Acta otorrinolaringologica espanola最新文献

{"title":"Transoral CO2 laser microsurgery for early hypopharyngeal cancer: Still a viable option?","authors":"Carlos M. Chiesa-Estomba,&nbsp;Alfonso Rodriguez-Urzay,&nbsp;Maria Landa-Garmendia,&nbsp;Aitor Vargas-Alvarez,&nbsp;Ehkiñe Larruscain-Sarasola,&nbsp;Jose A. González-García,&nbsp;Maider Andueza-Guembe,&nbsp;Jon A. Sistaga-Suarez","doi":"10.1016/j.otorri.2025.512278","DOIUrl":"10.1016/j.otorri.2025.512278","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypopharyngeal squamous cell carcinoma (HPSCC) is a highly aggressive malignancy with poor prognosis due to late-stage diagnosis and complex anatomical challenges. Advances in minimally invasive techniques, particularly transoral laser microsurgery (CO₂TOLMS), have demonstrated promise in improving oncologic and functional outcomes while preserving organ function.</div></div><div><h3>Materials and methods</h3><div>A retrospective study analyzed 25 patients with histologically confirmed HPSCC treated with CO₂TOLMS at a tertiary academic hospital (2016–2021). Patients underwent curative-intent CO₂TOLMS, with outcomes assessed for survival, recurrence, and functional recovery.</div></div><div><h3>Results</h3><div>The 3-year overall survival and disease-specific survival rates were 72% and 84%, respectively. Surgical margins were disease-free in 76% of patients, while postoperative complications were minimal (persistent tracheostomy in 4%, long-term nasogastric feeding tube dependency in 4%). Local and regional recurrence rates were each 8%. Laryngeal preservation was achieved in 95% of cases, significantly enhancing quality of life. Histologic grade correlated with recurrence risk, though survival outcomes were consistent across tumor stages and surgical margin status.</div></div><div><h3>Conclusions</h3><div>CO₂TOLMS offers an effective and minimally invasive treatment for early-stage HPSCC, achieving good oncological and functional outcomes. While it provides low morbidity and high organ preservation rates, further research is needed to refine multimodal treatment strategies for advanced-stage disease.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512278"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486447","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":"Eficacia y seguridad de la combinación cinarizina/dimenhidrinato frente a betahistina en el tratamiento del vértigo: revisión sistemática de la literatura","authors":"David Martín-Enguix ,&nbsp;Niceto Gómez Gabaldón ,&nbsp;Francisco J. Amaro-Gahete","doi":"10.1016/j.otorri.2025.512274","DOIUrl":"10.1016/j.otorri.2025.512274","url":null,"abstract":"<div><div>Vertigo is a frequent reason for medical consultation and may result from a wide range of etiologies. Betahistine and the fixed low-dose combination of cinnarizine 20<!--> <!-->mg and dimenhydrinate 40<!--> <!-->mg are commonly used therapeutic options, each with distinct antivertigo profiles. This systematic review, conducted in accordance with the PRISMA guidelines, aims to compare the efficacy and safety of these two treatments in patients with vertigo of various origins. A comprehensive search was conducted in PubMed, Cochrane Library, Google Scholar, and ClinicalTrials.gov, with no restrictions on language or publication date. Eligible studies included clinical trials and meta-analyses comparing the fixed low-dose combination (20<!--> <!-->mg/40<!--> <!-->mg) versus betahistine (12 or 16<!--> <!-->mg), assessing efficacy through the Mean Vertigo Score (MVS) and safety based on the incidence of adverse events (AEs). The RoB 2 and ROBIS tools were used to evaluate the risk of bias. A total of nine studies were identified (six clinical trials and three meta-analyses). In five of the six clinical trials, the fixed low-dose combination significantly reduced MVS compared with betahistine at weeks 1 and/or 4 (p<!--> <!-->&lt;<!--> <!-->0.05); these findings were corroborated by the three meta-analyses. Regarding safety, both treatments were well tolerated, with no serious AEs reported and a generally lower incidence observed in the fixed low-dose combination group. Overall, the fixed low-dose combination demonstrated superior clinical efficacy from the first week of treatment, along with a more favorable tolerability and safety profile. These results support its preferential use in the management of acute vestibular syndrome.