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Objective: To characterize salivary gland pathology and neoplasms associated with CYLD cutaneous syndrome, including location, risk of malignancy, and management practices.

Data sources: MEDLINE Ovid, Embase, Cochrane CENTRAL, and Scopus.

Review methods: Following Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines, a database search was performed to identify articles describing salivary gland lesions in the setting of CYLD cutaneous syndrome.

Results: Twenty-six articles meeting the inclusion criteria were identified, describing 31 patients with CYLD cutaneous syndrome who presented with salivary gland neoplasms. Mean age was 61.0 years (range 37-76). Sixteen (51.6%) patients were male, 12 (38.7%) female, and 3 (9.7%) did not specify patient sex. Neoplasms were located in the parotid gland in 27 (87.1%) patients, both the parotid and submandibular glands in 2 (6.5%) patients, the submandibular gland in 1 (3.2%) patient, and minor salivary glands in 1 (3.2%) patient. Fifteen (48.4%) neoplasms were reported as multifocal, and 9 (29.0%) patients presented with salivary gland malignancy during their disease course. Eight (25.8%) cases reported recurrence at a mean of 3.8 (range 1-10) years.

Conclusion: Salivary gland lesions presenting in the setting of CYLD cutaneous syndrome occur predominantly in the parotid gland. Tumors frequently present with multifocal and malignant pathology, and warrant definitive surgical excision with parotidectomy.

This developmental device pilot study compared transmission ultrasound detection of cervical esophageal bolus transit with videofluoroscopy contrast images during barium swallow evaluation. An ultrasound transmitter-receiver pair on the neck recorded contrast swallows compiled into heatmaps in adult patients. Using prespecified criteria for qualifying interpretable studies, a unique pattern of ultrasound heatmap features of signal attenuation hypothesized to indicate bolus transit effects on the ultrasound transmission signal was labeled for later comparison to the videofluoroscopic image frame ranges of swallowed bolus contrast passing between the paired ultrasound sensors anterior to C5-C6 cervical vertebrae. In total, 15 studied patients met the inclusion criteria for interpretable image labeling and quality for ultrasound and corresponding videofluoroscopy recordings for 211 swallows. Ultrasound detection yielded 200 true positives, 16 false positives, and 11 false negatives based on the overlap of ultrasound and videofluoroscopic frame ranges: sensitivity 95% and specificity 92%. Transmission ultrasound bolus detection in the cervical esophagus is feasible.

Objective: The purpose of this study is to perform the first systematic review and meta-analysis examining the risks of obstructive sleep apnea in head and neck cancer survivors with the goal of determining if there is a statistically significant increase in the risk of obstructive sleep apnea after treatment for head and neck cancer. Additionally, we sought to determine if specific treatment modalities are associated with an increased risk of obstructive sleep apnea.

Data sources: A comprehensive literature search was performed using Embase, Ovid MEDLINE, Web of Science, and Ovid All EBM Reviews.

Review methods: Included studies performed polysomnography in head and neck cancer patients before and/or after treatment. Random effects meta-analyses were used to estimate overall prevalences of obstructive sleep apnea and apnea-hypopnea index change before versus after head and neck cancer treatment.

Results: The literature search returned 575 articles for initial review, of which 16 articles met criteria for inclusion and meta-analysis (419 participants). The mean obstructive sleep apnea prevalence in head and neck cancer survivors was 83.7%. Mean prevalence before treatment was 79.9% [70.0%, 88.3%] and after treatment was 88.7% [82.3%, 94.0%]. In random effects meta-analysis, patients had a statistically significant increase in apnea-hypopnea index of 4.28 [0.46, 8.09] after treatment.

Conclusion: There is a high prevalence of obstructive sleep apnea in head and neck cancer survivors independent of treatment modality. Therefore, we propose that all head and neck cancer survivors undergo routine validated screening for obstructive sleep apnea.

Objective: Partial superficial parotidectomy (PSP) is the surgical option of choice for treating benign tumors in the superficial lobe of the parotid gland. The less invasive extracapsular parotidectomy (ECP) technique was previously described. Our goal was to review our PSP and ECP cases and compare the outcomes and complications between the surgeries.

Study design: Retrospective cohort review.

Setting: Tertiary care hospital.

Methods: We reviewed the medical records of 98 consecutive with benign parotid tumors restricted to the superficial lobe who underwent parotid surgery. The cohort was divided into 2 groups-ECP (41 patients) and PSP (57 patients). The demographics, tumor size and pathology, operative time, postoperative complications and recurrence rates were compared.

Results: No significant differences were found between the groups regarding age, gender, body mass index (BMI), and final tumor pathology. Moreover, no significant association was found between the tumor-specific pathology and the surgery type performed. The mean tumor diameter was significantly smaller in the ECP group compared to the PSP group. The operative time was significantly shorter in the ECP group than in the PSP group.

Conclusion: ECP is a safe alternative to PSP in properly selective benign parotid tumors. ECP has a significantly shorter operative time. ECP does not increase the risk of complications related to parotid surgery, including facial nerve paralysis.

Objective: The association, if any, between gene mutations, pathologic features of squamous cell carcinoma of the head and neck, and patient prognosis is unknown. This study investigates the association between common gene mutations in oral cavity squamous cell carcinoma, pathologic features of malignancy, and patient survival.

Study design: Retrospective database review.

Setting: US hospitals.

Methods: The cBioPortal for Cancer Genomics database was queried for oral cavity squamous cell carcinoma patient data. Statistical analyses were conducted using IBM SPSS v29.

