María Alharilla Montilla-Ibáñez , Javier Modesto García-Fernández , María Soledad Sánchez-Torices , María Pilar Gómez-Gallego , Miguel Angel Feliz-Fernández , Rafael Lomas-Vega
{"title":"Adaptación transcultural y validación psicométrica de la versión en español del cuestionario Nasal Polyposis Quality of Life (NPQ)","authors":"María Alharilla Montilla-Ibáñez , Javier Modesto García-Fernández , María Soledad Sánchez-Torices , María Pilar Gómez-Gallego , Miguel Angel Feliz-Fernández , Rafael Lomas-Vega","doi":"10.1016/j.otorri.2025.512310","DOIUrl":"10.1016/j.otorri.2025.512310","url":null,"abstract":"<div><h3>Introduction</h3><div>To perform the cross-cultural adaptation into Spanish and the psychometric validation of the Nasal Polyposis Quality of Life Questionnaire (NPQ) for use in patients with chronic rhinosinusitis with nasal polyps (CRSwNP).</div></div><div><h3>Methods</h3><div>A total of 140 adult patients diagnosed with CRSwNP were included. The original NPQ was adapted from Italian into Spanish following established international guidelines. Construct validity was assessed through exploratory factor analysis (EFA) with principal components. Internal consistency was analyzed using Cronbach's alpha coefficient. Test-retest reliability was determined by the intraclass correlation coefficient (ICC). Concurrent validity was examined using Pearson correlations with the SNOT-22 and NOSE-E questionnaires. Discriminant validity was analyzed using ROC curves.</div></div><div><h3>Results</h3><div>EFA revealed a five-factor structure explaining 67% of the total variance. The Spanish NPQ showed excellent internal consistency (Cronbach's α<!--> <!-->=<!--> <!-->0.917) and high test-retest reliability (ICC<!--> <!-->=<!--> <!-->0.991; 95% CI: 0.983-0.996). The standard error of measurement (SEM) was 2 points, and the minimal detectable change (MDC95) was 5 points. Strong correlations were observed with the NOSE-E (r<!--> <!-->=<!--> <!-->0.802) and SNOT-22 (r<!--> <!-->=<!--> <!-->0.870). The NPQ total score demonstrated high discriminative ability for severe symptoms (AUC<!--> <!-->=<!--> <!-->0.947), with a cutoff point >41 providing 88.9% sensitivity and 93.3% specificity.</div></div><div><h3>Conclusions</h3><div>The Spanish version of the NPQ is a valid, reliable, and clinically useful instrument for assessing symptom burden in patients with CRSwNP. Its multidimensional structure allows capturing the specific impact of this phenotype and supports its use in both clinical practice and research.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512310"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hussein Sherif Hamdy, Abeir Osman Dabbous, Enas Magdy Ahmed, Dina Fouad Osman
{"title":"Auditory attention ability in normal hearing patients with chronic subjective tinnitus","authors":"Hussein Sherif Hamdy, Abeir Osman Dabbous, Enas Magdy Ahmed, Dina Fouad Osman","doi":"10.1016/j.otorri.2025.512305","DOIUrl":"10.1016/j.otorri.2025.512305","url":null,"abstract":"<div><h3>Background</h3><div>Tinnitus is the perception of sounds in the absence of an external acoustic signal. Many patients with tinnitus complain of attention and concentration difficulties that affect their daily life activities.</div></div><div><h3>Objectives</h3><div>This study was done to assess the auditory attention ability in normal hearing patients with subjective chronic tinnitus, and to study the relation between auditory attention and the degree of tinnitus handicap and the psychoacoustic characterization of tinnitus.</div></div><div><h3>Subjects and methods</h3><div>This is a case control study that included 35 normal hearing chronic (>6 months duration) tinnitus patients, between 18–50 years of age, of both genders, compared to 35 normal hearing controls without tinnitus. Tinnitus severity was assessed by the Tinnitus Handicap Inventory, and the Hospital Anxiety and Depression Scale was used to assess the psychological status of the patients. Auditory attention was evaluated by behavioral measures: The vigilance test of the Montreal Cognitive Assessment (VMoCA), the Digit forward span test (DFST), Speech-in-noise (SPIN) test, and the Dichotic digits test (DDT).