Rogério Aparecido Dedivitis, Mario Augusto Ferrari de Castro, Leandro Luongo Matos, Daniel Araki Ribeiro, Bruno Pelison Duarte, Luiz Paulo Kowalski
Objective
To evaluate the accuracy of artificial intelligence (AI) in establishing clinical decision-making in the treatment of advanced laryngeal cancer.
Methods
A structured question was elaborated for each of the seven recommendations chosen. Each Large Language Model (LLM) platform answered the questions. The Claude platform identified the differences between the guidelines and the responses generated and three specialists evaluated the impact of such differences.
Results
Of the 28 analyzed responses, 22 (78.6%) demonstrated content similarity with existing guidelines. Two responses showed that guidelines contained significantly more comprehensive content, three responses from LLMs provided additional content not demonstrated in the guidelines, and one response showed direct disagreement with established guidelines.
Conclusion
There was a 78.6% overlap in responses between guideline recommendations and LLMs. Therefore, while AI holds promise for transforming guideline creation, its integration into clinical practice must be carefully evaluated to ensure that it complements, rather than replaces, established expert-driven protocols.
{"title":"Artificial Intelligence in Laryngeal Cancer Management: Enhancing Guidelines or Redefining Standards?","authors":"Rogério Aparecido Dedivitis, Mario Augusto Ferrari de Castro, Leandro Luongo Matos, Daniel Araki Ribeiro, Bruno Pelison Duarte, Luiz Paulo Kowalski","doi":"10.1002/lio2.70296","DOIUrl":"10.1002/lio2.70296","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the accuracy of artificial intelligence (AI) in establishing clinical decision-making in the treatment of advanced laryngeal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A structured question was elaborated for each of the seven recommendations chosen. Each Large Language Model (LLM) platform answered the questions. The Claude platform identified the differences between the guidelines and the responses generated and three specialists evaluated the impact of such differences.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 28 analyzed responses, 22 (78.6%) demonstrated content similarity with existing guidelines. Two responses showed that guidelines contained significantly more comprehensive content, three responses from LLMs provided additional content not demonstrated in the guidelines, and one response showed direct disagreement with established guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There was a 78.6% overlap in responses between guideline recommendations and LLMs. Therefore, while AI holds promise for transforming guideline creation, its integration into clinical practice must be carefully evaluated to ensure that it complements, rather than replaces, established expert-driven protocols.</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":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551531","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 feasibility of using superficial temporal vessels as recipient vessels for vascularized free flap reconstruction in “frozen neck” patients following radiotherapy for head and neck cancer (HNC).
Methods
Between February 2022 and November 2024, 16 patients underwent vascularized free flap reconstruction by using superficial temporal vessels at Peking University School and Hospital of Stomatology. Among them, anterolateral thigh flap (ALT, n = 5), radial forearm free flap (RFFF, n = 1), deep circumflex iliac artery microvascular free flap (DCIA, n = 8), and superficial iliac circumflex artery perforator flap (SCIP, n = 2) were utilized. Intraoperative vessel identification, flap survival, and postoperative complications were assessed.
Results
All patients attained optimal surgical outcomes. During the mean follow-up period of 9 months, all flaps survived with absence of major procedure-related morbidity.
Conclusion
Superficial temporal vessels offer a safe, reliable approach for vascularized free flap reconstruction in challenging “frozen neck” cases, providing an effective alternative in oral-maxillofacial reconstruction.
Level of Evidence
4.
