Auris Nasus Larynx最新文献

{"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":"2025-12-01","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":"Impact of perioperative oral care on postoperative infections in patients with head and neck cancer: A retrospective study comparing before and during the coronavirus disease 2019 pandemic","authors":"Azusa Kai ,&nbsp;Kimie Fujita ,&nbsp;Naohisa Wada ,&nbsp;Takashi Nakagawa","doi":"10.1016/j.anl.2025.10.003","DOIUrl":"10.1016/j.anl.2025.10.003","url":null,"abstract":"<div><h3>Objective</h3><div>Infection prevention is crucial in head and neck cancer surgery due to the high risk of surgical site contamination by oral bacteria and pharyngeal secretions. The coronavirus disease 2019 (COVID-19) pandemic has introduced significant challenges to infection control in medical settings, including restrictions on patient care and changes to perioperative management. This study investigated the incidence of postoperative pneumonia (PP) and surgical site infection (SSI) before and during the COVID-19 pandemic, and examined how perioperative oral care and oral hygiene status were associated with the occurrence of postoperative infections.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed the medical records of patients who underwent head and neck cancer surgery between January 2018 and March 2022. The incidences of PP and SSI were compared before and during the COVID-19 pandemic. In addition, variables identified by univariate analysis as predictors of postoperative infection were incorporated and examined using logistic regression analysis.</div></div><div><h3>Results</h3><div>A total of 213 patients were included in this study. The incidence rates of PP and SSI were 15.0% and 24.4%, respectively, with no statistically significant difference before and during the pandemic. The risk factors for PP included preoperative oral dryness (odds ratio [OR] = 2.65; 95% confidence interval [CI] = 1.14–6.17; <em>p</em> = 0.024), and diabetes (OR = 2.65; 95% CI = 1.04–6.72; <em>p</em> = 0.040), while for SSI, the risk factors included lack of postoperative oral care (OR = 0.29; 95% CI = 0.10–0.86; <em>p</em> = 0.026), prolonged operative time (OR = 1.80; 95% CI = 1.09–2.99; <em>p</em> = 0.022), and preoperative radiotherapy (OR = 2.25; 95% CI = 1.02–4.95; <em>p</em> = 0.044).</div></div><div><h3>Conclusion</h3><div>Appropriate perioperative oral care remains essential, even in the post-COVID-19 era. This study highlights the importance of preventing oral dryness before surgery and ensuring continuous professional oral care before and after surgery to prevent postoperative infections.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 735-743"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356880","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":"Complete and successful resection of antrochoanal polyps using endoscopic modified medial maxillectomy","authors":"Kotaro Kano ,&nbsp;Satoshi Yamada ,&nbsp;Arika Matsushita ,&nbsp;Taiki Mori ,&nbsp;Mamoru Masuda ,&nbsp;Yusei Makoshi ,&nbsp;Shigeru Matsuda ,&nbsp;Kotaro Ishida ,&nbsp;Kazutaka Takeuchi ,&nbsp;Yuki Nakamura ,&nbsp;Kosuke Sugawara ,&nbsp;Sosuke Sahara ,&nbsp;Natsuki Sugiyama ,&nbsp;Junya Kita ,&nbsp;Kotaro Morita ,&nbsp;Hiroshi Nakanishi ,&nbsp;Atsushi Imai ,&nbsp;Jun Okamura ,&nbsp;Yoshinori Takizawa ,&nbsp;Yuki Misawa ,&nbsp;Kiyoshi Misawa","doi":"10.1016/j.anl.2025.10.014","DOIUrl":"10.1016/j.anl.2025.10.014","url":null,"abstract":"<div><h3>Objective</h3><div>Antrochoanal polyps (ACPs) are benign lesions of the maxillary sinus mucosa that are often treated with endoscopic sinus surgery using middle meatal antrostomy (MMA). However, MMA alone may not provide sufficient access to the mucosal attachment site of polyp, particularly at the anterior or inferior wall of the maxillary sinus, and additional procedures may be required to achieve complete resection. Although many reports have described ACP resection with MMA in combination with supplementary procedures, no study has evaluated whether ACPs can be effectively removed using a single approach without MMA. Endoscopic modified medial maxillectomy (EMMM) provides wide access to the maxillary sinus without additional procedures. This study aimed to evaluate the efficacy of EMMM alone, without MMA, in achieving complete resection of ACPs.</div></div><div><h3>Methods</h3><div>A retrospective review was conducted using data of 13 patients with ACPs treated surgically (EMMM, n = 8; MMA with or without additional procedures, n = 5) between October 2019 and May 2023. Surgical outcomes, including operative time, blood loss, mucosal healing, complications, and recurrence, were compared between the two groups.</div></div><div><h3>Results</h3><div>Intraoperative blood loss was significantly reduced and mucosal healing was significantly rapid in the patients in the EMMM group (p &lt; 0.05). No complications occurred in both groups. Recurrence occurred in the MMA group only (n = 1). Postoperatively, the patients in the EMMM group had improved preservation of sinonasal structures and wound healing since the procedure avoided middle meatus manipulation.</div></div><div><h3>Conclusions</h3><div>In the present study, EMMM could be a safe and effective technique for complete ACP resection. It might minimizes tissue trauma, promote rapid healing, reduce the risk of recurrence, and have the potential to become a standard procedure for ACP removal, especially when preservation of nasal structures is prioritized.