Laryngoscope Investigative Otolaryngology最新文献_第2页

Postoperative Prescription Patterns After Sleep Surgery: An International Provider Survey Study 睡眠手术后的处方模式：一项国际提供者调查研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-28 DOI: 10.1002/lio2.70343

Amrita N. Bhat, Leyda S. Marrero Morales, Jolie L. Chang, Megan L. Durr

Objective

To characterize international opioid prescribing patterns among otolaryngologists performing sleep surgery.

Methods

Cross-sectional online survey of otolaryngologists and health care professionals who are members of the International Sleep Surgical Society (ISSS).

Results

Surveys were completed by 88 respondents representing an international group of providers from North America (34%), Europe (30%), and South America (24%). Twenty-two (25%) were from the United States (US). Opioids were routinely prescribed after palate surgery by 87% of providers, with 95% of US surgeons prescribing opioids to all post-palatoplasty patients compared to 32% of international surgeons. The average number of opioid tablets per patient after palatopharyngoplasty was > 25 tablets for 57% of US providers compared to 8% of international providers out of 86 total respondents. After HNS surgery, 70% (n = 19) of 27 respondents prescribed postoperative opioids, including 90% of US providers, compared to 0% of international providers. Important patient factors influencing provider prescription choices were patient history of chronic pain or chronic opioid use, age, and patient preference. Concerns about opioid abuse, studies on non-opioid analgesia, and adequate control of patients' pain were major underlying themes in influencing opioid prescription patterns after sleep surgery.

Conclusions

International survey of sleep surgeons reveals diverse opioid prescribing patterns after palate and hypoglossal nerve stimulation surgeries. Patient factors, provider preferences, and concerns about opioid abuse influence prescription decisions and highlight the complex considerations involved in pain management.

目的：了解国际上进行睡眠手术的耳鼻喉科医生的阿片类药物处方模式。方法：对国际睡眠外科学会（ISSS）成员的耳鼻喉科医生和卫生保健专业人员进行横断面在线调查。结果：88名受访者完成了调查，他们代表了来自北美（34%）、欧洲（30%）和南美（24%）的国际供应商集团。22例（25%）来自美国。87%的医生在上颚手术后常规开阿片类药物，95%的美国外科医生给所有腭成形术后患者开阿片类药物，而国际外科医生的这一比例为32%。在86个调查对象中，57%的美国供应商在腭咽成形术后为每位患者平均提供25片阿片类药物，而国际供应商的这一比例为8%。在HNS手术后，27名受访者中有70% （n = 19）开具了术后阿片类药物处方，其中包括90%的美国提供者，而国际提供者的这一比例为0%。影响医生处方选择的重要患者因素是慢性疼痛或慢性阿片类药物使用史、年龄和患者偏好。对阿片类药物滥用的担忧、对非阿片类药物镇痛的研究以及对患者疼痛的充分控制是影响睡眠手术后阿片类药物处方模式的主要潜在主题。结论：对睡眠外科医生的国际调查显示，腭和舌下神经刺激手术后阿片类药物的处方模式存在差异。患者因素、提供者偏好和对阿片类药物滥用的担忧影响处方决策，并突出了疼痛管理中涉及的复杂考虑因素。

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引用次数: 0

Supportive Care Needs Among Pretreatment Head and Neck Cancer Patients According to Smoking Status: A Cross-Sectional Study With Nested Analyses 前处理头颈癌患者吸烟状况的支持性护理需求：一项嵌套分析的横断面研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-28 DOI: 10.1002/lio2.70330

Dalia N. Mitchell, Aniah Jefferson, Justin Pyne, Amy Ho, Ayush G. Iyer, Baran D. Sumer, David Balis, Sharika Kumar, Robert Schnoll, Andrew T. Day

Objective

New head and neck cancer (HNC) patients may prioritize “competing” supportive care needs (SCNs) over smoking cessation, yet the burden of these SCNs according to smoking status is poorly characterized. We aimed to address this gap in knowledge.

