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":"Low-dose radiotherapy as a definitive treatment for Kimura's disease.","authors":"Kento Ko, Takeshi Takahashi, Hironori Baba, Genki Iwai, Nao Takahashi, Atsushi Ohta, Arata Horii","doi":"10.1007/s00405-025-09521-7","DOIUrl":"10.1007/s00405-025-09521-7","url":null,"abstract":"<p><strong>Purpose: </strong>Kimura disease (KD) is characterized by inflammatory granulomas with eosinophilic infiltration in young males. The characteristic large mass in the head and neck region poses esthetic concerns. Treatment may include corticosteroid administration, surgery, or both; however, these often result in recurrence. Low-dose radiation therapy (RT) is a second-line treatment option for KD and is mainly used for recurrence or as adjuvant therapy after surgery. In this study, we aimed to evaluate the outcomes of RT alone as a definitive treatment for seven patients with KD refractory to oral corticosteroids.</p><p><strong>Methods: </strong>This study included male patients with a median age of 37 years and median disease duration of 9 years. The lesion sites included the unilateral or bilateral cheek and auricular areas. RT was administered at a dose of 1.8 Gy per fraction five times per week for a total of 30.6 Gy. Their adverse events and predictive biomarkers were evaluated.</p><p><strong>Results: </strong>The maximal diameter of the mass significantly reduced from 10 ± 3.8 cm (mean ± SD) to 4.1 ± 1.9 cm without regrowth for 99 months. Peripheral blood eosinophil counts significantly decreased from 2,435 ± 241 to 1,106 ± 411/µL at one year after RT. The acute adverse events included grade 1 dermatitis and dry mouth in five patients, pharyngitis in 3, and alopecia in 2, all of which improved a few months after RT.</p><p><strong>Conclusion: </strong>RT is a satisfactory treatment for patients with corticosteroid-resistant KD with acceptable adverse events. The peripheral blood eosinophil count may be a useful biomarker for determining the disease status of KD.</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":"4807-4813"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144278068","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":"Readability, understandability, and quality of online education materials and large language models for retrograde cricopharyngeal muscle dysfunction.","authors":"Nurullah Türe, Emel Tahir, Necati Enver","doi":"10.1007/s00405-025-09628-x","DOIUrl":"10.1007/s00405-025-09628-x","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate online patient education materials on retrograde cricopharyngeal dysfunction (RCPD) by comparing the readability, understandability, and quality of content generated by large language models (LLM).</p><p><strong>Method: </strong>A web search in December 2024 evaluated 51 online resources and four LLMs (ChatGPT 4.0, Gemini 1.5 Flash, Perplexity GPT-3.5, DeepSeek-V2.5). Readability was analyzed using Readable.io, understandability actionability was assessed using PEMAT, and information quality was assessed using DISCERN.</p><p><strong>Results: </strong>The average readability level of the online material and the LLM responses was at the 11th-12th grade level. The Flesch Reading Ease score was lowest for the LLMs, especially for the DeepSeek-V2.5 model (24.21). While PEMAT understandability scores were adequate for online (82%) and LLMs (79%), actionability was low across all groups (25-37%). DISCERN analyses showed that both sources of information were of limited quality in supporting treatment decisions.</p><p><strong>Conclusion: </strong>This study revealed that both online and LLM-generated materials on RCPD exceeded the recommended readability levels. Although the materials demonstrated acceptable understandability, they exhibited low actionability and inadequate overall quality, emphasizing the need for more patient-centered digital health communication.</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":"4711-4720"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839837","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 importance of the anterior ethmoidal artery in idiopathic epistaxis: a retrospective study.","authors":"Nikolaos K Vovolinis, Vasileios T Panousopoulos, Efthymios Kyrodimos, Evangelos I Giotakis, Aris I Giotakis","doi":"10.1007/s00405-025-09624-1","DOIUrl":"10.1007/s00405-025-09624-1","url":null,"abstract":"<p><strong>Purpose: </strong>Data that compare the anterior ethmoidal artery (AEA) with the sphenopalatine artery (SPA) in epistaxis are limited. We intended to compare features of idiopathic epistaxis due to the anterior ethmoidal artery (AEA-epistaxis) with features of idiopathic epistaxis due to the sphenopalatine artery (SPA-epistaxis).</p><p><strong>Methods: </strong>We conducted a retrospective review of subjects that were hospitalized due to epistaxis between 1st January 2017 and 31st December 2024 at the University Department of Otorhinolaryngology.