Nicolas J. Casellas, Eytan Keidar, Mursalin M. Anis, D. Rosow
{"title":"Using a customizable L stent for laryngotracheal stenosis: Patterns of success and failure","authors":"Nicolas J. Casellas, Eytan Keidar, Mursalin M. Anis, D. Rosow","doi":"10.1002/wjo2.204","DOIUrl":"https://doi.org/10.1002/wjo2.204","url":null,"abstract":"A recent innovation in the management of tracheostomy‐dependent patients with laryngotracheal stenosis (LTS) has been the customizable laryngotracheal stent, made by dividing a T‐tube in half (“L stent”). These L stents can be placed into the subglottis as well as the posterior glottis to prevent rapid re‐stenosis following surgery, and they are easily removed in the office. We sought to review our experience with these stents and analyze patterns of success and failure.Retrospective chart review was performed of all tracheostomy‐dependent patients who underwent L stent placement from January 2019 through February 2024. Clinical and demographic data were reviewed, with decannulation as the primary endpoint. Patients were assessed as having comorbid conditions (diabetes, coronary artery disease, morbid obesity, prior radiation) or not.A total of 16 patients underwent stent placement. Six patients had posterior glottic stenosis (PGS), six had subglottic stenosis (SGS), and four had multilevel stenosis. Of these 16 patients, 9 were ultimately decannulated (56.2%). Three of the successes were PGS (33.3%), four were SGS (44.4%), and two had both SGS and PGS (22.2%). Patients who were decannulated were statistically less likely to have comorbid conditions than patients who failed decannulation (p = 0.0350).For tracheostomy‐dependent patients who have failed first‐line therapy, endoscopic surgery paired with L stent placement offers a reasonable alternative to open airway reconstruction or more destructive arytenoidectomy or cordotomy procedures. As with most airway surgeries, patient selection is important, as the presence of multilevel stenosis and/or comorbid conditions can predict a higher failure rate.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"42 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141928571","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":"Indocyanine green fluorescence‐guided sentinel lymph node biopsy: A systematic review","authors":"Sanjena Venkatesh, Emma De Ravin, K. Rajasekaran","doi":"10.1002/wjo2.197","DOIUrl":"https://doi.org/10.1002/wjo2.197","url":null,"abstract":"Accurate staging of cervical lymph nodes is crucial in the management of head and neck cancers (HNCs). Sentinel lymph node biopsy (SLNB) offers a minimally invasive alternative to neck dissection for identifying occult metastases. This review aims to assess the feasibility and effectiveness of indocyanine green (ICG) fluorescence‐guided SLNB for HNCs.Systematic searches of the PubMed, Embase, and Scopus databases were conducted to identify all clinical articles on ICG‐guided SLNB in HNC from database inception through May 1, 2022. Numerous variables were extracted across papers, including patient and study characteristics, imaging parameters, and SLN detection rates. Risk of bias was evaluated via the Methodological Index for Non‐Randomized Studies (MINORS) criteria.A final six studies met inclusion criteria, encompassing 86 distinct head and neck tumors. The mean number of SLNs identified was 2.46 for fluorescence imaging and 2.83 for gamma tracing. Fluorescence imaging exhibited a higher pooled SLN detection rate (98.0%) compared to gamma tracing (87.6%). Pooled sensitivity for fluorescence imaging (71.0%) was also determined to be higher than that for gamma tracing (66.7%). Pooled specificity was 100% across both modalities. Studies were assessed to be of moderate quality by the MINORS criteria, with an average score of 11.25 for noncomparative studies and 20.5 for comparative studies.ICG‐guided SLNB procedures are feasible and effective in the context of HNCs. The technique offers potentially higher SLN detection rates and shows promise in enhancing clinical and oncologic outcomes when compared to standard lymphoscintigraphy. Further studies with standardized metrics are, however, needed to validate these findings and identify optimal imaging techniques and parameters.