Dong Yun Lee, Hyun Jung Kim, Jayoung Oh, Siyeon Jin, Dongyoung Kim, Doo Hee Han, Hyun Jik Kim
Objective
While palatal surgery is an established treatment for obstructive sleep apnea (OSA), variability in outcomes has prompted investigation into factors predicting surgical success. This study aimed to evaluate whether preoperative polysomnographic (PSG) parameters, along with drug-induced sleep endoscopy (DISE) findings, can predict surgical outcomes in patients with OSA.
Methods
This retrospective study included 56 adult patients with OSA who completed both pre- and postoperative PSG and DISE assessments. Patients were classified into a successful outcome group (SG; ≥ 20 events/h reduction in apnea–hypopnea index [AHI]) or a worse outcome group (WG; ≥ 20 events/h increase in AHI). Baseline PSG and DISE findings were compared between groups, and multivariate regression analysis was used to identify independent predictors of surgical success.
Results
Patients in the SG exhibited significantly higher preoperative AHI and larger tonsil size compared to those in the WG. While DISE collapse patterns did not differ significantly between groups, key differences emerged in PSG metrics. SG patients had a significantly greater proportion of non-REM stage N3 sleep within non-REM sleep and a lower arousal index, both of which were independently associated with improved surgical outcomes. Additionally, respiratory events were more prominent during non-rapid eye movement sleep in SG patients. Multivariate analysis confirmed that a greater proportion of non-REM stage N3 sleep and lower arousal index were strong predictors of postoperative AHI reduction.
Conclusions
These findings may offer more reliable predictors of which OSA patients will benefit from sleep surgery and underscore the importance of incorporating detailed PSG analysis into preoperative evaluations.
{"title":"Predictive Value of Sleep Architecture and Arousal Index for Surgical Outcomes in Obstructive Sleep Apnea","authors":"Dong Yun Lee, Hyun Jung Kim, Jayoung Oh, Siyeon Jin, Dongyoung Kim, Doo Hee Han, Hyun Jik Kim","doi":"10.1002/lio2.70331","DOIUrl":"10.1002/lio2.70331","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>While palatal surgery is an established treatment for obstructive sleep apnea (OSA), variability in outcomes has prompted investigation into factors predicting surgical success. This study aimed to evaluate whether preoperative polysomnographic (PSG) parameters, along with drug-induced sleep endoscopy (DISE) findings, can predict surgical outcomes in patients with OSA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 56 adult patients with OSA who completed both pre- and postoperative PSG and DISE assessments. Patients were classified into a successful outcome group (SG; ≥ 20 events/h reduction in apnea–hypopnea index [AHI]) or a worse outcome group (WG; ≥ 20 events/h increase in AHI). Baseline PSG and DISE findings were compared between groups, and multivariate regression analysis was used to identify independent predictors of surgical success.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients in the SG exhibited significantly higher preoperative AHI and larger tonsil size compared to those in the WG. While DISE collapse patterns did not differ significantly between groups, key differences emerged in PSG metrics. SG patients had a significantly greater proportion of non-REM stage N3 sleep within non-REM sleep and a lower arousal index, both of which were independently associated with improved surgical outcomes. Additionally, respiratory events were more prominent during non-rapid eye movement sleep in SG patients. Multivariate analysis confirmed that a greater proportion of non-REM stage N3 sleep and lower arousal index were strong predictors of postoperative AHI reduction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings may offer more reliable predictors of which OSA patients will benefit from sleep surgery and underscore the importance of incorporating detailed PSG analysis into preoperative evaluations.</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 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12713024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806090","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}
Yuval Nachalon, Nogah Nativ-Zeltzer, Yosef Kula, Anne Tran, Stephanie Reshma Warrior, Peter C. Belafsky
Objective
To determine whether resting heart rate (HR) or heart rate variability (HRV) derived from finger photoplethysmography (PPG) predicts 6-month pneumonia risk in patients with dysphagia. HRV reflects autonomic regulation of inflammation which may predispose to respiratory complications.
Methods
A total of 301 patients who underwent a videofluoroscopic swallow study (VFSS) in 2020–2021 were enrolled. Prior to VFSS, resting HR was measured using the CorSense HRV finger sensor (ELITE HRV). Additional HRV metrics, including the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences (RMSSD) were collected from a subset of 153 participants. Pneumonia incidence was assessed at 3 and 6 months through phone interviews and medical record review.
Results
The mean age was 66.3 ± 12.5 years, and 38% were female. Twenty patients (7%) developed pneumonia, with 75% of cases occurring within 3 months. Patients who developed pneumonia had higher resting HR than those who did not (83.4 vs. 74.3 bpm, p < 0.01). This association remained significant after adjusting for age (p = 0.01). Pneumonia risk increased stepwise with higher HR thresholds, with a 2.4-fold greater risk observed at HR ≥ 82 bpm and a 2.8-fold risk at HR ≥ 90 bpm. HRV metrics were not significantly associated with pneumonia incidence.