</p><p><strong>Results: </strong>In 113 subjects with idiopathic epistaxis, 61 (54%) subjects presented with SPA-epistaxis and 27 (24%) with AEA-epistaxis. The most frequent AEA-epistaxis site was the Stamm's S point (23/27), with the anterior nasal roof following (4/27). Subjects with SPA-epistaxis needed less often (13%) blood transfusion compared to subjects with AEA-epistaxis (30%; p < 0.001). Type of anesthesia differed significantly between subjects with SPA-epistaxis (100% general anesthesia) and subjects with Stamm' S point AEA-epistaxis (30% local anesthesia; p < 0.001). More subjects with initial SPA-epistaxis were re-admitted with severe epistaxis on the same nasal side (4.9%) than subjects with initial AEA-epistaxis (0%; p > 0.2).</p><p><strong>Conclusion: </strong>In every fourth patient, idiopathic epistaxis might originate from septal branches of AEA, i.e., the Stamm's S point or the anterior nasal roof. Otorhinolaryngologists should not neglect looking for AEA branches during epistaxis. Delay of identification might result in higher blood transfusion rates. In contrast to the SPA, Stamm's S point can be occasionally addressed under local anesthesia, with very low re-admission rates.</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":"4691-4697"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839838","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":"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":"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":"4773-4784"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the prognostic model \"oncologiq palliative\" for head and neck cancer patients.","authors":"B N van den Besselaar, D van Klaveren, D Berzenji, A Hoesseini, J C Jansen, J A Hardillo, R J Baatenburg de Jong, M P J Offerman, A Sewnaik","doi":"10.1007/s00405-025-09462-1","DOIUrl":"10.1007/s00405-025-09462-1","url":null,"abstract":"<p><strong>Purpose: </strong>Patients diagnosed with incurable head and neck squamous cell carcinoma (HNSCC) have a poor prognosis, with a median survival of approximately five months. Physicians often struggle to predict prognosis accurately and tend to overestimate survival. Timely sharing of validated accurate individual information on life expectancy could aid in facilitating better patient counseling. However, this knowledge is lacking. Therefore, the aim of this study is to conduct temporal and external validation of the prognostic model OncologIQ Palliative to assess its accuracy and generalizability.</p><p><strong>Methods: </strong>The validation procedure involved temporal assessment in a retrospective cohort of 355 palliative HNSCC patients from Erasmus MC (2017-2020), followed by external validation in a retrospective cohort of 44 patients from Leiden University Medical Center (2019-2021).The discriminative ability of OncologIQ Palliative was assessed using the C-index and calibration was evaluated through graphical assessment, intercept, and slope.</p><p><strong>Results: </strong>The temporal cohort had a median follow-up of 115 days, and the external cohort 143 days. The model showed moderate discriminative ability in temporal validation (C-index 0.66) and better discrimination in external validation (C-index 0.71). Reasonable agreement was observed between predicted and observed 6-month and 1-year survival rates, with some deviations from the perfect calibration line.</p><p><strong>Conclusion: </strong>The validation methods conducted in this study underscored the reliability of OncologIQ Palliative. They showed adequate calibration and discrimination in both validation procedures, thereby facilitating the provision of more accurate prognostic counselling for head and neck cancer patients in the palliative phase.</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":"4735-4743"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solitary fibrous tumor in the pterygopalatine fossa: a rare case report and literature review.","authors":"Jian-Sheng Zhou, Hui Yuan, Jiu-Qiang Chen, Lei Shen","doi":"10.1007/s00405-025-09440-7","DOIUrl":"10.1007/s00405-025-09440-7","url":null,"abstract":"<p><strong>Introduction: </strong>Solitary fibrous tumor is a rare spindle cell tumor that may occur in various parts of the body. No documented case of solitary fibrous tumor has been reported in pterygopalatine fossa.</p><p><strong>Case report: </strong>A 25-year-old male complained of right facial numbness for 20 days. Computed tomography of the paranasal sinuses demonstrated a well-circumscribed lesion centered in the right pterygopalatine fossa. On magnetic resonance imaging the lesion was homogenously isointense to muscle on T1 weighted imaging (T1WI) and slightly hyperintense to muscle on T2 weighted (T2WI). The intro-operative frozen pathology reveals a benign spindle cell tumor. The tumor was removed successfully via transnasal combined with Caldwell-Luc approach without complications. However, the final pathology combined with immunohistochemistry confirmed the diagnosis of solitary fibrous tumor. No further radiotherapy is performed post-operation. After half a year follow up, there is no recurrence.