American Journal of Otolaryngology最新文献

{"title":"MRI evidence of inner ear hemorrhage in prognostic assessment of sudden sensorineural hearing loss","authors":"Shiyao Min,&nbsp;Jing Wang,&nbsp;Hui Zhao,&nbsp;Fang-lu Chi,&nbsp;Na Gao","doi":"10.1016/j.amjoto.2025.104620","DOIUrl":"10.1016/j.amjoto.2025.104620","url":null,"abstract":"<div><h3>Objectives</h3><div>This study sought to explore the association between MRI-detected inner ear hemorrhage and the prognosis and symptom of SSNHL.</div></div><div><h3>Methods</h3><div>A total of220 enrolled patients were asked to receive MRI and hearing test.</div></div><div><h3>Results</h3><div>Patients with MRI evidence of inner ear hemorrhage experienced significantly more severe hearing loss, differences in hearing before and after treatment, and subjective perceptions compared to individuals without these signs. The hearing recovery at speech frequencies (0.5, 1, 2 kHz) was better in the non-hemorrhage group compared to the hemorrhage group. Additionally, the non-hemorrhage group exhibited fewer symptoms of dizziness and a better prognosis for dizziness.</div></div><div><h3>Conclusion</h3><div>MRI played a crucial role in both identifying the location of hemorrhage and accurately predicting symptoms and prognosis.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104620"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143922615","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":"Comparison of cartilage myringoplasty for repairing non-cholesteatomatous chronic perforation with mastoid cavity pneumatization and opacification","authors":"Qinghua Wang ,&nbsp;Ningyu Feng ,&nbsp;Zhengcai Lou","doi":"10.1016/j.amjoto.2025.104621","DOIUrl":"10.1016/j.amjoto.2025.104621","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to compare the graft outcomes of cartilage myringoplasty for the repair of chronic otitis media (COM) with a complete ossicular chain between mastoid cavity pneumatization and opacification.</div></div><div><h3>Materials and methods</h3><div>Chronic perforations with non-cholesteatomatous COM were allocated to either mastoid cavity pneumatization (MCP) group and opacification (MCO) group. All patients underwent endoscopic cartilage underlay myringoplasty alone. The graft success rate, audiometric outcomes, soft tissue opacification change, and complications were evaluated at 12 months after surgery.</div></div><div><h3>Results</h3><div>The postoperative infection was 2.7 % patients in the MCP group and 8.1 % patients in the MCO group (P = 0.607). Overall graft success rates were 91.9 % in the MCP group and 89.2 % in the MCO group (P = 0.691). MCO group exhibited more deterioration in preoperative air conduction (AC) PTAs (P = 0.047) or pre-operative ABG (P = 0.039) compared with MCP group, while there were no significant differences between the groups in postoperative AC PTAs, BC PTAs, or ABGs. Nevertheless, MCO group exhibited better ABG gain compared with MCP group (21.2 ± 6.9 vs 13.8 ± 2.6 dB; P = 0.024). Temporal bone CT at postoperative 12 months revealed no change in opacification in 56.8 % patients and reduced opacification or complete pneumatization in 43.2 % patients in the CMO group. Also, none of the patients developed worsening sensorineural hearing loss or postoperative tinnitus.</div></div><div><h3>Conclusions</h3><div>Myringoplasty alone did not affect the graft success rate in the patients with mastoid cavity pneumatization or opacification, however, in comparison, the patients with mastoid cavity opacification had a worse preoperative hearing but better postoperative hearing recovery. In addition, myringoplasty alone could improve the mastoid cavity opacification.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104621"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143854397","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":"Tele-voice therapy. Application of the tele-medicine paradigm to speech therapy for dysphonia: A systematic review","authors":"Leonardo Franz ,&nbsp;Arianna Da Canal ,&nbsp;Giacomo Spinato ,&nbsp;Giovanna Baracca ,&nbsp;Emanuela Lucchini ,&nbsp;Cosimo de Filippis ,&nbsp;Gino Marioni","doi":"10.1016/j.amjoto.2025.104626","DOIUrl":"10.1016/j.amjoto.2025.104626","url":null,"abstract":"<div><h3>Objective</h3><div>Over the last decades, tele-rehabilitation has been gaining popularity in speech and language disorders. To date, studies on tele-speech therapy have been focused mostly on speech and/or communication disorders. However, only a minority of the available investigations delved into voice disorders. The main aim of this review has been to summarize and critically analyze the available evidence on tele-rehabilitation in voice disorders.