Laryngoscope最新文献_第5页

A National Survey on Retrograde Cricopharyngeus Dysfunction Practice Patterns Among Laryngologists.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-17 DOI: 10.1002/lary.32125

Diego E Razura, Ruben Ulloa, Matthew E Lin, Benjamin van der Woerd, Lee M Akst, Michael M Johns, Karla O'Dell

{"title":"A National Survey on Retrograde Cricopharyngeus Dysfunction Practice Patterns Among Laryngologists.","authors":"Diego E Razura, Ruben Ulloa, Matthew E Lin, Benjamin van der Woerd, Lee M Akst, Michael M Johns, Karla O'Dell","doi":"10.1002/lary.32125","DOIUrl":"https://doi.org/10.1002/lary.32125","url":null,"abstract":"Objective: Retrograde cricopharyngeus dysfunction (RCPD) is characterized by the inability to belch, abdominal bloating, and distension, as well as socially awkward gurgling noises and excessive flatulence. The use of various diagnostic tools remains variable, while the national incidence of preference among laryngologists toward management remains unknown. This study aims to analyze trends and practice patterns in the diagnostic workup and management of RCPD among academic laryngologists. By doing so, our goal is to elucidate clinical decision-making patterns and treatment outcomes associated with the management strategies for RCPD.Methods: An electronic survey was sent to 184 academic laryngologists. The survey assessed RCPD topics related to patient demographics, clinical characteristics, knowledge and experience levels, perceived importance of historical and physical factors in diagnosis, diagnostic workup and utility, the effectiveness of different management approaches, and specifics of botulinum toxin (BT) injection practices.Results: Of the 87 (47.2%) laryngologists who responded to the survey, 75.9% have heard of RCPD before. The most common management approaches were BT injections (79.2%) and cricopharyngeus myotomy (11.3%). The mean amount of BT injected by laryngologists was 59 units.Conclusion: The survey demonstrates that RCPD is likely conceived as a clinical diagnosis among practicing laryngologists. While BT injections are done more frequently and are perceived to be effective, the role of myotomy of the cricopharyngeus remains variable.Level of evidence: 5: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651635","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

Routine Contrasted Chest CT Identifies the Angular Branch of the Thoracodorsal Trunk: Case Series.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-17 DOI: 10.1002/lary.32116

Hayden Hairston, J Reed Gardner, Joshua Hagood, Deanne King, Emre A Vural, Mauricio A Moreno, Donald Benson, Jumin Sunde

{"title":"Routine Contrasted Chest CT Identifies the Angular Branch of the Thoracodorsal Trunk: Case Series.","authors":"Hayden Hairston, J Reed Gardner, Joshua Hagood, Deanne King, Emre A Vural, Mauricio A Moreno, Donald Benson, Jumin Sunde","doi":"10.1002/lary.32116","DOIUrl":"https://doi.org/10.1002/lary.32116","url":null,"abstract":"Objectives: The location of the angular branch is highly variable. Preoperative imaging localization could provide clinical value in scapular flap harvest.Methods: Surgical and radiographic case series at an academic, tertiary care center.Surgical case series: Eleven consecutive patients undergoing scapular tip free flaps between 8/2020 and 3/2021. The surgeon and radiologist independently reviewed contrasted computed tomography (CT) of the chest preoperatively. Radiographic findings were compared to surgical findings.Radiographic case series: Fifty-two patients (104 sides) with contrasted CT chest between 10/2019 and 10/2020 were reviewed by the surgeon and radiologist. Data was recorded as with the surgical series. Axillary fat dimension was recorded.Results: Surgical case series: Nine patients were correctly classified by both readers, giving 81.8% agreement between readers and surgical findings. This equated to a substantial level of agreement for readers relative to surgical findings (κ = 0.718-0.735). Maximum deviation was 2 mm from the surgical findings. Radiographic series: One or both readers were unable to identify the AV on 4/104 sides (3.8%). All four sides had an axillary fat pad of less than 14 mm measured in the transverse dimension. Two of the remaining 100 sides where the AV was identified were under 14 mm.Conclusion: Standard preoperative imaging can identify the angular vessels at a high rate in patients with more than 14 mm of fat in a transverse measurement at the third rib. The accuracy of the localization is within 2 mm and was confirmed surgically.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143651637","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

A Multi-Institutional Review of Characteristics of Idiopathic Versus Non-Idiopathic Facial Paralysis.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-15 DOI: 10.1002/lary.32112

Shreya Mandava, Katherine Gossett, Neil P Monaghan, Shaun A Nguyen, Michelle Hwang, Krishna Patel, Samuel Oyer

