Auris Nasus Larynx最新文献

{"title":"Intraoperative symptom-guided plug size selection in sitting position Kobayashi plug surgery for patulous eustachian tube","authors":"Takeshi Oshima ,&nbsp;Marin Yoshida ,&nbsp;Hideshi Shindo ,&nbsp;Hidetoshi Oshima ,&nbsp;Ryoji Hirai","doi":"10.1016/j.anl.2025.09.007","DOIUrl":"10.1016/j.anl.2025.09.007","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy and safety of Kobayashi Plug Surgery (KPS) for patulous Eustachian tube (PET) performed under local anesthesia in the sitting position, using intraoperative subjective symptoms to guide plug size selection, and to investigate its effect on revision surgery rates.</div></div><div><h3>Methods</h3><div>This retrospective study included 61 patients (73 ears) with refractory PET who underwent KPS between December 2023 and June 2025. All procedures were performed under local anesthesia with patients in the sitting position, allowing for real-time assessment of subjective symptoms immediately after plug placement. If symptoms persisted, the plug size was increased intraoperatively. Clinical data, surgical outcomes, plug sizes, and postoperative complications were analyzed. Long-term outcomes were assessed in 29 ears with follow-up exceeding 180 days using PHI-10, Eustachian tube function tests, and revision surgery rates.</div></div><div><h3>Results</h3><div>Plug placement was successful in 66 of 73 ears (90.4%). Plug size adjustment during initial surgery was performed in 5 ears (7.6%) based on persistent symptoms. Among 29 ears with long-term follow-up (median: 297.5 days), the overall revision surgery rate due to upsizing was 10.3%. However, among the 41 ears that presented with subjective symptoms at the time of surgery, only 1 case (2.4%) required revision surgery during follow-up. PHI-10 scores significantly improved from a median of 30 to 10 (p &lt; 0.001), and sonotubometry sound pressure levels increased from 85 dB to 99 dB (p &lt; 0.005). Tympanic membrane perforation was observed in one ear (preexisting), and ventilation tube placement for otitis media with effusion was required in 4 ears (13.8%).</div></div><div><h3>Conclusion</h3><div>KPS under local anesthesia in the sitting position allows for intraoperative symptom-based plug size selection, which may help reduce the need for revision surgery, especially in patients with active symptoms at the time of surgery. While the overall revision rate was 10.3%, it was markedly lower (2.4%) among symptomatic cases. Although the findings should be interpreted with caution due to the small sample size and retrospective design, this technique represents a promising approach for improving surgical outcomes in patients with refractory PET.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 704-708"},"PeriodicalIF":1.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326411","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":"Impact of hearing impairment in unilateral hearing loss: A multicenter study of standardized sound localization tests in Japan","authors":"Takashi Ishino ,&nbsp;Tadao Yoshida ,&nbsp;Satoshi Iwasaki ,&nbsp;Naoki Oishi ,&nbsp;Yusuke Matsuda ,&nbsp;Tetsuya Tono ,&nbsp;Kazuma Sugahara ,&nbsp;Hiroshi Yamazaki ,&nbsp;Sumito Jitsukawa ,&nbsp;Hiroshi Nakanishi ,&nbsp;Ryosuke Kitoh ,&nbsp;Takashi Sato ,&nbsp;Kazuki Nishida ,&nbsp;Takashi Oda ,&nbsp;Rikuto Fujita ,&nbsp;Tomohiro Kawasumi ,&nbsp;Chie Ishikawa ,&nbsp;Manabu Nishida ,&nbsp;Nobuyuki Chikuie ,&nbsp;Yuichiro Horibe ,&nbsp;Sachio Takeno","doi":"10.1016/j.anl.2025.09.010","DOIUrl":"10.1016/j.anl.2025.09.010","url":null,"abstract":"<div><h3>Objective</h3><div>This study had two primary objectives: first, to standardize a sound localization test across multiple facilities in Japan, and second, to use this standardized test to analyze sound localization ability in patients with unilateral hearing loss (UHL) and identify related clinical and demographic factors.</div></div><div><h3>Methods</h3><div>Sound localization tests were conducted at 11 facilities, enrolling 59 UHL subjects and 77 normal-hearing controls (Ctrl). The first part of the study focused on standardizing the test protocol and establishing reference ranges and cut-off values. The second part analyzed the sound localization ability in UHL patients, measured by the root mean squared (RMS) error. The association between RMS values and factors such as residual hearing, contralateral routing of signal (CROS) hearing aid use, and Hearing Handicap Inventory for Adults (HHIA) scores were analyzed.