Methods

The study applied a cross-sectional design and was guided by the Supportive Care Framework. Newly diagnosed HNC patients seen at the UTSW head and neck surgical oncology clinic between January 2021 and August 2024 and who completed the Patient Health Questionnaire (PHQ)-4 were eligible. Clinically significant SCNs were derived from validated measures. The primary outcome was smoking status and the primary exposure was moderate–severe psychological distress (PHQ-4 ≥ 6).

Results

Among 250 new HNC patients, 16.4% were current smokers. Relative to never or former smokers, current smokers exhibited significantly more SCNs (median 4 [3–5] vs. 2 [1–4], p < 0.001) and higher prevalence rates of pain (72.2%, 41.0%, p = 0.001), malnutrition (54.8%, 24.9%, p = 0.001), and anxiety (46.3%, 24.0%, p = 0.004). On univariate analysis, moderate–severe distress was not associated with smoking status. On adjusted analyses of a subsample of 136 patients with ≥ 98% complete SCN questionnaires, malnutrition was significantly associated with smoking (adjusted odds ratio: 3.49, 95% confidence interval: 1.34–9.03, p = 0.010) after adjusting for pain and anxiety.

Conclusion

Pretreatment HNC patients who smoke exhibit a high burden of SCNs. Further research is needed to determine whether targeting common needs such as malnutrition, pain, and anxiety may improve patients' ability to prioritize smoking cessation.

Level of Evidence

Level 3.

目的：新发头颈癌（HNC）患者可能优先考虑“竞争性”支持性护理需求（scn）而不是戒烟，但这些scn根据吸烟状况的负担尚不清楚。我们的目标是解决这方面的知识差距。方法：本研究采用横断面设计，并以支持性护理框架为指导。在2021年1月至2024年8月期间在UTSW头颈外科肿瘤学诊所就诊并完成患者健康问卷(PHQ)-4的新诊断的HNC患者符合条件。具有临床意义的scn来源于有效的测量方法。主要结局为吸烟状况，主要暴露为中度至重度心理困扰（PHQ-4≥6）。结果：250例新发HNC患者中，16.4%为吸烟者。与从不吸烟者或曾经吸烟者相比，目前吸烟者明显表现出更多的scn（中位数为4 [3-5]vs. 2 [1-4], p = 0.001）、营养不良（54.8%,24.9%,p = 0.001）和焦虑（46.3%,24.0%,p = 0.004）。单变量分析显示，中度至重度抑郁与吸烟状况无关。对136例完成SCN问卷≥98%的患者进行调整分析，在调整疼痛和焦虑后，营养不良与吸烟显著相关（调整优势比：3.49,95%置信区间：1.34-9.03,p = 0.010）。结论：吸烟的HNC前处理患者scn负担高。需要进一步的研究来确定针对营养不良、疼痛和焦虑等共同需求是否可以提高患者优先戒烟的能力。证据等级：三级。

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引用次数: 0

Malignant Otitis Externa Presenting With Nasopharyngeal Hematoma: A Case Report of an Unusual Complication 以鼻咽血肿为主要并发症的恶性外耳炎1例。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-26 DOI: 10.1002/lio2.70348

Vanessa Hui En Chen, Nicole Shi Min Chew, Li Shia Ng

Objective

Malignant otitis externa (MOE) is a potentially life-threatening infection of the external auditory canal (EAC), often with skull base extension. Vascular complications are exceptionally rare, with only six reports of petrous internal carotid artery (ICA) pseudoaneurysm following MOE.

Methods

We present the first reported case of a nasopharyngeal hematoma as a complication of MOE.

Results

An 82-year-old male with poorly controlled diabetes presented with 2 months of recurrent left ear otalgia, purulent otorrhea, and facial nerve palsy. He was commenced on 6 weeks of antimicrobial therapy following diagnosis of MOE on imaging. One month post-treatment, an interval scan found a new collection in the left pharyngeal submucosal region expanding into the torus tubarius. Endoscopic examination revealed a left torus tubarius mass effacing the eustachian tube orifice with some blood-stained mucous. The patient was otherwise afebrile and reported only mild trismus with rust-colored sputum. Subsequent computed tomography (CT) imaging revealed that the mass was likely a subacute or evolving nasopharyngeal hematoma, in close proximity to the left petrous and caudal lacerum ICA, with mild luminal irregularities. An angiogram showed no active contrast extravasation or pseudoaneurysm. He was managed conservatively given the absence of active bleeding and a stable airway. A repeat nasoendoscopy 2 weeks later revealed interval decrease in size of the mass, with resolution of symptoms.