</div></div><div><h3>Results</h3><div>Tinnitus cases in the current study performed significantly worse than their controls on the behavioral measures of auditory attention measured (<em>P</em> value <.05). The vigilance test of the Montreal Cognitive Assessment (VMOCA) was significantly affected with a mean of 1.49 (SD ± 0.66) as compared to controls (Mean: 2 ± 0). There was a statistically significant (<em>P</em> < .05) negative correlation between functional subscale of THI with DDT test right ear (r = −0.415) and left ear (r = −0.354). There was a statistically significant (<em>P</em> < .05) negative correlation between catastrophic subscale of THI with DDT test left ear (r = −0.387). There was a statistically significant (<em>P</em> < .05) negative correlation between total score of THI with DDT test right ear (r = −0.347). Also, there was a statistically significant (<em>P</em> < .05) negative correlation between functional subscale of THI and SPIN test results in the left ear (r = −0.39), and between total score of THI and SPIN test in the left ear (r = −0.382).</div></div><div><h3>Conclusion</h3><div>Chronic tinnitus is linked to anxiety, depression, and impaired auditory attention. These findings suggest that therapies for tinnitus should include cognitive and emotional support.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512305"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Costes directos del implante coclear unilateral en personas mayores de 60 años","authors":"Beatriz Tena-García , Sergio Barrientos Trigo , Francisco Ropero Romero , Serafín Sánchez-Gómez","doi":"10.1016/j.otorri.2025.512286","DOIUrl":"10.1016/j.otorri.2025.512286","url":null,"abstract":"<div><h3>Background and objective</h3><div>Unilateral cochlear implantation (CI) is the recommended treatment for profound sensorineural hearing loss in older adults when hearing aids fail to provide benefit. This study aimed to determine the direct costs associated with this procedure to support health-care provider decision-making.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional observational study was performed at a single-center tertiary hospital on 278 cochlear implant recipients aged 60 years or older between 2009 and 2020. A final sample of 71 subjects (37 women, 52,1%) was selected via stratified random sampling. A micro-costing (bottom-up) economic analysis was conducted. Direct costs were allocated according to the Framework Agreement and the Andalusian Health Service salary tables, including the device, allowances, personnel, surgery, hospitalization, clinical follow-up, complications, and technology upgrades. Costs were updated to 2024 € and calculated over a mean time horizon of 23.3 years.</div></div><div><h3>Results</h3><div>The mean age at CI was 67.7 ± 5.8 years. Complications occurred in 8.4% of patients, incorporating the costs of one explantation/reimplantation. The mean total cost per patient was € 44,555.08. Device acquisition and processor upgrades represented the largest share (93.58%, € 41,696), while personnel accounted for 6.41% (€ 2,859.08) and complications for 0.67% (€ 297).</div></div><div><h3>Conclusions</h3><div>The direct costs of a unilateral CI procedure in individuals over 60 amount to an investment of € 44,555.08, driven primarily by device and processor upgrade expenses. Personnel costs are low but involve substantial multiprofessional organizational complexity. Deriving direct costs from primary sources tied to a specific clinical pathway provides a more realistic estimate than probabilistic modelling and can aid health-care administrations in decision-making.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512286"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fernando López , Luis López , Patricia García-Cabo , Pilar Solis , Sonia Blanco , Pilar Blay , Ángeles de la Rúa , José Luis Llorente , Juan Pablo Rodrigo