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 790-795"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145520417","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":"Corrigendum to “Impact of hearing impairment in unilateral hearing loss: A multicenter study of standardized sound localization tests in Japan.” [Auris Nasus Larynx, Volume 52, Issue 6, December 2025, Pages 690-703]","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.2025.10.012","DOIUrl":"10.1016/j.anl.2025.10.012","url":null,"abstract":"","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 803-804"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551871","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":"2025-12-01","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":"Clinical and pathological characteristics of CRS with nasal polyps in patients with asthma–COPD overlap","authors":"Masayoshi Mukai ,&nbsp;Haruka Nakanishi ,&nbsp;Kanako Matsui ,&nbsp;Emiri Sato ,&nbsp;Manabu Nonaka ,&nbsp;Naoko Yanagisawa","doi":"10.1016/j.anl.2025.10.007","DOIUrl":"10.1016/j.anl.2025.10.007","url":null,"abstract":"<div><h3>Objective</h3><div>Bronchial asthma (BA) and Chronic Obstructive Pulmonary Disease (COPD) have been considered as independent diseases, but in recent years, Asthma and COPD Overlap (ACO), which combines characteristics of BA and COPD, has been defined. Chronic rhinosinusitis (CRS) with nasal polyps and BA, both caused by similar type 2 inflammation, often coexist and are considered to have a “one airway, one disease” relationship. In ACO, airway inflammatory cells of BA (eosinophils and CD4⁺ lymphocytes) and COPD (neutrophils, CD8+ lymphocytes and macrophages) coincide, theoretically leading to steroid resistance compared to BA alone. Based on the “one airway, one disease” concept, we hypothesized that clinical and pathological characteristics of CRS differs depending on its comorbidity with ACO or with BA alone.</div></div><div><h3>Methods</h3><div>Sixty-two CRS patients with BA who underwent endoscopic surgery for CRS with nasal polyp at our hospital between January 2014 and December 2022 were included in this study, and were followed at our hospital until December 2023. The patients were categorized by pulmonologists into 21 patients of CRS-ACO and 41 patients of CRS-BA according to the Japanese guidelines for the Management of ACO 2018. We compared recurrence-free period of nasal polyps between these two groups. Nasal polyps from CRS-ACO (<em>n</em> = 11) and CRS-BA (<em>n</em> = 13) those who consented to this study were subjected to histologic examination and the numbers of eosinophils, and cell positive for CD4, CD8, elastase (a marker for neutrophils), and CD163 (a marker for macrophages) were counted.</div></div><div><h3>Results</h3><div>CRS-ACO had a significantly faster recurrence time, compared to the recurrence time in CRS-BA, and was a risk factor for recurrence. Nasal polyps from CRS-ACO and CRS-BA those who consented to this study were subjected to histologic examination. Elastase, CD8, and CD163 positive cell numbers were significantly higher in CRS-ACO than in CRS-BA patients.</div></div><div><h3>Conclusion</h3><div>CRS-ACO patients were prone to recurrence of nasal polyps, and the pathology of nasal polyps in CRS-ACO patients were significantly infiltrated with neutrophilic inflammatory cells. CRS-ACO patients revealed inflammatory cell infiltration in the upper airway (nasal polyps) and similar cell types was confirmed to coexist in the lower airway, suggests the possibility of a “one airway, one disease” concept, not only in BA, but also in ACO as well.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 744-749"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145364135","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":"Transoral robotic approaches for benign and malignant parapharyngeal space tumors: comparative analysis and systematic review","authors":"Francesco Chiari ,&nbsp;Daria Maria Filippini ,&nbsp;Edoardo Serafini ,&nbsp;Matteo Fermi ,&nbsp;Livio Presutti ,&nbsp;Antonino Maniaci ,&nbsp;Claudio Donadio Caporale ,&nbsp;Pierre Guarino","doi":"10.1016/j.anl.2025.10.008","DOIUrl":"10.1016/j.anl.2025.10.008","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this systematic review was to provide a comprehensive overview of the clinical characteristics of patients with parapharyngeal space (PPS) tumors treated with transoral robotic surgery (TORS). Additionally, comparative analyses were conducted to evaluate differences based on tumor histology, tumor location, and the type of transoral robotic approach used.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. A comprehensive electronic search was performed across Embase, PubMed, Scopus, and Cochrane Library to identify studies published between 2007 and 2024.</div></div><div><h3>Results</h3><div>A total of 31 studies met the inclusion criteria, encompassing individual data from 148 patients. The TORS-combined approach was more frequently employed in the management of malignant PPS (<em>p</em> = .010), with a larger size (<em>p</em> = &lt;.001). Furthermore, malignant PPS tumors presented a higher incidence of feeding tube placement, tracheotomy, and prolonged hospitalization when compared to benign neoplasms (<em>p</em> &lt; .001). Post-operative complications were related to retro-styloid tumors (<em>p</em> = .023).