Conclusion

The pathophysiology of nasopharyngeal hematoma as a complication of MOE may involve direct infection-mediated and inflammatory-induced erosion of arterial walls. Though rare, nasopharyngeal hematomas should be considered in MOE patients with unexplained nasopharyngeal masses. These hematomas, especially when associated with luminal ICA irregularities, may represent a sentinel finding preceding the eventual formation of a carotid pseudoaneurysm. Thus, the presence of nasopharyngeal hematomas warrants vigilant surveillance, with escalation to urgent endovascular intervention in the event of vascular instability.

目的：恶性外耳炎（MOE）是一种可能危及生命的外耳道（EAC）感染，通常伴有颅底延伸。血管并发症是非常罕见的，只有6个报告的岩性颈内动脉（ICA）假性动脉瘤在MOE。方法：我们报告了第一例鼻咽血肿作为MOE的并发症。结果：一名82岁男性糖尿病控制不佳，表现为2个月复发性左耳痛症、化脓性耳漏和面神经麻痹。在影像学诊断为MOE后，患者开始接受6周抗菌药物治疗。治疗后一个月，间隔扫描发现在左侧咽粘膜下区有一个新的集合扩展到管环。内窥镜检查显示左侧管环肿块，覆盖咽鼓管口，有一些带血的粘液。除此之外，患者无发热症状，仅有轻度牙关咬合，痰呈铁锈色。随后的计算机断层扫描（CT）成像显示肿块可能是亚急性或正在发展的鼻咽血肿，靠近左侧乳状膜和尾端乳状膜，伴轻度腔内不规则。血管造影未见造影剂外溢或假性动脉瘤。由于没有活动性出血和气道稳定，他被保守管理。2周后复查鼻内窥镜显示肿块间隔缩小，症状缓解。结论：鼻咽血肿作为MOE并发症的病理生理可能与直接感染介导和炎症诱导的动脉壁侵蚀有关。鼻咽血肿虽然罕见，但在MOE患者出现不明原因的鼻咽肿块时应考虑鼻咽血肿。这些血肿，特别是与腔内ICA不规则相关的血肿，可能是最终形成颈动脉假性动脉瘤之前的前哨发现。因此，鼻咽部血肿的存在需要警惕的监测，并在血管不稳定的情况下升级到紧急血管内干预。

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引用次数: 0

Correction to “Succinate Dehydrogenase Pathogenic Variants Among Older Adults With Head and Neck Paragangliomas” 更正“头颈部副神经节瘤老年人琥珀酸脱氢酶致病变异”。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-22 DOI: 10.1002/lio2.70347

N. Bellamkonda, A. Naumer, L. O. Buchmann, et al., “Succinate Dehydrogenase Pathogenic Variants Among Older Adults With Head and Neck Paragangliomas,” Laryngoscope Investigative Otolaryngology 10, no. 6 (2025): e70302, https://doi.org/10.1002/lio2.70302.

In the last sentence of paragraph two of the Results section, the text—“Among the 21 patients with a HNPGL-associated PV, two were between 50 and 59 years of age, seven between 60 and 69, eight between 70 and 79, three between 80 and 89, and one between 90 and 99 (Figure 1)”—was incorrect.

It should have read: “Among the 21 patients with a HNPGL-associated PV, ten were diagnosed with their first HNPGL between 50 and 59 years of age, ten between 60 and 69, and one between 70 and 79 (Figure 1).”

We apologize for this error.

