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":"Effect of metformin on hypoxia-associated gene expression in oral cavity squamous cell carcinoma in non-diabetic patients - a prospective window of opportunity study.","authors":"Simon A Mueller, Olgun Elicin, Bastien Monney, Tilman Rau, Alan Dal Pra, Ludwig Sachs, Irene Centeno Ramos, Erik Vassella, Florian Dammann, Francesca Caparrotti, Andreas Limacher, Lluís Nisa, Matthias S Dettmer, Roland Giger","doi":"10.1007/s00405-025-09493-8","DOIUrl":"https://doi.org/10.1007/s00405-025-09493-8","url":null,"abstract":"<p><strong>Purpose: </strong>Research suggests that metformin may reduce tumor hypoxia, rendering it a potential radiosensitizer. This study investigated metformin's effect on hypoxia-associated gene expression in oral cavity squamous cell carcinoma (OCSCC).</p><p><strong>Methods: </strong>In this prospective trial, non-diabetic patients with OCSCC scheduled for curative surgery received preoperative metformin for 10 to 14 days. Tumor biopsies were taken before and after metformin treatment. Gene expression profiling was performed using RNASeq, emphasizing on hypoxia-associated signaling pathways.</p><p><strong>Results: </strong>Fifteen patients of 25 enrolled patients completed the study protocol and passed quality checks. No significant difference in gene expression was observed after adjustment for multiple testing. No significant changes were found in the hypoxia-associated hypoxia-inducible factor 1- alpha (HIF1A) pathway or in other signaling pathways associated with metformin reported in the literature.</p><p><strong>Conclusion: </strong>This study does not support the hypothesis that metformin improves tumor hypoxia in OCSCC after 10 to 14 days 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":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228376","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 role of matrix metalloproteinase expression levels in the pathogenesis of tympanosclerosis.","authors":"Semih Van, Doğukan Özdemir, Seda Koç Şahin, Şule Öztürk, Dursun Mehmet Mehel, Ayşe Çeçen","doi":"10.1007/s00405-025-09509-3","DOIUrl":"https://doi.org/10.1007/s00405-025-09509-3","url":null,"abstract":"<p><strong>Purpose: </strong>Tympanosclerosis is a disease characterized by the accumulation of hyaline calcareous deposits in the tympanic membrane, tympanic cavity, ossicular chain, ligaments, and rarely, in the mastoid. Matrix metalloproteinases, which are involved in physiological and pathologic processes, are also likely to play a role in tympanosclerosis. In our study, we aimed to investigate the presence of MMP 2 and 9 in patients with chronic otitis media with tympanosclerosis and its possible effect on tympanosclerosis severity and prognosis.</p><p><strong>Methods: </strong>In our study, 45 patients with myringosclerosis or myringosclerosis and intratympanic sclerosis who underwent endoscopic transcanal tympanoplasty due to COM (chronic otitis media) were included in the study group, and 35 patients with only COM, without tympanosclerosis, were included in the control group. Immunohistochemical staining of the mucosa samples of the eardrum and middle ear were compared with MMP-2 and MMP-9 in the study and control groups.</p><p><strong>Results: </strong>The rate of MMP-2 staining (64.3%) was higher than the control group (42.9%), and the rate of MMP-9 staining (16.7%) was lower than the control group (51.4%) (p < 0.05). The rate of MMP-9 staining in the middle ear mucosa samples (31.0%) was statistically lower than the control group (57.1%) (p < 0.05).</p><p><strong>Conclusion: </strong>In our study, high levels of MMP-2 staining in the study group and low levels of MMP-9 staining in the control group help to elucidate the complex relationship between both metalloproteinases. Compared with the inadequacy of animal models of tympanosclerosis to mimic the chronic process, our study reveals the late results of MMP-2 and MMP-9 in patients with tympanosclerosis.</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":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228379","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":"Sleep endoscopy in obstructive sleep apnea: analysis of pharyngeal collapse patterns and correlation with body mass index.","authors":"Dalila Mota Schudt, Marcia Jacomelli, Victor Arthur Ohannesian, Marcelo Gervilla Gregório, Addy Lidvina Mejia Palomino, Altair da Silva Costa","doi":"10.1007/s00405-025-09499-2","DOIUrl":"https://doi.org/10.1007/s00405-025-09499-2","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluated the impact of Body Mass Index (BMI) on upper airway obstruction severity in Obstructive Sleep Apnea (OSA) patients using sleep endoscopy.