Auris Nasus Larynx最新文献

{"title":"Removal of submandibular hilar stones using a sialendoscope and a high-definition endoscope: Our experience and outcomes","authors":"Takahiro Suzuki,&nbsp;Teruyuki Sato,&nbsp;Yutaka Tateda,&nbsp;Nobuo Ohta","doi":"10.1016/j.anl.2025.12.019","DOIUrl":"10.1016/j.anl.2025.12.019","url":null,"abstract":"<div><h3>Objective</h3><div>Sialendoscopy is a minimally invasive approach that enables better visualisation of the salivary ductal system, as well as treatment of salivary stones. A high-definition endoscope (HDE) is excellent for observing deep areas of the oral cavity. We have used these two types of endoscopes for the treatment of submandibular hilar stones. The aim of this study was to review the treatment outcomes of sialendoscopy with/without an HDE for submandibular hilar stones in our patient population.</div></div><div><h3>Methods</h3><div>We conducted a retrospective review of 74 cases of submandibular hilar stones that were treated at our hospital. The following factors were investigated in these cases: age, gender, stone size, removal method, success rates, postoperative complications, and rate of improvement in symptoms postoperatively. Regarding the removal method, stone retrieval via the Wharton's duct using the sialendoscope was classified as sialendoscopy alone, while endoscopic stone removal using a transoral approach with the assistance of the sialendoscope was classified as the combined approach.</div></div><div><h3>Results</h3><div>Median patient age was 35.5 years. There were 30 males and 44 females. Stone size ranged from 1 to 18 mm, with a median size of 6 mm. The stones were successfully removed transorally in 71 (96 %) of the 74 patients. Stone retrieval was performed by sialendoscopy alone in 10 cases, while a combined approach was required in the remaining 61 cases. Of these 61 cases, the stone location could be identified under a magnified view with HDE in 46 cases. In the remaining 15 cases, the stone location was identified by the simultaneous use of a sialendoscope and HDE. Regarding postoperative complications, ranula, transient lingual nerve paralysis and neck abscess were observed in three (4 %), two (2.7 %) and one (1.3 %) patient, respectively. In terms of the rate of symptom improvement, 67 of the 71 cases (94 %) in whom transoral stone removal was successful showed complete resolution of symptoms, while four cases (6 %) exhibited mild symptoms of obstruction.</div></div><div><h3>Conclusion</h3><div>Sialendoscopy is an effective method for removing submandibular hilar stones, with a low incidence of postoperative complications. Using an HDE during transoral surgery enhances its efficacy by aiding precise localisation of the stone, facilitating its removal and detecting residual fragments or stones.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 146-151"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949438","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":"Authors’ reply: Comments on “Physical therapy for peripheral facial palsy: A systematic review and meta-analysis”","authors":"Haruki Nakano ,&nbsp;Takashi Fujiwara ,&nbsp;Yasushi Tsujimoto ,&nbsp;Naohito Morishima ,&nbsp;Takashi Kasahara ,&nbsp;Misato Ameya ,&nbsp;Keita Tachibana ,&nbsp;Shota Sanada ,&nbsp;Saori Toufukuji ,&nbsp;Naohito Hato","doi":"10.1016/j.anl.2025.11.002","DOIUrl":"10.1016/j.anl.2025.11.002","url":null,"abstract":"","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 162-163"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662957","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":"Thyroid cancer with internal jugular vein tumor embolism and skull base invasion causing polyneuropathy","authors":"Hiroki Matsushita ,&nbsp;Gaku Omura ,&nbsp;Sumiyo Saburi ,&nbsp;Takahiro Tsujikawa ,&nbsp;Shigeru Hirano","doi":"10.1016/j.anl.2025.12.009","DOIUrl":"10.1016/j.anl.2025.12.009","url":null,"abstract":"<div><div>We report a rare case of thyroid cancer with tumor embolism of the internal jugular vein (IJV) that progressed cranially into the skull base and caused multiple cranial neuropathies. An 80-year-old woman presented with a progressively enlarging right cervical mass, which had been neglected for 10 years. Ultrasonography and magnetic resonance imaging revealed a cystic cervical lesion with a tumor embolism within the IJV extending to the jugular foramen and hypoglossal and facial canals. Fine-needle aspiration cytology yielded inconclusive results on two occasions, likely because of cystic degeneration. The patient developed facial paralysis, tongue deviation, and vocal cord paralysis. Biopsy confirmed papillary thyroid carcinoma with poorly differentiated areas. The patient elected the best supportive care and passed away four months after diagnosis. Cranial progression was likely facilitated by venous stasis due to an intraluminal tumor thrombus combined with the biological aggressiveness of dedifferentiation. To the best of our knowledge, this is the first documented case of thyroid cancer with retrograde IJV tumor embolism that led to skull base invasion and jugular foramen syndrome. This case highlights the variability in thyroid cancer extension patterns, which can occasionally result in highly atypical and clinically significant manifestations.