</div></div><div><h3>Results</h3><div>Reference ranges and cut-off values for the standardized sound localization test were successfully established. UHL subjects exhibited significantly higher RMS values (i.e., poorer localization) compared to controls. The use of CROS hearing aids did not improve performance, and the contribution of pinna-induced spectral cues was limited. Significant associations were found between RMS values and both sound presentation position and the number of audiogram frequencies with thresholds better than 40 dB and 50 dB, with the 50 dB threshold criterion being a more prominent factor. HHIA emotional and social scores were significantly associated only with age and not with sound localization performance or other audiological factors.</div></div><div><h3>Conclusions</h3><div>The standardized sound localization test proved to be a reliable tool for multicenter studies. Patients with UHL have significantly impaired sound localization. Residual hearing in the impaired ear, even if limited, was found to aid localization, whereas the benefits of CROS hearing aids and monaural spectral cues were negligible in our cohort. Since only age influenced the self-perceived hearing handicap (HHIA scores), it is crucial to consider restoring binaural hearing not just to improve sound localization but also to address the broader quality-of-life issues associated with UHL.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 690-703"},"PeriodicalIF":1.5,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145326424","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":"New method; continuous water perfusion method during endoscopic resection for the superficial pharyngeal squamous cell carcinoma","authors":"Naohiro Nakamura ,&nbsp;Tomofumi Sakagami ,&nbsp;Kensuke Suzuki ,&nbsp;Takuo Fujisawa ,&nbsp;Takuya Shijimaya ,&nbsp;Sanshiro Kobayashi ,&nbsp;Masataka Masuda ,&nbsp;Yu Takahashi ,&nbsp;Tomomitsu Tahara ,&nbsp;Makoto Naganuma","doi":"10.1016/j.anl.2025.10.002","DOIUrl":"10.1016/j.anl.2025.10.002","url":null,"abstract":"<div><div>Recent development in endoscopic imaging has led to the detection of superficial laryngopharyngeal carcinomas and the effectiveness of endoscopic resection for superficial pharyngeal squamous cell carcinoma have been reported. However, the en bloc and complete resection rates were not sufficient. To identify the precise incision and dissection lines, ensuring a clear operating view is important. Although underwater condition during dissection is useful, saliva, bleeding, and produced floating matter make the operating view worse as the dissection process continues. We presented new method; continuous water perfusion method (CWPM) may contribute to ensuring a clear operating view during dissection of endoscopic resection for superficial pharyngeal squamous cell carcinomas.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 687-689"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318745","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":"Establishing a comprehensive national auditory implant registry in Japan: Trends and demographics from the first two years (2023–2024)","authors":"Ayu Akazawa ,&nbsp;Takeshi Fujita ,&nbsp;Kensuke Uraguchi ,&nbsp;Megumi Kitayama ,&nbsp;Taku Ito ,&nbsp;Yasuhiro Osaki ,&nbsp;Kyoko Shirai ,&nbsp;Haruo Yoshida ,&nbsp;Norio Yamamoto ,&nbsp;Katsumi Doi ,&nbsp;Satoshi Iwasaki ,&nbsp;Naoki Oishi","doi":"10.1016/j.anl.2025.09.009","DOIUrl":"10.1016/j.anl.2025.09.009","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the establishment and initial findings of Japan’s first comprehensive nationwide registry covering cochlear implants (CIs), active middle ear implants (AMEIs), and bone conduction implants (BCIs), launched in 2023. The registry aims to improve national data collection, support evidence-based policymaking, and track trends in surgical practice and patient demographics.