</p><p><strong>Method: </strong>Retrospective analysis of OSA patients undergoing propofol-sedated sleep endoscopy. Obstruction patterns were classified using the VOTE protocol, analyzing collapse location, type, and severity. Patients were grouped by BMI: normal, overweight, and obese. The influence of age and gender was also analyzed.</p><p><strong>Results: </strong>210 patients (72.9% male, mean age 45.1 ± 11.1 years, mean BMI 27.06 ± 3.91) were analyzed. The velopharynx was the most frequently affected site (74.8%), followed by the tongue base (60%), epiglottis (55%), and oropharynx (40.5%). Anteroposterior collapse predominated at the tongue base (91.4%), while lateral collapse was most common in the oropharynx (68.1%). Obese patients had significantly higher rates of complete obstruction in the velopharynx (p = 0.023), oropharynx (p < 0.001), and multilevel obstruction (p = 0.049). Significant gender differences were observed in VOTE classification, with males exhibiting more circumferential, lateral, and multilevel collapses. Females had more anteroposterior collapse in the velopharynx and epiglottis. Complete obstruction was more prevalent in patients aged ≥ 45 years, particularly at the tongue base (p = 0.007).</p><p><strong>Conclusion: </strong>The velopharynx was the primary obstruction site in OSA patients. BMI, gender, and age significantly influenced airway collapse patterns, with obese patients demonstrating increased multilevel and complete obstruction. These findings support sleep endoscopy for personalized OSA 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":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228378","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 obstructive sleep apnoea surgery improve perceived insomnia severity in patients suffering from co-morbid insomnia and sleep apnoea (COMISA)?","authors":"Mohamed S Rashwan, Aranee Thirukketheesparan, Katherine Haworth, Asma Awad, Aaron Trinidade, Amro Hassaan","doi":"10.1007/s00405-025-09495-6","DOIUrl":"https://doi.org/10.1007/s00405-025-09495-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of obstructive sleep apnoea (OSA) surgery on insomnia in patients with co-morbid insomnia and sleep apnoea (COMISA).</p><p><strong>Methods: </strong>A retrospective interventional study was conducted on fifty consecutive adult patients with OSA who underwent surgery for OSA. Outcome measures included the Insomnia Severity Index (ISI) and the following polysomnography (PSG) indices: apnoea-hypopnea index (AHI), oxygen saturation index (ODI), lowest oxygen saturation (LOS) and Epworth Sleepiness Score (ESS) before treatment and at 4 months post-operatively.</p><p><strong>Results: </strong>In our study, 36% of the patients had clinical insomnia (ISI score > 15) prior to surgery. Following OSA surgery, there was an average improvement in the total ISI scores from 19.82 to 5.65 (p < 0.05). One patient continued to have moderate to severe clinical insomnia. Overall OSA parameters following surgery showed AHI decreased from 33.38 ± 23.76 to 18.37 ± 22.94 (p < 0.05); ODI reduced from 30.85 ± 22.37 to 16.77 ± 21.73 (p < 0.05); LOS significantly increased from 74.42 ± 11.93 to 87.70 ± 7.59 (p < 0.05); ESS showed significant reduction from 10 ± 5.9 to 6.55 ± 5.18 (p < 0.05).</p><p><strong>Conclusion: </strong>Our results showed a reduction in the insomnia scores of our COMISA subgroup and a significant post-operative improvement in ambulatory polysomograph variables. OSA and insomnia are strongly correlated and surgical treatment of OSA appears to be effective in reducing the insomnia burden in COMISA patients.</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":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218548","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":"Predicting surgical intervention in paediatric cervical abscesses using machine learning: a comparative analysis.","authors":"Ryota Koshu, Masao Noda, Haruna Nakamoto, Takahiro Fukuhara, Makoto Ito","doi":"10.1007/s00405-025-09505-7","DOIUrl":"https://doi.org/10.1007/s00405-025-09505-7","url":null,"abstract":"<p><strong>Background: </strong>Paediatric cervical abscesses necessitate careful assessment to determine appropriate treatment strategies. Some patients require surgical intervention, although conservative management is effective. However, the criteria for the surgical indications remain unclear. Machine learning models have demonstrated promise in improving diagnostic accuracy across different medical fields.