Current Opinion in Otolaryngology & Head and Neck Surgery最新文献

{"title":"Scaling early hearing detection in low-resource settings: evidence from recent pilots and policy implications.","authors":"Rachael Collins, Thomas Hampton, Wakisa Mulwafu","doi":"10.1097/MOO.0000000000001119","DOIUrl":"10.1097/MOO.0000000000001119","url":null,"abstract":"<p><strong>Purpose of review: </strong>Childhood hearing loss remains a major yet under-addressed public health challenge in low-income and middle-income countries (LMICs). Despite global policy momentum following the World Report on Hearing, early detection programmes remain fragmented, urban-centred, and difficult to scale. This review synthesizes evidence from recent newborn, infant, preschool, and school-age screening pilots (2024-2025) to clarify emerging models, persistent barriers, and policy implications for expanding equitable early hearing screening in resource-constrained settings.</p><p><strong>Recent findings: </strong>Recent studies demonstrate growing interest in community-based delivery, task-shifting to non-specialist health workers, and the use of portable and digital tools - including smartphone-based OAE, tablet screeners, and remote audiology services. Pilots across Africa and Asia show high feasibility and caregiver acceptability but reveal substantial challenges: limited diagnostic capacity, workforce shortages, high loss-to-follow-up, and uncertain programme costs. School-based and preschool screening programmes offer a critical second opportunity for detection, particularly for late-onset and infection-related hearing loss, and show strong potential when integrated into existing education or child-health platforms.</p><p><strong>Summary: </strong>Scalable early hearing detection in LMICs requires context-specific models, strengthened referral pathways, and sustainable financing. Digital tools and task-shifting offer promising avenues but need rigorous validation and integration into national systems. Future research should prioritize cost-effectiveness, culturally grounded family-centred approaches, and embedding screening within broader child-health policy frameworks.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"201-210"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357683","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":"The Copenhagen Model: Advancing multidisciplinary strategies for dysphagia and supportive care after head and neck cancer.","authors":"Irene Wessel, Tine Bloch Jensen","doi":"10.1097/MOO.0000000000001120","DOIUrl":"10.1097/MOO.0000000000001120","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review highlights the growing need for coordinated, multidisciplinary survivorship models for individuals treated for head and neck cancer (HNC), as modern treatments have improved survival for the group but also led to a higher prevalence of complex, multisystem late sequelae. The importance of authorities and academic societies in incorporating rehabilitation as part of treatment in national cancer plans is reviewed. As healthcare systems strive to integrate hospital-based and community-based services, the balance between centralisation of specialisation and the desire for patient-centred care is challenged. The Copenhagen Model for HNC Rehabilitation, provides a structured and standardised framework for assessing patient needs, enhancing care coordination across sectors, and deliver specialised, patient-centred rehabilitation from the early postoperative period through late sequelae, salvage treatment, and advance care planning.</p><p><strong>Recent findings: </strong>Dysphagia remains one of the most frequent and burdensome late sequelae after treatment of HNC, contributing to impaired quality of life, airway protection problems, nutritional concerns, and emotional distress. The Copenhagen Model offers a structured model for managing late sequelae after surgically treated HNC by systematic patient stratification, home-based visits, and multidisciplinary efforts with comprehensive clinical assessments, identifying unmet rehabilitation needs and initiating interventions. This systematic approach has contributed to creating an increased focus on palliative care and advanced care planning and to a greater degree of refraining from treatment.</p><p><strong>Summary: </strong>Insights from this model suggest that structured, multidisciplinary team-based rehabilitation can enhance the detection of late effects, promote well tolerated and effective therapeutic strategies, and strengthen patient-centred outcomes in survivorship care. The clinical experience underscores the need for ongoing research to refine interventions, assess long-term functional outcomes, and optimise multidisciplinary collaboration in HNC rehabilitation. Additionally, patients' posttreatment experiences influence clinicians' perspectives on the scope of future treatments, underscoring the need for surgeons' participation in rehabilitation and importance of research into prehabilitation assessment and communication.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"179-184"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146215106","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":"Scaling community-based care for conductive hearing loss in low- and middle-income settings.","authors":"De Wet Swanepoel","doi":"10.1097/MOO.0000000000001116","DOIUrl":"10.1097/MOO.0000000000001116","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines recent advances in community-based care for conductive hearing loss in low- and middle-income countries (LMICs), focusing on developments that have materially shifted the feasibility of decentralized service delivery across prevencommution, screening and diagnosis, medical management, and rehabilitation.</p><p><strong>Recent findings: </strong>World Health Organization guidance now explicitly endorses task-sharing for primary ear and hearing care, including community health worker-facilitated hearing aid provision. Long-term follow-up from pneumococcal vaccination trials demonstrates sustained otitis media prevention and improved hearing outcomes 16-20 years postvaccination. Smartphone-based screening and diagnostic tools, including AI-assisted otoscopy and mobile tympanometry, are enabling accurate community-level identification without specialist infrastructure. Medical management of common conductive hearing loss (CHL) causes, including cerumen impaction and uncomplicated chronic suppurative otitis media, can be safely delivered by trained community health workers and primary care nurses. Community-based hearing aid provision achieves sustained rehabilitation outcomes comparable to specialist-led models across diverse LMIC settings.