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 76-79"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145797297","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":"Validity and reliability of Bahasa Malaysia eating assessment tool (mEAT-10): A good screening tool for safe swallowing","authors":"Jia Ji Ng ,&nbsp;Hui Yan Ong ,&nbsp;Ziyad Al Harrasi ,&nbsp;Nik Fariza Husna Nik Hassan ,&nbsp;Sherin Sokmun ,&nbsp;Farah Liana Lokman ,&nbsp;Nadhirah Mohd Shakri ,&nbsp;Mawaddah Azman ,&nbsp;Mohd Razif Mohamad Yunus ,&nbsp;Marina Mat Baki","doi":"10.1016/j.anl.2025.12.002","DOIUrl":"10.1016/j.anl.2025.12.002","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to investigate the validity and reliability of the Bahasa Malaysia version of the Eating Assessment Tool-10 (mEAT-10) and determine the cutoff point for abnormal swallowing.</div></div><div><h3>Methods</h3><div>This prospective convenience sampling study was conducted at a tertiary center between December 2019 and May 2022. The mEAT-10 was produced following rigorous forward and backward translations. One hundred and thirty-eight participants, including 70 healthy volunteers and 68 patients with dysphagia, were recruited to complete the test–retest mEAT-10 assessment and the 3-ounce water test. The mEAT-10 was repeated within four weeks via telephone interviews or clinic visits. Patients in the dysphagia group underwent flexible endoscopic evaluation of swallowing (FEES). The FEES results were evaluated independently by four different raters to determine the reliability of the penetration-aspiration score (PAS) scoring, which categorizes them into safe and unsafe swallowing for data analysis. Internal consistency and test–retest agreement were assessed using Cronbach alpha and intraclass correlation coefficient (ICC). The mEAT-10 comparison between the normal and dysphagia groups was performed using the Mann–Whitney U test. The association between PAS and mEAT-10, gag reflex,3-ounce water test and the other risk factors were evaluated using chi-square and Fisher exact test, with univariable and multivariable logistic regression.</div></div><div><h3>Results</h3><div>The mEAT-10 test–retest showed a Cronbach alpha of &gt;0.90 and an ICC of &gt;0.85. The mEAT-10 cutoff score indicating abnormal swallowing is seven, with sensitivity and specificity of 0.82 and 0.54, respectively. In univariable analysis, higher mEAT-10 scores (≥7), absence of gag reflex, and failure of the 3-ounce water test were all significantly associated with unsafe swallowing (PAS ≥3). In multivariable logistic regression, however, failure of the 3-ounce water test was the only independent predictor of unsafe swallowing (PAS ≥3; adjusted odds ratio 4.24, 95% confidence interval 1.53–11.77; p=0.006).</div></div><div><h3>Conclusion</h3><div>mEAT-10 is a reliable tool for screening and assessing patients with dysphagia. A cutoff score of 7 or more indicates abnormal swallowing and maybe associated with unsafe swallowing (PAS ≥3).</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 91-98"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866647","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":"Three-dimensional analysis of vocal fold nodules in operatic soprano singers undergoing microlaryngeal surgery: Differences according to voice type subcategories (Lyric vs. Dramatic)","authors":"Nobuaki Honda ,&nbsp;Yusuke Watanabe ,&nbsp;Daigo Komazawa ,&nbsp;Mayu Hirosaki ,&nbsp;Michihiko Sone","doi":"10.1016/j.anl.2025.12.006","DOIUrl":"10.1016/j.anl.2025.12.006","url":null,"abstract":"<div><h3>Objectives</h3><div>Vocal demands in opera singers vary not only by vocal range but also by voice type subcategories (e.g., lyric vs. dramatic), which shapes technique and repertoire. Despite this, little is known about how these voice subcategories influence vocal fold pathology. To address this gap, we investigate the three-dimensional characteristics of vocal fold nodules in professional soprano opera singers and to clarify morphological differences based on voice type subcategories (lyric vs. dramatic).