Ear, nose, & throat journal最新文献

{"title":"Health Economics for the Otolaryngologist.","authors":"Sina J Torabi, R Peter Manes, Edward C Kuan","doi":"10.1177/01455613251370501","DOIUrl":"https://doi.org/10.1177/01455613251370501","url":null,"abstract":"<p><strong>Background: </strong>There is growing evidence throughout medicine, including otolaryngology, that reimbursements have consistently been falling over the last 2 decades, which no obvious end in sight. Herein, we aim to educate otolaryngologists on the macro and microeconomic forces acting on health economics, detail the trends in reimbursements, and discuss how these trends affect providers and patients.</p><p><strong>Methods: </strong>A narrative review of changes in reimbursements and practice patterns within otolaryngology was performed.</p><p><strong>Results: </strong>Otolaryngology procedures have experienced as much as a multifactorial 50% decrease in inflation-adjusted Medicare reimbursement since 2000. On a macroeconomic level, the decline has been driven by the 1997 Balanced Budget Act, which threatened a decrease in conversion factor (the rate per relative value unit [RVU] physicians are paid) year-after-year (often blunted by congressional acts). On a microeconomic level, many otolaryngologic procedures have been targets for bundling and decreased RVUs, most notably rhinologic procedures in 2018. Decreasing reimbursements may be contributing to increasing procedural volume, increasing demand for ancillary sources of practice income (eg, in-office CT scans), and increasing private equity/large hospital practice buyout. These may expose patients to decreased quality of care.</p><p><strong>Conclusions: </strong>Otolaryngologic payments have been in continued decline for 2 decades, with potential important consequences for providers and patients. Awareness of the issues surrounding this key trend are vital.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251370501"},"PeriodicalIF":0.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983907","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":"Isolated Enlarged Endolymphatic Sac Causing Sensorineural Hearing Loss: A Case Report.","authors":"Anne-Marie Daou, Jad Hosri, Randa Barazi","doi":"10.1177/01455613251370563","DOIUrl":"https://doi.org/10.1177/01455613251370563","url":null,"abstract":"<p><p>This is the case of a healthy 10-year-old girl presenting to the pediatric otolaryngology clinic for an incidental finding of a 20 mm dilatation within the left posterior fossa on brain computed tomography done for evaluation of left retro-auricular pain. Comprehensive audiometry showed left sensorineural hearing loss at low frequencies. Magnetic resonance imaging revealed a cystic lesion along the posterior aspect of the left temporal bone with normal inner ear anatomy consistent with an enlarged endolymphatic sac anomaly. This pathology is a rare entity with only one previously reported case in the literature.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251370563"},"PeriodicalIF":0.7,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983491","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":"Otolaryngology Department National Institutes of Health Grant Terminations.","authors":"Beau M Idler, Noel F Ayoub","doi":"10.1177/01455613251367174","DOIUrl":"https://doi.org/10.1177/01455613251367174","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251367174"},"PeriodicalIF":0.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983561","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":"Establishing a Unified Core Outcome Set for Evaluating Biologic Treatment Response in Chronic Rhinosinusitis with Nasal Polyps.","authors":"Haiting Liu, Kunpeng Yang, Yong Tang","doi":"10.1177/01455613251368685","DOIUrl":"https://doi.org/10.1177/01455613251368685","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251368685"},"PeriodicalIF":0.7,"publicationDate":"2025-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983859","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":"Extracorporeal Membrane Oxygen Assisted Intubation for Complex Airways.","authors":"Ritu V Bhalerao, Michael L Hinni, Kristen A Sell-Dottin, Brent A Chang","doi":"10.1177/01455613251368709","DOIUrl":"https://doi.org/10.1177/01455613251368709","url":null,"abstract":"<p><strong>Objective: </strong>Airway management in patients with severely-narrowed tracheal lumens presents significant challenges, especially when traditional intubation methods are not feasible. In such cases, failed intubation attempts can worsen airway compromise and cause life-threatening complications. Extracorporeal membrane oxygenation (ECMO) offers an alternative approach to ensure oxygenation and ventilation during complex airway surgeries. The objective of this study was to assess the safety and feasibility of using venovenous ECMO to ensure oxygenation before attempting intubation in patients with severely-narrowed tracheal lumens undergoing head and neck surgery.</p><p><strong>Methods: </strong>This is a retrospective case series of 3 adult patients who underwent venovenous ECMO-assisted intubation for head and neck surgeries at a single institution between 2010 and 2023. The primary outcome was the successful establishment of an airway and the avoidance of respiratory failure during the surgical procedure.