American Journal of Otolaryngology最新文献

{"title":"Early patient-reported psychological and quality-of-life outcomes following endoscopic and microscopic tympanoplasty: A prospective comparative cohort study","authors":"Dheeraj Korambeth, Deviprasad Dosemane, Suraj Pai, Meera Niranjan Khadilkar, Kiran Hegde","doi":"10.1016/j.amjoto.2026.104911","DOIUrl":"10.1016/j.amjoto.2026.104911","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate early postoperative patient-reported psychological and quality-of-life outcomes in patients undergoing endoscopic and microscopic tympanoplasty within a prospective non-randomized comparative cohort.</div></div><div><h3>Methods</h3><div>A prospective comparative study was conducted in 50 adults with mucosal-type chronic otitis media undergoing type I tympanoplasty at two tertiary referral centres (endoscopic, <em>n</em> = 25; microscopic, <em>n</em> = 25). Allocation to surgical approach was determined by institutional operating practice and surgeon assignment rather than randomization. Psychological status and disease-specific quality of life were assessed preoperatively and at outpatient follow-up 2 months postoperatively (±2 weeks) using validated versions of the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Chronic Otitis Media Questionnaire-12 (COMQ-12). Audiological outcomes were evaluated based on air-bone gap (ABG). Postoperative recovery parameters, including duration of hospitalization, return to work, cosmetic satisfaction, and subjective hearing perception, were additionally recorded. Analyses were exploratory and unadjusted.</div></div><div><h3>Results</h3><div>Fifty participants were included. No statistically significant differences were observed between groups in baseline demographic characteristics, preoperative audiological findings, or baseline patient-reported outcome measures. At 2 months, the endoscopic cohort demonstrated lower mean anxiety scores (5.4 ± 1.9 vs 8.6 ± 2.1; <em>p</em> < 0.001), lower depression scores (5.1 ± 1.8 vs 7.9 ± 2.2; <em>p</em> < 0.001), and lower COMQ-12 scores (17.2 ± 4.0 vs 24.6 ± 4.7; <em>p</em> < 0.001) compared with the microscopic cohort. Greater reductions were observed in GAD-7 scores (−9.8 ± 2.3 vs −7.9 ± 2.2; <em>p</em> = 0.005) and COMQ-12 scores (−21.7 ± 4.4 vs −18.6 ± 4.5; <em>p</em> = 0.018), whereas the reduction in PHQ-9 scores did not differ significantly between groups (−11.0 ± 2.3 vs −9.7 ± 2.4; <em>p</em> = 0.06). Audiological improvement as per ABG was comparable between groups (7.8 ± 1.0 vs 7.3 ± 0.9 dB; <em>p</em> = 0.07). Patients managed within the endoscopic group also had shorter hospitalization and higher cosmetic satisfaction scores (both <em>p</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>Patients in the endoscopic cohort reported more favorable early psychological and disease-specific quality-of-life outcomes, while short-term audiological improvement, as assessed by air–bone gap closure, was similar between cohorts. Given the non-randomized design, institution-level confounding, absence of detailed disease-specific baseline variables, and short follow-up duration, these findings should be interpreted as associative and exploratory rather than evidence of technique-specific superiority. The study highlights the value of incorporating patient-reported outcome measures alon","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104911"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between bone mineral density and presumed nasolacrimal duct obstruction in adults: A cross-sectional analysis of NHANES data","authors":"Hua Sun,&nbsp;Xin Shen,&nbsp;Kegao Liu","doi":"10.1016/j.amjoto.2026.104922","DOIUrl":"10.1016/j.amjoto.2026.104922","url":null,"abstract":"<div><h3>Background</h3><div>It is well-documented that primary acquired nasolacrimal duct obstruction (PANDO) is a prevalent cause of epiphora in the elderly population. While local inflammation and hormonal factors have been implicated, the potential influence of systemic skeletal health, in particular osteoporosis to the bony nasolacrimal canal remains poorly understood. Therefore, this study aimed to explore the association between systemic Bone Mineral Density (BMD) and presumed Nasolacrimal Duct Obstruction (NLDO) in a representative sample of US adults.