American Journal of Otolaryngology最新文献

{"title":"Risk factors for tonsillar hypertrophy and post-transplant lymphoproliferative disorder","authors":"Ross Rosen ,&nbsp;Jamil Hayden ,&nbsp;Jenna Rock ,&nbsp;Alexandra Welschmeyer ,&nbsp;Chelsea Cleveland ,&nbsp;Todd Otteson","doi":"10.1016/j.amjoto.2025.104756","DOIUrl":"10.1016/j.amjoto.2025.104756","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-transplant lymphoproliferative disorder (PTLD) is a rare complication of immunosuppression in solid organ transplant patients. Tonsillar hypertrophy commonly results from PTLD, and tonsillectomy is usually performed when PTLD is the suspected cause. Risk factors for PTLD-mediated tonsillar hypertrophy remain poorly defined. This study aimed to identify clinical and therapeutic factors associated with tonsillar hypertrophy following PTLD diagnosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective cohort study using the TriNetX Database. Pediatric solid organ transplant recipients were queried for tonsil disease, tonsillectomy, PTLD diagnosis, transplant history, and immunosuppressants using the associated Current Procedural Terminology, International Classification of Diseases, and RxNorm codes.</div></div><div><h3>Results</h3><div>We identified 21,582 children with a history of solid organ transplant. Tonsil disease was found in 1833 (8.49 %), and of these patients, 193 (10.53 %) were diagnosed with PTLD within six months. Immunosuppressants associated with higher rates of tonsil disease were tacrolimus (OR 2.74, 95 % CI 2.29–3.28), mycophenolate mofetil (OR 2.72, 95 % CI 2.29–3.24), and cyclosporine (OR 1.50, 95 % CI 1.08–2.10). Sirolimus was associated with lower rates (OR 0.66, 95 % CI 0.52–0.83). EBV diagnosis was associated with both higher rates of tonsil disease (OR 1.45, 95 % CI 1.21–1.72) and PTLD diagnosis (OR 3.52, 95 % CI 2.14–5.77).</div></div><div><h3>Discussion</h3><div>This is the largest study on tonsillar hypertrophy in PTLD and the first to identify tacrolimus, mycophenolate mofetil, and cyclosporine as significant risk factors for tonsil disease amongst pediatric transplant patients. Understanding risk factors that may predispose a patient to PTLD-mediated tonsil disease can guide decision making to help avoid this complication of immunosuppression.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104756"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676153","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":"Continuous positive airway pressure vs palatal surgery: Outcomes in obstructive sleep apnea treatment","authors":"Alec Kadrie ,&nbsp;Jonathan Laredo ,&nbsp;Evan Thomson ,&nbsp;M. Boyd Gillespie","doi":"10.1016/j.amjoto.2025.104776","DOIUrl":"10.1016/j.amjoto.2025.104776","url":null,"abstract":"<div><h3>Objective</h3><div>To compare short- and long-term clinical outcomes of continuous positive airway pressure versus palatal surgical interventions such as uvulopalatopharyngoplasty, including their impacts on sleep apnea-related cardiac, respiratory, and metabolic comorbidities.</div></div><div><h3>Study design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Database study using the TriNetX Network of Tennessee (2014–2024).</div></div><div><h3>Methods</h3><div>Adult patients diagnosed with obstructive sleep apnea and treated with either continuous positive airway pressure or palatal surgery were identified. Propensity score matching was performed to balance demographics and preexisting comorbidities between groups. Primary outcomes were cardiopulmonary events, and secondary outcomes were new-onset type 2 diabetes and weight change. Odds ratio with 95 % confidence intervals were computed across outcome measures.</div></div><div><h3>Results</h3><div>A total of 5030 continuous positive airway pressure and 220 palatal surgery patients met inclusion criteria. Following matching, 220 patients remained in each group. Patients treated with continuous positive airway pressure had significantly higher odds of post-treatment electronic medical record coding of acute respiratory failure (OR 4.67, [2.27, 9.60]), pulmonary hypertension (OR 20.0, [2.71, 147.7]), and new-onset atrial fibrillation/flutter (OR 3.32, [1.60, 6.96]) compared to the surgical cohort. No significant differences were observed in myocardial infarction, stroke, or new-onset type 2 diabetes.