{"title":"Resultados oncológicos y funcionales del tratamiento del carcinoma nasofaríngeo en un área no endémica","authors":"Fernando López , Luis López , Patricia García-Cabo , Pilar Solis , Sonia Blanco , Pilar Blay , Ángeles de la Rúa , José Luis Llorente , Juan Pablo Rodrigo","doi":"10.1016/j.otorri.2025.512311","DOIUrl":"10.1016/j.otorri.2025.512311","url":null,"abstract":"<div><h3>Background and objective</h3><div>Nasopharyngeal carcinoma (NPC) is an uncommon neoplasm in non-endemic regions such as Spain, with most data coming from Asia. The aim of this study is to describe the epidemiological characteristics, oncological and functional outcomes, and treatment-related toxicities in a cohort of patients from a single center in northern Spain.</div></div><div><h3>Patients and methods</h3><div>A retrospective study was conducted including 64 patients diagnosed with NPC between 2010 and 2022. Demographic and clinicopathological data, treatments received, survival outcomes, relapse patterns, and long-term sequelae were collected and analyzed.</div></div><div><h3>Results</h3><div>A total of 87.5% of the cases received primary treatment at our hospital, while the remaining 12.5% were referred from other centers for the management of either recurrence or treatment-related toxicities. The mean age was 52 years, with a predominance of males (76.6%). The most common histological subtype was undifferentiated (70.3%), although Epstein–Barr virus (EBV) was negative in 61% of cases. A total of 68.8% of patients were diagnosed at advanced stages. All patients received radiotherapy, which was intensity-modulated radiotherapy (IMRT) in 78.1% of cases, and 85.9% received concomitant chemotherapy. The 5-year disease-free survival was 68.4%. Most relapses were local (56.2%), and the most frequent long-term sequela was xerostomia (53.5%). Endoscopic surgery was an effective and safe treatment for local recurrences.</div></div><div><h3>Conclusions</h3><div>The epidemiology of NPC in this northern Spanish cohort is similar to that of endemic regions. Oral functional sequelae are the main treatment-related toxicity. Endoscopic surgery is a safe and effective treatment option for local recurrences.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512311"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Afectación laríngea en paciente con linfoma de células T asociado a enteropatía","authors":"Carmelo Morales-Angulo , Coral Rivas-Rivas , Sonia González de Villambrosia Pellón","doi":"10.1016/j.otorri.2025.512314","DOIUrl":"10.1016/j.otorri.2025.512314","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512314"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Carlota Rovira-Martínez , Mariana Campos-Motamayor , Aina Sansa-Perna , Elios Yuste , Laura Gelabert , Josep de Haro-Licer , Alda Cardesín-Revilla , Miguel Caballero-Borrego
{"title":"Evaluación del impacto de la disfunción olfativa post-COVID-19 en la calidad de vida: comparación de cuestionarios específicos","authors":"Carlota Rovira-Martínez , Mariana Campos-Motamayor , Aina Sansa-Perna , Elios Yuste , Laura Gelabert , Josep de Haro-Licer , Alda Cardesín-Revilla , Miguel Caballero-Borrego","doi":"10.1016/j.otorri.2025.512312","DOIUrl":"10.1016/j.otorri.2025.512312","url":null,"abstract":"<div><h3>Background and objectives</h3><div>Post-COVID-19 olfactory dysfunction persists in many patients and significantly affects quality of life. The primary objective was to evaluate olfactory function using psychophysical tests (BAST-24) and quality-of-life questionnaires. Secondary objectives included analysing correlations between questionnaires and the relationship between subjective and psychophysical measures.</div></div><div><h3>Materials and methods</h3><div>A prospective study was conducted including 86 adults with olfactory dysfunction ≥<!--> <!-->6 months after SARS-CoV-2 infection. Clinical and demographic data and scores from the Visual Analog Scale for smell (VAS-smell) and the SNOT-22, svQOD-NS, and QVOLF questionnaires were collected. Olfactory function was assessed using the BAST-24 (detection, identification, and olfactory memory). Descriptive statistics, Spearman's correlation coefficient, and the Mann-Whitney U test were used (p<!