{"title":"Tonsillectomy Versus Tonsillotomy in Pediatric Sleep-Disordered Breathing: A Systematic Review and Multi-subgroup Meta-analysis.","authors":"Jiahong Lao,Feitong Jian,Rongrong Ge,Shuo Wu","doi":"10.1002/lary.31776","DOIUrl":"https://doi.org/10.1002/lary.31776","url":null,"abstract":"OBJECTIVESTo evaluate the potential of tonsillotomy (TT) as an alternative to tonsillectomy (TE) for treating children with obstructive sleep-disordered breathing (oSDB).DATA SOURCESTwo independent reviewers searched PubMed, the Cochrane Library, Embase, and additional sources to identify controlled studies comparing TT versus TE in pediatric patients with oSDB.REVIEW METHODSWe evaluated post-surgery symptom relief, and short- and long-term postoperative benefits for children. Fixed-effect meta-analysis, sensitivity analysis, and subgroup analysis were conducted.RESULTSIn our analysis of 32 studies with 9,430 children, the analysis revealed TT group had a similar therapeutic effect on improvement of OSA-18 as TE group (MD = 5.20, 95% CI: -32.67 to 43.07, p = 0.96). In terms of short-term outcome, the days to return to normal diet for TT group were shorter than that for TE group (MD = -2.49, 95%CI: -3.57 to -1.28; p < 0.001), less analgesics use (MD = -3.19, 95% CI = -3.44 to -2.93, p < 0.001), and lower postoperative secondary bleeding (RR = 0.33; 95%CI: 0.23 to 0.47; p < 0.001). But the risk of reoperation (OR = 8.28; 95%CI: 2.66 to 12.64; p < 0.001), oSDB recurrence (OR = 2.16; 95%CI: 1.20-3.86; p = 0.01), and postoperative infection (OR = 1.82; 95%CI: 1.34 to 2.47; p < 0.001) in TT group was significantly higher than that in TE group.CONCLUSIONSTonsillotomy reduces postoperative pain and bleeding, speeding up recovery for children with oSDB, and improving their quality of life. Yet, the risk of recurrent infections from residual tonsil tissue, which may require reoperation, calls for a careful evaluation of the procedure's short-term gains against its long-term risks.LEVEL OF EVIDENCENA Laryngoscope, 2024.","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"209 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Meryem Demir,Vasileios Kouranos,Kostadin Stoenchev,Stephen R Durham,Guy W Scadding,Nilesh Morar,Chadwan Al Yaghchi,Guri S Sandhu,Hesham Saleh
{"title":"JAK-inhibitor Tofacitinib in Severe Laryngeal Sarcoidosis: A Case Report.","authors":"Meryem Demir,Vasileios Kouranos,Kostadin Stoenchev,Stephen R Durham,Guy W Scadding,Nilesh Morar,Chadwan Al Yaghchi,Guri S Sandhu,Hesham Saleh","doi":"10.1002/lary.31778","DOIUrl":"https://doi.org/10.1002/lary.31778","url":null,"abstract":"Sarcoidosis is an inflammatory, non-caseating granulomatous multisystem disease associated with JAK-STAT (Janus kinases-signal transducer and activator of transcription proteins) pathway activation. We present a patient with severe multi-systemic sarcoidosis who showed marked improvement with tofacitinib with regards to pulmonary, cutaneous, nasal and laryngeal disease. Tofacitinib prevented critical laryngeal stenosis from progressing to tracheostomy, induced regression of cutaneous lesions and improved pulmonary function in this steroid-resistant and immunosuppressive intolerant case. This case report supports further the role of JAK-inhibitors in the treatment of systemic sarcoidosis. Laryngoscope, 2024.","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"High‐Riding Innominate Artery: Booby Trap for ICU Tracheotomy","authors":"Vijay R. Ramakrishnan, Samuel L. Kaefer","doi":"10.1002/lary.31769","DOIUrl":"https://doi.org/10.1002/lary.31769","url":null,"abstract":"<jats:label/>Despite tracheotomy being a routine procedure, it is not rare to encounter anatomic irregularities that can compromise its success. In this report, we describe a case in which a high riding innominate artery was identified within the surgical trajectory moments before incision, which ultimately necessitated airway securement using an alternative laryngological procedure. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"100 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Use of Water Sac Dilation in Resecting Parapharyngeal Space Benign Tumor via Transoral Approach","authors":"Yuke Dong, Junbo Zhang, Yujie Li, Wei Huang, Yanwei Dang, Tao Li, Lianfang Xu, Xiao Shen, Hongyan Li, Lijie Huang, Beiying Li","doi":"10.1002/lary.31772","DOIUrl":"https://doi.org/10.1002/lary.31772","url":null,"abstract":"ObjectivesTo evaluate the effectiveness of employing the water sac dilation (WSD) method during endoscopy‐assisted transoral resection of parapharyngeal space benign tumor (PSBT).MethodsBetween February 2017 and January 2022, a total of 32 patients diagnosed with PSBT were included in this prospective study and were randomly allocated into two groups: the WSD group and the control group. Tumors of the WSD group patients were all dissected using the WSD method.ResultsThe final numbers of studied patients in WSD group and control group were 17 and 15, respectively. The basic information was comparable between these two groups of patients. All these patients successfully underwent tumor resection via transoral approach. The operation time, intraoperative blood loss, drainage volume on the first postoperative day, drainage duration, and the total drainage volume in the WSD group patients were significantly lower than those in the control group patients (all <jats:italic>p</jats:italic> < 0.05). No surgical complications occurred, and no residual tumor or recurrence could be identified at 6 months after surgery in both groups of patients.ConclusionThe application of the WSD method in endoscopy‐assisted transoral resection of PSBT effectively attenuated intraoperative injury, improved surgical efficiency, and accelerated postoperative recovery.Level of Evidence3 <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"65 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mihai A. Bentan, Graham Pingree, Lawrance Lee, Thomas Fitzpatrick, Theodore Schuman
{"title":"Impact of Biologics on Surgery in Chronic Rhinosinusitis with Polyps and Allergic Fungal Sinusitis","authors":"Mihai A. Bentan, Graham Pingree, Lawrance Lee, Thomas Fitzpatrick, Theodore Schuman","doi":"10.1002/lary.31774","DOIUrl":"https://doi.org/10.1002/lary.31774","url":null,"abstract":"ObjectiveTo compare the efficacy of th2‐targeted biologic medications (dupilumab, omalizumab, and mepolizumab) on absolute risk reduction (ARR) of functional endoscopic sinus surgery (FESS) in patients with chronic rhinosinusitis with nasal polyposis (CRSwNP) and allergic fungal rhinosinusitis (AFRS).MethodsThe TriNetX Research Network database was queried for each mAb's market lifespan through March 2024. Adults with CRSwNP were propensity score matched against non‐mAb controls based on age, sex, race, and asthma diagnosis. The primary outcome was rate of FESS, with secondary outcomes including inpatient admission, emergency department (ED) visit, and incidence of acute sinusitis. Subgroup analysis was performed for patients with AFRS.ResultsAll mAbs decreased FESS risk (dupilumab, ARR 11.48%, 95% CI 9.82%–13.15%, <jats:italic>p</jats:italic> < 0.001; omalizumab, ARR 12.02%, 95% CI 4.36%–19.68%, <jats:italic>p</jats:italic> = 0.002; mepolizumab, ARR 10.32%, 95% CI 5.24%–15.40%, <jats:italic>p</jats:italic> < 0.001) in CRSwNP patients. Only dupilumab also reduced risk of inpatient admission (ARR 8.59%, 95% CI 7.04%–10.15%, <jats:italic>p</jats:italic> < 0.001), ED visit (ARR 5.94%, 95% CI 4.28%–7.61%, <jats:italic>p</jats:italic> < 0.001), and acute sinusitis (ARR 2.60%, 95% CI 1.09%–4.12%, <jats:italic>p</jats:italic> = 0.001). In AFRS patients, only dupilumab reduced the risk of all outcomes: FESS (ARR 6.97%, 95 CI 2.86%–11.09%, <jats:italic>p</jats:italic> = 