</div></div><div><h3>Conclusion</h3><div>Patients treated with continuous positive airway pressure had higher odds of post-treatment electronic medical recording coding of cardiorespiratory complications than those undergoing palatal surgery. These findings highlight potentially important differences between treatment modalities in long-term obstructive sleep apnea related comorbidities.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104776"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145691265","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":"Headache resolution following the middle fossa repair of superior semicircular canal dehiscence","authors":"Layla Ali ,&nbsp;Adam Ali ,&nbsp;Samuel Salib ,&nbsp;Niloufar S. Tehrani ,&nbsp;Hong-Ho Yang ,&nbsp;Khashayar Mozaffari ,&nbsp;Quinton Gopen","doi":"10.1016/j.amjoto.2025.104752","DOIUrl":"10.1016/j.amjoto.2025.104752","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate predictors of headache resolution following surgical intervention for superior semicircular canal dehiscence (SSCD) syndrome.</div></div><div><h3>Method</h3><div>We conducted a retrospective chart review on 344 surgical repairs of SSCD via the middle cranial fossa (MCF) approach conducted at an institution. The primary outcome measure was the resolution of headaches after SSCD repair. Analyses explored the predictive potential of several comorbidities and lifestyle factors pre-operatively.</div></div><div><h3>Results</h3><div>Among a total of 344 repairs, 193 (56 %) reported headaches preoperatively. Among which, 114 (59 %) experienced headache resolution following surgery. Compared to patients without a history of general anxiety disorder (GAD), patients with GAD reported a 65 % lower odds of headache resolution following surgery (aOR 0.35, 95 % CI [0.14, 0.91]). Compared to patients without hypertension (HTN), patients with HTN were significantly more likely to experience headache resolution following surgery (aOR 4.65, [1.19, 18.22]).</div></div><div><h3>Conclusion</h3><div>A substantial portion of patients with headaches experienced resolution following SSCD repair (∼60 %). Patients with GAD were less likely to experience headache resolution following SSCD repair, whereas patients with HTN were more likely to experience headache resolution.</div><div>Level of Evidence: Level IV</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104752"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145754740","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":"Treatment preferences and values in chronic tinnitus patients: A cross-sectional survey study","authors":"Jeon Mi Lee ,&nbsp;Hyun Jung Kim ,&nbsp;Yong-Hwi An ,&nbsp;Ah. Rang Cho ,&nbsp;Jae Ho Chung ,&nbsp;Jae Sang Han ,&nbsp;Woojae Han ,&nbsp;Da Jung Jung ,&nbsp;Jung-Yup Lee ,&nbsp;Euyhyun Park ,&nbsp;Kyu-Yup Lee ,&nbsp;Ho Yun Lee","doi":"10.1016/j.amjoto.2026.104790","DOIUrl":"10.1016/j.amjoto.2026.104790","url":null,"abstract":"<div><h3>Purpose</h3><div>Tinnitus is a common condition that can severely impact patients' quality of life. However, little is known about how individuals with chronic tinnitus evaluate and prioritize available treatment options. This study aimed to explore the preferences, values and expectations of patients with chronic tinnitus to inform more patient-centered strategies in clinical care.</div></div><div><h3>Material and methods</h3><div>A cross-sectional survey was conducted from May 8 to June 19, 2025, involving 45 patients with chronic tinnitus. A structured 36-item questionnaire assessed demographic information, tinnitus severity using the Tinnitus Handicap Inventory (THI) and the Visual Analog Scale (VAS), treatment preferences across 16 key questions, perceived information needs, and impact on daily functioning.</div></div><div><h3>Results</h3><div>Participants (mean age 50.7 ± 14.8 years, 62.2% male, median tinnitus duration 12 months) showed strong preferences for non-invasive treatments: sound therapy (73.4%), tinnitus retraining therapy (TRT; 55.6%), and cognitive behavioral therapy (CBT; 44.4%). Pharmaceutical interventions had lower acceptance, with hearing aids showing highest rejection (33.3%). Key concerns included drug dependency (48.9%) and psychiatric medication stigma (28.9%). 