</p><p><strong>Results: </strong>All 3 patients successfully underwent ECMO-assisted intubation. None of the patients experienced major complications directly attributable to ECMO, and all were extubated within 24 hours postoperatively.</p><p><strong>Conclusions: </strong>Venovenous ECMO provides an effective strategy for managing difficult airways in patients with severely-narrowed tracheas, enabling safe anesthesia induction. This technique may be crucial in preventing complications associated with traditional airway management methods.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251368709"},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983898","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":"Metabolomics-Based Characterization of Fungal Ball Sinusitis.","authors":"Yi Wang, Hongzheng Wei, Ting Yang, Chengyao Liu, Pengyu Shi, Jie Zhou, Yun Zeng, Yunchuan Li","doi":"10.1177/01455613251361235","DOIUrl":"https://doi.org/10.1177/01455613251361235","url":null,"abstract":"<p><p><b>Objective:</b> This study used nontargeted metabolomics to characterize metabolic alterations in fungal ball sinusitis (FBS), identify differential metabolites, and explore their roles in fungal infection, immune dysregulation, and histopathological mechanisms. <b>Methods:</b> This study prospectively enrolled 30 patients with FBS and 29 controls with isolated nasal septum deviation who underwent surgery at Beijing Tongren Hospital between February 2023 and April 2024. Specimens of collected fungal balls and secretions of the middle meatus were analyzed for metabolites. Metabolomic profiling was performed using LC-MS/GC-MS. Metabolite identification was achieved through cross-referencing with the HMDB and METLIN databases. We use the package \"ropls\" in R language to perform multivariate statistical analysis, Principal Component Analysis (PCA) and Orthogonal Partial Least Squares Discriminant Analysis (OPLS-DA), detecting differential metabolites (VIP >1, <i>p</i> < .05). Metabolic pathway enrichment analysis was performed based on the KEGG database. <b>Results:</b> In the positive ionization mode, seven differentially expressed metabolites were identified, such as oxidized L-glutathione. In the negative ionization mode, six differentially expressed metabolites were identified, such as 4-acetamidobutanoic acid, lysophosphatidylcholine (LPC) O-18:0, LPC O-20:1, and LPE O-20:1. Comparative analysis revealed upregulation of LPC O-18:0, LPC O-20:1, and LPE O-20:1 in fungal ball specimens, while oxidized L-glutathione and 4-acetamidobutanoic acid showed relative downregulation. At the same time, significant dysregulation was observed in the nucleotide metabolism pathways within fungal ball samples. <b>Conclusion:</b> The composition of metabolites and metabolic pathways within the fungal ball in the affected sinus cavity of FBS exhibits significant differences compared to secretions from the middle meatus on the affected side, the healthy side, and the control group.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251361235"},"PeriodicalIF":0.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144983563","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 Multidisciplinary Analysis for Clinical Implications of Denture Use in Patients Presenting With Deep Neck Infections.","authors":"Tsai-Fu Lee, Chia-Ying Ho, Yu-Chien Wang, Shy-Chyi Chin, Kai-Chieh Chan, Shih-Lung Chen","doi":"10.1177/01455613251366041","DOIUrl":"https://doi.org/10.1177/01455613251366041","url":null,"abstract":"<p><strong>Background: </strong>Deep neck infection (DNI) is a potentially life-threatening condition, most commonly arising from odontogenic sources. Dentures frequently act as reservoirs for polymicrobial biofilms, facilitating the persistence and potential transmission of oral pathogens. Despite their widespread use, the role of dentures in predisposing individuals to DNI has not been thoroughly investigated. This study seeks to elucidate the possible association between denture use and the incidence of DNI, thereby addressing a gap in the current understanding of orodental risk factors in DNIs.</p><p><strong>Methods: </strong>A total of 337 patients diagnosed with DNI between August 2018 and July 2024 were retrospectively enrolled in this study. Among them, 29 individuals were identified as denture wearers. Relevant clinical parameters, including demographic data, comorbidities, infection characteristics, and treatment outcomes, were systematically analyzed to assess potential associations with denture use.</p><p><strong>Results: </strong>Involvement of the parapharyngeal (<i>P</i> = .0172), submandibular (<i>P</i> = .0190), and parotid (<i>P</i> = .0213) spaces in DNI was significantly more frequent in patients with dentures compared to those without. Univariate analysis identified age ≥60 years (odds ratio [OR] 27.000; 95% confidence interval [CI], 2.5034-291.19; <i>P</i> = .0010), C-reactive protein (CRP) level ≥220 mg/L (OR 8.5000; 95% CI, 1.2471-57.933; <i>P</i> = .0201), and involvement of ≥3 deep neck spaces (OR 8.4444; 95% CI, 1.2261-58.159; <i>P</i> = .0258) as significant risk factors for prolonged hospitalization. However, in multivariate logistic regression analysis, only age ≥60 years remained a significant independent predictor of prolonged hospitalization (OR 18.494; 95% CI, 1.5789-216.63; <i>P</i> = .0201).