The Annals of otology, rhinology, and laryngology最新文献

{"title":"3D Printing of the Pediatric Sinuses: Defining the Frontal Outflow Tract and Sinonasal Pathology.","authors":"Katie Melder, Hannah Piston, Elliott Hammersley, Anish Ghodadra, Amanda L Stapleton","doi":"10.1177/00034894251353312","DOIUrl":"https://doi.org/10.1177/00034894251353312","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the utility of 3-dimensional printing for both trainee education in frontal sinus anatomy and preoperative surgical planning in complex sinonasal pathology.</p><p><strong>Methods: </strong>A quasi-experimental pre/postsurvey study was performed at a tertiary care center pediatric rhinology clinic. Four otolaryngology residents and 1 pediatric attending at an academic otolaryngology program were included. Eleven 3D printed models of the pediatric sinuses were created from CT maxillofacial scans. Six models were used to define the frontal outflow pathway. Five additional 3D models were created for pre-surgical planning. The models were dissected in the lab to facilitate surgical planning, technique, and instrumentation selection. Pre- and post-survey evaluations of the training experience were completed by participants. Cost analysis data was collected from the home institution's 3D printing program.</p><p><strong>Results: </strong>Models were accurate to the actual CT scan that they were created from; however, the consistency of the 3D printed models was more firm than true anatomic specimens. Painting sinonasal pathology and the frontal outflow pathway in a distinct color was extremely helpful in identification. Participant post-simulation survey results showed that 60% of participants found the simulation moderately valuable and 40% found it valuable or very valuable as a training tool. A cost analysis was also performed with an average final production cost of $420.52 ± $239.52 per model.</p><p><strong>Conclusion: </strong>3D printed models are a useful tool to study and plan for uncommon sinonasal pathology. They can also serve as a useful trainee tool for learning frontal sinus anatomy. This feasibility study shows that 3D sinus models are affordable and accurate in preserving and identifying important anatomical landmarks. The cost-effectiveness, reusability, and customization of these models support their potential for broader implementation in pediatric surgical training curriculum.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251353312"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645241","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":"Quality of Life Assessment Following Botulinum Toxin Injection in Patients with Adductor Spasmodic Dysphonia Using the 5-Factor Glasgow Benefit Inventory.","authors":"Michael A Cirelli, Michael J Marino, David G Lott, Charles H Adler, Stephen F Bansberg","doi":"10.1177/00034894251356728","DOIUrl":"https://doi.org/10.1177/00034894251356728","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>Botulinum neurotoxin type-A (BoNT-A) injection into the true vocal cords is an effective treatment for restoring vocal functionality in adductor spasmodic dysphonia (AdSD). The Glasgow Benefit Inventory was developed to measure quality of life change following any otolaryngologic intervention and was recently revised to a 5-factor subdomain (GBI-5F) questionnaire to improve clinical utility. The study aim was to utilize the GBI-5F to measure patient-reported quality of life change in AdSD patients following BoNT-A injection.</p><p><strong>Methods: </strong>The GBI-5F questionnaire was administered to patients diagnosed with AdSD who received a BoNT-A vocal cord injection between December 2022 and May 2023. All patients had received multiple prior injections. GBI-5F subdomains and demographics were analyzed to identify areas for patient-reported improvement.</p><p><strong>Results: </strong>Sixty-six patients completed the GBI-5F. There were 52 (78.7%) females and average age was 69.4 years. The median total benefit score was +40.0 (interquartile range [IQR], 20.0). Median subdomain scores were +83.3 (IQR, 50.0) for quality of life, +50.0 (IQR, 50.0) for self-confidence, +33.3 (IQR, 33.3) for social involvement, +16.7 (IQR, 50.0) for support, and 0.0 (IQR, 16.7) for general health. Differences in the individual subdomain scores were statistically significant (<i>P</i> < .0001). No significant differences were found in the total GBI-5F score or any subdomain according to sex or presence of vocal tremor (all <i>P</i> > .05). A moderately positive correlation was noted between median total score and percent functional improvement (r = 0.46, <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Botulinum injection therapy for AdSD provides overall benefit to patients as measured by the GBI-5F, with particular improvement observed for perceived quality of life, self-confidence, and social involvement. Sex, presence/absence of vocal tremor, and age do not appear to modify benefit, though degree of functional improvement is positively correlated with total score.