Laryngoscope Investigative Otolaryngology最新文献_第2页

Nordic Questionnaire Use in Work-Related Musculoskeletal Injury Surveys Among Surgeons 北欧问卷在外科医生工作相关肌肉骨骼损伤调查中的应用。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-30 DOI: 10.1002/lio2.70303

Jasmine Gulati, Nicole A. Derdzakyan, Priya Katyal, Deeptha Bejugam, Patricia Timothee, Michael Hoa

Objective

To evaluate how the Nordic Musculoskeletal Questionnaire (NMQ) is modified in studies of surgeons and to identify additional variables associated with musculoskeletal (MSK) injury, with the goal of informing a more standardized survey tool.

Data Sources

Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection databases were searched for relevant studies published from 2000 to 2023.

Review Methods

A systematic review was conducted following PRISMA guidelines. Studies were included if they utilized a modified NMQ to assess MSK symptoms among surgeons or proceduralists. Randomized controlled trials and systematic reviews were excluded. Three reviewers independently screened articles using Rayyan. Data were extracted on questionnaire content, demographics, lifestyle factors, and occupational variables.

Results

Of 1822 studies screened, 26 met the inclusion criteria. All assessed neck pain using a modified NMQ; other regions were inconsistently included. Frequently assessed supplemental factors included exercise habits, impact of pain on daily life, length of practice, specialty, and work hours. Common demographic variables were gender, age, and training level. Lifestyle factors such as sleep and substance use were rarely assessed. Studies using modified NMQs were more likely to include detailed anatomical and behavioral data.

Conclusion

The use of inconsistent modifications to the NMQ limits comparability across studies. A standardized survey incorporating key ergonomic, occupational, and lifestyle elements could improve the study of MSK pain in surgeons and inform targeted interventions.

Level of Evidence

4.

目的：评估北欧肌肉骨骼问卷（NMQ）在外科医生研究中的修改情况，并确定与肌肉骨骼（MSK）损伤相关的其他变量，目的是为更标准化的调查工具提供信息。数据来源：检索Ovid MEDLINE、Ovid Embase、Cochrane Central Register of Controlled Trials和Web of Science Core Collection数据库，检索2000 - 2023年发表的相关研究。评价方法：按照PRISMA指南进行系统评价。如果研究使用改良的NMQ来评估外科医生或程序医生的MSK症状，则纳入研究。排除随机对照试验和系统评价。三位审稿人使用Rayyan独立筛选文章。数据提取自问卷内容、人口统计、生活方式因素和职业变量。结果：在筛选的1822项研究中，26项符合纳入标准。所有患者均使用改进的NMQ评估颈部疼痛；其他地区不一致地被包括在内。经常评估的补充因素包括运动习惯、疼痛对日常生活的影响、练习时间、专业和工作时间。常见的人口统计变量是性别、年龄和培训水平。生活方式因素，如睡眠和物质使用很少被评估。使用改良NMQs的研究更有可能包括详细的解剖和行为数据。结论：使用不一致的NMQ修改限制了研究之间的可比性。一项包含关键人体工程学、职业和生活方式因素的标准化调查可以改善外科医生MSK疼痛的研究，并为有针对性的干预提供信息。证据等级：4。

{"title":"Nordic Questionnaire Use in Work-Related Musculoskeletal Injury Surveys Among Surgeons","authors":"Jasmine Gulati, Nicole A. Derdzakyan, Priya Katyal, Deeptha Bejugam, Patricia Timothee, Michael Hoa","doi":"10.1002/lio2.70303","DOIUrl":"10.1002/lio2.70303","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate how the Nordic Musculoskeletal Questionnaire (NMQ) is modified in studies of surgeons and to identify additional variables associated with musculoskeletal (MSK) injury, with the goal of informing a more standardized survey tool.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>Ovid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials, and Web of Science Core Collection databases were searched for relevant studies published from 2000 to 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>A systematic review was conducted following PRISMA guidelines. Studies were included if they utilized a modified NMQ to assess MSK symptoms among surgeons or proceduralists. Randomized controlled trials and systematic reviews were excluded. Three reviewers independently screened articles using Rayyan. Data were extracted on questionnaire content, demographics, lifestyle factors, and occupational variables.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1822 studies screened, 26 met the inclusion criteria. All assessed neck pain using a modified NMQ; other regions were inconsistently included. Frequently assessed supplemental factors included exercise habits, impact of pain on daily life, length of practice, specialty, and work hours. Common demographic variables were gender, age, and training level. Lifestyle factors such as sleep and substance use were rarely assessed. Studies using modified NMQs were more likely to include detailed anatomical and behavioral data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The use of inconsistent modifications to the NMQ limits comparability across studies. A standardized survey incorporating key ergonomic, occupational, and lifestyle elements could improve the study of MSK pain in surgeons and inform targeted interventions.</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":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12856519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107985","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