</div></div><div><h3>Methods</h3><div>This retrospective study included 19 professional soprano singers who underwent microlaryngeal surgery for bilateral vocal fold nodules between January 2018 and May 2023. Voice type subcategories, based on self-reported repertoire, was categorized as either lyric or dramatic. Nodules were classified as edematous or fibrous. Vertical location, estimated area, estimated contact area, and estimated volume of the nodules were calculated using intraoperative measurements and surgical video review. Statistical comparisons were performed between the lyric and dramatic groups.</div></div><div><h3>Results</h3><div>A total of 38 nodules were analyzed: 26 from lyric sopranos and 12 from dramatic sopranos. Lyric sopranos predominantly exhibited edematous nodules (24/26), while dramatic sopranos had a higher proportion of fibrous nodules (6/12). In both groups, nodules were more frequently located in the upper part of the vocal folds. Lyric sopranos showed significantly greater width, estimated area, estimated contact area, and estimated volume of vocal fold nodules compared to dramatic sopranos.</div></div><div><h3>Conclusion</h3><div>Voice-type subcategories may influence the morphological characteristics of vocal fold nodules in professional soprano singers. Lyric sopranos tend to develop larger, edematous nodules, likely due to repetitive high-frequency phonation, while dramatic sopranos are more prone to smaller, fibrotic nodules, potentially resulting from greater horizontal mechanical stress.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 99-106"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938764","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 ear structures on fetal MRI: A comparative analysis at 1.5-T and 3-T","authors":"Said Sonmez ,&nbsp;Omer Orak ,&nbsp;Sumeyye Guzeloglu Orak ,&nbsp;Edanur Karapinar ,&nbsp;Mehmet Barburoglu ,&nbsp;Tugba Sarac Sivrikoz ,&nbsp;Tuğba Kalaycı ,&nbsp;Umit Tuzun ,&nbsp;Mehmet Celik ,&nbsp;Beldan Polat ,&nbsp;Yahya Guldiken ,&nbsp;Derya Umit Talas ,&nbsp;Kadir Serkan Orhan","doi":"10.1016/j.anl.2025.12.017","DOIUrl":"10.1016/j.anl.2025.12.017","url":null,"abstract":"<div><h3>Objectives</h3><div>To compare the visualization of fetal ear structures on 1.5-Tesla (T) and 3-T fetal MRI (feMRI) using a staging system, and to measure cochlear height (CH) at 3-T.</div></div><div><h3>Methods</h3><div>Between 2009–2024, 147 feMRI examinations were retrospectively evaluated; after excluding 25 suboptimal scans, 122 studies were analyzed (1.5-<em>T</em> = 80; 3-<em>T</em> = 42). The cochlea, vestibule–semicircular canals (V-SCC), middle ear–ossicular chain (ME-OC), and external auditory canal (EAC) were systematically staged by a blinded neuroradiologist. CH was measured on 3-T. Categorical and group comparisons, correlation and ROC analysis were performed.</div></div><div><h3>Results</h3><div>Mean gestational week (GW) was 29.1 ± 3.7 weeks with no between-group difference (<em>p</em> = 0.101). Staging scores were higher at 3-T for the cochlea and V-SCC (both <em>p</em> &lt; 0.001) and for ME-OC (<em>p</em> = 0.019), with no difference for EAC (<em>p</em> = 0.317). At 3-T, cochlear turns were identifiable in 83.3%, the lateral semicircular canal in 61.9%, and ossicles in 73.8%; at least one EAC was visualized in 71.4%. GW correlated with V-SCC (rₛ=0.220, <em>p</em> = 0.015) and EAC (rₛ=0.330, <em>p</em> &lt; 0.001). ROC analysis identified 29.5 GW as the optimal cutoff for EAC visualization (AUC=0.718; 95% CI, 0.626–0.809; sensitivity, 57.3%; specificity, 75.0%; <em>p</em> &lt; 0.001). At 3-T, CH averaged 5.17 ± 0.53 mm and showed no correlation with GW (<em>r</em> = 0.041, <em>p</em> = 0.794).</div></div><div><h3>Conclusion</h3><div>Compared with 1.5-T, 3-T feMRI provides superior visualization of inner and middle ear structures, with similar EAC performance. In suspected anomalies, a focused ear assessment within feMRI improves prenatal ear evaluation, alongside ultrasonography.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 137-145"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145945684","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":"Subtotal petrosectomy for extensive cholesteatoma: A case series from Japan","authors":"Hiroshi Sakaida,&nbsp;Kazuhiko Takeuchi","doi":"10.1016/j.anl.2025.12.001","DOIUrl":"10.1016/j.anl.2025.12.001","url":null,"abstract":"<div><h3>Objective</h3><div>Subtotal petrosectomy (STP) is a standard procedure for intractable middle ear disease in Western countries, but reports from Japan are scarce. This report describes the clinical experience, patient characteristics, and surgical outcomes of STP at a tertiary center in Japan.