</p><p><strong>Conclusion: </strong>For the tumor in the pterygopalatine fossa, the possibility of solitary fibrous tumor should be considered and radical endoscopic resection should be the preferred treatment approach.</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":"4899-4902"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144130025","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 changing profile of laryngeal cancer: a 20-year retrospective cohort analysis.","authors":"Kelten Clements, Rhona Hurley, David I Conway, Claire Paterson, Catriona M Douglas","doi":"10.1007/s00405-025-09500-y","DOIUrl":"10.1007/s00405-025-09500-y","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal cancer incidence has declined in the Western World, but subsite-specific trends are underreported. This study assessed changes in the profile of laryngeal cancer patients in a regional cancer network.</p><p><strong>Methods: </strong>Two patient cohorts from the west of Scotland were analysed: 326 patients diagnosed in 1999-2001 (historical cohort) and 386 diagnosed in 2018-2020 (contemporary cohort). Changes in risk factors, tumour characteristics, and treatment patterns were compared using Chi-square and Student's t-tests. Two-year survival was assessed using the Kaplan-Meier method and Cox proportional hazards models.</p><p><strong>Results: </strong>Overall proportion of supraglottic (C32.1) cancers increased from 38.0 to 58.0%, becoming the predominant subtype, while glottic (C32.0) cancers decreased from 56.7 to 32.6% (p < 0.001). Early-stage diagnosis of glottic cancers rose from 65.6 to 77.0% (p = 0.031), while supraglottic cancers continued present at advanced stages, 70.5% vs. 64.3% (p = 0.24). Surgical treatment for all laryngeal cancers increased from 10.4 to 38.2%, while radiotherapy declined from 57.7 to 38.2% (p < 0.001). Two-year risk of death for glottic cancers decreased by 42% in the contemporary cohort (p = 0.02), with no significant survival change for supraglottic or overall laryngeal cancers.</p><p><strong>Conclusion: </strong>Glottic cancers now represent a smaller proportion of laryngeal cancer cases, with earlier diagnosis and improved survival outcomes. Conversely, supraglottic cancers have become more prevalent, often diagnosed at advanced stages without improvements in overall survival.</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":"4795-4805"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295613","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":"Presentation of complex laryngotracheal surgeries using CT-based 3D models and 3D printing: a technical note.","authors":"Zoltán Tóbiás, Ádám Perényi, Ádám Bach, Roland Nagy, Miklós Csanády, Zsolt Geretovszky, Martin Cseh, László Rovó","doi":"10.1007/s00405-025-09497-4","DOIUrl":"10.1007/s00405-025-09497-4","url":null,"abstract":"<p><strong>Introduction: </strong>Slide laryngotracheopexy for cricotracheal stenosis and extended partial laryngectomy combined with tracheopexy for T2-T3 glottic tumors represent novel, complex laryngotracheal surgeries requiring meticulous preoperative planning.</p><p><strong>Methods: </strong>In addition to conventional diagnostic tools (imaging, endoscopy), digital/virtual 3D techniques along with 3D printing - also referred to as Additive Manufactoring (AM)- allow for the creation and application of CT-based virtual and 3D-printed models of the larynx and the trachea. These 3D technologies can facilitate surgical team preparation and provide an innovative approach to training on complex surgical solutions.</p><p><strong>Discussion: </strong>This paper presents the digital workflow for three cases where patient-specific 3D laryngotracheal models were developed and successfully applied in surgical planning and training. These models serve as high-fidelity anatomical representations for surgical rehearsal, training, and patient communication, demonstrating their potential for broader clinical implementation.