--> <!--><<!--> <!-->0.05).</div></div><div><h3>Results</h3><div>Mean age was 49 years (SD<!--> <!-->=<!--> <!-->14); 76.7% were women. According to the VAS, 90.7% had hyposmia and 8.1% anosmia. Mean scores (SD) were: VAS 6 (2), SNOT-22 26 (20), svQOD-NS 4 (4), and QVOLF 127 (50), suggesting a moderate impact on quality of life. BAST-24 scores: detection 91% (22), identification 52% (25), and memory 35% (20). QVOLF and svQOD-NS showed a strong correlation (ρ<!--> <!-->=<!--> <!-->0.797; p<!--> <!--><<!--> <!-->0.001), while SNOT-22 correlated moderately with both. No significant correlations were found between any questionnaire and BAST-24.</div></div><div><h3>Conclusions</h3><div>QVOLF and svQOD-NS questionnaires are more sensitive than SNOT-22 for assessing olfactory dysfunction. The lack of correlation with psychophysical tests highlights the need to combine both approaches for a comprehensive evaluation.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512312"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Martínez-Moreno , Paula Martínez Ruiz de Apodaca , Silvia Matarredona-Quiles , Elena González-Turienzo , Ruxandra Dinu-Pistolea , Blanca Espinosa-Arnau , Marina Carrasco-Llatas
{"title":"Surgery for sleep apnea. Long-term results","authors":"Miguel Martínez-Moreno , Paula Martínez Ruiz de Apodaca , Silvia Matarredona-Quiles , Elena González-Turienzo , Ruxandra Dinu-Pistolea , Blanca Espinosa-Arnau , Marina Carrasco-Llatas","doi":"10.1016/j.otorri.2025.512307","DOIUrl":"10.1016/j.otorri.2025.512307","url":null,"abstract":"<div><h3>Background</h3><div>Upper airway surgery is an effective treatment for OSA, improving both subjective and objective parameters that define the condition. However, the long-term stability of this improvement remains unclear.</div></div><div><h3>Methods</h3><div>An ambispective observational study was conducted using data from the Dr. Peset Hospital (Valencia, Spain) on patients who underwent palatal surgery using modern pharyngoplasty techniques between 2015 and 2023. A total of 83 patients were included, with follow-ups conducted at a mean of 7, 35, 51, 68, and 85 months post-surgery. Objective and subjective parameters were analyzed.</div></div><div><h3>Results</h3><div>Significant improvements were observed in AHI (from 38.82 ± 21.26 to 16.30 ± 16.60), ODI (from 40.71 ± 21.18 to 16.93 ± 18.02), T90 (from 16,31 ± 22.58 to 6.68 ± 10.50), and minimum oxygen saturation (from 76.14 ± 13.54 to 84.52 ± 7.74), as well as in subjective measures, following surgery. At the third follow-up, at a mean of approximately 4.2 years, the AHI was 15.30 ± 11.00, the ODI was 14.30 ± 12.02, the T90 was 8.51 ± 16.99, and the minimum oxygen saturation was 84.66 ± 6.84. These improvements persisted over time, although there is slight worsening in some cases.</div></div><div><h3>Conclusions</h3><div>Sleep surgery is effective in reducing OSA-related parameters and improving quality of life. Long-term follow-up indicates that these benefits are largely maintained, with minor variations over time. These findings support surgery as stable treatment for OSA, highlighting the importance of individualized surgical approaches and postoperative monitoring.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512307"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christian Calvo-Henriquez , Maria Solano Marmolejo , Irene Saura Vilela , Irene Botana , Antonino Maniaci , Carlos Magan , Andrés Alvo
