ORL; journal for oto-rhino-laryngology and its related specialties最新文献

{"title":"Prognostic Role of PD-L1 and IDO-1 Expression in Sinonasal Carcinoma.","authors":"Daria Rometsch, Frank Simon, Philipp Göttker, Felix Simon Heitkötter, Armands Riders, Claudia Rudack, Maximilian Oberste","doi":"10.1159/000546118","DOIUrl":"10.1159/000546118","url":null,"abstract":"<p><strong>Introduction: </strong>Sinonasal carcinomas (SNC) are rare, aggressive tumours with complex immunological aspects. Still, prognostic markers are missing. The study aimed to investigate the relationship between immune checkpoints - specifically programmed death-ligand 1 (PD-L1) and Indolamin-2,3-dioxygenase 1 (IDO-1) - and clinical parameters in SNC.</p><p><strong>Methods: </strong>In this monocentric study immunohistochemical analysis of the checkpoints PD-L1 and IDO-1 was carried out retrospectively in 85 SNC patients from 2004 to 2018. Tumour proportion score (TPS), combined positive score (CPS) and combined IDO-1 score classified the PD-L1 and IDO-1 expression. The study was conducted in a specialized tertiary care centre, indicating comprehensive multidisciplinary care with surgical, radiotherapeutic, and systemic treatment intervention.</p><p><strong>Results: </strong>Over a median observation period of 41 months, 52 squamous cell carcinomas (SCC, 61%) and 33 adenocarcinomas (AC, 39%) were included. A total of 31 patients (37%) were classified in UICC IV, 89.4% (n = 76) received a primary resection. Three-year progression-free survival (PFS)/overall survival (OS) rates were 63.6%/81.4% in SCC and 73.1%/82.5% in AC, respectively. Sinonasal AC showed significantly more frequently negative PD-L1 expression and CPS <1 compared to sinonasal SCC (p = 0.035, p = 0.002). Sinonasal SCC with TPS score >50%, combined low IDO-1 score and high UICC stage showed significantly worse 3-year PFS and OS values (p < 0.05).</p><p><strong>Conclusion: </strong>The study identifies PD-L1 and IDO-1 as possible prognostic factors for sinonasal SCC, but less so for sinonasal AC. A TPS score >50% and combined low IDO-1 score correlate with shortened 3-year PFS and OS in sinonasal SCC. Immune checkpoints could, therefore, represent important target molecules for the prognosis assessment of sinonasal SCC.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"98-107"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144145400","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":"Otolaryngology Residency Application Trends and Match Outcomes at a Large Academic Medical Center.","authors":"Ezer H Benaim, Lauren M Cook, Aurelia Monk, Cameron P Worden, John B Henrich, Kevin C Wang, Didong Li, Rupali N Shah, Adam J Kimple, Robert A Buckmire, Lauren K Leeper, Christine E DeMason, Brian D Thorp","doi":"10.1159/000548976","DOIUrl":"10.1159/000548976","url":null,"abstract":"<p><strong>Introduction: </strong>Despite significant changes over the past 5 years, the otolaryngology head and neck surgery (OHNS) residency application process remains highly competitive. This study assessed how applicant and medical school characteristics predict success in entering OHNS residency programs.</p><p><strong>Methods: </strong>1,363 application files submitted to a single academic OHNS residency program during the 2019-2020, 2020-2021, and 2023-2024 cycles were reviewed. Applicant characteristics, Step scores, medical school rankings, geographic locations, and research productivity were analyzed. T-tests and chi-square tests were used for comparative analyses, while linear modeling identified match success predictors.</p><p><strong>Results: </strong>Applications declined in the 2023-2024 cycle compared to earlier cycles. Although mean Step 1 scores predicted success previously, they lost significance in 2023‒2024. Step 2 scores remained reliable predictors across cycles (p = 0.021), with matched applicants consistently scoring higher (e.g., 2023-2024 mean: 255.8 ± 11.4 vs. 249.1 ± 14.3, p < 0.001). Research productivity increased throughout cycles, with matched applicants demonstrating higher output (e.g., 2023-2024 mean publications: 5.4 ± 6.3 vs. 4.4 ± 7.3, p < 0.001). Research fellowships increased (26.6% in 2023-2024) and were notably linked to higher productivity, especially for applicants from lower ranked schools. Modeling indicated that Step 2 scores, medical school rankings, and research output significantly predict match success.</p><p><strong>Conclusion: </strong>Fewer applications were received in the 2023-2024 cycle, and Step 1 scores lost their predictive value, reflecting recent evaluation changes. Still, Step 2 scores and research productivity remain crucial for match success, suggesting their increasing relevance for applicants seeking OHNS residencies.