European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery最新文献
{"title":"Letter to ''Biochemical and structural response in patients with tall cell papillary thyroid cancer''.","authors":"Ye Liu, Jinlin Liu","doi":"10.1007/s00405-025-09724-y","DOIUrl":"https://doi.org/10.1007/s00405-025-09724-y","url":null,"abstract":"","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208876","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}
Giovanni Salzano, Veronica Scocca, Umberto Committeri, Stefania Troise, Luigi Angelo Vaira, Jerome R Lechien, Vincenzo Abbate, Giovanni Dell'Aversana Orabona
{"title":"Parotid gland sialolithiasis: a comprehensive systematic review and meta-analysis : Title page.","authors":"Giovanni Salzano, Veronica Scocca, Umberto Committeri, Stefania Troise, Luigi Angelo Vaira, Jerome R Lechien, Vincenzo Abbate, Giovanni Dell'Aversana Orabona","doi":"10.1007/s00405-025-09697-y","DOIUrl":"https://doi.org/10.1007/s00405-025-09697-y","url":null,"abstract":"<p><strong>Purpose: </strong>Parotid sialolithiasis represents unique diagnostic and therapeutic challenges due to the anatomy of the gland and the proximity of the facial nerve. The aim of this systematic review and meta-analysis was to evaluate the efficacy and safety of various treatment modalities for parotid gland stones.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA guidelines. Eligible studies were identified by searching PubMed/MEDLINE, the Cochrane Library, Scopus and Google Scholar. Eligible observational studies and clinical trials reporting on patients with parotid stones were included. The outcomes assessed included stone-free rate, symptom improvement and the presence of any complications. A single-arm random-effects meta-analysis was performed, focusing on endoscopy-only, endoscopy-assisted and extracorporeal shock wave lithotripsy (ESWL). Bias risk was assessed using the Newcastle-Ottawa Scale.</p><p><strong>Results: </strong>A total of 42 studies involving 1,559 patients were analyzed. Endoscopy-assisted removal showed the highest stone-free rate (93%, 95%CI: 90-96) and symptom improvement (91%, 95%CI: 92-99) (p < 0.05). Combined endoscopic-external approaches were effective for complex stones but had higher complication rates (24%, 95% CI: 14-37). ESWL had a lower stone-free rate (58%) but aided long-term symptom control (p < 0.05). CT-navigation did not significantly enhance clearance (80%). Most complications were minor; no permanent facial nerve injuries were reported. The quality of the evidence was limited by heterogeneity and the lack of any randomized trials.</p><p><strong>Conclusions: </strong>Endoscopy-assisted and combined approaches offer effective, gland-preserving options for parotid sialolithiasis. ESWL and laser techniques remain adjunctive but warrant further research. Prospective, standardized trials are needed to define any optimal management strategies.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208972","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":"An exclusive endoscopic transcanal treatment of congenital cholesteatoma: A multi-institutional study.","authors":"Secaattin Gulsen, Ali Ozdek, Kadir Serkan Orhan, Ediz Yorgancilar, Ozgur Surmelioglu, Fazil Necdet Ardic","doi":"10.1007/s00405-025-09689-y","DOIUrl":"https://doi.org/10.1007/s00405-025-09689-y","url":null,"abstract":"<p><strong>Purpose: </strong>To present surgical and audiological outcomes of the pure endoscopic transcanal approach in the treatment of congenital cholesteatoma (CC).</p><p><strong>Methods: </strong>The present retrospective multicentre study included 34 patients who underwent exclusive transcanal endoscopic ear surgery (ETEES) for CC treatment by senior surgeons with expertise in endoscopic ear surgery. The extent of the CC was classified according to the Potsic stage. A comprehensive investigation was conducted, encompassing a multitude of parameters, including patients' demographics, CC characteristics, ossicular chain status, ossiculoplasty techniques, operative time, complications, residual or recurrent cholesteatoma, and audiological outcomes.