Zhaojun Zhu, Felix Johnson, Amir Bolooki, Luca Engelmann, Naglaa Mansour, Andreas Knopf, Elias Scherer, Anna Stenzl, Benedikt Hofauer
Objectives
One method for the reconstruction of the entire soft palate is to use prelaminated radial forearm flaps (PRFFF). In a two-step procedure the back of the flap is first epithelialized with split-skin and subsequently used for soft palate reconstruction. Limited data exist on the perioperative and postoperative course of this technique. In this study, we investigated the perioperative course and postsurgical outcomes of patients who received a PRFF for soft palate reconstruction.
Methods
All patients, who received a PRFFF at our clinics since 2012 were identified retrospectively. The operation was carried out in two stages. The perioperative course, postoperative complications and the functional outcome were recorded by analyzing patient files and operation protocols.
Results
A total of 11 patients were enrolled (sex: 9 male, 2 female; age: 58 ± 14, 10/11 squamous cell carcinoma of the soft palate, 1/11 adenoid cystic carcinoma of the soft palate). Postoperative complications occurred in 6/11 patients. Three patients underwent revision surgery. One patient developed postoperatively a central pulmonary embolism leading to a prolonged intensive care unit stay. Flap viability was 100% across all cases and there was no high donor site morbidity in postoperative follow-ups.
Conclusion
The prelaminated radial forearm free flap allows a better physiological reconstruction of the soft palate while showing similar perioperative complication rates compared to the standard radial forearm free flap. In this case series no flap loss occurred, and functional outcomes were satisfactory.
{"title":"Postoperative Outcome of Prelaminated Radial Forearm Free Flap for Soft Palate Reconstruction","authors":"Zhaojun Zhu, Felix Johnson, Amir Bolooki, Luca Engelmann, Naglaa Mansour, Andreas Knopf, Elias Scherer, Anna Stenzl, Benedikt Hofauer","doi":"10.1002/lio2.70299","DOIUrl":"10.1002/lio2.70299","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>One method for the reconstruction of the entire soft palate is to use prelaminated radial forearm flaps (PRFFF). In a two-step procedure the back of the flap is first epithelialized with split-skin and subsequently used for soft palate reconstruction. Limited data exist on the perioperative and postoperative course of this technique. In this study, we investigated the perioperative course and postsurgical outcomes of patients who received a PRFF for soft palate reconstruction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients, who received a PRFFF at our clinics since 2012 were identified retrospectively. The operation was carried out in two stages. The perioperative course, postoperative complications and the functional outcome were recorded by analyzing patient files and operation protocols.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 11 patients were enrolled (sex: 9 male, 2 female; age: 58 ± 14, 10/11 squamous cell carcinoma of the soft palate, 1/11 adenoid cystic carcinoma of the soft palate). Postoperative complications occurred in 6/11 patients. Three patients underwent revision surgery. One patient developed postoperatively a central pulmonary embolism leading to a prolonged intensive care unit stay. Flap viability was 100% across all cases and there was no high donor site morbidity in postoperative follow-ups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prelaminated radial forearm free flap allows a better physiological reconstruction of the soft palate while showing similar perioperative complication rates compared to the standard radial forearm free flap. In this case series no flap loss occurred, and functional outcomes were satisfactory.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12598804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145496711","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}
Ryan Stepp, Naushin Ali, Areli A. Rodriguez, Ethan Nicklow, Noah Thornton, Adithya Reddy, Hannah Kenny, Patrick S. Cottler, Donald R. Griffin, James J. Daniero
Objectives
Acute laryngeal injury (ALgI) is created as a result of endotracheal tube pressure ulcer formation leading to fibrosis and inflammation. This condition often leads to airway obstruction and voice and swallowing dysfunction. This study demonstrates a reliable animal model of ALgI to reproduce the acute wound process seen clinically, to explore the pathophysiology of this disease process, and to serve as a reproducible injury suitable for the evaluation of therapeutic interventions.
Methods
An ALgI model was developed in New Zealand White rabbits using precise mucosal stripping of the posterior larynx, followed by intubation with an oversized 4.0 endotracheal tube for 1 h to mimic intubation-associated trauma and pressure ischemia. Laryngoscopy and laryngeal harvest were performed 2 weeks post-injury for histologic and immunofluorescent evaluation.
Results
Injured rabbits demonstrated an eightfold increase in posterior glottic thickness (1.57 vs. 0.19 mm in controls; p = 0.0004) and an 11-fold increase in collagen content (1.93 vs. 0.17 mm2; p = 0.005). Collagen subtype analysis revealed a shift toward active collagen within the injured larynx compared to the uninjured, with increased Type III Collagen (69.0% vs. 26.1%; p < 0.0001) and reduced Type I Collagen (27.2% vs. 73.9%; p < 0.0001) in the posterior glottis, consistent with the proliferative phase of wound healing. Collagen fiber alignment analysis demonstrated increased coherency in injured tissues (0.36 vs. 0.21; p = 0.023), indicating early organized collagen formation consistent with scar formation within the posterior glottis.
Conclusions
The model offers a robust platform for studying the acute pathogenesis of laryngeal injury and for testing the treatment options in the management of ALgI.
Level of Evidence
3.
