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

{"title":"Vitamin D Supplementation for Preventing Recurrent Benign Paroxysmal Positional Vertigo: A Randomized Clinical Study.","authors":"Hussein Ali Tawfeeq, Mustafa Adnan Zaidan, Ali Kamal Ghanim","doi":"10.1177/00034894261449743","DOIUrl":"10.1177/00034894261449743","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether cholecalciferol supplementation reduces recurrence rates in patients with benign paroxysmal positional vertigo (BPPV) and concurrent vitamin D deficiency.</p><p><strong>Study design: </strong>Prospective, randomized, double-blind, placebo-controlled trial.</p><p><strong>Setting: </strong>Two tertiary otolaryngology centers in Baghdad, Iraq (Al-Kafaat Hospital ENT outpatient clinic and Al-Dora Hospital ENT outpatient clinic).</p><p><strong>Methods: </strong>One hundred sixty adults with confirmed idiopathic BPPV and serum 25-hydroxyvitamin D < 20 ng/mL were randomized 1:1 to receive cholecalciferol 10 000 IU weekly or matched placebo for 24 months. Primary outcome was BPPV recurrence (cumulative incidence, time-to-first recurrence) at 6, 12, 18, and 24 months. Secondary outcomes included vitamin D concentrations, DHI scores, per-participant recurrence frequency, and safety parameters. Full intention-to-treat analysis; missing data handled by multiple imputation.</p><p><strong>Results: </strong>Baseline characteristics were balanced between groups (mean age 36.8 ± 7.2 years). Cholecalciferol significantly elevated serum 25-hydroxyvitamin D concentrations at all timepoints (24 months: 24.8 ± 3.2 vs 9.8 ± 3.6 ng/mL, <i>P</i> < .001). BPPV recurrence was significantly reduced with cholecalciferol versus placebo at 6 months (15.0% vs 35.0%, <i>P</i> = .004), 12 months (22.5% vs 48.8%, <i>P</i> < .001), 18 months (25.0% vs 52.5%, <i>P</i> < .001), and 24 months (27.5% vs 55.0%, <i>P</i> < .001), representing a 50% relative risk reduction. Number needed to treat was 3.6. No hypercalcemic episodes occurred. Treatment adherence exceeded 94% in both groups.</p><p><strong>Conclusion: </strong>Cholecalciferol supplementation provides sustained, clinically meaningful reduction in BPPV recurrence among vitamin D-deficient patients over 24 months with excellent safety profile. Routine vitamin D assessment and targeted supplementation may be considered in vitamin D-deficient BPPV patients.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"720-727"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849234","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 Acute Tonsillitis: Re-evaluating Surgical Indications Through Long-Term Outcome Assessment.","authors":"Hannah Inez Houborg, Tejs Ehlers Klug","doi":"10.1177/00034894261437481","DOIUrl":"10.1177/00034894261437481","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether current tonsillectomy (TE) guidelines for adults with recurrent acute tonsillitis (RT) are too restrictive, potentially excluding patients who would benefit from surgery, and to explore predictive factors of improved postoperative Throat-Related Quality of Life (TR-QoL).</p><p><strong>Methods: </strong>In this prospective cohort study, patients undergoing TE were stratified into 3 groups based on increasingly stringent criteria: G1 (not meeting the Danish National Guidelines (DNG) or the Scottish Intercollegiate Guidelines Network [SIGN]/Paradise criteria), G2 (meeting only DNG), and G3 (meeting both DNG and SIGN/Paradise criteria). The effects of TE were assessed using the Tonsillectomy Outcome Inventory 14 (TOI-14) and the Glasgow Benefit Inventory (GBI). TOI-14 scores, GBI scores, patient satisfaction and postoperative sore throat episodes were evaluated after 12, 24 and 36 months. Predictive factors of improved TR-QOL were identified using multiple linear regression.</p><p><strong>Results: </strong>At baseline, 65 patients (G1: n = 21, G2: n = 33, G3: n = 11) were analyzed. Response rates ranged from 65% to 86% at follow-ups. All groups demonstrated significant, sustained improvements in TOI-14 and GBI scores. TOI-14 total scores improved from 45.0 at baseline to 8.1-10.2 at follow-ups, GBI total scores ranged from 34.9-40.1, satisfaction rates were high (96%-98%), and sore throat episodes were infrequent postoperatively. Group differences were minimal. The preoperative TOI-14 score was the strongest predictor of improved TR-QOL (adjusted <i>R</i>² = 0.723).</p><p><strong>Conclusions: </strong>TE provided sustained benefits and significantly improved TR-QoL across a broad range of RT patients, including those who did not meet current guideline criteria, suggesting that guidelines may be too restrictive. The preoperative TOI-14 score was the strongest predictor of TR-QoL improvement. Integrating such a patient-centered tool to select patients for TE may enhance RT patient management.