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2005–2008 cycles. Participants aged 40 years and older with valid dual-energy X-ray absorptiometry (DXA) measurements and complete ocular symptom questionnaires were included. Presumed NLDO was defined as self-reported frequent tearing in the absence of dry eye symptoms or ocular allergies. Survey-weighted logistic regression models were utilized and adjusted for sociodemographic and comorbidity covariates. Restricted cubic spline (RCS) analysis and subgroup interaction tests were conducted to explore non-linear relationships and effect modification.</div></div><div><h3>Results</h3><div>A total of 5423 participants were included in the final analysis, representing a weighted population of approximately 64 million US adults. The weighted prevalence of presumed NLDO was 8.4%. Participants with presumed NLDO had significantly lower lumbar spine BMD compared to controls (0.94 vs. 1.02 g/cm², P &lt; 0.001). In the fully adjusted multivariable model, every 1-standard deviation (SD) decrease in lumbar spine BMD was associated with a 32% increase in the odds of presumed NLDO (OR = 1.32, 95% CI: 1.15–1.52). Meanwhile, individuals with osteoporosis had an 86% higher odds of presumed NLDO compared to those with normal BMD (OR = 1.86, 95% CI: 1.34–2.58). Interaction analyses revealed that the association was significantly stronger in females (P for interaction = 0.038) and older adults aged &gt;60 years (P for interaction = 0.042).</div></div><div><h3>Conclusion</h3><div>Based on this study involving US adults as a research sample, low systemic bone mineral density is independently associated with increased odds of presumed nasolacrimal duct obstruction. These findings support the hypothesis that osteoporotic changes in the bony nasolacrimal canal may contribute to the etiology of this condition, particularly in postmenopausal women. Further longitudinal studies are warranted to confirm causality.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104922"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory evaluation of preoperative apparent diffusion coefficient as a candidate prognostic imaging marker in salivary gland carcinoma","authors":"Tomo Arai,&nbsp;Noriyuki Okonogi,&nbsp;Yasuo Kosugi,&nbsp;Jun Takatsu,&nbsp;Yoshifumi Matsumoto,&nbsp;Shinichi Ohba,&nbsp;Naoya Murakami,&nbsp;Naoto Shikama,&nbsp;Fumihiko Matsumoto","doi":"10.1016/j.amjoto.2026.104910","DOIUrl":"10.1016/j.amjoto.2026.104910","url":null,"abstract":"<div><h3>Background</h3><div>Salivary gland carcinoma (SGC) lacks reliable preoperative prognostic markers. This exploratory study evaluated whether volume-based apparent diffusion coefficient (ADC) parameters derived from preoperative diffusion-weighted magnetic resonance imaging (MRI) were associated with clinical outcomes in patients with SGC.</div></div><div><h3>Methods</h3><div>Sixty-five patients who underwent radical surgery for SGC between 2014 and 2024 were retrospectively reviewed; 55 had evaluable preoperative diffusion-weighted imaging (DWI) data for ADC analysis. Whole-tumor ADC values were derived using dedicated software with a threshold-based semi-automated workflow, and the median ADC and entropy were extracted. Disease-free survival (DFS), local control, and overall survival were analyzed using the Kaplan–Meier method. Associations between clinicopathological or imaging variables and outcomes were assessed using log-rank tests, Cox proportional hazards regression, and Spearman's correlation analysis.</div></div><div><h3>Results</h3><div>Advanced pathological stage, high-grade histology, preoperative facial nerve palsy, and low median ADC were associated with worse DFS in univariate analyses. The median ADC was negatively correlated with pathological grade. In the multivariable Cox proportional hazards model, median ADC remained associated with DFS; however, this finding should be interpreted cautiously because of the limited number of events and the wide confidence interval. Entropy showed no significant association with clinical outcomes.</div></div><div><h3>Conclusions</h3><div>Preoperative volume-based median ADC was associated with DFS in this exploratory cohort of patients with SGC. The median ADC may represent a candidate prognostic imaging marker for preoperative risk assessment. Further validation in larger cohorts with standardized MRI protocols is required before clinical application.