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":" 11","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141828303","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":"Diagnostic value of fasting hypopharyngeal salivary pepsin concentration test for laryngopharyngeal reflux disease","authors":"Chaofeng Liu, Chenjie Hou, Ting Chen, Liuqing Chen, Jingyi Zheng, Yu‐Jin Zheng, Xiaowei Zheng","doi":"10.1002/wjo2.200","DOIUrl":"https://doi.org/10.1002/wjo2.200","url":null,"abstract":"To investigate the diagnostic value of the fasting hypopharyngeal salivary pepsin concentration test for laryngopharyngeal reflux disease (LPRD).Volunteers were grouped by reflux symptom index scale, reflux finding score scale, and 24‐h hypopharyngeal‐esophageal multichannel intraluminal impedance with pH monitoring results. The study comprised 56, 27, and 20 individuals in the LPRD, asymptomatic laryngopharyngeal reflux (LPR), and asymptomatic non‐LPR groups, respectively. All underwent a fasting hypopharyngeal saliva pepsin testing via enzyme‐linked immunosorbent assay. Statistical analysis determined the optimal diagnostic cutoff value, sensitivity, and specificity of hypopharyngeal salivary pepsin for LPRD. Correlation analysis was performed with reflux scale scores and LPR parameters.Fasting hypopharyngeal salivary pepsin concentration in the LPRD group was significantly higher than in the asymptomatic control group (Z = −4.724, p < 0.05). The area under the receiver operating characteristic curve (AUC) analysis identified an optimal cutoff value of 29.62 ng/mL for salivary pepsin concentration (AUC, 0.767; sensitivity, 51.8%; and specificity, 93.6%). There was no statistically significant difference in salivary pepsin concentration between the asymptomatic LPR and non‐LPR groups. The concentration was higher in the LPRD group than in the asymptomatic LPR and non‐LPR groups (p < 0.05). Fasting hypopharyngeal salivary pepsin concentration exhibited a weakly positive correlation with vocal cord edema, intralaryngeal mucus adherence, excess throat mucus or postnasal drip, coughing during meals/lying down, troublesome or annoying cough, and liquid and weakly acidic reflux episodes.The fasting hypopharyngeal salivary pepsin concentration test is a highly specific, simple, and noninvasive method with significant clinical diagnostic value for LPRD.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141829648","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}
J. Douglas, Mandy K. Salmon, Rijul S. Kshirsagar, J. Eide, Caitlin A. White, Julia Kharlip, Christina Jackson, John Y.K. Lee, Daniel Yoshor, Michael A. Kohanski, James N. Palmer, N. Adappa
{"title":"Pituitary apoplexy is associated with concurrent or subsequent diagnosis of human immunodeficiency virus","authors":"J. Douglas, Mandy K. Salmon, Rijul S. Kshirsagar, J. Eide, Caitlin A. White, Julia Kharlip, Christina Jackson, John Y.K. Lee, Daniel Yoshor, Michael A. Kohanski, James N. Palmer, N. Adappa","doi":"10.1002/wjo2.201","DOIUrl":"https://doi.org/10.1002/wjo2.201","url":null,"abstract":"Pituitary apoplexy (PA) is a rare condition caused by hemorrhage or infarction of the pituitary gland with associated risk of cranial neuropathies, endocrinopathies, and even death. Human immunodeficiency virus (HIV) has been shown to have some association with pituitary apoplexy, however, large‐scale studies have not been performed.A retrospective cohort study of subjects greater than 18 years of age was performed using the national TriNetX database. The general population was first compared with those undergoing treatment for PA to compare general demographics and incidence of HIV. The PA cohort was then substratified by HIV status and propensity matched by age and sex to evaluate differences in visual outcomes and endocrine metrics. Using the diagnosis of pituitary apoplexy as an index event, the rate of HIV diagnosis at the time of presentation or in the three months following treatment was calculated. Two‐tailed, unpaired t‐tests were performed.A total 2066 patients were identified (902 HIV, 1158 controls). Those with HIV showed an increased rate of pituitary apoplexy (odds ratio [OR]: 19.8) versus healthy adults and were more likely to be younger and