American Journal of Otolaryngology最新文献

{"title":"Burden of obstructive sleep apnea and CPAP use on patients with chronic rhinosinusitis","authors":"","doi":"10.1016/j.amjoto.2024.104423","DOIUrl":"10.1016/j.amjoto.2024.104423","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the impact of obstructive sleep apnea (OSA) on the quality-of-life (QoL) of patients with chronic rhinosinusitis (CRS).</p></div><div><h3>Methods</h3><p>Retrospective cohort study of all adult patients with CRS presenting to our rhinology clinic between August 2020 and February 2023 was performed. OSA was established based on positive polysomnography. Patients' characteristics, apnea-hypopnea index, comorbidities, endoscopy scores, and SNOT-22 scores were collected.</p></div><div><h3>Results</h3><p>A total of 513 patients with CRS were included, 127 patients with OSA and 386 without OSA. CRS patients with OSA were older (<em>p</em> &lt; 0.001), had higher BMI (<em>p</em> &lt; 0.001), more likely to be males (<em>p</em> = 0.07), more likely to have asthma (<em>p</em> &lt; 0.001), and more likely to have COPD (<em>p</em> = 0.001). Presence of nasal polyps did not differ between the two groups. Baseline SNOT-22 scores were worse in the OSA cohort (44.4 vs 40.5, <em>p</em> = 0.064) secondary to worse sleep (13.4 vs 11.1; <em>p</em> = 0.002) and psychological (14.2 vs 11.5; <em>p</em> = 0.002) domains. Worse SNOT scores were strongly associated with presence of OSA after adjusting for confounding variables, including age, gender, asthma, allergic rhinitis, nasal septal deviation, and smoking status.</p></div><div><h3>Conclusion</h3><p>OSA is an independent negative contributor to the disease specific QoL in patients with CRS. CPAP use does not seem to affect the QoL in CRS patients with OSA. Further research is warranted to explore the impact of OSA in the outcome of medical and surgical treatment of CRS patients.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764866","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":"Real-time surgical simulation training for recurrent laryngeal nerve and facial nerve dissection","authors":"","doi":"10.1016/j.amjoto.2024.104420","DOIUrl":"10.1016/j.amjoto.2024.104420","url":null,"abstract":"<div><h3>Background</h3><p>Head and neck surgical simulation training (SST) is an important part in otolaryngology head and neck surgical education. In this study, we provide a live porcine model for SST in recurrent laryngeal nerve (RLN) and facial nerve (FN) dissection for otolaryngology head and neck residents.</p></div><div><h3>Methods</h3><p>A lecture with surgical manual is provided to illustrate the surgical landmarks of pig, and step-by-step procedures for thyroid and parotid surgery, as well as neck dissection. We used 4-month-old pig weighting 32 kg for the SST. The mentor demonstrated result of RLN injury with continuous nerve monitoring. Participants used monopolar stimulation probe (4 pulse/s, 100 μs, 3-8 mA; Medtronic) to identify and intermittent monitor the RLN and FN during the SST. After the dissection course, we conducted a questionnaire survey to check the effectiveness of this training model.</p></div><div><h3>Results</h3><p>Total 30 participants were recruited, including 16 female and 14 male resident doctors. There were 1, 4 and 25 learners for 3rd year, 4th and 5th years residents, respectively. Before this training course, 53 % (16/30) and 63 % (19/30) had successful experience in finding the RLN and FN, respectively. After the SST, all of our participants had successful identify the RLN and FN (<em>p</em>-value &lt;0.01); all had positive response to stimulation and familiar with the procedure.</p></div><div><h3>Conclusions</h3><p>The live porcine model is effectiveness in SST for RLN and FN dissection. Live porcine model with real-time RLN and FN monitoring should be provided for otolaryngology head and neck resident training.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787018","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":"Auditory brainstem response findings in autism spectrum disorder speech delay population","authors":"","doi":"10.1016/j.amjoto.2024.104417","DOIUrl":"10.1016/j.amjoto.2024.104417","url":null,"abstract":"<div><h3>Objectives</h3><p>Evaluate pediatric auditory brainstem response (ABR) findings in children with Autism Spectrum Disorder (ASD) after the 2013 DSM-5 update.</p></div><div><h3>Study design</h3><p>This was an IRB-approved, six-year retrospective chart review evaluating ABR results from pediatric patients with speech delay. Diagnosis of ASD and other neurodevelopmental abnormalities were collected for patient stratification.</p></div><div><h3>Methods</h3><p>From 2017 to 2023, 148 pediatric patients with speech delay were identified through diagnosis of speech delay and underwent ABR testing. Patients were then separated into two groups: Neurotypical (<em>N</em> = 79) and ASD (<em>N</em> = 69). ABR results were obtained through chart review and waveform and interpeak latency (IPL) results were recorded. Differences in waveform and IPL results were determined via Pearson's chi-square test, with multivariate analysis accounting for race, sex, and age.