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104910"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chemoradiotherapy versus transoral laser microsurgery for early T-stage (cT1–T2) hypopharyngeal cancer: A prospective randomized pilot study","authors":"Ciou Nan Ye,&nbsp;Chuan Hung Sun,&nbsp;Yuan Jhen Hsu,&nbsp;Yi Fan Chou","doi":"10.1016/j.amjoto.2026.104926","DOIUrl":"10.1016/j.amjoto.2026.104926","url":null,"abstract":"<div><h3>Background</h3><div>Early T-stage (cT1–T2) hypopharyngeal squamous cell carcinoma (HSCC) presents a therapeutic challenge in balancing oncological control with functional preservation.</div></div><div><h3>Objectives</h3><div>To compare the oncological and functional outcomes between transoral laser microsurgery (TLM)–based treatment pathway and definitive radiation-based (radiotherapy with or without concurrent chemotherapy, RT/CCRT) treatment pathway for early T-stage HSCC.</div></div><div><h3>Design, setting, and participants</h3><div>This prospective randomized pilot study was conducted at a tertiary care hospital from 2016 to 2021. Seventeen treatment-naïve patients with cT1–T2 HSCC were included.</div></div><div><h3>Interventions</h3><div>Participants were randomized to undergo either TLM-based pathway (<em>n</em> = 9) or definitive RT/CCRT (<em>n</em> = 8).</div></div><div><h3>Primary outcomes</h3><div>The primary endpoint was the functional laryngeal preservation rate at last follow-up (minimum follow-up: 1 year).</div></div><div><h3>Key results</h3><div>In the TLM group, 55.6% (5/9) of patients required adjuvant CCRT due to adverse pathological features. The 1-year functional laryngeal preservation rate was significantly higher in the RT/CCRT group than in the TLM group (100% vs. 44.4%; Cramer's V = 0.61; 95% CI, 0.39–0.88; <em>P</em> = 0.029). Regarding voice quality, RT/CCRT demonstrated favorable outcomes with lower jitter (0.76% vs. 1.68%; effect size, 0.49; 95% CI, −0.02 to 0.76; <em>P</em> = 0.046). A potential trend favoring the RT/CCRT group was observed for disease-free survival (Hazard Ratio, 0.26; 95% CI, 0.03–2.30; <em>P</em> = 0.189).</div></div><div><h3>Harms</h3><div>No grade 4 or higher treatment-related adverse events (CTCAE v5.0) were reported in either arm. However, a potential trend toward a higher incidence of hypopharyngeal fibrosis with narrowing was observed in the TLM group (Cramer's V = 0.52; <em>P</em> = 0.082).</div></div><div><h3>Conclusion</h3><div>For early T-stage (cT1–T2) HSCC, definitive RT/CCRT suggested potential functional advantages in laryngeal preservation and acoustic quality over a TLM-based pathway, likely by avoiding the cumulative morbidity of trimodality therapy in pathologically node-positive or high-risk disease. While oncological control appeared comparable, these findings remain hypothesis-generating given the limited pilot cohort, warranting validation in larger multicenter trials.</div></div><div><h3>Trial registration</h3><div>Not prospectively registered (Pilot trial approved by IRB of Taichung Tzu Chi Hospital, REC105–07).</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104926"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148910547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors of hearing disorders among working populations – A systematic review","authors":"Mohd Firdaus Ismail,&nbsp;Sheng Qian Yew,&nbsp;Zhi Qin Ooi,&nbsp;Hanizah Mohd Yusoff","doi":"10.1016/j.amjoto.2026.104927","DOIUrl":"10.1016/j.amjoto.2026.104927","url":null,"abstract":"<div><h3>Introduction</h3><div>This systematic review aimed to determine the prevalence of different subtypes of hearing disorders (hearing loss, noise-induced hearing loss, hearing impairment, and standard threshold shift) as well as to identify the risk factors associated with hearing disorders in working populations.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Scopus and Web of Science for English-language studies published from 2016 to 2025. Eligible studies included studies that were conducted among worker populations and those reported prevalence and/or risk factors of hearing disorders. Extracted data include study countries, industrial sectors, subtypes of hearing disorders, assessment tools for hearing disorders, prevalence (or incidence) estimates, and risk factors. Commonly reported risk factors were identified through descriptive analysis and van Tulder's criteria.