</p><p><strong>Conclusion: </strong>In patients with DNI who wore dentures, univariate analysis identified age 60 years or older, CRP levels of 220 mg/L or higher, and involvement of three or more deep neck spaces as significant predictors of prolonged hospitalization. However, multivariate analysis demonstrated that only age 60 years or older remained an independent risk factor for extended hospital stay. These findings highlight the need for targeted health education and preventive measures in elderly denture users to reduce the risk of severe DNI and its complications.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251366041"},"PeriodicalIF":0.7,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860013","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":"Comparison of the Clinical Efficacy and Complications of Low-Temperature Plasma Tonsillectomy Versus Traditional Tonsillectomy: A Systematic Review and Meta-Analysis.","authors":"Weijiao Liu, Jian Wang","doi":"10.1177/01455613251365762","DOIUrl":"https://doi.org/10.1177/01455613251365762","url":null,"abstract":"<p><strong>Background: </strong>Low-temperature plasma tonsillectomy (LTPT) has emerged as a promising surgical technique for treating chronic tonsillitis (CT), offering advantages such as reduced postoperative pain, faster recovery, and decreased risk of bleeding compared with traditional tonsillectomy (TT). However, the comparative effectiveness and safety of LTPT remain under debate.</p><p><strong>Objective: </strong>This study aimed to systematically evaluate the clinical outcomes and complication rates associated with LTPT versus TT in CT patients.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across major databases, including Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang, VIP, PubMed, EMBASE, and the Cochrane Library, covering studies published between January 2010 and the present. Eight case-control studies comprising 654 patients were included. Data were analyzed using the RevMan 5.3 software, and risk of bias was assessed based on the Cochrane Handbook.</p><p><strong>Results: </strong>Meta-analysis revealed that LTPT significantly reduced operation time (MD -12.4 minutes, 95% CI -15.2 to -9.6), intraoperative blood loss (MD -15.2 mL, 95% CI -20.1 to -10.3), and hospitalization duration (MD -0.7 days, 95% CI -1.0 to -0.4). LTPT was also associated with faster white membrane formation and lower postoperative visual analog scale scores. Inflammatory markers such as tumor necrosis factor-α (<i>P</i> = .002) and hypersensitivity C-reactive protein (<i>P</i> < .001) were significantly lower. Additionally, the complication rate in the LTPT group was markedly reduced (RR = 0.42, 95% CI 0.31 to 0.57; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>LTPT demonstrates superior perioperative outcomes and safety compared with TT in CT patients. Despite these benefits, further large-scale, high-quality studies are needed to confirm its long-term efficacy and guide clinical application.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251365762"},"PeriodicalIF":0.7,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860014","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":"Submandibular Gland Oncocytoma With Difficult Radiological Diagnosis.","authors":"Toshinori Iwai, Satomi Sugiyama, Takahito Yoshimi, Shuhei Minamiyama, Kenji Mitsudo","doi":"10.1177/01455613251367130","DOIUrl":"https://doi.org/10.1177/01455613251367130","url":null,"abstract":"","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251367130"},"PeriodicalIF":0.7,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144860015","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":"Delayed Post-Traumatic Temporal Bone Encephalocele With Lateral Ventricle Herniation.","authors":"Colyn White, Young Lee, Maryam Rahman, Si Chen","doi":"10.1177/01455613251358577","DOIUrl":"https://doi.org/10.1177/01455613251358577","url":null,"abstract":"<p><p>The main objective of this report was to describe a very unique clinical case of a post-traumatic temporal bone encephalocele with lateral ventricle herniation. This report involves a 60 year-old male who initially presented with right-sided hearing loss, otorrhea, and clear rhinorrhea with metallic taste and a history of a temporal bone fracture managed conservatively 6 years prior to presentation. Computed tomography (CT) revealed a large right tegmen defect and magnetic resonance imaging demonstrated herniation of a significantly-distended lateral ventricle into the mastoid cavity. The patient underwent a combined transmastoid and middle fossa approach for encephalocele removal and tegmen repair. However, 3 months later, follow-up CT scan showed an asymptomatic subacute subdural hematoma (SDH) managed with successful bur hole drainage. Long-term follow-up especially in large skull base defects is critical to monitor delayed occurrence of encephalocele and/or cerebrospinal fluid (CSF) leak. Surgical repair with the removal of devitalized brain tissue and multilayer closure may result in the development of subacute SDH after successful repair.</p>","PeriodicalId":93984,"journal":{"name":"Ear, nose, & throat journal","volume":" ","pages":"1455613251358577"},"PeriodicalIF":0.7,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839504","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}