</p><p><strong>Summary: </strong>Recent evidence demonstrates that community-based CHL care is feasible, safe, and effective when supported by appropriate training, technology, and task-sharing frameworks. The primary constraint to scale is no longer technological feasibility but prioritisation within health planning and financing frameworks.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"211-217"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146168138","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":"Transforming competency development through digital innovation and graduated learning models: the future of dysphagia and tracheostomy tube management training.","authors":"Mascha Wanke, Flavia Gentile, Meike Brockmann-Bauser","doi":"10.1097/MOO.0000000000001123","DOIUrl":"10.1097/MOO.0000000000001123","url":null,"abstract":"<p><strong>Purpose of review: </strong>This narrative review explores evidence- and simulation-based teaching strategies for tracheostomy management (TTM) and dysphagia in adult patients, focusing on immersive technologies and instructional approaches within speech and language education.</p><p><strong>Recent findings: </strong>Increasing clinical complexity and multimorbidity demand advanced competencies, yet many high-risk skills cannot be practiced safely in real-world settings. Simulation-based learning environments, including extended reality (XR) technologies such as virtual reality (VR), augmented reality (AR), and mixed reality (MR), provide safe, repeatable, and scalable opportunities for clinical reasoning, psychomotor skill development, and interprofessional communication. Evidence shows that VR-based TTM training improves knowledge acquisition, skill retention, and confidence. Competency-oriented instructional frameworks, including 4C/ID and ADDIE, with structured feedback and debriefing, support staged skill development. However, standardization of clinical workflows, guidelines, and outcome measures remains limited, particularly in speech and language therapy-specific scenarios.</p><p><strong>Summary: </strong>XR-based teaching enhances clinical, communication, and interdisciplinary skills in TTM. To fully realize its potential, standardized clinical guidelines, workflows, and evidence-based teaching standards are needed. Integrating VR within structured instructional models ensures pedagogical rigor and safe transfer of learning to clinical practice.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"185-190"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488714","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":"Speech and swallowing outcome measures for oral cancer - what should we be collecting?","authors":"Carly E A Barbon, Douglas B Chepeha","doi":"10.1097/MOO.0000000000001125","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001125","url":null,"abstract":"<p><strong>Purpose of review: </strong>Modest improvements in survival following oral cavity cancer have increased the population of long-term survivors, shifting attention toward speech and swallowing outcomes. However, functional outcome measurement remains heterogeneous and inconsistently reported, limiting comparability across studies and translation to clinical decision-making. This review evaluates current speech and swallowing outcome measures used in oral cavity cancer, with particular attention to glossectomy populations, and proposes a pragmatic framework for standardized, multidimensional assessment.</p><p><strong>Recent findings: </strong>Recent literature highlights the importance of integrating tongue-specific metrics (e.g., lingual strength, range of motion) with function-focused measures (e.g., diet level, speech intelligibility) and patient-reported outcomes. Tools such as instrumental swallow assessments, performance-based masticatory testing, and validated patient-reported instruments capture complementary dimensions of recovery. Emerging technologies, including speech-tracking approaches, offer greater sensitivity to subtle changes in function. Nonetheless, no unified core outcome set exists for oral cavity cancer, and oral phase-specific metrics remain underdeveloped, particularly in patients undergoing tongue resection and reconstruction.</p><p><strong>Summary: </strong>No single instrument adequately captures the multidimensional functional consequences of oral cavity cancer treatment. We propose a domain-anchored measurement framework integrating physiologic, performance-based, and patient-reported outcomes to improve precision, harmonization, and clinical relevance in survivorship research and rehabilitation.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":"34 3","pages":"171-178"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789899","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":"Hearing loss detection and hearing healthcare in low- and middle-income countries.","authors":"Emma Stapleton","doi":"10.1097/MOO.0000000000001124","DOIUrl":"https://doi.org/10.1097/MOO.0000000000001124","url":null,"abstract":"","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":"34 3","pages":"199-200"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789911","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":"Provision of hearing health services in Nepal: recent advances, persistent gaps, and emerging opportunities.","authors":"Catherine de Cates, Farizeh Jashek-Ahmed, Rishi Bhatta","doi":"10.1097/MOO.0000000000001118","DOIUrl":"10.1097/MOO.0000000000001118","url":null,"abstract":"<p><strong>Purpose of review: </strong>Provision of hearing healthcare in Nepal is evolving due to expanding screening programmes, new epidemiologic data and growing surgical and rehabilitative capacity. Recent literature offers updated prevalence estimates, insights into rural disparities, and evidence on the lack of ear care and hearing health amongst the population including health professionals.