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"180-192"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12812286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314427","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":"Digitizing Olfactory Assessment in Portugal: Pilot Clinical Application of a Digital Odor Identification Test.","authors":"Francisco Alves de Sousa, Márcio Nakanishi, Mariline Santos, Ana Nóbrega Pinto, Claúdia Galvão, Thomas Hummel","doi":"10.1159/000547473","DOIUrl":"10.1159/000547473","url":null,"abstract":"<p><p><p>Introduction: Current methods for olfactory assessment are often time-consuming and necessitate the involvement of an examiner for both administration and documentation of responses. This study aimed to evaluate the clinical utility of a novel digital olfactory device, the MultiScent-20 odor identification test (MultiScent-IT), in distinguishing individuals with olfactory dysfunction from those with normal olfactory function.</p><p><strong>Materials and methods: </strong>The work was conducted and reported in accordance with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement for case-control studies. The test was administered to individuals with olfactory dysfunction (cases) and normosmic volunteers (controls), who were classified using the Sniffin' Sticks threshold test.</p><p><strong>Results: </strong>A statistically significant difference was observed in the total test scores between cases (9.6 ± 4.5) and controls (13.2 ± 1.9), p = 0.01. The test performance, defined as (total score/total time) × 100, was significantly lower in cases (1.9 ± 1.4) compared to controls (3.2 ± 1), p = 0.016. A receiver operating characteristic curve analysis demonstrated an area under the curve of 0.749, indicating a fair to good ability of the MultiScent-IT to discriminate between the groups. A MultiScent-IT score below 10 demonstrated perfect sensitivity (100%) in detecting olfactory dysfunction. Significant correlations were identified between the MultiScent-IT score and the Sniffin' Sticks threshold score (p = 0.009, r = 0.524), as well as the Portuguese version of the Olfactory Disorders Questionnaire (PT-ODQ) score (p = 0.013, r = -0.423).</p><p><strong>Conclusion: </strong>MultiScent-IT is a promising tool for differentiating between individuals with and without olfactory dysfunction in clinical settings. </p>.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"143-152"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144791813","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":"Airway Endoscopy Findings in Children with Recurrent Croup.","authors":"Jane Y Tong, Charlyn Gomez, Nicholas Randolph, Kevin D Pereira, Amal Isaiah","doi":"10.1159/000547196","DOIUrl":"10.1159/000547196","url":null,"abstract":"<p><strong>Introduction: </strong>Microlaryngoscopy and bronchoscopy (MLB) is frequently performed to identify subglottic pathology in recurrent croup. However, the reported incidence of positive findings that could alter management or require intervention varies widely. We sought to determine the utility of endoscopic airway evaluation in this setting.</p><p><strong>Methods: </strong>All MLBs performed by three pediatric otolaryngologists at a tertiary care academic children's hospital from January 1, 2019, to December 31, 2023, were retrospectively reviewed.</p><p><strong>Results: </strong>Sixty-two MLBs were performed for recurrent croup. Forty-four (71.0%) patients were male. The mean age was 4.3 years (95% confidence interval, 3.7-4.9). Ten (16.1%) patients were born preterm. Despite serving a predominantly Medicaid-insured minority population, 59.7% of the referred children were privately insured and 85.5% were white. Twenty-one (33.9%) had abnormal findings on MLB, though most were relatively minor. Only 3 (4.8%) patients demonstrated subglottic stenosis, two classified as Cotton-Myer grade I and one as grade II, with the latter undergoing dilation. Preterm birth, younger age, history of intubation, or inpatient otolaryngology consultation were significantly associated with abnormal findings on MLB.</p><p><strong>Conclusion: </strong>MLB performed in children with recurrent croup has a low incidence of subglottic pathology. Those who could benefit from surgical intervention have characteristics that could identify them preoperatively. Healthcare disparities may significantly influence patterns of referral for MLBs. These results could help the discussion around procedure appropriateness and shared decision-making with caregivers.