目的：急性喉损伤（ALgI）是由于气管内管压性溃疡形成导致纤维化和炎症而产生的。这种情况通常会导致气道阻塞、声音和吞咽功能障碍。本研究展示了一种可靠的ALgI动物模型，可以再现临床所见的急性伤口过程，探索该疾病过程的病理生理学，并可作为一种可重复性损伤，适用于评估治疗干预措施。方法：采用精确剥除后喉粘膜的方法，建立新西兰大白兔ALgI模型，然后用大号4.0气管内插管1 h，模拟插管相关创伤和压力缺血。损伤后2周进行喉镜检查和喉部切除，进行组织学和免疫荧光评估。结果：损伤家兔声门后厚度增加了8倍（1.57比0.19 mm, p = 0.0004），胶原含量增加了11倍（1.93比0.17 mm2, p = 0.005）。胶原亚型分析显示，与未损伤的喉部相比，受损喉部的活性胶原向活性胶原转移，III型胶原增加（69.0%比26.1%;p p p = 0.023），表明早期有组织的胶原形成与后声门内瘢痕形成一致。结论：该模型为研究喉损伤的急性发病机制和测试喉损伤的治疗方案提供了一个强大的平台。证据等级：3。
{"title":"Development of a Clinically Relevant Rabbit Model of Acute Laryngeal Injury","authors":"Ryan Stepp, Naushin Ali, Areli A. Rodriguez, Ethan Nicklow, Noah Thornton, Adithya Reddy, Hannah Kenny, Patrick S. Cottler, Donald R. Griffin, James J. Daniero","doi":"10.1002/lio2.70298","DOIUrl":"10.1002/lio2.70298","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Acute laryngeal injury (ALgI) is created as a result of endotracheal tube pressure ulcer formation leading to fibrosis and inflammation. This condition often leads to airway obstruction and voice and swallowing dysfunction. This study demonstrates a reliable animal model of ALgI to reproduce the acute wound process seen clinically, to explore the pathophysiology of this disease process, and to serve as a reproducible injury suitable for the evaluation of therapeutic interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An ALgI model was developed in New Zealand White rabbits using precise mucosal stripping of the posterior larynx, followed by intubation with an oversized 4.0 endotracheal tube for 1 h to mimic intubation-associated trauma and pressure ischemia. Laryngoscopy and laryngeal harvest were performed 2 weeks post-injury for histologic and immunofluorescent evaluation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Injured rabbits demonstrated an eightfold increase in posterior glottic thickness (1.57 vs. 0.19 mm in controls; <i>p</i> = 0.0004) and an 11-fold increase in collagen content (1.93 vs. 0.17 mm<sup>2</sup>; <i>p</i> = 0.005). Collagen subtype analysis revealed a shift toward active collagen within the injured larynx compared to the uninjured, with increased Type III Collagen (69.0% vs. 26.1%; <i>p</i> < 0.0001) and reduced Type I Collagen (27.2% vs. 73.9%; <i>p</i> < 0.0001) in the posterior glottis, consistent with the proliferative phase of wound healing. Collagen fiber alignment analysis demonstrated increased coherency in injured tissues (0.36 vs. 0.21; <i>p</i> = 0.023), indicating early organized collagen formation consistent with scar formation within the posterior glottis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The model offers a robust platform for studying the acute pathogenesis of laryngeal injury and for testing the treatment options in the management of ALgI.</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":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460418","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}
<div> <section> <h3> Objective</h3> <p>Mastering otosclerosis surgery is challenging, especially in low-prevalence Asian populations. This study defines the learning curve for a single surgeon's first 100 consecutive CO<sub>2</sub> laser-assisted stapedotomies by analyzing audiometric and complication outcomes. Despite widespread descriptions of laser-assisted stapes surgery, there is a paucity of data examining the learning process in low-incidence, low-volume regions like East Asia. We aim to characterize the unique challenges and surgical adaptations required in such an environment.</p> </section> <section> <h3> Methods</h3> <p>A retrospective review of 100 primary stapedotomy cases was performed. The proficiency changepoint was identified using Bayesian and cumulative sum (CUSUM) analyses based on success (postoperative air-bone gap [ABG] ≤ 10 dB and no significant bone-conduction deterioration). Audiometric outcomes—including postoperative ABG, achievement of “Negative ABGe” (postoperative air conduction superior to preoperative bone conduction), and change in high-tone bone conduction—were compared between the pre-proficiency (cases 1–30) and post-proficiency (cases 31–100) phases.</p> </section> <section> <h3> Results</h3> <p>A proficiency changepoint was robustly identified at 30 cases. Subsequently, outcomes improved significantly: mean postoperative ABG decreased from 12.1 dB to 5.2 dB (<i>p</i> < 0.001), and the success rate (ABG ≤ 10 dB) increased from 53.3% to 91.4%. The rate of achieving a Negative ABGe surged from 3.3% to 50.0% (<i>p</i> < 0.001). The mean change in high-tone bone conduction also shifted from −0.3 to +6.1 dB of overclosure (<i>p</i> < 0.001). All major complications occurred within the initial 30 cases.</p> </section> <section> <h3> Conclusion</h3> <p>For CO<sub>2</sub> laser-assisted stapedotomy, proficiency significantly improves after approximately 30 cases. This study uniquely highlights how surgical mastery develops under conditions of limited disease prevalence and restricted training exposure. The findings suggest that even in low-volume environments, structured experience enables not only consistent ABG closure but also meaningful gains in patient-centered outcomes such as Negative ABGe and cochlear preservation. Our results advocate for simulation-enhanced education strategies tailored to resource-constrained surgical contexts.</p> </section> <section> <h3> Level of Evidence</h3> <p>4.</p>