Conclusion
Elevated resting HR, though within the normal range, was associated with increased pneumonia risk in patients with dysphagia. This may reflect underlying inflammation or autonomic dysfunction. Because comorbidities, medications, and VFSS severity were not accounted for, these findings should be interpreted as preliminary. Resting HR may represent a simple, non-invasive tool for pneumonia risk stratification in this population, but larger studies are needed for validation.
Level of Evidence
2.
目的：探讨由手指光容积脉搏波（PPG）测定的静息心率（HR）或心率变异性（HRV）能否预测吞咽困难患者6个月的肺炎风险。HRV反映了炎症的自主调节，这可能导致呼吸系统并发症。方法：共有301名患者在2020-2021年接受了视频透视吞咽研究（VFSS）。在VFSS之前，使用CorSense HRV手指传感器（ELITE HRV）测量静息心率。从153名参与者的子集中收集其他HRV指标，包括正态到正态区间的标准差（SDNN）和连续差异的均方根（RMSSD）。在第3个月和第6个月时通过电话访谈和病历回顾评估肺炎发病率。结果：平均年龄66.3±12.5岁，女性占38%。20名患者（7%）发生肺炎，其中75%的病例发生在3个月内。发生肺炎的患者的静息心率高于未发生肺炎的患者（83.4 vs 74.3 bpm, p p = 0.01）。随着HR阈值的升高，肺炎风险逐渐增加，HR≥82 bpm时风险增加2.4倍，HR≥90 bpm时风险增加2.8倍。HRV指标与肺炎发病率无显著相关性。结论：静息心率升高，虽然在正常范围内，但与吞咽困难患者肺炎风险增加有关。这可能反映了潜在的炎症或自主神经功能障碍。由于合并症、药物治疗和VFSS严重程度没有考虑在内，这些发现应该被解释为初步的。静息心率可能是该人群肺炎风险分层的一种简单、无创的工具，但需要更大规模的研究来验证。证据等级：2。
{"title":"Heart Rate as a Predictor of 6-Month Pneumonia Risk in Patients With Dysphagia","authors":"Yuval Nachalon, Nogah Nativ-Zeltzer, Yosef Kula, Anne Tran, Stephanie Reshma Warrior, Peter C. Belafsky","doi":"10.1002/lio2.70321","DOIUrl":"10.1002/lio2.70321","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine whether resting heart rate (HR) or heart rate variability (HRV) derived from finger photoplethysmography (PPG) predicts 6-month pneumonia risk in patients with dysphagia. HRV reflects autonomic regulation of inflammation which may predispose to respiratory complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 301 patients who underwent a videofluoroscopic swallow study (VFSS) in 2020–2021 were enrolled. Prior to VFSS, resting HR was measured using the CorSense HRV finger sensor (ELITE HRV). Additional HRV metrics, including the standard deviation of normal-to-normal intervals (SDNN) and the root mean square of successive differences (RMSSD) were collected from a subset of 153 participants. Pneumonia incidence was assessed at 3 and 6 months through phone interviews and medical record review.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age was 66.3 ± 12.5 years, and 38% were female. Twenty patients (7%) developed pneumonia, with 75% of cases occurring within 3 months. Patients who developed pneumonia had higher resting HR than those who did not (83.4 vs. 74.3 bpm, <i>p</i> < 0.01). This association remained significant after adjusting for age (<i>p</i> = 0.01). Pneumonia risk increased stepwise with higher HR thresholds, with a 2.4-fold greater risk observed at HR ≥ 82 bpm and a 2.8-fold risk at HR ≥ 90 bpm. HRV metrics were not significantly associated with pneumonia incidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated resting HR, though within the normal range, was associated with increased pneumonia risk in patients with dysphagia. This may reflect underlying inflammation or autonomic dysfunction. Because comorbidities, medications, and VFSS severity were not accounted for, these findings should be interpreted as preliminary. Resting HR may represent a simple, non-invasive tool for pneumonia risk stratification in this population, but larger studies are needed for validation.</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 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783394","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}
Ji Min Yun, Jamol Ergashev, Seong Hoon Bae, In Seok Moon
Objectives
This study aimed to determine the optimal placement of the cochlear implant (CI) magnet to ensure the visibility of the inner ear and internal auditory canal (IAC) on postoperative magnetic resonance imaging (MRI) scans in patients treated for vestibular schwannoma (VS).
Methods
Nine patients who underwent CI either simultaneously with VS resection or sequentially after gamma knife surgery between January 2021 and June 2024 were retrospectively reviewed. Three patients had the CI placed in the conventional position, while six had it positioned farther from the external auditory canal (EAC) at a more vertical angle (alternative positioning). Postoperative temporal MRI scans were analyzed for inner ear and IAC visibility. Postoperative brain computed tomography (CT) scans underwent three-dimensional reconstruction to measure the distances from the CI magnet to the EAC and IAC, and the nasion–EAC–magnet angle.