</div></div><div><h3>Methods</h3><div>A web-based electronic data capture (EDC) system was implemented to replace the previous paper-based reporting system. Between January 2023 and December 2024, data were voluntarily submitted by participating facilities across Japan. Collected data included patient demographics, implant types, hearing thresholds, etiologies, and manufacturer information. Registry completeness was assessed by comparison with Japan’s National Database of Health Insurance Claims (NDB).</div></div><div><h3>Results</h3><div>A total of 1880 patients were registered, and 1809 patients with surgical information entered from 104 facilities were selected for analysis, comprising 1723 CI cases and 86 AMEI or BCI cases (11 VSB, 22 BB, 53 Baha). Among 605 pediatric CI recipients, early-age implantation was increasingly observed, with 58 patients (10 %) aged under 1 year and 183 (30 %) aged 1 year. Among adult CI recipients, 271 patients were aged 75 years or older, including 40 patients aged 85 years or older. Additionally, simultaneous bilateral CI surgery was performed in 265 patients, of whom 175 were children, reflecting the expanding indications. Patients with better ear thresholds &lt;90 dB HL accounted for 33 % of adults and 29 % of children. Congenital hearing loss predominated in children, while acquired causes were more common in adults. Among cases with a known etiology, hereditary deafness was the most common (24.5 %), although 39.6 % of etiologies were unknown. CI data completeness reached 73 % compared with NDB, indicating strong nationwide participation and a high level of data reliability.</div></div><div><h3>Conclusion</h3><div>This is the first comprehensive report from the national registry in Japan that includes not only CIs but also AMEIs and BCIs. The registry demonstrated reliable data capture and highlighted important trends in patient demographics and surgical practices. Continued data collection will enhance clinical decision-making and support policy development, ultimately improving care for auditory implant recipients.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 679-686"},"PeriodicalIF":1.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318778","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":"Clinical features of cochlear implantation in Japan and factors affecting postoperative infection","authors":"Megumi Koizumi ,&nbsp;Akinori Kashio ,&nbsp;Miho Ishimaru ,&nbsp;Hiroki Matsui ,&nbsp;Kiyohide Fushimi ,&nbsp;Hideo Yasunaga ,&nbsp;Tatsuya Yamasoba","doi":"10.1016/j.anl.2025.09.001","DOIUrl":"10.1016/j.anl.2025.09.001","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the clinical features in a large cohort of patients who underwent cochlear implantation in Japan, including the number of simultaneous bilateral cochlear implantation, proportion of postoperative infectious complications, and factors associated with postoperative infectious complications.</div></div><div><h3>Methods</h3><div>This retrospective cohort study extracted data of 7893 patients who underwent 9427 cochlear implantations from a Japanese national inpatient database between July 2010 and March 2021. We determined the number of cochlear implantations, patient age, number of simultaneous bilateral surgeries, and incidence of infectious complications. The factors associated with postoperative infection were analyzed using a multivariate logistic regression model.</div></div><div><h3>Results</h3><div>Pediatric cases were predominant until 2016, whereas adult cases surpassed pediatric cases beginning in 2017. The proportion of patients aged &gt; 1 year and 6 months decreased gradually since 2014. The number of simultaneous cochlear implantations increased steadily since 2016. The incidence of postoperative infection was 4.8 %. Postoperative infectious complications were significantly associated with age &lt; 2 years at surgery, inner ear malformations, and medium hospital volumes in pediatric patients. In adults, chronic otitis media and comorbid diabetes mellitus without complications were associated with postoperative infectious complications.</div></div><div><h3>Conclusions</h3><div>The trends in patient age and the number of simultaneous surgeries in Japan are consistent with the revised guidelines. The incidence of postoperative infections was 4.8 %. The factors associated with postoperative infection differed between pediatric and adult patients. These findings may help surgeons in the management of cochlear implantation.