American Journal of Otolaryngology最新文献

{"title":"Evaluation of brain and neurophysiologic function in isolated congenital anosmia","authors":"Jia Liu ,&nbsp;Xing Gao ,&nbsp;Xiaojun Zhan ,&nbsp;Yingxia Lu ,&nbsp;Linyin Yao ,&nbsp;Xiaoli Yi ,&nbsp;Qinglong Gu","doi":"10.1016/j.amjoto.2025.104664","DOIUrl":"10.1016/j.amjoto.2025.104664","url":null,"abstract":"<div><h3>Purpose</h3><div>Isolated congenital anosmia (ICA) is a relatively rare condition characterized by a complete lack of olfactory perception dating from birth or early childhood. Congenital deficits in sensory systems appear to have distinct effects on brain function and nervous system pathway, but little is known about ICA. The study aims to explore the neural basis of ICA through measuring brain activation in response to olfactory stimuli and cerebral processing in patients with ICA.</div></div><div><h3>Methods</h3><div>Retrospective review of medical records of 11 ICA patients from two smell and taste centers. All patients who were diagnosed ICA thorough interview and medical investigation. We used olfactory pathway magnetic resonance imaging (MRI) to evaluate the structural change of olfactory system, and functional MRI (fMRI) to observe the brain's response to pleasant and unpleasant olfactory stimuli (phenethyl alcohol and isovaleric acid) in 11 patients with ICA and 11 age- and sex-matched controls. Additionally, we measured EEG signals using olfactory and trigeminal event-related potentials (oERP and tERP) in response to phenethyl alcohol and CO₂ stimuli, respectively. The Sniffin' Sticks test was used to evaluate the participants' subjective olfactory function.</div></div><div><h3>Results</h3><div>ICA patients showed the smaller olfactory bulb and shallower olfactory sulcus than controls. Healthy subjects showed brain activity in multiple regions associated with olfactory processing. Subjects with ICA exhibited reduced or no activation in the olfactory cortex, which is responsible for olfactory processing. Nevertheless, these subjects had activation outside the olfactory cortex, indicating functional compensation. In the case of ICA, oERP was missing in all patients while it was present in all control subjects. tERP was detected in 8 patients with anosmia, and these patients displayed higher amplitude signals in the N₁ and P₂ waves than the controls (<em>p</em> &lt; 0.001, <em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Congenital anosmia patients exhibit functional inactivation in the olfactory cortex and neurophysiologic deficits throughout the olfactory pathway. Our findings support the concept of distinct central nervous system abnormalities in ICA.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104664"},"PeriodicalIF":1.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917421","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":"Intratympanic steroid injection for treating sudden sensorineural hearing loss in patients with hepatitis B virus infection","authors":"Shih-Lung Chen ,&nbsp;Chia-Ying Ho ,&nbsp;Shy-Chyi Chin ,&nbsp;Kai-Chieh Chan ,&nbsp;Yu-Chien Wang","doi":"10.1016/j.amjoto.2025.104660","DOIUrl":"10.1016/j.amjoto.2025.104660","url":null,"abstract":"<div><h3>Background</h3><div>Sudden sensorineural hearing loss (SSNHL) is an acute auditory disorder commonly treated with steroids. However, the prognostic factors for patients with hepatitis B virus (HBV) undergoing intra-tympanic steroid injections (ITSIs) remain unclear. This research seeks to explore the prognostic factors affecting the outcome of ITSI treatment in HBV patients with unilateral SSNHL.</div></div><div><h3>Methods</h3><div>This retrospective study included 77 patients with HBV who presented with unilateral SSNHL from October 2018 to October 2024. All patients underwent ITSIs, and their clinical and audiological data were thoroughly analyzed.</div></div><div><h3>Results</h3><div>The mean age of the patients was 48.61 ± 15.98 years. Following ITSIs, the mean gain in hearing level was 15.51 ± 19.22 dB, the mean gain in speech reception threshold (SRT) was 16.23 ± 31.02 dB, and the mean gain in speech discrimination score (SDS) was 17.55 ± 30.69 %. According to Siegel’s criteria, 6 patients (7.79 %) achieved complete recovery, 13 (16.88 %) experienced partial recovery, 33 (42.86 %) had slight recovery, and 25 (32.47 %) showed no improvement.</div><div>In univariate analyses, factors such as age ≥ 50 years (odds ratio [OR] = 0.3257, 95 % confidence interval [CI]: 0.1085–0.9781, <em>p</em> = 0.0391), the presence of vertigo (OR = 0.2656, 95 % CI: 0.0696–1.0137, <em>p</em> = 0.0335), and profound hearing loss as measured by pure-tone audiometry (PTA; OR = 0.0638, 95 % CI: 0.0080–0.5099, <em>p</em> = 0.0003) were identified as adverse prognostic factors. In the multivariate analysis, age ≥ 50 years (OR = 0.2799, 95 % CI: 0.0830–0.9437, <em>p</em> = 0.0400) and profound hearing loss (OR = 0.0609, 95 % CI: 0.0072–0.5133, <em>p</em> = 0.0101) emerged as independent negative prognostic factors.