American Journal of Otolaryngology最新文献

{"title":"Predictors of therapeutic response and pain after near-infrared photoimmunotherapy in head and neck cancer","authors":"Junya Matsumoto,&nbsp;Takuma Makino,&nbsp;Yuto Naoi,&nbsp;Shohei Fujimoto,&nbsp;Mizuo Ando","doi":"10.1016/j.amjoto.2026.104848","DOIUrl":"10.1016/j.amjoto.2026.104848","url":null,"abstract":"<div><h3>Objective</h3><div>Near-infrared photoimmunotherapy (NIR-PIT) has been approved by the Japanese national health insurance for approximately five years, and clinical experience has steadily accumulated. However, reports analyzing treatment outcomes and pain-related factors remain limited. This study aimed to identify predictors of therapeutic response and pain following NIR-PIT.</div></div><div><h3>Methods</h3><div>This retrospective cohort study included 25 patients who underwent NIR-PIT for head and neck cancer between January 2021 and June 2025. Lesion diameter and thickness were evaluated in relation to complete response (CR), and the frequency and predictors of post-treatment pain were assessed.</div></div><div><h3>Results</h3><div>Among 22 evaluable patients, eight achieved CR. Lesions with a shorter longest diameter and thinner thickness were significantly associated with higher CR rates (<em>p</em> = 0.011 and <em>p</em> = 0.024). Moderate-to-severe pain (Numerical Rating Scale ≥4) occurred in 18 of 48 treatment cycles (37.5%) but was significantly less frequent in patients with a history of reconstructive surgery (<em>p</em> = 0.017).</div></div><div><h3>Conclusions</h3><div>NIR-PIT demonstrated particularly favorable efficacy for short, thin lesions, suggesting that early introduction of treatment may be associated with improved therapeutic outcomes. A history of reconstructive surgery was associated with reduced post-treatment pain, highlighting the importance of individualized treatment and pain management strategies in head and neck cancer patients undergoing NIR-PIT.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104848"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803403","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":"Effects of different hyrax maxillary expansion protocols compared with novel magnetic expansion on the pharyngeal airway and maxillary sinus spaces: A retrospective CBCT-based observational study","authors":"Ahmed Lotf Algahefi ,&nbsp;Maged S. Alhammadi ,&nbsp;Zhihua Li ,&nbsp;Fei Tong","doi":"10.1016/j.amjoto.2026.104844","DOIUrl":"10.1016/j.amjoto.2026.104844","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate three-dimensional changes in the maxillary sinus (MS) and pharyngeal airway space (PAS) following rapid (RME), slow (SME), and magnetic maxillary expansion (MME) using cone-beam computed tomography (CBCT).</div></div><div><h3>Methods</h3><div>This retrospective observational study included 60 patients (35 males, 25 females; mean age 12.83 ± 0.92 years) with transverse maxillary deficiency, allocated equally to RME, SME, and MME groups (<em>n</em> = 20 each). Expansion was carried out according to protocol-specific activation schedules, with appliances retained for three months post-expansion. CBCT scans were obtained at baseline (T1), post-expansion (T2), and after retention (T3). Measurements of MS volume, area, minimum constriction area, and PAS subdivisions (nasopharynx, oropharynx, hypopharynx) were analyzed using Dolphin Imaging software. An adjusted <em>p</em>-value of &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>All three expansion protocols demonstrated numerical increases in maxillary sinus and pharyngeal airway dimensions during the active expansion phase (T1–T2); however, after adjustment for multiple comparisons, statistically significant changes were limited. Significant within-group increases in maxillary sinus volume were observed only in the slow maxillary expansion group, while no pharyngeal airway parameter showed a statistically significant change after correction. No significant dimensional changes were detected during the retention period (T2-T3). Inter-group comparisons revealed no statistically significant differences among the three expansion protocols.