{"title":"A Multi-Institutional Review of Characteristics of Idiopathic Versus Non-Idiopathic Facial Paralysis.","authors":"Shreya Mandava, Katherine Gossett, Neil P Monaghan, Shaun A Nguyen, Michelle Hwang, Krishna Patel, Samuel Oyer","doi":"10.1002/lary.32112","DOIUrl":"https://doi.org/10.1002/lary.32112","url":null,"abstract":"Objective: Occult lesions involving the facial nerve can be misdiagnosed as idiopathic facial paralysis, also known as Bell's palsy. Our goal was to compare the clinical features of patients with idiopathic/viral versus non-idiopathic facial paralysis and identify predictors of malignant etiologies.Methods: Retrospective chart review of 276 patients referred for surgical management of facial paralysis at two large facial nerve tertiary care centers.Results: A total of 176 patients had idiopathic/viral facial paralysis (IFP) and 60 patients had non-idiopathic facial paralysis (non-IFP), including malignancies (50/60), benign neoplasms/nerve sheath tumors (8/60), and systemic/CNS disorders (2/60). Non-IFP was more likely to be characterized by gradual onset (57.4% vs. 10.3%; p < 0.01), progressive course (65.0% vs. 19.8%; p < 0.01), irreversible flaccid paralysis (41.7% vs. 10.4%; p < 0.01), and lack of response to medication therapy (71.4% vs. 28.7%; p < 0.01). A past medical history of skin cancer or pre-cancerous lesions (36.4% vs. 7.26%; p < 0.01) and salivary gland cancer (23.3% vs. 0.57%; p < 0.01) were also associated with non-IFP. Epiphora/tearing, facial pain, and facial numbness were associated with malignant FP. 14/60 (23%) patients with non-IFP experienced a diagnostic delay of greater than 6 months.Conclusion: Facial paralysis that is gradual onset (> 72 h), progressive, without synkinesis, and unresponsive to medications should be further evaluated for nonidiopathic causes. Malignant lesions may be associated with other symptoms such as facial pain, facial numbness, and epiphora/tearing. Also consider malignant causes of FP in patients with a history of skin or salivary gland cancer.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634913","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

Visualization of Vestibular Aqueduct and Endolymphatic Hydrops in Meniere's Disease With 3D-Real IR.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-14 DOI: 10.1002/lary.32122

Yan Huang, Qian Sun, Heyu Ding, Xu Han, Le Xia, Jicheng Wang, Zhenghan Yang, Shusheng Gong, Zhenchang Wang, Pengfei Zhao, Jing Xie

{"title":"Visualization of Vestibular Aqueduct and Endolymphatic Hydrops in Meniere's Disease With 3D-Real IR.","authors":"Yan Huang, Qian Sun, Heyu Ding, Xu Han, Le Xia, Jicheng Wang, Zhenghan Yang, Shusheng Gong, Zhenchang Wang, Pengfei Zhao, Jing Xie","doi":"10.1002/lary.32122","DOIUrl":"https://doi.org/10.1002/lary.32122","url":null,"abstract":"Objectives: To investigate the association between the vestibular aqueduct (VA) and endolymphatic hydrops (EH) in patients with Meniere's disease (MD) using three-dimensional real inversion recovery (3D-real IR) sequences.Methods: This retrospective study included patients diagnosed with unilateral MD who underwent computed tomography (CT) and 3D-real IR sequencing. The VA course was identified on CT, and its visibility was assessed using a 3D-real IR sequence. The presence and severity of the cochlear and vestibular EH were evaluated. VA visualization was classified as Grade 0, whereas nonvisualization was classified as Grade 1. Differences in VA visibility between the affected and unaffected ears were compared, and correlations between VA visibility and EH severity were analyzed. Finally, the diagnostic efficacy of various MD indicators was assessed.Results: A total of 56 patients with unilateral MD were analyzed. The incidence rates of cochlear or vestibular EH were higher in the affected ear group than in the unaffected ear group (p < 0.001). The rates of nonvisualization of the VA in the affected and unaffected ears were 91.1% and 41.1%, respectively, with a statistically significant difference (χ2 = 31.226, p < 0.001). The VA visualization status was positively correlated with vestibular and cochlear EH (p < 0.001). The area under the curve for diagnosing MD using combined VA nonvisualization and EH was 0.876, which was significantly higher than that obtained using EH alone (Z = 3.414, p = 0.001).Conclusion: VA visibility on 3D-real IR sequences may assist in the diagnosis of MD and associated EH.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626621","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

Evaluating Treatment Patterns in Bell's Palsy Using Nationwide Employer-Sponsored Healthcare Claims.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-14 DOI: 10.1002/lary.32115

