Michael P. Wu, Edward S. Sim, Tessa Goldsmith, Matthew Kovoor, Derrick T. Lin, Jeremy D. Richmon, Daniel G. Deschler
Objectives
The submental island flap can be used to reconstruct defects of the oral cavity and oropharynx. The objective of this study is to describe functional outcomes after this reconstruction.
Methods
Retrospective chart review was performed for 82 patients who underwent submental flap reconstruction of oral cavity cancer defects and 11 with oropharyngeal cancer defects. Primary outcomes were feeding tube use at last follow-up and time from surgery to first oral intake. The secondary outcome was the need for tracheostomy.
Results
Feeding tube use at last follow-up was 9% in the oral cavity group and 36% in the oropharynx group. Median time to oral intake was 7 days in both groups. Tracheostomy was avoided in 87% of oral cavity patients and in 46% of oropharynx patients. In regression analysis of the entire cohort, the outcomes of persistent feeding tube use at last follow-up and tracheostomy were associated with the following variables: prior irradiation, oropharyngeal primary site, and adjuvant treatment status. Among the oral cavity group, prior irradiation was associated with persistent feeding tube use.
Conclusion
The submental flap can be used in a wide range of oral cavity and oropharyngeal defects, even in elderly patients. This flap can be performed for oral cancers with avoidance of tracheostomy in most cases and reliable resumption of oral diet.
{"title":"Oral Diet Outcomes and Tracheostomy Avoidance After Submental Flap Reconstruction of Oral and Oropharyngeal Defects","authors":"Michael P. Wu, Edward S. Sim, Tessa Goldsmith, Matthew Kovoor, Derrick T. Lin, Jeremy D. Richmon, Daniel G. Deschler","doi":"10.1002/lio2.70271","DOIUrl":"https://doi.org/10.1002/lio2.70271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The submental island flap can be used to reconstruct defects of the oral cavity and oropharynx. The objective of this study is to describe functional outcomes after this reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective chart review was performed for 82 patients who underwent submental flap reconstruction of oral cavity cancer defects and 11 with oropharyngeal cancer defects. Primary outcomes were feeding tube use at last follow-up and time from surgery to first oral intake. The secondary outcome was the need for tracheostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Feeding tube use at last follow-up was 9% in the oral cavity group and 36% in the oropharynx group. Median time to oral intake was 7 days in both groups. Tracheostomy was avoided in 87% of oral cavity patients and in 46% of oropharynx patients. In regression analysis of the entire cohort, the outcomes of persistent feeding tube use at last follow-up and tracheostomy were associated with the following variables: prior irradiation, oropharyngeal primary site, and adjuvant treatment status. Among the oral cavity group, prior irradiation was associated with persistent feeding tube use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The submental flap can be used in a wide range of oral cavity and oropharyngeal defects, even in elderly patients. This flap can be performed for oral cancers with avoidance of tracheostomy in most cases and reliable resumption of oral diet.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ryota Koshu, Masao Noda, Haruna Nakamoto, Karin Kojima, Hisashi Sugimoto, Takahiro Fukuhara, Tomokazu Yoshizaki, Makoto Ito
<div> <section> <h3> Objectives</h3> <p>This study aimed to evaluate the long-term efficacy and safety of microdebrider-assisted endoscopic powered intracapsular tonsillectomy and adenoidectomy (PITA) in pediatric patients with obstructive sleep apnea (OSA) using caregiver-reported retrospective assessments of pre- and post-operative symptom states.</p> </section> <section> <h3> Methods</h3> <p>This single-center retrospective observational study included 65 children aged < 15 years who underwent PITA and at least 1 year of postoperative follow-up. Caregivers completed a structured postoperative questionnaire, retrospectively assessing preoperative and postoperative symptom severity using the validated Japanese version of the Obstructive Sleep Apnea Questionnaire-18 (OSA-18). The questionnaire evaluated sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns. Postoperative complications, including tonsillitis, peritonsillar abscess, and perceived symptom recurrence, were also assessed. All surgeries were performed using an endoscopic PITA technique designed to preserve the tonsillar capsules.</p> </section> <section> <h3> Results</h3> <p>Among the 65 pediatric patients (median follow-up, 48.0 months; interquartile range, 25.0–65.0), significant improvements were observed across all five OSA-18 domains. The mean preoperative scores were 5.2, 4.5, 2.3, 3.4, and 4.7 for sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns, respectively. Postoperative scores improved to 1.7, 2.3, 1.7, 2.1, and 1.8, respectively (all, <i>p</i> < 0.001). Subgroup analyses showed no significant differences in outcomes based on follow-up duration (< 5 vs. ≥ 5 years) or age at surgery (≤ 4 vs. > 4 years), suggesting durable and consistent long-term benefits of PITA regardless of age or time since surgery. No peritonsillar abscesses were reported; only three patients (4.6%) experienced postoperative tonsillitis. Thirteen percent of the caregivers reported a subjective recurrence of symptoms; however, none required revision surgery.</p> </section> <section> <h3> Conclusion</h3> <p>PITA is a potentially safe and effective long-term surgical option for pediatric OSA. Retrospective caregiver evaluation revealed sustained symptom improvement, minimal postoperative complications, and high satisfaction levels.</p> </section> <section> <h3> Level of Evidence</h3> <p>Level IV.</