</p><p><strong>Objective: </strong>This study aimed to assess the use of machine learning models in predicting the requirement for surgical intervention in paediatric cervical abscesses and compare their performance with that of traditional logistic regression.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 55 paediatric patients diagnosed with cervical abscesses between 2010 and 2024. The patient demographics, clinical findings, laboratory data, and imaging characteristics were examined. Six predictive models were developed: logistic regression, Random Forest, Lasso regression, Support Vector Machine (SVM), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine. Model performance was evaluated using the area under the curve (AUC), accuracy, precision, recall, and F1-score. Feature importance was examined to identify the main predictive factors.</p><p><strong>Results: </strong>Among all the factors, abscess size was the most significant predictor of surgical intervention. Machine-learning models, especially XGBoost, outperformed logistic regression, achieving the highest AUC, accuracy, and recall. Inflammatory markers, including neutrophil-to-lymphocyte ratio and neutrophil count, also substantially contributed to the prediction accuracy.</p><p><strong>Conclusion: </strong>Machine learning models, particularly XGBoost, provide superior predictive performance compared with logistic regression, providing a valuable tool for optimising treatment decisions in paediatric cervical abscesses. These models improve clinical decision-making by integrating multiple factors, decreasing unnecessary surgeries, and enhancing patient outcomes.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218551","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":"Proposal of a standardized testing protocol for BPPV: Using 3D simulations for insights into movement of otoliths during positional tests.","authors":"Rajneesh Bhandari, Anita Bhandari, David Samuel Zee, Daniele Nuti, Herman Kingma, Raymond van de Berg","doi":"10.1007/s00405-025-09400-1","DOIUrl":"https://doi.org/10.1007/s00405-025-09400-1","url":null,"abstract":"<p><strong>Background: </strong>Benign Paroxysmal Positional Vertigo (BPPV) is a common vestibular disorder caused by displaced otolith debris in the inner ear. This study explored the order effect related to the sequence of performing different diagnostic positional maneuvers.</p><p><strong>Methods: </strong>3D simulations of the Supine Roll Test (SRT), Dix-Hallpike maneuver (DHM), and Deep head hanging tests, performed in the standardized prescribed way, were used to study various types of horizontal, posterior, and anterior canal BPPV. The simulations allowed visualization of the movement of the otolith debris and the resulting nystagmus patterns. The results of the sequence of tests and the starting side of the tests (from left or right) were observed.</p><p><strong>Results: </strong>Simulations of the SRT on horizontal canal BPPV (hc-BPPV) showed different patterns of nystagmus: direction changing, direction fixed, and unilateral (only elicited in one position) nystagmus. These patterns depended on the position of the debris within the horizontal canal and the side from which the SRT began. Simulations of the DHM showed that the test procedure could displace debris in the horizontal canal. The SRT, however, caused no movement of debris in the vertical canals. The deep head hanging test could displace debris in all canals.</p><p><strong>Conclusion: </strong>An order effect can occur when performing diagnostic maneuvers for BPPV. The maneuvers can displace debris in the semicircular canals into new positions that may influence the findings in subsequent maneuvers and confound interpretation. A standardized testing protocol, starting with the SRT first, can decrease the order effect and simplify the interpretation of test results and in turn improve diagnostic accuracy and outcomes in the management of BPPV.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218552","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":"Iatrogenic cholesteatoma: a tertiary referral center experience.","authors":"Enrico Liaci, Maurizio Falcioni, Giulia Bertoli, Giovanni Pepe, Daniele Fasanella, Sebastiano Franzini, Enrico Pasanisi, Filippo Di Lella","doi":"10.1007/s00405-025-09471-0","DOIUrl":"https://doi.org/10.1007/s00405-025-09471-0","url":null,"abstract":"<p><strong>Purpose: </strong>To report and compare different etiopathogenic mechanisms for iatrogenic cholesteatoma formation together with their respective symptomatic onset, diagnostic latency, anatomical extension and surgical management.