Laryngoscope最新文献_第6页

Suicidal Ideation and Behaviors in Adults With Tinnitus: A Systematic Review and Meta-Analysis.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-11 DOI: 10.1002/lary.32118

Lauren R McCray, Megan K Scharner, Shaun A Nguyen, Habib G Rizk, Ted A Meyer, Robert F Labadie, Thomas W Uhde, Peter R Dixon

{"title":"Suicidal Ideation and Behaviors in Adults With Tinnitus: A Systematic Review and Meta-Analysis.","authors":"Lauren R McCray, Megan K Scharner, Shaun A Nguyen, Habib G Rizk, Ted A Meyer, Robert F Labadie, Thomas W Uhde, Peter R Dixon","doi":"10.1002/lary.32118","DOIUrl":"https://doi.org/10.1002/lary.32118","url":null,"abstract":"Objective: To assess relations between tinnitus and suicidality, measured by suicidal ideation and suicide attempts.Data sources: CINAHL, Cochrane Library, PubMed, PsycINFO, and SCOPUS databases were searched from inception through June 14, 2024.Review methods: Observational studies related to suicidality in tinnitus patients at least 18 years old were included. Case reports and studies on objective or pulsatile tinnitus were excluded. Two authors extracted data, and disagreements were resolved with a third party if needed. The risk of bias was assessed according to the Risk Of Bias In Non-randomized Studies of Exposure for cohort studies and the Joanna Briggs Institute critical appraisal checklist for cross-sectional studies. Random effects meta-analyses (single means, proportions, and relative risks (RR)) were used for primary analysis.Results: Nine studies (n = 912,013) pertaining to suicidality and tinnitus in an adult population were included. The tinnitus group experienced a significantly higher prevalence of suicidal ideation (19.5% [95% CI: 12.9%-27.1%] versus 9.9% [95% CI: 7.1%-13.2%]) and suicide attempts (1.9% [95% CI: 0.1%-5.7%] versus 0.9% [95% CI: 0.0%-3.9%]) than the control population (p < 0.0001). The tinnitus group had a significantly (p < 0.001) higher risk of suicidal ideation (RR = 2.1, 95% CI: 1.6-2.8) and suicide attempts (RR = 1.8, 95% CI: 1.3-2.4) than the control group.Conclusion: Nearly one in five people with tinnitus will experience suicidal ideation, and nearly 2% will attempt suicide. Thus, otolaryngologists should be mindful of the increased risk of suicidality in patients with tinnitus.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598167","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 Need for Postoperative Chest X-Ray After Placement of Hypoglossal Nerve Stimulator.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-10 DOI: 10.1002/lary.32103

Jacob Beiriger, Nicole Molin, Jared Robinson, Kalena Liu, Erin Creighton, Chihun Han, Dylan Bertoni, Maurits Boon, Colin Huntley

{"title":"The Need for Postoperative Chest X-Ray After Placement of Hypoglossal Nerve Stimulator.","authors":"Jacob Beiriger, Nicole Molin, Jared Robinson, Kalena Liu, Erin Creighton, Chihun Han, Dylan Bertoni, Maurits Boon, Colin Huntley","doi":"10.1002/lary.32103","DOIUrl":"https://doi.org/10.1002/lary.32103","url":null,"abstract":"Objective: Hypoglossal nerve stimulation (HGNS) is a surgical treatment for obstructive sleep apnea (OSA) in patients intolerant to CPAP. Current practice often involves chest x-ray (CXR) in the postanesthesia care unit (PACU), though the incidence of pulmonary complications is low. This study evaluates the necessity of immediate postoperative CXR after HGNS placement.Methods: We conducted a retrospective chart review of 361 patients who underwent unilateral HGNS placement from 2014 to 2021 at a single institution. Surgeries were performed by two high-volume sleep surgeons. Data collected included demographics, preoperative sleep study results, postoperative CXR findings, and subsequent management. Logistic regression calculated odds ratios (ORs) for the association between abnormal CXR findings and patient characteristics, with mean differences and 95% confidence intervals (CIs) for continuous variables.Results: Abnormal CXR findings occurred in five patients (1.4%), including two pneumothoraxes (0.6%) and three pulmonary edemas (0.8%). Patients with abnormal CXR findings had increased odds of reporting respiratory symptoms in the PACU compared to those without (OR: 3.8, 95% CI: 1.1-13.2, p < 0.001) and required extended postoperative stays. All patients with pulmonary edema had respiratory symptoms before CXR confirmation. No significant demographic or clinical differences were found between patients with normal and abnormal CXR findings.Conclusion: This study confirms the low incidence of pulmonary complications following HGNS placement by high-volume surgeons. Immediate CXR may not be necessary in asymptomatic patients. However, routine postoperative imaging in the recovery period is warranted to document hardware placement.Level of evidence: 4: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587921","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