male. Among patients treated for pituitary apoplexy, patients with HIV were more likely to have increased thyroid stimulating hormone, reduced T4, and increased prolactin compared with healthy controls. There were no significant differences in visual outcomes between HIV positive and control patients. Importantly, 74% of patients did not carry a diagnosis of HIV on presentation but were diagnosed at the time of or in the three months following treatment for pituitary apoplexy.Diagnosis and treatment of pituitary apoplexy shows a high rate of concurrent or subsequent diagnosis of HIV. Screening for HIV should be considered in patients undergoing treatment for pituitary apoplexy.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141831755","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":"Development and validity of type II sulcus vocalis in excised canine larynx","authors":"Ting Gong, Peng‐Cheng Yu, Chao Xue, An‐Rong Sun, Yi Zhang, Rui Fang, Bing‐Hua Zhu","doi":"10.1002/wjo2.193","DOIUrl":"https://doi.org/10.1002/wjo2.193","url":null,"abstract":"This study aims to develop a sulcus vocalis model in the excised canine larynx and to investigate the validity of the model.Type II sulcus vocalis was created by continuous intradermal suture in six excised canine larynges. We investigated the validity of the model based on phonatory (aerodynamic and acoustic) measures, laryngeal videostroboscopy (LVS), and histological examination. The aeroacoustic parameters included phonation threshold pressure (PTP), fundamental frequency (Fo), jitter %, shimmer %, and harmonics‐to‐noise ratio (HNR).In all the experimental specimens, there were significant increases in the PTP ([6.61 ± 1.66] cm H2O, p < 0.01), the Fo ([106.48 ± 49.59] Hz, p = 0.003), the jitter ([0.76 ± 0.42]%, p = 0.007), the shimmer ([6.87 ± 2.99%, p = 0.002]), while the HNR decreased ([5.71 ± 4.68] dB, p = 0.031), compared to that of the untreated canine larynges. The estabilished model simulated the histology with type Ⅱ sulcus.Type Ⅱ sulcus vocalis was successfully created in excised canine larynx. The aeroacoustic and LVS analysis of this model resembled the characteristics of patients with sulcus vocalis. The model could be helpful to elucidate the pathology of the phonation, and evaluate and compare the treatments for sulcus vocalis.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141367983","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}
Uzair Chilwan, Smita Caren Mathias, Asif Maitheen, Al Shifa Khan, R. Balasubramanium
{"title":"Assessment and management approaches for dysphagia in tracheostomized patients: Practices of speech‐language pathologists in India","authors":"Uzair Chilwan, Smita Caren Mathias, Asif Maitheen, Al Shifa Khan, R. Balasubramanium","doi":"10.1002/wjo2.184","DOIUrl":"https://doi.org/10.1002/wjo2.184","url":null,"abstract":"Speech language pathologists (SLPs) play a crucial role while dealing with tracheostomized patients, particularly in addressing communication impairments and dysphagia. However, in India, there is a lack of standardized guidelines for SLPs in the treatment of tracheostomy patients, resulting in variations in clinical practices and patient care.An online survey was conducted among 106 experienced SLPs in India. The survey included questions pertaining to various aspects of assessment and treatment in tracheostomized patients. Survey data were analyzed to identify the level of consensus among SLPs in these areas.The survey results revealed varying levels of consensus among SLPs in most of the domains. Most responses fell within the moderate to low consensus range, indicating a lack of standardized practices.The study highlights the lack of standardized guidelines among SLPs in India when it comes to tracheostomy patient care. Hence, the study recommends collaboration among relevant organizations to enhance knowledge sharing and standardize clinical guidelines to improve the overall quality of care for tracheostomy patients in India.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"136 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141115130","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}
Shayan Khalid Ghaloo, Syed Shabbir Afzal, S. A. Abbas, Shayan Ansari, Mriganka De, H. Iftikhar
