American Journal of Otolaryngology最新文献

{"title":"Using fresh frozen cadaveric rib cartilage graft for nasal septal perforation repair","authors":"Parker Tumlin,&nbsp;Amani Kais,&nbsp;Chadi A. Makary","doi":"10.1016/j.amjoto.2024.104590","DOIUrl":"10.1016/j.amjoto.2024.104590","url":null,"abstract":"<div><h3>Introduction</h3><div>The anterior ethmoidal artery (AEA) flap has been demonstrated to be a reliable option for endoscopic repair of symptomatic nasal septal perforations. The use of fresh frozen cadaveric rib cartilage has been described as a safe alternative graft for rhinoplasty procedures.</div></div><div><h3>Goal</h3><div>The aim of this study was to discuss our initial outcomes of use of cadaveric rib cartilage graft in combination with the AEA flap in endoscopic nasal septal perforation repair.</div></div><div><h3>Methods</h3><div>A single institution retrospective case series of all consecutive patients who underwent repair of nasal septal perforation utilizing the AEA flap combined with a cadaveric rib cartilage between December of 2022 to August of 2024 was conducted. Demographics and comorbidities were collected preoperatively. The main outcome of this study was surgical success rate defined as closure of the septal perforation.</div></div><div><h3>Results</h3><div>Six patients were included. Four out of six patients had previously failed septal perforation repair, and two patients had a concomitant open septorhinoplasty after raising the AEA flap endoscopically. Overall success rate for complete closure was 100 % with mean follow up of 9.5 months (range of 2–22 months). No major or minor direct postoperative adverse events were encountered.</div></div><div><h3>Conclusion</h3><div>Initial outcomes of use of the endoscopic AEA flap in combination with a cadaveric rib cartilage graft for closure of a nasal septal perforation are promising. Future studies with larger sample sizes and longer follow up time would be useful to verify these outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104590"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891428","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":"PET/CT for perforator identification in deep inferior epigastric perforator flap harvest","authors":"Elizabeth Shay,&nbsp;Akash N. Naik,&nbsp;Michael G. Moore,&nbsp;Jessica A. Yesensky,&nbsp;Avinash V. Mantravadi,&nbsp;Michael W. Sim","doi":"10.1016/j.amjoto.2024.104593","DOIUrl":"10.1016/j.amjoto.2024.104593","url":null,"abstract":"<div><h3>Background</h3><div>CT angiography (CTA) is used for preoperative localization in deep inferior epigastric perforator (DIEP) flaps, but is an additional costly study that involves contrast and radiation exposure. Many patients with head and neck cancer already undergo PET/CT. We investigated if PET/CT could be used to preoperatively localize perforators and if this corresponded with the intraoperative location.</div></div><div><h3>Methods</h3><div>This was a prospective cohort study at an academic tertiary care center between 2017 and 2022. Participants were adults with head and neck cancer who had undergone PET/CT and were scheduled to undergo reconstruction with DIEP flaps. The mean difference between the preoperative and intraoperative horizontal and vertical distance of perforators from the umbilicus was determined.</div></div><div><h3>Results</h3><div>Preoperative and intraoperative measurements were obtained from 42 perforators (30 patients). The mean difference between preoperative and intraoperative measurements was not statistically significant for HDU (−0.05 with 95 % CI [−0.11, 0.01], <em>p</em> = 0.13) or VDU (−0.02 with 95 % CI [−0.06, 0.03] <em>p</em> = 0.41). Bland-Altman analysis demonstrated limits of agreement of −0.42 (95 % CI [−0.52, −0.31]) to 0.33 (95 % CI [0.23, 0.43]) for HDU and −0.31 (95 % CI [−0.39, −0.23]) to 0.27 (95 % CI [0.19, 0.35]) for VDU. This was within our chosen limit of agreement of 1 cm.</div></div><div><h3>Conclusion</h3><div>Preoperative identification of DIEP perforators on PET/CT can be used to locate perforators intraoperatively. Utilizing this method facilitates efficient flap harvesting and does not require an additional imaging study since many patients undergo PET/CT.