Comparing Tinnitus Suppression in Asymmetric Hearing Loss and Single-Sided Deafness: Cochlear Versus Bone Conduction Implants.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-10 DOI: 10.1002/lary.32090

Jae Sang Han, Min Chae Jeon, Chan Mi Lee, Gianfranco C Velasco, So Young Park, Shi Nae Park

{"title":"Comparing Tinnitus Suppression in Asymmetric Hearing Loss and Single-Sided Deafness: Cochlear Versus Bone Conduction Implants.","authors":"Jae Sang Han, Min Chae Jeon, Chan Mi Lee, Gianfranco C Velasco, So Young Park, Shi Nae Park","doi":"10.1002/lary.32090","DOIUrl":"https://doi.org/10.1002/lary.32090","url":null,"abstract":"Objectives: Implantable hearing devices, such as cochlear implants (CI) and bone conduction implants (BCI), are options for hearing rehabilitation in patients with asymmetric hearing loss (AHL) and single-sided deafness (SSD). This study aimed to compare the effects of CI and BCI on tinnitus in AHL/SSD patients with tinnitus.Methods: This retrospective study enrolled adult AHL/SSD patients with significant tinnitus who underwent CI or BCI placement between 2017 and 2023. Clinical characteristics, preoperative and postoperative audiologic test results, and tinnitus questionnaires (tinnitus handicap inventory, THI; visual analog scale, VAS) were collected and analyzed.Results: Of 33 AHL/SSD patients with significant tinnitus (THI ≥ 18), 16 received CI and 17 BCI. In the CI group, all four VAS scores (loudness, awareness, annoyance, and effect on life) and THI scores significantly improved. In the BCI group, annoyance and effect on life categories of VAS and THI scores significantly improved, while VAS loudness and awareness remained similar. Linear mixed model analysis showed that the decrease in VAS loudness, awareness, and annoyance scores was significantly greater in the CI group compared to the BCI group. The CI group showed a significantly higher tinnitus cure rate (62.5.0%) compared with the BCI group (11.8%) at 6-months postoperative.Conclusion: Both CI and BCI effectively improved tinnitus in AHL/SSD patients with tinnitus. However, CI is considered the first-line therapeutic option for tinnitus due to its stronger effect on tinnitus suppression as well as the higher cure rate in SSD/AHL patients with tinnitus.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587918","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 Augmentation for Velopharyngeal Insufficiency Treatment in Wind Instrument Players.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-10 DOI: 10.1002/lary.32100

Calabria DeFazio, Lily Stevenson, Phillip Song

引用次数: 0

Rare Hypopharyngeal Polyp Presenting Without Dysphagia: A Case Report.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-10 DOI: 10.1002/lary.32110

