Laryngoscope最新文献_第7页

Ultrasound Predicts Drug-Induced Sleep Endoscopy Findings Using Machine Learning Models.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-29 DOI: 10.1002/lary.31950

Samuel E Jones, Natalie Aw, Molly Acord, Sarah Miller, Danielle Sidelnikov, Sunny J Haft, Stephen M Restaino

{"title":"Ultrasound Predicts Drug-Induced Sleep Endoscopy Findings Using Machine Learning Models.","authors":"Samuel E Jones, Natalie Aw, Molly Acord, Sarah Miller, Danielle Sidelnikov, Sunny J Haft, Stephen M Restaino","doi":"10.1002/lary.31950","DOIUrl":"https://doi.org/10.1002/lary.31950","url":null,"abstract":"Objectives: Ultrasound is a promising low-risk imaging modality that can provide objective airway measurements that may circumvent limitations of drug-induced sleep endoscopy (DISE). This study was devised to identify ultrasound-derived anatomical measurements that could accurately predict collapse pattern and location based on the VOTE criteria (VOTE: Velum, Oropharynx, Tongue, and Epiglottis).Methods: Ultrasonography was performed on 20 adult patients of various airway subsites while awake and sedated with concurrent endoscopy performed during drug-induced sleep. Measurements were obtained from the ultrasonographic images, and percent collapse (Pc) was estimated then graded using a standard VOTE score. Generalized Least Squares regression (GLS) was used to establish models predictive of Pc on a continuous scale, while multiple machine learning (ML) models were trained to predict each VOTE score (binary, >50% collapse) from ultrasound measurements.Results: Measurements of multiple ultrasonographic airway subsites demonstrated associations with endoscopic collapse using Kendall Tau correlation. The GLS models showed moderate to strong correlation between multiple ultrasound features and Pc (R2 adj 0.53-0.82) across all VOTE subsites. ML models accurately predicted binarized VOTE scores from ultrasound measurements in four out of five VOTE subsites (F1 score >0.65), while the VOTE subsite with the most accurately predicted collapse was lateral velum collapse with an F1 score of 0.93 averaged across all models.Conclusions: Ultrasound is a reliable imaging modality and can identify features of airway collapse during drug-induced sleep. Regression (GLS) and ML models show promise in predicting severity of collapse during DISE with analysis of airway ultrasonographic measurements.Level of evidence: 3 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060955","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 Bilateral Temporal Artery Biopsy More Effective than Unilateral to Diagnose Giant Cell Arteritis?

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-29 DOI: 10.1002/lary.32020

Madhavi Murali, David B Hom

引用次数: 0

Combined Deep Plane Facelift/Necklift and Inspire Hypoglossal Nerve Stimulator Surgery.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-29 DOI: 10.1002/lary.32010

Sonam Dodhia, Cullen Taylor, José E Barrera

引用次数: 0

Laryngopharyngeal Reflux and Upper Airway Obstruction Patterns in Nonobese Sleep Apnea Patients.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-29 DOI: 10.1002/lary.32030

Fatih Gul, Aslihan Ensari, Mehmet Ali Babademez

{"title":"Laryngopharyngeal Reflux and Upper Airway Obstruction Patterns in Nonobese Sleep Apnea Patients.","authors":"Fatih Gul, Aslihan Ensari, Mehmet Ali Babademez","doi":"10.1002/lary.32030","DOIUrl":"https://doi.org/10.1002/lary.32030","url":null,"abstract":"Objectives: The study aims to investigate the relationship between the presence of laryngopharyngeal reflux (LPR) and obstruction levels identified during drug-induced sleep endoscopy (DISE) in obstructive sleep apnea (OSA) among nonobese patients.Methods: We conducted a prospective study of 105 adult patients diagnosed with OSA who underwent DISE using propofol sedation from 2019 to 2024 at a tertiary hospital. To control for the confounding impact of obesity on LPR, the study selectively enrolled individuals presenting a body mass index within the normal range. LPR was assessed using Reflux Symptom Index and Reflux Finding Score. DISE was performed to evaluate upper airway obstruction at various levels, documented using the VOTE classification system by three blinded reviewers. Hypertrophy of the lingual and palatine tonsils was graded using a four-point scale.Results: Approximately 48.57% of 105 patients showed the presence of LPR. The chi-square test demonstrated a statistically significant association between LPR and the level of airway obstruction, particularly at the tongue base (p = 0.039). Lingual tonsil hypertrophy Grade 3 at the tongue base and palatine tonsil hypertrophy Grade 3 at the oropharynx both showed significant overrepresentation, with adjusted residual values of 4.0 and 4.8, respectively. Complete tongue base obstruction showed a statistically significant association with LPR, with a strong predictive value in both univariate (β = 2.325, OR = 10.227, p = 0.007) and multivariate analyses (β = 2.295, OR = 9.921, p = 0.008).Conclusions: The presence of LPR in nonobese OSA patients appears to be significantly associated with an increased likelihood of tongue base obstruction.Level of evidence: 3 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060773","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

