Annals of Otology Rhinology and Laryngology最新文献

{"title":"Development and Validation of a Hybrid Simulation Model for Septoplasty Training.","authors":"Jenny Kim, Terral Patel, Vanessa Helou, Noel Jabbour","doi":"10.1177/00034894251339556","DOIUrl":"https://doi.org/10.1177/00034894251339556","url":null,"abstract":"<p><strong>Objectives: </strong>To develop, describe, and validate a novel hybrid training model for endoscopic septoplasty that combines pig ears with a 3D-printed model.</p><p><strong>Methods: </strong>The pig ear was chosen for its similarity to the human septum and wide availability. A frame for the nasal septum substitute was designed to mimic the appearance of a human nose, securely anchor the septum, and create a bend to simulate a deviated septum. The external nose was 3D-printed using polylactic acid (PLA) filament. The model underwent validation with a group of 13 junior and 7 senior trainees who performed endoscopic septoplasties on the simulator and completed a subjective assessment tool; recordings of their procedures were also analyzed and graded in a blind manner.</p><p><strong>Results: </strong>Overall, residents agreed that the simulator is a good training tool for knowledge of the steps of a septoplasty (mean = 4.67 ± 0.59), as well as for the skills required of the procedure (mean rating = 4.61 ± 0.50). Residents also agreed that the simulator had adequately realistic characteristics and features (mean = 4.13 ± 0.81). Junior residents more strongly agreed than the senior residents that the simulator improved their knowledge of performing a septoplasty (4.50 ± 0.90 vs 3.40 ± 0.55, <i>P</i> < .01). Senior residents performed significantly better in all assessed domains and completed the procedure significantly faster than junior residents.</p><p><strong>Conclusion: </strong>This study describes the first endoscopic septoplasty simulator to combine a pig ear with a 3D-printed model. The model provides realistic tactile feedback of the human nasal septum while offering a precise, standardized, and reproducible construction at an affordable cost. Our findings support the validity of this simulator that can provide an opportunity for otolaryngology trainees to improve their septoplasty skills in a safe and effective manner.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251339556"},"PeriodicalIF":1.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Local Corticosteroid on Electrical Impedances after Cochlear Implantation in children: A Prospective Double-Blind Randomized Clinical Trial.","authors":"Kharrat Ines, Hammami Bouthaina, Walha Omar, Ben Ayed Mariam, Zouche Imen, Achour Imen, Chaabouni Mohammed Amine, Charfeddine Ilhem","doi":"10.1177/00034894251339564","DOIUrl":"https://doi.org/10.1177/00034894251339564","url":null,"abstract":"<p><strong>Objectives: </strong>The primary aim of this study is to determine the effects of associating local and systemic corticosteroids on electrical impedance of electrode contacts during the 6 months following cochlear implantation in children. We assessed the effect of this association along the electrode array to evaluate its impact on both basal and apical electrodes.</p><p><strong>Methods: </strong>In 2 different patient groups, the evolution of electrical impedances was investigated during 6 months post-implantation. Children in Group 1 received systemic corticosteroids (1 ml injection of 4 mg/ml Dexamethasone (DXM) intravenously 12 hours before the procedure followed by an injection of 1 ml of 4 mg/ml de DXM during the induction of anesthesia). Group 2 received the same systemic corticosteroids with local corticosteroid (intratympanic injection [ITI] of Methylprednisolone (MP) 40 mg/1 ml given at the start of the procedure). Impedances were assessed perioperatively, on the third post-operative day, at 1 week, 1 month, 2 months, 3 months, and 6 months after implantation. We compared the mean impedance values and the average impedance at the apical and basal electrodes between both groups.</p><p><strong>Results: </strong>Impedances in Group 1 were significantly higher than those in Group 2, both perioperatively (<i>P</i> = .037) and on the third post-operative day (<i>P</i> = .027). Starting from the first week and throughout the 6 months post-implantation, the difference between both groups was not significant. When comparing impedances at the apical and basal electrodes between both groups, the mean impedance at the basal electrodes was significantly higher in Group 1 compared to Group 2 at 1 month (<i>P</i> = .042).