Single-Port Transoral Robotic Surgery for Head and Neck Lesions and Obstructive Sleep Apnea: A Prospective Real-World Case Series From Taiwan 单孔经口机器人手术治疗头颈部病变及阻塞性睡眠呼吸暂停：来自台湾的前瞻性真实案例系列。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-30 DOI: 10.1002/lio2.70334

Ting-Shen Lin, Chang-Yo Pan, Shih-Wei Chen, Mei-Wen Nian, Min-Che Tung, Stella Chin-Shaw Tsai

Objectives

To assess the clinical practicality, procedural characteristics, and short-term recovery outcomes of single-port transoral robotic surgery (SP TORS) for diverse head and neck pathologies, including malignancies, benign tumors, and obstructive sleep apnea, in a regional hospital setting in Taiwan.

Methods

A prospective case series was conducted at a regional teaching hospital from May to July 2025. Twelve patients underwent SP TORS utilizing the da Vinci SP system. Indications spanned oncologic, nononcologic, and functional conditions. Detailed perioperative data were collected, including exposure management, docking and console durations, blood loss, and complication profiles. Postoperative recovery trajectories, such as ICU admission, nasogastric support, and hospitalization length, were analyzed.

Results

All operations were successfully completed using the single-port platform without conversion or reoperation. Docking was efficient, with a median time of 4.5 min (range 4–11 min) and median console time of 71 min (range 18–150). Most procedures involved minimal intraoperative bleeding; only two required more substantial hemostasis. Enhanced workspace around the oropharynx was noted, improving assistant access. Postsurgical outcomes were favorable: no tracheostomies were needed and half of the patients avoided nasogastric tube insertion. Hospital stays varied by case complexity, with no major adverse events reported.

Conclusion

SP TORS can be effectively introduced in mid-volume institutions, demonstrating technical reliability, ergonomic benefits, and safe patient recovery. Its versatility across a spectrum of indications suggests broad clinical utility, warranting further multicenter studies to define long-term outcomes and expand implementation.

Level of Evidence

IV.

目的：评估台湾某地区医院采用单孔经口机器人手术（SP TORS）治疗多种头颈部病变（包括恶性肿瘤、良性肿瘤和阻塞性睡眠呼吸暂停）的临床实用性、手术特点和短期恢复效果。方法：于2025年5月至7月在某地区教学医院进行前瞻性病例系列研究。12例患者采用达芬奇SP系统行SP TORS。适应症涵盖肿瘤、非肿瘤和功能性疾病。收集了详细的围手术期数据，包括暴露管理、对接和控制台持续时间、出血量和并发症概况。分析术后恢复轨迹，如ICU入院、鼻胃支持和住院时间。结果：所有手术均在单口平台上顺利完成，无中转和再手术。对接是有效的，平均时间为4.5分钟（范围4-11分钟），平均控制台时间为71分钟（范围18-150分钟）。大多数手术涉及最小的术中出血；只有两例需要更大量的止血。注意到口咽周围的工作空间增强，改善了助手的访问。术后结果良好：不需要气管切开术，一半的患者避免了鼻胃管插入。住院时间因病例复杂程度而异，无重大不良事件报告。结论：SP TORS可以有效地应用于中型医疗机构，具有技术可靠性、人体工程学效益和患者康复安全性。它在适应症范围内的多功能性表明了广泛的临床应用，需要进一步的多中心研究来确定长期结果并扩大实施范围。证据等级：四级。

{"title":"Single-Port Transoral Robotic Surgery for Head and Neck Lesions and Obstructive Sleep Apnea: A Prospective Real-World Case Series From Taiwan","authors":"Ting-Shen Lin, Chang-Yo Pan, Shih-Wei Chen, Mei-Wen Nian, Min-Che Tung, Stella Chin-Shaw Tsai","doi":"10.1002/lio2.70334","DOIUrl":"10.1002/lio2.70334","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To assess the clinical practicality, procedural characteristics, and short-term recovery outcomes of single-port transoral robotic surgery (SP TORS) for diverse head and neck pathologies, including malignancies, benign tumors, and obstructive sleep apnea, in a regional hospital setting in Taiwan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective case series was conducted at a regional teaching hospital from May to July 2025. Twelve patients underwent SP TORS utilizing the da Vinci SP system. Indications spanned oncologic, nononcologic, and functional conditions. Detailed perioperative data were collected, including exposure management, docking and console durations, blood loss, and complication profiles. Postoperative recovery trajectories, such as ICU admission, nasogastric support, and hospitalization length, were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All operations were successfully completed using the single-port platform without conversion or reoperation. Docking was efficient, with a median time of 4.5 min (range 4–11 min) and median console time of 71 min (range 18–150). Most procedures involved minimal intraoperative bleeding; only two required more substantial hemostasis. Enhanced workspace around the oropharynx was noted, improving assistant access. Postsurgical outcomes were favorable: no tracheostomies were needed and half of the patients avoided nasogastric tube insertion. Hospital stays varied by case complexity, with no major adverse events reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>SP TORS can be effectively introduced in mid-volume institutions, demonstrating technical reliability, ergonomic benefits, and safe patient recovery. Its versatility across a spectrum of indications suggests broad clinical utility, warranting further multicenter studies to define long-term outcomes and expand implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12858423/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107988","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