Lingual Artery Identification for Ligation in Neck Dissection and Transoral Surgery for Oropharyngeal Tumors.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-29 DOI: 10.1002/lary.32025

Clemente Chia, Samuel Sharp, Henry Zhang, Matthew J R Magarey

{"title":"Lingual Artery Identification for Ligation in Neck Dissection and Transoral Surgery for Oropharyngeal Tumors.","authors":"Clemente Chia, Samuel Sharp, Henry Zhang, Matthew J R Magarey","doi":"10.1002/lary.32025","DOIUrl":"https://doi.org/10.1002/lary.32025","url":null,"abstract":"Objectives: Transoral robotic surgery (TORS) and transoral laser microsurgery (TOLM) plus neck dissection are viable alternatives to radiotherapy as a treatment modality in select cases of oropharyngeal squamous cell carcinoma. Many centers advocate for elective ligation of the feeding arteries at index neck dissection prior to TORS/TOLM to mitigate the risk of catastrophic perioperative hemorrhage. Although there are multiple cadaveric studies in the literature to identify the lingual artery at multiple points throughout its course, there are no studies on the intraoperative identification of the lingual artery for elective ligation prior to TORS/TOLM.Methods: A retrospective review of all patients undergoing neck dissection with vessel ligation prior to TORS. Lingual artery was identified at its origin, and relation to hypoglossal nerve was recorded. Patient demographics, intraoperative findings including the relation between lingual artery and hypoglossal nerve measured in millimeters, and postoperative complications were extracted from medical records.Results: Of the 33 cases eligible for this study, the lingual artery was identified directly deep to the hypoglossal nerve in 21 cases (63.6%). Of the remaining cases, seven were within 5 mm inferior to the hypoglossal nerve (21.2%), and only two cases (6.1%) were identified superior to the hypoglossal nerve.Conclusion: The hypoglossal nerve is a useful landmark for the intraoperative identification of the lingual nerve in elective neck dissection prior to TORS. The lingual artery can be identified either immediately deep to or within 5 mm inferior to the hypoglossal nerve in majority of cases.Level of evidence: 4 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143060932","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

Histological Type-Specific Behavior in Sarcomas: Analysis of Head and Neck Cancer Registry of Japan.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-27 DOI: 10.1002/lary.32027

Kenya Kobayashi, Seiichi Yoshimoto, Koji Yamamura, Megumi Kitayama, Daisuke Kawakita, Ken-Ichi Nibu, Kenji Kondo, Yuki Saito

{"title":"Histological Type-Specific Behavior in Sarcomas: Analysis of Head and Neck Cancer Registry of Japan.","authors":"Kenya Kobayashi, Seiichi Yoshimoto, Koji Yamamura, Megumi Kitayama, Daisuke Kawakita, Ken-Ichi Nibu, Kenji Kondo, Yuki Saito","doi":"10.1002/lary.32027","DOIUrl":"https://doi.org/10.1002/lary.32027","url":null,"abstract":"Objective: The goal of this study was to better understand the epidemiology, clinical characteristics, and treatment outcomes of head and neck sarcomas using real-world data from Japan.Methods: Using the Japanese Head and Neck Cancer Registry, we identified 438 patients who were pathologically diagnosed with head and neck sarcoma between 2011 and 2020. We compared epidemiological, clinical, and prognostic data for the different histological types of sarcoma.Results: The top five most common histopathological types were rhabdomyosarcoma, osteosarcoma, chondrosarcoma, leiomyosarcoma, and liposarcoma. The most common primary sites were the nasal cavity and paranasal sinuses. The overall cohort had clinical, pathologic, and occult lymph node positivity rate (OLR) of 18%, 15%, and 2%, respectively. Clinical lymph node positivity was highest in rhabdomyosarcoma (46%), followed by angiosarcoma (26%), with leiomyosarcoma, chondrosarcoma, and liposarcoma accounting for less than 10%. The 3-year overall survival rate was 74.8% among the 147 patients with available prognostic information. The histological type with the lowest 3-year overall survival was undifferentiated pleomorphic sarcoma (54%), followed by leiomyosarcoma (65%), and angiosarcoma (69%). In six of seven histological types, the 3-year locoregional-free survival rate was less than 70%.Conclusion: Sarcomas of the head and neck most commonly occur in the nasal cavity and paranasal sinuses. The prevalent histological type depended on the primary site. Rhabdomyosarcoma and angiosarcoma are histological types with a high risk of cervical metastasis. In the head and neck region, there are numerous histological types many of which lack local control.Level of evidence: Level 3 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048650","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