</p><p><strong>Conclusion: </strong>The association of intratympanic and intravenous corticosteroids results in significantly reduced impedances during the early postoperative period. The basal electrodes have a more pronounced effect from this association. Based on these findings, this protocol is effective in lowering impedances in the short term but not in the medium term following cochlear implantation.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251339564"},"PeriodicalIF":1.3,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144087001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral Clear Thin Rhinorrhea: How Often Is It a Cerebrospinal Fluid Leak?","authors":"William Mason, Hussein Mackie, Alan Kulawczyk, Jun Jin, John R Craig","doi":"10.1177/00034894251338895","DOIUrl":"https://doi.org/10.1177/00034894251338895","url":null,"abstract":"<p><strong>Objectives: </strong>Determine frequencies of conditions causing unilateral clear thin rhinorrhea (UCTR), and assess whether certain clinical features are associated with CSF rhinorrhea.</p><p><strong>Methods: </strong>This was a retrospective review identifying all patients presenting with UCTR to one rhinologist over a 6-year period. The conditions causing UCTR were recorded, and the following demographic or clinical variables were collected when available: body-mass index (BMI, kg/m2), gender, age, race, and self-reported drainage volume (whether the UCTR dripped out the nose and could be collected, or it felt like a wet nostril with intermittent running down lip that was unlikely to be collectable).</p><p><strong>Results: </strong>Of 3,041 patients, 146 were identified with at least UCTR (4.8%). Mean age was 56.2 ± 17.6 years, and 65.8% were female. Amongst UCTR, nonallergic rhinitis (NAR) was the most common cause (45%), followed by CSF rhinorrhea (30%). On multivariate analysis, the following were significantly positively associated with CSF rhinorrhea: BMI≥30 (OR=4.95), ages 45-54 years (OR=3.67) and 55-64 years (OR=4.15), and self-reported UCTR dripping with collectability (OR=5.96)).</p><p><strong>Conclusions: </strong>NAR was the most common cause of UCTR, representing nearly 50% of cases. However, CSF rhinorrhea still represented 30% of cases, reinforcing that UCTR should be worked up for CSF rhinorrhea, ideally with B2-Tf testing. BMI ≥30, ages 45-64 years, and patient-reported higher volume UCTR were positively associated with CSF rhinorrhea. If B2-Tf testing is negative or unobtainable, or clinical suspicion for CSF leak is low, clinicians can consider starting medical therapy for rhinitis or rhinosinusitis before pursuing further invasive CSF confirmatory testing.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251338895"},"PeriodicalIF":1.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Characteristics of Mesenchymal Tumors Involving the Parotid Gland.","authors":"Hannah Q Baratz, Linda X Yin, Eric J Moore, Jeremy Molligan, Kendall K Tasche, Kathryn Van Abel, Daniel L Price","doi":"10.1177/00034894251336840","DOIUrl":"https://doi.org/10.1177/00034894251336840","url":null,"abstract":"<p><strong>Background: </strong>Malignant mesenchymal tumors involving the parotid gland are uncommon, characteristically aggressive, and little is known with few reports documented.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Setting: </strong>Single institution tertiary care center, 2010 to 2022.</p><p><strong>Method: </strong>Patients were identified from an institutional parotid tumor database. Patient history, demographics, pathologic diagnosis, treatment, and follow up were documented.</p><p><strong>Results: </strong>Eight patients were identified, 3 were males. The average age was 61 years old, and the most common tumors identified were pleomorphic sarcomas (3 patients). Presenting symptoms included: preauricular/cheek mass in 7 patients, facial pain (4), otalgia (4), aural fullness (3), and numbness (1). All patients received a parotidectomy, and 4 patients received adjuvant therapy of either radiation or chemoradiation. Post-operatively, there were 3 cases of distant recurrence, 2 cases of regional recurrence, and 1 case of local recurrence. There were 2 reports of death.</p><p><strong>Conclusion: </strong>Malignant mesenchymal tumors of the parotid are rare, represent varied histologies. Due to their aggressive nature, surgical resection with radiation and close follow-up may be an appropriate treatment regimen in controlling the disease.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251336840"},"PeriodicalIF":1.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Simultaneous Labyrinthectomy and Cochlear Implantation in Patients With Refractory Ménière's Disease.","authors":"Robert J Macielak, Markus E Harrigan, Vivian F Kaul, Meghan M Hiss, Aaron C Moberly, Edward E Dodson, Oliver F Adunka, Yin Ren","doi":"10.1177/00034894251322623","DOIUrl":"https://doi.org/10.1177/00034894251322623","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy and safety of simultaneous labyrinthectomy and cochlear implantation (CI) in patients with refractory Ménière's disease (MD).