A Prospective Cohort Study of Aesthetic Outcomes Following Hyoid Myotomy and Suspension for Obstructive Sleep Apnea 阻塞性睡眠呼吸暂停患者舌骨肌切开术和悬吊术后美学效果的前瞻性队列研究。

IF 1.7 4区医学 Q2 OTORHINOLARYNGOLOGY

Laryngoscope Investigative Otolaryngology

Pub Date : 2026-01-29 DOI: 10.1002/lio2.70342

Chad A. Nieri, Stephen F. White, Michael Eggerstedt, Meghana Chanamolu, Ezer H. Benaim, Raj Dedhia, M. Boyd Gillespie

Objective

To evaluate subjective and objective submental/neck aesthetic outcomes after hyoid myotomy and suspension (HMS) performed for obstructive sleep apnea (OSA).

Methods

Single-blind, single-center, prospective cohort study including 20 adults undergoing HMS (active) and 11 adults undergoing septoplasty (control) between July 2020 and November 2022. Participants completed FACE-Q Neck and Area Under Chin modules and underwent standardized frontal and lateral photography preoperatively and 6 weeks postoperatively. Primary outcomes were change in cervicomental angle (CMA), hyomental distance (HMD), Rainbow Scale (RS), and FACE-Q scores; frontal neck width was a secondary outcome. Between-group differences in change were assessed using ANCOVA adjusting for age and baseline values.

Results

HMS participants were older than controls (median 67 [IQR 54–74] vs. 47 [35–56] years; p = 0.021). In adjusted analyses, HMS demonstrated greater improvement than controls in FACE-Q Area Under Chin (adjusted mean difference + 17.48; 95% CI, 2.2 to 32.8; p = 0.022), FACE-Q Neck (+14.60; 95% CI, 2.1 to 27.2; p = 0.025), and CMA (−10.17°; 95% CI, −19.4 to −1.0; p = 0.026). Differences were not significant for RS (−0.36; p = 0.311), HMD (−0.69 cm; p = 0.095), or neck width (−0.20 cm; p = 0.547).

Conclusion

In this feasibility cohort with 6-week follow-up, HMS for OSA was associated with improved patient-reported aesthetic satisfaction and a greater reduction in CMA compared with septoplasty controls. Larger studies with longer follow-up are needed to assess durability and longer-term outcomes.

Level of Evidence

3.

目的：评价舌骨肌切开术和悬吊术（HMS）治疗阻塞性睡眠呼吸暂停（OSA）后主观和客观的颏下/颈部美学效果。方法：单盲、单中心、前瞻性队列研究，包括2020年7月至2022年11月期间20名接受HMS（活跃）和11名接受中隔成形术（对照组）的成年人。参与者完成了FACE-Q颈部和下颌面积模块，并在术前和术后6周进行了标准化的正面和侧面摄影。主要结果为颈椎角度（CMA）、眼瞳距离（HMD）、彩虹量表（RS）和FACE-Q评分的变化；前颈宽是次要指标。使用ANCOVA调整年龄和基线值来评估组间变化差异。结果：HMS参与者比对照组年龄大（中位数为67岁[IQR 54-74]对47岁[35-56]；p = 0.021）。在调整分析中，HMS在FACE-Q颏下面积（调整平均差值+ 17.48;95% CI， 2.2至32.8;p = 0.022）、FACE-Q颈部（+14.60;95% CI， 2.1至27.2;p = 0.025）和CMA（-10.17°；95% CI, -19.4至-1.0;p = 0.026）方面比对照组有更大的改善。RS （-0.36; p = 0.311）、HMD （-0.69 cm; p = 0.095）或颈宽（-0.20 cm; p = 0.547）的差异无统计学意义。结论：在这个为期6周随访的可行性队列中，与中隔成形术对照组相比，HMS治疗OSA可改善患者报告的美学满意度和更大的CMA降低。需要更大的研究和更长的随访时间来评估持久性和更长期的结果。证据等级：3。