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251356728"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144645242","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":"Comment on \"Leveraging Large Language Models to Enhance Patient Educational Resources in Rhinology\": Implications for ENT Education and Equity.","authors":"James R Burmeister, Forrest Bohler","doi":"10.1177/00034894251356571","DOIUrl":"https://doi.org/10.1177/00034894251356571","url":null,"abstract":"","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251356571"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621767","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":"Comment on \"Health-Related Quality of Life Metrics in Patients With Retrograde Cricopharyngeus Dysfunction\": Highlighting the Psychosocial Burden of R-CPD.","authors":"James R Burmeister, Lauren L Walkon","doi":"10.1177/00034894251357136","DOIUrl":"https://doi.org/10.1177/00034894251357136","url":null,"abstract":"","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251357136"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621766","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":"Five-Year Graft Outcomes and Complications of Endoscopic Cartilage-Perichondrium Sandwich Myringoplasty for Large Central Perforations.","authors":"Zhonghan Jiang, Rongxin Mao","doi":"10.1177/00034894251356306","DOIUrl":"https://doi.org/10.1177/00034894251356306","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated the 5-year graft success rate and incidence of iatrogenic cholesteatoma following endoscopic cartilage-perichondrium sandwich myringoplasty for the repair of large central tympanic membrane perforations.</p><p><strong>Materials and methods: </strong>This retrospective study included patients with large central perforations who underwent endoscopic cartilage-perichondrium sandwich myringoplasty. Graft integrity and the presence of iatrogenic middle ear cholesteatoma were assessed at a 5-year postoperative follow-up.</p><p><strong>Results: </strong>In total, 86 patients were included in the final analysis. The mean follow-up duration was 6.4 ± 1.2 years (range, 5-7 years). The graft take rates were 96.5% at 3 months, 94.2% at 6 months, and 93.0% at 5 years postoperatively. At 6 months postoperatively, 2.44% of patients demonstrated no change in hearing, whereas 3.66% experienced a deterioration in conductive hearing. In the remaining 93.90% of patients, the improvement in hearing was statistically significant; the mean air-bone gap decreased from 25.1 ± 4.6 dB preoperatively to 14.9 ± 3.1 dB postoperatively (<i>P</i> < .05). At the 5-year follow-up, high-resolution computed tomography (HRCT) revealed well-pneumatized mastoid and middle ear cavities in 93.02% of patients, eliminating the need for magnetic resonance imaging (MRI). HRCT revealed soft tissue opacities in the mastoid region in 4 patients who had undergone canal wall up mastoidectomy (CWUM) and in 2 patients without CWUM; however, subsequent MRI excluded mastoid cholesteatoma in all 6 cases. Notably, a small graft cholesteatoma was detected in 1 patient (1.16%).</p><p><strong>Conclusions: </strong>Five-year imaging follow-up demonstrated that endoscopic cartilage-perichondrium sandwich myringoplasty, performed without removal of the epithelium from the tympanic membrane remnant, achieved a stable graft success rate in the repair of large central perforations. The procedure was associated with a minimal risk of graft cholesteatoma and no observed risk of middle ear cholesteatoma.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251356306"},"PeriodicalIF":0.0,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621768","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":"Familial Laryngeal Cleft: Pediatric Detection Leads to Adult Diagnosis and Intervention.","authors":"Hannah R Turbeville, Robert J Morrison, Glenn E Green","doi":"10.1177/00034894251356731","DOIUrl":"https://doi.org/10.1177/00034894251356731","url":null,"abstract":"<p><strong>Objective: </strong>This case report describes five related patients presenting with signs and symptoms of chronic aspiration who were found to have laryngeal clefts requiring surgical intervention. This case highlights a possible underlying genetic cause of laryngeal cleft and need for further study in this area.</p><p><strong>Methods: </strong>A retrospective review of patients' clinical presentations, surgical intervention, procedural photographs and imaging studies was conducted.</p><p><strong>Results: </strong>Five members of a family of 6 demonstrated symptoms consistent with chronic aspiration that became more evident during the COVID pandemic due to social isolation and perceived social pressure around coughing. One child had a history of swallowing difficulty and was found to have a laryngeal cleft on operative evaluation. This led to further evaluation of the rest of the family, with all 4 children and their father having an identifiable laryngeal cleft. All showed marked improvement after surgical repair. Genetic testing was performed and identified a familial variant of uncertain significance in the <i>FBN1</i> gene (c.466A > C; p.N156H).