目的：掌握耳硬化手术是具有挑战性的，特别是在低患病率的亚洲人群中。本研究通过分析听力学和并发症结果，定义了单个外科医生前100例连续CO2激光镫骨切除术的学习曲线。尽管对激光辅助镫骨手术有广泛的描述，但在东亚等低发病率、低容量地区，研究学习过程的数据却很缺乏。我们的目标是描述在这样的环境中所需要的独特挑战和手术适应。方法：对100例原发性镫骨切除术病例进行回顾性分析。基于手术成功（术后气骨间隙[ABG]≤10 dB且无明显骨传导恶化），使用贝叶斯和累积和（CUSUM）分析确定熟练度变化点。比较熟练前（病例1-30）和熟练后（病例31-100）阶段的听力学结果，包括术后ABG、“阴性ABGe”（术后空气传导优于术前骨传导）和高音调骨传导的变化。结果：熟练程度变化点在30例中得到了明确的确定。随后，结果显著改善：术后平均ABG从12.1 dB降至5.2 dB （p pp）。结论：对于CO2激光辅助镫骨切开术，熟练程度在大约30例后显著提高。这项研究独特地强调了在有限的疾病患病率和有限的培训暴露条件下，外科掌握如何发展。研究结果表明，即使在低容量的环境中，结构化的经验不仅可以使ABG闭合一致，而且在以患者为中心的结果（如ABGe阴性和耳蜗保存）方面也有意义的收获。我们的研究结果提倡为资源受限的外科环境量身定制模拟强化教育策略。证据等级：4。
{"title":"Learning Curve for CO2 Laser Stapedotomy: A Single-Surgeon Experience in South Korea","authors":"Dong Woo Nam, Hyoungwon Jeon, Ja-Won Koo","doi":"10.1002/lio2.70294","DOIUrl":"10.1002/lio2.70294","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Mastering otosclerosis surgery is challenging, especially in low-prevalence Asian populations. This study defines the learning curve for a single surgeon's first 100 consecutive CO<sub>2</sub> laser-assisted stapedotomies by analyzing audiometric and complication outcomes. Despite widespread descriptions of laser-assisted stapes surgery, there is a paucity of data examining the learning process in low-incidence, low-volume regions like East Asia. We aim to characterize the unique challenges and surgical adaptations required in such an environment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 100 primary stapedotomy cases was performed. The proficiency changepoint was identified using Bayesian and cumulative sum (CUSUM) analyses based on success (postoperative air-bone gap [ABG] ≤ 10 dB and no significant bone-conduction deterioration). Audiometric outcomes—including postoperative ABG, achievement of “Negative ABGe” (postoperative air conduction superior to preoperative bone conduction), and change in high-tone bone conduction—were compared between the pre-proficiency (cases 1–30) and post-proficiency (cases 31–100) phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A proficiency changepoint was robustly identified at 30 cases. Subsequently, outcomes improved significantly: mean postoperative ABG decreased from 12.1 dB to 5.2 dB (<i>p</i> < 0.001), and the success rate (ABG ≤ 10 dB) increased from 53.3% to 91.4%. The rate of achieving a Negative ABGe surged from 3.3% to 50.0% (<i>p</i> < 0.001). The mean change in high-tone bone conduction also shifted from −0.3 to +6.1 dB of overclosure (<i>p</i> < 0.001). All major complications occurred within the initial 30 cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>For CO<sub>2</sub> laser-assisted stapedotomy, proficiency significantly improves after approximately 30 cases. This study uniquely highlights how surgical mastery develops under conditions of limited disease prevalence and restricted training exposure. The findings suggest that even in low-volume environments, structured experience enables not only consistent ABG closure but also meaningful gains in patient-centered outcomes such as Negative ABGe and cochlear preservation. Our results advocate for simulation-enhanced education strategies tailored to resource-constrained surgical contexts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 ","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460436","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}
Layth R. Alkhani, Yusef Qazi, Siddhant Suri Dhawan, Paraag R. Bhatt, Christopher J. Shin, Tarik F. Massoud
Objective
Thickness of torus tubarius (TT) surface mucosa overhanging the Eustachian tube (ET) ostium, and mucosa covering the posterior aspects of bilateral inferior turbinates (ITs) are potentially pertinent to ET balloon tuboplasty. Whether TT and IT mucosal thickness is fixed or varies cyclically is potentially important in therapeutic planning but remains unknown. We establish normative MRI morphometrics for mucosa of TTs, posterior ITs (post-ITs), and anterior ITs (ant-ITs) in healthy subjects, and test the hypothesis that post-IT and TT mucosal thickness may vary during the nasal cycle akin to known changes in ant-ITs.
Methods
We retrospectively selected 60 subjects with normal nasopharynx MRIs, and measured maximal contrast-enhancing mucosal thickness for bilateral TTs, post-ITs, and ant-ITs. We conceived a novel indirect test for nasal cycle variations by computing likelihood ratio (LR) statistics comparing unimodal versus bimodal Gaussian distributions of left–right mucosal thickness differences, with significance assessed using bootstrapped p values. We validated this test by confirming detection of known nasal cycling in ant-ITs, and then applied it to assess potential cycling in TTs and post-ITs. Significance was set at p < 0.05.