</div></div><div><h3>Results</h3><div>Among the 47 studies included, the prevalence of hearing loss, NIHL, and hearing impairment ranged from 3.8%–73.5%, 0.2%–63.6%, and 2.7%–71.2%, respectively. The prevalence of STS was 50.0%. There were 89 risk factors of hearing disorders, across eight domains, namely medical conditions (25 risk factors), work-related (18 risk factors), noise-related (13 risk factors), lifestyle (12 risk factors), sociodemographic characteristics (8 risk factors), HPD-related (5 risk factors), exposure to other occupational hazards (4 risk factors), and knowledge-related (4 risk factors). Among these 89 risk factors, only noise exposure and previous smoking showed consistent associations with hearing disorders.</div></div><div><h3>Conclusion</h3><div>The prevalence of hearing loss varied widely. Among the 89 reported risk factors (across eight domains) of hearing disorders, only noise exposure and previous smoking showed consistent associations with hearing disorders.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104927"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148935199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mastoid cavity obliteration in revision tympanomastoidectomy with ossiculoplasty for chronic cholesteatomatous otitis media: A retrospective case series on audiological and Patient-reported outcomes","authors":"Filippo Valentini,&nbsp;Riccardo De Lellis,&nbsp;Patrizia Mancini,&nbsp;Armando De Virgilio,&nbsp;Francesca Yoshie Russo,&nbsp;Daniele De Seta","doi":"10.1016/j.amjoto.2026.104925","DOIUrl":"10.1016/j.amjoto.2026.104925","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;Mastoid cavity obliteration is a surgical strategy rather than an intervention per se, that has been proposed as an effective approach to reduce post-operative complications and long-term morbidity associated with canal wall down (CWD) tympanomastoidectomies. The present study aims to evaluate, in a retrospective case series, audiological, functional, and quality-of-life (QoL) outcomes in adult patients undergoing revision tympanomastoidectomy and ossicular chain reconstruction with mastoid obliteration.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and methods&lt;/h3&gt;&lt;div&gt;A retrospective analysis was performed on a cohort of patients affected by recurrent cholesteatomatous chronic otitis media (CCOM) who underwent revision tympanomastoidectomy, ossiculoplasty, and mastoid cavity obliteration in the same surgical session. Inclusion criteria were age &gt;18 years and a minimum follow-up of 12 months with available pre- and postoperative audiometric data. Audiological outcomes were assessed using mean pure-tone average (PTA, 250–4000 Hz) and air–bone gap (ABG), calculated over the same frequency range and consistently applied to all cases. QoL was evaluated pre- and postoperatively using the validated Italian versions of the Chronic Otitis Media Outcome Test-15 (COMOT-15) and the Chronic Ear Survey–Italian version (CES&lt;img&gt;I), scored according to their original validated format. Outcomes were also compared, as an exploratory analysis, in a subgroup analysis between patients receiving partial ossicular replacement prostheses (PORP) and total ossicular replacement prostheses (TORP).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Fourteen of eighteen eligible patients (6 males, 8 females; mean age 45.4 years) met the established inclusion criteria, completing both audiological and QoL assessments. Mastoid obliteration was performed using different autologous or synthetic biocompatible materials, whose choice was based on intraoperative findings and surgeon preference. A significant improvement in mean PTA was observed postoperatively (66.7 ± 5.3 dB preoperatively vs. 53.8 ± 7.3 dB postoperatively; &lt;em&gt;p&lt;/em&gt; &lt; 0.05), as well as a significant reduction in ABG (34.5 ± 7.3 dB vs. 22.3 ± 10.8 dB; &lt;em&gt;p&lt;/em&gt; &lt; 0.05). Greater audiological improvement was noted, in this small and non-randomized subgroup comparison, in patients rehabilitated with PORP compared to TORP. QoL scores, based on patient-reported questionnaires, significantly improved at 12 months postoperatively, with CES-I scores increasing (30.5 ± 11 vs. 76 ± 14.2; &lt;em&gt;p&lt;/em&gt; &lt; 0.01) and COMOT-15 scores decreasing (78.7 ± 15.7 vs. 40.5 ± 20.8; &lt;em&gt;p&lt;/em&gt; &lt; 0.01), particularly in domains related to activity limitation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;Mastoid cavity obliteration combined with ossiculoplasty in revision tympanomastoidectomy was associated – in our retrospective analysis – with postoperative improvement in hearing outcomes and QoL, with greater audiological improve","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104925"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148896414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between chronic headache and tinnitus in an Arab community in Southwest Iran: A population-based cross-sectional study","authors":"Mohammad Shahmansouri,&nbsp;Nader Saki,&nbsp;Bahman Cheraghian,&nbsp;Sara Saki,&nbsp;Zahra Rahimi","doi":"10.1016/j.amjoto.2026.104916","DOIUrl":"10.1016/j.amjoto.2026.104916","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between tinnitus and chronic headache in adults aged 35–70 years in southwestern Iran.