0.001), inpatient admission (ARR 16.93%, 95% CI 11.30%–22.57%, <jats:italic>p</jats:italic> < 0.001), ED visit (ARR 13.15%, 95% CI 7.15%–19.14%, <jats:italic>p</jats:italic> < 0.001), and acute sinusitis (ARR 7.17%, 95% CI 2.18%–12.17%, <jats:italic>p</jats:italic> = 0.005).ConclusionAlthough all mAbs reduced FESS risk in CRSwNP, only dupilumab reduced secondary outcomes as well. Similarly, only dupilumab improved all outcomes in AFRS patients. These data demonstrate the potential of mAbs in reducing disease burden and enhancing patient outcomes in CRSwNP and AFRS.Level of EvidenceNA <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Costantino, Jeffery Scott Magnuson, Uthman Alamoudi, Bruce Haughey
{"title":"Prognostic Significance of Human Papillomavirus Genotypes in Oropharyngeal Squamous Cell Carcinoma","authors":"Andrea Costantino, Jeffery Scott Magnuson, Uthman Alamoudi, Bruce Haughey","doi":"10.1002/lary.31775","DOIUrl":"https://doi.org/10.1002/lary.31775","url":null,"abstract":"ObjectivesThe prognostic significance of human papillomavirus (HPV) genotypes in oropharyngeal squamous cell carcinoma (OPSCC) has garnered considerable attention due to the increasing reliance on HPV status for clinical decision‐making. This study aimed to compare the survival outcomes associated with different HPV genotypes in patients with OPSCC relative to HPV‐negative tumors, providing insights into the potential implications for treatment de‐intensification strategies.MethodsPatients diagnosed with invasive OPSCC were included from the National Cancer Database (NCDB). Patients were stratified based on HPV status and genotype, with HPV‐negative tumors serving as the reference group. Multivariable Cox regression analysis was performed to assess the independent prognostic value of different HPV genotypes.ResultsTh majority of patient were classified as HPV‐positive (<jats:italic>N</jats:italic> = 17,358, 70.0%), with HPV 16 being the most common genotype (<jats:italic>N</jats:italic> = 15410/17358, 88.8%) compared with other high‐risk (<jats:italic>N</jats:italic> = 1217/17,358, 7.0%) and low‐risk (<jats:italic>N</jats:italic> = 731/17,358, 4.2%) HPV genotypes. A significantly lower risk of death was measured for all HPV‐positive compared with HPV‐negative tumors (HPV 16: adjusted HR 0.51; 95% CI: 0.49–0.54; other high‐risk HPV: adjusted HR 0.56; 95% CI: 0.49–0.63; low‐risk HPV: adjusted HR 0.59; 95% CI: 0.50–0.68; <jats:italic>p</jats:italic> < 0.001).ConclusionThis study highlights the significant prognostic value of HPV genotypes in OPSCC, underscoring the superior survival outcomes of HPV‐positive tumors across all genotypes compared with HPV‐negative tumors. Detailed HPV subtype analysis can inform better treatment decisions and support de‐intensification strategies for patients with low‐risk genotypes.Level of Evidence3 <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Priya Arya, Yansy Salmerón, Alexandra E. Quimby, Kevin Wong, Jason A. Brant, Tiffany P. Hwa
{"title":"The Impact of Monoclonal Antibody Usage on Hearing Outcomes: A Systematic Review","authors":"Priya Arya, Yansy Salmerón, Alexandra E. Quimby, Kevin Wong, Jason A. Brant, Tiffany P. Hwa","doi":"10.1002/lary.31763","DOIUrl":"https://doi.org/10.1002/lary.31763","url":null,"abstract":"ObjectiveTo ascertain trends in ototoxicity observed with monoclonal antibodies (mABs) and understand the impact they may have on hearing function.Data SourcesPubMed, Embase, Scopus.Review MethodsA systematic review was performed following PRISMA guidelines. Data were reviewed for demographics, utilized mABs with respective indication and dosing, audiometric outcomes, and treatment for otologic effects.ResultsOf 757 studies reviewed, a total of 44 were included, encompassing 18,046 patients treated with mABs. Mean age of the sample was 57.8 years old. The search yielded 18 agents of