{"title":"Long-Term Outcomes of Microdebrider-Assisted Endoscopic Powered Intracapsular Tonsillectomy and Adenoidectomy in Pediatric Obstructive Sleep Apnea: A Questionnaire-Based Observational Study","authors":"Ryota Koshu, Masao Noda, Haruna Nakamoto, Karin Kojima, Hisashi Sugimoto, Takahiro Fukuhara, Tomokazu Yoshizaki, Makoto Ito","doi":"10.1002/lio2.70274","DOIUrl":"https://doi.org/10.1002/lio2.70274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to evaluate the long-term efficacy and safety of microdebrider-assisted endoscopic powered intracapsular tonsillectomy and adenoidectomy (PITA) in pediatric patients with obstructive sleep apnea (OSA) using caregiver-reported retrospective assessments of pre- and post-operative symptom states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This single-center retrospective observational study included 65 children aged < 15 years who underwent PITA and at least 1 year of postoperative follow-up. Caregivers completed a structured postoperative questionnaire, retrospectively assessing preoperative and postoperative symptom severity using the validated Japanese version of the Obstructive Sleep Apnea Questionnaire-18 (OSA-18). The questionnaire evaluated sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns. Postoperative complications, including tonsillitis, peritonsillar abscess, and perceived symptom recurrence, were also assessed. All surgeries were performed using an endoscopic PITA technique designed to preserve the tonsillar capsules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 65 pediatric patients (median follow-up, 48.0 months; interquartile range, 25.0–65.0), significant improvements were observed across all five OSA-18 domains. The mean preoperative scores were 5.2, 4.5, 2.3, 3.4, and 4.7 for sleep disturbance, physical symptoms, emotional distress, daytime functioning, and caregiver concerns, respectively. Postoperative scores improved to 1.7, 2.3, 1.7, 2.1, and 1.8, respectively (all, <i>p</i> < 0.001). Subgroup analyses showed no significant differences in outcomes based on follow-up duration (< 5 vs. ≥ 5 years) or age at surgery (≤ 4 vs. > 4 years), suggesting durable and consistent long-term benefits of PITA regardless of age or time since surgery. No peritonsillar abscesses were reported; only three patients (4.6%) experienced postoperative tonsillitis. Thirteen percent of the caregivers reported a subjective recurrence of symptoms; however, none required revision surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PITA is a potentially safe and effective long-term surgical option for pediatric OSA. Retrospective caregiver evaluation revealed sustained symptom improvement, minimal postoperative complications, and high satisfaction levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level IV.</","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To elucidate the genetic etiology of sporadic vestibular schwannomas (VSs) and investigate the correlation between NF2 inactivation mechanisms and preoperative clinical characteristics, including hearing function and tumor growth.
Methods
Nineteen patients who underwent VS resection at our otorhinolaryngology or neurosurgery department between June 2020 and March 2022 were included in this study. Whole-exome sequencing (WES) was performed to detect somatic changes in NF2. Additionally, NF2 promoter methylation status and copy number changes were evaluated using methylation analysis and multiple ligation-dependent probe amplification (MLPA). Preoperative clinical data, including pure tone audiometry, speech discrimination scores, and tumor growth rates, were collected and analyzed for correlations with genetic findings.
Results
WES identified somatic alterations in both NF2 alleles in 16 cases (84.2%). The addition of methylation analysis and MLPA confirmed biallelic NF2 inactivation in all cases. NF2 promoter methylation was suggested to be associated with hearing loss and tumor progression. A weak correlation between NF2 expression levels and tumor growth rate was observed (r = 0.21), while no significant correlation was found between NF2 expression and pure tone audiometry or speech discrimination scores.
Conclusion
Comprehensive genetic analyses, including WES, methylation analysis, and MLPA, are essential for identifying NF2 inactivation mechanisms in sporadic VSs. The findings suggest that NF2 methylation may contribute to variations in clinical presentation. Further studies with larger cohorts are necessary to clarify the role of epigenetic modifications in disease progression and their potential impact on patient management strategies.