Results
Mean maximal mucosal thicknesses for TTs, post-ITs, and ant-ITs were 3.1 ± 0.8, 7.6 ± 1.9, and 4.5 ± 1.3 mm, respectively. LR testing revealed significant cyclical variations in ant-ITs (LR = 4.599; p = 0.021), thus validating our methodology for inferring nasal cycling. There was no mucosal cycling for TTs (LR = −0.801; p = 0.728) or post-ITs (LR = −1.208; p = 0.799).
Conclusion
TT and post-IT mucosa unlikely exhibit nasal cycle variations. Single MRI views of TTs and post-ITs would suffice for assessment during pre-interventional planning of ET procedures.
Level of Evidence
4.
目的：耳咽管（ET）口悬垂的管环（TT）表面粘膜厚度和覆盖双侧下鼻甲（ITs）后侧面的粘膜厚度可能与耳咽管球囊成形术有关。TT和IT粘膜厚度是固定的还是周期性变化的，在治疗计划中具有潜在的重要意义，但仍不清楚。我们在健康受试者中建立了TTs、ITs后部（后ITs）和ITs前部（抗ITs）粘膜的规范MRI形态计量学，并验证了后it和TT粘膜厚度可能在鼻循环中发生变化的假设，类似于已知的抗ITs变化。方法：我们回顾性地选择了60名正常鼻咽部mri的受试者，并测量了双侧TTs，后its和抗its的最大对比增强粘膜厚度。我们通过计算似然比（LR）统计量，比较左右粘膜厚度差异的单峰和双峰高斯分布，设想了一种新的鼻周期变化的间接检验，并使用自举p值评估显著性。我们通过确认在抗its中检测到已知的鼻腔循环来验证该测试，然后将其应用于评估tt和后its的潜在循环。结果：TTs组、后its组和抗its组的平均最大粘膜厚度分别为3.1±0.8、7.6±1.9和4.5±1.3 mm。LR测试显示抗its显著的周期性变化（LR = 4.599; p = 0.021），从而验证了我们推断鼻腔循环的方法。TTs组（LR = -0.801; p = 0.728）和its后组（LR = -1.208; p = 0.799）未见粘膜循环。结论：TT和it后粘膜不可能出现鼻循环变化。TTs和post-ITs的单一MRI视图足以在介入前计划ET手术时进行评估。证据等级：4。
{"title":"Gaussian Mixture Modeling of MRI-Derived Torus Tubarius and Inferior Turbinate Mucosal Morphometrics: Implications for Nasal Cycling and Eustachian Tube Interventions","authors":"Layth R. Alkhani, Yusef Qazi, Siddhant Suri Dhawan, Paraag R. Bhatt, Christopher J. Shin, Tarik F. Massoud","doi":"10.1002/lio2.70295","DOIUrl":"10.1002/lio2.70295","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Thickness of torus tubarius (TT) surface mucosa overhanging the Eustachian tube (ET) ostium, and mucosa covering the posterior aspects of bilateral inferior turbinates (ITs) are potentially pertinent to ET balloon tuboplasty. Whether TT and IT mucosal thickness is fixed or varies cyclically is potentially important in therapeutic planning but remains unknown. We establish normative MRI morphometrics for mucosa of TTs, posterior ITs (post-ITs), and anterior ITs (ant-ITs) in healthy subjects, and test the hypothesis that post-IT and TT mucosal thickness may vary during the nasal cycle akin to known changes in ant-ITs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively selected 60 subjects with normal nasopharynx MRIs, and measured maximal contrast-enhancing mucosal thickness for bilateral TTs, post-ITs, and ant-ITs. We conceived a novel indirect test for nasal cycle variations by computing likelihood ratio (LR) statistics comparing unimodal versus bimodal Gaussian distributions of left–right mucosal thickness differences, with significance assessed using bootstrapped <i>p</i> values. We validated this test by confirming detection of known nasal cycling in ant-ITs, and then applied it to assess potential cycling in TTs and post-ITs. Significance was set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mean maximal mucosal thicknesses for TTs, post-ITs, and ant-ITs were 3.1 ± 0.8, 7.6 ± 1.9, and 4.5 ± 1.3 mm, respectively. LR testing revealed significant cyclical variations in ant-ITs (LR = 4.599; <i>p</i> = 0.021), thus validating our methodology for inferring nasal cycling. There was no mucosal cycling for TTs (LR = −0.801; <i>p</i> = 0.728) or post-ITs (LR = −1.208; <i>p</i> = 0.799).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TT and post-IT mucosa unlikely exhibit nasal cycle variations. Single MRI views of TTs and post-ITs would suffice for assessment during pre-interventional planning of ET procedures.</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":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460459","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}
Alexander Szymczak, Ben Hirsch, Ashley Young, Rachel D. Yoon, Taher Valika, Jonathan Ida, Saied Ghadersohi, Inbal Hazkani
Background
Patients with severe Bronchopulmonary dysplasia (BPD) are prone to upper airway complications due to their need for prolonged intubation, early tracheostomy placement, and chronic high-pressure ventilation. This study examines structural changes over time in tracheostomy-dependent BPD patients compared to those without BPD.
Methods
A retrospective cohort study of children who underwent tracheostomy at an age less than 6 months at a tertiary-care children's hospital between January 2012 and December 2022.