</div></div><div><h3>Methods</h3><div>We conducted a population-based cross-sectional study using baseline data from 10,009 participants in the Hoveyzeh Cohort Study. Tinnitus was assessed by self-report, and chronic headache was classified according to the (ICHD-3). Multivariable logistic regression was performed to assess associations, adjusting for key covariates.</div></div><div><h3>Results</h3><div>The prevalence of tinnitus and chronic headache was 10.5% and 7.5%, respectively. Chronic headache was associated with higher odds of tinnitus (OR = 1.81; 95% CI: 1.48–2.22). Older age (OR = 2.23), dizziness (OR = 1.90), and head trauma (OR = 1.76) were also independent predictors. Male sex (OR = 0.77) and higher physical activity (OR = 0.69) were associated with lower odds.</div></div><div><h3>Conclusion</h3><div>Chronic headache is independently associated with tinnitus in adults, suggesting shared pathophysiological mechanisms and emphasizing the need for integrated clinical approaches.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104916"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hemithyroidectomy alone versus completion thyroidectomy in patients with papillary thyroid carcinoma and pathological central nodal disease (pN1a): A retrospective cohort study","authors":"Alvin Shing-hei Lin,&nbsp;Michael Ching-ho Chan,&nbsp;Tam-lin Chow","doi":"10.1016/j.amjoto.2026.104913","DOIUrl":"10.1016/j.amjoto.2026.104913","url":null,"abstract":"<div><h3>Background</h3><div>The optimal extent of surgery for papillary thyroid carcinoma (PTC) with pathologically confirmed central nodal metastasis (pN1a) remains debatable, particularly in an era of surgical de-escalation. This study aimed to compare the outcomes of hemithyroidectomy alone versus hemithyroidectomy followed by completion thyroidectomy in patients with pN1a PTC.</div></div><div><h3>Methods</h3><div>A retrospective study was performed. Patients who underwent hemithyroidectomy for PTC with pN1a disease from 2001 to 2023 were reviewed. Patients were stratified by whether they subsequently underwent completion thyroidectomy. Demographic, surgical and oncological outcomes were compared.</div></div><div><h3>Results</h3><div>A total of 29 patients were included: 21 in the hemithyroidectomy-alone group and 8 in the completion thyroidectomy group. The completion thyroidectomy group was significantly older (56.6 ± 19.4 vs. 39.4 ± 13.7 years; <em>p</em> = 0.012) and had a higher ATA 2025 risk category (<em>p</em> = 0.040). The complication rate was significantly higher in the completion thyroidectomy group (62.5% vs. 14.3%; <em>p</em> = 0.019). At a mean follow-up of 144 months, there was no structural recurrence or disease-related mortality in either group. In the completion thyroidectomy group, 7 of 8 patients (87.5%) achieved undetectable serum thyroglobulin following RAI ablation; one patient had persistently detectable thyroglobulin (3.4μg/L) with a negative diagnostic I-131 scan and no structural recurrence identified.</div></div><div><h3>Conclusion</h3><div>In selected patients with pN1a PTC, hemithyroidectomy alone appears to achieve durable locoregional control with lower morbidity compared with completion thyroidectomy. These findings support a conservative surgical approach for low- to intermediate-risk pN1a PTC.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104913"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Platelet-rich plasma/fibrin in otolaryngology: A systematic review of randomized and non-randomized studies","authors":"Zoe Lafont,&nbsp;Antonino Maniaci,&nbsp;Cyril Bouland,&nbsp;Jérôme R. Lechien","doi":"10.1016/j.amjoto.2026.104915","DOIUrl":"10.1016/j.amjoto.2026.104915","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review the current evidence of Platelet-rich plasma (PRP) applications in otorhinolaryngology and evaluate treatment outcomes across different ENT pathologies.