</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":"4785-4794"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295611","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":"Management of pott's puffy tumor: a Delphi-method international clinical consensus statement.","authors":"Nicolien van der Poel, Gopi Shah, Nikolaus Wolter, Christos Georgalas, Anneclaire Vroegop, Vincent Couloigner, Francois Simon, Amanda L Stapleton, Dana Crosby, Uma Ramaswamy, Patrick Walz, Randa Al-Barazi, Peter-John Wormald, Enrique Ortiz, Perla Villamor, Jin-Young Min, Alvaro Pacheco, Cristobal Langdon, Paresh Naik, Shazia Peer, Rania Mehanna, John R Craig, Alberto Maria Saibene","doi":"10.1007/s00405-025-09589-1","DOIUrl":"10.1007/s00405-025-09589-1","url":null,"abstract":"<p><strong>Purpose: </strong>Pott's puffy tumor (PPT) is a rare and complex condition that requires a comprehensive diagnostic approach and multi-faceted treatment strategy. It is associated with a significant risk of intracranial complications. The purpose of this clinical consensus statement (CCS) is to systematically assess diagnostic and therapeutic approaches of patients with PPT, using the best available evidence and expertise of the panel. The results and recommendations are intended to support clinicians in making informed decisions when managing patients with PPT and to standardize diagnostic, antibiotic, and surgical management across institutions. This consensus also aimed to provide a basis for a subsequent international prospective registry to inform data-driven care.</p><p><strong>Methods: </strong>A literature review was performed via PubMed, and an international panel of 23 experts judged 33 statements in two rounds using a modified Delphi method survey to establish expert recommendations on the diagnostic considerations, medical and surgical management, and postoperative considerations. Strong consensus was defined by a mean score of ≥ 8.00 with no outliers, and consensus by a mean score of ≥ 7.00 with no more than 1 outlier.</p><p><strong>Results: </strong>A strong consensus was reached on important aspects of the diagnosis and treatment of patients with PPT. Most pivotal are the importance of urgent imaging, imaging of the brain with a preference of MRI, the importance of broad spectrum intravenous antibiotic treatment, and the goal of surgery - resolution of the periosteal abscess and clearance of the frontal sinus drainage pathway - which can be established in various ways and is case and surgeon dependent.</p><p><strong>Conclusion: </strong>In patients with PPT, a high index of suspicion of intracranial complications is important to prevent any delay in treatment initiation. The recommendations formulated in this international consensus statement aim to improve the diagnosis and care for patients with PPT and to address gaps and uncertainties in current guidelines. Items that did not reach consensus may serve as areas for further 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":"4669-4680"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144805570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-intubation laryngeal injuries: incidence, types, and outcomes in a tertiary setup.","authors":"Varchasvi Meena, Nishant Gill","doi":"10.1007/s00405-025-09632-1","DOIUrl":"10.1007/s00405-025-09632-1","url":null,"abstract":"<p><strong>Background: </strong>Endotracheal intubation is a routine yet critical procedure during general anesthesia that can cause a spectrum of laryngeal injuries, potentially affecting vocal function and airway integrity. The route of intubation, oral versus nasal, may influence the incidence and severity of such injuries, but evidence is inconclusive.</p><p><strong>Objective: </strong>This study aims to prospectively compare the incidence, severity, and clinical impact of laryngeal injuries following oral and nasal intubation in adult patients undergoing elective surgeries under general anesthesia.</p><p><strong>Methods: </strong>A prospective observational study was conducted involving 67 patients scheduled for elective surgery with endotracheal intubation. Patients were allocated into oral (n = 35) and nasal (n = 32) intubation groups based on surgical requirements. Flexible fiberoptic laryngoscopy was performed within six hours of extubation to evaluate laryngeal injuries, graded using the Eckerbom classification. Hoarseness severity was assessed and recorded. Statistical analysis including chi-square tests and multivariate logistic regression identified predictors of injury and compared groups, with significance set at p < 0.05.</p><p><strong>Results: </strong>The incidence and severity of laryngeal injuries did not significantly differ between oral and nasal intubation groups (p = 0.67). Grade 0 injury (no visible abnormality) was predominant (oral 65.7%, nasal 71.9%). Hoarseness severity distribution was also comparable (p = 0.78). Multivariate analysis revealed no significant association between injury occurrence and variables including tube size, duration of intubation, or number of intubation attempts.</p><p><strong>Conclusion: </strong>Oral and nasal routes of endotracheal intubation demonstrated comparable rates and severity of post-intubation laryngeal injuries in this cohort. Skilled intubation technique remains paramount to minimizing complications regardless of route.</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":"4721-4725"},"PeriodicalIF":2.2,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839836","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}