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104593"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142902594","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":"Predicting sinonasal inverted papilloma attachment using machine learning: Current lessons and future directions","authors":"Sean P. McKee ,&nbsp;Xiaomin Liang ,&nbsp;William C. Yao ,&nbsp;Brady Anderson ,&nbsp;Jumah G. Ahmad ,&nbsp;David Z. Allen ,&nbsp;Salman Hasan ,&nbsp;Andy J. Chua ,&nbsp;Chinmay Mokashi ,&nbsp;Samia Islam ,&nbsp;Amber U. Luong ,&nbsp;Martin J. Citardi ,&nbsp;Luca Giancardo","doi":"10.1016/j.amjoto.2024.104549","DOIUrl":"10.1016/j.amjoto.2024.104549","url":null,"abstract":"<div><h3>Background</h3><div>Hyperostosis is a common radiographic feature of inverted papilloma (IP) tumor origin on computed tomography (CT). Herein, we developed a machine learning (ML) model capable of analyzing CT images and identifying IP attachment sites.</div></div><div><h3>Methods</h3><div>A retrospective review of patients treated for IP at our institution was performed. The tumor attachment site was manually segmented on CT scans by the operating surgeon. We used a nnU-Net model, a state-of-the-art deep learning-based segmentation algorithm that automatically configures image preprocessing, network architecture, training, and post-processing to identify the IP attachment site. The model was trained and evaluated using a 5-fold cross validation, where each iteration split the data into train/validation/test to avoid chances of overfitting. The attachment site was classified as either ‘identified or ‘not identified’ using the nnU-Net model output and the Sørensen–Dice coefficient (Dice) was used to further evaluate the segmentation performance of each subject.</div></div><div><h3>Results</h3><div>A total of 58 subjects met enrollment criteria. The algorithm identified the attachment site in 55.2 % (<em>n</em> = 32) of patients with an average dice score (+/-SD) of 0.34 (+/− 0.24). In the univariate analysis, the algorithm performed better for attachment sites within the maxillary sinus (OR 4.0; <em>p</em> &lt; 0.05) and performed worse during revision surgery (OR 0.13; <em>p</em> &lt; 0.05). Multivariate logistic regression analysis confirmed these associations for maxillary attachment site (OR 4.6; <em>p</em> &lt; 0.05) and revision surgery (OR 0.11; <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>A state-of-the-art ML model successfully identified the attachment site of IP with a high degree of fidelity in select cases, but requires larger sample sizes and more diverse datasets to become reliably integrated into clinical practice.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104549"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909071","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 postoperative intracranial pressure in patients with radiological diagnosis of idiopathic intracranial hypertension","authors":"Valeria Barcia Castilla ,&nbsp;Pedro Mino Vianna ,&nbsp;Rodrigo Aragão Torres ,&nbsp;Fabiolla Maria Martins Costa ,&nbsp;Luziana de Lima Ramalho ,&nbsp;Débora de Carvalho Garcez ,&nbsp;Rogerio Pezato ,&nbsp;Beatriz Sarno Ramos ,&nbsp;José Marcelo Ferreira Bezerra ,&nbsp;Miguel Soares Tepedino","doi":"10.1016/j.amjoto.2024.104542","DOIUrl":"10.1016/j.amjoto.2024.104542","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess postoperative intracranial pressure in patients with clinical and/or radiological features of idiopathic intracranial hypertension (IIH) undergoing endoscopic endonasal surgery for primary cerebrospinal fluid (CSF) leak repair.</div></div><div><h3>Methods</h3><div>Data was prospectively collected from 9 patients diagnosed with CSF nasal leaks who underwent corrective endonasal surgery between January 1, 2021, and October 31, 2022. Postoperative intracranial pressure was measured via lumbar puncture at least one month after surgery. Preoperative and postoperative MRI scans were compared to evaluate changes.</div></div><div><h3>Results</h3><div>Postoperative lumbar puncture revealed elevated intracranial pressure in 67 % of patients, and 100 % showed persistent signs of intracranial hypertension on MRI.