Tiffany Win, Komal Hombal, Melissa Mortensen-Welch

{"title":"Rare Hypopharyngeal Polyp Presenting Without Dysphagia: A Case Report.","authors":"Tiffany Win, Komal Hombal, Melissa Mortensen-Welch","doi":"10.1002/lary.32110","DOIUrl":"https://doi.org/10.1002/lary.32110","url":null,"abstract":"Fibrovascular polyps (FVPs) of the hypopharynx are exceedingly rare benign tumors. This case showcases an incidental finding of a fibrovascular hypopharyngeal polyp discovered during a flexible laryngoscopy secondary to ear pain in a 72-year-old male. The patient reported no associated dysphagia, voice changes, dyspnea, or globus sensation. Imaging studies, including a CT neck scan, MRI, and videofluoroscopic swallow study, revealed a 1.2 × 1.3 × 1.4 cm solid polyp attached to the hypopharynx without extending into the esophagus. The patient underwent a successful endoscopic excision of the pharyngeal polyp with a partial pharyngectomy. The biopsy of the specimen showed squamous mucosa with stromal degeneration, consistent with a benign polyp. This case report describes a rare asymptomatic hypopharyngeal FVP, notable for its small size and lack of typical symptoms like dysphagia. It emphasizes the importance of early identification through a multimodal approach and careful surgical management to prevent potential complications, as complete surgical excision is curative. While dysphagia is the common symptom of FVPs, this case demonstrates that FVPs can present without it, highlighting the need for FVPs to remain in the differential diagnosis, even when found incidentally.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587920","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

Dental Prosthetic Rehabilitation in Mandibular Reconstruction: Optimizing Timing and Patient Selection.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-06 DOI: 10.1002/lary.32084

Amanda J Bastien, Jay Lee, Steven Kupferman, Avi Donitza, Aria Davodi, Luv Amin, Missael Vasquez, Leila Musavi, Harsh Patel, Michelle Chen, Evan Walgama, Zachary S Zumsteg, Allen S Ho, Jon Mallen-St Clair

{"title":"Dental Prosthetic Rehabilitation in Mandibular Reconstruction: Optimizing Timing and Patient Selection.","authors":"Amanda J Bastien, Jay Lee, Steven Kupferman, Avi Donitza, Aria Davodi, Luv Amin, Missael Vasquez, Leila Musavi, Harsh Patel, Michelle Chen, Evan Walgama, Zachary S Zumsteg, Allen S Ho, Jon Mallen-St Clair","doi":"10.1002/lary.32084","DOIUrl":"https://doi.org/10.1002/lary.32084","url":null,"abstract":"Background: Dental prosthetic rehabilitation (DPR) plays a critical role in restoring function and quality of life following mandibular reconstruction. This study examines the rate of patients undergoing dental implants and DPR after reconstruction of a segmental jaw defect with a fibula free flap reconstruction. We identify factors associated with successful dental implants and DPR in this patient population.Methods: Retrospective review examining the rate of dental implants and DPR in fibula free flaps at a tertiary academic hospital.Results: Of the 67 patients, 34 did not undergo dental implants at the time of reconstruction, 33 underwent primary dental implants, with 19 of these patients undergoing implants alone with a plan for later prosthesis and 14 (20.9%) getting immediate implants with provisional prosthesis-referred to as jaw in a day (JIAD). Implants were placed with a success rate of 89.3% for implants alone and 94.0% for JIAD patients. None of the 34 patients who did not receive dental implants at the time of reconstruction later underwent dental implants or DPR. In contrast, of those who underwent dental implants without the placement of a provisional prosthesis, 63.2% (12/19) successfully obtained a final prosthesis. In patients who underwent JIAD, 92.8% (13/14) went on to get a final dental prosthesis.Conclusion: Our study demonstrates that immediate placement of dental implants with or without a tissue-borne prosthesis during mandibular reconstruction can be performed with a high rate of success. Furthermore, our data suggest that immediate placement of a dental prosthesis is the most efficient method of achieving dental rehabilitation.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574560","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

Factors Influencing Nasal Irrigation Efficacy in Infants: An Exploratory 3D Model Study.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-06 DOI: 10.1002/lary.32107

Pierre Cnockaert, Emma Trehoux, Jeremy Patarin, Lydia Esteban Enjuto, Nicolas Audag, William Poncin