Results
Among the six patients in the alternative positioning group, five showed unobstructed IAC visibility, with both magnet-to-EAC and magnet-to-IAC distances exceeding 90 mm. The remaining patient in this group, whose distances were below 90 mm, showed obscured IAC structures due to artifacts. All three patients in the conventional positioning group had distances less than 90 mm and exhibited obscured IAC visibility. A strong correlation was observed between the magnet-to-EAC and magnet-to-IAC distances.
Conclusion
Optimal positioning of the CI magnet, particularly maintaining a distance greater than 90 mm from the EAC, is crucial for achieving clear postoperative MRI visualization of the IAC in patients undergoing VS treatment.
{"title":"Optimizing Cochlear Implant Position for Magnetic Resonance Imaging of Vestibular Schwannoma","authors":"Ji Min Yun, Jamol Ergashev, Seong Hoon Bae, In Seok Moon","doi":"10.1002/lio2.70319","DOIUrl":"10.1002/lio2.70319","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to determine the optimal placement of the cochlear implant (CI) magnet to ensure the visibility of the inner ear and internal auditory canal (IAC) on postoperative magnetic resonance imaging (MRI) scans in patients treated for vestibular schwannoma (VS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Nine patients who underwent CI either simultaneously with VS resection or sequentially after gamma knife surgery between January 2021 and June 2024 were retrospectively reviewed. Three patients had the CI placed in the conventional position, while six had it positioned farther from the external auditory canal (EAC) at a more vertical angle (alternative positioning). Postoperative temporal MRI scans were analyzed for inner ear and IAC visibility. Postoperative brain computed tomography (CT) scans underwent three-dimensional reconstruction to measure the distances from the CI magnet to the EAC and IAC, and the nasion–EAC–magnet angle.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the six patients in the alternative positioning group, five showed unobstructed IAC visibility, with both magnet-to-EAC and magnet-to-IAC distances exceeding 90 mm. The remaining patient in this group, whose distances were below 90 mm, showed obscured IAC structures due to artifacts. All three patients in the conventional positioning group had distances less than 90 mm and exhibited obscured IAC visibility. A strong correlation was observed between the magnet-to-EAC and magnet-to-IAC distances.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Optimal positioning of the CI magnet, particularly maintaining a distance greater than 90 mm from the EAC, is crucial for achieving clear postoperative MRI visualization of the IAC in patients undergoing VS treatment.</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 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783410","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}
Ali B. Jafar, Ghabrielle Almeida, Fatima Al Mousawi, Eric Delgado Rendon, Amber U. Luong
Background
Olfactory dysfunction significantly impairs quality of life. Conventional treatments such as corticosteroids and olfactory training offer limited and inconsistent efficacy. Platelet-rich plasma (PRP), a biologically active agent, has shown potential regenerative effects in olfactory neuroepithelium. This study systematically evaluates the efficacy of PRP compared to placebo in improving olfactory function.
Methods
A systematic review and meta-analysis was conducted according to PRISMA guidelines and was registered in PROSPERO (CRD 420251045079). The databases searched included PubMed, Scopus, Embase, Central, and Web of Science. Seven studies (four RCTs, three non-RCTs) involving 789 patients were included. Subjective and objective outcomes were extracted and pooled using a random-effects model. Risk of bias was assessed using ROB-2 and ROBIN-I tools.
Results
PRP was significantly more effective than placebo in improving subjective olfactory scores at 1 month (SMD = 1.16, 95% CI [0.29–2.03], p = 0.009), 3 months (SMD = 0.29, 95% CI [0.07–0.50], p = 0.01), and 12 months (SMD = 1.47, 95% CI [1.06–1.89], p = 0.00001). Objective testing also favored PRP at all timepoints, including 1 month (SMD = 1.55, 95% CI [0.36–2.73], p = 0.01), 3 months (SMD = 0.44, 95% CI [0.05–0.82], p = 0.03), and 12 months (SMD = 2.42, 95% CI [0.35–4.5], p = 0.02). Subgroup analysis showed younger age (< 40 years old) was associated with greater improvements. The safety profile was favorable with no serious adverse events reported.
Conclusion
PRP demonstrates both short- and long-term benefits in olfactory recovery compared to placebo, especially among younger adults. Given the promising results and safety profile, PRP represents a viable treatment option for olfactory dysfunction. Standardization of PRP protocols and further high-quality RCTs need to be further explored.
