American Journal of Otolaryngology最新文献

{"title":"Machine learning developed regulatory T cells-related signature for prognosis and immunotherapy benefit in oral squamous cell carcinoma","authors":"Azhu Duan ,&nbsp;Yicai Zheng ,&nbsp;Guoxiu Xiao","doi":"10.1016/j.amjoto.2025.104670","DOIUrl":"10.1016/j.amjoto.2025.104670","url":null,"abstract":"<div><h3>Background</h3><div>Oral squamous cell carcinoma (OSCC) is one of the most common malignancies with poor clinical outcome. Regulatory T cells (Tregs) have a dual role in maintaining immune homeostasis and suppressing anti-tumor immunity. The role of Tregs related genes (TRGs) in the prognosis of OSCC patients were rarely been reported.</div></div><div><h3>Methods</h3><div>Integrative analysis procedure containing 10 machine learning methods was used to develop a Tregs related gene signature (TRS) using datasets from TCGA, GSE41613, GSE65858, and GSE117973 cohort. Several predicting scores were used to investigate the performance of TRS in predicting immunotherapy benefit. The biological function of TNFAIP3 was explored by in vitro assay.</div></div><div><h3>Results</h3><div>The prognostic signature constructed using the LASSO algorithm was identified as the optimal TRS with the highest average C-index of 0.78. TRS served as a prognostic biomarker, with low TRS score correlating with favorable clinical outcome. Specifically, in TCGA dataset, the 1-, 3-, and 5-year AUC values were 0.796, 0.838 and 0.812, respectively. OSCC with low TRS score exhibited higher levels of immune-activated cells and immune-related functions, including CD8⁺ T, macrophage M1, and cytolytic activity. Low TRS indicated higher PD1&amp;CTLA4 immunophenoscores, higher TMB, higher MSI, lower tumor immune dysfunction and exclusion score, decreased immune escape score, and lower intratumor heterogeneity scores. Additionally, OSCC cases with high TRS score showed elevated cancer-related hallmark score. Knock-down of TNFAIP3 inhibited OSCC cell proliferation.</div></div><div><h3>Conclusion</h3><div>This research established an optimal TRS for OSCC, which functions as a valuable indicator for forecasting clinical outcomes and assessing potential benefits from immunotherapy.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104670"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106506","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":"Exploring surgical outcomes in endoscopic repair of type 1 laryngeal clefts (LC-1) and deep interarytenoid notches (DIN)","authors":"Brooke Swain ,&nbsp;Niketna Vivek ,&nbsp;Oliver Sihua Zhao ,&nbsp;Kalpnaben Patel ,&nbsp;Heidi Chen ,&nbsp;Lyndy Jane Wilcox","doi":"10.1016/j.amjoto.2025.104658","DOIUrl":"10.1016/j.amjoto.2025.104658","url":null,"abstract":"<div><div>The authors conducted a retrospective chart review evaluating the predictors of success for endoscopic repair of type 1 laryngeal clefts (LC-1) or deep interarytenoid notches (DIN). Demographics, birth history, medical comorbidities, surgical details, feeding history, and swallow function were collected (n = 52). Repair success was defined as improvement on videofluoroscopic swallowing study (VFSS) when initially evaluating the procedure's success (n = 36) and patient-reported symptom improvement when assessing predictive factors (n = 48). McNemar or McNemar-Bowker tests evaluated VFSS-assessed symptom improvement. Patients with post-operative symptom documentation were categorized based on predictors in outcome and assessed for post-operative improvement using the Pearson Chi-square test. Postoperatively, 58 % of patients with VFSS-identified aspiration had resolution. Dysphagia severity decreased (p = 0.009) with no severe cases post-repair. Furthermore, pregnancy complications, preterm birth, NICU stay, prior airway and feeding interventions, and syndromes were not significantly correlated with outcomes. However, trends in data suggest that preterm birth and NICU stay are more common in unsuccessful repairs. Overall, operative intervention significantly reduced aspiration and dysphagia severity.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104658"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143907988","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":"Gender differences in the management of pediatric orbital cellulitis","authors":"Tyler Wanstreet,&nbsp;Amani Kais,&nbsp;Chadi A. Makary,&nbsp;Ruifeng Cui,&nbsp;Hassan H. Ramadan","doi":"10.1016/j.amjoto.2025.104661","DOIUrl":"10.1016/j.amjoto.2025.104661","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this study is to investigate gender differences in the disease severity and management of orbital infections in children hospitalized for treatment.</div></div><div><h3>Methods</h3><div>Retrospective cohort study of all children aged 0 to 18 years who had a confirmed diagnosis of preseptal or postseptal cellulitis and were hospitalized over a 15-year period.</div></div><div><h3>Results</h3><div>The sample consisted of 124 children, 52.4 % male, with mean age of 7.1 years (SD = 4.88, range = 4.9–18) and a relatively equal distribution between preseptal (52.4 %) and postseptal (47.6 %) cellulitis. Although males and females did not differ in rates of preseptal and postseptal cellulitis and Lund-Mackay scores (p &gt; 0.05 for all), males were more likely to undergo surgical management (21.5 % vs 8.5 %; p = 0.049).