[这更正了文章DOI: 10.1002/lio2.70302.]。

引用次数: 0

Lobe-Specific Risk of Malignancy in Parotid Gland Lesions: A Milan System-Based Analysis 腮腺病变的叶特异性恶性肿瘤风险：基于米兰系统的分析。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-19 DOI: 10.1002/lio2.70344

Serkan Şerifler, Fatih Gül, Ali Öztürk, Mehmet Emin Ak, Burak Çelik, Kadir Şinasi Bulut, Mehmet Ali Babademez

Purpose

To evaluate the diagnostic accuracy of fine-needle aspiration cytology (FNAC) for parotid gland lesions using the Milan System while eliminating verification bias, and to systematically compare risk of malignancy (ROM) between superficial and deep lobe lesions across all Milan categories.

Methods

A retrospective review was conducted of 332 patients who underwent ultrasound-guided FNAC and subsequent surgical excision between 2019 and 2025. Cytology results were classified according to the Milan System. ROM values and diagnostic performance metrics were calculated for each category, with subgroup analysis according to lobe location. Final pathology results were available for all cases, ensuring complete diagnostic verification.

Results

Histopathology confirmed malignancy in 37 cases (11.1%), with significantly higher frequency in the deep lobe compared to the superficial lobe (24.6% vs. 7.9%, p < 0.001), representing a 3.1-fold increased malignancy risk. Deep lobe lesions demonstrated mostly higher ROM across multiple Milan categories. Most notably, within the “benign neoplasm” category, deep lobe lesions exhibited a significantly higher ROM of 7.3% compared to 1.0% for superficial lobe lesions (p = 0.009), representing a 7.3-fold increased malignancy risk even within this traditionally low-risk cytological category. In contrast, high-risk categories (suspicious for malignancy and malignant) showed similar ROM values regardless of anatomical location.

Conclusion

FNAC with Milan System classification provides reliable diagnostic performance for parotid lesions. However, anatomical location significantly influences malignancy risk, with deep lobe lesions carrying substantially higher ROM across multiple diagnostic categories.

Level of Evidence

3.

目的：评估细针穿刺细胞学（FNAC）对腮腺病变的诊断准确性，同时消除验证偏差，并系统地比较所有米兰分类中浅表和深叶病变的恶性风险（ROM）。方法：回顾性分析2019 - 2025年间332例超声引导下FNAC及术后手术切除的患者。细胞学结果根据米兰系统进行分类。计算每个类别的ROM值和诊断性能指标，并根据瓣位置进行亚组分析。所有病例均可获得最终病理结果，确保完整的诊断验证。结果：组织病理学证实37例（11.1%）为恶性肿瘤，与浅表叶相比，深叶的频率明显更高（24.6% vs. 7.9%, p p = 0.009），即使在这种传统上低风险的细胞学分类中，恶性肿瘤风险也增加了7.3倍。相反，高风险类别（可疑为恶性和恶性）无论解剖位置如何，ROM值相似。结论：FNAC米兰系统分型对腮腺病变具有可靠的诊断价值。然而，解剖位置显著影响恶性风险，在多种诊断类别中，深叶病变携带的ROM要高得多。证据等级：3。

{"title":"Lobe-Specific Risk of Malignancy in Parotid Gland Lesions: A Milan System-Based Analysis","authors":"Serkan Şerifler, Fatih Gül, Ali Öztürk, Mehmet Emin Ak, Burak Çelik, Kadir Şinasi Bulut, Mehmet Ali Babademez","doi":"10.1002/lio2.70344","DOIUrl":"10.1002/lio2.70344","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To evaluate the diagnostic accuracy of fine-needle aspiration cytology (FNAC) for parotid gland lesions using the Milan System while eliminating verification bias, and to systematically compare risk of malignancy (ROM) between superficial and deep lobe lesions across all Milan categories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review was conducted of 332 patients who underwent ultrasound-guided FNAC and subsequent surgical excision between 2019 and 2025. Cytology results were classified according to the Milan System. ROM values and diagnostic performance metrics were calculated for each category, with subgroup analysis according to lobe location. Final pathology results were available for all cases, ensuring complete diagnostic verification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Histopathology confirmed malignancy in 37 cases (11.1%), with significantly higher frequency in the deep lobe compared to the superficial lobe (24.6% vs. 7.9%, <i>p</i> < 0.001), representing a 3.1-fold increased malignancy risk. Deep lobe lesions demonstrated mostly higher ROM across multiple Milan categories. Most notably, within the “benign neoplasm” category, deep lobe lesions exhibited a significantly higher ROM of 7.3% compared to 1.0% for superficial lobe lesions (<i>p</i> = 0.009), representing a 7.3-fold increased malignancy risk even within this traditionally low-risk cytological category. In contrast, high-risk categories (suspicious for malignancy and malignant) showed similar ROM values regardless of anatomical location.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FNAC with Milan System classification provides reliable diagnostic performance for parotid lesions. However, anatomical location significantly influences malignancy risk, with deep lobe lesions carrying substantially higher ROM across multiple diagnostic categories.</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":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12813619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146012796","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}