背景：嗅觉功能障碍显著影响生活质量。常规治疗如皮质类固醇和嗅觉训练的效果有限且不一致。富血小板血浆（PRP）是一种生物活性物质，在嗅觉神经上皮中具有潜在的再生作用。本研究系统地评价了PRP与安慰剂在改善嗅觉功能方面的疗效。方法：根据PRISMA指南进行系统评价和荟萃分析，并在PROSPERO注册（CRD 420251045079）。检索的数据库包括PubMed、Scopus、Embase、Central和Web of Science。纳入7项研究（4项随机对照试验，3项非随机对照试验），涉及789例患者。使用随机效应模型提取并汇总主观和客观结果。使用rob2和ROBIN-I工具评估偏倚风险。结果：PRP在改善1个月（SMD = 1.16, 95% CI [0.29-2.03], p = 0.009）、3个月（SMD = 0.29, 95% CI [0.07-0.50], p = 0.01）和12个月（SMD = 1.47, 95% CI [1.06-1.89], p = 0.00001）的主观嗅觉评分方面明显优于安慰剂。客观检验在所有时间点也支持PRP，包括1个月（SMD = 1.55, 95% CI [0.36-2.73], p = 0.01）、3个月（SMD = 0.44, 95% CI [0.05-0.82], p = 0.03）和12个月（SMD = 2.42, 95% CI [0.35-4.5], p = 0.02）。亚组分析显示年龄更小(结论：与安慰剂相比，PRP在嗅觉恢复方面表现出短期和长期的益处，尤其是在年轻人中。鉴于有希望的结果和安全性，PRP代表了嗅觉功能障碍的可行治疗选择。PRP方案的标准化和更高质量的随机对照试验需要进一步探索。
{"title":"Efficacy of Platelet Rich Plasma Versus Placebo for Improvement in Olfactory Function in Adults With Olfactory Dysfunction: A Systematic Review and Meta-Analysis","authors":"Ali B. Jafar, Ghabrielle Almeida, Fatima Al Mousawi, Eric Delgado Rendon, Amber U. Luong","doi":"10.1002/lio2.70317","DOIUrl":"10.1002/lio2.70317","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Olfactory dysfunction significantly impairs quality of life. Conventional treatments such as corticosteroids and olfactory training offer limited and inconsistent efficacy. Platelet-rich plasma (PRP), a biologically active agent, has shown potential regenerative effects in olfactory neuroepithelium. This study systematically evaluates the efficacy of PRP compared to placebo in improving olfactory function.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic review and meta-analysis was conducted according to PRISMA guidelines and was registered in PROSPERO (CRD 420251045079). The databases searched included PubMed, Scopus, Embase, Central, and Web of Science. Seven studies (four RCTs, three non-RCTs) involving 789 patients were included. Subjective and objective outcomes were extracted and pooled using a random-effects model. Risk of bias was assessed using ROB-2 and ROBIN-I tools.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>PRP was significantly more effective than placebo in improving subjective olfactory scores at 1 month (SMD = 1.16, 95% CI [0.29–2.03], <i>p</i> = 0.009), 3 months (SMD = 0.29, 95% CI [0.07–0.50], <i>p</i> = 0.01), and 12 months (SMD = 1.47, 95% CI [1.06–1.89], <i>p</i> = 0.00001). Objective testing also favored PRP at all timepoints, including 1 month (SMD = 1.55, 95% CI [0.36–2.73], <i>p</i> = 0.01), 3 months (SMD = 0.44, 95% CI [0.05–0.82], <i>p</i> = 0.03), and 12 months (SMD = 2.42, 95% CI [0.35–4.5], <i>p</i> = 0.02). Subgroup analysis showed younger age (< 40 years old) was associated with greater improvements. The safety profile was favorable with no serious adverse events reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PRP demonstrates both short- and long-term benefits in olfactory recovery compared to placebo, especially among younger adults. Given the promising results and safety profile, PRP represents a viable treatment option for olfactory dysfunction. Standardization of PRP protocols and further high-quality RCTs need to be further explored.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145775969","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}
Basir S. Mansoor, Matthew Zhang, Stephen Chorney, Yann-Fuu Kou, Cynthia S. Wang, Rebecca Brooks, Romaine F. Johnson
Objective
To evaluate the effect of multidisciplinary tracheostomy team (MDT) interventions on emergency department utilization in pediatric patients with tracheostomy.
Methods
This retrospective cohort study analyzed a prospective registry of 364 children who underwent tracheostomy from 2015 to 2023 at a single tertiary pediatric center. The study period encompassed pre-intervention, post-intervention pre-COVID, COVID-19, and post-COVID recovery phases. Primary outcomes were time to ED visits and ED visit frequency, analyzed using parametric survival analysis and mixed-effects negative binomial regression.
Results
Among 364 patients (mean age 3.5 ± 5.4 years; 53% male), MDT implementation was associated with a 50% reduction in ED visit rates (incidence rate ratio 0.50, 95% CI: 0.43–0.57, p < 0.001) during the post-intervention, pre-COVID period. Benefits sustained through COVID (65% reduction) and post-COVID recovery (91% reduction). Time to first ED visit increased significantly across post-intervention periods (post-intervention, pre-COVID: time ratio 1.22, 95% CI: 1.12–1.32, p < 0.001; post-COVID recovery: time ratio 1.25, 95% CI: 1.11–1.40, p < 0.001). During median follow-up of 2.8 years, 1056 of 1842 total encounters (57%) involved ED visits. Respiratory conditions accounted for 34% of ED visits. Hispanic ethnicity (time ratio 0.88, p = 0.003) and respiratory-related visits (time ratio 0.78, p < 0.001) were associated with shorter return intervals but did not affect overall visit frequency.