{"title":"Tracheomalacia in patients undergoing thyroid surgery—What is the true estimate: A systematic review and meta‐analysis","authors":"Shayan Khalid Ghaloo, Syed Shabbir Afzal, S. A. Abbas, Shayan Ansari, Mriganka De, H. Iftikhar","doi":"10.1002/wjo2.182","DOIUrl":"https://doi.org/10.1002/wjo2.182","url":null,"abstract":"Tracheomalacia is defined as the weakening of the tracheal rings secondary to long‐standing compression or inherent structural weakness, leading to stridor and airway compromise. The common etiological factor of tracheomalacia includes compression of the tracheal framework due to a large multinodular goiter. There are various management techniques described in the literature to manage a patient with tracheomalacia including tracheostomy, tracheal stenting, and tracheopexy. However, the evidence of tracheomalacia in the literature is conflicting. Therefore, a systematic review was conducted to estimate the incidence of tracheomalacia after thyroidectomy.The systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. A literature search was performed on PubMed, Web of Science, Cochrane library, and Elton B. Stephens Co. cumulative index to nursing and allied health literature plus to determine the incidence of tracheomalacia among patients undergoing thyroidectomy up till October 2021. The eligibility was assessed by two independent authors. A quality assessment of individual studies was performed using the National Institute of Health quality assessment tool. Outcomes were double data extracted and were analyzed using OpenMeta.The online search retrieved 214 papers, out of which 17 studies were included that fulfilled the eligibility criteria. The number of patients included in the systematic review who underwent thyroidectomy was 1108. The mean age was 55.8 ± 7.7 years, ranging from 48 to 75 years. Tracheomalacia was reported in 146 patients (1.4%). Sternotomy was performed in 102 patients to approach the goiters with retrosternal extension. The most common intervention to manage tracheomalacia was tracheostomy or prolonged intubation.Tracheomalacia is a rare complication. In cases where tracheomalacia is encountered, common methods of management include tracheostomy or prolonged endotracheal intubation. Prospective, long‐term studies are required to accurately assess its true incidence and associated factors.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"55 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140975317","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}
M. A. Fornazieri, B. M. Cunha, S. P. Nicacio, L. K. Anzolin, José L. B. da Silva, Aristides Fernandes Neto, Deusdedit Brandão Neto, R. Voegels, F. Pinna
{"title":"Effect of drug therapies on self‐reported chemosensory outcomes after COVID‐19","authors":"M. A. Fornazieri, B. M. Cunha, S. P. Nicacio, L. K. Anzolin, José L. B. da Silva, Aristides Fernandes Neto, Deusdedit Brandão Neto, R. Voegels, F. Pinna","doi":"10.1002/wjo2.183","DOIUrl":"https://doi.org/10.1002/wjo2.183","url":null,"abstract":"The aim of this study was to assess the relative efficacy of medications used following severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) infection on self‐reported alterations in taste and/or smell function.Seven hundred and fourteen persons with self‐reported postcoronavirus disease 2019 (post‐COVID‐19) chemosensory disorders were personally interviewed regarding specific medications they were administered following the acute phase of the disease. The dependent measure—self‐reported total recovery of chemosensory symptoms—was subjected to stepwise logistic regression. Independent predictors included demographic and clinical variables, in addition to specific medications used to mitigate disease symptoms (i.e., systemic corticosteroids, oseltamivir, vitamin C, ibuprofen, hydroxychloroquine, azithromycin, ivermectin, nitazoxanide, anticoagulants, and zinc).The median time between COVID‐19 symptom onset and the interviews was 81 days (interquartile range: 60–104). Of the 714 subjects, 249 (34.9%) reported total recovery of their chemosensory function; 437 (61.2%) had at least one treatment since the beginning of the disease. Women and those with more comorbidities had undergone more treatments. The recovery rates of the treated and nontreated groups did not differ significantly. Nonetheless, respondents who had used nitazoxanide tended to have a higher rate of self‐reported taste or smell recovery. Those who took oral zinc were less likely to improve.No medication employed during the first months after SARS‐CoV‐2 infection had a clear positive effect on returning self‐reported smell or taste function to normal, although nitrazoxide trended in a positive direction. Oral zinc had a negative effect on the reported recovery of these senses.