Results
A total of 82 patients underwent tracheostomy at an age of less than 6 months, of which 42 (51.2%) had BPD. Patients with BPD were older at the time of tracheostomy (4.44 vs. 3.36 months, p = 0.012) and had a younger gestational age (26.5 vs. 37.0 weeks, p < 0.001). Additionally, patients with BPD had higher rates of mechanical ventilation (42/42 vs. 24/40, p = 0.0018) and a greater number of days intubated prior to tracheostomy (92 vs. 21, p < 0.001). The median follow-up period for all patients was 28.8 months [IQR = 36.8]. BPD infants were more likely to develop subglottic stenosis (30/42 vs. 16/40, p = 0.0082), glottic edema (32/42 vs. 19/40, p = 0.0074), require laryngotracheal reconstruction (16/42 vs. 5/40, p = 0.0095) and get decannulated (21/42 vs. 8/40, p = 0.0045) compared to infants without BPD.
Conclusions
Tracheostomy-dependent infants with BPD had higher rates of glottic edema, subglottic stenosis, and laryngotracheal reconstruction but were more likely to be decannulated. These findings suggest that, despite increased airway pathology, tracheostomy is a safe and effective intervention in this population, with outcomes comparable to other pediatric cohorts.
Level of Evidence
4.
背景：重度支气管肺发育不良（BPD）患者由于需要长时间插管、早期气管造口和长期高压通气，容易发生上呼吸道并发症。本研究考察了依赖气管造口术的BPD患者与非BPD患者的结构变化。方法：对2012年1月至2022年12月间在一家三级儿童医院接受气管切开术的6个月以下儿童进行回顾性队列研究。结果：82例患者年龄小于6个月行气管切开术，其中42例（51.2%）为BPD。BPD患者当时旧的气管造口术(4.44和3.36个月,p = 0.012),年轻的胎龄(26.5 vs 37.0周,p p = 0.0018)和更多的天插管前气管造口术(92 vs . 21, p p = 0.0082),声门的水肿(32/42和19/40,p = 0.0074),需要喉气管的重建(16/42和5/40,p = 0.0095), decannulated(21/42和8/40,p = 0.0045),而对婴儿没有桶。结论：气管造瘘依赖的BPD患儿声门水肿、声门下狭窄和喉气管重建的发生率较高，但更有可能断开气管管。这些发现表明，尽管气道病理增加，气管切开术在这一人群中是一种安全有效的干预措施，其结果与其他儿科队列相当。证据等级：4。
{"title":"Tracheal Structural Changes in Tracheostomy-Dependent Children With Bronchopulmonary Dysplasia","authors":"Alexander Szymczak, Ben Hirsch, Ashley Young, Rachel D. Yoon, Taher Valika, Jonathan Ida, Saied Ghadersohi, Inbal Hazkani","doi":"10.1002/lio2.70293","DOIUrl":"10.1002/lio2.70293","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Patients with severe Bronchopulmonary dysplasia (BPD) are prone to upper airway complications due to their need for prolonged intubation, early tracheostomy placement, and chronic high-pressure ventilation. This study examines structural changes over time in tracheostomy-dependent BPD patients compared to those without BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of children who underwent tracheostomy at an age less than 6 months at a tertiary-care children's hospital between January 2012 and December 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 82 patients underwent tracheostomy at an age of less than 6 months, of which 42 (51.2%) had BPD. Patients with BPD were older at the time of tracheostomy (4.44 vs. 3.36 months, <i>p</i> = 0.012) and had a younger gestational age (26.5 vs. 37.0 weeks, <i>p</i> < 0.001). Additionally, patients with BPD had higher rates of mechanical ventilation (42/42 vs. 24/40, <i>p</i> = 0.0018) and a greater number of days intubated prior to tracheostomy (92 vs. 21, <i>p</i> < 0.001). The median follow-up period for all patients was 28.8 months [IQR = 36.8]. BPD infants were more likely to develop subglottic stenosis (30/42 vs. 16/40, <i>p</i> = 0.0082), glottic edema (32/42 vs. 19/40, <i>p</i> = 0.0074), require laryngotracheal reconstruction (16/42 vs. 5/40, <i>p</i> = 0.0095) and get decannulated (21/42 vs. 8/40, <i>p</i> = 0.0045) compared to infants without BPD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Tracheostomy-dependent infants with BPD had higher rates of glottic edema, subglottic stenosis, and laryngotracheal reconstruction but were more likely to be decannulated. These findings suggest that, despite increased airway pathology, tracheostomy is a safe and effective intervention in this population, with outcomes comparable to other pediatric cohorts.</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":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12587431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145460461","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}
This study aimed to investigate the therapeutic effects of eucalyptol (1,8-cineole), a natural monoterpene oxide with known anti-inflammatory and antioxidant properties, on the healing of nasal septal perforations (NSPs) using an experimental rat model. The study evaluated macroscopic closure rates, histological changes, and inflammation-related outcomes.
Methods
A total of 22 Sprague Dawley rats were used to create a standardized NSP model. The animals were randomly divided into two groups: a control group (n = 11) receiving 0.2 mL saline and a treatment group (n = 11) receiving 0.2 mL of topical eucalyptol daily for 14 days. One rat in the treatment group died due to anesthesia-related complications, resulting in 10 animals in that group. After the treatment period, all rats were sacrificed, and macroscopic and histological assessments were performed. Histopathological parameters included epithelial regeneration and degeneration, fibroblast density, collagen deposition, vascularization, acute and chronic inflammatory cell infiltration, granulation tissue formation, and cartilage degeneration.