Early Division of the Paramedian Forehead Flap: A Systematic Review and Retrospective Analysis.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-27 DOI: 10.1002/lary.32009

Connie C Ma, Clara Si, Feyisayo Adegboye, Jaclyn Lee, Ina Lee, Scott J Stephan, Priyesh N Patel, Shiayin F Yang

{"title":"Early Division of the Paramedian Forehead Flap: A Systematic Review and Retrospective Analysis.","authors":"Connie C Ma, Clara Si, Feyisayo Adegboye, Jaclyn Lee, Ina Lee, Scott J Stephan, Priyesh N Patel, Shiayin F Yang","doi":"10.1002/lary.32009","DOIUrl":"https://doi.org/10.1002/lary.32009","url":null,"abstract":"Objective: To determine whether and when early division of the paramedian forehead flap may be safely performed.Data sources: PubMed (NLM), Scopus (Elsevier), and Embase (Elsevier).Methods: A systematic search of PubMed, Scopus, and Embase was conducted according to PRISMA guidelines. Data extraction included time to pedicle division, patient and defect characteristics, and postoperative complications. Additionally, a retrospective analysis of patients at our institution was performed to augment the cohort.Results: A total of 103 patients (85 from 6 studies identified via systematic review and 18 via retrospective review) underwent early flap division defined as 16 days and earlier. The average time to division was 9.89 days (3-16). There were no cases of flap loss, and complications were rare. Several studies excluded full thickness defects. Five studies included patients requiring cartilage grafting, although some limited this to less than 50% of the defect area. All patients in our retrospective cohort had partial thickness defects and none required cartilage grafting. Despite smoking being a major risk factor for vascular disease, 13.7% of patients were current smokers. Several studies utilized imaging tools such as indocyanine green angiography to assess flap perfusion. Notably, in these instances, no cases were delayed due to lack of adequate neovascularization.Conclusion: Early paramedian forehead flap division may be an option in select patients with partial thickness nasal defects. Adjunct imaging may be a cost-effective method of evaluating appropriate timing of division.Level of evidence: NA Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054101","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

Hearing Loss and Discrimination: Evidence of Intersectionality in the All of Us Research Program.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-27 DOI: 10.1002/lary.32023

Michael W Denham, Lauren H Tucker, Justin S Golub

{"title":"Hearing Loss and Discrimination: Evidence of Intersectionality in the All of Us Research Program.","authors":"Michael W Denham, Lauren H Tucker, Justin S Golub","doi":"10.1002/lary.32023","DOIUrl":"https://doi.org/10.1002/lary.32023","url":null,"abstract":"Objectives: Hearing loss (HL) has significant implications on social functioning. Here, we study the relationship between HL, race, and these combined categories as risk factors for discrimination in the large national All of Us cohort.Methods: The National Institutes of Health All of Us dataset was analyzed after including individuals who completed the Everyday Discrimination Survey between November 2021 and January 2022. HL and potential medical confounders were defined per ICD-10 codes or demographics. Multivariable linear regressions analyzing the relationship between HL and discrimination were adjusted for potential confounders, including age, gender, race, ethnicity, other demographic factors, and relevant medical conditions, such as depression and dementia. Additional regressions were conducted to evaluate how combined HL and race categories associated with discrimination risk.Results: Totally 8,722 individuals ≥18 years old had complete data. The mean age was 65 years (SD = 13.0 years), and 41% were women. Individuals with HL, compared with those without, were more likely to report discrimination in six out of nine questions on the Everyday Discrimination Survey (p < 0.05, with effect sizes ranging from -0.05 to -0.16 on a 6-point scale from 0 = \"Almost everyday\" to 5 = \"Never\"). Notably, for four out of those six questions, combined Black race and HL was associated with a risk of discrimination independent from the risk conveyed by race and/or HL individually.Conclusions: This study offers evidence of HL as a risk factor for self-reported discrimination. Further, this study provides support for an intersectional understanding between discrimination, race, and HL.Level of evidence: III, Laryngoscope, 2024 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048649","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