{"title":"Factors Influencing Nasal Irrigation Efficacy in Infants: An Exploratory 3D Model Study.","authors":"Pierre Cnockaert, Emma Trehoux, Jeremy Patarin, Lydia Esteban Enjuto, Nicolas Audag, William Poncin","doi":"10.1002/lary.32107","DOIUrl":"https://doi.org/10.1002/lary.32107","url":null,"abstract":"Background: Nasal irrigation is widely practiced in infants, but its execution varies greatly. Although a consensus on how to perform this procedure has been published, supporting experimental evidence is lacking. In vitro investigations using anatomical models are a promising first step toward clinical research. Quantitative, exploratory data on pediatric nasal irrigation, obtained from a pragmatic irrigation setup, are needed.Methods: A previously validated upper airway model of a 10-month-old infant was used and filled with mucus-mimicking hydrogel at two different concentrations. The upper airway clearance efficacy (UAC%) of nasal irrigation (i.e., the extent of airway clearance) was tested by varying different parameters: head position and the nostril selected for irrigation (side-lying via the supra- or infra-lateral nostril, or sitting), irrigation pattern (unilateral or bilateral irrigation), irrigation volume (5, 10, 15, or 20 mL), and hydrogel concentration (1 or 1.5%).Results: Increasing nasal irrigation volume significantly improved UAC% with each 5 mL increment: mean (SD) UAC% was 75.10 (8.06), 84.00 (7.79), 89.94 (5.86), and 93.15 (4.63) % for 5, 10, 15, and 20 mL/nostril, respectively. Performing unilateral nasal irrigation through the supra-lateral nostril led to a greater UAC% compared to infra-lateral nostril irrigation (mean UAC% (SD) was 83.02 (7.32) and 75.30 (9.29) %, respectively; p < 0.001). The other parameters did not significantly impact the UAC%.Conclusion: The irrigation volume and the nostril selected for unilateral nasal irrigation significantly impacted upper airway clearance during in vitro nasal irrigation. Future studies should investigate whether large irrigation volumes improve clinical outcomes in infants.Level of evidence: NA, in vitro study.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568291","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

Evaluation of Arclight Frugal Smartphone Video Otoscopy.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-06 DOI: 10.1002/lary.32106

Christoph R Buhr, Katharina Bahr-Hamm, Christopher Seifen, Johannes Pordzik, Jonas Eckrich, Thomas Murray, Christoph Matthias, Andrew Blaikie

{"title":"Evaluation of Arclight Frugal Smartphone Video Otoscopy.","authors":"Christoph R Buhr, Katharina Bahr-Hamm, Christopher Seifen, Johannes Pordzik, Jonas Eckrich, Thomas Murray, Christoph Matthias, Andrew Blaikie","doi":"10.1002/lary.32106","DOIUrl":"https://doi.org/10.1002/lary.32106","url":null,"abstract":"Background: Frugal innovations are essential in low-resource settings to provide cost-effective medical solutions without compromising functionality. The Arclight is a robust, solar-powered device that functions as both an ophthalmoscope and an otoscope, priced at approximately 12€ in low- and middle-income countries (LMICs).Objectives: This study evaluates the Arclight's potential as a video otoscope when attached to smartphones, aiming to enhance telemedicine capabilities in ear examinations.Methods: Twenty otorhinolaryngology (ORL) specialists rated the standalone Arclight as well as its attachment to an iPhone 12 and a Samsung Galaxy A14 for ear examinations at the University Medical Centre in Mainz, Germany.Results: The standalone Arclight received the highest ratings overall, followed by the Arclight attached to a Samsung Galaxy A14. Attached to the Samsung Galaxy A14, the Arclight demonstrated significantly higher performance regarding ease of focus (p < 0.01), quality of view (p < 0.05), and zoom capabilities (p < 0.05) compared to the iPhone12 attachment. The iPhone12 setup performed lowest in all categories.Conclusion: The Arclight is an effective, low-cost tool for ear examinations in low-resource settings. While smartphone integration enhances its potential for telemedicine, performance varies depending on the smartphone used. The Samsung Galaxy A14 proved to be a more reliable option for tele-otoscopy than the iPhone 12. Further optimization is needed to improve smartphone integration and address identified limitations, enhancing the Arclight's utility in telemedicine applications.Level of evidence: NA.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568286","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

Mechanism of Eustachian Tube Balloon Dilation in Minipigs.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-04 DOI: 10.1002/lary.32101

Jianping Jia, Hui Song, Mengyuan Guo, Nan Jiang, Kun Hou, Yanjun Guo, Wenjie Zhao, Shuolong Yuan, Min Zu, Zhenhao Fu, Jingcheng Zhou, Haoze Zhang, Yulin Ding, Xiaolong Li, Zhaohui Hou

