Hno最新文献

{"title":"[Lower eyelid blepharoplasty : A comparison of transconjunctival, transcutaneous, and combined blepharoplasty techniques].","authors":"Nina Schwaiger-Hessel","doi":"10.1007/s00106-026-01764-y","DOIUrl":"https://doi.org/10.1007/s00106-026-01764-y","url":null,"abstract":"<p><p>Lower eyelid blepharoplasty is one of the most demanding techniques of aesthetic and functional oculoplasty. The past two decades have witnessed a paradigm shift from resective procedures toward tissue-preserving, volume-maintaining approaches. The transconjunctival technique offers a scarless approach with very low rates of eyelid malposition, whereas the transcutaneous approach enables simultaneous correction of skin, muscle, and septal pathologies. Midface lifting remains an important adjunct in patients with malar descent, negative vector, or midfacial volume deficiency. This review discusses anatomy, indications, surgical techniques, postoperative care, complication management, and current trends.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Expert certificate : \"Otological, neurotological, and (lateral) skull base surgery\"].","authors":"Hubert Löwenheim, Thomas Deitmer, Dirk Beutner, Thomas Zahnert, Timo Stöver, Martin Jäckel, Christian Betz, Andreas Neumann, Christoph Arnoldner, Thomas K Hoffmann","doi":"10.1007/s00106-026-01767-9","DOIUrl":"https://doi.org/10.1007/s00106-026-01767-9","url":null,"abstract":"<p><p>The German Society of Otorhinolaryngology, Head and Neck Surgery (DGHNO-KHC) and the German Academy of Otorhinolaryngology, Head and Neck Surgery (DAHNO-KHC), in cooperation with the relevant working groups, have developed expert certificates for the subfields \"head and neck onco-surgery\" and \"paranasal sinus and (anterior) skull base surgery.\" The aim was to demonstrate the applicants' expertise in the respective subfield, in line with international standards. For the subspecialty \"surgical otology, neurotology, and lateral skull base surgery,\" the Association of German-Speaking Audiologists, Neurotologists, and Otologists (ADANO) has developed a set of criteria for obtaining the expert certificate \"Otological, neurotological, and (lateral) skull base surgery.\" This personal certificate can be used to demonstrate individual expertise. Practical implementation is carried out by an independent certification body (ClarCert GmbH) on behalf of the DGHNO-KHC and in cooperation with the DAHNO-KHC and the respective working groups. Applications for the expert certificate can now be submitted by members of the DGHNO-KHC and the DAHNO-KHC.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Physical activity in head and neck cancer patients : Exploring subjective attitudes, symptoms and accelerometry data].","authors":"Sabine Felser, Christina Grosse-Thie, Julia Daunheimer, Daniel Strüder, Chia Jung Busch, Christian Junghanss, Sabina Ulbricht","doi":"10.1007/s00106-026-01768-8","DOIUrl":"https://doi.org/10.1007/s00106-026-01768-8","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) supports physical and psychosocial rehabilitation after cancer. However, motivating patients with head and neck cancer (HNC) to become more active remains challenging. This study investigated the association of the self-rated importance of increasing PA with current activity levels as well as sociodemographic and clinical factors.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, outpatient HNC patients (≥ 18 years) were included. Sociodemographic data, symptom burden (e.g., fatigue, pain) using visual analog scales (VAS; 0-10), dyspnea (modified Medical Research Council scale, mMRC), and the perceived importance of becoming more active (VAS 0-10) were recorded. Current PA was assessed via 7‑day accelerometry (valid if ≥ 10 h/day on ≥ 4 days). Analyses were conducted using univariate, bivariate, and multivariate methods.</p><p><strong>Results: </strong>A total of 51 patients (82% male; mean age 67 ± 19 years) were included; 39 provided valid accelerometry data. Increasing PA was rated as important or very important by 68% of participants. On average, participants were physically active for 179 ± 89 min per day. The perceived importance of becoming more active was higher among those living alone (p = 0.033) and tended to be higher in participants with greater dyspnea (p = 0.056) or more severe pain (p = 0.068).</p><p><strong>Conclusion: </strong>The average activity level in this sample was low, with around 3 h of movement per day. For the majority of participants, increasing activity was important. Further research is needed to clarify why higher symptom burden and social factors are associated with a greater perceived importance of becoming more active.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":""},"PeriodicalIF":1.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Treatment standards and future developments in radiotherapy for older patients with head and neck cancer].","authors":"Alexander Rühle, Nils H Nicolay","doi":"10.1007/s00106-025-01702-4","DOIUrl":"10.1007/s00106-025-01702-4","url":null,"abstract":"<p><strong>Background: </strong>The proportion of older adults with head and neck cancer is steadily rising. Treatment planning in this population is often challenging due to more frequent comorbidities; reduced physiological reserves; and, at times, differing treatment goals. Additionally, older adults have been significantly underrepresented in pivotal radiotherapy trials, making evidence-based decision-making difficult.</p><p><strong>Objective: </strong>This article strives to present current controversies in the radiotherapeutic management of older adults with head and neck cancer.