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"86 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140983058","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}
Jing‐Lin Su, Jing Kang, Qin‐Yi Ren, Zhi‐Xian Zhu, Si‐Yi Zhang, Ping‐Jiang Ge
{"title":"Effect of medical mask on voice in patients with dysphonia","authors":"Jing‐Lin Su, Jing Kang, Qin‐Yi Ren, Zhi‐Xian Zhu, Si‐Yi Zhang, Ping‐Jiang Ge","doi":"10.1002/wjo2.181","DOIUrl":"https://doi.org/10.1002/wjo2.181","url":null,"abstract":"Medical masks have been shown to significantly influence speech communication in healthy people. The effect of mask‐wearing on phonatory capability and daily communication exchanges in patients with voice disorders remains unclear. To evaluate the effect of the medical mask on acoustic parameters in patients with a voice disorder, we measured the voice frequency, quality, and intensity.Thirty‐three healthy and 44 voice disorder patients were involved in this study, including 27 patients with vocal‐fold lesions and 17 with primary functional dysphonia. Perceptual evaluation and acoustic parameters, including F0 (fundamental frequency), jitter, shimmer, and maximum vocal intensity, were analyzed without and with medical masks.With medical mask‐wearing, the maximum vocal intensity significantly decreased in all patients with voice disorders (p < 0.05), especially in patients with lesions of vocal folds (p < 0.05) and functional dysphonia (p < 0.05). The perceptual evaluation roughness scales also increased in patients with lesions of vocal folds (p < 0.05) and functional dysphonia (p < 0.05) with mask‐wearing. There were no significant effects of mask‐wearing on acoustic parameters for healthy participants.The intensity was influenced when wearing medical masks in patients with disordered voices. The voice perceptual roughness scales also significantly increased compared to those without medical masks.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"122 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986376","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":"Value of high‐definition laryngoscopy in the diagnosis of pyriform sinus fistula","authors":"Pei‐Jun Zhang, Xiu‐Fen Tian","doi":"10.1002/wjo2.180","DOIUrl":"https://doi.org/10.1002/wjo2.180","url":null,"abstract":"Efficient methods are available to diagnose pyriform sinus fistula (PSF). This study aimed to assess the value of high‐definition laryngoscopy (HDL) in the diagnosis of PSF.From January 2017 to December 2019, patients with PSF were enrolled into this study. HDL was performed without general anesthesia. Laryngoscopy characteristics were analyzed. An inner orifice in the pyriform fossa indicated the presence of PSF. The diagnostic accuracy of HDL was compared to that of barium swallow.A total of 56 patients (33 males and 23 females, ages 2–57 years) were included. The positive predictive value of HDL was 96.4%, and that of barium swallow was 89.2%. Compared to pronouncing the English letter “e,” anterior cervical skin traction plus Valsalva maneuver could offer a clearer view of the inner orifice in the pyriform fossa (χ2 = 11.187, p < 0.05). Nevertheless, compared to barium swallow, HDL showed no statistically significant difference in diagnosing PSF (χ2 = 2.598, p > 0.05).Both HDL and barium swallow have their advantages and are complementary in diagnosing PSF. Their combination may achieve a higher diagnostic accuracy for PFS.","PeriodicalId":510563,"journal":{"name":"World Journal of Otorhinolaryngology - Head and Neck Surgery","volume":"109 35","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140986903","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}