Conclusion
MDTs were associated with sustained 50% reductions in pediatric ED utilization, with reductions continuing through the COVID-19 pandemic.
Levels of Evidence
3.
目的：评价多学科气管切开术团队（MDT）干预对儿科气管切开术患者急诊科使用率的影响。方法：本回顾性队列研究分析了2015年至2023年在一家三级儿科中心接受气管切开术的364名儿童的前瞻性登记。研究期间包括干预前、干预后、干预前、COVID-19和COVID-19后恢复阶段。主要结局为ED就诊时间和ED就诊频率，采用参数生存分析和混合效应负二项回归进行分析。结果：在364例患者（平均年龄3.5±5.4岁，53%为男性）中，MDT实施与急诊科就诊率降低50%（发病率比0.50,95% CI: 0.43-0.57, p p p p = 0.003）和呼吸相关就诊（时间比0.78,p）相关。结论：MDT与儿科急诊科使用率持续降低50%相关，并在COVID-19大流行期间持续降低。证据等级：3。
{"title":"Multidisciplinary Tracheostomy Teams Reduce Emergency Department Utilization in Pediatric Patients: A Retrospective Cohort Study","authors":"Basir S. Mansoor, Matthew Zhang, Stephen Chorney, Yann-Fuu Kou, Cynthia S. Wang, Rebecca Brooks, Romaine F. Johnson","doi":"10.1002/lio2.70327","DOIUrl":"10.1002/lio2.70327","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the effect of multidisciplinary tracheostomy team (MDT) interventions on emergency department utilization in pediatric patients with tracheostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analyzed a prospective registry of 364 children who underwent tracheostomy from 2015 to 2023 at a single tertiary pediatric center. The study period encompassed pre-intervention, post-intervention pre-COVID, COVID-19, and post-COVID recovery phases. Primary outcomes were time to ED visits and ED visit frequency, analyzed using parametric survival analysis and mixed-effects negative binomial regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 364 patients (mean age 3.5 ± 5.4 years; 53% male), MDT implementation was associated with a 50% reduction in ED visit rates (incidence rate ratio 0.50, 95% CI: 0.43–0.57, <i>p</i> < 0.001) during the post-intervention, pre-COVID period. Benefits sustained through COVID (65% reduction) and post-COVID recovery (91% reduction). Time to first ED visit increased significantly across post-intervention periods (post-intervention, pre-COVID: time ratio 1.22, 95% CI: 1.12–1.32, <i>p</i> < 0.001; post-COVID recovery: time ratio 1.25, 95% CI: 1.11–1.40, <i>p</i> < 0.001). During median follow-up of 2.8 years, 1056 of 1842 total encounters (57%) involved ED visits. Respiratory conditions accounted for 34% of ED visits. Hispanic ethnicity (time ratio 0.88, <i>p</i> = 0.003) and respiratory-related visits (time ratio 0.78, <i>p</i> < 0.001) were associated with shorter return intervals but did not affect overall visit frequency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>MDTs were associated with sustained 50% reductions in pediatric ED utilization, with reductions continuing through the COVID-19 pandemic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Levels of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769697","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}
Ghedak Ansari, Jeanne A. Darbinian, Samuel A. Collazo, Nikolas R. Block-Wheeler, Megan L. Durr
Objective
In adult patients who undergo soft tissue and maxillomandibular advancement (MMA) sleep surgery for obstructive sleep apnea (OSA), we identify preoperative pain diagnoses and postoperative pain medication dispensing patterns by surgery type.
Methods
This retrospective cohort chart review study examines adults who underwent sleep surgery for OSA at an integrated healthcare delivery system (2009–2017). Data obtained from electronic sources included demographics, surgery type, presentation to the emergency department, hospital readmission, and postoperative medication dispensings.
Results
A total of 2287 adult patients were identified. The average age at surgery was 40.8 ± 12.5 years. Surgeries performed included (n, %) uvulopalatopharyngoplasty (1312, 57.3%) tonsillectomy (577, 25.2%), genioglossus muscle advancement (GA) alone or combined with MMA (108, 4.7%) and MMA alone (170, 7.4%), adenoidectomy (60, 2.6%), tongue and palate surgery (54, 2.4%), and tongue reduction (6, 0.3%). A total of 811 (35.5%) had a preoperative pain-related diagnosis, and 336 (14.7%) had a preoperative diagnosis of depression. Of the total cohort, 912 (39.9%) had a preoperative opioid prescription. In our cohort, 91.7% were prescribed outpatient opioid medication postoperatively. This varied by surgery type, with the highest proportion of opioid prescription dispensings observed in the soft tissue surgery group (non-MMA ± GA) and the lowest in the maxillofacial surgery group (MMA ± GA). In contrast, the maxillofacial surgery group had the highest proportion of nonopioid prescriptions dispensed, while the soft tissue surgery group had the lowest.
Conclusions
Non-hypoglossal nerve stimulation (non-HGNS) sleep surgery for OSA is associated with high (nearly 92%) postoperative opioid dispensings. Adult patients undergoing non-HGNS sleep surgery are likely at increased risk of opioid complications given the high prevalence of preoperative opioid use, chronic pain, and depression.
