinguishing the pathological types of PPS tumors.Conclusion: The DLR model demonstrated a high predictive ability in diagnosing MTs and BTs of PPS and could serve as a powerful tool to aid clinical decision-making in the preoperative diagnosis of PPS tumors.Level of evidence: III Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392338","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

In Reference to Utilization of Artificial Intelligence in the Creation of Patient Information on Laryngology Topics.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-11 DOI: 10.1002/lary.32032

Luigi Angelo Vaira, Giacomo De Riu, Antonino Maniaci, Miguel Mayo-Yáñez, Alberto Maria Saibene, Carlos Miguel Chiesa-Estomba, Jerome R Lechien

引用次数: 0

Do Disinfectants Induce Ototoxicity and Cause Structural Damage to the Inner Ear?

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-02-11 DOI: 10.1002/lary.32044

Xi Wang, Zhongcheng Xing, Wen Jiang, Yuan Li, Wei Li, Caiji Wang, Zeqi Zhao, Naveena Konduru, Kang Li, Xuanyi Li, Yuehua Qiao, Wen Liu

{"title":"Do Disinfectants Induce Ototoxicity and Cause Structural Damage to the Inner Ear?","authors":"Xi Wang, Zhongcheng Xing, Wen Jiang, Yuan Li, Wei Li, Caiji Wang, Zeqi Zhao, Naveena Konduru, Kang Li, Xuanyi Li, Yuehua Qiao, Wen Liu","doi":"10.1002/lary.32044","DOIUrl":"https://doi.org/10.1002/lary.32044","url":null,"abstract":"Background: This study examines the impact of commonly used disinfectants on hearing and the structural integrity of the inner ear.Objective: To evaluate the effects of indophor, alcohol, and chlorhexidine on auditory function and cochlear morphology in mice.Methods: Sixty-four mice were evenly divided into four groups: saline, indophor, alcohol, and chlorhexidine. Each mouse received a 25 μL injection of the designated liquid into the left ear, while the right ear was remained untreated. Auditory brainstem response (ABR) testing was performed at three intervals: before injection, 24 h post-injection, and one week post-injection. Cochlear tissues from both ears were analyzed using immunofluorescence and scanning electron microscopy to observe morphological changes.Results: Chlorhexidine and alcohol significantly increased ABR thresholds in the left ear 24 h and one week post-injection (p < 0.001). Chlorhexidine caused severe damage to outer hair cells, inner hair cells, and spiral ganglion cells, while alcohol had a milder effect. Iodophor mainly affected outer hair cells, with partial recovery after seven days. In the right ear, only chlorhexidine caused a sustained ABR threshold increase (p < 0.001) and severe damage to outer and inner hair cells. Both alcohol and chlorhexidine induced demyelination of spiral ganglion cells in the left ear, but recovery was seen only in the alcohol group after one week.Conclusion: Indophor, alcohol, and chlorhexidine can all affect hearing, with alcohol and chlorhexidine causing more severe and lasting damage. These findings provide crucial insights for selecting disinfectants in ear surgeries.Level of evidence: NA Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143392339","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