背景：本研究旨在探讨应用颞浅血管作为受体血管用于头颈癌（HNC）放疗后“冰冻颈部”患者带血管游离皮瓣重建的可行性。方法：于2022年2月至2024年11月在北京大学附属口腔医院行颞浅血管带血管游离皮瓣重建16例。其中，采用股前外侧皮瓣（ALT, n = 5）、前臂桡骨游离皮瓣（RFFF, n = 1）、旋髂深动脉微血管游离皮瓣（DCIA, n = 8）、旋髂浅动脉穿支皮瓣（SCIP, n = 2）。评估术中血管识别、皮瓣存活及术后并发症。结果：所有患者均获得最佳手术效果。在平均9个月的随访期间，所有皮瓣均存活，无重大手术相关并发症。结论：颞浅血管为具有挑战性的“冰冻颈部”病例提供了一种安全可靠的带血管游离皮瓣重建方法，为口腔颌面部重建提供了一种有效的选择。证据等级：4。
{"title":"Use of Superficial Temporal Vessels in Reconstructive Oral and Maxillofacial Surgery With Vascularized Free Flaps Among “Frozen Neck” Patients","authors":"Pei-Yi Lin, Cheng-Ri Jin, Hong-Feng Li, Shu-Ming Liu, Jie Zhang, Xiao-Ming Lyu, Ming-Wei Huang","doi":"10.1002/lio2.70283","DOIUrl":"10.1002/lio2.70283","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to evaluate the feasibility of using superficial temporal vessels as recipient vessels for vascularized free flap reconstruction in “frozen neck” patients following radiotherapy for head and neck cancer (HNC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between February 2022 and November 2024, 16 patients underwent vascularized free flap reconstruction by using superficial temporal vessels at Peking University School and Hospital of Stomatology. Among them, anterolateral thigh flap (ALT, <i>n</i> = 5), radial forearm free flap (RFFF, <i>n</i> = 1), deep circumflex iliac artery microvascular free flap (DCIA, <i>n</i> = 8), and superficial iliac circumflex artery perforator flap (SCIP, <i>n</i> = 2) were utilized. Intraoperative vessel identification, flap survival, and postoperative complications were assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>All patients attained optimal surgical outcomes. During the mean follow-up period of 9 months, all flaps survived with absence of major procedure-related morbidity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Superficial temporal vessels offer a safe, reliable approach for vascularized free flap reconstruction in challenging “frozen neck” cases, providing an effective alternative in oral-maxillofacial reconstruction.</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":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551485","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}
Chuan-Ming Li, Howard J. Hoffman, Bryan K. Ward, Charles C. Della Santina, Mary Frances Cotch, May S. Chiu, Katalin G. Losonczy, Christa L. Themann, Lenore J. Launer, Kristin Siggeirsdottir, Palmi V. Jonsson, Vilmundur Gudnason, Hannes Petersen
Objective
To investigate the impact of balance and dizziness problems (BDP) and other risk factors on falls in a longitudinal, population-based cohort of older adults.
Methods
The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS I) 2002–2006 examined 5764 adults aged 66–98. Five years later, 3316 surviving subjects were reexamined in AGES-RS II. Participants were asked about BDP, falls, usual activities, and health conditions. BDP symptoms during the past 12 months included: vertigo (spinning/moving sensation); floating/spacey sensation; light-headedness (no moving sensation); near fainting (presyncope) or fainting (syncope); blurred vision with head movement (oscillopsia); and feeling off-balance/unsteady. Clinical assessments included hand grip and leg strength plus steps and time to walk 6 m.
Results
During the past 12 months in AGES-RS II, BDP prevalence was 40.1% (males 35.2%, females 43.7%) and the prevalence of falling was 23.0% (males 20.9%, females 24.8%). BDP increased steps and time to walk 6 m. BDP increased the risk of falls (adjusted prevalence ratio [PR] = 1.53; 95% confidence interval [CI]: 1.34–1.76 for AGES-RS I, PR = 1.77, 95% CI: 1.55–2.03 for AGES-RS II). The prevalence of ≥ 2 falls was 8.9% (15.6% with BDP vs. 4.4% without BDP). Among those who fell ≥ 2 times, 70.4% reported BDP in the past 12 months. Additional risk of falling was associated with fear/panic attacks, memory loss, hearing loss, and other health conditions.
Conclusion
BDP are common in older adults and associated with 50% to 80% increased risk of falling and even greater risk of falling ≥ 2 times. Quantitative estimates are provided for contributing factors that further increase the risk of falls.