</div></div><div><h3>Methods</h3><div>A search of the English literature was conducted in PubMed, Scopus and Web of Science.</div><div>Original reports were included investigating the feasibility and efficacy of tele-speech therapy in human patients with dysphonia and reporting pre- and post-treatment outcomes. Studies with no objective outcomes or a small case series (fewer than 10 participants) were ruled out.</div></div><div><h3>Results</h3><div>482 articles were retrieved. After duplicates' removal, and title/abstract screening, 20 potentially relevant articles remained. After subsequent full-text screening, only 6 articles were included.</div></div><div><h3>Conclusion</h3><div>Despite their methodological heterogeneity and small sample size, the available studies seem to support tele-speech therapy as an effective tool for selected dysphonia patients. In particular, remote therapy may be proposed to overcome logistical issues, potentially increasing patients' adherence, especially in case of rehabilitation programs requiring no direct contact or manipulation (e.g. Lee Silverman Voice Treatment for Parkinson's disease). Moreover, hybrid in-person and remote approaches may be proposed as flexible solutions to administer a patient-tailored rehabilitation program, potentially maximizing the benefits of both settings. However, to develop stronger evidence-based practices, large-scale prospective controlled studies are required (preferably in a multi-center setting).</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104626"},"PeriodicalIF":1.8,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859260","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":"Resistance exercise and its impact on allergic rhinitis","authors":"Tao Yu,&nbsp;WenHui Yue,&nbsp;ShuJun Zhang","doi":"10.1016/j.amjoto.2025.104613","DOIUrl":"10.1016/j.amjoto.2025.104613","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of resistance exercise on nasal and eye symptoms, quality of life, and levels of inflammatory markers in patients with allergic rhinitis.</div></div><div><h3>Study design</h3><div>A prospective randomized controlled trial.</div></div><div><h3>Setting</h3><div>Conducted at a single tertiary care center.</div></div><div><h3>Methods</h3><div>A total of 156 patients with allergic rhinitis were randomly divided into a resistance exercise group and a control group for a 6-month intervention. Changes in nasal symptom scores, eye symptom scores, quality of life scores, and serum IL-4, IL-6, and IgE levels were evaluated.</div></div><div><h3>Results</h3><div>The resistance exercise group showed significantly greater improvement in nasal and eye symptoms, quality of life, and reduction in inflammatory markers compared to the control group (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Resistance exercise significantly improved symptoms and quality of life in patients with allergic rhinitis, showing promising clinical potential as an important adjunctive treatment.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104613"},"PeriodicalIF":1.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143783435","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":"Vocal fold lateralization by percutaneous suture in children: A systematic review","authors":"Neemias Santos Carneiro ,&nbsp;José Faibes Lubianca Neto ,&nbsp;Bárbara Salgueiro ,&nbsp;Rita Carolina Pozzer Krumenauer Padoin ,&nbsp;Renata Loss Drummond ,&nbsp;Mateus Campestrini Harger ,&nbsp;Marcelo Neves Lubianca","doi":"10.1016/j.amjoto.2025.104606","DOIUrl":"10.1016/j.amjoto.2025.104606","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Percutaneous vocal fold lateralization (PVFL) consists of external fixation with non-absorbable percutaneous suture of the vocal fold in a lateral position, under direct glottic visualization. The objective, through a systematic review, was to identify, select, evaluate, and synthesize the relevant evidence available to define whether PVFL is effective in avoiding the tracheostomy, as well as whether it is effective in allowing decannulation of children who have already been tracheostomized. Secondarily, vocal quality, complications and reversibility of the procedure were evaluated.