</p><p><strong>Methods: </strong>A retrospective review of patients with definite refractory MD per American Academy of Otolaryngology-Head and Neck Surgery treated via simultaneous transmastoid labyrinthectomy and CI was performed at a tertiary referral center. Patients' clinical and audiometric outcomes were assessed and analyzed.</p><p><strong>Results: </strong>Twenty-four patients underwent simultaneous transmastoid labyrinthectomy and CI between 7/2015 and 9/2023 (median age = 58 years [interquartile range (IQR) = 43.5-64.5], 54% female). Complete resolution of vertigo occurred in 23 patients (96%). Evaluating available data at ≥6 months postoperatively, both CNC (n = 9; 36% vs 40%, <i>P</i> = .76) and AzBio scores (n = 13; 40% vs 62%, <i>P</i> = .15) improved after surgery. When performing a sound localization task with the CI on, the median score in identifying the noise was 32% (IQR = 22%-56%) with a median degree error of 27.9 (IQR = 15.8-38.0) versus a median score with the CI off of 20% (IQR = 14%-42%) with a median degree error of 43.8 (IQR = 21.9-73.5) at a median of 9.8 months (IQR = 6.7-14.6) from surgery.</p><p><strong>Conclusions: </strong>The present study represents one of the largest cohorts of refractory MD patients undergoing simultaneous labyrinthectomy and CI. Combining these procedures appears safe, enables excellent control of vertigo, and expedites aural rehabilitation in appropriately selected candidates, but future study is warranted to continue to evaluate this treatment paradigm.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251322623"},"PeriodicalIF":1.3,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor on \"Perioperative Outcomes of Branchial Cleft Sinus Tract Excision in Pediatric Patients Without the Use of Intraoperative Dye\".","authors":"Daniel R S Habib, Naadir H Jamal, Kalpnaben Patel, Christopher T Wootten, Ryan H Belcher","doi":"10.1177/00034894251340544","DOIUrl":"https://doi.org/10.1177/00034894251340544","url":null,"abstract":"","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251340544"},"PeriodicalIF":1.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor on \"Perioperative Outcomes of Branchial Cleft Sinus Tract Excision in Pediatric Patients Without the Use of Intraoperative Dye\".","authors":"Kirubhagaran Ravichandran","doi":"10.1177/00034894251338545","DOIUrl":"https://doi.org/10.1177/00034894251338545","url":null,"abstract":"","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251338545"},"PeriodicalIF":1.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sialosis (Sialadenosis): A Sialographic Study with Clinical Correlates.","authors":"Piper A Wenzel, Evgeniya Molotkova, Joan Maley, Kailey Henkle, Benjamin Fick, Ryan Thorpe, Henry Hoffman","doi":"10.1177/00034894251337823","DOIUrl":"https://doi.org/10.1177/00034894251337823","url":null,"abstract":"<p><strong>Objective: </strong>Characterize radiographic findings and co-existing pathologic processes in the parotid glands of patients with swelling or pain identified on radiographic review to be consistent with sialosis (sialadenosis) employing dynamic infusion digital sialography correlated with computed tomography (CT).</p><p><strong>Methods: </strong>Retrospective chart review of a consecutive series of 578 sialograms performed by the senior investigator over a 16-year period identified 39 patients with 1 or both parotid gland sialograms recorded as \"sialosis\" by radiologists' interpretation. After inclusion and exclusion criteria were applied, 20 patients remained for evaluation. A review of sialograms was conducted by a senior radiologist to identify co-existing pathologies (ex: stricture, sialectasis, sialolith) as well as characterize an overall aggregate impression and specific findings of ductal curvature, splaying, and truncation on a numerical scale from 1 (absent finding) to 10 (severely abnormal). Two normal sialograms served as controls. The density of each gland was assessed through CT measurement of Hounsfield units (HU). Variables collected included sex, age, symptoms, BMI, alcohol use, and comorbidities.</p><p><strong>Results: </strong>Twenty patients with a total of 27 glands classified as \"sialosis\" on sialography and 2 patients with normal sialography findings were evaluated. Indications for sialography included pain (90%), fluctuation in swelling of the parotid gland(s) (65%), or xerostomia (35%). Sialographic analysis identified 7 glands (26%) with sialosis to have an additional co-existing pathology (2 with strictures, 5 with sialectasis). Consistent features in glands with sialosis included ductal curvature, splaying, and truncation. CT analysis of glands with sialosis identified a median HU measurement of -36 compared to +30 for glands identified as normal (<i>P</i> = .03).