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"673-685"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147694747","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":"A Novel 3D-Printed Simulator for Patient-Directed Home Drain Removal in Head and Neck Surgery.","authors":"Vidhya Kannan, Taylor Freeman, Matthew Marquardt, Rachel Herster, Kyle Vankoevering, Nolan Seim","doi":"10.1177/00034894261438573","DOIUrl":"10.1177/00034894261438573","url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to develop and implement a novel 3D printed simulator to be used to educate patients about home drain removal prior to discharge and to highlight its benefits to the patient and healthcare systems.</p><p><strong>Methods: </strong>A deidentified CT scan was used to create an anatomically accurate 3D printed mold of a neck. Additional conduits and inserts were added to the simulator during the silicone molding process. Simulators were produced and utilized on inpatient floors of a head and neck service at one comprehensive cancer center to assist with patient education for an existing home drain removal program.</p><p><strong>Results/discussion: </strong>Three novel simulators were produced and used in the patient discharge training program for patient-directed home drain removal. 3D anatomic models have been shown to improve patient understanding and assist with acquisition of procedural skills, so the incorporation of a drain removal simulator into a home drain removal program sought to improve patient comfort with drain removal and expand the number of eligible patients for this program. Home drain removal is associated with reduced unnecessary clinic visits, lower healthcare costs, and optimized resource utilization.</p><p><strong>Conclusion: </strong>A 3D printed drain removal simulator has the potential to enhance patient education for home-based surgical neck drain removal and expand enrollment in self-directed drain removal. Greater enrollment in home drain removal has the potential to benefit patients and healthcare systems through improved time efficiency and financial savings.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"692-697"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680248","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":"Functional Outcomes of Tympanoplasty Based on Graft Position: Medial Versus Lateral to the Malleus Handle.","authors":"Tabish Maqbool, Showkat Ahmed Showkat, Ihsan Ali, Waqar Ul Hamid, Danish Andrabi","doi":"10.1177/00034894261437484","DOIUrl":"10.1177/00034894261437484","url":null,"abstract":"<p><strong>Objectives: </strong>This study compared the functional and anatomical outcomes of medial versus lateral graft placement techniques in type I tympanoplasty, focusing on hearing improvement and residual perforation rates. Tympanoplasty is a common surgical intervention for tympanic membrane (TM) perforations aimed at improving hearing and achieving tympanic closure. Debate continues regarding the optimal graft placement-medial or lateral to the handle of the malleus-for superior postoperative outcomes.</p><p><strong>Methods: </strong>A retrospective comparative study was conducted on 48 patients aged 15 to 50 years with central TM perforations and preoperative air-bone gap (ABG) > 25 dB. Group 1 (n = 23) underwent medial graft placement, and Group 2 (n = 25) underwent lateral placement. ABG changes at 3 months post-surgery were assessed using audiometry. Statistical analysis included independent and paired t-tests, Fisher's Exact Test, 2-way ANOVAs, and Cohen's d for effect size estimation. Ethical approval was obtained from the Institutional Ethical Committee (ECR/467/Inst/AP/2013/RR-19).</p><p><strong>Results: </strong>Both groups exhibited significant postoperative hearing improvement. Mean ABG gain was 21.6 dB in Group 1 and 20.1 dB in Group 2 (<i>P</i> = .567). No statistically significant difference was found in pre- or postoperative ABG values or residual perforation rates (<i>P</i> = 1.0). Effect sizes for all comparisons were negligible (Cohen's <i>d</i> < 0.2). Demographics, including age and gender, showed no interaction effects on outcomes.</p><p><strong>Conclusion: </strong>Medial and lateral graft placements in tympanoplasty yield comparable functional and anatomical results. Given the negligible differences, graft positioning should be tailored to intraoperative findings and individual anatomical considerations. Larger, multicenter studies with varied graft materials and longer follow-up are warranted for definitive guidance.