引用次数: 0

Appraisal of Readability in Patient-Facing Resources for the Inspire Hypoglossal Nerve Implant 启发舌下神经植入术面向患者资料的可读性评价。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-08 DOI: 10.1002/lio2.70335

Brandon D. Abell, Caroline F. Smith, Phillip Q. Richards, Jacob T. Boyd, Andrew P. Johnson

Objective

Online searches for medical educational material have continued to increase since the Inspire implant system for treatment of obstructive sleep apnea received FDA approval, and over 50,000 patients have undergone device placement as of 2023. Several professional societies, including the American Medical Association (AMA) and National Institutes of Health (NIH), recommend that patient-facing materials be written at or below a sixth-grade reading level. A review was conducted to evaluate the readability, quality, and transparency of online educational resources concerning the Inspire implant.

Methods

Fifty websites were identified through a popular search engine and categorized as Academic Medical Center Websites (AMC), Health Journalism/Media Websites (HJ/M), Other Websites (OW), or Private Practice Websites (PP). Readability was assessed using nine formulas from ReadabilityFormulas.com. Three independent reviewers scored each site using the DISCERN Instrument and HONcode criteria, with average scores calculated for analysis.

Results

Except for the Linsear Write Readability Formula, all sites exceeded a sixth-grade reading level. No statistically significant differences were found between any groups across readability assessments. HJ/M websites had significantly higher overall HONcode scores than AMC and PP websites and a significantly higher DISCERN score than AMC websites.

Conclusion

All surveyed websites provided information on the Inspire Hypoglossal Nerve Implant at similar reading levels, although these reading levels were well above the recommended sixth-grade target recommended by the AMA and NIH. As Americans increasingly turn to the internet as a source of medical information, healthcare providers must ensure that patient-facing materials are accessible, comprehensible, and transparent.

目的：自用于治疗阻塞性睡眠呼吸暂停的Inspire植入系统获得FDA批准以来，医学教育材料的在线搜索量持续增加，截至2023年，已有超过50,000名患者接受了植入设备。包括美国医学协会（AMA）和美国国立卫生研究院（NIH）在内的几个专业协会建议，面向患者的材料应达到或低于六年级的阅读水平。对有关Inspire植入物的在线教育资源的可读性、质量和透明度进行了评估。方法：通过流行的搜索引擎确定50个网站，并将其分类为学术医学中心网站（AMC）、健康新闻/媒体网站（HJ/M）、其他网站（OW）和私人诊所网站（PP）。可读性使用ReadabilityFormulas.com上的9个公式进行评估。三名独立评审员使用DISCERN Instrument和HONcode标准对每个站点进行评分，并计算平均值以供分析。结果：除了Linsear写可读性公式外，所有网站都超过了六年级的阅读水平。在可读性评估中，各组之间没有发现统计学上的显著差异。HJ/M网站的HONcode总分显著高于AMC和PP网站，DISCERN得分显著高于AMC网站。结论：所有被调查的网站都以相似的阅读水平提供了关于Inspire舌下神经植入物的信息，尽管这些阅读水平远远高于AMA和NIH推荐的六年级目标。随着美国人越来越多地将互联网作为医疗信息的来源，医疗保健提供者必须确保面向患者的材料是可访问的、可理解的和透明的。

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引用次数: 0

Variability in Physical Exam Documentation for Obstructive Sleep Apnea 阻塞性睡眠呼吸暂停体格检查文件的可变性。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-12-31 DOI: 10.1002/lio2.70338

Jacob Hauser, Alexandra Vacaru, Nihal Punjabi, Jared C. Inman

Objectives

This study evaluates variability in obstructive sleep apnea (OSA) physical exam templates, contrasts documentation between institutional settings, and identifies inter-specialty differences in documentation.