</div></div><div><h3>Conclusions</h3><div>ITSIs are effective in managing SSNHL in patients with HBV while minimizing the side effects associated with high-dose systemic steroids. Among the 77 HBV patients with SSNHL who received ITSI, age ≥ 50 years and profound hearing loss were identified as negative prognostic factors. For HBV patients with these risk factors, timely and proactive treatment is essential.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104660"},"PeriodicalIF":1.8,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886960","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":"Transoral robotic surgery versus conventional transoral surgery for submandibular stones: Systematic review and meta-analysis","authors":"Matteo Lazzeroni ,&nbsp;Giulia Buccichini ,&nbsp;Muhammad Suleiman ,&nbsp;Emma Finnegan ,&nbsp;Luke Mattey ,&nbsp;Davide Tosini ,&nbsp;Michele Proh ,&nbsp;Lorenzo Pignataro ,&nbsp;Antonino Maniaci ,&nbsp;Mario Lentini ,&nbsp;Sara Torretta ,&nbsp;Pasquale Capaccio ,&nbsp;Michelle Azevedo","doi":"10.1016/j.amjoto.2025.104647","DOIUrl":"10.1016/j.amjoto.2025.104647","url":null,"abstract":"<div><h3>Purpose</h3><div>The recent diffusion of transoral robotic surgery has prompted its application not only in the oropharyngeal and hypopharyngeal-laryngeal fields, which are the anatomical sites of major use of the method, but also in the oral floor for the removal of tumours and other diseases affecting the salivary glands, such as sialothiasis. This study aims to assess the safety and efficacy profiles of transoral robotic surgery compared to traditional transoral procedures for the treatment of submandibular stones.</div></div><div><h3>Methods</h3><div>PubMed, Embase, and Web of Science were searched for studies reporting on traditional or robotic transoral surgery for submandibular stones. As recommended by the PRISMA guidelines, proportion meta-analysis was performed on a random-effects model. The present review was registered on PROSPERO (CRD42024522199).</div></div><div><h3>Results</h3><div>A total of 2520 participants from 23 studies were included. The selected patients had a mean age of 44 years (range 5-87), with 48 % of them being female. Transoral robotic surgery had a success rate of 95.7 % (95 % CI 90.9-99.0), higher than traditional transoral approaches (success rate 92.6 %; 95 % CI 89.3-95.4). Transient <em>stupor</em> of the lingual nerve was observed more frequently in robotic surgeries (15.8 % vs 8.1 %). However, no reports of permanent injury to the lingual nerve were found.</div></div><div><h3>Conclusion</h3><div>Transoral robotic surgery is a valid treatment option for submandibular stones. Due to the high costs of the procedure, strict patient selection is mandatory.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104647"},"PeriodicalIF":1.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887070","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":"Personalized therapeutic strategies and prognosis for advanced laryngeal squamous cell carcinoma: Insights from machine learning models","authors":"Sakhr Alshwayyat ,&nbsp;Alia Alawneh ,&nbsp;Haya Kamal ,&nbsp;Tala Abdulsalam Alshwayyat ,&nbsp;Mustafa Alshwayyat ,&nbsp;Hamdah Hanifa ,&nbsp;Raghad Al-Shami ,&nbsp;Kholoud Qassem","doi":"10.1016/j.amjoto.2025.104633","DOIUrl":"10.1016/j.amjoto.2025.104633","url":null,"abstract":"<div><h3>Purpose</h3><div>Despite the development of diverse treatment options, there has been an increase in mortality rates for laryngeal squamous cell carcinoma (LSCC). Our research employed survival analysis and machine learning (ML) techniques to evaluate the impact of different therapeutic options on survival and to build a prognostic model for individualized clinical decisions in advanced LSCC.</div></div><div><h3>Methods</h3><div>The Surveillance, Epidemiology and End Results (SEER) database provided the data used for this study’s analysis. To identify the prognostic variables for patients with LSCC, we conducted Cox regression analysis and constructed prognostic models using five machine learning (ML) algorithms to predict 5-year survival. A method of validation that incorporated the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was employed to validate the accuracy and reliability of the ML models. We also investigated the role of multiple therapeutic options using Kaplan Meier (K-M) survival analysis.</div></div><div><h3>Results</h3><div>The study included 7350 patients, of whom 2689 were diagnosed with glottic cancer (GC), 4349 with supraglottic (SuGC) and 312 with subglottic (SC). ML models identified age, sex, and stage as the most important factors that affect survival. In terms of treatment, bets survival therapeutic options for all anatomical sites was surgery and radiotherapy (RT).