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 672-678"},"PeriodicalIF":1.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253777","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":"Hospital readmission and mortality after discharge with pediatric tracheostomy: A one-year population-based cohort study in Taiwan","authors":"Chia-Hsuan Lee ,&nbsp;Che-Yi Lin ,&nbsp;Kun-Tai Kang ,&nbsp;Wei-Chung Hsu","doi":"10.1016/j.anl.2025.09.008","DOIUrl":"10.1016/j.anl.2025.09.008","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze hospital readmission and mortality rates within 1 year after discharge with pediatric tracheostomy.</div></div><div><h3>Methods</h3><div>Data were obtained from Taiwan’s National Health Insurance Research Database. All inpatients aged &lt;18 years who underwent tracheostomy between 2001 and 2019 were identified using <em>International Classification of Diseases</em> codes. All-cause readmission and mortality rates at 30, 90, 180, 270, and 365 days after pediatric tracheostomy were calculated, and factors associated with readmission and mortality at 1 year after tracheostomy were analyzed.</div></div><div><h3>Results</h3><div>A total of 1911 children who underwent tracheostomy were included. At 1 year after tracheostomy, 1485 (78 %) children experienced hospital readmission, and 273 (14 %) died. The accumulated readmission rates at 30, 90, 180, 270, and 365 days were 32 %, 56 %, 69 %, 74 %, and 78 %, respectively. The accumulated mortality rates at 30, 90, 180, 270, and 365 days were 2 %, 6 %, 9 %, 12 %, and 14 %, respectively. Children who experienced readmission within the 1-year follow-up period were significantly younger (8.3 vs 9.9 years) and less indicated for trauma or head injury (33 % vs 39 %), and they had longer intensive care unit stays (38 days vs 30 days) and hospital stays (62 days vs 51 days) than had those without readmission. Multivariable analysis revealed that infants (HR = 1.20, 95 % CI: 1.01 to 1.44) and toddlers (HR = 1.24, 95 % CI: 1.04 to 1.48) were at significantly greater risk of readmission than were adolescents during the 1-year follow-up period. Mortality risk within this period was significantly higher among infants, toddlers, preschoolers, and school-aged children than among adolescents.</div></div><div><h3>Conclusion</h3><div>Children at young ages are at greater risk of readmission and mortality following tracheostomy.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 664-671"},"PeriodicalIF":1.5,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145245773","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":"Effect of histone acetyltransferase inhibitor against middle ear cholesteatoma in mouse model","authors":"Naotaro Akiyama ,&nbsp;Tomomi Yamamoto-Fukuda ,&nbsp;Hiromi Kojima","doi":"10.1016/j.anl.2025.09.006","DOIUrl":"10.1016/j.anl.2025.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>Middle ear cholesteatoma (Cholesteatoma) consists of proliferative epithelial cells. In the previous study, we demonstrated that histone H3 acetylation at lysine 27 (H3K27ac), associated with high transcriptional activation, was accumulated in the Cholesteatoma. In this study, we firstly investigated the expression of H3K27ac and histone acetyltransferase, p300 in human Cholesteatoma tissues. And then, we investigated the effects of a p300 inhibitor, C646, against Cholesteatoma growth.</div></div><div><h3>Methods</h3><div>Immunohistochemical analysis was demonstrated in the human Cholesteatoma specimens using anti-p300 and anti-H3K27ac antibodies and in the KGF-induced Cholesteatoma mouse model after p300 inhibitor administration using anti-p300, anti-H3K27ac, and anti-Ki67 antibodies.</div></div><div><h3>Results</h3><div>The expression levels of p300 were significantly increased and colocalized with H3K27ac in the human Cholesteatoma specimens. Moreover, C646 decreased proliferative activities of Cholesteatoma cells in the KGF-induced Cholesteatoma mouse model.</div></div><div><h3>Conclusion</h3><div>We demonstrated that inhibition of the H3K27ac may be a potential treatment strategy for Cholesteatoma from a new perspective.