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512274"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486395","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":"Newborn nasal obstruction: Rare anatomical causes to consider","authors":"Montserrat Asensi-Diaz ,&nbsp;Alejandro Lowy Benoliel ,&nbsp;Juan Antonio Pasamontes Pingarron ,&nbsp;Ismael Nieva Pascual ,&nbsp;Pilar Cifuentes Canorea ,&nbsp;Monica Hernando Cuñado","doi":"10.1016/j.otorri.2025.512279","DOIUrl":"10.1016/j.otorri.2025.512279","url":null,"abstract":"<div><div>Neonatal nasal obstruction, though rare, can be life-threatening due to the obligate nasal breathing pattern in newborns. Even partial obstruction may compromise ventilation and feeding.</div><div>This study aims to describe rare anatomical causes of neonatal nasal obstruction, highlighting their clinical presentation, diagnostic evaluation, and management.</div><div>A retrospective review was conducted of four neonates with respiratory distress who were diagnosed with congenital nasal malformations through endoscopic examination and craniofacial imaging. The identified cases included bilateral choanal atresia in a patient with CHARGE syndrome, congenital nasal pyriform aperture stenosis (CNPAS) with a solitary median mega-incisor, isolated CNPAS with midnasal hypoplasia, and bilateral congenital dacryocystoceles. Symptoms ranged from noisy breathing to feeding intolerance. Management included both medical and surgical interventions depending on the severity of the obstruction.</div><div>Although infrequent, anatomical nasal anomalies should be promptly considered in neonates presenting with respiratory distress, as early diagnosis and appropriate treatment are essential to avoid complications and ensure favourable outcomes.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512279"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486396","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":"Validación del cuestionario de autoevaluación para pacientes con parálisis vocal unilateral (PVU-HI-10) en castellano","authors":"Rosa Hernández-Sandemetrio ,&nbsp;Natsuki Oishi ,&nbsp;Isabel López ,&nbsp;Cristina Rodríguez-Prado ,&nbsp;Isabel García-Lopez ,&nbsp;Enrique Zapater","doi":"10.1016/j.otorri.2025.512271","DOIUrl":"10.1016/j.otorri.2025.512271","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Unilateral vocal cord paralysis (UVCP) is a condition that directly affects laryngeal functions. While most cases have an organic cause, idiopathic cases have also been described. Patients with UVCP often experience symptoms that impact not only their vocal abilities but also their nutritional and social well-being. Our primary objective is to validate a self-assessment questionnaire for patients with UVCP and unilateral vocal immobility, incorporating questions that cover all possible symptoms of this condition, adapted to the Spanish spoken in Spain.</div></div><div><h3>Methodology</h3><div>This is a prospective observational study using the PVU-HI-10 questionnaire, which assesses the functional, physical, and emotional impact of UVCP-related symptoms. For validation, we statistically evaluated test-retest reliability, item-total correlation, internal consistency, concurrent validity, and discriminative validity, with sensitivity and specificity analysis. A total of 62 subjects participated: 33 patients (case group) and 29 healthy individuals (control group). All participants completed the PVU-HI-10 questionnaire twice, with a three-week interval between assessments and no treatment administered between them. The maximum phonation time (MPT) was used as the objective reference measure.</div></div><div><h3>Results</h3><div>The test-retest reliability was high, with an intraclass correlation coefficient (ICC) of 0.95. Internal consistency, measured using McDonald's omega coefficient, was 0.91 for the case group and 0.94 for the control group. The correlation between MPT and questionnaire scores was strong and inversely related (-0.61 and -0.67, respectively). Discriminative validity was demonstrated using the ROC curve, with a cutoff point of 12.1, yielding a sensitivity of 82% and a specificity of 93.1%.</div></div><div><h3>Conclusions</h3><div>In the management of unilateral vocal immobility, it is essential to consider the degree of disability caused by the symptoms. The PVU-HI-10 is a condition-specific questionnaire that has shown high reliability and validity. It is a brief, simple test that provides a numerical result, allowing for the quantification and comparison of treatment outcomes. This makes it a useful tool in the evaluation protocol for patients with unilateral vocal paralysis in Spanish-speaking populations.