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records of all patients who underwent STP in our department between January 2018 and April 2022. We analyzed patient demographics, underlying pathology, preoperative findings, postoperative complications, and the cholesteatoma recurrence rate.</div></div><div><h3>Results</h3><div>The cohort included 11 patients (7 male, 4 female) with a median age of 75 years. The primary indication was extensive cholesteatoma (11 cases), which was often complicated by dural exposure (6 cases) and labyrinthine fistula (6 cases). Postoperative complications occurred in 1 patient (9 %), who developed a fistula at the blind sac closure site. There were no instances of postoperative facial nerve palsy or inner ear complications. MRI surveillance revealed a residual cholesteatoma recurrence rate of 27 % (3 cases).</div></div><div><h3>Conclusion</h3><div>STP is an option for managing extensive primary cholesteatoma where hearing reconstruction is not feasible, particularly in the elderly population. However, the risk of residual cholesteatoma is significant, as evidenced by a 27 % recurrence rate in this series, and careful surgical indication is essential to avoid potential over-indication. This finding highlights the critical importance of meticulous surgical technique and rigorous postoperative imaging surveillance to ensure long-term disease control.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 13-18"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145716756","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":"C-C chemokine receptor 4 is a candidate for regulatory T-cell-depletion immunotherapy in differentiated thyroid cancer","authors":"Rui Sano ,&nbsp;Hiromu Nakamura ,&nbsp;Susumu Suzuki ,&nbsp;Daisuke Inukai ,&nbsp;Hiroki Okamoto ,&nbsp;Shunpei Yamanaka ,&nbsp;Taishi Takahara ,&nbsp;Akira Satou ,&nbsp;Yasushi Fujimoto ,&nbsp;Toyonori Tsuzuki ,&nbsp;Ryuzo Ueda ,&nbsp;Tetsuya Ogawa","doi":"10.1016/j.anl.2025.12.004","DOIUrl":"10.1016/j.anl.2025.12.004","url":null,"abstract":"<div><h3>Objective</h3><div>Immunotherapy using immune checkpoint inhibitors is a standard treatment option for many types of malignancies but is not effective for differentiated thyroid cancer (DTC). Regulatory T-cells (Tregs), which are one of the main suppressive factors in the tumor microenvironment, are another important target for immunotherapy. This study investigated the characteristics of Tregs in DTC with the aim of further developing immunotherapy.</div></div><div><h3>Methods</h3><div>Peripheral blood lymphocytes (PBLs) and tumor-infiltrating lymphocytes (TILs) were obtained from 12 patients with DTC and 12 patients with goiter (benign control group) who underwent primary surgery between February 2017 and September 2022. Flow cytometry analyses were performed for CD4, CD45RA, FOXP3, C<img>C chemokine receptor 4 (CCR4; a candidate Treg-targeting molecule), and immune checkpoint molecules in order to characterize the features of Tregs.</div></div><div><h3>Results</h3><div>In the DTC patients, age ranged from 39 to 84 years, and the male:female ratio was 7:5. Pathological staging was pT1 or pT2 in 4 patients, pT3 in 8, pN0 in 5, and pN1 in 7, and extrathyroidal extension was observed in 5 patients. Effector Treg (eTreg) frequency in CD4⁺ <em>T</em>-cells in TILs and PBLs was significantly higher in DTC than in goiter. Extrathyroidal extension was associated with a higher eTreg frequency in TILs. A positive correlation was found between eTreg frequency and the expression of immune checkpoint molecules (PD-1, TIM3, GITR, and OX40) on eTregs in TILs from DTC patients. These findings suggest that Tregs are activated in DTC and are important in the creation of an immunosuppressive microenvironment. In addition, the mean positive rate (±standard deviation) of CCR4 on eTregs was high in PBLs (95.8 % ± 3.8 %) and TILs (92.8 % ± 9.8 %) from DTC patients, suggesting that CCR4 is a potential target for eTreg-depletion immunotherapy for DTC.</div></div><div><h3>Conclusion</h3><div>Tregs were increased and activated in DTC tumor tissue, indicating that they play an important role in creating an immunosuppressive microenvironment in DTC. The results suggest that eTreg-depletion immunotherapy using an anti-CCR4 antibody (mogamulizumab) might be effective for treating DTC.