Acta otorrinolaringologica espanola最新文献

{"title":"Average lifetime of voice prostheses in laryngectomized patients and influencing factors.","authors":"Clara Espina González, Anna Sumarroca Trouboul, Joan Lop Gros, Xavier León Vintró, Carla Vanessa Merma Linares, José Miguel Costa González","doi":"10.1016/j.otoeng.2026.512394","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512394","url":null,"abstract":"<p><strong>Purpose: </strong>The placement of a phonatory prosthesis is the reference treatment for phonatory rehabilitation in laryngectomised patients. These devices have a predetermined useful life and require periodic replacements, the frequency of which varies between patients and depends on various factors not yet clearly established. The objective of this study was to determine the factors related to the frequency of prosthesis changes as well as to describe the characteristics of the sample and the average useful life of the prostheses.</p><p><strong>Methods: </strong>A retrospective multicentre study was conducted. The dependent variable was the number of annual replacements of speaking prostheses. Independent variables included age, sex, tumour location and staging, type of surgery (laryngectomy vs. pharyngolaryngectomy), timing of prosthesis placement (primary vs. secondary), and treatment with preoperative or postoperative chemoradiotherapy. A univariate (t-test, ANOVA) and multivariate (multiple linear regression) analysis was performed.</p><p><strong>Results: </strong>135 patients were included. The average useful life of the voice prosthesis was 115 days (3.15 replacements per year). In the multivariate analysis, the type of surgery was the only variable independently associated with the number of replacements (IC 95% = .16 - 2.05 replacements/year more in pharyngolaryngectomygroup; p = .02). No significant associations were observed with the time of placement of the prosthesis, chemoradiotherapy or with the rest of the factors analyzed.</p><p><strong>Conclusion: </strong>The number of annual replacements was higher in patients with pharyngolaryngectomy. A trend was observed, bordering on statistical significance, towards a lower rate of annual replacements in patients whose prosthesis was inserted secondarily. None of the other factors analysed significantly influenced the durability of the prosthesis.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512394"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oblique modification of the greater palatine artery flap for septal perforation repair: anatomical rationale, surgical technique, and clinical outcomes in a series of 46 patients.","authors":"Isam Alobid, Mohammed Albouq","doi":"10.1016/j.otoeng.2026.512386","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512386","url":null,"abstract":"<p><p>The objective was to describe a modification of the greater palatine artery (GPA) flap, oriented obliquely toward the sphenoid sinus, and to compare it with the traditional vertical design in the treatment of septal perforations (SP). Anatomical principles, surgical technique, and clinical outcomes were evaluated. A retrospective study was conducted including 46 patients with SP who underwent reconstruction using GPA flaps. Thirty patients were treated with the classic vertical flap (vGPA), and sixteen with the modified oblique flap (oGPA). Anatomical variables, quality of life (SNOT-22, NOSE-Perf), individual and total nasal symptoms (SNT7, visual analogue scale), aetiology, olfactory function (Barcelona Smell Test / BAST-24), and reperforation rate were analysed. Both flap designs produced significant functional improvements in SNT7 scores and quality of life measures. Reperforation occurred in two patients (4.9%), both in the vGPA group, with no statistically significant difference between techniques according to Fisher's exact test. Perforation size showed no statistically significant association with reperforation. Neither technique had a negative impact on olfactory function. The oblique design allowed for greater advancement length and a wider distal portion without increasing pedicle tension. This study concludes that the oblique GPA flap represents a safe and anatomically advantageous alternative to the vertical design. Its superoposterior orientation improves reach, reduces axial stress on the pedicle, and optimizes coverage of large or high septal perforations.