{"title":"Role of Pain in Adults Undergoing Soft Tissue and Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea","authors":"Ghedak Ansari, Jeanne A. Darbinian, Samuel A. Collazo, Nikolas R. Block-Wheeler, Megan L. Durr","doi":"10.1002/lio2.70322","DOIUrl":"10.1002/lio2.70322","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In adult patients who undergo soft tissue and maxillomandibular advancement (MMA) sleep surgery for obstructive sleep apnea (OSA), we identify preoperative pain diagnoses and postoperative pain medication dispensing patterns by surgery type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort chart review study examines adults who underwent sleep surgery for OSA at an integrated healthcare delivery system (2009–2017). Data obtained from electronic sources included demographics, surgery type, presentation to the emergency department, hospital readmission, and postoperative medication dispensings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2287 adult patients were identified. The average age at surgery was 40.8 ± 12.5 years. Surgeries performed included (<i>n</i>, %) uvulopalatopharyngoplasty (1312, 57.3%) tonsillectomy (577, 25.2%), genioglossus muscle advancement (GA) alone or combined with MMA (108, 4.7%) and MMA alone (170, 7.4%), adenoidectomy (60, 2.6%), tongue and palate surgery (54, 2.4%), and tongue reduction (6, 0.3%). A total of 811 (35.5%) had a preoperative pain-related diagnosis, and 336 (14.7%) had a preoperative diagnosis of depression. Of the total cohort, 912 (39.9%) had a preoperative opioid prescription. In our cohort, 91.7% were prescribed outpatient opioid medication postoperatively. This varied by surgery type, with the highest proportion of opioid prescription dispensings observed in the soft tissue surgery group (non-MMA ± GA) and the lowest in the maxillofacial surgery group (MMA ± GA). In contrast, the maxillofacial surgery group had the highest proportion of nonopioid prescriptions dispensed, while the soft tissue surgery group had the lowest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Non-hypoglossal nerve stimulation (non-HGNS) sleep surgery for OSA is associated with high (nearly 92%) postoperative opioid dispensings. Adult patients undergoing non-HGNS sleep surgery are likely at increased risk of opioid complications given the high prevalence of preoperative opioid use, chronic pain, and depression.</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 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12703013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769691","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}
Sandhya Ganesan, Sharwani Kota, Sana Smaoui, Tyler P. Tufano, Leena Zitoun, Arjun Joshi, Punam Thakkar
Introduction
The treatment of laryngeal cancer often results in alterations of speech and swallowing, which may contribute to the development of depression in this patient population and subsequently affect treatment outcomes and survivorship. This study aims to determine the prevalence of depression in patients with laryngeal cancer and identify contributing risk factors.
Methods
Patients with laryngeal cancer were identified using ICD-10 codes within the TriNetX Research Network. Patients were stratified by treatment type (surgical versus non-surgical), age, socioeconomic (SES) risk factors, and post-treatment side effects. The effect of these factors on the development of depression was analyzed while controlling for cancer stage.
Results
Briefly, 93,018 patients with laryngeal cancer were identified. These patients had a significantly higher risk of depression compared to the overall head and neck cancer population (RR = 1.15, 95% CI: [1.12, 1.18]). Patients under 70 were more likely to develop depression than those over 70 (RR = 1.27, 95% CI: [1.22, 1.33]). SES risk factors were associated with over double the risk of depression (RR = 2.67, 95% CI: [2.42, 2.97]). Surgical treatment conferred a higher risk than non-surgical treatment modalities (RR = 1.54, 95% CI: [1.41, 1.68]). Patients who experienced long-term complications such as dysphagia, xerostomia, or malnutrition had a 7.62% increased risk of depression (p < 0.01).
Conclusions
Patients with laryngeal cancer face a uniquely high risk of developing post-treatment depression. Future studies evaluating optimal screening protocols and supportive care strategies may help improve mental health care in this population.