Results: Of the 423 patients included, the majority were male (66.6%), white (89.3%), and current/former smokers (74.1%). Tumor protein p53 (TP53), titin (TTN), and FAT atypical cadherin 1 (FAT1) mutations were present in 72.3%, 31.2%, and 22.0% of patients, respectively. Mutant TP53 was associated with positive extranodal extension compared to wild-type (WT) TP53 (31.0% vs 18.8%) (P = .038) and perineural invasion (59.4% vs 44.3%, P = .021). High tumor mutational burden was present in 5.4% of cases. Gene mutations were not associated with differences in median overall survival or disease-free survival. Multivariable analysis revealed an association between mutant TP53 and the presence of extranodal extension (odds ratio [OR] 2.61, 95% CI 1.05-6.52, P = .039) and perineural invasion (OR 2.14, 95% CI 1.04-4.42, P = .039).

Conclusion: Mutant TP53 was associated with high-risk pathologic features, including extranodal extension and perineural invasion, but not with inferior survival. A high tumor mutational burden (>10) is rare in oral cavity squamous cell carcinoma. Further research into the interplay between genetic mutations and patient outcomes is needed.

[This corrects the article DOI: 10.1002/oto2.70173.].

Objective: Recurrent acute rhinosinusitis (RARS) significantly decreases quality of life. Transplant recipients (TR) are particularly vulnerable to rhinologic conditions. There is a lack of guidelines for managing RARS in this population. Our study aims to determine the prevalence of and risk factors for RARS among TR and assess the need for sinus surgery within this group.

Study design: Retrospective cohort.

Setting: Mayo Clinic between 2017 and 2022.

Methods: A total of 1116 patients met the inclusion criteria and were divided based on the presence or absence of a new incident RARS diagnosis during the posttransplant period and frequency of sinus surgery. Logistic regression (LR) analysis was performed to identify the odds ratio.

Results: In total, 111/1116 (9.95%) had RARS. Patients with RARS had an increased history of asthma, viral infection, and rheumatoid arthritis (RA) (P = .003) in the pretransplant period. According to the LR analysis, patients with neutropenia, RA, and mantle cell lymphoma were 1.91, 2.71, and 4.02 times more likely to develop RARS (95% CI: 1.19-3.05, P = .01), (95% CI: 0.90-8.14, P = .07), and (95% CI: 1.16-13.89, P = .02) during the posttransplant period, respectively. In those that developed RARS, only 5.5% failed medical therapy and required surgery.

Conclusion: This is the first cohort to investigate the incidence of RARS in TR and the predictive factors associated with its development posttransplant. We found that patients with pretransplant comorbidities such as RA, viral infections, hematologic deficiencies, and malignancies were at an increased risk for developing RARS, though this is not linked to an increased necessity for sinus surgery.

Objective: To identify clinical and polysomnographic factors predicting poor long-term positive airway pressure (PAP) compliance in patients with obstructive sleep apnea (OSA) in a Southeast Asian population and to develop a simple risk model applicable in routine practice.

Study design: Retrospective cohort study.

Setting: Songklanagarind Hospital, Thailand, from January 2012 to December 2022.

Methods: Adult OSA patients aged 18 to 65 years prescribed PAP therapy were included. Adherence was objectively recorded from device downloads. Good adherence was defined as ≥4 hours per night on ≥70% of nights at 12 months. Logistic regression identified predictors of poor long-term adherence.

Results: A total of 343 patients were enrolled; 253 had follow-up data at 12 months. Good adherence was observed in 47.8% of patients. In multivariate analysis, age < 50 years (odds ratio [OR] 1.92; 95% CI 1.01-3.67; P = .046) and poor short-term adherence (OR 4.47; 95% CI 2.33-8.72; P < .001) independently predicted poor long-term adherence. The resulting "AP" model (Age and Poor early adherence) achieved an area under the curve of 0.73 (95% CI 0.66-0.79), with a high specificity of 94%.

Conclusion: Although predictors of PAP adherence have been described in Western populations, this study provides the first large data set from Thailand. The AP model, while simple, is pragmatic and easily applied in resource-limited settings. Prospective, multicenter validation across Southeast Asia is warranted to enhance its generalizability and incorporate modifiable predictors.

Objective: Glucagon-like peptide 1 receptor agonists (GLP-1RA) have shown remarkable results in glycemic control for patients with type 2 diabetes (T2DM). While no association has been made, there is a concern for thyroid cancer (TC) from GLP-1RA. We aimed to study the 5-year risk of TC in T2DM patients taking GLP-1RA.

Study design: Retrospective cohort.

Setting: TriNetX database.

Methods: TriNetX was queried to identify T2DM patients between 2017 and 2019. The 5-year risk of TC in patients using GLP-1RA was compared to patients taking sodium-glucose cotransporter 2 inhibitors (SGLT-2I), metformin, and dipeptidyl peptidase 4 inhibitors (DPP-4I) after propensity score matching by demographics and comorbidities.

Results: On analysis of T2DM patients taking GLP-1RA compared to SGLT-2I, 7736 patients were in each cohort after matching. The 5-year rate of TC in patients taking GLP-1RA was 0.30% compared to 0.48% in those taking SGLT-2I (RR 0.62 (95% CI 0.37-1.05); P = .07). Analysis of GLP-1RA versus metformin yielded 5158 patients in each cohort. Patients taking GLP-1RA had similar rates of TC compared to those taking metformin (0.25% vs 0.39%; RR 0.65 (95% CI 0.32-1.31); P = .22). A comparison of GLP-1RA versus DPP-4I yielded 12,570 patients in each cohort. The rate of TC was not increased in those taking GLP-1RA compared to those taking DPP-4I (0.33% vs 0.37%; RR 0.91 (0.60-1.39); P = .67).

Conclusion: T2DM patients taking GLP-1RA may not have an increased 5-year risk of TC compared to those taking metformin, SGLT-2I, or DPP-4I. Conclusions of long-term use are limited as most GLP-1RA were approved within the last decade.