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"666-672"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648799","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":"Tinnitus Trends in Young Adults: Prevalence and Duration from 2008 to 2023.","authors":"Ryan A Bartholomew, Calvin J Kersbergen, Neil Bhattacharyya","doi":"10.1177/00034894261449794","DOIUrl":"10.1177/00034894261449794","url":null,"abstract":"<p><strong>Purpose: </strong>To assess for longitudinal changes in the prevalence, duration, and self-perceived impact of persistent tinnitus amongst young adults (ages 18-24) in the United States.</p><p><strong>Methods: </strong>The adult National Health Interview Surveys (NHIS) for calendar years 2008 and 2023 were investigated for specific tinnitus related symptoms among young adults (ages 18-24). The prevalence of tinnitus in the past 12 months and the overall duration of tinnitus symptoms were determined and compared between the 2 survey years.</p><p><strong>Results: </strong>In 2023, an estimated 2.30 million young adults reported tinnitus in the prior 12 months, risk for which was increased with very loud sound exposure (odds ratio [95% confidence interval], 2.6 [1.7-3.9]). Tinnitus was reported to be a moderate or big problem in 8.7% and 3.1% of respondents, respectively, and only 10.1% saw a medical specialist for their tinnitus. The prevalence of tinnitus increased from 5.8% in 2008 to 7.8% in 2023 (<i>P</i> = .030). From 2008 to 2023 there was also an increase in duration of tinnitus (<i>P</i> < .001).</p><p><strong>Conclusion: </strong>Nationally representative data indicate a concerning increasing prevalence and duration of tinnitus among young adults with a significant self-perceived impact. This increasing prevalence of tinnitus may reflect underlying issues of noise exposure and merits further ongoing surveillance.</p><p><strong>Level of evidence: </strong>IV.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"728-730"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147849250","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":"Intraoperative and Postoperative Advantages of two Absorbable Materials for Supporting Graft in Endoscopic Tympanoplasty: Oxidized Regenerated Cellulose (Surgicel^®) Over Gelatin Sponge (Spongostan^®).","authors":"Erkan Karatas, Mustafa Ibas, Mehmet Nuri Elgormus","doi":"10.1177/00034894261437476","DOIUrl":"10.1177/00034894261437476","url":null,"abstract":"<p><strong>Objective: </strong>To compare the intraoperative and postoperative outcomes of using oxidized regenerated cellulose (Surgicel^®) versus absorbable gelatin sponge (Spongostan^®) for supporting graft material in endoscopic tympanoplasty.</p><p><strong>Methods: </strong>We retrospectively analyzed 92 patients who underwent endoscopic type 1 tympanoplasty between 2020 and 2024. Patients were divided into 2 groups based on the supporting graft material used: 47 received Surgicel^® and 45 received Spongostan^®. Primary outcome measures included intraoperative hemostasis quality, duration of graft placement, postoperative graft success, graft lateralization, and hearing outcomes at 6 and 12 months.</p><p><strong>Results: </strong>Hemostasis during graft placement was better in the Surgicel^® group (<i>P</i> = .017), and shorter graft placement duration was observed (<i>P</i> = .047). At ≥ 6 months, graft success rates were comparable between the groups (89.4% for Surgicel^® vs 82.2% for Spongostan^®; <i>P</i> = .380). However, graft lateralization was significantly less frequent in the Surgicel^® group (2.1%) compared to the Spongostan^® group (15.6%; <i>P</i> = .029). While the Spongostan^® group showed significantly better hearing results at 6 months (mean ABG 16.9 dB vs 28.6 dB; <i>P</i> < .001), hearing outcomes were similar by 12 months.</p><p><strong>Conclusion: </strong>Both Spongostan^® and Surgicel^® are effective supporting graft materials in endoscopic tympanoplasty. However, Surgicel^® was associated with certain intraoperative advantages, including superior hemostasis and shorter operative time, along with a significantly lower risk of postoperative graft lateralization. These benefits suggest Surgicel^® may be a preferable option for enhancing surgical efficiency and optimizing outcomes in endoscopic ear surgery.