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 657-663"},"PeriodicalIF":1.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214158","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":"Evaluation of the optimal approach for endoscopic neck dissection using Thiel cadavers","authors":"Takashi Maruo ,&nbsp;Toshifumi Tomioka ,&nbsp;Wataru Okano ,&nbsp;Takashi Mukaigawa ,&nbsp;Takahiro Fukuhara ,&nbsp;Hiromu Nakamura ,&nbsp;Takuma Takeuchi ,&nbsp;Munekazu Naito ,&nbsp;Naoyuki Hatayama ,&nbsp;Yasushi Fujimoto","doi":"10.1016/j.anl.2025.09.003","DOIUrl":"10.1016/j.anl.2025.09.003","url":null,"abstract":"<div><h3>Objective</h3><div>Endoscopic neck dissection (END) has been developed in Asia; however, it is necessary to validate a technique that has a short learning curve and is easy to introduce. The purpose of this study was to determine the approach with the easiest introduction and shortest learning curve using donated cadavers fixed with the Thiel method.</div></div><div><h3>Methods</h3><div>A total of four different approaches were examined. Each approach was evaluated by a questionnaire administered to five head and neck surgeons, the extent of dissection was confirmed, and the number of dissected lymph nodes was counted.</div></div><div><h3>Results</h3><div>Endoscopic supra-omohyoid-neck dissection (SOHND) by entering from the anterior margin of the sternocleidomastoid muscle (SCM) through a retroauricular (RA) approach was the most highly rated in the questionnaire, and the extent of dissection and number of lymph nodes dissected were reasonable in this study. Jugular neck dissection (JND) by entering the anterior margin of the SCM from the subclavian was the second highest scoring approach, but further advances in instrument development and technique are needed.</div></div><div><h3>Conclusions</h3><div>Endoscopic SOHND by the RA approach was considered optimal. Endoscopic JND by the subclavian approach was the second most promising approach.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 643-650"},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134836","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":"Clinical characteristics and diagnostic value of symptoms and objective findings in patulous eustachian tube: a large-scale study based on the Japan Otological Society criteria","authors":"Hidetoshi Oshima ,&nbsp;Marin Yoshida ,&nbsp;Hideshi Shindo ,&nbsp;Ryoji Hirai ,&nbsp;Takeshi Oshima","doi":"10.1016/j.anl.2025.09.002","DOIUrl":"10.1016/j.anl.2025.09.002","url":null,"abstract":"<div><h3>Objective</h3><div>To clarify the clinical characteristics of patulous Eustachian tube (PET) based on the Japan Otological Society (JOS) diagnostic criteria and to assess the diagnostic contribution of individual symptoms and objective findings.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed patients diagnosed with definite PET or non-PET at a subspecialty Eustachian tube clinic between June 2019 and July 2025, excluding possible PET to minimize diagnostic uncertainty. Demographics, background factors, symptoms, and objective test results—including tympanic membrane (TM) flutter, tubo-tympano-aerodynamic graphy, and sonotubometry—were examined. Logistic regression identified independent factors, and receiver operating characteristic (ROC) curves were generated to evaluate diagnostic performance.</div></div><div><h3>Results</h3><div>Among 1009 patients (1613 ears), definite PET was associated with habitual sniffing (OR = 8.18), history of weight loss (OR = 1.78), and, in females, low-dose estrogen–progestin use (OR = 7.31). Lower body mass index and younger age also showed significant associations. Voice autophony (OR = 4.09) and breathing autophony (OR = 9.98) were the most predictive symptoms. Objective findings demonstrated high diagnostic accuracy, with TM flutter showing the highest odds ratio (OR = 42.17). The seven-symptom model achieved an area under the ROC curve (AUC) of 0.862.</div></div><div><h3>Conclusion</h3><div>This large-scale study identified key background factors and symptoms valuable for PET diagnosis and confirmed that objective tests have strong discriminatory ability, supporting earlier and more accurate clinical decision-making.