{"title":"Comprehensive Genetic Analysis of NF2 in Sporadic Vestibular Schwannoma","authors":"Takeshi Wakabayashi, Koichiro Wasano, Kohei Nakamura, Makoto Hosoya, Ryutaro Kawano, Reika Takamatsu, Masafumi Ueno, Marie N. Shimanuki, Nobuyoshi Tsuzuki, Takanori Nishiyama, Takenori Akiyama, Masahiro Toda, Hiroshi Nishihara, Hiroyuki Ozawa, Naoki Oishi","doi":"10.1002/lio2.70265","DOIUrl":"https://doi.org/10.1002/lio2.70265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To elucidate the genetic etiology of sporadic vestibular schwannomas (VSs) and investigate the correlation between <i>NF2</i> inactivation mechanisms and preoperative clinical characteristics, including hearing function and tumor growth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nineteen patients who underwent VS resection at our otorhinolaryngology or neurosurgery department between June 2020 and March 2022 were included in this study. Whole-exome sequencing (WES) was performed to detect somatic changes in <i>NF2</i>. Additionally, <i>NF2</i> promoter methylation status and copy number changes were evaluated using methylation analysis and multiple ligation-dependent probe amplification (MLPA). Preoperative clinical data, including pure tone audiometry, speech discrimination scores, and tumor growth rates, were collected and analyzed for correlations with genetic findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>WES identified somatic alterations in both <i>NF2</i> alleles in 16 cases (84.2%). The addition of methylation analysis and MLPA confirmed biallelic <i>NF2</i> inactivation in all cases. <i>NF2</i> promoter methylation was suggested to be associated with hearing loss and tumor progression. A weak correlation between <i>NF2</i> expression levels and tumor growth rate was observed (<i>r</i> = 0.21), while no significant correlation was found between <i>NF2</i> expression and pure tone audiometry or speech discrimination scores.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comprehensive genetic analyses, including WES, methylation analysis, and MLPA, are essential for identifying <i>NF2</i> inactivation mechanisms in sporadic VSs. The findings suggest that <i>NF2</i> methylation may contribute to variations in clinical presentation. Further studies with larger cohorts are necessary to clarify the role of epigenetic modifications in disease progression and their potential impact on patient management strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70265","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Amy Wang, Yuki Yoshiyasu, Brian McKinnon, Tyler Janz
Objective
Gains in Asian representation have been reported across otolaryngology residency programs over the previous decade. We provide an update on otolaryngology resident demographics from 2018 to 2024 to determine how Asian representation has changed.
Methods
Demographic data from annual reports by the Journal of the American Medical Association (JAMA) and Association of American Medical Colleges (AAMC). Otolaryngology resident reports were compared to other medical specialties. Asian representation was assessed and compared to that of other reported races/ethnicities. Trends were compared between 2018 and 2024.
Results
Between 2018 and 2024, Asian representation in Otolaryngology remained stable, showing a small decline from 2018 to 2023 that was followed by rebound growth in 2023–2024 observed across multiple specialties. The total proportion of Asian, Black, and Hispanic residents rose significantly (p < 0.05), while the percent of White residents declined. At 24.48%, Asian otolaryngology resident levels for the period were only 0.34% higher than the Asian medical student graduate level.
Conclusion
From 2018 to 2024, Asian representation in Otolaryngology remained stable, with limited but insignificant growth overall. Sustained increases in the proportion of Asian otolaryngology residents have yet to be seen, but there remain promising levels of Asian resident representation, especially compared to other minority groups.
{"title":"Sound Progress? Asian Representation in Otolaryngology Residency Programs: A 5-Year Update","authors":"Amy Wang, Yuki Yoshiyasu, Brian McKinnon, Tyler Janz","doi":"10.1002/lio2.70252","DOIUrl":"https://doi.org/10.1002/lio2.70252","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Gains in Asian representation have been reported across otolaryngology residency programs over the previous decade. We provide an update on otolaryngology resident demographics from 2018 to 2024 to determine how Asian representation has changed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Demographic data from annual reports by the Journal of the American Medical Association (JAMA) and Association of American Medical Colleges (AAMC). Otolaryngology resident reports were compared to other medical specialties. Asian representation was assessed and compared to that of other reported races/ethnicities. Trends were compared between 2018 and 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between 2018 and 2024, Asian representation in Otolaryngology remained stable, showing a small decline from 2018 to 2023 that was followed by rebound growth in 2023–2024 observed across multiple specialties. The total proportion of Asian, Black, and Hispanic residents rose significantly (<i>p</i> < 0.05), while the percent of White residents declined. At 24.48%, Asian otolaryngology resident levels for the period were only 0.34% higher than the Asian medical student graduate level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>From 2018 to 2024, Asian representation in Otolaryngology remained stable, with limited but insignificant growth overall. Sustained increases in the proportion of Asian otolaryngology residents have yet to be seen, but there remain promising levels of Asian resident representation, especially compared to other minority groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>5</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70252","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145146615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Diana Hallak, Logan F. McColl, Meredith M. Lind, Kris R. Jatana
Introduction
Hairy polyps (HPs), also known as bigerminal choristoma, are rare tumors most often occurring within the nasopharynx and oropharynx, linked to the development of the first and second pharyngeal arches. Commonly, HPs present in female neonates and are left-sided. This case report and systematic literature review provide a comprehensive overview of HPs' presentation, management, and outcomes.
Case Description
A female neonate demonstrated persistent rightward head positioning and gagging at 1 day of life. Oral examination revealed a protuberant tubular soft-tissue mass appearing to originate from the posterior pharynx or nasopharynx. Neck MRI with and without contrast revealed a lobular, exophytic, and pedunculated soft-tissue mass arising from the left soft palate and extending to the oropharynx with minimal post-contrast enhancement. At 3 days of life, she underwent transoral mass resection. Final operative findings revealed a 6-cm mass based on the posterior aspect of the left soft palate near the superior left tonsillar pillar. Histopathological evaluation revealed skin-like epidermis with hair follicles and adnexa surrounding a cartilage core, muscle bundles, fat, and vascular channels consistent with bigerminal choristoma.
Literature Review
Systematic review, conducted according to PRISMA guidelines using PubMed database, yielded 106 published reports with 147 HP cases with a female and childhood-onset predominance. Respiratory distress, feeding difficulties, or a combination of both was the most commonly reported presenting symptoms occurring in 63.9% of cases. Surgical excision is the standard treatment across published reports.