</p><p><strong>Methods: </strong>A retrospective single-center cohort observational study was conducted on patients who presented history of previous otologic surgery and subsequent diagnosis of iatrogenic cholesteatoma and underwent revision otologic surgery between January 2014 and December 2023.</p><p><strong>Results: </strong>Seventeen cases of iatrogenic cholesteatoma were investigated. Previous otologic procedures included myringoplasty (10 cases, 58,8%), cochlear implantation (3 cases, 17,6%), tympanoplasty (3 cases, 17,6%), and subtotal petrosectomy associated with cochlear implantation (1 case, 5,9%). Three etiopathogenic mechanisms were identified: vascular strip displacement or incorrect management of external auditory canal skin flaps (76,5%), erosion of the posterior bony wall of the external auditory canal in canal wall up mastoidectomies for cochlear implantation (17,6%) and external auditory canal skin residuals in subtotal petrosectomy cavity (5,9%). Symptomatic onset was characterized by hearing loss and otorrhea. Mean diagnostic latency was 74 months (min 10 - max 190). Surgical management included canalplasty, canal wall up and canal wall down mastoidectomy, subtotal petrosectomy and subtotal petrosectomy with cochlear implant explantation and reimplantation. The mean follow-up time was 51,35 months (range 14-125 months).</p><p><strong>Conclusion: </strong>Iatrogenic cholesteatoma is a potential complication of a large variety of otologic surgical approaches. The late symptomatic onset and the consequent long mean diagnostic latency of this pathology makes it mandatory to carry out an accurate follow-up even after routine surgical procedure.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218550","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":"Surgical interventions for empty nose syndrome: A meta-analysis of meta-analyses.","authors":"Leire Aguirre-Peña, Octavio Garaycochea, Isam Alobid, Holger Sudhoff, Manuel Bernal-Sprekelsen","doi":"10.1007/s00405-025-09501-x","DOIUrl":"https://doi.org/10.1007/s00405-025-09501-x","url":null,"abstract":"<p><strong>Introduction: </strong>Empty nose syndrome (ENS) is a complex iatrogenic condition resulting from excessive inferior turbinate resection, leading to paradoxical nasal obstruction despite an objectively patent airway.</p><p><strong>Methods: </strong>This system review and meta-analysis of meta-analyses, performed with the AMSTAR2 tool, evaluates surgical treatment outcomes for ENS, focusing on validated patient-reported measures such as the ENS6Q and SNOT questionnaires.</p><p><strong>Results: </strong>Data from three meta-analysis, including over 1500 cases, highlights the long-term benefits and limitations of various surgical approaches.</p><p><strong>Discussion: </strong>While surgical interventions demonstrate sustained improvements in patient quality of life, substantial heterogeneity across meta-analyses and overlapping primary data highlight the need for standardized protocols, harmonized outcome measures, and meta-evaluation frameworks in future ENS research.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218555","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":"Impact of cochlear implant indications on outcome, assessed and reported using the international classification of functioning, disability and health model.","authors":"Ellen Andries, Artur Lorens, Piotr Henryk Skarżyński, Henryk Skarżyński, Miryam Calvino, Javier Gavilán, Luis Lassaletta, Dayse Tavora-Vieira, Aanand Acharya, Anja Kurz, Rudolf Hagen, Ilona Anderson, Karin Koinig, Yassin Abdelsamad, Paul Van de Heyning, Vincent Van Rompaey, Griet Mertens","doi":"10.1007/s00405-025-09454-1","DOIUrl":"https://doi.org/10.1007/s00405-025-09454-1","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the impact of various Cochlear Implant (CI) indications on outcomes assessed using the International Classification of Functioning, disability and health (ICF)-based CI outcome assessment (CI-ICF) protocol.