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"686-691"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826267","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":"Factors Influencing Post-Operative Oral Intake Following Tonsillectomy in Children with OSA.","authors":"Michael Nicolette, Yekaterina Shapiro, Kathy Zhang, Lucia Diaz Garcia, Nadeem R Kolia, Krystal Hunter, Hari Roth, Benjamin Rosen, Bailey Balouch, Donald Solomon","doi":"10.1177/00034894261437492","DOIUrl":"10.1177/00034894261437492","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the factors that influence oral intake in the first 24 hours following tonsillectomy in children performed for Obstructive Sleep Apnea (OSA) and their impact on dehydration in the 30-day post-operative period.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted reviewing the records of 1200 patients who underwent tonsillectomy. Patients were excluded if they were 19 years or older, did not have a diagnosis of SDB (sleep disordered breathing) or OSA (obstructive sleep apnea), or their oral intake was not recorded for 24 hours post-operatively. Primary outcomes were 24-hour post-operative oral intake controlled for body weight and post-operative dehydration determined by ED visits or phone calls for dehydration within 30 days post-operatively.</p><p><strong>Results: </strong>357 patients were included. Higher BMI (body mass index; <i>r</i> = -.261) older age (<i>r</i> = -.393), longer operative time (<i>r</i> = -.125), longer time under anesthesia (<i>r</i> = -.186), higher apnea-hypopnea index (AHI; <i>r</i> = -.171), higher pain scores (<i>r</i> = -.239), and the presence of a resident (<i>P</i> = .028) were all significantly associated with lower oral intake. Post-operative oral intake did not have a significant effect on post-operative dehydration events (OR = 0.995, 95% CI [0.975-1.015]).</p><p><strong>Conclusion: </strong>Our findings suggest that age, BMI, operative time, time under anesthesia, AHI, pain, and the presence of a resident were significantly associated with post-operative oral intake following tonsillectomy. Post-operative oral intake was not associated with dehydration in the 30-day surgical recovery period.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"659-665"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147648805","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":"Identifying and Mitigating Risk Factors for Last Minute Otolaryngology Surgical Cancelations.","authors":"Lauren Linquest, Courtney B Shires, Noah Young, Amir Kaskas, Andee Fontenot, Kayla Jasper, Karuna Dewan","doi":"10.1177/00034894261440647","DOIUrl":"10.1177/00034894261440647","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective is to identify patient-based risk factors influencing otolaryngologic surgical no-shows. Secondarily we compare surgical no-show rates of patients undergoing otolaryngology surgery in the pre-COVID-19 pandemic versus the post-COVID-19 pandemic.</p><p><strong>Methods: </strong>Retrospective chart review performed on all patients with surgical appointments at Ochsner-LSU Health with any Otolaryngology physician over a 3-months pre- and post-pandemic. Participants were separated as having the surgical procedure completed, canceled greater than 48 hours before the procedure, or a cancelation within 48 hours of the procedure. Distance from the hospital, procedure type, diagnosis related to surgery, cancelation reasons, subspecialty clinic, date of clinic appointment, need for medical clearances, and any pre-operative test results were recorded.</p><p><strong>Results: </strong>Elective cases were significantly more likely to no-show than non-elective cases (24% vs 16.3%, <i>P</i> = .02). Additionally, patients who did not show up to the pre-operative testing appointments were significantly more likely to cancel within 48 hours of surgery than those with normal or abnormal pre-operative testing (<i>P</i> < .001). A difference in no-show rates was found between subspecialties (<i>P</i> = .01) with rhinology having the most no-shows (30.4%). No statistically significant difference was found between the pre- and post-pandemic groups who canceled within 48 hours of surgery.</p><p><strong>Conclusion: </strong>Risks for no-show included failure to attend pre-op appointment, elective surgery, and rhinology surgery. There was no change in no-show risk factors from pre-COVID-19 pandemic to post COVID-19 pandemic.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"707-713"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147826248","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":"Exploring the Predictive Value of National Residency Matching Program (NRMP) Rank in Residency Outcomes.","authors":"Emily Kwon, Mingzhuo Pei, Annie Xu, Rohini Ravi Bahethi, Evelyne Kalyoussef, Wayne Daniel Hsueh","doi":"10.1177/00034894261436872","DOIUrl":"10.1177/00034894261436872","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between the National Residency Matching Program (NRMP) rank list position and otolaryngology residency performance.