{"title":"A Prospective Cohort Study of Aesthetic Outcomes Following Hyoid Myotomy and Suspension for Obstructive Sleep Apnea","authors":"Chad A. Nieri, Stephen F. White, Michael Eggerstedt, Meghana Chanamolu, Ezer H. Benaim, Raj Dedhia, M. Boyd Gillespie","doi":"10.1002/lio2.70342","DOIUrl":"10.1002/lio2.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate subjective and objective submental/neck aesthetic outcomes after hyoid myotomy and suspension (HMS) performed for obstructive sleep apnea (OSA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single-blind, single-center, prospective cohort study including 20 adults undergoing HMS (active) and 11 adults undergoing septoplasty (control) between July 2020 and November 2022. Participants completed FACE-Q Neck and Area Under Chin modules and underwent standardized frontal and lateral photography preoperatively and 6 weeks postoperatively. Primary outcomes were change in cervicomental angle (CMA), hyomental distance (HMD), Rainbow Scale (RS), and FACE-Q scores; frontal neck width was a secondary outcome. Between-group differences in change were assessed using ANCOVA adjusting for age and baseline values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>HMS participants were older than controls (median 67 [IQR 54–74] vs. 47 [35–56] years; <i>p</i> = 0.021). In adjusted analyses, HMS demonstrated greater improvement than controls in FACE-Q Area Under Chin (adjusted mean difference + 17.48; 95% CI, 2.2 to 32.8; <i>p</i> = 0.022), FACE-Q Neck (+14.60; 95% CI, 2.1 to 27.2; <i>p</i> = 0.025), and CMA (−10.17°; 95% CI, −19.4 to −1.0; <i>p</i> = 0.026). Differences were not significant for RS (−0.36; <i>p</i> = 0.311), HMD (−0.69 cm; <i>p</i> = 0.095), or neck width (−0.20 cm; <i>p</i> = 0.547).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this feasibility cohort with 6-week follow-up, HMS for OSA was associated with improved patient-reported aesthetic satisfaction and a greater reduction in CMA compared with septoplasty controls. Larger studies with longer follow-up are needed to assess durability and longer-term outcomes.</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":"2026-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12855620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107971","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

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。

{"title":"Postoperative Prescription Patterns After Sleep Surgery: An International Provider Survey Study","authors":"Amrita N. Bhat, Leyda S. Marrero Morales, Jolie L. Chang, Megan L. Durr","doi":"10.1002/lio2.70343","DOIUrl":"10.1002/lio2.70343","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To characterize international opioid prescribing patterns among otolaryngologists performing sleep surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cross-sectional online survey of otolaryngologists and health care professionals who are members of the International Sleep Surgical Society (ISSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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% (<i>n</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12848518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087628","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

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。

{"title":"Supportive Care Needs Among Pretreatment Head and Neck Cancer Patients According to Smoking Status: A Cross-Sectional Study With Nested Analyses","authors":"Dalia N. Mitchell, Aniah Jefferson, Justin Pyne, Amy Ho, Ayush G. Iyer, Baran D. Sumer, David Balis, Sharika Kumar, Robert Schnoll, Andrew T. Day","doi":"10.1002/lio2.70330","DOIUrl":"10.1002/lio2.70330","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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], <i>p</i> < 0.001) and higher prevalence rates of pain (72.2%, 41.0%, <i>p</i> = 0.001), malnutrition (54.8%, 24.9%, <i>p</i> = 0.001), and anxiety (46.3%, 24.0%, <i>p</i> = 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, <i>p</i> = 0.010) after adjusting for pain and anxiety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</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":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12852051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146107982","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

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。

{"title":"Malignant Otitis Externa Presenting With Nasopharyngeal Hematoma: A Case Report of an Unusual Complication","authors":"Vanessa Hui En Chen, Nicole Shi Min Chew, Li Shia Ng","doi":"10.1002/lio2.70348","DOIUrl":"10.1002/lio2.70348","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We present the first reported case of a nasopharyngeal hematoma as a complication of MOE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12835613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146094478","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

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。

{"title":"Appraisal of Readability in Patient-Facing Resources for the Inspire Hypoglossal Nerve Implant","authors":"Brandon D. Abell, Caroline F. Smith, Phillip Q. Richards, Jacob T. Boyd, Andrew P. Johnson","doi":"10.1002/lio2.70335","DOIUrl":"10.1002/lio2.70335","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12781087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953627","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

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。

{"title":"Variability in Physical Exam Documentation for Obstructive Sleep Apnea","authors":"Jacob Hauser, Alexandra Vacaru, Nihal Punjabi, Jared C. Inman","doi":"10.1002/lio2.70338","DOIUrl":"10.1002/lio2.70338","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study evaluates variability in obstructive sleep apnea (OSA) physical exam templates, contrasts documentation between institutional settings, and identifies inter-specialty differences in documentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</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":"11 1","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12754690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890260","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