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"126-132"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556557","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":"Real-World Outcomes of 3-Month Olfactory Training on Post-COVID-19 Parosmia.","authors":"Xinni Xu, Kristóf Peter Ludányi, Jerry Hadi Juratli, Fruzsina Németh, Dávid Nagy, Helga Kraxner, Thomas Hummel","doi":"10.1159/000549019","DOIUrl":"10.1159/000549019","url":null,"abstract":"<p><strong>Introduction: </strong>Post-COVID-19 parosmia can be protracted and psychologically distressing. The effect of olfactory training (OT) on parosmia is still unclear. The primary objective was to investigate the effect of 3 months of OT on COVID-19-related parosmia. The secondary objectives were to study whether improvement in olfactory quantitative function and compliance to OT influenced improvement in parosmia.</p><p><strong>Methods: </strong>This prospective cohort study was conducted from October 5, 2022, to February 7, 2023, at a tertiary smell and taste clinic. Patients with persistent post-COVID-19 parosmia were instructed to perform OT twice daily for 3 months. Improvement in parosmia was measured using self-rated intensity and pleasantness scales, a structured parosmia questionnaire, and the Sniffin' Sticks Parosmia Test (which measures hedonic direction and range). Quantitative olfactory function was measured with Sniffin' Sticks to determine the threshold, discrimination, and identification (TDI) score. Pre- and post-OT assessment of parosmia and quantitative olfactory function was performed. Compliance to OT was calculated as a percentage of the number of OT sessions performed over the expected number of training sessions over 3 months.</p><p><strong>Results: </strong>Thirty-eight patients (mean age 41.8 [±13.3] years, 12 [31.6%] males) were recruited. After 3 months, 52.6% (n = 20) reported perceived improvement in parosmia. There was improvement in perceived pleasantness (-2.0 [-3.0 to -1.0] vs. -3.0 [-4.0 to -2.0], p = 0.027), hedonic range (2.4 [±1.3] vs. 1.9 [±1.6], p = 0.023), and TDI (27.9 [±7.4] vs. 25.2 [±7.2], p = 0.001) from baseline. All measures of parosmia did not differ significantly between patients who achieved the minimum clinically important difference of ≥5.5 in TDI scores versus those who did not. Patients who had >70% compliance to OT displayed more significant improvements in hedonic range (1.1 [±1.1] vs. 0.2 [±1.3] p = 0.04) compared to those who were less compliant.</p><p><strong>Conclusion: </strong>COVID-19-related parosmia and olfactory dysfunction improved with OT over 3 months. Improvement in olfactory function does not necessarily improve parosmia perception. However, compliance with OT appears to have an effect on improvement in parosmia.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"153-161"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145314484","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":"Impact of Ambient Air Pollution on Obstructive Sleep Apnea Surgery: A Longitudinal Study.","authors":"Chung-Wei Lin, Yu-Han Wang, Pei-Wen Lin, Li-Wen Chiu, Chun-Tuan Chang, Michael Friedman, Anna M Salapatas, Hsin-Ching Lin","doi":"10.1159/000548550","DOIUrl":"10.1159/000548550","url":null,"abstract":"<p><strong>Introduction: </strong>Obstructive sleep apnea (OSA) is a worldwide health concern having been proved to be associated with air pollution. However, it remains unclear whether air pollution could also compromise the effect of OSA treatment, especially OSA surgery. This study investigated the impact of mid- to long-term ambient air pollution exposure on postsurgical outcomes of OSA patients.</p><p><strong>Methods: </strong>A total of 382 OSA patients who had failed conservative treatment first and received OSA surgery afterward were enrolled; the patients were then categorized into the severely (192 patients; 50.3%) and mildly (190 patients; 49.7%) air-polluted group based on the calculated average exposure of air particles according to the report of Taiwan Ministry of Environment. The relationships among the airborne particles and sleep indices changes were analyzed for determining the impact of air pollution on OSA surgery.</p><p><strong>Results: </strong>After a mid- to long-term exposure following OSA surgery, the results of the follow-up polysomnography showed that ΔAHI, ΔLSAT, and Δarousal index were significantly different between the two air-polluted groups. Pearson's correlations revealed that the above sleep indices were significantly yet weakly associated with air quality index (AQI), SO₂, NO₂, CO, and O₃. After adjusting the confounding factors, the multivariate analysis showed that different air pollution levels still had statistically significant influence on Δarousal index (β = -0.105, p = 0.045).