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512271"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486393","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":"Resultados de las versiones españolas del Cuestionario de otitis media crónica-12 (COMQ-12) y del Inventario de beneficios de otitis media crónica (COMBI) en pacientes y controles en nuestro medio","authors":"Alberto Codina ,&nbsp;Berta Alegre ,&nbsp;Elena Hernández-Montero ,&nbsp;Jorge Vega ,&nbsp;Miguel Caballero-Borrego ,&nbsp;Francisco Larrosa","doi":"10.1016/j.otorri.2025.512273","DOIUrl":"10.1016/j.otorri.2025.512273","url":null,"abstract":"<div><h3>Background and objective</h3><div>The Chronic Otitis Media Questionnaire-12 (COMQ-12) and the Chronic Otitis Media Benefits Inventory (COMBI) seek to assess the quality of life related to chronic otitis media or its surgical treatment. The objective of this study was to determine and evaluate the scores of the Spanish versions of the COMQ-12 and the COMBI.</div></div><div><h3>Materials and methods</h3><div>Multicenter retrospective study. Mean scores of the Spanish versions (COMQ-12-Spa and COMBI-Spa) were compared in consecutive adult patients diagnosed with chronic otitis media (COM), with or without cholesteatoma, undergoing tympanoplasty with and/or mastoidectomy and in a separate cohort of unaffected adults.</div></div><div><h3>Results</h3><div>120 patients and 60 unnaffected adults completed the study. The mean score of the COMQ-12-Spa in patients with COM and in healthy adults was 22.95<!--> <!-->±<!--> <!-->11.72 and 0.8<!--> <!-->±<!--> <!-->1.3 respectively (p &lt;<!--> <!-->0.0001). COMQ-12-Spa did not discriminate between COM without (21.9<!--> <!-->±<!--> <!-->10.45) and with cholesteatoma (23.82<!--> <!-->±<!--> <!-->9.53) (<em>P</em> <!-->&gt; 0.05). COMBI-Spa showed a mean postoperative score of 46.02<!--> <!-->±<!--> <!-->9.08 and was not able to discriminate between tympanoplasty without mastoidectomy (48.01<!--> <!-->±<!--> <!-->8.09) and mastoidectomy (45.32<!--> <!-->±<!--> <!-->10.03) (<em>P</em> <!-->&gt; 0.05).</div></div><div><h3>Conclusions</h3><div>The COMQ-12-Spa and the COMBI-Spa allow the pre- and post-intervention evaluation of the subjective severity of COM in adult patients in our setting, so their use is recommended.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512273"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486434","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":"Speech discrimination and binaural processing in bilateral symmetric vs. asymmetric sensorineural hearing loss","authors":"Mai El Ghazaly,&nbsp;Esraa Meckawy,&nbsp;Hesham Kozou,&nbsp;Doaa Elmoazen","doi":"10.1016/j.otorri.2025.512265","DOIUrl":"10.1016/j.otorri.2025.512265","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the effects of symmetric and asymmetric sensorineural hearing loss (SSNHL and ASNHL) on speech discrimination abilities and binaural processing, including integration and interaction.</div></div><div><h3>Materials and methods</h3><div>This cross-sectional study included 36 adult patients with bilateral sensorineural hearing loss, divided into two groups based on the symmetry of their hearing loss: ASNHL and SSNHL. Speech discrimination abilities were evaluated using the maximum speech discrimination score (SDSmax) with Arabic monosyllabic words. Binaural integration was assessed using the free-recall double dichotic digit test (DDT), while binaural interaction was evaluated through the binaural fusion test (BFT).</div></div><div><h3>Results</h3><div>The SDSmax of the worse-hearing ear in ASNHL patients (48.89 ± 10.13%) was significantly lower than in SSNHL patients (69.33 ± 7.97%) with comparable degrees of hearing loss. ASNHL patients exhibited a greater disparity between the better and worse-hearing ears in DDT scores (53.15 ± 13.98%) compared to SSNHL patients (22.96 ± 5.93%). Additionally, the BFT scores in ASNHL patients (55.14 ± 13.30%) were significantly lower than in SSNHL patients (72.92 ± 12.55%).</div></div><div><h3>Conclusions</h3><div>ASNHL patients experience greater impairments in speech discrimination, binaural integration, and interaction compared to SSNHL patients. These differences likely stem from auditory deprivation and asymmetry-induced deficits. Developing tailored hearing rehabilitation strategies is critical to addressing the unique challenges posed by asymmetric hearing loss.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512265"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108262","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":"Aberrant intratympanic internal carotid artery","authors":"Saúl Astray-Gómez ,&nbsp;Celia Montón-Gómez ,&nbsp;Carlos de Paula-Vernetta","doi":"10.1016/j.otorri.2025.512268","DOIUrl":"10.1016/j.otorri.2025.512268","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512268"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108270","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":"Skull base surgery via extended endoscopic endonasal approach: Predictors of ear-nose-throat complications","authors":"Anna Penella ,&nbsp;Alejandro Portillo ,&nbsp;Ricardo Bartel ,&nbsp;Jose María Caballero ,&nbsp;Enric Cisa ,&nbsp;Francesc Cruellas ,&nbsp;Mireia Golet ,&nbsp;Jose L Sanmillan ,&nbsp;Alberto Torres ,&nbsp;Xavier González-Compta","doi":"10.1016/j.otorri.2025.512264","DOIUrl":"10.1016/j.otorri.2025.512264","url":null,"abstract":"<div><h3>Objective</h3><div>To identify predictive factors for ear-nose-throat (ENT) complications in patients undergoing skull base surgery via extended endoscopic endonasal approaches (EEEA).