</p><p><strong>Recent findings: </strong>Recent studies highlight the high burden of hearing impairment in remote provinces where there is often limited knowledge, the feasibility of infant-hearing screening in low-resource settings, and new data on paediatric cochlear implant outcomes. Earlier literature contextualises chronic otitis media, school-aged hearing loss, and sociocultural barriers. Workforce limitations, financing, and patchy geographic distribution of services remain substantial challenges.</p><p><strong>Summary: </strong>Despite resource constraints, Nepal is making meaningful progress in screening, epidemiologic characterisation, and surgical rehabilitation. Further advances will require integration of ear and hearing care into primary health systems, scaling of newborn screening, equitable cochlear implant access, workforce expansion, and implementation research to guide policy.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"218-223"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272849","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":"Optimizing voice therapy interventions: the application of the principles of motor learning in clinical practice.","authors":"Catherine Madill, Kirrie Ballard","doi":"10.1097/MOO.0000000000001126","DOIUrl":"10.1097/MOO.0000000000001126","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to present an overview of principles of motor learning (PML) and summarize the most recent evidence regarding the application of PML to optimize voice therapy intervention.</p><p><strong>Recent findings: </strong>The principles of motor learning that have been proven effective in sport, neuroscience, physical therapies and motor speech and swallowing therapies are now being demonstrated to be relevant and effective in voice therapy.</p><p><strong>Summary: </strong>Current research is in its early stages with a small number of retrospective, prospective and experimental studies investigating aspects of practice, feedback, instruction and modelling. Low participant numbers are noted as a limitation in many studies. Research shows motor learning principles are effective, but large-scale studies are needed to develop a deeper understanding of how to optimise the PML in individual therapeutic scenarios.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"137-144"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13152083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147629245","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":"Thinking outside the (voice) box: considering respiratory function in presbyphonia.","authors":"Brian Saccente-Kennedy, Roganie Govender","doi":"10.1097/MOO.0000000000001122","DOIUrl":"10.1097/MOO.0000000000001122","url":null,"abstract":"<p><strong>Purpose of review: </strong>Presbyphonia has long been framed as a laryngeal disorder driven by presbylaryngis, yet emerging evidence suggests that age-related respiratory decline plays a central but under-recognized role in symptomatic vocal aging. This review synthesizes work on respiratory aging, speech-breathing patterns, and respiratory muscle performance in older adults with presbyphonia, and evaluates early attempts to target these systems in rehabilitation.</p><p><strong>Recent findings: </strong>Laryngeal atrophy and glottic insufficiency are common in aging but do not reliably predict presbyphonia. Age-related reductions in lung elasticity, chest wall compliance, respiratory muscle strength, and respiratory interoception alter speech breathing and may compound glottic inefficiency. Recent studies indicate that \"exuberant\" voice therapies targeting maximal vocal function outperform gentler, skill-based approaches. Preliminary trials combining these therapies with respiratory muscle strength training, particularly inspiratory training, suggest added benefits for vocal effort, fatigue, and connected speech, though underlying mechanisms remain unclear.</p><p><strong>Summary: </strong>Respiratory aging appears to meaningfully influence symptom severity in presbyphonia yet remains poorly characterized in the condition. Incorporating respiratory assessment, kinematic measures of speech breathing, and targeted respiratory training may enhance diagnostic precision and optimize therapy outcomes. Future work should clarify how respiratory mechanics and sensory monitoring interact with laryngeal deficits and identify which older adults benefit most from respiration-focused rehabilitation.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"157-163"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147464398","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":"Rehabilitation treatment specification system: latest tools, trials, and pathways to advance the science underlying voice therapy.","authors":"Jarrad H Van Stan","doi":"10.1097/MOO.0000000000001121","DOIUrl":"10.1097/MOO.0000000000001121","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review summarizes the latest advances in applying the rehabilitation treatment specification system (RTSS) to voice therapy.</p><p><strong>Recent findings: </strong>Recent RTSS work has moved beyond conceptual endorsement to practical demonstrations in vocal rehabilitation. Multiple studies now provide complete RTSS specifications of voice therapy protocols and everyday clinical care, supporting content validity and enabling direct comparison of treatment components across approaches and sites. RTSS-guided intervention development has produced componentized protocols that translate treatment theories into explicit ingredient-target hypotheses suitable for refinement through empirical testing. RTSS-based mapping has also clarified overlap and meaningful differences across evidence-based therapies. Finally, RTSS-informed evidence synthesis has reduced heterogeneity in meta-analytic work by regrouping studies according to mechanism-relevant component categories (organ functions vs. skills & habits), yielding more interpretable patterns of treatment effects.</p><p><strong>Summary: </strong>The RTSS is emerging as a practical infrastructure for cumulative, component-based voice therapy science, supporting clearer intervention reporting, mechanistic interpretation, cross-disciplinary transfer, and scalable adoption in routine documentation.</p>","PeriodicalId":55195,"journal":{"name":"Current Opinion in Otolaryngology & Head and Neck Surgery","volume":" ","pages":"145-150"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13007710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147488757","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}