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 651-656"},"PeriodicalIF":1.5,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134873","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":"Phonosurgery for vocal fold polyps: A comprehensive analysis of multidimensional voice outcomes in 201 cases and the impact of polyp size","authors":"Toshiyuki Mitsuhashi ,&nbsp;Hirohito Umeno ,&nbsp;Shun-ichi Chitose ,&nbsp;Takashi Kurita ,&nbsp;Kyoji Furukawa ,&nbsp;Fumihiko Sato ,&nbsp;Kiminobu Sato ,&nbsp;Mioko Fukahori ,&nbsp;Takeharu Ono ,&nbsp;Shintaro Sueyoshi ,&nbsp;Sachiyo Hamakawa","doi":"10.1016/j.anl.2025.08.012","DOIUrl":"10.1016/j.anl.2025.08.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To elucidate the clinical characteristics of vocal fold polyps (VFPs) and evaluate the efficacy of phonosurgery using a comprehensive analysis of multidimensional voice parameters.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We conducted a retrospective review of 201 patients with VFPs treated at Kurume University Hospital between 1996 and 2022. All patients underwent either endolaryngeal microsurgery (LMS) under general anesthesia or forceps excision (FE) under local anesthesia. Lesions were categorized as pedunculated or sessile and as hemorrhagic or non-hemorrhagic based on coloration. Polyp size was calculated as the ratio of the lesion diameter to the distance from the anterior commissure to the vocal process. Pre- and postoperative values and postoperative differences (Δ) were analyzed for voice parameters: maximum phonation time (MPT), mean flow rate (MFR), fundamental frequency (&lt;em&gt;F&lt;/em&gt;&lt;sub&gt;o&lt;/sub&gt;), &lt;em&gt;F&lt;/em&gt;&lt;sub&gt;o&lt;/sub&gt; range, sound pressure level (SPL), SPL range, pitch perturbation quotient (PPQ), amplitude perturbation quotient (APQ), jitter, shimmer, normalized noise energy (NNEa), noise-to-harmonic ratio, Voice Handicap Index-10 (VHI-10), Voice-Related Quality of Life (V-RQOL), and GRB scale (G = grade, R = roughness, B = breathiness). Outcomes between LMS and FE were compared using adjusted analyses to control for baseline differences.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Men were significantly older than women (&lt;em&gt;p&lt;/em&gt; = 0.034) and had larger polyps (&lt;em&gt;p&lt;/em&gt; = 0.005) that were more often pedunculated (&lt;em&gt;p&lt;/em&gt; = 0.006) and hemorrhagic (&lt;em&gt;p&lt;/em&gt; = 0.031); bilateral lesions were more common in women (&lt;em&gt;p&lt;/em&gt; = 0.040). Except for &lt;em&gt;F&lt;/em&gt;&lt;sub&gt;o&lt;/sub&gt; and SPL, all multidimensional voice parameters improved significantly after surgery. Comparing surgical approaches, the LMS group (&lt;em&gt;n&lt;/em&gt; = 166) was younger (&lt;em&gt;p&lt;/em&gt; = 0.003) and had larger polyps (&lt;em&gt;p&lt;/em&gt; &lt; 0.001) than the FE group (&lt;em&gt;n&lt;/em&gt; = 35). After adjusting for age and polyp size, most voice parameters showed no significant difference between LMS and FE. Polyp size was weakly to moderately correlated with multiple preoperative parameters; it correlated positively with MFR in men (&lt;em&gt;p&lt;/em&gt; = 0.025), PPQ (&lt;em&gt;p&lt;/em&gt; = 0.032), APQ (&lt;em&gt;p&lt;/em&gt; = 0.003), jitter (&lt;em&gt;p&lt;/em&gt; = 0.027), shimmer (&lt;em&gt;p&lt;/em&gt; = 0.001), NNEa (&lt;em&gt;p&lt;/em&gt; = 0.004), VHI‑10 (&lt;em&gt;p&lt;/em&gt; = 0.030), G (&lt;em&gt;p&lt;/em&gt; = 0.001), R (&lt;em&gt;p&lt;/em&gt; = 0.006), and B (&lt;em&gt;p&lt;/em&gt; = 0.006) and negatively with MPT (&lt;em&gt;p&lt;/em&gt; = 0.012) and &lt;em&gt;F&lt;/em&gt;&lt;sub&gt;o&lt;/sub&gt; range in men (&lt;em&gt;p&lt;/em&gt; = 0.015). Larger polyps also showed weak negative correlations with ΔAPQ (&lt;em&gt;p&lt;/em&gt; = 0.029), Δjitter (&lt;em&gt;p&lt;/em&gt; = 0.009), Δshimmer (&lt;em&gt;p&lt;/em&gt; = 0.047), ΔVHI-10 (&lt;em&gt;p&lt;/em&gt; = 0.037), ΔG (&lt;em&gt;p&lt;/em&gt; = 0.005), ΔR (&lt;em&gt;p&lt;/em&gt; = 0.031), and ΔB (&lt;em&gt;p&lt;/em&gt; = 0.005).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Phonosurgery for VFPs significantly improves multidimensional voice outcomes. Polyp size is a ","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 633-642"},"PeriodicalIF":1.5,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145134872","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}