</p><p><strong>Results: </strong>Of the 34 CC patients enrolled in the study, 19 (55.9%) were male and 15 (44.1%) were female; their mean age was 15.2 ± 6.1 years, and their average follow-up period was 36.4 ± 10.2 months. There were 11 cases (32.4%) of Potsic stage I CC, 7 (20.6%) stage II, 10 (29.4%) stage III, and 6 (17.6%) stage IV. The average operating time was 86.2 ± 16.9 min (ranging 40-180 min). Overall, 9 (26.5%) patients underwent a second-look and revision surgery via ETEES approach, due to conductive hearing loss and recurrence, in 4 (11.8%) cases with Potsic stage III and in 2 (5.8%) cases with Potsic stage IV iatrogenic and residual CC were observed. The preoperative air-bone gap (ABG) values demonstrated a notable postoperative improvement, declining from a mean of 31.4 ± 8.1 dB preoperatively to 13.5 ± 3.6 dB (p < 0.001).</p><p><strong>Conclusion: </strong>ETEES, with the advantage of being able to visualize concealed areas of the middle ear with minimal bone work, is a feasible, safe, and effective surgical technique in the treatment of CC, even when CC extends into the mastoid, offering comparable audiological outcomes with lower recurrence ratios relative to conventional surgical techniques present in the current literature.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208906","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":"Epidemiology, prognosis, and treatment of head and neck mucoepidermoid carcinoma: a SEER-based analysis of 6228 patients (2004-2020).","authors":"Liang Peng, Yong Pan, Hui-Fang Wang, Xiao-Lin Zhu, Zhang-Feng Wang, Wen-Bin Lei, Wei-Ping Wen","doi":"10.1007/s00405-025-09646-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09646-9","url":null,"abstract":"<p><strong>Purpose: </strong>To conduct a comprehensive analysis of the epidemiology, prognosis, and treatment of the head and neck mucoepidermoid carcinoma (HNMEC).</p><p><strong>Methods: </strong>Patients diagnosed with HNMEC from 2004 to 2020 were retrieved from the Surveillance, Epidemiology, and End Results database. The demographic, clinicopathological and treatment-related characteristics of the cohort were described. Associations between categorical variables were examined by Pearson's χ<sup>2</sup> test. The overall survival (OS) and disease-specific survival (DSS) were compared among groups using the log-rank test. Multivariate Cox analysis was used to adjust for confounding effects.</p><p><strong>Results: </strong>A total of 6228 patients were included. The 5-year OS and DSS rates were 81.1% and 89.4%, respectively. Major salivary gland MEC accounted for the largest proportion, followed by oral cavity MEC. Oral cavity MEC exhibited the most favorable survival outcome, which may be due to the higher proportion of early-stage and low-grade disease. Patients with a history of cancer before or after diagnosis of HNMEC had worse OS, but not DSS. The patterns of local treatment for HNMEC remained unchanged from 2004 to 2020. Radiotherapy (alone or combined with surgery) was associated with a worse DSS, even after adjustment. Compared to patients diagnosed between 2004 and 2009, patients diagnosed between 2010 and 2015 had statistically significant improvements in both 5-year OS (3.7%) and 5-year DSS (3.4%).</p><p><strong>Conclusion: </strong>A simplified 2-tierd grading system was appropriate for HNMEC, with Grade 1/2 being low-grade, and Grade 3/4 being high-grade. Tumor stage and grade are significant prognostic factors for HNMEC. Early-stage and low-grade HNMEC could be regarded as low-risk malignancy with favorable prognosis, which could usually be effectively treated with surgery alone.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133262","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}
Francesco Chiari, Pierre Guarino, Matteo Fermi, Claudio Donadio Caporale, Livio Presutti, Gabriele Molteni
{"title":"An overview on manifestation and management of glossopharyngeal schwannoma: a systematic review.","authors":"Francesco Chiari, Pierre Guarino, Matteo Fermi, Claudio Donadio Caporale, Livio Presutti, Gabriele Molteni","doi":"10.1007/s00405-025-09682-5","DOIUrl":"https://doi.org/10.1007/s00405-025-09682-5","url":null,"abstract":"<p><strong>Objectives: </strong>Glossopharyngeal schwannoma is a rare benign tumor of myelin-producing Schwann cells. Kaye and Pellet classified lower cranial nerves' (CN) schwannomas into 4 different categories, according to size, location, and tumoral extension. This systematic review aims to provide a comprehensive overview of epidemiology, clinical manifestation, diagnostic features, therapeutic management, and outcomes of patients affected by IX CN schwannoma.