</div></div><div><h3>Conclusion</h3><div>Managing elevated intracranial pressure in patients with CSF nasal leaks should be prioritized alongside surgical correction. Consideration of permanent peritoneal shunt or pharmacological treatment may be necessary for patients with classic IIH phenotype. Longitudinal studies are essential for further understanding long-term outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104542"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926278","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":"Decoding RAS mutations in thyroid cancer: A meta-analysis unveils specific links to distant metastasis and increased mortality","authors":"Isabel Riccio ,&nbsp;Alexandra Laforteza ,&nbsp;Madeleine B. Landau ,&nbsp;Mohammad H. Hussein ,&nbsp;Joshua Linhuber ,&nbsp;Jonathan Staav ,&nbsp;Peter P. Issa ,&nbsp;Eman A. Toraih ,&nbsp;Emad Kandil","doi":"10.1016/j.amjoto.2024.104570","DOIUrl":"10.1016/j.amjoto.2024.104570","url":null,"abstract":"<div><h3>Background/objectives</h3><div>RAS mutations are common in thyroid cancer, but their impact on clinical outcomes remains controversial. This study aimed to evaluate the prevalence of RAS mutations in thyroid cancer and their association with various clinical and pathological features.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis of studies reporting on RAS mutations in thyroid cancer. Both one-arm and pairwise meta-analyses were performed to compare outcomes between RAS-mutated (RAS+) and wild-type (RAS-) thyroid cancers.</div></div><div><h3>Results</h3><div>Our analysis included 2552 thyroid cancer patients from 17 studies. The overall prevalence of RAS mutations was 35.4 % (95 % CI: 22.7 %–50.7 %). NRAS mutations were most common (69.47 %, 95 % CI: 66.15 %–72.66 %), followed by HRAS (25.83 %, 95 % CI: 22.77 %–29.14 %) and KRAS (6.92 %, 95 % CI: 5.27 %–9.04 %). No statistically significant differences were found between RAS+ and RAS- cases in rates of T1/2 tumors, lymph node metastasis, extrathyroidal extension, or recurrence. The risk of distant metastasis was significantly higher in RAS+ cases (15 %, 95 % CI: 6 %–34 %) compared to RAS- cases (4 %, 95 % CI: 1 %–12 %), with a relative risk of 3.23 (95 % CI: 1.49–7.02). Notably, RAS+ cases showed a significantly higher mortality rate (8 %, 95 % CI: 3 %–18 %) compared to RAS- cases (2 %, 95 % CI: 1 %–5 %), with a relative risk of 4.36 (95 % CI: 1.23–15.50, p = 0.03).</div></div><div><h3>Conclusion</h3><div>While RAS mutations are prevalent in thyroid cancer, they do not significantly impact most clinical and pathological features. However, the presence of RAS mutations is associated with a significantly higher risk of distant metastasis and mortality, suggesting their potential role as a prognostic marker in thyroid cancer. These findings underscore the importance of RAS mutation testing in risk stratification and treatment planning for thyroid cancer patients.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104570"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142871084","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":"The relationship of nasal mucus properties and symptoms in allergic and acute non-allergic rhinitis","authors":"Melissa A. Yopp ,&nbsp;Erika Tokita ,&nbsp;Kelley Dodson ,&nbsp;Bruce K. Rubin","doi":"10.1016/j.amjoto.2024.104569","DOIUrl":"10.1016/j.amjoto.2024.104569","url":null,"abstract":"<div><h3>Background</h3><div>Allergic rhinitis (AR) and acute non-allergic rhinosinusitis (ARS) often present with similar symptoms. While these are generally differentiated by history and occasionally by secretion cell counts, there are few data temporally comparing these conditions.</div></div><div><h3>Methods</h3><div>A prospective, observational study was conducted to assess nasal mucus properties, nasal obstruction, nasal secretion cells, and health related QOL during the acute phase (Day 5) and during a later phase of illness (Day 14/28). We screened 280 patients and enrolled 42 subjects (ARS, n = 34; and AR, n = 8) who were otherwise healthy and met eligibility criteria. Nasal secretions for cell count and rheology, and acoustic rhinometry were measured on days 5 and 14 of symptoms. SNOT-20 was administered on Day 5, 14, 10 and 28.</div></div><div><h3>Results</h3><div>In subjects with ARS, there was significantly improved SNOT-20 and major symptom score at day 28 in association with increased nasal cavity volume by acoustic rhinometry and decreased mast cells; all consistent with improvement. However, in subjects with AR there was no symptomatic improvement or change in nasal volume and although there were fewer mast cells and epithelial cells, there was no decrease in the number of eosinophils, neutrophils, or goblet cells in secretions. There was no change in in vitro secretion mucociliary clearability in either group, although values were normal at baseline.