</div></div><div><h3>Conclusion</h3><div>Magnetic maxillary expansion demonstrates anatomical effects comparable to conventional expansion protocols; importantly, no distinct or superior pharyngeal airway benefit was identified, highlighting the limits of airway-related effects of maxillary expansion rather than evidence of enhanced functional respiratory impact.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104844"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803402","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":"Why does sound stimulation not cause dizziness?","authors":"Hiroaki Ichijo,&nbsp;Hisako Ichijo","doi":"10.1016/j.amjoto.2026.104839","DOIUrl":"10.1016/j.amjoto.2026.104839","url":null,"abstract":"<div><h3>Background</h3><div>Sound waves stimulate the saccule. Therefore, sound waves are transmitted from the perilymph to the endolymph, causing the otolithic membrane of the saccule to vibrate and the cilia of the hair cells to move. Nevertheless, dizziness does not occur in response to auditory stimuli. To investigate this mystery, we examined the presence or absence of dizziness and nystagmus when loud sounds were presented to healthy individuals and reconsidered the auditory reception mechanism.</div></div><div><h3>Methods</h3><div>Ten healthy individuals without ear pathology were studied. Stapedial reflex testing was performed on both ears using an impedance audiometer and the occurrence of dizziness and nystagmus was examined.</div></div><div><h3>Results</h3><div>None of the subjects complained of dizziness or showed nystagmus.</div></div><div><h3>Conclusions</h3><div>The saccule does not cause nystagmus or dizziness. Sound waves do not stimulate the lateral semicircular canal, this means that sound waves selectively stimulate the saccule (i.e., no vertical expansion). As an auditory mechanism, we propose the endolymph conduction theory, in which sound waves are transmitted through the ductus reuniens to the endolymph of the cochlear duct and directly bend the cilia of the hair cells. This is more scientific and credible than Bekesy's traveling wave theory.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104839"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759880","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":"Reply to the commentary on “Impact of time-to-surgery on survival and quality of life in oral cancer”","authors":"Giancarlo Tirelli ,&nbsp;Margherita Tofanelli ,&nbsp;Paolo Boscolo-Rizzo","doi":"10.1016/j.amjoto.2026.104801","DOIUrl":"10.1016/j.amjoto.2026.104801","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104801"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321122","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":"Management and graft outcomes of chronic tympanic membrane perforation with isolated malleus cholesteatomas","authors":"Qinghua Wang ,&nbsp;Zhengcai Lou","doi":"10.1016/j.amjoto.2026.104802","DOIUrl":"10.1016/j.amjoto.2026.104802","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to evaluate the graft outcomes of endoscopic cartilage-perichondrium underlay myringoplasty, without raising the tympanomeatal flap, for managing chronic central perforation associated with isolated malleus cholesteatomas.</div></div><div><h3>Materials and methods</h3><div>Twenty-three patients with chronic perforation and isolated malleus cholesteatomas underwent endoscopic cholesteatoma removal followed by cartilage underlay myringoplasty. The graft success rate, hearing improvement, and recurrence of cholesteatoma were assessed at 24 months postoperatively.</div></div><div><h3>Results</h3><div>Intraoperative findings in all 23 patients revealed the accumulation of keratin debris in the superior part of the tympanic membrane perforation around the tip of the malleus handle. Histopathological analysis confirmed the presence of squamous epithelium with keratin debris in all cases. All grafts were successful, and complete closure of the perforations was achieved at the 24-month follow-up. Postoperative pure-tone average air conduction thresholds improved significantly from 56.2 ± 11.6 dB to 43.4 ± 16.6 dB (<em>P</em> &lt; 0.05, paired-sample <em>t</em>-test). Similarly, the air-bone gap (ABG) improved from 35.8 ± 8.2 dB to 19.7 ± 10.5 dB, with a significant difference (<em>P</em> &lt; 0.05, paired-sample t-test). The average ABG gain was 16.1 ± 6.6 dB. No recurrence of cholesteatoma was detected through computed tomography or endoscopic examination during the 24-month follow-up period.