</p><p><strong>Methods: </strong>A systematic literature review has been performed following the PRISMA 2020 checklist statement. A computerized search has been carried on by an extensive set of queries on the Embase/PubMed, Scopus, and Web of Sciences databases, relating to papers published from 1975 to 2024.</p><p><strong>Results: </strong>Of the 77 patients affected by glossopharyngeal schwannoma reviewed in 37 studies, 52% were females and 48% were males. The mean age of patients was 41 years. Most of the reported lesions were intra-cranial type A tumors (69%), according to the high prevalence of ear disturbances (77%) and cerebellar signs (23%). The full removal of the tumor was described in 96% of cases with only 4 cases of tumoral recurrences.</p><p><strong>Conclusion: </strong>Current evidence suggests overall favorable oncological outcomes and a low rate of recurrence. Surgery is considered the gold standard treatment for glossopharyngeal schwannomas and it is generally indicated when the tumor causes significant neurological symptoms, mass effect, or progressive growth. Nonetheless, radiosurgery is not commonly used.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133167","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":"C-reactive protein and its ratio with albumin as a marker of poor prognosis in oral cancer: a systematic review and meta-analysis.","authors":"Jiating Xuan, Xiaoqing Ma","doi":"10.1007/s00405-025-09702-4","DOIUrl":"https://doi.org/10.1007/s00405-025-09702-4","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to examine the prognostic ability of C-reactive protein (CRP) and CRP-albumin ratio (CAR) for oral cancer.</p><p><strong>Methods: </strong>Repositories of PubMed, Scopus, Embase, and Web of Science were searched for studies reporting an association between CRP or CAR and overall survival (OS) or disease-free survival (DFS) in oral cancer patients. The search ended on 13th December 2024. Random-effects meta-analysis was conducted.</p><p><strong>Results: </strong>A total of 11 studies (six on CRP and five on CAR) were included. Meta-analysis showed that high CRP levels were associated with worse OS survival (HR: 1.80 95% CI: 1.11, 2.92 I<sup>2</sup> = 80%) and DFS in oral cancer patients (HR: 1.81 95% CI: 1.28, 2.56 I<sup>2</sup> = 0%). The pooled analysis also showed a statistically significant relationship between high CAR and poor OS (HR: 3.15 95% CI: 2.25, 4.42 I<sup>2</sup> = 0%) and DFS (HR: 2.50 95% CI: 1.38, 4.55 I<sup>2</sup> = 19%). Results of OS based on CRP were not robust on sensitivity and subgroup analysis. However, no change in the significance of results was noted for OS based on CAR on sensitivity and subgroup analysis.</p><p><strong>Conclusions: </strong>Both CRP and CAR could be potential biomarkers for predicting survival after oral cancer. Stronger association and better stability of results were seen with CAR. The low number of studies and high interstudy heterogeneity are limitations of current evidence.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133287","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":"Does the cricoid resection increase the risk of complications in the surgical treatment of benign laryngotracheal stenoses?","authors":"Jović Rajko, Samac Tovilović Ksenija, Dragičević Danijela, Tovilović Vanja, Sivčev Ivan, Bogdanović Mladen","doi":"10.1007/s00405-025-09717-x","DOIUrl":"https://doi.org/10.1007/s00405-025-09717-x","url":null,"abstract":"<p><strong>Purpose: </strong>The most of post-intubation stenoses occurs in the cricotracheal segment and require open surgery. Resection of the cricoid arch is a part of the surgical technique that carries certain difficulties. Resection of the cricoid arch, sometimes also the posterior cricoids plate, is part of a surgical technique that carries potential risks of complications, due to the proximity of the recurrent nerve and the need to preserve the airway lumen, in which the cricoids cartilage plays a central role. Purpose of this study is to evaluate whether resection of the cricoid cartilage is associated with a higher incidence of postoperative complications, increased need for additional interventions, prolonged patient recovery, extended hospitalization, and ultimately, a less favorable outcome in the surgical management of cricotracheal stenosis.