</p><p><strong>Methods: </strong>A selective literature search for studies addressing radiotherapy in elderly head and neck cancer patients was conducted via PubMed and ClinicalTrials.gov.</p><p><strong>Results: </strong>Geriatric screening tools such as the G8 test are associated with treatment adherence and survival but are still rarely implemented in routine clinical practice. The SENIOR cohort study (NCT05337631) demonstrated a survival benefit for the combination of radiotherapy with concurrent chemotherapy in older patients with good performance status and few comorbidities, but not for the combination with cetuximab. Current studies are investigating hypofractionated radiotherapy regimens and novel agents for patients with contraindications to cisplatin. For patients ineligible for curative treatment, effective palliative radiotherapy concepts with shortened overall treatment duration are available.</p><p><strong>Conclusion: </strong>The management of older adults with head and neck cancer remains challenging and requires further prospective research. Advanced age alone should not be considered a contraindication to curative radiotherapy, including concurrent chemotherapy. For patients not eligible for curative treatment, various palliative radiotherapy regimens are available.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"265-274"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Outcome of the geriatric head and neck cancer patient].","authors":"J M Vahl, M D Denkinger, A von Witzleben, S Laban, J Greve, T K Hoffmann","doi":"10.1007/s00106-026-01750-4","DOIUrl":"10.1007/s00106-026-01750-4","url":null,"abstract":"<p><strong>Background: </strong>Demographic changes are influencing the spectrum of patients seen in ear, nose, and throat medicine. Geriatric tumor patients vary greatly in terms of their comorbidities and physical function, requiring an adaptation of typical treatment concepts.</p><p><strong>Objective: </strong>The aim of this work was to examine the current prospects for treating head and neck tumors in geriatric patients, with a focus on survival, functionality, and quality of life.</p><p><strong>Materials and methods: </strong>A narrative literature search and discussion were conducted, considering the aforementioned question. The graphics were created using Windows PowerPoint 2019 (Microsoft, Redmond, WA, USA), Servier Medical Art (Servier, Munich, Germany).</p><p><strong>Results: </strong>Patients with head and neck tumors who are older than 70 years survive for significantly shorter periods than younger patients (under 70 years), with a median survival time of 35 months. They generally require comprehensive, personalized treatment plans that extend well beyond acute oncological intervention to achieve optimal therapeutic outcomes.</p><p><strong>Conclusion: </strong>The increased complexity of cases involving geriatric patients, coupled with their growing numbers, requires expanded collaboration with geriatric screening and intervention programs, the development of the necessary infrastructure, staff training, and the inclusion of this patient group in future studies.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"290-296"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Der geriatrische Tumorpatient.","authors":"Tabea Abel, Andreas Knopf","doi":"10.1007/s00106-026-01759-9","DOIUrl":"https://doi.org/10.1007/s00106-026-01759-9","url":null,"abstract":"","PeriodicalId":55052,"journal":{"name":"Hno","volume":"74 5","pages":"263-264"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Prevention in oncological follow-up].","authors":"Matthias Santer, Charles Schmit, Lukas Schmutzler, Daniel Dejaco, Benedikt Hofauer","doi":"10.1007/s00106-026-01756-y","DOIUrl":"10.1007/s00106-026-01756-y","url":null,"abstract":"<p><strong>Background: </strong>In light of increasing remission and 5‑year survival rates, prevention-orientated follow-up care of patients after head and neck cancer is becoming increasingly relevant. In addition to oncologic surveillance, measures aimed at preventing recurrent, second primaries, and long-term functional sequalae are gaining importance.</p><p><strong>Objective: </strong>The aim of this review is to analyze preventive strategies in the follow-up care of patients with head and neck cancer.</p><p><strong>Materials and methods: </strong>A narrative literature review was conducted in PubMed, focusing on prevention-oriented follow-up care in head and neck cancer. In addition, national and international guidelines (Association of the Scientific Medical Societies in Germany, AWMF; National Comprehensive Cancer Network, NCCN) were considered.</p><p><strong>Results: </strong>Structured follow-up programs enable early detection of local recurrences and treatment-associated secondary neoplasms. Molecular approaches such as liquid biopsy offer promising perspectives for individualized, risk-adapted follow-up care but require further prospective validation. Lifestyle interventions, particularly smoking and alcohol cessation, are associated with a reduction in the risk of recurrence and second primary tumors. Human papillomavirus (HPV) vaccination exerts a preventive effect within the framework of primary prevention of HPV-associated tumors. Early functional rehabilitation in the domains of voice, swallowing, nutrition, and mobility substantially contributes to the prevention of persistent functional deficits.</p><p><strong>Conclusion: </strong>Structured interdisciplinary follow-up care enables early detection of recurrence and improves functional outcomes as well as quality of life. However, innovative approaches require further clinical validation.