{"title":"Depression Among Patients With Laryngeal Cancer: A Retrospective Cohort Study","authors":"Sandhya Ganesan, Sharwani Kota, Sana Smaoui, Tyler P. Tufano, Leena Zitoun, Arjun Joshi, Punam Thakkar","doi":"10.1002/lio2.70325","DOIUrl":"https://doi.org/10.1002/lio2.70325","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The treatment of laryngeal cancer often results in alterations of speech and swallowing, which may contribute to the development of depression in this patient population and subsequently affect treatment outcomes and survivorship. This study aims to determine the prevalence of depression in patients with laryngeal cancer and identify contributing risk factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with laryngeal cancer were identified using ICD-10 codes within the TriNetX Research Network. Patients were stratified by treatment type (surgical versus non-surgical), age, socioeconomic (SES) risk factors, and post-treatment side effects. The effect of these factors on the development of depression was analyzed while controlling for cancer stage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Briefly, 93,018 patients with laryngeal cancer were identified. These patients had a significantly higher risk of depression compared to the overall head and neck cancer population (RR = 1.15, 95% CI: [1.12, 1.18]). Patients under 70 were more likely to develop depression than those over 70 (RR = 1.27, 95% CI: [1.22, 1.33]). SES risk factors were associated with over double the risk of depression (RR = 2.67, 95% CI: [2.42, 2.97]). Surgical treatment conferred a higher risk than non-surgical treatment modalities (RR = 1.54, 95% CI: [1.41, 1.68]). Patients who experienced long-term complications such as dysphagia, xerostomia, or malnutrition had a 7.62% increased risk of depression (<i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients with laryngeal cancer face a uniquely high risk of developing post-treatment depression. Future studies evaluating optimal screening protocols and supportive care strategies may help improve mental health care in this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70325","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739606","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}
Matin Ghazizadeh, Behrouz Barati, Mohammad Moini, Homeira Mansurzadeh
Introduction
The study was designed to compare the final long-term outcomes of septoplasty with and without unilateral pyriform plasty on the concave side in patients with septal deviation.
Materials and Methods
A randomized clinical trial was conducted from 2020 to 2023. Patients were randomly divided into two groups of 30. The control group underwent septoplasty alone (without pyriform plasty). Septoplasty with pyriform plasty was performed for the intervention group. The patient's subjective feelings were compared using the NOSE questionnaire pre- and post-operatively. Six months after surgery, the patients were evaluated objectively using rhinomanometry.
Results
The mean age of the patients was 37.07 ± 10.39 years. Based on the rhinomanometry evaluation, the amounts of airflow in the intervention and control groups were 791.23 ± 113.14 (cm3/s) and 665.44 ± 101.03 (p < 0.001), respectively. Also, the resistance level was 0.20 ± 0.04 (Pa/cm3/s) in the intervention group and 0.23 ± 0.05 (Pa/cm3/s) in the control group (p = 0.036). Among evaluated symptoms, significant improvement in nasal obstruction was detected in the intervention group (p = 0.044).
Conclusion
Although septoplasty improved the patient's clinical condition by increasing nasal airflow and decreasing airflow resistance, septoplasty with pyriform plasty on the concave side significantly resulted in more favorable outcomes.
{"title":"Pyriform Plasty as an Adjunct to Septoplasty: A Double-Blind Randomized Trial in Patients With Septal Deviation","authors":"Matin Ghazizadeh, Behrouz Barati, Mohammad Moini, Homeira Mansurzadeh","doi":"10.1002/lio2.70324","DOIUrl":"https://doi.org/10.1002/lio2.70324","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The study was designed to compare the final long-term outcomes of septoplasty with and without unilateral pyriform plasty on the concave side in patients with septal deviation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>A randomized clinical trial was conducted from 2020 to 2023. Patients were randomly divided into two groups of 30. The control group underwent septoplasty alone (without pyriform plasty). Septoplasty with pyriform plasty was performed for the intervention group. The patient's subjective feelings were compared using the NOSE questionnaire pre- and post-operatively. Six months after surgery, the patients were evaluated objectively using rhinomanometry.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of the patients was 37.07 ± 10.39 years. Based on the rhinomanometry evaluation, the amounts of airflow in the intervention and control groups were 791.23 ± 113.14 (cm<sup>3</sup>/s) and 665.44 ± 101.03 (<i>p</i> < 0.001), respectively. Also, the resistance level was 0.20 ± 0.04 (Pa/cm<sup>3</sup>/s) in the intervention group and 0.23 ± 0.05 (Pa/cm<sup>3</sup>/s) in the control group (<i>p</i> = 0.036). Among evaluated symptoms, significant improvement in nasal obstruction was detected in the intervention group (<i>p</i> = 0.044).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although septoplasty improved the patient's clinical condition by increasing nasal airflow and decreasing airflow resistance, septoplasty with pyriform plasty on the concave side significantly resulted in more favorable outcomes.</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 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70324","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739581","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}
Erik Appelberg, Sanna Viitasalo, Saku Tapani Sinkkonen
Objectives
To study whether patient self-recorded digital otoscopy (PDO) is a reliable diagnostic tool in otologic remote consultations.
Methods
Based on real-life referrals, 45 otologic outpatients were recruited. The patients were shown an instructional video on the use of a digital otoscope. After the tutorial, they recorded a short video of their ears. For comparison, digital otoscopy (DO) was performed by an ENT resident, and the patient was examined in person by an otologist. The recordings were evaluated by otologists, general otolaryngologists and ENT residents. The recordings were evaluated for their quality, usefulness in remote consultations, diagnostic accuracy, and observers' confidence in setting the diagnosis.
Results
The average PDO quality was 5.2 ± 2.5 (mean ± SEM; scale of 1–10). The ENT resident recorded DO (RDO) quality was 6.6 ± 2.3 (mean ± SEM; scale of 1–10). The diagnosis was correct in 48.4% of the PDO cases and in 63.5% of the RDO cases. The diagnostic accuracy varied significantly across different pathologies.