</p><p><strong>Conclusion: </strong>An unidentified genetic or environmental component may contribute to laryngeal cleft. There is insufficient reporting of case of related patients to identify an inheritance pattern or specific genetic mutation. Further case reporting and study is needed in this area.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251356731"},"PeriodicalIF":0.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593818","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":"Facial Neuromas Misdiagnosed as Recurrent or Idiopathic Palsy: A Systematic and Institutional Review.","authors":"Kaitlynne Y Pak, Alberto Nunez, Andre Boyke, Mia E Miller","doi":"10.1177/00034894251350898","DOIUrl":"https://doi.org/10.1177/00034894251350898","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the incidence of recurrent facial palsy and the frequency of misdiagnosis as Bell's palsy in patients with intratemporal facial nerve schwannomas (FNSs)Methods:A systematic review of PubMed and Cochrane databases and a single-institutional analysis were conducted, covering studies from the past 10 years on adult cases of intratemporal FNS with documented facial nerve function at presentation. Inclusion criteria focused on patients presenting with facial paralysis to assess recurrence rates and misdiagnoses as Bell's palsy. Key outcomes included incidence, severity, and the number of prior facial paralysis episodes at the time of FNS diagnosis.</p><p><strong>Results: </strong>From 284 studies identified, 77 full texts were reviewed, and 53 met inclusion criteria, totaling 531 patients. Among the 531 patients, 55.6% (295) initially presented with facial paralysis. We found that 4.5% (24) of all patients in the systematic review and 22.2% (2) of cases in our institutional review with an intratemporal FNS were initially misdiagnosed with Bell's palsy. Of those who presented with facial paralysis, misdiagnosis as Bell's palsy was noted in 8.14% (24) of the systematic review and 100% (2) of our institutional review. The average House-Brackmann (HB) scores worsened from initial presentation to pre-operative assessment (mean scores: 2.07 ± 1.49 vs 2.94 ± 1.73).</p><p><strong>Conclusions: </strong>Our single-institutional and systematic review emphasizes that facial paralysis is a common presenting symptom of FNS. Although idiopathic (Bell's) palsy is the most frequent cause of facial paralysis, it remains a diagnosis of exclusion and a neoplastic cause should be ruled out in certain cases. A high index of suspicion is warranted for persistent (>3 months) or recurrent facial palsy, particularly when accompanied by otologic symptoms. Early identification of FNS enables timely interventions, such as facial nerve decompression, which may preserve native nerve function.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251350898"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586185","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":"Neuritis Ossificans in the Facial Nerve: A Case Report.","authors":"Alyssa J Snyder, Keven Seung Yong Ji, Matthew D Wood, Myriam Loyo Li","doi":"10.1177/00034894251353576","DOIUrl":"https://doi.org/10.1177/00034894251353576","url":null,"abstract":"<p><strong>Objectives: </strong>Neuritis ossificans is a rare condition involving heterotopic ossification of nerves, usually affecting major peripheral nerves. Two cases involving cranial nerves are documented, with none affecting the facial nerve. The aim of this report is to present the first documented case of neuritis ossificans involving the facial nerve (CN VII), with a review of clinical, radiologic, and histologic findings.</p><p><strong>Methods: </strong>An 88-year-old male with a history of radiation therapy for right ear basal cell carcinoma presented with 18 months of progressive right-sided facial weakness, resulting in complete flaccid paralysis. MRI revealed subtle enhancement of the right trigeminal nerve. He underwent facial nerve exploration. Intraoperatively, a large segment of the facial nerve appeared grossly abnormal, and biopsy revealed small rounded and linear mineral deposits with concentric internal structuring, lined focally by collections of histiocytes. This is a single case report with literature review.</p><p><strong>Results: </strong>Histopathology confirmed the absence of malignancy and identified mineral deposits consistent with neuritis ossificans. Given the extensive nerve damage, nerve transfers were not feasible, leading to the decision to proceed with static suspension surgery.</p><p><strong>Conclusion: </strong>This case is the first known instance of neuritis ossificans affecting the facial nerve, emphasizing the diagnostic challenge in this rare condition. Histopathological evaluation was critical for diagnosis, informing the decision for static suspension surgery due to irreversible paralysis.