</div></div><div><h3>Data sources</h3><div>PubMed, Scopus, and Cochrane databases.</div></div><div><h3>Review method</h3><div>A systematic literature search was conducted from inception to August 2025 with the PRISMA statements. Meta-analysis was not performed due to substantial protocol heterogeneity. Randomized controlled trials and observational studies investigating PRP use in ENT disorders were included. Risk of bias was assessed using the RoB2 tool for randomized trials. Data extraction focused on clinical outcomes, preparation protocols, and methodological quality.</div></div><div><h3>Results</h3><div>Forty-two studies met inclusion criteria (31 RCTs (randomized controlled trials), six prospective controlled trials, four retrospective controlled studies, one prospective case series), accounting for 3197 patients. Applications included rhinology (<em>n</em> = 15), otology (<em>n</em> = 14), and laryngology/head-neck surgery (<em>n</em> = 13). 33 studies (78.6%) showed PRP was better than controls, while 9 studies (21.4%) showed no significant difference. The strongest evidence is for tympanic membrane perforation repair and olfactory dysfunction. Substantial protocol heterogeneity existed in blood volumes, anticoagulation methods, and centrifugation protocols. Only six studies (15.4%) reported platelet concentrations (3–10-fold baseline); none analyzed plasma composition. Bias assessment revealed 35.5% low-, 41.9% moderate-, and 22.6% high-risk RCTs, primarily due to inadequate blinding procedures (55.2% moderate/high risk) and outcome measurement issues (22.6% high risk).</div></div><div><h3>Conclusion</h3><div>PRP demonstrates promising efficacy in otolaryngology, particularly for tympanic membrane repair and olfactory dysfunction. Significant protocol heterogeneity and the absence of biological content analysis limit evidence quality and clinical standardization.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 5","pages":"Article 104915"},"PeriodicalIF":1.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of systemic inflammation in sinonasal inverted papilloma using hematological and biochemical markers","authors":"Cemal ÖZYILMAZ,&nbsp;İsmail Safa POYRAZOĞLU","doi":"10.1016/j.amjoto.2026.104883","DOIUrl":"10.1016/j.amjoto.2026.104883","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate systemic inflammatory markers in patients with sinonasal inverted papilloma (IP) and to investigate the diagnostic performance of composite indices.</div></div><div><h3>Methods</h3><div>This retrospective study included 41 patients with histologically confirmed IP and 41 age- and sex-matched healthy controls, conducted at a tertiary care center in Istanbul, Turkey, between 2017 and 2022. Hematological and biochemical inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), platelet count, platelet-to-lymphocyte ratio (PLR), eosinophil-to-lymphocyte ratio (ELR), systemic immune-inflammation index (SII), and C-reactive protein-to-albumin ratio (CAR), were compared between groups. ROC analysis was performed to assess discriminative performance.</div></div><div><h3>Results</h3><div>CAR was higher in the IP group (median 0.53, IQR 0.36–0.85) compared with controls (median 0.34, IQR 0.16–0.51; <em>p</em> = 0.001, <em>r</em> = 0.37, 95% CI 0.17–0.54). Similarly, SII was higher in the inverted papilloma group (median 435.3, IQR 351.06–641.19) compared to the control group (median 361.88, IQR 256.4–517.6; <em>p</em> = 0.027, <em>r</em> = 0.24, 95% CI [0.03, 0.43]).No significant differences were detected in NLR, PLR, and ELR (<em>p</em> &gt; 0.05). ROC analysis demonstrated that CAR had an AUC of 0.717 (95% CI: 0.606–0.829), with a sensitivity of 73.2% and specificity of 61.0% at a cut-off value of 0.41. SII showed a lower AUC of 0.642 (95% CI: 0.521–0.762).</div></div><div><h3>Conclusion</h3><div>Systemic inflammation appears to be associated with sinonasal inverted papilloma. CAR demonstrated better discriminative performance than SII, while traditional indices such as NLR and PLR were not informative. Composite inflammatory indices may provide additional value in the assessment of IP.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"Article 104883"},"PeriodicalIF":1.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148366640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}