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"297-302"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Geriatric oncology patients at the center of nurse-led delirium management].","authors":"Julius Schmidt","doi":"10.1007/s00106-026-01753-1","DOIUrl":"10.1007/s00106-026-01753-1","url":null,"abstract":"<p><strong>Background: </strong>Postoperative delirium is an acute, fluctuating neurocognitive syndrome. It is among the most common perioperative complications in older patients and is associated with increased morbidity and mortality, a prolonged length of stay, complications, and persistent cognitive impairment. After major head and neck procedures, the risk is particularly high; risk factors often accumulate, including advanced age, pre-existing cognitive impairment, high American Society of Anesthesiologists (ASA) status, polypharmacy, malnutrition, and prolonged operative time. No established pharmacological primary therapy exists; early detection, prevention, and treatment of underlying causes are first line.</p><p><strong>Objective: </strong>This work constitutes the initial implementation and testing of a process-oriented delirium management program in the departments of otorhinolaryngology (ENT) and ophthalmology of a university hospital.</p><p><strong>Methods: </strong>A practice development project was carried out (2022-2024) to implement standardized delirium management in ENT and ophthalmology. It included risk stratification upon admission, monitoring using the Delirium Observation Screening Scale, and non-pharmacological preventive measures. Positive screenings were validated by a nursing-led delirium assessment team using the confusion assessment method. Process-related routine data screenings from 2023/2024 were evaluated descriptively.</p><p><strong>Results: </strong>A delirium assessment team was established alongside a systematic delirium pathway focusing on risk identification, screening, prevention, confirmatory diagnosis, and treatment of deliriogenic causes. In the ENT clinic, 63 positive screenings were recorded in 2023/2024. The cumulative delirium incidence was 30.2% overall (men 32.0%, women 23.1%); age-stratified: 0% (< 65 years), 45.8% (65-79 years), and 27.6% (≥ 80 years). The new processes showed good acceptance.</p><p><strong>Conclusion: </strong>Structured capture of positive screenings enables collection of robust routine data for quality management. Process breaks due to manual steps favor underdetection and treatment delays. Digitally automated process components can increase adherence and process stability. Artificial intelligence (AI)-based decision-support tools appear promising for future clinical use.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"275-281"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Immunology of aging in head and neck cancer : From the tumor microenvironment to translational approaches and clinical response].","authors":"C H L Kürten, T Peis, L Boosfeld, M Peis, S Lang","doi":"10.1007/s00106-026-01757-x","DOIUrl":"10.1007/s00106-026-01757-x","url":null,"abstract":"<p><p>The immune system undergoes profound age-related changes that manifest as impaired immune function (immunosenescence) and chronic low-grade inflammation (inflammaging), both of which may influence the tumor biology of head and neck squamous cell carcinoma. While phenotypic analyses of peripheral and intratumoral immune cells have so far shown few age-associated differences, omics studies have identified senescence-related signatures linked to poor prognosis and reduced immune activity. Emerging translational data suggest that senolytic therapies may overcome mechanisms of immunosenescence-driven resistance to immune checkpoint inhibitors. Clinical trials and real-world evidence consistently demonstrate that current immunotherapies are effective and well tolerated in older patients. Overall, biological age-captured, for example, through geriatric frailty assessments or molecular markers-appears more relevant for tumor biology and therapeutic decision-making than mere chronological age.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"282-289"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147583141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[On the German S3 guideline on perioperative and periinterventional antibiotic prophylaxis].","authors":"Sarina K Müller, Benedikt Hofauer","doi":"10.1007/s00106-026-01752-2","DOIUrl":"10.1007/s00106-026-01752-2","url":null,"abstract":"<p><p>In December 2024, the German S3 guideline on perioperative and periinterventional antibiotic prophylaxis (PAP) was published after years of interdisciplinary collaboration. This guideline was developed with the involvement of a delegation from the German Society of Otorhinolaryngology, Head and Neck Surgery, because it is particularly important for our medical specialty: in interdisciplinary comparison, otorhinolaryngologists traditionally prescribe a relatively high number of antibiotics in perioperative settings. The S3 guideline is based on randomized controlled trials and review articles evaluated by the Robert Koch Institute using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The aim of this CME article is to present the S3 guideline with a focus on the indications for PAP, its duration, risk assessment, and selection of the appropriate antibiotic. Practical application examples and a dosage table further illustrate these points.</p>","PeriodicalId":55052,"journal":{"name":"Hno","volume":" ","pages":"305-316"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13109251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147596166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}