</p></div><div><h3>Results</h3><p>28 patients with ASD (40.6 %) had at least one waveform/IPL prolongation. Analysis showed an increased incidence of waveform III (<em>p</em> = 0.028) and IPL III-V (<em>p</em> = 0.03) prolongation in the ASD group compared to their neurotypical counterparts. Waveform III prolongation was noted more in females with ASD (<em>p</em> = 0.001) than in males. No statistically significant difference when comparing race and age was found, except in the 2–3 age range (<em>p</em> = 0.003).</p></div><div><h3>Conclusions</h3><p>There were higher percentages of prolongation for all waveforms and IPLs in the ASD group versus neurotypical, though not as high as previously reported. Race and age did not appear to be factors in ABR findings though more data is needed to make clinical associations.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764825","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":"Pediatric intramuscular hemangioma in the submandibular triangle and other musculoskeletal presentations: A pediatric case series","authors":"","doi":"10.1016/j.amjoto.2024.104415","DOIUrl":"10.1016/j.amjoto.2024.104415","url":null,"abstract":"<div><h3>Background</h3><p>Intramuscular hemangiomas (IMH) account for 0.8 % or less of all benign soft tissue tumors in the general population. Due to their uncommon nature, especially in the head and neck, they are often misdiagnosed and not included in the differential diagnosis.</p></div><div><h3>Methods</h3><p>This study describes a case series of eleven pediatric patients with a diagnosis of IMH through a retrospective review of the electronic health records and archival records in the Department of Pathology at Children's Hospital of Colorado (CHCO).</p></div><div><h3>Results</h3><p>The index case had a unique presentation in the submandibular triangle, while the remaining ten cases are appendicular and thoracolumbar in nature.</p></div><div><h3>Conclusions</h3><p>This case series contributes to the sparse scientific literature available regarding IMH, particularly in its head and neck presentation as relevant to otolaryngologists.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756634","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 evaluation of temporal bone anatomical abnormalities and surgical method selection in patients with congenital aural atresia","authors":"","doi":"10.1016/j.amjoto.2024.104430","DOIUrl":"10.1016/j.amjoto.2024.104430","url":null,"abstract":"<div><h3>Objectives</h3><p>To analyze anatomic variations of the temporal bone in congenital aural atresia (CAA) and their correlation with the Jahrsdoerfer score, in order to guide clinical selection of surgical treatment methods.</p></div><div><h3>Material and methods</h3><p>We retrospectively studied 53 patients (72 ears) with unilateral or bilateral CAA, including 34 ears with normal hearing as controls. Audiological and imaging data were collected and analyzed. We evaluated the Jahrsdoerfer score and anatomical variations, including tegmen mastoideum position, anterior sigmoid sinus displacement, and elevated jugular bulb.</p></div><div><h3>Results</h3><p>The average air conduction hearing threshold (PTA4) ranged from 0.5 to 4 kHz was 65.48 ± 8.19 dBHL, with an average Jahrsdoerfer score of 4.93 ± 2.78. In CAA group, there was a higher prevalence and severity of anterior sigmoid sinus and low position of the tegmen mastoideum (<em>P</em> &lt; 0.01). However, there was no significant difference in incidence rates among groups with high jugular bulb (<em>P</em> &gt; 0.05). Anterior sigmoid sinus and high jugular bulb showed no correlation with the Jahrsdoerfer score, while the low position of the tegmen mastoideum had a weak correlation. The Jahrsdoerfer score did not adequately predict temporal bone anatomical abnormalities in CAA patients.</p></div><div><h3>Conclusion</h3><p>CAA exhibit a higher incidence and greater severity of temporal bone anatomical abnormalities compared to the control group, and the Jahrsdoerfer score inadequately assesses these abnormalities. Anomalies like low position of the tegmen mastoideum, anterior sigmoid sinus, and high jugular bulb should also be considered as independent factors influencing surgical decisions for atresiaplasty.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141764867","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":"Growth rate, impact of smoking and management of incidentally found paranasal sinus osteomas","authors":"","doi":"10.1016/j.amjoto.2024.104427","DOIUrl":"10.1016/j.amjoto.2024.104427","url":null,"abstract":"<div><h3>Objective</h3><p>To build upon existing literature regarding growth rate of asymptomatic, incidentally found paranasal sinus (PNS) osteomas, evaluate potential factors associated with growth rate and present an argument for how to follow up.</p></div><div><h3>Methods</h3><p>At our institution, EPIC SlicerDicer was used to screen imaging studies using keyword ‘osteoma’ and included patients with at least 2 imaging studies 6 months apart that both demonstrated a PNS osteoma(s). Imaging studies with the largest time interval were selected. Non-PNS osteomas were excluded.