</div></div><div><h3>Conclusion</h3><div>Employing multimodal therapies such as surgery and radiotherapy is crucial for managing advanced-stage LSCC. Tailored approaches that consider prognostic factors such as age, sex, and tumor stage are necessary. Additionally, chemotherapy did not significantly impact overall survival, suggesting potential areas for improvement in LSCC management.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104633"},"PeriodicalIF":1.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869245","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":"Health-related quality of life perspectives of cochlear implanted children, their hearing peers, and their parents: a prospective case-control study","authors":"Debora d.P. Jiménez Montesdeoca ,&nbsp;Juan C. Falcón González ,&nbsp;Silvia A. Borkoski Barreiro ,&nbsp;Angel M. Ramos Macías","doi":"10.1016/j.amjoto.2025.104652","DOIUrl":"10.1016/j.amjoto.2025.104652","url":null,"abstract":"<div><h3>Background</h3><div>Hearing loss is one of the most common sensory alterations in humans. Cochlear implants in children provide significant benefits from a clinical point of view. However, the benefits in the health-related quality of life have been seldom studied.</div></div><div><h3>Objective</h3><div>To assess whether the health-related quality of life of 5-18 old children with cochlear implants, as measured with the PedsQL pediatric quality of life questionnaire version 4.0, is comparable with the perception of their parents/caregivers.</div></div><div><h3>Design</h3><div>Prospective, observational, cross-sectional and analytical study.</div></div><div><h3>Setting(s)</h3><div>Hearing loss Unit of the Hospital Universitario Insular Materno-Infantil (Mother and Child University Hospital), León y Castillo Infant and Primary Education Center and La Minilla Secondary Education Institute.</div></div><div><h3>Participants</h3><div>140 pediatric subjects (108 with cochlear implants, 32 hearing) plus one of their parents or guardians.</div></div><div><h3>Methods</h3><div>The original and Spanish-validated PedsQL™ pediatric quality of life questionnaires version 4.0 were used.</div></div><div><h3>Results</h3><div>Cochlear implantation yielded statistically significant results in terms of physical functioning and psychosocial health in children of 5-18 years of age.</div></div><div><h3>Conclusions</h3><div>The health-related quality of life of cochlear implanted pediatric patients (5-18 years old) evaluated with the PedsQL™ pediatric quality of life questionnaire version 4.0, is comparable to the perception of their parents/caregivers.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104652"},"PeriodicalIF":1.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869191","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":"Hearing loss among otolaryngologist and healthcare workers: Case control study","authors":"Dana A. Obeid ,&nbsp;Hassan Assiri ,&nbsp;Jawaher AlShalawi ,&nbsp;Abdullah AlKhaldi ,&nbsp;Farid AlZhrani","doi":"10.1016/j.amjoto.2025.104635","DOIUrl":"10.1016/j.amjoto.2025.104635","url":null,"abstract":"<div><h3>Background</h3><div>Noise-induced hearing loss is a prevalent occupational hazard characterized by gradual, sensorineural hearing impairment, primarily affecting higher frequencies (3–6 kHz) due to prolonged exposure to excessive noise. The severity of hearing impairment is directly linked to sound pressure intensity, frequency, exposure duration, and pattern. Otolaryngologists, among other healthcare specialists, frequently use instruments that surpass safety limits, rendering them more susceptible to noise-induced hearing loss. This condition detrimentally impacts communication, performance, healthcare personnel well-being, and patient safety.</div></div><div><h3>Objectives</h3><div>This study aims to assess whether otolaryngologists and other operating room staff face a higher risk of hearing loss compared to their peers in non-surgical fields, particularly considering advances in surgical instrumentation.</div></div><div><h3>Methods</h3><div>A case-control study conducted at King Saud University Medical City in Riyadh, Saudi Arabia, in collaboration with the Otolaryngology and Audiology departments from June 2021 to December 2023. Comprehensive medical histories, physical measurements, and various audiological tests, including tympanometry, standard pure-tone audiometry, extended high-frequency pure-tone audiometry, and distortion-product otoacoustic emission (DPOM), were administered to ensure precise results. The study included 20 otolaryngologists of varying ages and experience levels (<em>n</em> = 20) and a comparison group of 20 apparently healthy non-otolaryngologist medical professionals. Both groups were drawn from the same population and matched for age, socioeconomic factors, and environments. All subjects underwent extensive audiological testing for result accuracy.