</div></div><div><h3>Conclusion</h3><div>Additional research is needed to understand why the management of cellulitis differs between male and female pediatric patients and how it may affect treatment outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104661"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949068","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":"Pain management after pediatric adenotonsillectomy: Do opioids influence healthcare utilization?","authors":"Tae Ho Koh ,&nbsp;Amy S. Whigham","doi":"10.1016/j.amjoto.2025.104657","DOIUrl":"10.1016/j.amjoto.2025.104657","url":null,"abstract":"<div><h3>Introduction</h3><div>Adenotonsillectomy (AT) is one of the most common outpatient pediatric surgical procedures in the United States. Due to the risks of opioids, guidelines recommend multimodal pain regimens. This study aims to assess differences in healthcare utilization in pediatric postoperative AT patients by postoperative medication regimen.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 699 patients aged 3–18 years who underwent AT from December 2015 to March 2017 was analyzed. Patients were stratified into young children (3–4 years), children (5–12 years), and adolescents (≥13 years). Non opioid regimens of acetaminophen and ibuprofen were recommended for all. Some patients also received an opioid prescription. Total calls made, calls made regarding pain/dehydration (P/D), and ED visits were recorded.</div></div><div><h3>Results</h3><div>There was no significant correlation between opioid prescriptions and calls nor ED visits for P/D in patients ≥5 years. In young children, non-opioid prescriptions were associated with a higher likelihood of any phone call (<em>p</em> = 0.049). White patients had a significantly higher rate of phone calls (<em>p</em> = 0.0183). White and unknown-race patients made significantly more calls (<em>p</em> &lt; 0.001) related to P/D. No racial differences were observed in ED visits.</div></div><div><h3>Conclusion</h3><div>Limiting opioid prescriptions in pediatric AT patients does not appear to impact healthcare utilization. However, in young children, opioid use correlated with fewer phone calls, though not specifically related to P/D. Future prospective studies documenting pain scores and medication administration would more accurately explore the optimization of pain control in pediatric patients after AT.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104657"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143949069","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 myringoplasty techniques for eardrum perforations","authors":"Chappel Pettit,&nbsp;Shelby Barrera,&nbsp;Boris Kuyeb,&nbsp;Joshua Stanford,&nbsp;Oishika Paul,&nbsp;Jeffrey Carron","doi":"10.1016/j.amjoto.2025.104662","DOIUrl":"10.1016/j.amjoto.2025.104662","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective study aims to analyze and compare the surgical outcomes and efficacy of different myringoplasty techniques, specifically focusing on Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft. The objective is to provide insights into the success rates and associated factors for each method in pediatric patients undergoing myringoplasty.</div></div><div><h3>Materials and methods</h3><div>The study included patients under 18 years who underwent myringoplasty between 2014 and 2022. Data was collected on patient demographics, perforation size and location, etiology, age at myringoplasty, technique used, operative time, and postoperative outcomes.</div></div><div><h3>Results</h3><div>Out of 561 myringoplasties, 325 met study criteria with an average age of 7 years. Gelfoam overlay (39 %), Gelfoam-stuffed (51 %), and fat graft (10 %) were the techniques analyzed. Overall, 96.3 % of cases were successful, with no significant differences among the three techniques. Postoperatively, 17.7 % had perforation, 13.8 % had otorrhea, and 2.1 % required additional surgery. Fat grafts associated with significantly longer operative times and were more likely to be done for persistent perforations rather than retained ear tubes.</div></div><div><h3>Conclusion</h3><div>This study demonstrates comparable efficacy among Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft myringoplasty techniques in pediatric patients. While surgical time differed, there were no clinically significant variations in postoperative outcomes. Despite limitations, these findings suggest that all three techniques are viable options, allowing otolaryngologists flexibility in choosing myringoplasty methods based on patient characteristics and clinical considerations.