Conclusion
HPs commonly present with respiratory symptoms and a visible mass. Timely diagnosis and surgical intervention are critical to avoid significant complications to the airway and aerodigestive function.
{"title":"Pediatric Hairy Polyp of the Naso-Oropharynx: A Case Report and Systematic Literature Review","authors":"Diana Hallak, Logan F. McColl, Meredith M. Lind, Kris R. Jatana","doi":"10.1002/lio2.70262","DOIUrl":"10.1002/lio2.70262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Hairy polyps (HPs), also known as bigerminal choristoma, are rare tumors most often occurring within the nasopharynx and oropharynx, linked to the development of the first and second pharyngeal arches. Commonly, HPs present in female neonates and are left-sided. This case report and systematic literature review provide a comprehensive overview of HPs' presentation, management, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Case Description</h3>\u0000 \u0000 <p>A female neonate demonstrated persistent rightward head positioning and gagging at 1 day of life. Oral examination revealed a protuberant tubular soft-tissue mass appearing to originate from the posterior pharynx or nasopharynx. Neck MRI with and without contrast revealed a lobular, exophytic, and pedunculated soft-tissue mass arising from the left soft palate and extending to the oropharynx with minimal post-contrast enhancement. At 3 days of life, she underwent transoral mass resection. Final operative findings revealed a 6-cm mass based on the posterior aspect of the left soft palate near the superior left tonsillar pillar. Histopathological evaluation revealed skin-like epidermis with hair follicles and adnexa surrounding a cartilage core, muscle bundles, fat, and vascular channels consistent with bigerminal choristoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Literature Review</h3>\u0000 \u0000 <p>Systematic review, conducted according to PRISMA guidelines using PubMed database, yielded 106 published reports with 147 HP cases with a female and childhood-onset predominance. Respiratory distress, feeding difficulties, or a combination of both was the most commonly reported presenting symptoms occurring in 63.9% of cases. Surgical excision is the standard treatment across published reports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HPs commonly present with respiratory symptoms and a visible mass. Timely diagnosis and surgical intervention are critical to avoid significant complications to the airway and aerodigestive function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455882/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mirabelle Sajisevi, Kenny Nguyen, Peter Callas, Andrew J. Holcomb, Emre Vural, Kyle P. Davis, Carissa M. Thomas, John S. Stein, Ameya Asarkar, Ricardo Aulet, Rebecca K. Bell, Michael A. Blasco, Vanessa B. Bowmaster, Clayton P. Burruss, Jeffson Chung, Kimberly Chan, Brent A. Chang, Charles S. Coffey, David M. Cognetti, Dylan J. Cooper, Joehassin Cordero, John Donovan, Yue Jennifer Du, Yusuf Dundar, Rogerio Dedivitis, Heather Edwards, Boban M. Erovic, Antoine Eskander, Philip A. Feinberg, Emily A. Garvey, David Goldstein, Joseph F. Goodman, Rafael N. Goulart, Neerav Goyal, Stefan Grasl, Jonathan Giurintano, Nikita Gupta, Andy Habib, Trevor Hackman, Jared H. Hara, Christina Henson, Michael L. Hinni, Nadia Hua, Stephanie Johnson-Obaseki, Aditya Juloori, Noah S. Kalman, Alexandra Kejner, Sobia F. Khaja, Jamie A. Ku, Arnaud Lambert, Bao K. Luu, Kelly R. Magliocca, Luiz R. Medina dos Santos, Cara Michael, Brett Miles, Giulianno Molina de Melo, Michael G. Moore, Gregoire B. Morand, Kauê Moura, Hesameddin Noroozi, Rusha Patel, Joseph Paydarfar, Karolina A. Plonowska-Hirschfeld, Nader Sadeghi, Fabrice Savaria, Nicole C. Schmitt, Justin Shapiro, Timothy B. Shaver, Sandro J. Stoeckli, William Alvo Stokes, Anita Sulibhavi, Jason Tasoulas, Varun Vendra, Daniel B. Vinh, Celina G. Virgen, Neil M. Woody, Geoffrey D. Young, Kiran Kakarala, Danny J. Enepekides, Michael P. Hier, Louise Davies, William R. Ryan
Objectives
To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.
Methods
Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.
Results
Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (n = 384, 53%) or total (n = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, p < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, p < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, p < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, p = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, p = 0.58).
Conclusions
Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials.
Level of Evidence
2b.