</p><p><strong>Methods: </strong>Five consecutive graduating classes at a single institution's otolaryngology residency training program (2021-2025) were evaluated (n = 18) using their complete 5-year data. Correlation coefficients were calculated to assess the relationship between NRMP rank and in-service exam scores, research productivity, total case logs, milestone evaluations, selection as Administrative Chief Resident, receipt of teaching awards, and post residency position. Milestone evaluations were based on faculty ratings across all 7 core competencies on a 1- to 7-point scale, with an average score calculated for each resident. Spearman's rho was used to evaluate correlations between NRMP rank and both in-service scores and milestone evaluations. Chi-square tests were conducted to assess associations between NRMP rank and categorical outcomes, including selection as Administrative Chief Resident, receipt of the teaching award, and post residency position.</p><p><strong>Results: </strong>The average NRMP rank of the residents was 8.778 (range: 1-26). There was a significant correlation between higher NRMP rank and higher milestone evaluations (ρ = -.544, <i>P</i> = .020). However, no significant correlations between NRMP rank and in-service exam scores, research productivity, total case logs, selection as Administrative Chief Resident, receipt of the teaching award, or post residency position were found.</p><p><strong>Conclusion: </strong>Our results suggest that better-ranked residents receive higher milestone evaluation scores. However, NRMP rank alone may not reliably predict performance on in-service exam scores, chief resident selection, receipt of teaching awards, or position after residency training.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"653-658"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147625305","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":"Medicare Reimbursement Trends in Sleep Surgery: A 2 Decade Analysis of the Most Billed Codes.","authors":"Antony A Fuleihan, Praneet Kaki, Tyler J Allcroft, Anders Sideris, Maurits Boon, Colin Huntley","doi":"10.1177/00034894261441050","DOIUrl":"10.1177/00034894261441050","url":null,"abstract":"<p><strong>Objectives: </strong>The prevalence of sleep-disordered breathing, including obstructive sleep apnea, has driven the rapid growth of sleep surgery as a subspecialty. Medicare reimbursement plays a pivotal role in the economic viability of sleep surgery, but trends remain understudied. This study analyzes reimbursement trends for commonly performed sleep surgery procedures from 2000 to 2024, assessing inflation-adjusted changes in facility-based professional reimbursement.</p><p><strong>Methods: </strong>The 11 most frequently billed sleep surgery procedures at a single institution in 2024 were identified. Medicare data on facility-based professional reimbursement were extracted from 2000 to 2024 using the CMS Physician Fee Schedule. Inflation adjustments were applied using the CPI Inflation Calculator. Year-to-year percentage changes and linear regression analyses were performed.</p><p><strong>Results: </strong>Among the analyzed CPT codes, a consistent decline in inflation-adjusted facility prices was observed, with an average aggregate decrease of 39.8%. The most pronounced decline was in CPT 42975 (Drug-Induced Sleep Endoscopy), which decreased by 72.1% (<i>R</i>² = .88). Other procedures, such as CPT 30140 (Submucous Resection of Inferior Turbinate) and CPT 31231 (Diagnostic Nasal Endoscopy), experienced aggregate declines exceeding 58%. Procedures like CPT 30130 (Excision of Inferior Turbinate) showed relatively stable pricing with a 2.6% aggregate reduction.</p><p><strong>Conclusion: </strong>The substantial decline in inflation-adjusted facility prices for sleep surgery procedures underscores challenges in sustaining the financial and operational viability of this growing subspecialty. Reduced reimbursement may hinder innovation, training, and resource allocation, with potential downstream impacts on patient access and care. Policymakers should consider these findings to ensure equitable and sustainable support within the healthcare system.</p><p><strong>Level of evidence: </strong>4.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"714-719"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147795861","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}