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104662"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943425","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":"A short-term longitudinal study of vocal development in young children with simultaneous bilateral cochlear implants","authors":"Youngmee Lee ,&nbsp;Yesol Jeon","doi":"10.1016/j.amjoto.2025.104648","DOIUrl":"10.1016/j.amjoto.2025.104648","url":null,"abstract":"<div><h3>Objectives/hypothesis</h3><div>Vocal development is crucial for children's speech and language acquisition, allowing them to produce sounds, form words, and construct sentences for verbal communication. This study examined the vocal development trajectory in children who received early simultaneous bilateral cochlear implants (CIs) and compared it to age-matched children with typical hearing (TH).</div></div><div><h3>Study design</h3><div>Case-control study design.</div></div><div><h3>Methods</h3><div>Participants included nine children who received simultaneous bilateral CIs between 7 and 20 months of age and eight age-matched children with TH. Parent-child play interactions were video- and audio-recorded at 6-month intervals. Child vocalizations were categorized into four categories: noncanonical babbling, canonical babbling, words, and sentences. Developmental trajectories and group differences were analyzed over three points: initial visit, 6 months, and 12 months after the initial visit (mean age at the first session: 19.76 months; standard deviation: 4.89; range: 12–28 months).</div></div><div><h3>Results</h3><div>Both groups showed an increase in total vocalizations and advanced forms over 1 year. However, the CI group produced a significantly lower proportion of words and sentences and a higher proportion of noncanonical babbling than the TH group.</div></div><div><h3>Conclusions</h3><div>Although children with early-identified hearing loss and simultaneous bilateral CIs make significant progress in vocal development, their vocal milestones remain delayed compared to those of their peers with TH. These children do not fully catch up in vocal development within 1 to 2 years of bilateral CI use. These findings highlight the need for targeted support and early intervention for children with CIs and their parents.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104648"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943424","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":"Laryngeal mask airway in pediatric tonsillectomy and adenoidectomy: a large cohort analysis","authors":"Travis Peng ,&nbsp;Matthew I. Saleem ,&nbsp;Michelle S. Kars ,&nbsp;Lee P. Smith","doi":"10.1016/j.amjoto.2025.104641","DOIUrl":"10.1016/j.amjoto.2025.104641","url":null,"abstract":"<div><div>Tonsillectomy and/or adenoidectomy are often performed with endotracheal intubation (ETT), however use of laryngeal mask airway (LMA) may offer decreased airway irritation. We investigated the laryngospasm rate and conversion rate of LMA use in a total of 1585 retrospective cases of tonsillectomies and/or adenoidectomies, the largest single center cohort to date. We found a low complication rate of 0.19 % and no significant clinical complications. Our study provides data on the safety and efficacy of LMA use in these surgeries and supports the potential use of LMA in cases without significant blood loss.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104641"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916553","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":"Olfactory and gustatory impairment in systemic cardiac amyloidosis: a prospective case-control study","authors":"Clémentine Hyvrard ,&nbsp;Maxime Fieux ,&nbsp;Thibaud Damy ,&nbsp;Marina Dockes ,&nbsp;Marion Renaud ,&nbsp;Julien Lucas ,&nbsp;Axelle Coban ,&nbsp;Margaux Petitjean ,&nbsp;Nisrine Khemies ,&nbsp;Florence Canouï-Poitrine ,&nbsp;Imene Nouri ,&nbsp;Mounira Kharoubi ,&nbsp;André Coste ,&nbsp;Emilie Bequignon ,&nbsp;Sophie Bartier","doi":"10.1016/j.amjoto.2025.104665","DOIUrl":"10.1016/j.amjoto.2025.104665","url":null,"abstract":"<div><h3>Purpose</h3><div>Amyloidosis is a multi-systemic disease with a poor prognosis. We hypothesized that amyloid proteins could deposit along the olfactory and gustatory systems and cause olfactory and gustatory impairment. The objective was to assess the prevalence of olfactory and gustatory disorders in a population of patients diagnosed with cardiac amyloidosis (CA).</div></div><div><h3>Methods</h3><div>CA patients from three amyloid subtypes (hereditary or wild-type transthyretin (ATTRv and ATTRwt) and light chain (AL)) and a control group of patients with chronic non-amyloidotic heart failure were enrolled prospectively in this case-control study. Nasal endoscopy, olfactory and gustatory questionnaires, “shortened Sniffin’ Sticks” test (sSST) and Taste Band Strips test were performed.</div></div><div><h3>Results</h3><div>Thirty-eight CA patients (mean age of 80.8 +/− 8.6 years; 65.8 % males) and 13 control patients (mean age of 63.2 +/− 16.4 years; 53.8 % males) were included. The mean total score on the sSST for CA patients was significantly lower than that of the control group (15.4±6.2 vs 20.3 +/− 5.3, respectively, <em>p</em> = 0.02). Five out of 38 (13.1 %) CA patients were complaining of dysosmia compared to 3/13 (23.1 %) patients in the control group. Taste impairment was noted in 24/37 (64.9 %) CA patients vs 6/12 (50 %) patients in the control group (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study comparing olfactory function of CA patients to chronic non-amyloidotic heart failure patients found that CA patients had significantly more olfactory impairments. Olfactory impairments could therefore be a new “red flag” that may help in early diagnosis and treatment of CA.