ototoxicity, with reported symptoms of ototoxicity such as hearing loss, tinnitus, and/or aural fullness occurring in 1079 of total patients. Main agents causing ototoxicity were teprotumumab (<jats:italic>n</jats:italic> = 17/44 studies), nivolumab (<jats:italic>n</jats:italic> = 10/44), ipilimumab (<jats:italic>n</jats:italic> = 9/44), pembrolizumab (<jats:italic>n</jats:italic> = 5/44), and rituximab (<jats:italic>n</jats:italic> = 4/44). Thirty‐one of 44 studies encompassing eight agents reported audiometric data for ototoxic agents, showing sensorineural hearing loss primarily in the high‐frequency range. Only two articles performed ultrahigh‐frequency audiograms.ConclusionMonoclonal antibody usage is expanding, but the vast majority of studies lack substantial audiometric data. Where reported, study design and inclusion criteria vary greatly. Future studies would benefit from rigid inclusion of audiometric data, prospective study design, and consideration of formal ototoxicity screening. Otolaryngologists should be aware of the cochlear immune response and potential impact of this expanding medication class on hearing function. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142268896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gulce Kirazli, Fidan Balayeva, Melis Kacan Yilmaz, Isa Kaya, Tayfun Kirazli, Figen Gokcay, Nese Celebisoy
{"title":"vHIT and fHIT in Patients With Migraine, Vestibular Migraine, and Persistent Postural‐Perceptual Dizziness","authors":"Gulce Kirazli, Fidan Balayeva, Melis Kacan Yilmaz, Isa Kaya, Tayfun Kirazli, Figen Gokcay, Nese Celebisoy","doi":"10.1002/lary.31758","DOIUrl":"https://doi.org/10.1002/lary.31758","url":null,"abstract":"ObjectiveImpairment in the integration of different vestibular stimuli is the proposed mechanisms in vestibular migraine (VM). In this study, it was aimed to assess the vestibulo‐ocular reflex (VOR) and dynamic visual acuity (DVA) in patients with VM and to compare the results with migraine without vestibular symptoms (MwoV), and persistent postural‐perceptual dizziness (PPPD) to find out if there are discriminative differences and search for a correlation with the levels of anxiety.MethodsTwenty‐two patients with MwoV, 23 patients with VM, 22 patients with PPPD, and 23 healthy controls (HC) were studied. Video head impulse test (vHIT) and functional head impulse test (fHIT) without and with an optokinetic background (OB) were performed. Percentage of correctly identified optotypes (CA%) was considered for the fHIT test. Beck anxiety inventory (BAI) was used to assess anxiety.ResultsLateral canal vHIT gain of the patient groups were not different from the healthy controls (<jats:italic>p</jats:italic> > 0.05). fHIT and fHIT/OB CA% results of all patient groups were lower than the HC (<jats:italic>p</jats:italic> < 0.005), and VM patients had the lowest scores for both tests. BAI scores of the PPPD patients were the highest and a correlation between anxiety levels, and fHIT results could not be identified (<jats:italic>p</jats:italic> > 0.05).ConclusionProminent CA% drop by the use of an OB was the main finding in patients with VM. This discriminative feature was not correlated with anxiety scores. Difficulty in resolving the conflict between visual and vestibular inputs seem to be the underlying mechanism.Level of Evidence3 <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Serena Pu, Spencer Johnson, Lily Martin, Benjamin Laitman, Mark Courey