目的：在治疗指南出台之前，探讨中低级别唾液腺癌治疗的实践模式和结果。方法：分析2010年至2019年期间因中低级别癌接受腮腺和颌下腺切除术的登记患者。结果：在纳入研究的所有786例患者中，726例（92%）进行了术前影像学检查，653例（83%）进行了术前活检。在729例腮腺癌患者中，大多数接受了浅表（n = 384, 53%）或全部（n = 254, 35%）腮腺切除术。在保留面神经的患者中，腮腺全切除术与短暂性面肌无力显著增加（72/177（41%）比82/311 (26%),RR 0.65, 95% CI 0.50-0.84, p p p p = 0.06）或区域控制率（RR 0.75, 95% CI 0.26-2.13, p = 0.58）相关。结论：从2010年到2019年，中低级别唾液癌的管理是可变的，考虑到疾病的稀缺性和异质性，以及2021年之前缺乏治疗指南，这是意料之中的。大多数腮腺恶性肿瘤患者行表面或全腮腺切除术。腮腺切除术的程度对面神经功能的预后有影响。随着时间的推移，辅助辐射的递送呈下降趋势。这里提供的数据将支持指南的传播，并为未来的试验提供数据。证据等级：2b。
{"title":"Practice Patterns in Management of Low- to Intermediate-Grade Salivary Gland Carcinoma: A Multi-Institutional Study","authors":"Mirabelle Sajisevi, Kenny Nguyen, Peter Callas, Andrew J. Holcomb, Emre Vural, Kyle P. Davis, Carissa M. Thomas, John S. Stein, Ameya Asarkar, Ricardo Aulet, Rebecca K. Bell, Michael A. Blasco, Vanessa B. Bowmaster, Clayton P. Burruss, Jeffson Chung, Kimberly Chan, Brent A. Chang, Charles S. Coffey, David M. Cognetti, Dylan J. Cooper, Joehassin Cordero, John Donovan, Yue Jennifer Du, Yusuf Dundar, Rogerio Dedivitis, Heather Edwards, Boban M. Erovic, Antoine Eskander, Philip A. Feinberg, Emily A. Garvey, David Goldstein, Joseph F. Goodman, Rafael N. Goulart, Neerav Goyal, Stefan Grasl, Jonathan Giurintano, Nikita Gupta, Andy Habib, Trevor Hackman, Jared H. Hara, Christina Henson, Michael L. Hinni, Nadia Hua, Stephanie Johnson-Obaseki, Aditya Juloori, Noah S. Kalman, Alexandra Kejner, Sobia F. Khaja, Jamie A. Ku, Arnaud Lambert, Bao K. Luu, Kelly R. Magliocca, Luiz R. Medina dos Santos, Cara Michael, Brett Miles, Giulianno Molina de Melo, Michael G. Moore, Gregoire B. Morand, Kauê Moura, Hesameddin Noroozi, Rusha Patel, Joseph Paydarfar, Karolina A. Plonowska-Hirschfeld, Nader Sadeghi, Fabrice Savaria, Nicole C. Schmitt, Justin Shapiro, Timothy B. Shaver, Sandro J. Stoeckli, William Alvo Stokes, Anita Sulibhavi, Jason Tasoulas, Varun Vendra, Daniel B. Vinh, Celina G. Virgen, Neil M. Woody, Geoffrey D. Young, Kiran Kakarala, Danny J. Enepekides, Michael P. Hier, Louise Davies, William R. Ryan","doi":"10.1002/lio2.70246","DOIUrl":"10.1002/lio2.70246","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To characterize practice patterns and outcomes in the management of low- and intermediate-grade salivary gland carcinoma prior to the existence of treatment guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Analysis of a registry of patients who underwent parotid and submandibular gland resections for low-and intermediate-grade carcinomas between 2010 and 2019.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of all 786 patients included in the study, 726 (92%) had preoperative imaging and 653 (83%) had preoperative biopsy. Of the 729 patients with parotid gland cancer, the majority underwent superficial (<i>n</i> = 384, 53%) or total (<i>n</i> = 254, 35%) parotidectomy. In patients with facial nerve preservation, total parotidectomy was associated with a significant increase in transient facial weakness (72/177 (41%) vs. 82/311 (26%), RR 0.65, 95% CI 0.50–0.84, <i>p</i> < 0.05) and permanent facial nerve weakness (23/176 (13%) vs. 16/301 (5%), RR 0.41, 95% CI 0.22–0.75, <i>p</i> < 0.05) compared to superficial parotidectomy. Adjuvant radiation therapy (RT) was delivered to 285 (36%) patients. The proportion of patients receiving adjuvant RT declined significantly over the time period from 2015 to 2019 compared to 2010 to 2014 at 162/504 (32%) and 123/282 (44%), respectively (RR 0.74, 95% CI 0.61–0.89, <i>p</i> < 0.05). When comparing the time periods from 2015 to 2019 and 2010 to 2014, there was no significant difference in local control rates (RR 0.52, 95% CI 0.26–1.04, <i>p</i> = 0.06) or regional control rates (RR 0.75, 95% CI 0.26–2.13, <i>p</i> = 0.58).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Management of low- and intermediate-grade salivary cancer from 2010 to 2019 was variable, which is expected given the rarity and heterogeneity of the disease and the lack of treatment guidelines prior to 2021. Most patients with parotid malignancies underwent superficial or total parotidectomy. The extent of parotidectomy had an impact on facial nerve function outcomes. Delivery of adjuvant radiation trended down with time. The data presented here will support dissemination of the guidelines and provide data that could inform future trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2b.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12455896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ashley L. Miller, Vinay K. Rathi, Molly O. Meeker, Lauren E. Miller, Jason Pedicini, Charles E. Elmaraghy
In an effort enhance reimbursement for cognitive specialties, the Centers for Medicare and Medicaid Services (CMS) increased the payment for outpatient and inpatient E&M services in 2021 and 2023, respectively. Notably, visits during the postoperative global period were excluded from this increase. It is well-established that pediatric subspecialties, including pediatric otolaryngology, are less well-compensated than their adult counterparts. In this study, we estimated the potential annual revenue increase per academic pediatric otolaryngologist had CMS included global period visits in its revaluation.