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;A systematic review was carried out based on the protocols described in the QUORUM/PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was carried out in the PubMed, Embase, Scopus, Web of Science, SciELO and VHL databases. The terms searched were a combination of indexed keywords using Boolean terms. Inclusion criteria: Primary studies that documented intervention outcomes in patients with BVFP; Studies including pediatric patients (defined here as &lt;18 years of age); and studies with well documented postoperative follow-up. Exclusion criteria: Duplicate studies or with the same clinical data; articles that exclusively evaluated other surgical interventions, animal studies, reviews, or post-mortem studies; and studies with only patients with unilateral vocal fold paralysis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Among the patients under study, 80 cases, underwent the surgical technique under study, 41 of these (51.25 %) are male. The average age of patients undergoing the procedures ranged from 4 days to 10 years of age. Most patients already had preoperative comorbidities, generally cardiothoracic and laryngeal, followed by neurological causes. In 31 % of patients, only a high-flow nasal catheter was required and in 3 patients, transient orotracheal intubation was required. At the mean follow-up of 30 months [SD:24], around 20 of the 80 (25.6 %) patients presented some degree of dysphonia. However, there was no standardization of scales. Approximately 11 % of patients had some postoperative complication, with reintubation due to glottic edema being the most prevalent. There was only 1 death. Preoperatively, 38 % of patients with BVFP were tracheostomized. After the procedure, only 13 % of them still needed to continue with the tracheostomy during the postoperative period. However, 13 % of patients needed to remain with a tracheostomy. Among the tracheostomy patients, only 3 of them achieved return of vocal fold mobility. Among all patients, vocal fold mobility returned in 35 % of patients, with a total of 10 % of patients postoperatively. However, there were studies that did not report mobility due to the short follow-up. During follow-up, 6 patients required revision procedures to relocate lateralization suture or even due to skin abscess. Granu","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104606"},"PeriodicalIF":1.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636424","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":"Expansion sphincter pharyngoplasty with cartilage implant in uvulopalatal flap for treatment of obstructive sleep apnea","authors":"Fereshte Shenavayi ,&nbsp;Shayan Dasdar ,&nbsp;Hamed Amirifard ,&nbsp;Reza Erfanian ,&nbsp;Arezu Najafi ,&nbsp;Nika Kianfar ,&nbsp;Amin Amali ,&nbsp;Shohre Ghasemi ,&nbsp;Reihaneh Heidari","doi":"10.1016/j.amjoto.2025.104608","DOIUrl":"10.1016/j.amjoto.2025.104608","url":null,"abstract":"<div><h3>Background</h3><div>Uvulopalatopharyngoplasty and its modifications, including expansion sphincter pharyngoplasty, are the most common surgical interventions for obstructive sleep apnea.</div></div><div><h3>Objective</h3><div>To introduce a novel surgery technique in which expansion sphincter pharyngoplasty was performed accompanied by inserting a cartilage implant into the palate.</div></div><div><h3>Methods</h3><div>Adult patients required septoplasty and pharyngoplasty were selected. In intervention group, expansion sphincter pharyngoplasty was performed with the insertion of a cartilage implant, obtained from their septum into the uvulopalatal flap site. In control group, similar procedures were performed except for cartilage insertion. Surgery outcome was assessed at the 3rd and 6th month post-operation by STOP-Bang Questionnaire (SBQ), Epworth Sleepiness Scale (ESS), and snoring level.</div></div><div><h3>Results</h3><div>Thirty-one individuals with a mean age of 36.9 ± 9.0 years, consisting of 27 (87.1 %) men, were recruited. At follow-ups sessions of intervention group (<em>n</em> = 16), the SBQ decreased from 3.94 ± 1.39 to 2.33 ± 1.11 and 1.80 ± 1.21 (<em>p</em> &lt; 0.001), ESS decreased from 10.31 ± 5.52 to 5.20 ± 2.83 and 3.33 ± 1.76 (p &lt; 0.001), and snoring level decreased from 2 to 1 and 1 (<em>p</em> &lt; 0.001). In control group (<em>n</em> = 15), the SBQ decreased from 4.23 ± 0.60 to 2.38 ± 0.96 and 2.08 ± 1.11 (<em>p</em> &lt; 0.001), ESS decreased from 13.08 ± 5.88 to 7.69 ± 4.27 and 5.69 ± 4.05 (p &lt; 0.001), and snoring level decreased from 3 to 2 and 1 (p &lt; 0.001). Between group comparison indicated that ESS was marginal at the second follow-up (<em>p</em> = 0.051), and the snoring level was significantly different at first (<em>p</em> = 0.019) and second (<em>p</em> = 0.031) follow-ups.