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}
Abdul-Latif Hamdan, Lana Ghzayel, Zeina Maria Semaan, Omar Aboul Hosn, Anne Marie Daou, Jonathan Abou Chaar, Nader Nawfal, Randa Barazi
Objective
To investigate tolerance to office-based laser surgery (OBLS) in patients with no prior history of mental illnesses, and to analyze the correlation between patient tolerance, anxiety, and depression using validated questionnaires.
Methods
Patients aged 18–65 with no prior history of mental disorders undergoing OBLS from May 2024 to September 2024 were included in this study. All patients completed the Generalized Anxiety Disorder scale-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). After surgery, tolerance was assessed using the IOWA satisfaction with anesthesia scale and a Visual Analog Scale for discomfort.
Results
A total of 25 patients were enrolled. Eighteen patients had moderate–severe anxiety and six patients had moderate–severe depression. The mean GAD-7 was 12.32 ± 4.09, and the PHQ-9 score was 6.60 ± 5.43. The mean IOWA score was 1.78 ± 1.07, and the mean VAS for discomfort was 4.60 ± 3.31. There was a moderate negative correlation between IOWA score and GAD-7 score (r = −0.489) and a mild positive correlation between the GAD-7 score and the VAS score for discomfort (r = 0.372). A mild negative correlation was found between IOWA scores and PHQ-9 scores (r = −0.357) and a weak positive correlation between the PHQ-9 score and the VAS score (r = 0.204). It is important to note that although this study group had a high risk for anxiety and depression, the results indicated that OBLS was a well-tolerated procedure. This could be ascribed to the non-invasiveness of OBLS and proper application of topical anesthesia.
Conclusion
The study revealed a high tolerance level despite a high risk for anxiety and depression in a large percentage of our study group. Moreover, there was a mild to moderate negative correlation between anxiety, depression, and patient tolerance.
{"title":"Correlation Between Anxiety, Depression, and Patient Tolerance in Patients With no Prior History of Mental Disorders Undergoing Office-Based Laser Surgery: A Case Study","authors":"Abdul-Latif Hamdan, Lana Ghzayel, Zeina Maria Semaan, Omar Aboul Hosn, Anne Marie Daou, Jonathan Abou Chaar, Nader Nawfal, Randa Barazi","doi":"10.1002/lio2.70256","DOIUrl":"10.1002/lio2.70256","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate tolerance to office-based laser surgery (OBLS) in patients with no prior history of mental illnesses, and to analyze the correlation between patient tolerance, anxiety, and depression using validated questionnaires.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged 18–65 with no prior history of mental disorders undergoing OBLS from May 2024 to September 2024 were included in this study. All patients completed the Generalized Anxiety Disorder scale-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9). After surgery, tolerance was assessed using the IOWA satisfaction with anesthesia scale and a Visual Analog Scale for discomfort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 25 patients were enrolled. Eighteen patients had moderate–severe anxiety and six patients had moderate–severe depression. The mean GAD-7 was 12.32 ± 4.09, and the PHQ-9 score was 6.60 ± 5.43. The mean IOWA score was 1.78 ± 1.07, and the mean VAS for discomfort was 4.60 ± 3.31. There was a moderate negative correlation between IOWA score and GAD-7 score (<i>r</i> = −0.489) and a mild positive correlation between the GAD-7 score and the VAS score for discomfort (<i>r</i> = 0.372). A mild negative correlation was found between IOWA scores and PHQ-9 scores (<i>r</i> = −0.357) and a weak positive correlation between the PHQ-9 score and the VAS score (<i>r</i> = 0.204). It is important to note that although this study group had a high risk for anxiety and depression, the results indicated that OBLS was a well-tolerated procedure. This could be ascribed to the non-invasiveness of OBLS and proper application of topical anesthesia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The study revealed a high tolerance level despite a high risk for anxiety and depression in a large percentage of our study group. Moreover, there was a mild to moderate negative correlation between anxiety, depression, and patient tolerance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2.</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/PMC12442252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087777","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}
Nihal Evran, Gulcin Hancer Arslan, Murat Arslan, Selis Gulseven Guven, Ahmet Koder, Erdogan Bulut
Objectives
This study aimed to investigate balance system modifications under different conditions using cervical Vestibular Evoked Myogenic Potentials (c-VEMP) testing. Specifically, we examined vestibular compensation mechanisms in various dynamic balance positions through evoked potential analysis.