51.1% of respondents expected complete symptom resolution despite limited evidence. Information needs were high across all modalities (40–50%). Sleep disorders (THI difference: 12.9 points) and anxiety (6.5 points) significantly associated with increased tinnitus severity.</div></div><div><h3>Conclusions</h3><div>Tinnitus patients strongly prefer non-invasive treatments while harboring unrealistic expectations for cure. These findings underscore the importance of structured education and shared decision-making to align clinical care with patient values and promote more effective tinnitus management.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104790"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973015","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 clinical shift toward personalized cochlear implantation: Using preoperative planning to optimize insertion depth","authors":"Benjamin Bircher ,&nbsp;Philipp Aebischer ,&nbsp;Wilhelm Wimmer ,&nbsp;Georgios Mantokoudis ,&nbsp;Stephan Schraivogel ,&nbsp;Marco Caversaccio ,&nbsp;Stefan Weder","doi":"10.1016/j.amjoto.2025.104777","DOIUrl":"10.1016/j.amjoto.2025.104777","url":null,"abstract":"<div><h3>Objective:</h3><div>To evaluate the clinical implementation of preoperative, anatomy-tailored planning for electrode selection in cochlear implantation, quantify planning accuracy under routine conditions, and identify factors associated with deviations from the planned angular insertion depth (AID).</div></div><div><h3>Methods:</h3><div>We retrospectively analyzed 71 consecutive implantations; 17 cases were excluded due to unsuccessful segmentation/fusion, yielding 54 implanted ears. Before 2023 (Group A, <span><math><mrow><mi>n</mi><mo>=</mo><mn>32</mn></mrow></math></span>), electrode choice followed surgeon preference independent of cochlear duct length (CDL). From 2023 (Group B, <span><math><mrow><mi>n</mi><mo>=</mo><mn>22</mn></mrow></math></span>), automated OTOPLAN-based planning targeted an AID of 600° (cap 650°). Pre- and postoperative computed tomography scans provided cochlear metrics and postoperative AID. Planning accuracy was defined as the difference between planned and achieved AID. Linear models assessed demographic/clinical, anatomical, and surgical predictors. Speech outcomes at 6 months used Freiburger monosyllables at 65 dB HL.</div></div><div><h3>Results:</h3><div>Group B showed deeper and more consistent insertions (median AID 568° [IQR 62°]) than Group A (527° [IQR 99°]; <span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>01</mn></mrow></math></span>). Median planning deviation was <span><math><mrow><mo>−</mo><msup><mrow><mn>9</mn></mrow><mrow><mo>∘</mo></mrow></msup></mrow></math></span> (IQR 78°) with no relationship to planned depth ( <span><math><mrow><msup><mrow><mi>R</mi></mrow><mrow><mn>2</mn></mrow></msup><mo>=</mo><mn>0</mn><mo>.</mo><mn>008</mn></mrow></math></span>, <span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>514</mn></mrow></math></span>). Greater inaccuracies were found in patients with shorter CDL (<span><math><mrow><mi>p</mi><mo>=</mo><mn>0</mn><mo>.</mo><mn>001</mn></mrow></math></span>) and in cases with observed intraoperative resistance (<span><math><mrow><mi>p</mi><mo>&lt;</mo><mn>0</mn><mo>.</mo><mn>001</mn></mrow></math></span>).</div></div><div><h3>Conclusion:</h3><div>cochlear anatomy exhibited substantial inter-individual variability. Implementing preoperative, anatomy-tailored planning was associated with the selection of longer arrays, deeper and more consistent AID, and overall high planning accuracy. Deviations from the planned position were primarily linked to shorter CDL and intraoperative resistance, whereas deeper targets themselves did not reduce accuracy. Audiological performance at 6 months did not differ significantly between groups, although a modest trend favored the planned cohort. These findings support the feasibility of routine, examiner-independent planning and suggest that patient-specific anatomical markers should inform the selection of an appropriate electrode array.