</div></div><div><h3>Conclusions</h3><div>Endoscopic removal of malleus cholesteatomas combined with cartilage graft underlay myringoplasty, without raising the tympanomeatal flap, demonstrated a high rate of graft success and significant hearing improvement in patients with chronic perforation and isolated malleus cholesteatoma. No recurrence of cholesteatoma was observed during the two-year follow-up.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104802"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147372077","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":"Comprehensive big database analysis of outcomes and complications of combination endoscopic sinus surgery and septorhinoplasty","authors":"Robert E. Africa ,&nbsp;Scott A. Hardison ,&nbsp;Felix Maldonado-Chapa ,&nbsp;Brian J. McKinnon","doi":"10.1016/j.amjoto.2026.104795","DOIUrl":"10.1016/j.amjoto.2026.104795","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate postoperative outcomes and complications of combination functional endoscopic sinus surgery (FESS) and septorhinoplasty (SRP).</div></div><div><h3>Methods</h3><div>This is a multicenter retrospective database study utilizing data from 106 healthcare organizations in the United States from January 1, 2010 to July 31, 2025. The TriNetX database was used to obtain summary statistics on adult patients aged 18 years or older who underwent combination FESS/SRP, FESS alone, or SRP alone. Postoperative outcomes and complications evaluated in comparing combined FESS/SRP with either procedure alone included epistaxis, mucocele formation, postoperative pain, orbital injury, abscess or infection, revision rhinoplasty, and septal perforation needing repair among others.</div></div><div><h3>Results</h3><div>Compared with FESS alone, combination FESS/SRP showed higher rates of acute postoperative pain and nasal mucocele (RR: 1.25 [1.02–1.52]; 1.33 [1.15–1.53]) but no increased risk of recurrent acute sinusitis or chronic sinusitis (RR: 0.97 [0.89–1.06]; 0.99 [0.97–1.03]). Combination FESS/SRP did not have a higher rate of cerebrospinal fluid (CSF) leak (RR: 0.24 [0.13–0.44), meningitis (0.44 [0.21–0.91]), and orbital injury (0.84 [0.74–0.95]) compared to FESS alone. Compared with SRP alone, combination surgery was associated with more persistent septal deviation (RR: 1.18 [1.10–1.26]) and higher rates of epistaxis and control of epistaxis procedures (RR: 1.85 [1.49–2.29]; 2.00 [1.28–3.12]). Septal perforation repair was not significantly increased with combination surgery (RR: 1.11 [0.60–2.05]), though nasal infection or abscess was more frequent (RR: 1.17 [1.13–1.21]).</div></div><div><h3>Conclusion</h3><div>Combination surgery did not show significant major complications, though rates of epistaxis, nasal congestion, and infection were higher. Differences in complications and outcomes may reflect patient selection, potentially explaining the lower risk of major complications in the combined surgery group. The data from this study does not support combined surgery for complicated sinus disease, as anatomic complexity could not be distinguished.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104795"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146058599","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":"Distribution of adverse pathological features and prognosis across tongue, buccal, gum, and other oral cancer subsites: A nationwide study","authors":"Ming-Hsun Wen ,&nbsp;Dun-Hao Chang ,&nbsp;Hsin-Yi Huang ,&nbsp;Wei-Chien Yang ,&nbsp;Wan-Lun Hsu ,&nbsp;Chun-Ju Chiang ,&nbsp;Wen-Chung Lee ,&nbsp;Li-Jen Liao","doi":"10.1016/j.amjoto.2026.104803","DOIUrl":"10.1016/j.amjoto.2026.104803","url":null,"abstract":"<div><h3>Background</h3><div>Staging of oral squamous cell carcinoma (OSCC) does not account for anatomical subsites. However, these subsites demonstrate considerable pathological heterogeneity and survival differences. Most prior studies have not systematically examined the influence of distinct pathological factors across subsites. Therefore, this study aimed to evaluate the clinical and pathological characteristics, as well as survival outcomes of OSCC across major oral subsites, using a nationwide cancer registry.