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 27-34"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745818","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":"Feasibility of ensuring surgical margins of transoral robotic surgery for lateral oropharyngectomy for p16-positive oropharyngeal squamous cell carcinoma patients compared with non-robotic surgery: A single-center, retrospective study","authors":"Go Omura ,&nbsp;Kohtaro Eguchi ,&nbsp;Toshihiko Sakai ,&nbsp;Tatsuya Ito ,&nbsp;Akihisa Tanaka ,&nbsp;Mitsuhiko Katoh ,&nbsp;Sorane Maezumi ,&nbsp;Yoko Murayama ,&nbsp;Hiroki Kuroyanagi ,&nbsp;Paulina Maria Angela C. Villar ,&nbsp;Azusa Sakai ,&nbsp;Hideaki Takahashi ,&nbsp;Chihiro Fushimi ,&nbsp;Taisuke Mori ,&nbsp;Seiichi Yoshimoto","doi":"10.1016/j.anl.2025.12.016","DOIUrl":"10.1016/j.anl.2025.12.016","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to elucidate the utility of transoral robotic surgery (TORS) for lateral oropharyngectomy in patients with HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) by comparing its treatment outcomes with those of conventional non-robotic procedures.</div></div><div><h3>Methods</h3><div>The clinical charts of patients with newly diagnosed p16-positive OPSCC from the lateral wall who underwent lateral oropharyngectomy at our institution between 2016 and 2025 were retrospectively reviewed. The patients were divided into two groups according to the surgical approach: the non-robotic procedure group, treated via direct visualization or transoral videolaryngoscopic surgery, and the TORS group, treated using the da Vinci Surgical System. Clinicopathological data were compared between the groups.</div></div><div><h3>Results</h3><div>This study included 105 patients, 80 of whom underwent non-robotic procedures, and 25 underwent TORS. The TORS group exhibited a significantly lower rate of positive surgical margins (36% vs. 4%, <em>P</em> &lt; .001). Logistic regression analysis revealed that TORS is an independent predictor of negative margins (odds ratio, 0.15; 95% confidence interval, 0.03–0.70; <em>P</em> = .02).</div></div><div><h3>Conclusions</h3><div>TORS was associated with superior margin control, supporting its utility as a primary treatment modality for p16-positive OPSCC.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 107-110"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145938595","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":"Cost and clinical outcomes of transoral robotic surgery versus radiation therapy for T1–2N0–1M0 pharyngeal and laryngeal cancers","authors":"Susumu Kunisawa ,&nbsp;Ichiro Tateya ,&nbsp;Hisayuki Kato ,&nbsp;Koichi Omori ,&nbsp;Kiyohide Fushimi ,&nbsp;Yuichi Imanaka","doi":"10.1016/j.anl.2025.12.012","DOIUrl":"10.1016/j.anl.2025.12.012","url":null,"abstract":"<div><h3>Objectives</h3><div>Since 2022, transoral robotic surgery (TORS) for pharyngeal and laryngeal cancers has been covered under Japan’s national health insurance system. Despite its technical advantages, such as improved access and functional preservation, its adoption remains limited. One of the barriers may be that TORS is reimbursed at the same level as conventional endoscopic surgery, despite requiring substantial initial investment and operational costs. This raises concerns about the underutilization of a potentially valuable technology. Therefore, an economic evaluation of TORS is warranted to inform reimbursement policy.</div></div><div><h3>Methods</h3><div>We used data from Japan’s national Diagnosis Procedure Combination (DPC) database to identify patients with T1–2N0–1M0 pharyngeal or laryngeal cancers who received either TORS or intensity-modulated radiation therapy (IMRT) in 2022. Total medical costs during the treatment period were compared.</div></div><div><h3>Results</h3><div>Among 447 patients identified, 40 received TORS and 407 underwent IMRT. The TORS group had significantly shorter hospital stays (mean 16.3 vs. 55.5 days) and lower mean costs (1.26 vs. 3.45 million yen; <em>P</em> &lt; 0.01) than those who underwent IMRT. Using a generalised linear model with a gamma distribution and log link, and adjusting for sex, age, tumour site, tumour size and nodal status, TORS was associated with significantly lower costs than IMRT (adjusted cost ratio 0.39; 95 % confidence interval 0.35–0.43; <em>P</em> &lt; 0.01). A similar result was observed even when the analysis was limited to patients with oropharyngeal cancer and N0.</div></div><div><h3>Conclusions</h3><div>TORS demonstrated a significant reduction in medical costs for treating patients with T1–2N0–1M0 pharyngeal or laryngeal cancer. However, this result should be interpreted with caution, as the observed cost advantage is probably due to the current Japanese reimbursement pricing. Nevertheless, the shortened treatment period associated with TORS offers meaningful benefits from the patient perspective. Even with moderate adjustments in reimbursement, the cost-effectiveness of TORS is expected to remain robust.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"53 1","pages":"Pages 86-90"},"PeriodicalIF":1.5,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866650","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}