</div></div><div><h3>Conclusion</h3><div>Performing expansion sphincter pharyngoplasty with a cartilage implant in selected individuals improved surgery outcome.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104608"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629301","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":"Systematic review and meta-analysis of the correlation between tinnitus and mental health","authors":"Yuyang Jiang ,&nbsp;Qiang Liu ,&nbsp;Yi Ding,&nbsp;Yongdong Sun","doi":"10.1016/j.amjoto.2025.104611","DOIUrl":"10.1016/j.amjoto.2025.104611","url":null,"abstract":"<div><h3>Objective</h3><div>This paper assesses the correlation between tinnitus and mental health, including depression, anxiety, stress, insomnia, and suicide through meta-analysis.</div></div><div><h3>Methods</h3><div>Web of Science, Embase, PubMed, and Cochrane databases were searched until January 2024. After article screening, data extraction, and quality evaluation, meta-analysis was performed using Stata 15.1.</div></div><div><h3>Results</h3><div>22 papers were enrolled, including 5 case-control studies, 8 cohort studies, and 9 cross-sectional studies. Meta-analysis uncovered that tinnitus was associated with depression (OR = 1.92, 95 % CI: 1.56, 2.36), anxiety (OR = 1.63, 95 % CI: 1.34, 1.98), stress (OR = 1.17, 95 % CI: 1.01, 1.36), insomnia (OR = 3.07, 95 % CI: 2.36, 3.98), and suicide (OR = 5.31, 95 % CI: 4.34, 6.51).</div></div><div><h3>Conclusion</h3><div>A correlation is indicated between tinnitus and mental health. Therefore, it is critical to incorporate psychological interventions in tinnitus treatment and to implement a comprehensive treatment program.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104611"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619346","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":"Intraoperative parathyroid hormone monitoring in parathyroidectomy: Predicting cure and recurrence in tertiary hyperparathyroidism - systematic review","authors":"Kevin P.J. Finnegan,&nbsp;Gavin P. Dowling,&nbsp;Sami Abd El Wahab ,&nbsp;Arnold D.K. Hill","doi":"10.1016/j.amjoto.2025.104609","DOIUrl":"10.1016/j.amjoto.2025.104609","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this systematic review was to investigate the value of intraoperative parathyroid hormone (IOPTH) monitoring in parathyroidectomy for tertiary hyperparathyroidism (THPT) to predict cure and recurrence.</div></div><div><h3>Data sources</h3><div>Ovid, Embase, EBSCO Host, Citation Checking.</div></div><div><h3>Methods</h3><div>This study was performed in accordance with PRISMA guidelines. A systematic search of the literature was conducted to identify studies evaluating IOPTH monitoring in patients with THPT. Only studies addressing THPT with documented use of IOPTH in their surgery were included.</div></div><div><h3>Results</h3><div>In 11 of the 18 studies included in this review IOPTH monitoring influenced the surgery by identifying insufficient resection or ectopic/supernumerary glands necessitating further resection to cure patients. Rates of recurrence were absent or minimal in patients who achieved appropriate IOPTH drops at specified time intervals.</div></div><div><h3>Conclusion</h3><div>IOPTH monitoring is a useful adjunct to prevent insufficient resection of hyperplastic glands and to identify ectopic/supernumerary glands. Median PTH drop at specified time intervals can help predict cure and recurrence in parathyroidectomy for THPT.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104609"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643209","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":"Synchronous versus asynchronous delivery of concurrent chemotherapy and radiation for head and neck cancer: Does timing matter?","authors":"Allen M. Chen ,&nbsp;Meng Gan ,&nbsp;Tjoson Tjoa ,&nbsp;Yarah Haidar ,&nbsp;William B. Armstrong","doi":"10.1016/j.amjoto.2025.104612","DOIUrl":"10.1016/j.amjoto.2025.104612","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the impact of variations in the timing of chemotherapy and radiation on clinical outcome for patients treated with concurrent chemoradiation for head and neck cancer.