</div></div><div><h3>Methods</h3><div>Single-center retrospective observational study of a cohort of patients who underwent EEEA for skull base surgery between January 2015 and December 2021. Patients were stratified according to ENT complications.</div></div><div><h3>Results</h3><div>Sixty-one patients were included in the study: 37 women (60.66%) and 24 men (39.34%). Craniopharyngioma was the most frequently observed pathology (36%). 40 patients (65,57%) presented with ENT complications, being olfactory disturbance the most common complication (40,98%), followed by nasal obstruction (24,59%) and synechiae formation (18,03%). Logistic regression analysis revealed that younger age (<em>P</em> = .026) and excision of middle turbinates during EEEA surgery (<em>P</em> = .034) were independent factors with a significant association with ENT complications. Anterior septal deviation was an independent factor significantly associated with synechiae formation (<em>P</em> = .023).</div></div><div><h3>Conclusion</h3><div>Surgeons performing skull base surgery using EEEA should be aware that excision of middle turbinate, younger age and anterior septal deviation may be risk factors for ENT postoperative complications.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512264"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108268","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":"Patient reported voice outcomes following multi-disciplinary approach to botulism toxin for spasmodic dysphonia","authors":"Sahil Kakar ,&nbsp;Keshav Kumar Gupta ,&nbsp;Emma Richards ,&nbsp;Colin Shirley ,&nbsp;Paige Bradley ,&nbsp;Anita Sonsale","doi":"10.1016/j.otorri.2025.512261","DOIUrl":"10.1016/j.otorri.2025.512261","url":null,"abstract":"<div><h3>Purpose</h3><div>Spasmodic dysphonia (SD) is a debilitating disorder primarily affecting voice production. Current treatment includes repeat botulinum toxin (botox) injections for symptomatic management. The aim of this study is to review the impact of botox injections on patient reported outcome measures (PROM), using a novel and unique quality of life, proforma, and side effects in patients treated at our centre.</div></div><div><h3>Methods</h3><div>This retrospective case series evaluated all patients who were treated in our specialised voice clinic, at a single tertiary referral centre between May 2019 and April 2024 with botox for SD. The primary outcome measure was PROM of voice quality weekly post-injection as per a unique proforma. Variables extracted included patient demographics, treatment specifics and complications.</div></div><div><h3>Results</h3><div>Fifty-two patients were included representing 21 (40.4%) males. Forty-two (80.8%) suffered from adductor spasmodic dysphonia with 8 (15.4%) having abductor dysphonia and 1 (1.92%) with mixed dysphonia. Patients with abductor dysphonia had a statistical improvement in voice following dose 2, (1.8–3.0, <em>p</em> <!-->=<!--> <!-->0.03) and dose 3 (1.4–3.2, <em>p</em> = &lt;0.001). Patients with adductor dysphonia had significant improvements in voice following all doses (2.1–2.9, <em>p</em> <!-->=<!--> <!-->0.01), (1.9–3.0, <em>p</em> = &lt;0.01) and (2.1–3.0, <em>p</em> = &lt;0.01). The most common complication was a ‘breathy voice’, ranging from 31.4% to 51.0% but all patients reported this as transient.</div></div><div><h3>Conclusion</h3><div>Patient reported quality of voice is improved following botox injections for spasmodic dysphonia, and most patients do not suffer from long-term complications.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512261"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108263","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":"Disease control in unresectable laryngeal carcinoma cuniculatum using pembrolizumab and chemotherapy: A case report","authors":"Natalia Arango Cabezas ,&nbsp;Rosa Delia Ramirez-Ruiz ,&nbsp;Nuria Cuesta ,&nbsp;Isabel Vilaseca","doi":"10.1016/j.otorri.2025.512270","DOIUrl":"10.1016/j.otorri.2025.512270","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 5","pages":"Article 512270"},"PeriodicalIF":1.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145108265","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}