Methods
The study conducted c-VEMP test repetitions on 45 healthy subjects under different conditions. Participants underwent comprehensive otoscopic examination and hearing and balance assessments, with only those demonstrating normal hearing included in the analysis. c-VEMP testing was performed under three distinct conditions: condition 1 (standing on a flat surface with eyes open), condition 2 (standing on a flat surface with eyes closed), and condition 3 (standing on a FoamPad with eyes open). The analysis evaluated P1-N1 latencies and amplitudes in c-VEMP responses, with subsequent statistical analysis of the collected data.
Results
Analysis revealed statistically significant differences in P1-N1 amplitudes and latencies in left ears when comparing conditions 1 and 2 (p < 0.01). Right ears demonstrated significant differences only in amplitudes between conditions 1 and 2 (p < 0.01). Comparison of conditions 2 and 3 yielded statistically significant differences in P1-N1 amplitudes and latencies for left ears (p < 0.01), while right ears showed significant differences in amplitudes and N1 latency only (p < 0.01). No significant differences were observed in either ear when comparing conditions 1 and 3 (p > 0.05).
Conclusion
Our findings suggest that while the vestibular system is fundamental, visual input plays a more substantial role in balance maintenance compared to proprioceptive input.
Level of Evidence
3.
目的：利用颈椎前庭诱发肌源性电位（c-VEMP）测试研究不同条件下平衡系统的改变。具体来说，我们通过诱发电位分析研究了不同动态平衡位置的前庭代偿机制。方法：对45名健康受试者在不同条件下进行c-VEMP重复测试。参与者接受了全面的耳镜检查，听力和平衡评估，只有那些听力正常的人被纳入分析。c-VEMP测试在三种不同的条件下进行：条件1（站在平坦的表面上睁开眼睛），条件2（站在平坦的表面上闭上眼睛）和条件3（站在FoamPad上睁开眼睛）。分析评估了c-VEMP反应的P1-N1潜伏期和振幅，随后对收集的数据进行统计分析。结果：对比条件1和条件2，左耳P1-N1振幅和潜伏期差异有统计学意义（p p p p p > 0.05）。结论：我们的研究结果表明，虽然前庭系统是基本的，但视觉输入在平衡维持方面比本体感觉输入发挥更大的作用。证据等级：3。
{"title":"Evaluation of Vestibular Evoked Myogenic Potentials in Different Dynamic Equilibrium Conditions","authors":"Nihal Evran, Gulcin Hancer Arslan, Murat Arslan, Selis Gulseven Guven, Ahmet Koder, Erdogan Bulut","doi":"10.1002/lio2.70253","DOIUrl":"10.1002/lio2.70253","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to investigate balance system modifications under different conditions using cervical Vestibular Evoked Myogenic Potentials (c-VEMP) testing. Specifically, we examined vestibular compensation mechanisms in various dynamic balance positions through evoked potential analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The study conducted c-VEMP test repetitions on 45 healthy subjects under different conditions. Participants underwent comprehensive otoscopic examination and hearing and balance assessments, with only those demonstrating normal hearing included in the analysis. c-VEMP testing was performed under three distinct conditions: condition 1 (standing on a flat surface with eyes open), condition 2 (standing on a flat surface with eyes closed), and condition 3 (standing on a FoamPad with eyes open). The analysis evaluated P1-N1 latencies and amplitudes in c-VEMP responses, with subsequent statistical analysis of the collected data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis revealed statistically significant differences in P1-N1 amplitudes and latencies in left ears when comparing conditions 1 and 2 (<i>p</i> < 0.01). Right ears demonstrated significant differences only in amplitudes between conditions 1 and 2 (<i>p</i> < 0.01). Comparison of conditions 2 and 3 yielded statistically significant differences in P1-N1 amplitudes and latencies for left ears (<i>p</i> < 0.01), while right ears showed significant differences in amplitudes and N1 latency only (<i>p</i> < 0.01). No significant differences were observed in either ear when comparing conditions 1 and 3 (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggest that while the vestibular system is fundamental, visual input plays a more substantial role in balance maintenance compared to proprioceptive input.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3.</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/PMC12442251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087796","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}
Malnutrition and weight loss in patients with laryngeal cancer impair immune function and wound healing. Understanding how underweight status impacts outcomes is crucial to improving care. Accordingly, we evaluated perioperative outcomes of patients undergoing laryngectomy for laryngeal cancer, with a secondary focus on patients with recent unintentional weight loss.