</div></div><div><h3>Conclusions</h3><div>The TORS-only approach is appropriate for the treatment of isolated, small, and well-encapsulated tumors. Based on previously published evidence, a TORS-combined approach has been recommended for the management of malignant tumors exceeding 3 cm in diameter. In the current analysis, larger tumor size was associated with the choice of a TORS-combined procedure, but this was not directly correlated with malignant histology</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 776-784"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440265","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 and safety of transaxillary robotic thyroidectomy in Japan – Comparison with video-assisted neck surgery in initial cases","authors":"Yosuke Tanabe,&nbsp;Tomoki Kuki,&nbsp;Kohei Yamahara,&nbsp;Hisayuki Kato,&nbsp;Ichiro Tateya","doi":"10.1016/j.anl.2025.10.006","DOIUrl":"10.1016/j.anl.2025.10.006","url":null,"abstract":"<div><h3>Objective</h3><div><strong>:</strong> To evaluate the safety and feasibility of transaxillary robotic thyroidectomy (TART) in Japan by comparing early cases with video-assisted neck surgery (VANS).</div></div><div><h3>Methods</h3><div><strong>:</strong> Single-center retrospective review of 31 consecutive thyroid lobectomies: 16 VANS (Nov 2020–Feb 2025) and 15 TART (Mar 2022–Feb 2025). TART used da Vinci Surgical system (da Vinci) Xi for early cases and predominantly da Vinci SP thereafter. Indications included differentiated cancer ≤4 cm, cN0, unilateral disease without extrathyroidal invasion, or follicular tumors 3–5 cm. Operative time, blood loss, hospital stay, complications, and cosmetic outcomes were evaluated and compared with statistical analysis.</div></div><div><h3>Results</h3><div><strong>:</strong> All procedures were completed without conversion to open surgery. Blood loss (16.5 g vs 25.8 g) and length of stay (6.3 vs 6.1 days) were comparable. Complications included two transient recurrent laryngeal nerve palsies after VANS and, after TART, one axillary bleed controlled under local anesthesia and one lymphatic leak; overall rates were similar. High cosmetic satisfaction was reported in both cohorts.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> Early experience shows TART is feasible and safe in Japan, achieving perioperative outcomes comparable to VANS with excellent cosmetic results.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 769-775"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145440200","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":"2025-12-01","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}

{"title":"High-salt intake exacerbates endolymphatic hydrops and alters aldosterone regulation in a Ménière’s disease animal model","authors":"Makoto Kinoshita ,&nbsp;Akinobu Kakigi ,&nbsp;Yuki Katsutani ,&nbsp;Teru Kamogashira ,&nbsp;Kento Koda ,&nbsp;Kentaro Ichijo ,&nbsp;Chisato Fujimoto ,&nbsp;Shinji Yamashita ,&nbsp;Kenji Kondo","doi":"10.1016/j.anl.2025.10.010","DOIUrl":"10.1016/j.anl.2025.10.010","url":null,"abstract":"<div><h3>Objective</h3><div>Ménière’s disease (MD) causes episodic vertigo and fluctuating hearing loss and is pathologically characterized by endolymphatic hydrops (EHs), often resulting from impaired endolymph absorption in the endolymphatic sac (ES). Although salt restriction is widely recommended, its mechanistic basis remains unclear. This study aims to examine how ES dysfunction and dietary salt intake interactively affect endolymphatic homeostasis, vestibular function, and aldosterone regulation.</div></div><div><h3>Methods</h3><div>Guinea pigs underwent ES ablation or sham surgery and were fed either a normal- (0.41 % NaCl) or high-salt (2.0 % NaCl) diet, generating four groups (Sham-Normal, Sham-Na, ES-Normal, ES-Na; <em>n</em> = 4 per group). Vestibular evoked potential (VsEP) thresholds and plasma aldosterone were measured at 4 weeks post-surgery. Animals were then given their assigned diets for 2 weeks, after which both variables were re-evaluated at week 6. Animals were subsequently euthanized, and EHs were quantified using optical coherence tomography (OCT) as the extension ratio of Reissner’s membrane length and increase ratio of scala media area (IR-A).</div></div><div><h3>Results</h3><div>Two-way ANOVA revealed a significant surgery × salt interaction for IR-A, indicating synergistic hydrops when ES damage and high salt co-occurred. VsEP thresholds increased with both factors but showed no interaction, indicating additive vestibular impairment. Aldosterone exhibited a clear interaction: ES ablation elevated aldosterone under normal salt conditions, whereas high salt suppressed aldosterone irrespective of surgical status.</div></div><div><h3>Conclusion</h3><div>Sodium excess is associated with worsening EHs in ES dysfunction, suggesting a relation between sodium intake and EHs formation in MD. These results support further studies, including a low-salt group, to clarify whether and how sodium restriction could improve MD symptoms.</div></div>","PeriodicalId":55627,"journal":{"name":"Auris Nasus Larynx","volume":"52 6","pages":"Pages 756-763"},"PeriodicalIF":1.5,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145395269","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}