</p><p><strong>Conclusion: </strong>Sialography is useful in selected patients to evaluate for co-existing pathologies contributing to salivary symptoms. Sialography additionally demonstrates consistent findings (ductal curvature, splaying, and truncation) associated with sialosis that correlate with fat infiltration identified on CT imaging.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251337823"},"PeriodicalIF":1.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oncological Efficacy and Postoperative Outcomes of Low Grade Mucoepidermoid Carcinoma Treated With Partial Parotidectomy.","authors":"Hawa M Ali, Katelyn S Rourk, Jamie O Byrne, Kendall K Tasche, Daniel L Price, Kathryn M Van Abel, Linda X Yin, Eric J Moore","doi":"10.1177/00034894251335405","DOIUrl":"https://doi.org/10.1177/00034894251335405","url":null,"abstract":"<p><strong>Objective: </strong>To assess the impact of extent of parotidectomy on surgical and oncologic outcomes in low grade mucoepidermoid carcinoma (LGMEC).</p><p><strong>Methods: </strong>A retrospective chart review of all patients undergoing primary surgical treatment for LGMEC from 2000 to 2022 was conducted. Clinical features collected included demographics, facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence.</p><p><strong>Results: </strong>58 patients were included; 10 patients underwent partial parotidectomy (PP), 38 underwent superficial parotidectomy (SP), and 10 underwent near-total/total parotidectomy. PP and SP patients had smaller tumors and more superficial tumors compared to near-total/total parotidectomy group (<i>P</i> = .03). PP and SP were more likely to have negative margins and less locoregional disease compared to near-total/total parotidectomy patients (<i>P</i> < .01). Near-total/total parotidectomy were more likely to undergo facial nerve resection (20% vs 0% for PP & SP respectively) (<i>P</i> = .05). Immediate postoperative facial nerve function was significantly better among PP patients (73% HB I) compared to SP (44% HB I) and near-total/total parotidectomy patients (0% HB I) (<i>P</i> < .01). Most patients regained their facial nerve function although only 40% of the near-total/total parotidectomy patients had a HB I at the time of last follow up (<i>P</i> < .01). Patients were followed for a median of 6.2 years, during which only 1 patient (total parotidectomy) had a recurrence.</p><p><strong>Conclusions: </strong>PP offers a safe and effective approach for small LGMEC tumors, ensuring better facial nerve function postoperatively with minimal complications compared to more extensive surgery.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251335405"},"PeriodicalIF":1.3,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Salvage Surgery for Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck Following Definitive Surgery and Radiation Therapy.","authors":"Nikhil Bellamkonda, Marcus M Monroe","doi":"10.1177/00034894251335402","DOIUrl":"https://doi.org/10.1177/00034894251335402","url":null,"abstract":"<p><strong>Objective: </strong>To describe outcomes of patients with a history of cutaneous squamous cell carcinoma (cSCC) of the head and neck previously treated with definitive surgery and radiation therapy (RT), who undergo salvage surgery for disease recurrence. There is minimal data available on this cohort of patients.</p><p><strong>Methods: </strong>This was a retrospective case series. Patients evaluated for advanced cSCC of the head and neck between 2003 and 2022 were reviewed. Those with a history of surgery and adjuvant RT undergoing salvage surgery for recurrence were included in the main cohort. Comparisons were made to patients undergoing primary/initial treatment, and to those undergoing salvage surgery for recurrence but without a history of adjuvant RT.</p><p><strong>Results: </strong>Of the 579 patients reviewed, 49 met inclusion criteria for the main cohort. Average length of follow up was 22 months. A total of 19 patients (38.8%) experienced recurrence, all within 14 months of salvage surgery. Among patents staged BWH T2b or T3, there was a 50% recurrence rate. Average overall survival following surgery was 35.6 months (95% CI = 24.7-46.4).</p><p><strong>Conclusion: </strong>Patients in this cohort have a high rate of recurrence and an overall survival of approximately 3 years.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894251335402"},"PeriodicalIF":1.3,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}