</div></div><div><h3>Conclusions</h3><div>These results suggest that nasal symptoms in ARS are improved over 14–28 days with the reduction of mast cells, and increased nasal volume, while in AR, symptoms persist.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104569"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891426","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":"Revisiting the closed stapler laryngectomy: Technique and review of recent evidence","authors":"Ryan T. Judd ,&nbsp;Jeremy Godsell ,&nbsp;Hannah Kuhar ,&nbsp;Hilary McCrary ,&nbsp;Janice Farlow ,&nbsp;Amit Agrawal ,&nbsp;Enver Ozer","doi":"10.1016/j.amjoto.2024.104512","DOIUrl":"10.1016/j.amjoto.2024.104512","url":null,"abstract":"<div><h3>Objective</h3><div>To review the current literature regarding stapler-assisted closed total laryngectomy (TL), present a case series, and provide details on operative technique.</div></div><div><h3>Finding</h3><div>Several meta-analyses and randomized controlled trials have demonstrated lower rates of pharyngocutaneous fistula (PCF) with closed stapler-assisted TL compared to traditional manual closure. Operative time, hospital stay, and time to oral feeding also appear to be lower. We present a five-patient case series of stapler-assisted closed TL with successful outcomes, including the first reported salvage case with free flap reconstruction, and provide technical detail including intraoperative photographs.</div></div><div><h3>Conclusion</h3><div>Stapler-assisted closed TL appears to be a safe alternative to traditional manual closure in select patients with endolaryngeal tumors with potential for lower rates of PCF and shorter operative time, hospital stay, and time to oral feeding.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104512"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692592","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":"Persistent sleep apnea after adenotonsillectomy in pediatric patients with head and neck burns","authors":"Robert E. Africa ,&nbsp;Amber M. Dunmire ,&nbsp;Austin L. Johnson ,&nbsp;Nadia Z. Quadri ,&nbsp;Harold S. Pine ,&nbsp;Charles A. Hughes ,&nbsp;Brian J. McKinnon ,&nbsp;Yusif Hajiyev","doi":"10.1016/j.amjoto.2024.104546","DOIUrl":"10.1016/j.amjoto.2024.104546","url":null,"abstract":"<div><h3>Background</h3><div>To determine if face, head, or neck burns increases risk of persistent sleep disordered breathing (SDB) or obstructive sleep apnea (OSA) after adenotonsillectomy.</div></div><div><h3>Methods</h3><div>The TriNetX database was used to gather data for patients who had face, head, or neck burn including mouth and pharynx and history of sleep study with adenotonsillectomy. A comparison of persistent SDB or OSA was done between cohort 1, a group with sleep study and adenotonsillectomy after burn injury, and cohort 2, a group with treatment before a burn. Risk of persistence was evaluated as relative risk (RR) with 95 % confidence interval (CI).</div></div><div><h3>Results</h3><div>Eighty-three pediatric patients were included. Fifty-one patients were in cohort 1, and 32 in cohort 2. Forty-three patients in cohort 1 had persistent SDB or OSA as compared to 11 in cohort 2, which was statistically significant (RR: 2.45; 95 % CI: 1.50–4.02; <em>p</em>-value &lt;0.0001). After propensity score matching, both groups had 23 patients, and 19 had persistent SDB or OSA in cohort 2, while cohort 1 had 10 patients. The difference in persistence was significant (RR 1.9; 95 % CI: 1.15–3.14; <em>p</em>-value equals 0.006).</div></div><div><h3>Conclusions</h3><div>Pediatric patients with a face, head, or neck burn had a higher rate of persistent SDB or OSA after adenotonsillectomy compared to patients who had surgery prior to thermal injury.