{"title":"CMS Exclusion of Global Period Visits From E/M Payment Reform: Estimated Payment Loss for Pediatric Otolaryngologists","authors":"Ashley L. Miller, Vinay K. Rathi, Molly O. Meeker, Lauren E. Miller, Jason Pedicini, Charles E. Elmaraghy","doi":"10.1002/lio2.70254","DOIUrl":"https://doi.org/10.1002/lio2.70254","url":null,"abstract":"<p>In an effort enhance reimbursement for cognitive specialties, the Centers for Medicare and Medicaid Services (CMS) increased the payment for outpatient and inpatient E&M services in 2021 and 2023, respectively. Notably, visits during the postoperative global period were excluded from this increase. It is well-established that pediatric subspecialties, including pediatric otolaryngology, are less well-compensated than their adult counterparts. In this study, we estimated the potential annual revenue increase per academic pediatric otolaryngologist had CMS included global period visits in its revaluation.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145111188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesco Mattioli, Matteo Miglio, Edoardo Serafini, Roberto Tonelli, Edoardo Meneguzzi, Elisa D'Angelo, Roberta Depenni, Martina Napolitano, Massimo Dominici, Daniele Marchioni, Federica Bertolini
Objective
Oropharyngeal carcinoma represents a tumor with an increased concern in human health and treatment strategy. This study aims to identify any tumor or patient-related characteristics capable of predicting response to non-surgical curative treatment in a cohort of oropharyngeal squamous cell carcinoma and define oncological outcomes of overall survival and progression-free survival.
Methods
A monocentric retrospective cohort study was performed, including 223 patients with non-metastatic oropharyngeal squamous cell carcinoma treated with curative intent with a non-surgical strategy. Patients were treated at the University Hospital of Modena (Italy) after a multidisciplinary evaluation between January 2010 and December 2021. The treatment response was assessed by using the RECIST 1.1 Criteria on imaging performed 3 months after treatment.
Results
Tonsil subsite and stage I were independently associated with a complete treatment response (OR = 0.53, p = 0.05, and OR = 0.32, p = 0.01, respectively). The association between smoking and p16− status resulted in a higher probability of a not-complete response (OR = 1.72, p = 0.05). Similar results were found for soft palate subsite, cT4, N2 in the p16+ group, and stage IVb in the p16− group. Conversely, cT1 was associated with a higher probability of complete response. Age and the extension to nearby structures did not influence the response.
Conclusions
This retrospective study shows a possible stratification of patients with oropharyngeal squamous cell carcinoma based on factors that influence treatment response rate. The identification of a phenotype of a non-responding tumor could better define therapeutic and follow-up programs.
Level of Evidence
4.
目的：口咽癌是一种日益受到人类健康和治疗策略关注的肿瘤。本研究旨在确定在口咽鳞状细胞癌队列中能够预测非手术治疗反应的任何肿瘤或患者相关特征，并确定总生存期和无进展生存期的肿瘤学结果。方法：进行了一项单中心回顾性队列研究，包括223例非转移性口咽鳞状细胞癌患者，以非手术治疗为目的。患者在2010年1月至2021年12月期间进行多学科评估后，在摩德纳大学医院（意大利）接受治疗。治疗后3个月，采用RECIST 1.1影像学标准评估治疗效果。结果：扁桃体亚位和I期与完全治疗反应独立相关（OR = 0.53, p = 0.05, OR = 0.32, p = 0.01）。吸烟与p16-状态之间的关联导致不完全缓解的概率更高（OR = 1.72, p = 0.05）。p16+组软腭亚区、cT4、N2及p16-组IVb期均有相似的结果。相反，cT1与更高的完全缓解概率相关。年龄和向附近结构的延伸对反应没有影响。结论：这项回顾性研究显示，根据影响治疗反应率的因素对口咽鳞状细胞癌患者进行可能的分层。鉴定无应答肿瘤的表型可以更好地确定治疗和随访方案。证据等级：4。
{"title":"Other Than Complete Response in Oropharyngeal Carcinoma: Patient and Tumor-Related Factors","authors":"Francesco Mattioli, Matteo Miglio, Edoardo Serafini, Roberto Tonelli, Edoardo Meneguzzi, Elisa D'Angelo, Roberta Depenni, Martina Napolitano, Massimo Dominici, Daniele Marchioni, Federica Bertolini","doi":"10.1002/lio2.70258","DOIUrl":"10.1002/lio2.70258","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Oropharyngeal carcinoma represents a tumor with an increased concern in human health and treatment strategy. This study aims to identify any tumor or patient-related characteristics capable of predicting response to non-surgical curative treatment in a cohort of oropharyngeal squamous cell carcinoma and define oncological outcomes of overall survival and progression-free survival.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A monocentric retrospective cohort study was performed, including 223 patients with non-metastatic oropharyngeal squamous cell carcinoma treated with curative intent with a non-surgical strategy. Patients were treated at the University Hospital of Modena (Italy) after a multidisciplinary evaluation between January 2010 and December 2021. The treatment response was assessed by using the RECIST 1.1 Criteria on imaging performed 3 months after treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Tonsil subsite and stage I were independently associated with a complete treatment response (OR = 0.53, <i>p</i> = 0.05, and OR = 0.32, <i>p</i> = 0.01, respectively). The association between smoking and p16− status resulted in a higher probability of a not-complete response (OR = 1.72, <i>p</i> = 0.05). Similar results were found for soft palate subsite, cT4, N2 in the p16+ group, and stage IVb in the p16− group. Conversely, cT1 was associated with a higher probability of complete response. Age and the extension to nearby structures did not influence the response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This retrospective study shows a possible stratification of patients with oropharyngeal squamous cell carcinoma based on factors that influence treatment response rate. The identification of a phenotype of a non-responding tumor could better define therapeutic and follow-up programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ahlam Alamri, Abdulmajeed Alharbi, Hussain Albaharna, Ahmad Alsayed, Abdulrazag Ajlan, Ashwag Alqurashi, Basem Noor Elahi, Abdulaziz Alrasheed, Saud Alromaih, Saad Alsaleh, Ahmad Alroqi
Background
Quality of life (QoL) is a critical outcome measure in patients undergoing endoscopic endonasal resection of anterior skull base lesions. This study aimed to validate the Arabic version of the Anterior Skull Base Questionnaire 35 for endoscopic endonasal resections (AVQ35).