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104665"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898701","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":"Refining necrotising otitis externa management: A follow-up study on a departmental algorithm and the role of nuclear medicine imaging","authors":"A.H. Haleem ,&nbsp;S. Shahidi ,&nbsp;J.M. Hilton ,&nbsp;M. Pringle ,&nbsp;T.C. Biggs ,&nbsp;J. Buckland","doi":"10.1016/j.amjoto.2025.104659","DOIUrl":"10.1016/j.amjoto.2025.104659","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the effectiveness of a departmental diagnostic and treatment algorithm for necrotising otitis externa (NOE), with a particular focus on the role of nuclear medicine imaging in improving diagnostic accuracy and patient outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted on patients admitted with suspected NOE to a major UK general hospital over a two-year period. Clinical presentation, imaging modalities, and treatment outcomes were reviewed to assess the algorithm's impact, with a focus on the diagnostic yield of CT, Technetium scans, and MRI, as well as treatment success rates and recurrence.</div></div><div><h3>Results</h3><div>Among 33 patients (mean age: 77 years), 28 were diagnosed with necrotising otitis externa (NOE). Diabetes was present in 41 %, and <em>Pseudomonas aeruginosa</em> was identified in 70 % of cases.</div><div>CT confirmed NOE in 21 patients (64 %), including two with skull base erosion. Among 12 patients with negative CT findings, 9 underwent Technetium bone scintigraphy, with 5 (56 %) yielding positive results. Two patients underwent MRI, confirming NOE in one case. One patient was diagnosed clinically. Overall, 6 of 12 patients (50 %) with negative CT results were ultimately diagnosed with NOE following further imaging.</div><div>All 28 diagnosed patients received prolonged intravenous or oral antibiotic therapy based on microbiological sensitivity. Of these, 24 had follow-up (mean: 5.6 weeks), with clinical resolution observed in 20 patients (83 %). Additional imaging was performed in 13 cases, including MRI (<em>n</em> = 4), CT (<em>n</em> = 5), Gallium scan (<em>n</em> = 1), PET-CT (n = 1), and combined CT/MRI (<em>n</em> = 2), primarily for persistent symptoms. Four patients were diagnosed with alternative conditions, including canal cholesteatoma and squamous cell carcinoma.</div><div>Overall, the cure rate within the cohort was 83 %, with no NOE recurrences or NOE-related mortality recorded during the follow-up period.</div></div><div><h3>Conclusion</h3><div>This study validates the efficacy of the department's updated NOE diagnostic and treatment algorithm, reinforcing the utility of technetium bone scans in cases where CT results are inconclusive. Findings highlight the importance of combining advanced imaging with clinical assessment for optimal NOE management, ensuring high-resolution rates and preventing unnecessary interventions.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104659"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917422","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":"Lymph node ratio as an independent prognostic factor in cN0 floor of mouth squamous cell carcinoma: A single-institution retrospective cohort analysis","authors":"Duy Quoc Ngo ,&nbsp;Thang Manh Hoang ,&nbsp;Trong Van Nguyen ,&nbsp;Quy Xuan Ngo","doi":"10.1016/j.amjoto.2025.104644","DOIUrl":"10.1016/j.amjoto.2025.104644","url":null,"abstract":"<div><h3>Background</h3><div>To analyze the influence of lymph node ratio (LNR) in survival of clinically node-negative (cN0) patients with floor of mouth squamous cell carcinoma (FMSCC).</div></div><div><h3>Materials and methods</h3><div>Clinicopathologic data from 48 patients with cN0 FMSCC who underwent curative surgery and selective neck dissection from 2015 to 2020 was retrospectively assessed. The impact of LNR and other variables on overall survival (OS) and disease-free survival (DFS) was analyzed in univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Occult nodal metastases were identified in 11 patients (22.9 %). The mean lymph node yield was 13.94 ± 7.11 nodes. ROC curve analysis identified an optimal LNR threshold of 0.034, with an area under the curve of 0.691 (<em>p</em> = 0.03). In the multivariate analysis, LNR was an independent prognostic factor for both OS (HR 9.018, 95 % CI 3.214–25.306, <em>p</em> &lt; 0.001) and DFS (OR 12.889, 95 % CI 2.426–68.473, <em>p</em> = 0.002). Patients with LNR &gt;0.034 demonstrated significantly inferior 5-year OS rates (26.7 % versus 89.1 %).</div></div><div><h3>Conclusions</h3><div>The LNR is an independent prognostic factor in cN0 FMSCC patients. An LNR threshold of 0.034 effectively stratifies risk and may guide adjuvant therapy decisions.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104644"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902244","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}