Sujay Ratna, Shaun Edalati, Yehia Elkersh, Parul Agarwal, Joshua Rosenberg, Mingyang Gray

{"title":"Evaluating Treatment Patterns in Bell's Palsy Using Nationwide Employer-Sponsored Healthcare Claims.","authors":"Sujay Ratna, Shaun Edalati, Yehia Elkersh, Parul Agarwal, Joshua Rosenberg, Mingyang Gray","doi":"10.1002/lary.32115","DOIUrl":"https://doi.org/10.1002/lary.32115","url":null,"abstract":"Objective: Professional society guidelines provide clear recommendations regarding the use of high-dose steroids and/or antiviral therapy for Bell's palsy patients. This study evaluates national trends in the care of Bell's palsy patients and identifies current treatments.Methods: A retrospective cohort study of adult Bell's palsy patients was conducted using ICD-9-CM and ICD-10-CM diagnosis codes from 2013 to 2020. These patients were continuously enrolled in the employer-sponsored MarketScan commercial or Medicare outpatient and prescription drug claims data for at least 1 year. The main outcome of interest was prescription rates of high-dose steroids and antivirals after the diagnosis date.Results: In this cohort of 66,708 adult Bell's palsy patients, 29,824 (44.7%) received no treatment. 22,736 (34.1%) received combination therapy, 11,866 (17.8%) received steroids only, and 2282 (3.4%) received antivirals only. Males were more likely to receive combination therapy. 51.9% of Bell's palsy patients in this cohort received the AAO-recommended treatment of steroids within 72 h of diagnosis. Patients in the Southern and Western United States were more commonly prescribed combination therapy. Comorbidities such as cerebrovascular disease and symptoms like ear pain were associated with a higher likelihood of receiving combination therapy. Treatment initiation, particularly for steroids, occurred on the index date, first insurance claim, in 94.56% of cases.Conclusion: Only 51.9% of Bell's palsy patients in this cohort received the AAO-recommended treatment with high-dose steroids with or without antiviral therapy. This research provides valuable insights into the real-world management of Bell's palsy, emphasizing the need for adherence to established treatment guidelines.Level of evidence: N/A.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143626615","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

Binocular vHIT in Healthy Participants: An Optimized Strategy.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-13 DOI: 10.1002/lary.32102

Yu Jiaodan, Li Fei, Gao Rui, Wu Peixia, Zhuang Jianhua, Li Wenyan

{"title":"Binocular vHIT in Healthy Participants: An Optimized Strategy.","authors":"Yu Jiaodan, Li Fei, Gao Rui, Wu Peixia, Zhuang Jianhua, Li Wenyan","doi":"10.1002/lary.32102","DOIUrl":"https://doi.org/10.1002/lary.32102","url":null,"abstract":"Objective: The objectives of this study were to observe the differences between the left and right eyes in healthy individuals during binocular video head impulse testing (vHIT) and to identify the optimal eye for a more precise evaluation of the vestibulo-ocular reflex (VOR) gain.Materials and methods: This is a prospective two-center study involving 41 healthy individuals. All participants included in the study underwent binocular vHIT, which was performed by experienced technicians.Results: Significant differences in VOR gain were observed between the left and right eyes across all six semicircular canals when binocular vHIT was used (t1 = 3.621, P1 = 0.001; t2 = 13.929, P2 < 0.001; t3 = -3.598, P3 = 0.001; t4 = -3.929, P4 < 0.001; t5 = -14.380, P5 < 0.001; t6 = 5.507, P6 < 0.001). The gains were higher in the adduction eye than in the abduction eye (t1 = 13.929, P1 < 0.001; t2 = -14.38, P2 < 0.001). The gains were lower in the left eye than in the right eye when the left posterior-right anterior (LPRA) plane was tested (t1 = 5.507, P1 < 0.001; t2 = 3.621, P2 = 0.001) and the gains were lower in the right eye than in the left eye when the right posterior-left anterior (RPLA) plane was tested (t1 = -3.598, P1 = 0.001; t2 = -3.929, P2 < 0.001).Conclusions: The binocular vHIT can be used as an optimization of monocular vHIT, assisting in selecting the ideal test eye in clinical protocols, aiming for a VOR gain closer to 1. We suggest using the anterior eye as the reference eye during testing of the vertical semicircular canal (SCC) plane and selecting the abducting eye as the reference when testing the horizontal SCC plane.Levels of evidence: 3.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617569","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

Endoscopic Butterfly Myringoplasty: Comparison of Tragal Cartilage Graft and Dermal Allograft.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-13 DOI: 10.1002/lary.32085