Methods
This study included patients who underwent endoscopic endonasal resection of anterior skull base lesions between January 2022 and December 2022 at King Saud University Medical City in Riyadh. QoL assessments were performed using standardized questionnaires at baseline and during the postoperative follow-up visits. Statistical analyses, including paired t-tests and regression analysis, were used to assess changes in QoL and to identify associated factors.
Results
All individual components or items within the AVQ-35 questionnaire were valuable and relevant when assessing a patient's QoL. The findings demonstrated a significant improvement in QoL scores following endoscopic endonasal resection of the anterior skull base lesions (p < 0.05). The AVQ-35's validity was established by evaluating its internal consistency, test–retest reliability, capacity, and ability to detect clinical changes before and after surgery at two different time points. The internal consistency of the AVQ-35 was excellent, with a Cronbach's alpha > 0.95 (0.980) across all time points for all domains.
Conclusion
This study successfully validated the AVQ-35 for use in patients undergoing endoscopic endonasal resection of anterior skull base lesions. The AVQ-35 demonstrated excellent internal consistency (Cronbach's alpha > 0.95) and responsiveness to clinical changes, as evidenced by significant improvements in QoL scores postoperatively. These findings establish the AVQ-35 as a robust and culturally appropriate instrument for assessing QoL in Arabic-speaking populations, filling a critical gap in patient-reported outcome measures for anterior skull base surgery.
{"title":"Validation of the Arabic Version of Anterior Skull Base Questionnaire 35 (AVQ-35) in Endoscopic Endonasal Resection","authors":"Ahlam Alamri, Abdulmajeed Alharbi, Hussain Albaharna, Ahmad Alsayed, Abdulrazag Ajlan, Ashwag Alqurashi, Basem Noor Elahi, Abdulaziz Alrasheed, Saud Alromaih, Saad Alsaleh, Ahmad Alroqi","doi":"10.1002/lio2.70263","DOIUrl":"10.1002/lio2.70263","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Quality of life (QoL) is a critical outcome measure in patients undergoing endoscopic endonasal resection of anterior skull base lesions. This study aimed to validate the Arabic version of the Anterior Skull Base Questionnaire 35 for endoscopic endonasal resections (AVQ35).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included patients who underwent endoscopic endonasal resection of anterior skull base lesions between January 2022 and December 2022 at King Saud University Medical City in Riyadh. QoL assessments were performed using standardized questionnaires at baseline and during the postoperative follow-up visits. Statistical analyses, including paired <i>t</i>-tests and regression analysis, were used to assess changes in QoL and to identify associated factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All individual components or items within the AVQ-35 questionnaire were valuable and relevant when assessing a patient's QoL. The findings demonstrated a significant improvement in QoL scores following endoscopic endonasal resection of the anterior skull base lesions (<i>p</i> < 0.05). The AVQ-35's validity was established by evaluating its internal consistency, test–retest reliability, capacity, and ability to detect clinical changes before and after surgery at two different time points. The internal consistency of the AVQ-35 was excellent, with a Cronbach's alpha > 0.95 (0.980) across all time points for all domains.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study successfully validated the AVQ-35 for use in patients undergoing endoscopic endonasal resection of anterior skull base lesions. The AVQ-35 demonstrated excellent internal consistency (Cronbach's alpha > 0.95) and responsiveness to clinical changes, as evidenced by significant improvements in QoL scores postoperatively. These findings establish the AVQ-35 as a robust and culturally appropriate instrument for assessing QoL in Arabic-speaking populations, filling a critical gap in patient-reported outcome measures for anterior skull base surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087965","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Herz, Aman M. Patel, George S. Bebawy, Anthony M. Saad, Ghayoour S. Mir, Andrey Filimonov
Objectives
Objective preoperative risk assessment tools inform physician and patient decision making. Our study examines the relationship between the Charlson–Deyo comorbidity index (CCI) and overall survival (OS) following surgery for sinonasal squamous cell carcinoma (SNSCC).