</div></div><div><h3>Methods</h3><div>A total of 17,118 patients with surgically treated OSCC diagnosed between 2018 and 2022 were identified from the Taiwan Cancer Registry. Pathological factors—including perineural invasion (PNI), lymphovascular invasion (LVI) and extranodal extension (ENE)—were analyzed across four major oral subsites (tongue, buccal mucosa, gum, and others). Multivariable logistic regression was used to assess the associations between pathological factors and subsites. Survival analyses were performed using life table methods with Kaplan–Meier plots and Cox regression analysis to estimate overall survival (OS) and disease-specific survival (DSS).</div></div><div><h3>Results</h3><div>Adverse pathological features—including PNI, LVI, and ENE—showed varied distributions across OSCC subsites. After adjusting for gender, age, and tumor status, tongue cancer was associated with higher odds of adverse pathological factors: OR 1.76 (95% CI: 1.56–1.98) for PNI, OR 1.34 (95% CI: 1.17–1.53) for LVI, and OR 1.21 (95% CI: 1.08–1.35) for ENE. Notably, despite these aggressive pathological features, tongue tumors were associated with superior survival outcomes (5-year OS: 66%, 95% CI: 65–69%) compared to other subsites (5-year OS: 63%, 95% CI: 61–66%).</div></div><div><h3>Conclusions</h3><div>PNI, LVI and ENE status showed distinct distributions among OSCC subsites, highlighting the need for tailored prognostic assessment according to subsites of OSCC and individualized management strategies.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104803"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147421675","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":"Marked enhancement of bone conduction subsequent to TORP implantation following oval window reinforcement: A case report and comprehensive narrative review","authors":"Ying Li ,&nbsp;Gang Luo","doi":"10.1016/j.amjoto.2026.104806","DOIUrl":"10.1016/j.amjoto.2026.104806","url":null,"abstract":"<div><h3>Objective</h3><div>To report a rare case of a marked improvement in bone conduction (BC) thresholds following the reinforcement of the oval window (OW) prior to the implantation of a total ossicular replacement prosthesis (TORP).</div></div><div><h3>Methods</h3><div>A clinical case involving OW reinforcement followed by TORP implantation was retrospectively analyzed, with pre- and postoperative pure tone averages (PTA) at four frequencies for BC and air conduction (AC) measured and compared.</div></div><div><h3>Results</h3><div>The bone conduction PTA across four frequencies improved significantly from 62 dB preoperatively to 16 dB postoperatively in the patient's only hearing ear, which had previously experienced acute hearing loss and was affected by cholesteatoma. Concurrently, the AC PTA also improved, decreasing from 76 dB to 33 dB.</div></div><div><h3>Conclusion</h3><div>In patients presenting with benign middle ear lesions that result in destruction of the stapes footplate and concomitant reduction in BC, it is essential to first exclude sensorineural etiologies, including labyrinthitis and auditory neuropathy. Subsequently, consideration should be given to reinforcing the OW utilizing autologous cartilage.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104806"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147448563","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":"Stopping the flow: Tranexamic acid as an adjunct to anterior epistaxis management – An invited commentary","authors":"Richa S. Nathan ,&nbsp;Michael Setzen","doi":"10.1016/j.amjoto.2026.104796","DOIUrl":"10.1016/j.amjoto.2026.104796","url":null,"abstract":"<div><div>Anterior epistaxis is one of the most common emergencies encountered by otolaryngologists and is usually managed with anterior nasal pressure, topical vasoconstrictors, anesthetics, cautery, and nasal packing. While traditional methods are often effective, they can cause discomfort and can result in recurrent bleeding and repeat emergency department visits. Tranexamic acid (TXA) is a synthetic lysine analog developed in the 1960s as an antifibrinolytic agent and has become an emerging adjunct in the acute management of epistaxis. By inhibiting fibrinolysis locally at the bleeding site, topical TXA offers rapid hemostasis without the discomfort and complications of traditional packing.