</p></div><div><h3>Results</h3><p>47 patients that fit this criterion with a median duration of interval imaging of 35.9 months. Growth rate was measured to be 0.39 mm/year in the cephalocaudal direction and 0.45 mm/year in the mediolateral direction, together averaging 0.42 mm/year. Increases in growth rate additionally did not appear to impact the likelihood of developing conditions including nasal polyposis or chronic sinusitis and symptoms such as sinus pressure, headache, postnasal drip, or congestion. Those with interval scans &gt;36 months were found to have a slower growth rate than those with closer interval scans. Furthermore, former smokers and current smokers had significantly greater growth rates than nonsmokers.</p></div><div><h3>Conclusion</h3><p>Given their slow growth rate, we conclude that select lesions likely do not require follow-up. If there is concern that growth could cause an obstructive complication, such as blocking the frontal outflow tract, we argue a single scan at one year is appropriate. If there is additional growth on this scan, surveillance scans up to 3 years could be performed to assess stability. Lastly, while there was a significant growth rate for smokers compared to non-smokers, the slow growth rate is unlikely to influence management.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849864","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":"Efficacy of cochlear implantation in cochlear nerve deficiency children – A single center study","authors":"","doi":"10.1016/j.amjoto.2024.104428","DOIUrl":"10.1016/j.amjoto.2024.104428","url":null,"abstract":"<div><h3>Purposes</h3><p>The objective of this research was to interpret and analyze the imaging, audiological features and cochlear implantation outcomes in cochlear nerve deficiency children.</p></div><div><h3>Material and methods</h3><p>Retrospective analysis.</p></div><div><h3>Results</h3><p>25 prelingual hearing loss children diagnosed cochlear nerve deficiency (CND), the age range from 1 to 15 (mean age, 5.04), underwent cochlear implantation at Ear Nose and Throat Hospital - Ho Chi Minh City (ENT hospital – HCMC) from 2016 to 2023. All children had sensorineural hearing loss (SNHL) from severe to profound degree. Magnetic resonance imaging (MRI) showed cochlear nerve hypoplasia in 76 % and cochlear nerve aplasia in 24 % of cases. Inner ear malformations were found in 52 % of cases. The mean Categories of Auditory Performance (CAP) score at 1 year after surgery was 4.8. At 6 months and 1 year after surgery, the mean CAP score of the aplasia group was significantly lower than that of the hypoplasia group (<em>p</em> &lt; 0.05).</p></div><div><h3>Conclusions</h3><p>In cochlear nerve deficiency children, auditory perception and speech performance still improved after cochlear implantation. However, this progress was significantly limited in cochlear nerve aplasia group.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141847808","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":"Age-based disparities in hearing loss diagnosis and treatment in the United States population","authors":"","doi":"10.1016/j.amjoto.2024.104403","DOIUrl":"10.1016/j.amjoto.2024.104403","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate age-related disparities in the diagnosis and treatment of borderline/mild hearing loss (HL) in the United States.</p></div><div><h3>Study design</h3><p>A cross-sectional epidemiologic study.</p></div><div><h3>Setting</h3><p>The National Health and Nutrition Examination Survey (NHANES).</p></div><div><h3>Methods</h3><p>Multivariable logistic regressions controlling for hearing level were performed to investigate the association between: (1) age and recent hearing test; (2) age and hearing aid use. Age was grouped into quartiles (&lt;25, 25–49, 50–74, ≥75 years). The first quartile of life was used as a reference group in all odds ratios, controlling for hearing level.</p></div><div><h3>Results</h3><p>Of 2115 participants with borderline/mild HL, 3 % (n = 53) were in age quartile Q1; 7 % (n = 147) were in Q2, 56 % (n = 1190) were in Q3, and 34 % (n = 725) were in Q4. Compared to Q1, those in Q2, Q3, and Q4 had 4.06 times (95 % CI = 2.11–8.02, p &lt; 0.001), 4.51 times (2.56–8.19, p &lt; 0.001), and 4.56 times (2.55–8.39, p &lt; 0.001) lower odds of a hearing test within the past 4 years. Similar, although slightly larger, odds ratios were obtained when the outcome was hearing test within 1 year. Compared to Q1, those in Q2, Q3, and Q4 respectively had 4.38 times (1.47–13.5, p &lt; 0.05), 5.41 times (2.27–11.8, p &lt; 0.001), and 3.95 times (1.65–8.72, p &lt; 0.05) lower odds of using a hearing aid.</p></div><div><h3>Conclusion</h3><p>We have characterized a large, unaddressed, and modifiable disparity in the treatment of borderline/mild HL as individuals age out of the first quartile of life. Future studies are needed to explore factors, such as ageism, that may underlie these findings.