{"title":"Impact of Balance and Dizziness Problems on Falls in Older Adults: The Longitudinal AGES-Reykjavik Study","authors":"Chuan-Ming Li, Howard J. Hoffman, Bryan K. Ward, Charles C. Della Santina, Mary Frances Cotch, May S. Chiu, Katalin G. Losonczy, Christa L. Themann, Lenore J. Launer, Kristin Siggeirsdottir, Palmi V. Jonsson, Vilmundur Gudnason, Hannes Petersen","doi":"10.1002/lio2.70266","DOIUrl":"10.1002/lio2.70266","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the impact of balance and dizziness problems (BDP) and other risk factors on falls in a longitudinal, population-based cohort of older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The Age, Gene/Environment Susceptibility-Reykjavik Study (AGES-RS I) 2002–2006 examined 5764 adults aged 66–98. Five years later, 3316 surviving subjects were reexamined in AGES-RS II. Participants were asked about BDP, falls, usual activities, and health conditions. BDP symptoms during the past 12 months included: vertigo (spinning/moving sensation); floating/spacey sensation; light-headedness (no moving sensation); near fainting (presyncope) or fainting (syncope); blurred vision with head movement (oscillopsia); and feeling off-balance/unsteady. Clinical assessments included hand grip and leg strength plus steps and time to walk 6 m.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the past 12 months in AGES-RS II, BDP prevalence was 40.1% (males 35.2%, females 43.7%) and the prevalence of falling was 23.0% (males 20.9%, females 24.8%). BDP increased steps and time to walk 6 m. BDP increased the risk of falls (adjusted prevalence ratio [PR] = 1.53; 95% confidence interval [CI]: 1.34–1.76 for AGES-RS I, PR = 1.77, 95% CI: 1.55–2.03 for AGES-RS II). The prevalence of ≥ 2 falls was 8.9% (15.6% with BDP vs. 4.4% without BDP). Among those who fell ≥ 2 times, 70.4% reported BDP in the past 12 months. Additional risk of falling was associated with fear/panic attacks, memory loss, hearing loss, and other health conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>BDP are common in older adults and associated with 50% to 80% increased risk of falling and even greater risk of falling ≥ 2 times. Quantitative estimates are provided for contributing factors that further increase the risk of falls.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2 (prospective cohort study).</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12620664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551436","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}
Rhea Verma, Alexander Szymczak, Ashley Young, Steven Tomasi, Rachel L. Schappacher, Sara K. Perry, Rachel D. Yoon, Saied Ghadersohi, Taher Valika, Jonathan Ida, Inbal Hazkani
Objective
Infraglottic edema secondary to swelling of the conus elasticus is a common observation in children after tracheostomy. We sought to describe the natural course of infra-glottic edema as seen at first direct laryngoscopy and bronchoscopy (DLB) and explore its association with developing subglottic stenosis (SGS) in tracheostomy-dependent children.
Methods
A retrospective cohort study of children who underwent tracheostomy between 2012 and 2022 in a tertiary care children's hospital.
Results
A total of 255 children (mean age 3.5 ± 5.3 years) were enrolled, of whom 150 met inclusion criteria. Infraglottic edema was observed in 74 patients (49.3%) at first DLB, performed a median of 1.7 months after tracheostomy. Patients with edema were significantly younger at the time of tracheostomy and more likely to be ventilator-dependent due to bronchopulmonary dysplasia. Thirty patients (20%) developed SGS within 12–24 months of follow-up. On univariable analysis, factors associated with increased odds of developing SGS included the presence of infraglottic edema at first DLB, gestational age, age at tracheostomy, and medical comorbidities; no significant association between SGS and other variables was identified in multivariable analysis; however, the adjusted odds ratio suggested a 94% increase in odds of developing SGS in patients with infraglottic edema [OR 1.94, p = 0.16].
Conclusions
Infraglottic edema is a common early finding after pediatric tracheostomy. While none of the variables of interest were associated with the development of SGS, the comparatively higher odds of SGS in patients with infraglottic edema suggest a potential link that warrants further investigation in prospective studies.
Level of Evidence
4.
目的儿童气管切开术后继发于弹性圆锥肿胀的膨胀性水肿较为常见。我们试图描述首次直接喉镜检查和支气管镜检查（DLB）所见的声门下水肿的自然过程，并探讨其与气管造瘘依赖儿童发生声门下狭窄（SGS）的关系。方法对2012 - 2022年在某三级儿童医院行气管切开术的患儿进行回顾性队列研究。结果共纳入255例儿童，平均年龄（3.5±5.3）岁，其中150例符合纳入标准。74例（49.3%）患者在气管切开术后中位时间为1.7个月的首次DLB患者中观察到房颤性水肿。水肿患者在气管切开术时明显更年轻，并且由于支气管肺发育不良更容易依赖呼吸机。30例（20%）患者在随访12-24个月内发生SGS。在单变量分析中，与发生SGS的几率增加相关的因素包括：首次DLB时是否存在房颤性水肿、胎龄、气管切开术年龄和医疗合并症；在多变量分析中，SGS与其他变量无显著相关性；然而，调整后的优势比显示，骶髂水肿患者发生SGS的几率增加94% [OR 1.94, p = 0.16]。结论小儿气管切开术后常见的早期症状是室性水肿。虽然所有的变量都与SGS的发展无关，但在声带膨大性水肿患者中，SGS的相对较高的几率表明有潜在的联系，值得在前瞻性研究中进一步调查。证据级别4。