Results
Macroscopic closure occurred in 100% of the eucalyptol group vs. 45.5% of controls (p = 0.003). Histologically, eucalyptol increased epithelial regeneration, fibroblast proliferation, and collagen deposition, and reduced epithelial degeneration (p < 0.05); capillary density and eosinophils did not differ significantly. No significant differences were found in acute (p = 0.202) or chronic (p = 0.143) inflammatory cell infiltration. Granulation tissue formation was significantly higher in the eucalyptol group (p = 0.006). Cartilage degeneration scores were also significantly higher in the eucalyptol group compared to controls (p = 0.005).
Conclusion
Eucalyptol significantly improved both macroscopic and histological healing outcomes in NSPs. Its anti-inflammatory, antioxidant, and pro-regenerative effects suggest that eucalyptol may serve as a promising and non-invasive therapeutic agent in the management of nasal septal perforations.
{"title":"Eucalyptol (1,8-Cineole) Enhances Wound Healing in Nasal Septal Perforations: An Experimental Rat Model Study","authors":"Ahmet Koder, Lütfü Şeneldir","doi":"10.1002/lio2.70297","DOIUrl":"https://doi.org/10.1002/lio2.70297","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to investigate the therapeutic effects of eucalyptol (1,8-cineole), a natural monoterpene oxide with known anti-inflammatory and antioxidant properties, on the healing of nasal septal perforations (NSPs) using an experimental rat model. The study evaluated macroscopic closure rates, histological changes, and inflammation-related outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 22 Sprague Dawley rats were used to create a standardized NSP model. The animals were randomly divided into two groups: a control group (<i>n</i> = 11) receiving 0.2 mL saline and a treatment group (<i>n</i> = 11) receiving 0.2 mL of topical eucalyptol daily for 14 days. One rat in the treatment group died due to anesthesia-related complications, resulting in 10 animals in that group. After the treatment period, all rats were sacrificed, and macroscopic and histological assessments were performed. Histopathological parameters included epithelial regeneration and degeneration, fibroblast density, collagen deposition, vascularization, acute and chronic inflammatory cell infiltration, granulation tissue formation, and cartilage degeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Macroscopic closure occurred in 100% of the eucalyptol group vs. 45.5% of controls (<i>p</i> = 0.003). Histologically, eucalyptol increased epithelial regeneration, fibroblast proliferation, and collagen deposition, and reduced epithelial degeneration (<i>p</i> < 0.05); capillary density and eosinophils did not differ significantly. No significant differences were found in acute (<i>p</i> = 0.202) or chronic (<i>p</i> = 0.143) inflammatory cell infiltration. Granulation tissue formation was significantly higher in the eucalyptol group (<i>p</i> = 0.006). Cartilage degeneration scores were also significantly higher in the eucalyptol group compared to controls (<i>p</i> = 0.005).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Eucalyptol significantly improved both macroscopic and histological healing outcomes in NSPs. Its anti-inflammatory, antioxidant, and pro-regenerative effects suggest that eucalyptol may serve as a promising and non-invasive therapeutic agent in the management of nasal septal perforations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70297","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145399084","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}
Camaren M. Cuenca, David M. Bruss, David J. Fei-Zhang, Jill N. D'Souza, Anthony M. Sheyn, Jeffrey C. Rastatter, Daniel C. Chelius
Objectives
Prior studies investigating the impacts of social determinants of health (SDoH) on hypopharyngeal cancer have only assessed the impact of individual factors on patient outcomes. This study uses the CDC's Social Vulnerability Index (SVI) and a national patient cohort to examine how the interrelational influence of SDoH affect hypopharyngeal cancer prognosis, treatment, and follow-up.
Methods
This retrospective cohort study analyzed patients from 1975 to 2017 with a diagnosis of hypopharyngeal carcinoma in the NCI-SEER database. Net social vulnerability and its contributions from 15 SDoH variables were ranked and scored across all US counties, yielding a SVI. SVI scores were matched to the patient's county of residence, and univariate linear regressions were performed on the length of care and prognosis, while univariate logistic regressions were performed on advanced staging at presentation and treatment modalities across SVI quintiles.
Results
Across 16,038 hypopharyngeal cancer patients, there was a significant 22.3% (35.41–27.50 months) decrease in survival time and a 16.6% (40.00–33.36 months) decrease in surveillance time between the lowest and highest overall-social vulnerability groups. Patients with greater vulnerability were more likely to have advanced staging at presentation and to receive chemotherapy, but less likely to receive surgery or radiation, with each treatment being differentially associated with vulnerability factors.
Conclusion
This study on SDoH in adults with hypopharyngeal carcinoma found significant declines in care and prognosis with higher social vulnerability, along with specific associations across SDoH themes, underscoring the need for targeted public health interventions to mitigate these disparities and improve cancer care equity.