{"title":"Cellular and Molecular Effects of Steroid Sex Hormones on the Vocal Folds: A Scoping Review","authors":"Serena Pu, Spencer Johnson, Lily Martin, Benjamin Laitman, Mark Courey","doi":"10.1002/lary.31771","DOIUrl":"https://doi.org/10.1002/lary.31771","url":null,"abstract":"ObjectiveSteroid sex hormones (SSH) target cell nuclei to affect transcription. Although laryngeal tissue is theorized to be hormonally responsive, SSH receptor presence and cellular effects on the vocal folds are not well‐established. A scoping review of this literature might inform future research.Data SourcesMedline, Embase, Scopus, and Web of Science were searched.Review MethodsThis review followed JBI and PRISMA‐ScR Guidelines. Two independent reviewers screened each title/abstract and full text according to eligibility criteria. Exclusion criteria included primary outcomes based on subjective interpretation and secondary effects on the vocal folds (e.g., voice).ResultsThree hundred and sixty one articles were screened at the title/abstract level, 83 at the full‐text level, and 32 met inclusion criteria. Fourteen studies were performed in humans and 15 in animals; 3 were review articles. In studies directly examining receptors (<jats:italic>n</jats:italic> = 17), estrogen receptors (ER) were found in 10 of 15 studies, progesterone receptors (PR) in 6/10, and androgen receptors (AR) in 6/9. When the effects of SSH on vocal folds were studied (<jats:italic>n</jats:italic> = 16), estrogen had effects in 10/13, progesterone in 3/3, and androgens in 4/5. ER and PR were mostly identified in epithelium and fibroblasts of lamina propria (LP) while AR was found in muscle, lamina propria, and epithelium.ConclusionsExisting evidence variably supports the presence of SSH receptors in vocal fold tissue; therefore, further clarification is needed. Estrogen and progesterone were most identified in mucosal tissue, where they decrease fibrosis and help maintain the epithelial barrier. Androgens appear to be pro‐fibrotic in epithelium and hypertrophic in muscle. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Washing Illness Away: A Systematic Review of the Impact of Nasal Irrigation and Spray on COVID‐19","authors":"Karan Gandhi, Freeman Paczkowski, Leigh Sowerby","doi":"10.1002/lary.31761","DOIUrl":"https://doi.org/10.1002/lary.31761","url":null,"abstract":"ObjectiveNasal irrigation is a common treatment for sinonasal disorders; however, it is unknown if it can reduce SARS‐CoV‐2 nasopharyngeal viral load (NVL). This systematic review investigated the efficacy of nasal irrigation with saline, povidone iodine (PVP‐I), and intranasal corticosteroids (INCS) at reducing SARS‐CoV‐2 NVL and transmissibility.Data SourcesDatabases including Embase, MEDLINE, Web of Science, and ClinicalTrials.gov.Review MethodsA systematic review was completed with pre‐defined search criteria using keywords related to nasal irrigation and COVID‐19 from 1946 through January 2024. This review followed PRISMA reporting guidelines and was registered on PROSPERO. Only in‐vivo studies testing nasal irrigation with either saline, PVP‐I, or INCS for reducing NVL were included.ResultsNine out of ten studies on saline‐based solutions reported positive effects in reducing NVL, with benefits noted in earlier time to negative nasopharyngeal PCR and a greater decline in NVL during early study time points, compared with controls. Isotonic and hypertonic saline mediums were found to be effective with three studies demonstrating enhanced efficacy with additives. Four out of seven studies on PVP‐I showed a positive effect on reducing NVL, but results were heterogenous. Four studies demonstrated reduction of transmission with saline or PVP‐I. No studies were found on INCS.ConclusionSaline nasal irrigation showed the best efficacy in reducing SARS‐CoV‐2 NVL. Additives to saline may have a clinical benefit, but further studies are needed to elucidate their isolated impacts on NVL. Data on PVP‐I is inconclusive and further studies are warranted to determine the ideal concentration for irrigation. <jats:italic>Laryngoscope</jats:italic>, 2024","PeriodicalId":501696,"journal":{"name":"The Laryngoscope","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142253016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}