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104777"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145910005","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":"Stapokibart (CM310): A review in seasonal allergic rhinitis","authors":"Ping Xue ,&nbsp;Jing Yan ,&nbsp;Jianwei Li","doi":"10.1016/j.amjoto.2025.104765","DOIUrl":"10.1016/j.amjoto.2025.104765","url":null,"abstract":"<div><h3>Background</h3><div>Stapokibart (CM310), a humanized anti-IL-4Rα monoclonal antibody, blocks IL-4/IL-13 signaling for type 2 inflammatory diseases like seasonal allergic rhinitis (SAR), where standard of care often fails.</div></div><div><h3>Objective</h3><div>Assess stapokibart's efficacy on the primary endpoint (reflective Total Nasal Symptom Score, rTNSS) and safety as add-on therapy in SoC-inadequate moderate-to-severe SAR.</div></div><div><h3>Methods</h3><div>Data from a Phase II trial (MERAK, <em>n</em> = 92) and the pivotal Phase III PHECDA trial (<em>n</em> = 108; enriched for blood eosinophils ≥300 cells/μL) were reviewed. Patients received subcutaneous stapokibart (600 mg loading, then 300 mg Q2W) or placebo + SoC for 4 weeks.</div></div><div><h3>Results</h3><div>In MERAK, stapokibart Q2W showed a trend for rTNSS improvement (LSMD -1.0 vs placebo, <em>p</em> = 0.065). In PHECDA, stapokibart significantly improved rTNSS at Week 4 (LSMD -1.7, 95 % CI: −2.5, −0.8; <em>p</em> = 0.0002). Treatment-emergent adverse event rates were comparable to placebo in both trials (e.g., PHECDA: 52.0 % vs 46.6 %), mostly mild/moderate.</div></div><div><h3>Conclusion</h3><div>Add-on stapokibart is a valuable therapeutic option for adults with SoC-inadequate moderate-to-severe SAR and elevated eosinophils, providing statistically significant improvements in nasal symptoms and quality of life, with an acceptable safety profile.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104765"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145676074","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":"The role of metformin in dysplastic mucosa of the larynx: A follow up study","authors":"Diana N. Kirke ,&nbsp;Diana S. Shaari ,&nbsp;Corina Din-Lovinescu ,&nbsp;Andrew Blitzer ,&nbsp;Marshall Strome","doi":"10.1016/j.amjoto.2025.104769","DOIUrl":"10.1016/j.amjoto.2025.104769","url":null,"abstract":"<div><h3>Objective</h3><div>This longitudinal case series reports our ongoing experience with metformin, an oral antihyperglycemic drug, as a possible agent to halt the progression of dysplastic lesions to carcinoma, in those with previously treated head and neck squamous cell carcinoma (HNSCC).</div></div><div><h3>Design</h3><div>Case series.</div></div><div><h3>Results</h3><div>Three patients were included who had laryngeal dysplasia (age 66.67 ± 7.09; range 59–73 years; 3 male) with a follow up time of 17 to 88 months. The average dose of metformin was 500 mg twice daily. Two patients showed complete or partial regression of the dysplastic mucosa, while the third demonstrated a worsening of dysplasia after he halted treatment for six weeks.</div></div><div><h3>Conclusion</h3><div>Metformin is a safe agent that has the potential to prevent progression of laryngeal dysplasia in patients with a history of HNSCC. Further studies are needed to verify and expand on this limited case series.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104769"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145780012","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":"Preliminary study on classification and treatment of type I variant preauricular fistula","authors":"Kanu Lal Saha","doi":"10.1016/j.amjoto.2025.104781","DOIUrl":"10.1016/j.amjoto.2025.104781","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104781"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145748371","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":"Adenoid regrowth and obesity in a longitudinal pediatric cohort","authors":"Liliana Arida-Moody ,&nbsp;Daniel R.S. Habib ,&nbsp;Emma H. Neal ,&nbsp;Amy S. Whigham","doi":"10.1016/j.amjoto.2025.104764","DOIUrl":"10.1016/j.amjoto.2025.104764","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to elucidate the association between pediatric obesity and revision adenoidectomy in a cohort with longitudinal care needs.