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512386"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of FDG-PET/CT in the persistence of lymph node involvement in patients with squamous cell carcinoma of the head and neck treated with radiotherapy, chemoradiotherapy or bioradiotherapy.","authors":"Cristina Vázquez-López, Cristina Valero, Alejandro Fernández-León, Anna Holgado, Arnau Parellada, Valle Camacho, Xavier León","doi":"10.1016/j.otoeng.2026.512388","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512388","url":null,"abstract":"<p><strong>Introduction: </strong>The primary objective was to determine the diagnostic accuracy of FDG-PET/CT for identifying persistent cervical lymph node metastases in patients with head and neck squamous cell carcinoma (HNSCC) with clinical nodal involvement (cN+), treated with radiotherapy (RT), chemo-radiotherapy (CRT) or bio-RT, in a cohort with a low prevalence of human papillomavirus (HPV) infection and high exposure to toxic substances.</p><p><strong>Materials and methods: </strong>This was a retrospective study of 125 patients with cN+ HNSCC treated between 2010 and 2022. All patients achieved complete response of the primary tumour after RT or CRT and had an FDG-PET/CT performed between 2 and 4 months after treatment. Cervical metabolic response was classified as positive, negative, or indeterminate; indeterminate cases were re-evaluated for definitive reclassification.</p><p><strong>Results: </strong>FDG-PET/CT was initially positive in 10 patients (8.0%), negative in 99 (79.2%), and indeterminate in 16 (12.8%). After review, 12 indeterminate studies were reclassified as positive and 4 as negative. Overall sensitivity was 40.0% and specificity was 94.3%, the positive predictive value (PPV) was 57.1%, and the negative predictive value (NPV) was 89.2%. Among oropharyngeal carcinomas, NPV was 95.8% in HPV-positive tumours and 85.7% in HPV-negative tumours. NPV was higher in patients treated with CRT (92.2%) than in those treated with RT/bio-RT (76.2%).</p><p><strong>Conclusion: </strong>FDG-PET/CT is a useful tool for excluding nodal persistence after RT or CRT in cN+ HNSCC, with a high NPV (89.2%) that supports its value in guiding post-treatment cervical management.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512388"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute intratumoral bleeding in vestibular schwannoma.","authors":"Elisa Antolinos-Macho, Oihane Lodeiro-Moreno, Beatriz Alba-Pérez","doi":"10.1016/j.otoeng.2026.512396","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512396","url":null,"abstract":"","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512396"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Tomographic characteristics of the frontal sinus in a public hospital in Peru\".","authors":"Neeraj Singh, Monika Srivastav","doi":"10.1016/j.otoeng.2026.512391","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512391","url":null,"abstract":"","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512391"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond dacryocystorhinostomy: our experience with the Jones tube for the treatment of epiphora.","authors":"Clara Isabel Ros Rodríguez, Gianmarco Narciso Martínez, Cristina Minguez García, César Hita Anton, Cristina Antón Rodríguez, Lorena Sanz López","doi":"10.1016/j.otoeng.2026.512392","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512392","url":null,"abstract":"<p><strong>Introduction: </strong>Ocular epiphora is excessive tearing caused by an imbalance between tear production and drainage. In cases of lacrimal pathway obstruction, dacryocystorhinostomy (DCR) or conjunctivodacryocystorhinostomy (C-DCR) are the techniques commonly used for treatment. In complex cases, the Jones tube (JT) represents an effective surgical option, although not free of complications. The aim of this study was to describe the experience of the University Hospital of Torrejón with JT implantation and to analyze the factors associated with its patency.</p><p><strong>Material and methods: </strong>A retrospective analytical study was conducted on patients who underwent DCR or C-DCR between 2017 and 2024. A total of 15 patients (23 eyes) with indication for JT placement were included. Variables analyzed included sex, age, laterality, previous diagnostic studies, site of obstruction, previous dilatation, number and type of surgeries, surgical technique, JT placement and size, reoperations, postoperative complications, and patency at 1, 3, 6, and 12 months. Statistical analysis was performed using SPSS software, applying Fisher´s exact test to assess the association between clinical factors and patency.