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251353576"},"PeriodicalIF":0.0,"publicationDate":"2025-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577627","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":"Efficacy of the Exhalation Delivery System With Fluticasone for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.","authors":"Yeon Hee Im, Gulnaz Stybayeva, Se Hwan Hwang","doi":"10.1177/00034894251349397","DOIUrl":"https://doi.org/10.1177/00034894251349397","url":null,"abstract":"<p><strong>Objectives: </strong>Novel biomechanics of the exhalation delivery system can deliver fluticasone (EDS-FLU; XHANCE) to sinonasal areas above the inferior turbinate, especially sinus drainage pathways not reached by standard nasal sprays. This study aimed to evaluate the effectiveness of EDS-FLU in treating chronic rhinosinusitis (CRS).</p><p><strong>Methods: </strong>Studies were retrieved from PubMed, SCOPUS, Embase, Web of Science, and Cochrane databases up to April 2024. We analyzed 5 studies that compared EDS-FLU with a control group (exhalation delivery system with placebo) on various outcomes, including the 22-item Sinonasal Outcome Test (SNOT-22), nasal symptom scores (congestion, facial pain, olfactory dysfunction, and rhinorrhea), nasal polyp scores, surgical indication rate, and the incidence of adverse effects.</p><p><strong>Results: </strong>Five studies with 2129 patients were included. EDS-FLU significantly improved SNOT-22 score (-20.9657 [-23.5639; -18.3674]) and the polyp score (-1.5099 [-1.7810; -1.2388]) after 6 months. The incidence of epistaxis was significantly higher in the treatment group compared to the control group (OR = 5.7954 [2.1004; 15.9909]). Effects of EDS-FLU on polyp score (-0.6497 [-0.8186; -0.4807]), responder rate (OR = 2.1755 [1.2784; 3.7020]), complete responder rate (OR = 2.0423 [1.0109; 4.1262]), surgical indication rate (OR = 0.7313 [0.5459; 0.9797]), and SNOT-22 score (-6.1513 [-11.3054; -0.9972]) were significantly higher in the treatment group than in the control group.</p><p><strong>Conclusions: </strong>This study demonstrated that EDS-FLU (372 µg twice daily) produced statistically significant improvements compared to EDS-placebo in multiple subjective and objective outcomes, although some adverse effects, such as epistaxis, may occur.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251349397"},"PeriodicalIF":0.0,"publicationDate":"2025-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568322","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":"Influence of Spirituality on Severity, Quality of Life, and Mental Health of Tinnitus Patients.","authors":"Ludimila de Oliveira Cardoso Ouverney, Giancarlo Lucchetti, Caroline Hansen da Silva, Julia Berzoini Albuquerque, Oscarina da Silva Ezequiel, Alessandra Lamas Granero Lucchetti","doi":"10.1177/00034894251349411","DOIUrl":"https://doi.org/10.1177/00034894251349411","url":null,"abstract":"<p><strong>Objective: </strong>Despite the growing evidence on the role of spiritual and religious beliefs on physical and mental health outcomes, this remains inadequately explored in the field of otolaryngology, particularly for chronic conditions such as tinnitus. This study aims to investigate the influence of spiritual and religious beliefs on symptom severity, quality of life, and mental health of Brazilian patients with chronic subjective tinnitus.</p><p><strong>Methods: </strong>Cross-sectional study including patients with chronic subjective tinnitus.</p><p><strong>Setting: </strong>Specialized outpatient center in Brazil. Religious and spiritual variables (Duke Religion Index, FACIT-Sp 12, and SRCOPE - religious coping) were investigated on the relationship with tinnitus severity (Tinnitus Handicap Inventory), mental health (DASS-21), and quality of life (WHOQOL-Bref), adjusting for sociodemographics, clinical data, and physical examination findings. Linear Regression models were used.</p><p><strong>Results: </strong>A total of 313 patients were included. Spiritual well-being measures were associated with better results (particularly for Meaning and Peace); meanwhile, negative religious coping was associated with worse outcomes for all variables. Religiosity has presented a mixed effect, with nonorganizational religiosity having better outcomes for mental health and quality of life, and intrinsic religiosity having worse outcomes for tinnitus severity.</p><p><strong>Conclusion: </strong>The present study found that religious and spiritual beliefs can have an important influence on the perception of tinnitus severity, mental health, and quality of life of individuals with chronic tinnitus. These findings support the importance of otolaryngologists' and audiologists' understanding of their patients' beliefs to provide more comprehensive and integrative care.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"34894251349411"},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532883","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}