Methods

Cross-sectional analysis was performed using the Epic Community Library, a shared database of user-created documentation templates from institutions using the Epic electronic medical record system. Physical exam templates assessing sleep apnea were identified and evaluated against a checklist of 25 key physical exam characteristics from a clinical guideline.

Results

Of 6621 templates from 478 institutions, 579 relevant templates were identified. The most frequently included features were vital signs (89.1%), tonsil size (69.5%), and septal deviation (60.2%). The least frequently recorded features were waist-hip ratio (0.8%), hyomental distance (1.6%), and Cottle maneuver (1.6%). The median template included only 7 out of our 25 key features, with an IQR of 5. Body mass index (BMI) was documented in 36.7% of exams. Of the templates from academic centers, 63% were unique compared to 14% from community centers and 27% from health networks. Otolaryngology templates documented nasal cavity and nasopharyngeal features and specialized airway techniques significantly more frequently than sleep medicine, pulmonology, and unspecified templates. In contrast, sleep medicine and pulmonology documented neck circumference more often than otolaryngology, and sleep medicine recorded Mallampati scores more frequently.

Conclusion

Significant variability exists in OSA physical exam documentation across institutions and specialties. This may contribute to disparities in patient evaluation and treatment. Standardized OSA physical exam templates could provide a more consistent and comprehensive anatomic exam, facilitate subspecialty communication, and support more accurate patient treatment selections.

Level of Evidence

Level 3.

目的：本研究评估了阻塞性睡眠呼吸暂停（OSA）体检模板的可变性，对比了不同机构间的记录，并确定了不同专业间的记录差异。方法：使用Epic社区图书馆进行横断面分析，该图书馆是使用Epic电子病历系统的机构用户创建文档模板的共享数据库。评估睡眠呼吸暂停的体检模板被确定并根据临床指南的25个关键体检特征清单进行评估。结果：在478所院校的6621个模板中，鉴定出579个相关模板。最常见的特征是生命体征（89.1%）、扁桃体大小（69.5%）和间隔偏曲（60.2%）。最不常记录的特征是腰臀比（0.8%）、眼骨距离（1.6%）和卡托运动（1.6%）。中位数模板只包含了25个关键特征中的7个，IQR为5。36.7%的检查记录了身体质量指数（BMI）。在来自学术中心的模板中，63%是独一无二的，而来自社区中心的是14%，来自医疗网络的是27%。耳鼻喉科模板比睡眠医学、肺科和未指定模板更频繁地记录鼻腔和鼻咽特征以及专门的气道技术。相比之下，睡眠医学和肺科记录颈围的频率高于耳鼻喉科，睡眠医学记录Mallampati评分的频率更高。结论：不同机构和专业的OSA体检记录存在显著差异。这可能导致患者评估和治疗的差异。标准化的OSA体检模板可以提供更加一致和全面的解剖检查，方便亚专科交流，支持更准确的患者治疗选择。证据等级：三级。

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引用次数: 0

Chronic Rhinosinusitis and Autoimmune Diseases: A Comprehensive Large Population-Based Analysis 慢性鼻窦炎和自身免疫性疾病：一项基于人群的综合分析。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-12-30 DOI: 10.1002/lio2.70340

Robert E. Africa, Brian J. McKinnon, Charles A. Hughes, Scott A. Hardison

Objectives

To evaluate associations between a wide variety of autoimmune diseases and chronic rhinosinusitis without nasal polyposis (CRSsNP), CRS with nasal polyposis (CRSwNP), and the need for endoscopic sinus surgery.

Methods

This is a multicenter retrospective study from January 1, 2010 to July 31, 2025 utilizing data from 106 healthcare organizations in the United States. The TriNetX database was used to identify adult patients over 18 years with a specified autoimmune disease from a comprehensive list that were included in the study. These groups were compared to patients without autoimmune diseases. The evaluated outcomes included the rate of developing CRSsNP, CRSwNP, and the need for endoscopic sinus surgery.