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756591","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":"Outcomes of a step-up approach to the treatment of neurogenic cough","authors":"","doi":"10.1016/j.amjoto.2024.104412","DOIUrl":"10.1016/j.amjoto.2024.104412","url":null,"abstract":"<div><h3>Introduction</h3><p>Neurogenic cough (NC) is thought to be related to sensory neuropathy in the hypopharynx and larynx. Defined as a cough persisting longer than 8 weeks refractory to standard therapy, it is a diagnosis of exclusion when other common etiologies (asthma, gastroesophageal reflux disease (GERD), medication side effects) are ruled out. It affects roughly 11 % of Americans and can negatively impact quality of life.</p></div><div><h3>Methods</h3><p>Following institutional review board approval, we evaluated the medical records of adult patients seen at the University of Arizona's tertiary laryngology center from 2018 to 2023. Patients were included if their cough persisted for &gt;8 weeks, and they either did not respond to prior proton pump inhibitor and asthma therapy or had GERD and asthma ruled out. These patients underwent a progressive escalation of therapy, which included neuromodulators with or without cough suppression therapy, superior laryngeal nerve (SLN) block, and laryngeal botulinum toxin injections. The primary outcome was patient-reported improvement in cough symptoms rated on a 1–5 scale: 1 = no response, 2 = mild improvement, 3 = moderate improvement, 4 = significant improvement, 5 = complete resolution.</p></div><div><h3>Results</h3><p>A total of 56 patients were included. Mean (SD) age was 64.6 (14.8) years, and 66 % were female. Overall, 42 patients (75.0 %) responded to treatment. Among responders, 7 (16.7 %) experienced mild improvement, 14 (33.3 %) experienced moderate improvement, 17 (40.5 %) experienced significant improvement, and 4 (9.5 %) experienced complete resolution of their cough.</p><p>33 patients (58.9 %) were managed exclusively with neuromodulators ± cough suppression therapy; 27 responded, with an average response rating of 3.0 (SD = 1.2). 11 patients (19.6 %) failed medical therapy and underwent SLN block without subsequent botox treatment; 7 responded, with an average response rating of 2.5 (SD = 1.4). 9 patients (16.1 %) failed all previous therapies and underwent laryngeal botulinum toxin injections; 6 responded with an average response rating of 2.4 (SD = 1.3). The remaining 3 patients underwent cough suppression therapy alone, with 2 responding and an average response rating of 3.3 (SD = 1.7).</p></div><div><h3>Conclusions</h3><p>Neurogenic cough can be effectively treated with a stepwise multimodal approach, including neuromodulators, cough suppression therapy, SLN block, and laryngeal botulinum toxin injections.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756595","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":"Facial nerve palsy after ethylene vinyl alcohol arterial embolization of glomus tympanicum","authors":"","doi":"10.1016/j.amjoto.2024.104401","DOIUrl":"10.1016/j.amjoto.2024.104401","url":null,"abstract":"<div><h3>Background &amp; objective</h3><p>Glomus tympanicum and jugulare tumors are highly vascular and are therefore commonly embolized before surgical resection to prevent intra-operative bleeding. We report a case of facial nerve paralysis after pre-operative embolization for a glomus tympanicum tumor with ethylene vinyl alcohol (EVOH also known as Onyx) embolic agent. We discuss the choice of embolic agent in relation to the risk of this complication and potential management strategies.</p></div><div><h3>Methods</h3><p>A 57F with right glomus tympanicum developed right facial nerve palsy immediately after embolization. She received 24 mg of dexamethasone over the course of 24 h immediately following her embolization, surgical facial nerve decompression concurrent with tumor resection, and a 10-day prednisone taper. Our main outcome measure was facial nerve function on follow-up physical examinations.</p></div><div><h3>Results</h3><p>The patient developed right facial paralysis (HB 6/6) after Onyx embolization of branches of the external carotid artery system, likely due to translocation of embolic agent into facial nerve vasa nervosa as seen on post-embolization CT. No immediate improvement was observed with high dose steroids and decompression, however over the next 6 months her facial nerve function began to improve (HB 3/6).</p></div><div><h3>Conclusions</h3><p>Surgical excision is the standard of care for glomus jugulare and glomus tympanicum tumors. Due to their propensity to bleed, their arterial feeders (branches of the external carotid) are often embolized prior to surgery, however, facial nerve paralysis is a rare but serious complication. There is a possible relationship between the choice of embolic agent and this complication. Though facial palsy is of sufficient rarity that no standard treatment pathway exists, due to the impact on a patient's quality of life, we recommend aggressive therapy to salvage nerve function.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141756593","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}