Methods
In a retrospective cohort study, the 2004–2016 National Cancer Database was used to extract adult patients with pT1-4N0-3 M0 SNSCC undergoing surgery. Kaplan–Meier survival analysis and Cox-proportional hazards modeling were used to analyze the impact of CCI on OS.
Results
Of the 3307 patients satisfying inclusion criteria, 2613 (79.0%) were CCI = 0, 533 (16.1%) were CCI = 1, and 161 (4.9%) were CCI = 2+. On univariate analysis, CCI groups differed by age (42.8% were ≥ 65 years old in CCI = 0 vs. 53.3% and 64.0% in CCI groups 1 and 2+, respectively, p < 0.001) and race (p < 0.001). There was no significant difference between CCI groups in sex, T-stage, N-stage, margin status, primary site, radiation therapy, or systemic therapy. On Kaplan–Meier analysis, 5-year OS for CCI = 0, CCI = 1, and CCI = 2+ was 58.6%, 48.0%, and 42.9%, respectively (p < 0.001). CCI = 1 (HR 1.20, 95% CI 0.99–1.45, p = 0.069) was not associated with worse OS than CCI = 0. CCI = 2+ (HR 1.43, 95% CI 1.05–1.96, p = 0.025) was associated with worse OS than CCI = 0.
Conclusions
In a cohort of adult patients with SNSCC undergoing surgery, higher CCI was independently associated with worse OS. These findings support the use of CCI as a predictor of postoperative outcomes in SNSCC patients. Future studies should explore how comorbidity burden interacts with frailty and other prognostic factors to refine risk stratification tools.
Level of Evidence
4
目的：客观的术前风险评估工具为医生和患者的决策提供信息。本研究探讨了鼻窦鳞状细胞癌（SNSCC）术后Charlson-Deyo共病指数（CCI）与总生存率（OS）之间的关系。方法：在一项回顾性队列研究中，使用2004-2016年国家癌症数据库提取手术的成年pT1-4N0-3 M0 SNSCC患者。采用Kaplan-Meier生存分析和cox比例风险模型分析CCI对OS的影响。结果：在符合纳入标准的3307例患者中，CCI = 0的患者2613例（79.0%），CCI = 1的患者533例（16.1%），CCI = 2+的患者161例（4.9%）。在单因素分析中，CCI组存在年龄差异（CCI = 0组≥65岁者占42.8%，CCI 1组和CCI 2+组分别为53.3%和64.0%,p p p p = 0.069），与CCI = 0相比，CCI组的OS较差无相关性。CCI = 2+ (HR 1.43, 95% CI 1.05 ~ 1.96, p = 0.025)与CCI = 0的OS差相关。结论：在接受手术的成年SNSCC患者队列中，较高的CCI与较差的OS独立相关。这些发现支持使用CCI作为SNSCC患者术后预后的预测指标。未来的研究应该探索共病负担如何与虚弱和其他预后因素相互作用，以完善风险分层工具。证据等级：4。
{"title":"Charlson–Deyo Index Impact on Overall Survival After Surgery for Sinonasal Squamous Cell Carcinoma","authors":"David Herz, Aman M. Patel, George S. Bebawy, Anthony M. Saad, Ghayoour S. Mir, Andrey Filimonov","doi":"10.1002/lio2.70259","DOIUrl":"10.1002/lio2.70259","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Objective preoperative risk assessment tools inform physician and patient decision making. Our study examines the relationship between the Charlson–Deyo comorbidity index (CCI) and overall survival (OS) following surgery for sinonasal squamous cell carcinoma (SNSCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a retrospective cohort study, the 2004–2016 National Cancer Database was used to extract adult patients with pT1-4N0-3 M0 SNSCC undergoing surgery. Kaplan–Meier survival analysis and Cox-proportional hazards modeling were used to analyze the impact of CCI on OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 3307 patients satisfying inclusion criteria, 2613 (79.0%) were CCI = 0, 533 (16.1%) were CCI = 1, and 161 (4.9%) were CCI = 2+. On univariate analysis, CCI groups differed by age (42.8% were ≥ 65 years old in CCI = 0 vs. 53.3% and 64.0% in CCI groups 1 and 2+, respectively, <i>p</i> < 0.001) and race (<i>p</i> < 0.001). There was no significant difference between CCI groups in sex, T-stage, N-stage, margin status, primary site, radiation therapy, or systemic therapy. On Kaplan–Meier analysis, 5-year OS for CCI = 0, CCI = 1, and CCI = 2+ was 58.6%, 48.0%, and 42.9%, respectively (<i>p</i> < 0.001). CCI = 1 (HR 1.20, 95% CI 0.99–1.45, <i>p</i> = 0.069) was not associated with worse OS than CCI = 0. CCI = 2+ (HR 1.43, 95% CI 1.05–1.96, <i>p</i> = 0.025) was associated with worse OS than CCI = 0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In a cohort of adult patients with SNSCC undergoing surgery, higher CCI was independently associated with worse OS. These findings support the use of CCI as a predictor of postoperative outcomes in SNSCC patients. Future studies should explore how comorbidity burden interacts with frailty and other prognostic factors to refine risk stratification tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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