Results

Higher rates of CRSsNP and CRSwNP were noted in patients with certain autoimmune diseases. In patients with CRSsNP, a higher likelihood of undergoing sinus surgery was identified for Graves' disease, multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosus (RR: 1.84 [1.60–2.13]; 1.20 [1.02–1.43]; 1.19 [1.09–1.29]; 1.30 [1.05–1.61]). Among patients with CRSwNP, a higher rate of surgery was associated with eosinophilic esophagitis, Hashimoto's disease, and ulcerative colitis (RR: 1.08 [1.02–1.14]; 1.06 [1.02–1.11]; 1.15 [1.04–1.32]).

Conclusions

A wide variety of autoimmune diseases are associated with CRSsNP and CRSwNP. The autoimmune diseases that were associated with a higher rate of surgery were rheumatoid arthritis and Graves' disease.

Level of Evidence

3.

目的：评估多种自身免疫性疾病与慢性鼻窦炎无鼻息肉（CRSsNP）、慢性鼻窦炎伴鼻息肉（CRSwNP）以及鼻窦内窥镜手术的必要性之间的关系。方法：这是一项从2010年1月1日至2025年7月31日的多中心回顾性研究，利用了来自美国106家医疗机构的数据。TriNetX数据库用于从纳入研究的综合列表中识别患有特定自身免疫性疾病的18岁以上成年患者。这些组与没有自身免疫性疾病的患者进行比较。评估的结果包括CRSsNP、CRSwNP的发生率和鼻窦内窥镜手术的必要性。结果：在某些自身免疫性疾病患者中，CRSsNP和CRSwNP的发生率较高。在crsssnp患者中，Graves病、多发性硬化、类风湿性关节炎和系统性红斑狼疮接受鼻窦手术的可能性更高（RR: 1.84[1.60-2.13]; 1.20[1.02-1.43]; 1.19[1.09-1.29]; 1.30[1.05-1.61]）。在CRSwNP患者中，较高的手术发生率与嗜酸性粒细胞性食管炎、桥本氏病和溃疡性结肠炎相关（RR: 1.08[1.02-1.14]; 1.06[1.02-1.11]; 1.15[1.04-1.32]）。结论：多种自身免疫性疾病与crsssnp和CRSwNP相关。与高手术率相关的自身免疫性疾病是类风湿关节炎和格雷夫斯病。证据等级：3。

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引用次数: 0

Geospatial Analysis of Rural–Urban Access of Otolaryngology-Head and Neck Surgeons and Clinics in Vermont 佛蒙特州耳鼻喉头颈外科医生和诊所城乡通道的地理空间分析。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-12-30 DOI: 10.1002/lio2.70308

Christopher P. Kruglik, Josephine Yalovitser, John L. Rustad, Sara F. Santagostino, Erin T. Ostby, Heather C. Herrington, Mirabelle B. Sajisevi

Objective(s)

This study examines the distribution of Otolaryngology-Head and Neck Surgeons (OHNS) in Vermont to identify gaps in OHNS clinic accessibility between rural and urban areas and better understand the disparities faced by Vermonters.

Methods

A geospatial, population-based cross-sectional study was conducted, and the OHNS workforce was assessed using public databases. The ArcGIS Pro Near Analysis tool was used to assess the travel burden to OHNS clinics. Wilcoxon rank sum tests were used to compare the average distances to Comprehensive Otolaryngology Care Centers (COCC) and General Otolaryngology Clinics (GOC) between rural and urban towns.

Results

Vermonters have access to 15 OHNS clinics in Vermont, with 10 additional clinics in counties of bordering states. Nearly 43% of counties in Vermont lacked any OHNS clinic. While urban areas of Vermont had the fewest OHNS clinics, they had the largest number of practicing otolaryngologists. On average, Vermonters in urban towns were 31.0 km from a COCC, while those in rural towns were 68.7 km away (p < 0.001). Conversely, on average, Vermonters in urban towns were 25.9 km from a GOC, compared to 22.0 km for those in rural towns (p < 0.001).