{"title":"Mechanism of Eustachian Tube Balloon Dilation in Minipigs.","authors":"Jianping Jia, Hui Song, Mengyuan Guo, Nan Jiang, Kun Hou, Yanjun Guo, Wenjie Zhao, Shuolong Yuan, Min Zu, Zhenhao Fu, Jingcheng Zhou, Haoze Zhang, Yulin Ding, Xiaolong Li, Zhaohui Hou","doi":"10.1002/lary.32101","DOIUrl":"https://doi.org/10.1002/lary.32101","url":null,"abstract":"Objective: In this study, in situ balloon dilation of the Eustachian tube (BDET) was performed using minipigs as an animal model to observe the dynamic process of damage and repair of the Eustachian tube mucosa and surrounding tissues.Methods: The Eustachian tubes of 30 minipigs were divided into seven groups. The five groups included an immediate postoperative group, a 1-week group, a 2-week group, a 3-week group, and a 4-week group following 3 mm balloon dilation. The other two groups were selected as the immediate postoperative group following 7 mm balloon dilation and the normal control group.Results: The damage caused by the 7 mm-diameter balloon involved almost the whole circumference and length of the Eustachian tube, and the depth of the damage included epithelial injury and subcutaneous tissue compression injury, whereas the damage caused by the 3 mm-diameter balloon was relatively limited, with the whole-circumference injury limited near the tympanic orifice. The most noticeable process of postoperative repair was proliferation, with goblet cells recovering faster than other cells, followed by stratified squamous epithelium; pseudostratified columnar epithelium recovered the slowest, but the ciliated structure was restored.Conclusion: Eustachian tube injury was caused by mechanical force against the Eustachian tube wall and included limited stripping of the mucosa, compression and fragmentation of submucosal tissues, and localized linear tearing of the tube wall. The process of pathological repair was initiated immediately after dilation, and the damaged Eustachian tube regained its normal structure and function in about 4 weeks.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544286","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

Margin Status and Recurrence in Surgically Treated Patients With HPV+ Oropharyngeal Cancer. HPV+口咽癌手术治疗患者的边缘状态和复发情况

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-03-04 DOI: 10.1002/lary.32091

Madeleine Ausburn, Justin M Pyne, Andrew T Day, Natalia Hajnas, Dominic Moon, Larry Leonard Myers, David Jonathan Sher, John M Truelson, Brittny Tillman, Baran Sumer

{"title":"Margin Status and Recurrence in Surgically Treated Patients With HPV+ Oropharyngeal Cancer.","authors":"Madeleine Ausburn, Justin M Pyne, Andrew T Day, Natalia Hajnas, Dominic Moon, Larry Leonard Myers, David Jonathan Sher, John M Truelson, Brittny Tillman, Baran Sumer","doi":"10.1002/lary.32091","DOIUrl":"10.1002/lary.32091","url":null,"abstract":"Background: The optimal margins for surgically treated human papilloma virus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) remain undefined. We evaluated the impact of surgical margins on progression-free survival (PFS) in patients with HPV+ OPSCC treated with primary transoral robotic surgery (TORS).Methods: Patients undergoing primary TORS from May 2012 to December 2021 for intermediate-risk (T1-T2, resected to clear (≥ 3 mm) or close margins (< 3 mm), and N1-N2) HPV+ OPSCC were included. Survival outcomes were reviewed, and overall and PFS at 3 years posttreatment were determined using Kaplan-Meier analysis.Results: A total of 69 subjects met inclusion criteria. At a median follow-up of 47 months, overall survival (OS) was 100%, and the PFS was 88.9% for the entire subject group. Among subjects not receiving adjunctive radiotherapy (RT), those with close margins had an OS of 100% and a PFS of 100% (median follow-up 47 months). Subjects with clear margins had an OS probability of 100% and a PFS probability of 100% (median follow-up 47 months).Conclusion: In subjects undergoing TORS for HPV+ OPSCC, clear margins did not confer a significant OS or PFS survival advantage compared to those with close margins, even when adjuvant therapy was omitted.Level of evidence: 3: ","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544284","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