</div></div><div><h3>Methods</h3><div>Data were collected via chart review from a tertiary pediatric hospital for patients who underwent adenoidectomy from January 2015 to January 2016 and had 2 years of post-operative follow-up. Demographic, surgical, and clinical data were analyzed using logistic and Cox regression models to identify factors affecting the likelihood and timing of revision adenoidectomy.</div></div><div><h3>Results</h3><div>Of 461 patients, 115 (24.9 %) were obese at primary intervention. Secondary intervention was performed for 136 patients (29.5 %), with a median interval of 29 months between procedures. In the logistic regression, predictors of revision included younger age at primary intervention (OR = 0.844, <em>p</em> = 0.002), adenoidectomy over adenotonsillectomy as the initial surgery (OR = 0.3, <em>p</em> &lt; 0.001), higher BMI percentile (OR = 1.008, <em>p</em> = 0.048), and allergic rhinitis (OR = 1.722, <em>p</em> = 0.039). In the Cox regression, hazard was lower with adenotonsillectomy (HR = 0.358, <em>p</em> &lt; 0.001), older age at initial surgery (HR = 0.858, <em>p</em> = 0.001), and GERD (HR = 0.595, <em>p</em> = 0.05), but higher with laryngomalacia/tracheomalacia (HR = 1.909, <em>p</em> = 0.034). BMI percentile was not associated with revision timing in the Cox model. Model concordance was 0.694.</div></div><div><h3>Conclusion</h3><div>Odds of revision adenoidectomy in this population are increased with higher BMI percentile, younger age at primary intervention, undergoing initial adenoidectomy rather than adenotonsillectomy, and various comorbidities, with differing time-dependent effects. These findings support the potential role of obesity-related inflammation in adenoid hypertrophy and individualized surgical decision-making in pediatric patients with sleep disordered breathing.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104764"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145713052","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":"Efficacy of acupuncture combined with various traditional Chinese medicine therapies for peripheral facial paralysis: A systematic review and network meta-analysis","authors":"Mengzhong Li ,&nbsp;Wenjie Liang ,&nbsp;Wei Liang ,&nbsp;Jianguo Zhang ,&nbsp;Xiaoping Lei","doi":"10.1016/j.amjoto.2026.104787","DOIUrl":"10.1016/j.amjoto.2026.104787","url":null,"abstract":"<div><h3>Background and purpose</h3><div>This meta-analysis aimed to evaluate whether acupuncture combined with other traditional Chinese medicine (TCM) therapies is more effective in the treatment of peripheral facial palsy (PFP) than acupuncture alone.</div></div><div><h3>Methods</h3><div>Eight databases were searched until May 2025. Two independent reviewers extracted relevant data on study characteristics and used the Cochrane Risk of Bias Assessment Tool 2 (RoB2) to assess the risk of bias of the included studies.</div></div><div><h3>Results</h3><div>266 articles were included. Results showed that compared with acupuncture alone, acupuncture combined with tuina and cupping (surface under the cumulative ranking curve (SUCRA) = 99.33%) was the most effective intervention for improving the overall effective rate; acupuncture combined with topical application of TCM (SUCRA = 90.61%) was the optimal approach for enhancing facial nerve function (House-Brackmann (H<img>B) scale); acupuncture combined with herbal fumigation and steaming therapy (SUCRA = 80.40%) was the best intervention for improving social function (Facial Disability Index - Social Function (FDIS)) in patients with facial paralysis; acupuncture combined with pricking blood (SUCRA = 87.62%) was the most effective method for improving physical function (Facial Disability Index - Physical Function (FDIP)) in patients with facial paralysis; and acupuncture combined with cupping and pricking blood (SUCRA = 86.90%) was associated with the lowest incidence of adverse reactions.</div></div><div><h3>Conclusion</h3><div>This study showed that interventions such as acupuncture+tuina+cupping, acupuncture+topical application of TCM, acupuncture+herbal fumigation and steaming therapy, and acupuncture+pricking blood are all associated with facial nerve recovery and demonstrate superior efficacy compared with acupuncture alone.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104787"},"PeriodicalIF":1.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145973150","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}