</p><p><strong>Methods: </strong>Data from a multicenter longitudinal cohort study was analyzed. A consecutive sample of adult CI users (N = 72), including unilateral (n = 22), bilateral (n = 2), electric acoustic stimulation (EAS) (n = 6), single-sided deafness (SSD) (n = 6), and bimodal (n = 36) CI users, were enrolled based on clinical indications for cochlear implantation. Participants were assessed preoperatively and six months postoperatively using the CI-ICF protocol, which comprises patient-reported outcome measures (PROMs), pure tone and speech audiometry and localization tests.</p><p><strong>Results: </strong>All CI indication groups showed benefits across most PROMs, pure tone and speech audiometry and localization. Differences were mainly observed in participants with SSD, who showed better baseline auditory abilities and less postoperative improvement compared to other groups for sound detection (PTA4) [e.g. PTA4 difference over time: SSD versus unilateral CI (p = 0.003)] and listening (HISQUI19) [e.g. HISQUI19 difference over time: SSD versus bimodal (p = 0.039)]. Participants with bimodal stimulation or SSD generally exhibited superior speech discrimination in noise abilities pre- and postoperatively, and demonstrated an equivalent amount of improvement for this category compared to EAS and unilateral CI users.</p><p><strong>Conclusion: </strong>Various CI indication groups experienced improvements following cochlear implantation, highlighting its broad efficacy. Personalized CI strategies are essential to maximize individual outcomes. These findings support the comprehensive and readily interpretable assessment framework provided by the CI-ICF protocol in evaluating CI outcomes.</p><p><strong>Trial registration: </strong>Clinicaltrials.gov (NCT04611555), retrospectively registered on 2-Nov-2020.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210689","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":"Recurrent angiofibroma: analysis of risk factors and common sites of recurrence.","authors":"Hisham Mohamed Anwar Attya, Mohamed Salah Hassouna, Abdelrahman Ali Shawky, Mena Esmat Abdelmalek","doi":"10.1007/s00405-025-09476-9","DOIUrl":"https://doi.org/10.1007/s00405-025-09476-9","url":null,"abstract":"<p><strong>Objective: </strong>To detect risk factors and common anatomical sites for recurrence of juvenile nasopharyngeal angiofibroma (JNA).</p><p><strong>Methods: </strong>This is a retrospective study, included all male patients who were diagnosed histopathologically with juvenile nasopharyngeal angiofibroma (JNA) and were operated before at Kasr Al-Ainy Hospital, Cairo University in the period between January 2012 and December 2021. Their clinical data were retrieved and analyzed.</p><p><strong>Results: </strong>Among 68 patients included in this study, 26 patients experienced recurrence with total recurrence rate (38.2%). JNA recurrence was significantly associated with primary tumor size (≥ 4 cm), advanced primary tumor stages (stage IIIa, IIIb according to Radkowski classification) and their correlatives of preoperative embolization, perioperative blood transfusion or open surgical approach. Age on presentation, tumor stage, perioperative blood transfusion and tumor size were significant factors affecting the recurrence rate according to cox regression univariate analysis, while on multivariate analysis the only significant independent predictors of JNA recurrence were age on presentation and tumor size. 61.53% of recurrent cases were discovered accidently through their regular postoperative follow up examination and/or imaging and were asymptomatic upon diagnosis of recurrence. Moreover, patients with early tumor stage or didn't undergo preoperative embolization or had a primary tumor size < 4 cm had significantly longer recurrence interval than those with advanced tumor stage or underwent preoperative embolization or had a primary tumor size ≥ 4 cm. Pterygoid process (92.3%) was significantly the commonest to be invaded by recurrent/residual tumor, followed by nasopharynx (84.6%) and sphenoid sinus (76.9%).</p><p><strong>Conclusion: </strong>JNA recurrence is significantly associated with primary tumor size, primary tumor stage and their correlatives of preoperative embolization, perioperative blood transfusion or open surgical approach, but age on presentation and primary tumor size were the only independent predictors of tumor recurrence. Meticulous surgical attention should be paid for pterygoid process in order to decrease residual/recurrence incidence.</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":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218554","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}