</p><p><strong>Methods: </strong>Retrospective analysis of 75 elderly patients with circotracheal stenosis divided in two groups: group I with resection of the cricoid arch, group II with submucosal resection of the stenotic connective tissue and preservation of the cricoid arch.</p><p><strong>Results: </strong>There is no difference in the length of the resected segment, 3.54 cm-3.48 cm (p = 0.32). Mobilization of the larynx was performed in 13/23 and 21/52 p = 0.004. Postoperatively, 6/23 and 4/52 had a recurrent nerve lesion, p = 0.02. The most common postoperative complications are granulations at the suture line in 21/75 (28%) patients, 12/23 (52.1%) and 9/52 (17.3%) p = 0.008. One patient died (1.3%). Normal respiratory function, without need for tracheostomy, had 98.6% of patients.</p><p><strong>Conclusion: </strong>Resection of the cricoid arch carries an increased risk of postoperative complications, most often granulation and recurrent nerve lesions, but they don't affect the final outcome of treatment.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133253","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}
Haiyun Wang, Jia Peng, Wenjing Liu, Xi Wang, Jinwen Jiang, Luying Huang, Shunlan Wang
{"title":"Therapeutic association and mechanistic exploration of modified Sijunzi Decoction in radiation-induced sinusitis: an integrated retrospective analysis and network pharmacology study.","authors":"Haiyun Wang, Jia Peng, Wenjing Liu, Xi Wang, Jinwen Jiang, Luying Huang, Shunlan Wang","doi":"10.1007/s00405-025-09688-z","DOIUrl":"https://doi.org/10.1007/s00405-025-09688-z","url":null,"abstract":"<p><strong>Purpose: </strong>Nasopharyngeal carcinoma (NPC) is highly sensitive to radiotherapy, which, however, may trigger complications such as radiation-induced sinusitis (RIS) to impair patients' quality of life. Modified Sijunzi decoction (SJZD), a traditional Chinese medicine (TCM) formulation, has been revealed to exert therapeutic potential in RIS prevention and management. However, at this stage, we know little about its specific composition and molecular mechanism, which was a focus of our current study.</p><p><strong>Methods: </strong>This cross-sectional study was conducted on 86 NPC patients treated at our institution between August 2019 and August 2022. This study further assessed the association between TCM use and RIS incidence by using univariate analysis and multivariate logistic regression. Association rule mining and cluster analysis were employed to identify modified SJZD as the core prescription. Network pharmacology analysis was further applied to elucidate its mechanism of action.</p><p><strong>Results: </strong>Univariate analysis demonstrated that TCM exposure was associated with reduced RIS prevalence (55.81%) (P = 0.002), and binary logistic regression analysis confirmed TCM use as an independent protective factor against RIS development (P = 0.001, OR = 0.156, 95% CI: 0.050-0.487). Furthermore, cluster analysis and association rule mining indicated that modified SJZD emerged as the core therapeutic prescription. Network pharmacology analysis identified 67 potential molecular targets of modified SJZD in RIS treatment. In addition, KEGG pathway enrichment revealed that modified SJZD exerted its therapeutic effects through multi-target mechanisms, particularly involving pathways in cancer, microRNAs in cancer, the JAK-STAT signaling pathway, and the NF-κB signaling pathway.</p><p><strong>Conclusion: </strong>There is a potential inverse association between TCM use and RIS incidence. Modified SJZD is identified as the core therapeutic formula, which appears to exert its protective effects through multiple bioactive components, diverse molecular targets, and multiple pathways.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133342","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}
Maura C Eggink, Maarten J F de Wolf, Fenna A Ebbens, Frederik G Dikkers, Erik van Spronsen