{"title":"Social Vulnerability Associations With Hypopharyngeal Carcinoma Treatment and Prognostic Disparities","authors":"Camaren M. Cuenca, David M. Bruss, David J. Fei-Zhang, Jill N. D'Souza, Anthony M. Sheyn, Jeffrey C. Rastatter, Daniel C. Chelius","doi":"10.1002/lio2.70260","DOIUrl":"https://doi.org/10.1002/lio2.70260","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Prior studies investigating the impacts of social determinants of health (SDoH) on hypopharyngeal cancer have only assessed the impact of individual factors on patient outcomes. This study uses the CDC's Social Vulnerability Index (SVI) and a national patient cohort to examine how the interrelational influence of SDoH affect hypopharyngeal cancer prognosis, treatment, and follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study analyzed patients from 1975 to 2017 with a diagnosis of hypopharyngeal carcinoma in the NCI-SEER database. Net social vulnerability and its contributions from 15 SDoH variables were ranked and scored across all US counties, yielding a SVI. SVI scores were matched to the patient's county of residence, and univariate linear regressions were performed on the length of care and prognosis, while univariate logistic regressions were performed on advanced staging at presentation and treatment modalities across SVI quintiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Across 16,038 hypopharyngeal cancer patients, there was a significant 22.3% (35.41–27.50 months) decrease in survival time and a 16.6% (40.00–33.36 months) decrease in surveillance time between the lowest and highest overall-social vulnerability groups. Patients with greater vulnerability were more likely to have advanced staging at presentation and to receive chemotherapy, but less likely to receive surgery or radiation, with each treatment being differentially associated with vulnerability factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study on SDoH in adults with hypopharyngeal carcinoma found significant declines in care and prognosis with higher social vulnerability, along with specific associations across SDoH themes, underscoring the need for targeted public health interventions to mitigate these disparities and improve cancer care equity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70260","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367165","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}
This study aimed to evaluate the relationship between clinical features, BPPV subtypes, and dizziness complaints in patients with BPPV to identify factors contributing to dizziness distress.
Methods
This study included 129 patients diagnosed with BPPV. Demographic and clinical features of the patients were determined. The degree of dizziness was assessed using the Dizziness Handicap Inventory (DHI) and Visual Analog Scale (VAS).
Results
Female patients experienced longer BPPV durations and higher dizziness-related distress. Recurrent BPPV was more common in females (46.5%), with higher physical distress reported in these patients. Cupulolithiasis was associated with significantly higher emotional and functional DHI scores. There was no correlation between age and dizziness severity, but a positive correlation was found between age and BPPV duration in patients without recurrence.
Conclusion
Dizziness severity is influenced by sex, BPPV subtype, and recurrence. Females and patients with cupulolithiasis experience greater dizziness distress, particularly in functional and emotional domains.
{"title":"Sex and Age Differences in the Severity of Dizziness Complaints in Benign Paroxysmal Positional Vertigo (BPPV)","authors":"Emre Gürses, Esma Akış, İsa Tuncay Batuk","doi":"10.1002/lio2.70275","DOIUrl":"https://doi.org/10.1002/lio2.70275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to evaluate the relationship between clinical features, BPPV subtypes, and dizziness complaints in patients with BPPV to identify factors contributing to dizziness distress.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 129 patients diagnosed with BPPV. Demographic and clinical features of the patients were determined. The degree of dizziness was assessed using the Dizziness Handicap Inventory (DHI) and Visual Analog Scale (VAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Female patients experienced longer BPPV durations and higher dizziness-related distress. Recurrent BPPV was more common in females (46.5%), with higher physical distress reported in these patients. Cupulolithiasis was associated with significantly higher emotional and functional DHI scores. There was no correlation between age and dizziness severity, but a positive correlation was found between age and BPPV duration in patients without recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dizziness severity is influenced by sex, BPPV subtype, and recurrence. Females and patients with cupulolithiasis experience greater dizziness distress, particularly in functional and emotional domains.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145367117","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}
Molly A. Knigge, Sarah P. Rosen, Timothy M. McCulloch, Susan Thibeault
Objective
The upper esophageal sphincter (UES) serves multiple functions in the management of the upper aerodigestive tract. Prior investigations have defined the roles of UES resting and nadir pressures in normal swallowing. The distinctly high-amplitude UES peak pressures, a patterned feature of pressure propagation in the transition from the pharynx to the esophagus on high-resolution manometry (HRM), have not been characterized beyond normative data reports. This study investigated the relationship between peak UES and pharyngeal pressures at the velopharyngeal and tongue base regions in both patients with dysphagia and healthy controls.
Methods
Sixty-three adult patients with dysphagia underwent pharyngeal HRM to obtain peak measures of velopharyngeal, tongue base region, and UES pressures. Age- and sex-matched healthy controls were analyzed for comparison.
Results
UES peak pressures in patients with dysphagia showed no significant correlation with velopharyngeal or tongue base region pressures (p > 0.05). In contrast, UES peak pressures were positively correlated with velopharyngeal (r = 0.525, p < 0.001) and tongue base (r = 0.415, p = 0.001) region peak pressures in healthy subjects. Velopharyngeal region pressures showed a significant correlation with tongue base region pressures in both patients with dysphagia (r = 0.377, p = 0.002) and healthy subjects (r = 0.406, p = 0.001).
Conclusions
Pharyngeal and UES peak pressures are correlated in healthy subjects; loss of this relationship in patients with dysphagia indicates that UES peak pressures may be influenced by factors independent of pharyngeal contractile responses and bolus-related sensory feedback.
Level of Evidence
4.