</div></div><div><h3>Results</h3><div>The mean age of otolaryngologists was 31 ± 11 years with a balanced gender distribution. In contrast, the mean age of the non-otolaryngologist group was 32 ± 10 years, with a male predominance. Otolaryngologists exhibited higher odds of low-frequency hearing loss. Additionally, most otolaryngologists displayed the absence of DPOM at 8 kHz, 9 kHz, and 10 kHz, whereas in non-otolaryngologists, DPOM was predominantly present.</div></div><div><h3>Conclusions</h3><div>This study provides objective evidence of varying hearing levels among otolaryngologists and their peers in different specialties. Preventive measures should be implemented to mitigate communication challenges and enhance patient safety.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104635"},"PeriodicalIF":1.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895333","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 utility of computed tomography in idiopathic subglottic stenosis","authors":"Sarah Benyo ,&nbsp;Radhika Duggal ,&nbsp;Rebecca C. Nelson ,&nbsp;Paul C. Bryson ,&nbsp;Michael S. Benninger ,&nbsp;William S. Tierney","doi":"10.1016/j.amjoto.2025.104651","DOIUrl":"10.1016/j.amjoto.2025.104651","url":null,"abstract":"<div><h3>Objectives</h3><div>1) To develop a standardized and reproducible protocol for evaluating airway stenosis on CT imaging. 2) To compare idiopathic subglottic stenosis (iSGS) measurements on CT imaging to intraoperative findings and determine the practical value of CT imaging in evaluation of the stenotic airway.</div></div><div><h3>Methods</h3><div>We conducted a single institution retrospective chart review of patients 18 years of age and older with a diagnosis of iSGS who had surgical intervention for iSGS performed at our institution and CT neck/chest within 6-months of first surgical intervention. We developed a standardized protocol for measuring cross-sectional area of the stenosis and percent stenosis based on CT imaging. Operative reports were queried for percent stenosis for comparison. Accuracy of CT measurements were assessed by interclass correlation coefficients (area of greatest stenosis, <em>r</em> = 0.936; distance below the vocal folds, <em>r</em> = 0.766).</div></div><div><h3>Results</h3><div>A total of 37 patients were included. One hundred percent were female and 86 % were Caucasian. The average age at first operative intervention was 48 years. The most common imaging modality was CT neck with IV contrast (64 %). The average percent stenosis on imaging was 59 % versus 62 % intraoperatively (<em>p</em> = 0.03). The average difference between percent stenosis on imaging and intraoperatively for each individual patient was 11 %.</div></div><div><h3>Conclusion</h3><div>This study directly examines the correlation of stenosis measurements on CT to intraoperative airway dimensions in patients with iSGS. Our results demonstrate that imaging may tend to underestimate stenosis by an average of 11 %, and generally correlated with intraoperative findings in 90 % of cases.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104651"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912557","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":"Iranian females report more severe symptoms on the SNOT-22: A cross-sectional population-based study","authors":"Soheila Nikakhlagh ,&nbsp;Nader Saki ,&nbsp;Bahman Cheraghian ,&nbsp;Zahra Rahimi ,&nbsp;Sara Saki ,&nbsp;Seyed Mohammad Tabibzadeh","doi":"10.1016/j.amjoto.2025.104631","DOIUrl":"10.1016/j.amjoto.2025.104631","url":null,"abstract":"<div><h3>Purpose</h3><div>Rhinosinusitis encompasses a group of conditions characterized by inflammation of the nasal mucosa and paranasal sinuses, impacting the quality of life for those affected. This study was designed to assess the quality of life in the general population using the SNOT-22 questionnaire.</div><div>This study was designed to assess quality of life among the general population using the SNOT-22 questionnaire, which is a tool for measuring quality of life related to rhinological issues.</div></div><div><h3>Material and methods</h3><div>This population-based cross-sectional study was conducted as part of the baseline assessment for the Hoveyzeh cohort study, focusing on adults aged 35–70 in southwest Iran. Data related to socioeconomic factors, demographic characteristics, and anthropometric measurements were gathered. Subsequently, a random sample of 1324 individuals participated in the study, completing the Self-reported SNOT-22 questionnaire.