</p><p><strong>Results: </strong>Of the 15 patients, 14 were women (93.3%) with a mean age of 62 years. Left unilateral involvement was observed in 46.7% (7/15) of cases, while bilateral involvement was present in 53,3% (8/15). Previous lacrimal pathway dilatations had been performed in 26.1% of the 23 eyes (6/23). Technical placement of the Jones tube was successful in 16 of the 17 eyes in which implantation was attempted (94.1%). The surgical approach was external in 11 of 17 cases (64.7%) and endoscopic in 6 (35.3%). The median number of surgical interventions per eye was 2. Among the 16 implanted tubes, the most frequent complications were extrusion (7/16; 43.8%) and obstruction (4/16; 25.0%). Patency rates were 88.2% at 1 month, 52.9% at 3 months, and 23.5% at 6 and 12 months. A significant association was found between previous dilatation and greater patency at 6 and 12 months (Fisher's exact test, p* = 0.022).</p><p><strong>Discussion and conclusion: </strong>DCR or C-DCR with a Jones tube may be considered an alternative in refractory lacrimal obstruction, although it carries a considerable complication rate, with progressive decline in patency comparable to that described in the literature. Previous dilatation may be associated with better outcomes. However, prospective studies with larger sample sizes are needed to obtain more conclusive results.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512392"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Consonant production in children with prelingual profound hearing loss using cochlear implants.","authors":"F Núñez-Batalla, I Sandoval Menéndez, A Pulido Alcón, M Hernando Suárez, P Sánchez Fernández, V Martínez López, E Diaz-Fresno, L Aguayo, J Ramirez, P García García, P Tomás Gamasa, J Gómez Martínez, J L Llorente Pendás","doi":"10.1016/j.otoeng.2026.512395","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512395","url":null,"abstract":"<p><strong>Introduction: </strong>Hearing plays a key role in the development and control of speech production. In children with prelingual profound hearing loss, auditory deprivation may affect articulation and acoustic precision of speech sounds. Although cochlear implantation improves auditory perception, its impact on consonant production remains an area of ongoing research.</p><p><strong>Material and methods: </strong>A cross-sectional observational study was conducted to analyze acoustic parameters of fricative and stop consonants. Three groups were included: 22 children with prelingual profound hearing loss using cochlear implants, 42 normal-hearing children aged 5-11 years, and 19 normal-hearing adults used as a reference group for stop consonant analysis. Spectral parameters of the fricatives /s/ and /ʃ/ and Voice Onset Time (VOT) of stop consonants were analyzed using acoustic speech recordings.</p><p><strong>Results: </strong>Children with cochlear implants showed greater variability in the spectral parameters of fricatives compared with normal-hearing children, suggesting a less stable production of these sounds. The spectral center of gravity distance between /s/ and /ʃ/ was greater in the implanted group, which may reflect articulatory compensation strategies to maintain phonetic contrast. VOT values in children with cochlear implants in our sample were comparable to those observed in normal-hearing children, particularly for voiceless stop consonants.</p><p><strong>Conclusions: </strong>Children with cochlear implants exhibit greater variability in fricative production, likely related to limitations in high-frequency perception. However, the developmental pattern of VOT in our sample appears similar to that of normal-hearing children. These acoustic parameters may represent useful objective measures for evaluating phonetic development and guiding speech rehabilitation in cochlear implant users.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512395"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149120000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic management of pediatric subglottic stenosis: Impact of a frequent dilation regimen at a referral center in Colombia.","authors":"Katherin Andrea Borda Pedraza, Luis Gabriel Sandoval Medina","doi":"10.1016/j.otoeng.2026.512389","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512389","url":null,"abstract":"<p><strong>Introduction and objective: </strong>Pediatric subglottic stenosis (SGS) is a serious complication of prolonged intubation. There is no consensus on the optimal interval between endoscopic dilatations. This study reports the clinical outcomes of deferred dilation (DD) versus frequent dilation (FD).