{"title":"Assessing the role of adenoid biofilm on children in different ENT diseases. A state-of-the-art systematic review","authors":"Christian Calvo-Henriquez , Maria Solano Marmolejo , Irene Saura Vilela , Irene Botana , Antonino Maniaci , Carlos Magan , Andrés Alvo","doi":"10.1016/j.otorri.2025.512306","DOIUrl":"10.1016/j.otorri.2025.512306","url":null,"abstract":"<div><h3>Introduction</h3><div>Adenoid hypertrophy (AH) and recurrent or persistent adenoiditis are common pediatric conditions linked to complications such as obstructive sleep apnea (OSA), otitis media (OM), and sinusitis. Adenoidectomy is a standard treatment, potentially effective through mechanical removal of biofilms, which acts as infection reservoirs. This state of the art review systematically assesses the role of adenoidal biofilms in pediatric upper airway diseases.</div></div><div><h3>Methods</h3><div>Databases searched included PubMed, Cochrane Library, EMBASE, and SciELO. Inclusion criteria encompassed studies on adenoidal biofilms in children (<18 years). Data were summarized in 8 research questions.</div></div><div><h3>Results</h3><div>Of 18 studies (706 patients, 392 controls), evidence suggests a potential role of biofilms in recurrent acute otitis media (RAOM) and chronic otitis media (COM), with some studies indicating associations with otitis media with effusion (OME) and sinusitis. No correlation was found between biofilm presence and adenoid size. Evidence on diagnostic methods (swabs) and non-surgical treatments for biofilm remains inconclusive.</div></div><div><h3>Conclusion</h3><div>Biofilms likely contribute to RAOM and COM, albeit with weak evidence due to cross-sectional study designs. Associations with OME and sinusitis are suggested but unproven, and biofilm relevance to adenoid size is unsupported. Future research should focus on biofilm-targeted diagnostics and therapies to refine clinical management.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 2","pages":"Article 512306"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147552643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
María Agustina Sevilla García , Carlos Miguel Chiesa-Estomba , Luz Barona-Lleó , Ángel Álvarez Sánchez , Carlos Martín de Argila
{"title":"Consenso multidisciplinar español para el diagnóstico y manejo del reflujo faringolaríngeo (Consenso ReFaL)","authors":"María Agustina Sevilla García , Carlos Miguel Chiesa-Estomba , Luz Barona-Lleó , Ángel Álvarez Sánchez , Carlos Martín de Argila","doi":"10.1016/j.otorri.2025.512309","DOIUrl":"10.1016/j.otorri.2025.512309","url":null,"abstract":"<div><h3>Introduction</h3><div>Laryngopharyngeal reflux (LPR) represents a diagnostic and therapeutic challenge due to the nonspecific nature of its clinical manifestations and the absence of objective biomarkers. The aim of this work is to establish a national consensus on its definition, diagnosis, and treatment through a modified Delphi methodology that integrates the perspectives of otolaryngologists (ENT) and gastroenterologists (GI).</div></div><div><h3>Materials and methods</h3><div>A scientific committee composed of three ENTs and two GIs developed 117 items distributed across seven thematic sections. The Delphi process involved 73 panellists in the first round, of whom 65 (89%) completed both rounds of voting. Participants were representative of the Spanish autonomous communities, with an average of 17<!--> <!-->years of clinical experience and a multidisciplinary profile (63.1% ENT; 36.9% GI).</div></div><div><h3>Results</h3><div>After two rounds of voting, positive consensus was reached on 67 items (64.9%), distributed as follows: 14 on definition and pathophysiology; 12 on symptoms and pharyngeal findings; 2 on associations with other ENT diseases; 10 on diagnostic methods; 3 on validated questionnaires; 15 on treatment and recommendations; and 11 on clinical follow-up.</div></div><div><h3>Conclusion</h3><div>The results of the consensus reflect the suitability and effectiveness of the Delphi methodology used to create a consensus document on the definition, presentation, diagnosis, and management of a condition that until now has been poorly defined, such as LPR. The aim is to support specialists in their daily clinical practice, and unlike previous efforts, it has succeeded in unifying within a single document the criteria of the two specialties most involved in managing these patients.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512309"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}