</div></div><div><h3>Result</h3><div>The mean age of 1324 participants was 49.92 ± 8.97 years, and about 60 % were women. The average SNOT-22 score was 7.84 ± 10.78. Approximately 34 % of the participants had an abnormal score on the SNOT-22 questionnaire. These participants were assessed for domains related to nasal, otologic, sleep and emotional symptoms. The most common issues reported were sneezing, dizziness or vertigo, waking up tired, and feelings of sadness, respectively. We observed that the odds of having an abnormal SNOT-22 scores were 62 % higher in women compared to men.</div></div><div><h3>Conclusion</h3><div>Our results revealed a relatively higher prevalence of abnormal SNOT-22 scores, especially among women. Therefore, designing and implementing therapeutic and educational interventions for these people seems necessary.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104631"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869244","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":"Histopathology of superior turbinate mucosal contact in migraine: Preliminary findings","authors":"Dean Clerico,&nbsp;Benjamin Keiser,&nbsp;Jordon Wagner","doi":"10.1016/j.amjoto.2025.104623","DOIUrl":"10.1016/j.amjoto.2025.104623","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the histopathology of migraine-inducing mucosal compression between the superior turbinate and septum.</div></div><div><h3>Study design</h3><div>Observational case control series.</div></div><div><h3>Setting</h3><div>Primary author's private practice.</div></div><div><h3>Methods</h3><div>Superior turbinates in contact with the nasal septum in four migraine patients were excised, variously stained, and examined histologically. Superior turbinates free of contact with septum from three patients without migraine served as controls.</div></div><div><h3>Results</h3><div>Compared to control turbinates, we found epithelial denudation, fibrosis, calcification, fewer glands, and nerve fiber hypertrophy in the mucosa of superior turbinates of migraine patients. All four of these patients improved substantially after superior turbinate resection.</div></div><div><h3>Conclusion</h3><div>Areas of mucosal contact/compression from superior turbinates of migraine patients show pathologic changes that are apparently responsible for migraine symptoms. This is the first study we know of that demonstrates pathologic changes in the turbinates of patients with mucosal contact headaches.</div><div>Level of Evidence: 4</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104623"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143886962","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":"Opioid prescribing after thyroid and parathyroid surgery: A survey of North American surgeons","authors":"Phillip Staibano ,&nbsp;Michael Xie ,&nbsp;Kelvin Zhou ,&nbsp;Han Zhang","doi":"10.1016/j.amjoto.2025.104640","DOIUrl":"10.1016/j.amjoto.2025.104640","url":null,"abstract":"<div><h3>Objectives</h3><div>Opioid overprescribing remains an issue following thyroid and parathyroid surgery (TPS). We performed a cross-sectional survey study to describe opioid prescribing trends of otolaryngology–head and neck surgeons across North America.</div></div><div><h3>Methods</h3><div>We performed a cross-sectional survey study of otolaryngology–head and neck surgeons who are members of the Canadian Society of Otolaryngology–Head and Neck Surgery (CSO) or the American Head and Neck Society (AHNS). The voluntary 20-item online survey addressed surgeon analgesia practices for TPS and was distributed from February 2023–July 2024. Statistical analysis included descriptive methods, multivariable logistic regression, and Chi-square testing.</div></div><div><h3>Results</h3><div>Overall, 153 surgeons completed the survey (response rate: 22.6 %) and of these surgeons, most were Canadian, fellowship-trained, and practicing for 0–10 years. Most surgeons (73 %) rated postoperative patient pain as 3–5/10. Over 75 % of surgeons prescribed opioids for inpatient thyroid surgery with early-career surgeons more likely to prescribe opioids and US surgeons were less likely to prescribe opioids. Oxycodone was commonly prescribed by US surgeons and Canadian surgeons preferred codeine. Canadian surgeons were likelier to prescribe opioids, especially ≥20 opioid tabs, when compared to US surgeons. Almost 50 % of surgeons prescribed 10–19 opioid tabs despite predicting that postoperative patients likely only use 0–10 opioid tabs.</div></div><div><h3>Conclusions</h3><div>Otolaryngology–head and neck surgeons routinely prescribe opioids for TPS despite identifying that patients only consume a fraction of their opioid prescription. Standardization of opioid prescribing and promotion of multimodal analgesia practices are needed to reduce opioid overprescription.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104640"},"PeriodicalIF":1.8,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143869190","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}