Methods
This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database. CPT codes were used to identify patients undergoing open total or partial laryngectomies for cancer. Only those with underweight (< 18.5) or normal weight (18.5–29.9) BMIs were included. A subgroup analysis assessed patients with recent unintentional weight loss. Univariate and multivariate analyses were performed, with significance set at p < 0.05.
Results
2012 patients were analyzed: 276 underweight (79 female, 197 male) and 1736 normal weight (306 female, 1430 male). Age distribution among underweight patients was 2.5% (ages 20–44), 76.1% (ages 45–69), and 21.4% (ages 70–90), compared to 2.9%, 66.7%, and 30.1%, respectively, in normal-weight patients. Underweight patients were more likely to experience medical complications (p < 0.001), longer hospital stays (p < 0.001), wound disruptions (p = 0.002), and to have greater transfusion requirements (p < 0.001). In those with recent, unintentional weight loss, underweight individuals were at increased risk of experiencing medical complications (p = 0.046) and requiring a transfusion (p < 0.001), but were not more likely to experience wound disruptions (p = 0.119) or experience increased lengths of stay (p = 0.225).
Conclusion
Underweight status and recent weight loss are associated with heightened risks of perioperative medical complications and transfusions. Preoperative optimization may enhance surgical recovery and outcomes.
Level of Evidence
Level 3.
目的：营养不良和体重减轻对喉癌患者免疫功能和伤口愈合的影响。了解体重过轻状况如何影响结果对改善护理至关重要。因此，我们评估了接受喉癌切除术患者的围手术期预后，并对近期意外体重减轻的患者进行了二次关注。方法：本回顾性队列研究使用美国外科医师学会国家手术质量改进计划数据库。CPT代码用于识别因癌症而接受开放式全喉或部分喉切除术的患者。结果：分析了2012例患者：体重不足276例（女性79例，男性197例），体重正常1736例（女性306例，男性1430例）。体重不足患者的年龄分布分别为2.5%（20-44岁）、76.1%（45-69岁）和21.4%（70-90岁），而体重正常患者的年龄分布分别为2.9%、66.7%和30.1%。体重过轻的患者更有可能出现医疗并发症（p p = 0.002），需要更多的输血（p p = 0.046），需要输血（p p = 0.119）或住院时间延长（p = 0.225）。结论：体重过轻和近期体重减轻与围手术期医学并发症和输血风险增加有关。术前优化可提高手术恢复和预后。证据等级：三级。
{"title":"Nutritional Status and Outcomes Following Open Laryngeal Surgery for Laryngeal Cancer: A NSQIP Database Study","authors":"Emma R. Thompson, Nour Abdel-Azim, Kenneth Yan","doi":"10.1002/lio2.70257","DOIUrl":"10.1002/lio2.70257","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Malnutrition and weight loss in patients with laryngeal cancer impair immune function and wound healing. Understanding how underweight status impacts outcomes is crucial to improving care. Accordingly, we evaluated perioperative outcomes of patients undergoing laryngectomy for laryngeal cancer, with a secondary focus on patients with recent unintentional weight loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study used the American College of Surgeons National Surgical Quality Improvement Program database. CPT codes were used to identify patients undergoing open total or partial laryngectomies for cancer. Only those with underweight (< 18.5) or normal weight (18.5–29.9) BMIs were included. A subgroup analysis assessed patients with recent unintentional weight loss. Univariate and multivariate analyses were performed, with significance set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>2012 patients were analyzed: 276 underweight (79 female, 197 male) and 1736 normal weight (306 female, 1430 male). Age distribution among underweight patients was 2.5% (ages 20–44), 76.1% (ages 45–69), and 21.4% (ages 70–90), compared to 2.9%, 66.7%, and 30.1%, respectively, in normal-weight patients. Underweight patients were more likely to experience medical complications (<i>p</i> < 0.001), longer hospital stays (<i>p</i> < 0.001), wound disruptions (<i>p</i> = 0.002), and to have greater transfusion requirements (<i>p</i> < 0.001). In those with recent, unintentional weight loss, underweight individuals were at increased risk of experiencing medical complications (<i>p</i> = 0.046) and requiring a transfusion (<i>p</i> < 0.001), but were not more likely to experience wound disruptions (<i>p</i> = 0.119) or experience increased lengths of stay (<i>p</i> = 0.225).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Underweight status and recent weight loss are associated with heightened risks of perioperative medical complications and transfusions. Preoperative optimization may enhance surgical recovery and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</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/PMC12442250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087931","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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