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104546"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794197","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":"Feasibility and efficacy of home-based lymphedema exercises for head and neck cancer patients at a safety net hospital","authors":"Kelsey Wood,&nbsp;Samuel Hopper,&nbsp;M. Caroline Murray,&nbsp;Josephine Alston,&nbsp;Oishika Paul,&nbsp;Gina D. Jefferson,&nbsp;Lana L. Jackson,&nbsp;Anne C. Kane","doi":"10.1016/j.amjoto.2024.104560","DOIUrl":"10.1016/j.amjoto.2024.104560","url":null,"abstract":"<div><h3>Purpose</h3><div>Lymphedema therapy is an effective tool in mitigating head and neck lymphedema morbidity and long-term fibrosis. Studies have shown the efficacy of facility-based therapy; however, access can be limited by sociodemographic factors, including socioeconomic status and transportation. This study evaluates the feasibility and effectiveness of home-based lymphedema therapy in a socially vulnerable patient population.</div></div><div><h3>Materials and methods</h3><div>A retrospective chart review analyzed patients who underwent home-based lymphedema exercise regimen after training with a lymphedema-trained speech language pathologist between 2019 and 2022 at a tertiary academic medical center. Patient and cancer demographics were collected. Primary outcomes measured were quality of life surveys and diet status.</div></div><div><h3>Results</h3><div>Of the 27 patients included, 85.1 % were in the two highest quintiles of neighborhood deprivation based on national Area Deprivation Index (ADI). Treatment breakdown included 78 % who were treated with surgery, 96 % completed radiation and 59.3 % chemotherapy. Six months after initiating lymphedema therapy, most patients (59.3 %) were compliant with exercises. Quality of life scores showed trends toward improvement, but only a decrease in condition-related anxiety at 3 months (<em>p</em> = 0.004) reached statistical significance. Improvement in diet was significant at 6 and 9 months after initiation of treatment (<em>p</em> = 0.020).</div></div><div><h3>Conclusions</h3><div>Patient compliance rate demonstrates feasibility of home exercises for lymphedema treatment in a tertiary care setting with a socially vulnerable patient population. Home-based head and neck lymphedema treatment showed improvements in patient diet over time.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104560"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823741","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":"Chemoradiation for human papillomavirus positive oropharyngeal cancer in smokers: A single-institutional experience","authors":"Allen M. Chen ,&nbsp;Rupali Nabar ,&nbsp;Tjoson Tjoa ,&nbsp;Yarah Haidar ,&nbsp;William B. Armstrong","doi":"10.1016/j.amjoto.2024.104591","DOIUrl":"10.1016/j.amjoto.2024.104591","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine how smoking intensity impacts the prognosis of patients with human papillomavirus (HPV)-positive oropharyngeal cancer treated by chemoradiation.</div></div><div><h3>Methods and materials</h3><div>The medical records of 32 patients with histologically proven squamous cell carcinoma of the oropharynx and a prior smoking history were retrospectively reviewed. All patients were treated with intensity-modulated radiotherapy to a median dose of 70 Gy (range 63 to 72 Gy) with concurrent cisplatin. Seventeen patients (53 %) had stage II disease; and 15 patients (47 %) had stage III disease. Distribution of T-classification was: T1 8 (25 %); T2 4 (13 %); T3 10 (31 %); and T4 10 (31 %). Smoking history was categorized as follows: ≤10 pack-years (10 patients); 10–20 pack-years (6 patients); 20–30 pack-years (7 patients); &gt;30 pack-years (9 patients).</div></div><div><h3>Results</h3><div>With a median follow-up of 40 months (range, 6 to 121 months), the 3-year overall survival for the entire population was 79 %. Significant differences in 3-year overall survival (83 % vs 54 %, <em>p</em> = 0.01), local-regional control (86 % vs 62 %, <em>p</em> &lt; 0.001), and progression-free survival (75 % vs 52 %, <em>p</em> = 0.02) were observed when comparing patients with ≤30 pack-year versus those with &gt;30 pack-year smoking histories.</div></div><div><h3>Conclusion</h3><div>The deleterious effect of smoking seemed to be most impactful in those with heavy consumption (i.e., &gt;30 pack-year history).</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104591"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891418","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}