</div><div>Evidence from randomized controlled trials and meta-analyses shows that topical TXA improves acute bleeding control, reduces rebleeding, and shortens emergency department stays compared to packing, especially in patients on antiplatelet or anticoagulant therapy. TXA preparations typically include 500 mg in 5 mL applied to a pledget or sponge and put in place for 10–15 min before reassessment of bleeding. Advantages include improved patient comfort, reduced need for follow-up removal, and minimal systemic absorption. Precautions include avoidance in patients with active thromboembolic disease, though safety data are favorable overall.</div><div>The implementation of topical TXA in clinical protocols demonstrates a movement toward less invasive evidence-based treatments which provide better patient outcomes without compromising effectiveness. The emergency care team along with otolaryngologists can use TXA as a safe and effective treatment for epistaxis management. Incorporating TXA into treatment protocols has the potential to reduce the need for packing and follow-up visits.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104796"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146123474","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":"Can microbial profiles influence type II inflammation in chronic rhinosinusitis with nasal polyps?","authors":"Gaia Vertillo Aluisio ,&nbsp;Maria Santagati ,&nbsp;Giovanna Stilo ,&nbsp;Mario Lentini ,&nbsp;Leigh J. Sowerby ,&nbsp;Miguel Mayo-Yáñez ,&nbsp;Ahmad R. Sedaghat ,&nbsp;Jerome R. Lechien ,&nbsp;Stefania Stefani ,&nbsp;Igo La Mantia ,&nbsp;Antonino Maniaci","doi":"10.1016/j.amjoto.2026.104786","DOIUrl":"10.1016/j.amjoto.2026.104786","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess how different treatments – dupilumab vs surgery - influence the nasal microbiota, type 2 inflammation, and clinical outcomes in CRSwNP patients.</div></div><div><h3>Methods</h3><div>This was a prospective observational study of 44 CRSwNP patients assigned to 6 months of biweekly dupilumab injections or functional endoscopic sinus surgery (FESS). Nasal microbiotas were analyzed at baseline and 6 months using culture techniques. Inflammatory biomarkers (IgE, eosinophils) and clinical endpoints (polyp score, SNOT-22, smell test) were measured. Patients were also stratified into groups based on which bacteria were cultured from their sinuses.</div></div><div><h3>Results</h3><div>At baseline, the most prevalent bacteria were <em>Staphylococcus aureus</em> (43%), <em>Stapylococcus epidermidis</em> (36%), and <em>Pseudomonas aeruginosa</em> (16%). After 6 months, <em>S. aureus</em> and <em>S. epidermidis</em> significantly increased while <em>P. aeruginosa</em> decreased. Eosinophil counts were stable. IgE levels notably decreased in the <em>S. aureus</em> and <em>S. epidermidis</em> groups but increased with <em>P. aeruginosa</em>. All bacterial groups showed reduced polyp score and SNOT-22, and improved smell, but <em>P. aeruginosa</em> had smaller gains. Higher baseline <em>S. aureus</em> and <em>S. epidermidis</em> correlated with more significant IgE decrease.</div></div><div><h3>Conclusions</h3><div>Dupilumab and surgery-induced favourable microbiota changes by reducing pathogenic bacteria. Nasal microbiota composition may be associated inflammatory and clinical treatment responses in CRSwNP. <em>S. aureus</em> and <em>S. epidermidis</em> correlated with a greater improvement of IgE levels, whereas <em>P. aeruginosa</em> correlated with worse IgE outcomes. Analyzing each patient's nasal microbiome could enable more personalized, microbiome-directed treatment approaches for optimal CRSwNP management.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 2","pages":"Article 104786"},"PeriodicalIF":1.7,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103622","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}