目的食管上括约肌（UES）在上气道消化道的治疗中具有多种功能。先前的研究已经确定了UES静息和最低点压在正常吞咽中的作用。在高分辨率测压仪（HRM）上，明显的高振幅UES峰值压力，即从咽部到食道过渡过程中压力传播的模式特征，除了规范的数据报告之外，还没有被表征。本研究调查了吞咽困难患者和健康对照者的UES峰值与腭咽和舌根区的咽压之间的关系。方法63例成年吞咽困难患者行咽部HRM测定舌咽部、舌根区和UES压力峰值。分析年龄和性别匹配的健康对照进行比较。结果吞咽困难患者的UES峰值压力与腭咽区或舌根区压力无显著相关性（p > 0.05）。健康受试者的UES峰值压力与腭咽部（r = 0.525, p < 0.001）和舌根（r = 0.415, p = 0.001）区域峰值压力呈正相关。吞咽困难患者（r = 0.377, p = 0.002）和健康者（r = 0.406, p = 0.001）舌咽区压力与舌基区压力均有显著相关性。结论健康人咽部压力峰值与UES压力峰值存在相关性；吞咽困难患者失去这种关系表明UES峰值压力可能受到咽收缩反应和丸相关感觉反馈之外的独立因素的影响。证据级别4。
{"title":"Correlation Between Peak Upper Esophageal Sphincter and Pharyngeal Pressures in Patients With Dysphagia","authors":"Molly A. Knigge, Sarah P. Rosen, Timothy M. McCulloch, Susan Thibeault","doi":"10.1002/lio2.70286","DOIUrl":"https://doi.org/10.1002/lio2.70286","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The upper esophageal sphincter (UES) serves multiple functions in the management of the upper aerodigestive tract. Prior investigations have defined the roles of UES resting and nadir pressures in normal swallowing. The distinctly high-amplitude UES peak pressures, a patterned feature of pressure propagation in the transition from the pharynx to the esophagus on high-resolution manometry (HRM), have not been characterized beyond normative data reports. This study investigated the relationship between peak UES and pharyngeal pressures at the velopharyngeal and tongue base regions in both patients with dysphagia and healthy controls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Sixty-three adult patients with dysphagia underwent pharyngeal HRM to obtain peak measures of velopharyngeal, tongue base region, and UES pressures. Age- and sex-matched healthy controls were analyzed for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>UES peak pressures in patients with dysphagia showed no significant correlation with velopharyngeal or tongue base region pressures (<i>p</i> > 0.05). In contrast, UES peak pressures were positively correlated with velopharyngeal (<i>r</i> = 0.525, <i>p</i> < 0.001) and tongue base (<i>r</i> = 0.415, <i>p</i> = 0.001) region peak pressures in healthy subjects. Velopharyngeal region pressures showed a significant correlation with tongue base region pressures in both patients with dysphagia (<i>r</i> = 0.377, <i>p</i> = 0.002) and healthy subjects (<i>r</i> = 0.406, <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Pharyngeal and UES peak pressures are correlated in healthy subjects; loss of this relationship in patients with dysphagia indicates that UES peak pressures may be influenced by factors independent of pharyngeal contractile responses and bolus-related sensory feedback.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70286","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366551","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}
Michelle Pistner Nixon, Anas Qatanani, Amanda J. Young, Mudit Gupta, Kenneth W. Altman
Background/Objectives
Cough is a prevalent clinical problem associated with comorbidities and environmental conditions. We seek to highlight the clinically measurable impact of the environment on cough physiology by modeling the incidence and prevalence of seasonal cough as a function of certain environmental factors.
Methods
An IRB-exempt population-based retrospective electronic record review was performed to analyze the incidence and prevalence of cough in an integrated rural healthcare system from January 1, 2021, through December 31, 2023. Using time series methods including dynamic regression models, these data were measured against the seasonal incidence and prevalence of influenza based on data from the Centers for Disease Control (CDC) and air quality metrics including Air Quality Index (AQI) and particulate matter counts (PM10) based on data from the Environmental Protection Agency (EPA).
Results
There were 101,635 patients that met inclusion criteria involving 145,428 medical encounters for cough. There is a positive relationship between the seasonal prevalence and incidence of cough with influenza levels. AQI and PM10 demonstrated seasonality. While these were correlated with each other, we found no association between air quality metrics and the incidence and prevalence of cough. Results were validated within age groups, as each group independently demonstrated these associations.
Conclusion
This study demonstrates a clear seasonal trend in our rural population in the diagnosis of cough, which also correlated with seasonal trends of influenza, illustrating the significance of seasonal factors in the development of informed healthcare practices.
{"title":"Seasonality in Cough: The Influence of Environmental Physiology","authors":"Michelle Pistner Nixon, Anas Qatanani, Amanda J. Young, Mudit Gupta, Kenneth W. Altman","doi":"10.1002/lio2.70292","DOIUrl":"https://doi.org/10.1002/lio2.70292","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Objectives</h3>\u0000 \u0000 <p>Cough is a prevalent clinical problem associated with comorbidities and environmental conditions. We seek to highlight the clinically measurable impact of the environment on cough physiology by modeling the incidence and prevalence of seasonal cough as a function of certain environmental factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An IRB-exempt population-based retrospective electronic record review was performed to analyze the incidence and prevalence of cough in an integrated rural healthcare system from January 1, 2021, through December 31, 2023. Using time series methods including dynamic regression models, these data were measured against the seasonal incidence and prevalence of influenza based on data from the Centers for Disease Control (CDC) and air quality metrics including Air Quality Index (AQI) and particulate matter counts (PM10) based on data from the Environmental Protection Agency (EPA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 101,635 patients that met inclusion criteria involving 145,428 medical encounters for cough. There is a positive relationship between the seasonal prevalence and incidence of cough with influenza levels. AQI and PM10 demonstrated seasonality. While these were correlated with each other, we found no association between air quality metrics and the incidence and prevalence of cough. Results were validated within age groups, as each group independently demonstrated these associations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrates a clear seasonal trend in our rural population in the diagnosis of cough, which also correlated with seasonal trends of influenza, illustrating the significance of seasonal factors in the development of informed healthcare practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70292","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145366860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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