</p><p><strong>Material and method: </strong>Retrospective cohort study in a tertiary pediatric hospital (2009-2022). We included 190 patients with SGS divided into historical cohorts: DD group (2009-2018, n = 140) and FD group (2019-2022, n = 50). The primary outcome was therapeutic failure, defined as the need for >5 dilatations, tracheostomy, or laryngotracheal reconstruction (LTR).</p><p><strong>Results: </strong>The median interval between dilatations was 38.5 days (IQR 28-52) in the DD group and 27.5 days (IQR 4-40) in the FD group (p < 0.01). Failure rates were higher in the DD group: >5 dilatations (12.1% vs 0%; p = 0.01), tracheostomy (29.3% vs 22.0%; p = 0.31), and LTR (8.6% vs 4.0%; p = 0.36). Adjuvant use was high and safe (0% adverse events). The use of mitomycin C increased from 75.6% to 89.6% and triamcinolone from 88.3% to 90.9% in the FD group. The need for >5 dilatations was strongly associated with the need for surgery (p = 0.00049).</p><p><strong>Conclusions: </strong>The frequent dilation (FD) regimen was associated with a lower need for multiple procedures and a trend towards lower rates of tracheostomy and LTR. The increased use of adjuvants, with a favorable safety profile, suggests a complementary role in improving outcomes.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512389"},"PeriodicalIF":0.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COMITAR - CO-Morbid Insomnia Temporomandibular disorder upper Airway Resistance syndrome - a 50-year review.","authors":"Kenny P Pang, Claudio Vicini, Manuele Casale, Charlotte E Pang, Antonio Moffa, Andrea De Vito","doi":"10.1016/j.otoeng.2026.512410","DOIUrl":"https://doi.org/10.1016/j.otoeng.2026.512410","url":null,"abstract":"<p><strong>Objective: </strong>To introduce a new association of combined insomnia, temporomandibular joint disorder (TMD) and upper airway resistance syndrome (UARS) -- COMITAR.</p><p><strong>Methodology: </strong>Systemic review of MEDLINE, Google Scholar, Cochrane Library and Evidence Based Medicine Reviews to identify publications relevant to UARS, insomnia, orofacial pain and temporomandibular joint disorders between 1973 to March 2026.</p><p><strong>Results: </strong>Eight studies included in this 50-year systematic review with a total of 5,442 UARS patients. All eight articles not only demonstrate the association between UARS and insomnia, with prevalence of insomnia in these UARS patients ranging from 50% to 58.6%, they also illustrate the paradox of the excessively sleepy UARS patient having insomnia. Four articles also described temporomandibular joint issues / bruxism in these group of UARS / insomnia patients, ranging from 16.7% to 90.7%, with associated headaches, neckaches and depression being common. Comparatively, COMISA patients have AHI > 5 and possibly hypertension with rarely any TMD issues, these COMITAR patients have AHI < 5, hypotension and very commonly TMD with bruxism/clenching. Treatment has also been documented to be different, most UARS and COMITAR patients do not tolerate CPAP well but have better results with nasal surgery treatment and oral appliances.</p><p><strong>Conclusion: </strong>There is distinct group of patients with co-morbid UARS, insomnia and TMD issues that warrant a separate description, as their clinical phenotype and treatment modalities are distinct and different.</p><p><strong>Level of evidence: </strong>III.</p>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512410"},"PeriodicalIF":0.0,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149077098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Langerhans Cell Histiocytosis Masquerading as Benign Pediatric Head and Neck Lesions: A Diagnostic Pitfall","authors":"Alex Zxi Jian Ho,&nbsp;Siew Chung Cheah,&nbsp;Azwan Halim Abdul Wahab,&nbsp;Khairul Azhar M. Rajet","doi":"10.1016/j.otoeng.2026.512380","DOIUrl":"10.1016/j.otoeng.2026.512380","url":null,"abstract":"","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 5","pages":"Article 512380"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}