Conclusions
The overall quality of PDOs is satisfactory, although inferior to that of RDOs. The diagnostic accuracy of PDOs was comparable to that of RDOs for certain pathologies, highlighting that self-recorded DO may be used for remote consultations with limitations. Digital otoscopes could be used by general practitioners and nurses to facilitate otologic remote consultations.
{"title":"Patient Self-Recorded Digital Otoscopy in Otology Diagnostics","authors":"Erik Appelberg, Sanna Viitasalo, Saku Tapani Sinkkonen","doi":"10.1002/lio2.70318","DOIUrl":"10.1002/lio2.70318","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To study whether patient self-recorded digital otoscopy (PDO) is a reliable diagnostic tool in otologic remote consultations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on real-life referrals, 45 otologic outpatients were recruited. The patients were shown an instructional video on the use of a digital otoscope. After the tutorial, they recorded a short video of their ears. For comparison, digital otoscopy (DO) was performed by an ENT resident, and the patient was examined in person by an otologist. The recordings were evaluated by otologists, general otolaryngologists and ENT residents. The recordings were evaluated for their quality, usefulness in remote consultations, diagnostic accuracy, and observers' confidence in setting the diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The average PDO quality was 5.2 ± 2.5 (mean ± SEM; scale of 1–10). The ENT resident recorded DO (RDO) quality was 6.6 ± 2.3 (mean ± SEM; scale of 1–10). The diagnosis was correct in 48.4% of the PDO cases and in 63.5% of the RDO cases. The diagnostic accuracy varied significantly across different pathologies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The overall quality of PDOs is satisfactory, although inferior to that of RDOs. The diagnostic accuracy of PDOs was comparable to that of RDOs for certain pathologies, highlighting that self-recorded DO may be used for remote consultations with limitations. Digital otoscopes could be used by general practitioners and nurses to facilitate otologic remote consultations.</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 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12673622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679225","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}
Raj Patel, Daaren Bukhari, Sullivan Smith, Luis Rubio, Amy Pittman
Objective
The main objective of this scoping review was to identify various surgical techniques used to treat nasal airway obstruction Caused by facial paralysis and summarize available outcome data for these techniques.
Data Sources
A literature search was conducted using Medline (PubMed) and Embase to find clinical studies on nasal obstruction and facial paralysis from their inception to April 2024.
Review Methods
Literature was reviewed for studies that investigated the surgical treatment for nasal valve obstruction in patients experiencing facial paralysis. A search was conducted using PubMed and Embase. The search yielded 82 articles that described nasal obstruction correction. Abstract analysis narrowed the selection to seven papers. The criteria entailed studies that described patients undergoing surgical intervention in treating nasal obstruction due to facial paralysis and had subjective or objective outcome measures. Any study that addressed nasal obstruction not caused by facial paralysis was excluded.
Results
Fascia lata sling and suture suspension improved NOSE scores by 21 and 31 points, respectively. Subjective symptom relief ranged from 77% to 100%, with fascia lata sling showing consistent 100% improvement. Complication rates were lowest with fascia lata sling, at 4.3%, and highest with suture suspension, at 23.5%. Revision rates were 1.5% for fascia lata and 14.1% for suture suspension.
Conclusions
Surgical correction of nasal valve obstruction in facial paralysis requires unique considerations. Further studies are necessary to determine the safest and most effective options for treating this unique problem.
{"title":"A Scoping Review of Surgical Interventions for Nasal Valve Obstruction in Facial Paralysis","authors":"Raj Patel, Daaren Bukhari, Sullivan Smith, Luis Rubio, Amy Pittman","doi":"10.1002/lio2.70301","DOIUrl":"https://doi.org/10.1002/lio2.70301","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The main objective of this scoping review was to identify various surgical techniques used to treat nasal airway obstruction Caused by facial paralysis and summarize available outcome data for these techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>A literature search was conducted using Medline (PubMed) and Embase to find clinical studies on nasal obstruction and facial paralysis from their inception to April 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>Literature was reviewed for studies that investigated the surgical treatment for nasal valve obstruction in patients experiencing facial paralysis. A search was conducted using <i>PubMed</i> and <i>Embase</i>. The search yielded 82 articles that described nasal obstruction correction. Abstract analysis narrowed the selection to seven papers. The criteria entailed studies that described patients undergoing surgical intervention in treating nasal obstruction due to facial paralysis and had subjective or objective outcome measures. Any study that addressed nasal obstruction not caused by facial paralysis was excluded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fascia lata sling and suture suspension improved NOSE scores by 21 and 31 points, respectively. Subjective symptom relief ranged from 77% to 100%, with fascia lata sling showing consistent 100% improvement. Complication rates were lowest with fascia lata sling, at 4.3%, and highest with suture suspension, at 23.5%. Revision rates were 1.5% for fascia lata and 14.1% for suture suspension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Surgical correction of nasal valve obstruction in facial paralysis requires unique considerations. Further studies are necessary to determine the safest and most effective options for treating this unique problem.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70301","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145619144","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号