</p><p><strong>Conclusion: </strong>Despite the effectiveness of OSA surgery, mid- to long-term exposure to ambient air pollution postoperatively may still have statistically significant association on OSA patients' postsurgical outcomes, and thus could not be overlooked.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"170-179"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139957","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":"Familiarity with Odors Does Not Play a Role in Olfactory Training Efficiency.","authors":"Ayaho Yoshino, Ryosuke Murakami, Taro Komachi, Yuki Kawaguchi, Kimihiro Okubo, Mehmet Kibris Mahmut, Thomas Hummel","doi":"10.1159/000547489","DOIUrl":"10.1159/000547489","url":null,"abstract":"<p><strong>Introduction: </strong>Olfactory training (OT) is known to be beneficial for olfactory disorders. The study aimed to explore whether the familiarity of odors influences the effectiveness of OT.</p><p><strong>Methods: </strong>Participants were divided into three groups: original training (OG), modified training with familiar odors to the Japanese population (FG), and modified training with unfamiliar odors to the Japanese population (UFG). Over 3 months, all participants completed OT. Olfactory function was evaluated using T&T olfactometry (combined odor detection threshold and odor recognition threshold test), intravenous olfactory test (retronasal olfactory test), and an open essence (OE) (odor identification test) before and after OT.</p><p><strong>Results: </strong>Sixty participants (mean age 53 years, SD 18) completed the study. Two participants were in the normosmic range, 10 were mild hyposmia, 14 were moderate hyposmia, 13 were severe hyposmia, and 21 were anosmia. Significant improvements were observed in olfactory detection threshold and recognition threshold function and retronasal olfactory function tests across all groups following OT. However, there was no significant effect observed on OE score. Furthermore, no significant differences were found among the OG, FG, and UFG groups.</p><p><strong>Conclusion: </strong>These findings suggest that regardless of odor familiarity, OT led to notable enhancements in olfactory function among participants. The study contributes to understanding the impact of odor familiarity on the effectiveness of OT, indicating that both familiar and unfamiliar odors yielded similar improvements. These results underscore the robustness of OT as a therapeutic approach for olfactory dysfunction, regardless of the familiarity of the odors used.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"77-84"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144693120","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":"Surgery Alone without Adjuvant Radiation Therapy for High- or Intermediate-Grade Salivary Gland Cancer.","authors":"Younghac Kim, Hyojun Kim, Nayeon Choi, Eun-Hye Kim, Junhun Cho, Han-Sin Jeong","doi":"10.1159/000547198","DOIUrl":"10.1159/000547198","url":null,"abstract":"<p><p><p>Introduction: Postoperative radiation therapy (RT) is recommended for completely resected T1-2 salivary gland cancer (SGC), if the tumor pathology is adenoid cystic carcinoma, intermediate, or high-grade tumors. In this case series, we reviewed cases of intermediate- or high-grade SGC, managed with curative surgery alone without adjuvant RT, and compared those outcomes with pathology- and tumor stage-matched SGC, treated with surgery and postoperative RT.</p><p><strong>Methods: </strong>We retrieved cases of intermediate- or high-grade tumors arising from the major salivary glands treated with surgery alone without adjuvant RT (N = 29) from the institutional SGC database. The main reasons for no adjuvant RT and treatment outcomes were reviewed in detail. In addition, we established the tumor pathology (grade)- and tumor stage (T1-2N0M0)-matched cases treated with surgery and postoperative RT as comparison groups (N = 59), to investigate relative treatment outcomes.</p><p><strong>Results: </strong>The overall treatment outcome was 82.7% disease-specific survival (DSS) at a median follow-up of 41 months, with a 10.3% incidence of systemic metastasis in intermediate- or high-grade SGCs treated with surgery alone. The primary reasons for not receiving adjuvant RT were no recommendation by the surgeon (37.9%) and patient refusal of RT (27.6%). Comparisons of the surgery alone and surgery with postoperative RT in tumor pathology (grade)- and tumor stage-matched groups revealed similar treatment outcomes; 100% DSS at 35-50 months in the surgery alone group and 90-100% DSS at 37-60 months in the surgery and postoperative RT group. Meanwhile, patients with advanced SGCs (T3-4 or N+) treated with surgery alone had a DSS of 50.0% at a median follow-up of 63 months, and systemic metastasis was the main cause of treatment failure (37.5%).