Seok-Hyun Kim, Hyun-Taek Jeong, In-Seok Moon, Il-Woo Lee

{"title":"Endoscopic Butterfly Myringoplasty: Comparison of Tragal Cartilage Graft and Dermal Allograft.","authors":"Seok-Hyun Kim, Hyun-Taek Jeong, In-Seok Moon, Il-Woo Lee","doi":"10.1002/lary.32085","DOIUrl":"https://doi.org/10.1002/lary.32085","url":null,"abstract":"Objectives: Tympanic membrane perforation (TMP) is a common reason for visits to otolaryngology clinics. For decades, various surgical methods and grafts have been employed to treat TMP. This study aimed to compare the efficacy of tragal cartilage grafts (TCG) and dermal allografts (DAG) in myringoplasty for treating TMP.Methods: We retrospectively analyzed 80 patients who underwent endoscopic butterfly inlay myringoplasty between 2019 and 2022. The patients were divided into two groups based on the graft material used: TCG (n = 40) and DAG (n = 40). We compared preoperative and postoperative hearing results and surgical outcomes between the two groups.Results: Both the TCG and DAG groups demonstrated significant postoperative improvements in hearing. The air-bone gap decreased from 11.87 to 7.74 dB in the TCG group (p = 0.01) and from 13.6 to 8.96 dB in the DAG group (p = 0.013). Similarly, the low-tone average improved significantly: from 40.49 to 25.26 dB in the TCG group (p < 0.001) and from 38.33 to 25.15 dB in the DAG group (p < 0.001). The graft closure rates were comparable at 97.5% for TCG and 92.5% for DAG, indicating that both procedures are effective and similar in efficacy. However, the TCG group required more follow-up visits (average of 4 vs. 2.6 for DAG).Conclusions: Both TCG and DAG techniques demonstrated comparable efficacy in terms of graft success rates and hearing improvement, with no significant differences in postoperative complications.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617562","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

Major Human Leukocyte Antigen Expression in Respiratory Papillomatosis Clinical Specimens.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-13 DOI: 10.1002/lary.32121

Yvette Robbins, Wiem Lassoued, Ke Bai, Angel Huynh, Scott M Norberg, Clint T Allen

{"title":"Major Human Leukocyte Antigen Expression in Respiratory Papillomatosis Clinical Specimens.","authors":"Yvette Robbins, Wiem Lassoued, Ke Bai, Angel Huynh, Scott M Norberg, Clint T Allen","doi":"10.1002/lary.32121","DOIUrl":"https://doi.org/10.1002/lary.32121","url":null,"abstract":"Objectives: Prior studies have reported low or absent major HLA class I expression on respiratory papilloma cells, conflicting with the recent clinical success of immunotherapy designed to activate HPV-specific T cells in patients with recurrent respiratory papillomatosis (RRP). We aimed to determine major human leukocyte antigen (HLA) class I expression on respiratory papilloma cells in untreated RRP clinical specimens using contemporary techniques.Methods: Formalin-fixed, paraffin-embedded RRP sections were subjected to signal-amplified multispectral immunofluorescence using the OPAL system to determine major and minor HLA class I expression, and digitally scanned slides were analyzed using digital pathology software. Positive and negative controls were used to optimize primary antibody conditions.Results: All samples harbored major HLA class I expression on varying proportions of papilloma cells. Considering all samples, major HLA class I expression was observed on the majority (74%) of papilloma cells. Nearly all (98%) papilloma infiltrating immune cells were positive for major HLA class I expression, serving as an internal control for each stained sample. Major HLA class I negative papilloma cells were enriched in the apical, suprabasal layers compared to the basal layers of the papillomatous epithelium, suggesting an association with the epithelial cell differentiation state. Fewer papilloma cells inconsistently expressed the minor HLA class I HLA-E across the basal and suprabasal epithelial layers.Conclusion: Papilloma cells express major HLA class I molecules. Using contemporary immunofluorescent techniques with signal amplification that likely provide improved sensitivity, these results clarify the major HLA class I expression status on papilloma cells in clinical specimens.Level of evidence: N/A.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617665","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

Is Cognitive Behavioral Therapy Effective for Tinnitus?

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-13 DOI: 10.1002/lary.32105

Elizabeth Bader, Elizabeth Dinces, Howard S Moskowitz, Joshua J Sturm

引用次数: 0

What Is the Current Management of Osteoradionecrosis of the Temporal Bone Following Head and Neck Cancer Radiotherapy?

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-11 DOI: 10.1002/lary.32111

Shravani Pathak, Richard V Smith

引用次数: 0