{"title":"What can we learn from precise reporting of residual disease after various types of cholesteatoma surgery using STAM areas?","authors":"Maura C Eggink, Maarten J F de Wolf, Fenna A Ebbens, Frederik G Dikkers, Erik van Spronsen","doi":"10.1007/s00405-025-09579-3","DOIUrl":"https://doi.org/10.1007/s00405-025-09579-3","url":null,"abstract":"<p><strong>Purpose: </strong>1. To evaluate current reporting of residual cholesteatoma localisation. 2. To assess prevalent localisations of residual disease following various types of cholesteatoma surgery in our population.</p><p><strong>Methods: </strong>1. Review of the literature on reported localisation of residual disease following cholesteatoma surgery. 2. Retrospective chart review of patients undergoing cholesteatoma surgery in a tertiary referral centre with a minimum follow-up of two years. Localisation of residual cholesteatoma was noted according to the STAM areas and compared to initial cholesteatoma. Overlapping localisations and multiple pearls were specified.</p><p><strong>Results: </strong>Overall residual disease rate of 14.4% in 1084 surgeries was similar to the pooled data from the literature. In our population, residual disease was most prevalent in A (attic), followed by T (tympanic cavity). The risk of residual disease in M (mastoid) was low. Surgery type influenced the overall risk of residual disease per localisation, as well as the proportion of affected areas. Obliteration reduced the risk of residual disease. Of the residual pearls, 12% were found remote of initial cholesteatoma localisation.</p><p><strong>Conclusion: </strong>Surgery type is a determining factor not only in residual disease rate, but also in localisation of residual disease. Both the efficacy and safety of obliteration is underlined. Standardised reporting of residuals utilising STAM areas, including specification of overlapping areas and remote residuals, will facilitate comparative research on surgical factors influencing residual disease, while providing useful insights for otologic surgeons.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133328","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 impact of 4DryField PH on hemostasis and postoperative drain placement in thyroid surgery.","authors":"Yu-Yang Lin, Yen-Chen Wu, Shih-Wei Wang, Hsin-Yi Tseng, Yi-Chu Lin, Jia Joanna Wang, Cheng-Hsun Chuang, Leong-Perng Chan, Tzu-Yen Huang, Che-Wei Wu","doi":"10.1007/s00405-025-09713-1","DOIUrl":"https://doi.org/10.1007/s00405-025-09713-1","url":null,"abstract":"<p><strong>Purpose: </strong>Thyroid surgery carries a risk of postoperative hematoma due to rich vascularity, commonly managed by drain placement, potentially increasing hospital stay. 4DryField PH (4DF), a powdered hemostatic material, has been widely used in surgery to improve hemostasis. This study investigates the impact of using 4DF in thyroid surgery on postoperative drainage placement.</p><p><strong>Methods: </strong>This retrospective study analyzed 208 patients undergoing neuro-monitored and Ligasure-assisted thyroidectomy. Patients were divided into non-hemostatic material and drain (NHM, n = 107), and 4DF groups (n = 101). In the 4DF group, drain placement was determined by intraoperative bloody exudate assessment approximately 30 s after 4DF application, classifying into drain (4DF + D, n = 23) and no-drain (4DF-D, n = 78) groups. Clinical characteristics, drainage volumes, and duration of drain placement were compared between groups.</p><p><strong>Results: </strong>No significant demographic differences existed between NHM and 4DF groups. Drain placement in 22.8% of the 4DF group, significantly associated with extensive surgery, larger tumor volume, and elevated anti-thyroid antibodies. Despite these higher-risk factors, total drainage volumes were similar between the 4DF + D and NHM groups (34.9 mL vs. 38.8 mL, p = 0.364). Almost all patients in the 4DF + D group (95.7%) had drainage > 20mL. Drainage volumes > 100mL occurred in two NHM group patients (1.9%), but not in the 4DF + D group. All drains in 4DF + D were removed by postoperative day 2.</p><p><strong>Conclusion: </strong>Using 4DF during thyroid surgery reduced the need for drain placement by identifying high-risk patients through standardized intraoperative exudate assessment. This approach effectively controlled postoperative drainage and appeared helpful in preventing excessive exudate and enabling tailored drain management.</p>","PeriodicalId":520614,"journal":{"name":"European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145133334","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}