Effects of Interaural Latency and Frequency Mismatch on Speech Recognition for Bimodal Cochlear Implant Users.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-27 DOI: 10.1002/lary.32026

Margaret T Dillon, Emily Buss, Margaret E Richter, Kevin D Brown

{"title":"Effects of Interaural Latency and Frequency Mismatch on Speech Recognition for Bimodal Cochlear Implant Users.","authors":"Margaret T Dillon, Emily Buss, Margaret E Richter, Kevin D Brown","doi":"10.1002/lary.32026","DOIUrl":"https://doi.org/10.1002/lary.32026","url":null,"abstract":"Objectives: Bimodal cochlear implant (CI) users vary in speech recognition outcomes. This variability may be influenced partly by the CI and contralateral hearing aid (HA) programming procedures, which can result in mismatches in latency and frequency. We assessed the performance of bimodal listeners when latency mismatches were corrected and analyzed how frequency mismatches influenced outcomes.Methods: Twelve adults with at least 1 year of bimodal use were evaluated in latency mismatched versus matched conditions. Masked sentence recognition was assessed in a 10-talker masker for three spatial configurations: target from the front and the masker either co-located, 90° toward the CI-ear, or 90° toward the HA-ear. Frequency mismatch for the most apical electrode (E1) was determined from postoperative imaging and the filter frequency assignment of their familiar CI map.Results: Participants had significantly better performance when latency mismatches were small or matched between the devices, with an approximately 10% improvement in the configuration with the masker toward the HA-ear. Significantly, poorer performance was observed with larger magnitudes of frequency mismatch, with a 2% drop in performance for every one semitone deviation increase in mismatch. The interaction between latency and frequency mismatch was nonsignificant, suggesting that the benefit of latency matching was approximately additive across the range of frequency mismatches.Conclusions: Detrimental effects of interaural mismatches in latency and frequency were observed, even after long-term device use. These preliminary results suggest that bimodal CI users might benefit from individualized fitting procedures that match latency across devices and minimize frequency mismatch for the CI.Level of evidence: 3 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054116","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

Early Prognostic Markers for Idiopathic Facial Palsy.

IF 2.2 3区医学

Laryngoscope Pub Date : 2025-01-27 DOI: 10.1002/lary.32022

Miguel Vaca, Belén Alonso, Rubén Polo, María Del Mar Medina, Adela Cordero, Cecilia Pérez, Gonzalo de Los Santos

{"title":"Early Prognostic Markers for Idiopathic Facial Palsy.","authors":"Miguel Vaca, Belén Alonso, Rubén Polo, María Del Mar Medina, Adela Cordero, Cecilia Pérez, Gonzalo de Los Santos","doi":"10.1002/lary.32022","DOIUrl":"https://doi.org/10.1002/lary.32022","url":null,"abstract":"Objectives: To analyze the prognostic value of markers available at the onset of idiopathic facial palsy. To define the evolution of the episode by tracing changes in facial function over time.Methods: This is an observational prospective study on patients with facial palsy consulting in the first 24 hs. The evolution was recorded with photographs and monthly visits. Multivariate analysis was conducted between clinical and analytical parameters determined in the first visit and prognostic outcomes: progression, resolution, and \"facial palsy evolution index,\" which integrates severity of the palsy and duration.Results: Sixty-five patients were included. The mean initial HB grade was III, but 31% of the cases progressed in the following days. Complete recovery was observed in 89.5% of the cases (mean duration of the episode of 48 days), and exposure keratitis in 21.5%, with a mean of 42 days after the onset. Multivariate analysis showed that retroauricular pain and white blood cell count were significantly related to progression (odds ratio [OR] 19.08; 1.49, p < 0.05), incomplete resolution (OR 1/0.04; 1/0.59, p < 0.05), and higher evolution index (12.8; 2.9, p < 0.05). Age was also significantly associated with evolution index (0.27, p < 0.05), and platelet-to-lymphocyte ratio with progression (OR 1.02, p < 0.05). The rest of the parameters did not show an association with prognosis.Conclusions: Retroauricular pain and white blood cell count are early indicators of prognosis in idiopathic facial palsy. Initial examinations may not reflect the maximum grade of weakness reached by the patient. Ocular complications can occur several weeks after the onset, even with mild grades of paralysis.Level of evidence: 3 Laryngoscope, 2025.","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054113","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