</p><p><strong>Conclusion: </strong>Our findings suggest that surgery alone may yield favorable outcomes for a specific subset of early-stage, intermediate- to high-grade SGCs without any adverse pathological features. Further studies are warranted to validate this approach. </p>.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"116-125"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532863","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":"Implications of Intranasal Trigeminal Nerve Function on the Surgical Management of Nasal Obstruction.","authors":"Anna Kristina Hernandez, Konstantinos Garefis, Iordanis Konstantinidis, Thomas Hummel","doi":"10.1159/000547916","DOIUrl":"10.1159/000547916","url":null,"abstract":"<p><p><p>Background: Surgical interventions for nasal obstruction represent a significant proportion of everyday rhinology practice. Failure to improve patients' symptoms may be due to incomplete assessment of co-morbidities, low sensitivity for nasal airflow, and inadequate therapeutic approaches. This narrative review summarizes the evidence on studies assessing the results of nasal obstruction surgery in relation to trigeminal function measurements. Focus was given to specific procedures such as septoplasty, endoscopic sinus surgery, and surgery of inferior turbinates. Summary: Current literature provides evidence that a significant proportion of patients have decreased intranasal trigeminal function before surgery. Most nasal surgeries conserve trigeminal nerve function, except when more aggressive techniques like inferior turbinate resection or excessive cautery are performed. Key Messages: Trigeminal function should be evaluated in patients presenting with nasal obstruction, especially in the absence of major anatomical blockage. Nasal trigeminal sensitivity may be a contributing factor to perceived obstruction that surgery alone cannot resolve. </p>.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"85-97"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12503671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144819079","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":"Trends in Etiology and Outcomes of Acquired Unilateral Vocal Fold Paralysis: A Multicenter Retrospective Study in Peninsular Malaysia.","authors":"Nadhirah Mohd Shakri, Jason Yun Bing Lo, Marina Mat Baki, Zahirrudin Zakaria, Nik Fariza Husna Nik Hassan, Syarifah Nafisah Syed Hamzah, Bao Ling Wong, Puvanaeswaran Dakshinamurthi, Mawaddah Azman","doi":"10.1159/000546457","DOIUrl":"10.1159/000546457","url":null,"abstract":"<p><strong>Introduction: </strong>Unilateral vocal fold paralysis (UVFP) results from either mechanical or neurological causes, significantly impacting voice, breathing, and swallowing functions. Thyroid and parathyroid surgeries are commonly implicated as surgical causes; however, nonsurgical etiologies remain diverse. Some studies have suggested a change in the trend of UVFP etiologies over time, likely due to advancements in surgical techniques, improved diagnostics, and evolving healthcare practices. This study examines trends in etiology and outcomes of UVFP with early interventions in a multicenter setting in Malaysia over 2 decades.</p><p><strong>Methods: </strong>A retrospective, multicenter review of UVFP cases was conducted over two periods: 2004-2012 and 2013-2021. Data on patient demographics, UVFP etiology, laterality, and intervention outcomes were analyzed. Interventions included voice therapy alone or in combination with early surgical interventions. Statistical analysis was performed to compare trends and outcomes across periods.</p><p><strong>Results: </strong>Thyroid and parathyroid surgeries remained the predominant surgical cause of UVFP. Iatrogenic UVFP was more commonly right-sided, while nonsurgical cases predominantly involved the left side. No significant differences were observed in the distribution of surgical and nonsurgical etiologies between the two study periods. Early interventions demonstrated significantly better voice outcomes compared to voice therapy alone (p < 0.05).</p><p><strong>Conclusion: </strong>This is the first long-term, multicenter study in Malaysia addressing UVFP trends and outcomes. Early surgical interventions provide superior outcomes compared to conservative approaches, highlighting the need for timely diagnosis and management to optimize patient care.</p>","PeriodicalId":520736,"journal":{"name":"ORL; journal for oto-rhino-laryngology and its related specialties","volume":" ","pages":"108-115"},"PeriodicalIF":1.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144487745","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}