Conclusion

Rural residents in Vermont must travel farther distances to obtain OHNS services. However, rural Vermonters face significantly less travel burden to GOCs than urban residents, suggesting that GOCs are well-positioned to reduce disparities in travel burden to OHNS for rural populations. GOCs tend to provide less comprehensive care than COCCs and may, therefore, incompletely improve the distribution and availability of comprehensive otolaryngology services in rural areas.

目的：本研究考察了佛蒙特州耳鼻喉头颈外科医生（OHNS）的分布，以确定农村和城市地区OHNS诊所可及性的差距，并更好地了解佛蒙特州面临的差异。方法：进行了一项地理空间、基于人口的横断面研究，并使用公共数据库对OHNS劳动力进行了评估。使用ArcGIS Pro Near Analysis工具评估前往OHNS诊所的旅行负担。采用Wilcoxon秩和检验比较城乡居民到综合耳鼻喉科护理中心（COCC）和普通耳鼻喉科诊所（GOC）的平均距离。结果：佛蒙特人可以使用佛蒙特州的15个OHNS诊所，在边境州的县有10个额外的诊所。佛蒙特州近43%的县没有OHNS诊所。虽然佛蒙特州的城市地区拥有最少的OHNS诊所，但他们拥有最多的耳鼻喉科医生。佛蒙特州城镇居民与COCC的平均距离为31.0公里，而农村居民与COCC的平均距离为68.7公里。(p)结论：佛蒙特州农村居民必须走更远的距离才能获得OHNS服务。然而，与城市居民相比，佛蒙特州农村居民面临的goc旅行负担要少得多，这表明goc在减少农村人口到OHNS的旅行负担方面处于有利地位。GOCs提供的综合护理往往不如cocs，因此可能无法完全改善农村地区综合耳鼻喉科服务的分布和可得性。

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引用次数: 0

Transoral Approach for Balloon Dilation of the Eustachian Tube 经口入路治疗咽鼓管球囊扩张

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2025-12-26 DOI: 10.1002/lio2.70339

Jared Zhao, Bryan K. Ward

Objectives

Balloon dilation of the Eustachian tube (BDET) is typically performed by advancing a balloon through the nasal cavity into the Eustachian tube orifice using a guide catheter. However, in patients with challenging nasal or Eustachian tube anatomy, this transnasal approach may be unsuccessful. Here, we present a case in which transnasal BDET was not possible due to challenging Eustachian tube anatomy, but a transoral approach provided a successful alternative.

Methods

After unsuccessful attempts at BDET through the nasal passages, a Crowe-Davis mouth retractor was placed. With endoscopic visualization through the nasal passage, the guide catheter was advanced into the oral cavity and around the soft palate to the Eustachian tube orifice.

Results

The angle of insertion from the transoral approach enabled easy advancement into the Eustachian tube. After the procedure, the patient was able to ventilate the ears without difficulty.

Conclusion

We describe a transoral technique for BDET that bypasses obstructive nasal anatomy and offers greater flexibility in catheter angulation. This approach may serve as a useful alternative in select cases where standard access is not feasible.

目的：咽鼓管球囊扩张（BDET）通常是通过使用导尿管将球囊通过鼻腔进入咽鼓管孔来完成的。然而，对于鼻腔或咽鼓管解剖困难的患者，这种经鼻入路可能不成功。在这里，我们提出了一个病例，经鼻BDET是不可能的，因为挑战咽鼓管解剖，但经口入路提供了一个成功的选择。方法采用Crowe-Davis口腔牵开器对经鼻道BDET不成功的患者进行牵开。内镜下通过鼻道显示，引导导管进入口腔，绕过软腭到达咽鼓管口。结果经口入路的置入角度便于推进至咽鼓管。手术后，患者能够毫无困难地对耳朵进行通气。结论：我们描述了一种经口BDET技术，该技术绕过了阻塞性鼻解剖结构，并在导管成角方面提供了更大的灵活性。在标准访问不可行的特定情况下，这种方法可以作为一种有用的替代方法。

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引用次数: 0