</div></div><div><h3>Methods and materials</h3><div>The medical records of 264 consecutive adult patients treated with concurrent cisplatin-based chemoradiation for squamous cell carcinoma of the head and neck were reviewed. Among these 187 patients (71 %) had chemotherapy and radiation commencing on the same day (“synchronous delivery”) and 87 patients had chemotherapy and radiation commencing on different days (“asynchronous delivery”).</div></div><div><h3>Results</h3><div>The 3-year actuarial estimates of overall survival (74 % vs. 76 %), progression-free survival (75 % vs. 75 %), and local-regional control (71 % vs. 73 %) were not significantly different between concurrent chemoradiation patients treated by synchronous and asynchronous delivery methods, respectively (<em>p</em> &gt; 0.05, for all). Exploratory subset analysis using the 1, 3, 7, 10, and 14 day cutoffs as thresholds for starting chemotherapy and radiation together demonstrated that patients who had greater than a 7 day gap between chemotherapy and radiation had significantly worse 3-year overall survival (63 % vs. 78 %, <em>p</em> = 0.01), progression-free survival (59 % vs. 77 %, <em>p</em> = 0.01), and local-regional control (65 % vs. 74 %, <em>p</em> = 0.02) compared to those whose treatment commencement occurred within 7 days, respectively.</div></div><div><h3>Conclusion</h3><div>While the clinical repercussions of not starting concurrent chemotherapy and radiation on the same day are likely of minimal consequence for patients with head and neck cancer, efforts to start treatments within 7 days of one another are recommended.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104612"},"PeriodicalIF":1.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143679965","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":"Effect of palatoplasty technique on otologic outcomes in children with cleft palate","authors":"Shaina W. Gong ,&nbsp;Paul Hung ,&nbsp;Chioma G. Obinero ,&nbsp;Jose Barrera ,&nbsp;Zi Yang Jiang ,&nbsp;Matthew R. Greives ,&nbsp;Zhen Huang","doi":"10.1016/j.amjoto.2025.104610","DOIUrl":"10.1016/j.amjoto.2025.104610","url":null,"abstract":"<div><h3>Background</h3><div>In patients with cleft palate (CP), the impact of primary palatoplasty technique on otologic outcomes remains a major point of contention. While some studies report improved outcomes after certain techniques of palatal repair, there is a lack of consensus on the most effective procedure.</div></div><div><h3>Objective</h3><div>We sought to characterize the effects of primary palatoplasty technique on otologic outcomes in children with CP.</div></div><div><h3>Methods</h3><div>A single institution retrospective review of patients with CP who underwent primary palatoplasty (straight-line repair or Furlow Z-plasty) was performed. Primary outcomes of interest included time to placement of T-tubes, number of tympanostomy tube placements, tympanic membrane (TM) perforation, and 3-year and 6-year postoperative hearing thresholds.</div></div><div><h3>Results</h3><div>A total of 140 patients were included in this study. The mean number of tympanostomy tube placements in the straight-line repair group (1.93 ± 1.28) was significantly higher than in the Furlow Z-plasty group (1.42 ± 1.03, <em>p</em> = 0.03). Median time from primary palate repair to T-tube placement was 38.93 (IQR 33.03) months. Higher birth weight (<em>p</em> &lt; 0.01) and multiple tympanostomy tube placements (<em>p</em> &lt; 0.05) were associated with longer time to T-tube placement. T-tube replacement was associated with a 16.9 times higher likelihood of TM perforation (<em>p</em> &lt; 0.05). The median PTA significantly improved from 16.25 (IQR 7) dB at 3 years to 11.00 (IQR 5.25) dB at 6 years (<em>p</em> &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>Furlow palatoplasty technique was associated with fewer number of tympanostomy tube placements; however, palatoplasty technique did not significantly impact time to T-tube placement, TM perforation, or hearing outcomes. There were no significant differences in long-term hearing outcomes between patients who underwent Furlow Z-plasty and those who had straight-line repair. Most patients achieved normal hearing thresholds by 6 years after primary palatoplasty and tympanostomy tube placement. These are important considerations to discuss when counseling patients' families on surgical management of CP and otologic outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104610"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643289","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}