{"title":"Infraglottic Edema and Subglottic Stenosis in Tracheostomy-Dependent Children: A Retrospective Cohort Study","authors":"Rhea Verma, Alexander Szymczak, Ashley Young, Steven Tomasi, Rachel L. Schappacher, Sara K. Perry, Rachel D. Yoon, Saied Ghadersohi, Taher Valika, Jonathan Ida, Inbal Hazkani","doi":"10.1002/lio2.70306","DOIUrl":"https://doi.org/10.1002/lio2.70306","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Infraglottic edema secondary to swelling of the conus elasticus is a common observation in children after tracheostomy. We sought to describe the natural course of infra-glottic edema as seen at first direct laryngoscopy and bronchoscopy (DLB) and explore its association with developing subglottic stenosis (SGS) in tracheostomy-dependent children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of children who underwent tracheostomy between 2012 and 2022 in a tertiary care children's hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 255 children (mean age 3.5 ± 5.3 years) were enrolled, of whom 150 met inclusion criteria. Infraglottic edema was observed in 74 patients (49.3%) at first DLB, performed a median of 1.7 months after tracheostomy. Patients with edema were significantly younger at the time of tracheostomy and more likely to be ventilator-dependent due to bronchopulmonary dysplasia. Thirty patients (20%) developed SGS within 12–24 months of follow-up. On univariable analysis, factors associated with increased odds of developing SGS included the presence of infraglottic edema at first DLB, gestational age, age at tracheostomy, and medical comorbidities; no significant association between SGS and other variables was identified in multivariable analysis; however, the adjusted odds ratio suggested a 94% increase in odds of developing SGS in patients with infraglottic edema [OR 1.94, <i>p</i> = 0.16].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Infraglottic edema is a common early finding after pediatric tracheostomy. While none of the variables of interest were associated with the development of SGS, the comparatively higher odds of SGS in patients with infraglottic edema suggest a potential link that warrants further investigation in prospective studies.</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":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70306","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530033","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}
Morgan McBride, Allyson Dunlap, Siva Chinnadurai, Brianne B. Roby, Andrew Redmann, Abby C. Meyer, Luke Jakubowski, Hannah Herd, Rebecca Maher, Chelsea Kimlinger, Madeline Poland, Michael Finch, Asitha D. L. Jayawardena
Objective
To determine if specific pediatric diagnostic criteria exist to determine the presence of conductive hearing loss (CHL) digits in noise (DIN) tablet testing in children.
Methods
One hundred forty nine children aged 3–18 underwent a conventional audiogram, followed by an otolaryngologist examination and tablet-based digits in noise (DIN) testing. DIN testing consisted of diotic (same-phased stimuli) and antiphasic (out-of-phase stimuli) digits-in-noise testing on a HearX Samsung Galaxy tablet with over-the-ear headphones, for a total of 298 measurements. Children were included if they could repeat the numbers 1–10 in English, and excluded if they could not complete testing or could not tolerate ear-level examination.
Results
The signal-to-noise ratios of all participants were correlated with the hearing diagnosis determined by sound booth audiometric evaluation. Two unique parameters were identified that allowed us to identify conductive hearing loss (CHL) in the pediatric population with a high positive predictive value (76% and 95%) and acceptable specificity (81% and 98%), but poor sensitivity (39% and 22%).
Conclusion
Pediatric DIN testing did not delineate CHL from NH as cleanly as adult data. Trends were noted, but improvements need to be made to sensitivity prior to utilizing DIN as a screening tool for pediatric CHL.
{"title":"Establishing New Pediatric Thresholds for Digits-In-Noise Testing","authors":"Morgan McBride, Allyson Dunlap, Siva Chinnadurai, Brianne B. Roby, Andrew Redmann, Abby C. Meyer, Luke Jakubowski, Hannah Herd, Rebecca Maher, Chelsea Kimlinger, Madeline Poland, Michael Finch, Asitha D. L. Jayawardena","doi":"10.1002/lio2.70287","DOIUrl":"https://doi.org/10.1002/lio2.70287","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine if specific pediatric diagnostic criteria exist to determine the presence of conductive hearing loss (CHL) digits in noise (DIN) tablet testing in children.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One hundred forty nine children aged 3–18 underwent a conventional audiogram, followed by an otolaryngologist examination and tablet-based digits in noise (DIN) testing. DIN testing consisted of diotic (same-phased stimuli) and antiphasic (out-of-phase stimuli) digits-in-noise testing on a HearX Samsung Galaxy tablet with over-the-ear headphones, for a total of 298 measurements. Children were included if they could repeat the numbers 1–10 in English, and excluded if they could not complete testing or could not tolerate ear-level examination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The signal-to-noise ratios of all participants were correlated with the hearing diagnosis determined by sound booth audiometric evaluation. Two unique parameters were identified that allowed us to identify conductive hearing loss (CHL) in the pediatric population with a high positive predictive value (76% and 95%) and acceptable specificity (81% and 98%), but poor sensitivity (39% and 22%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pediatric DIN testing did not delineate CHL from NH as cleanly as adult data. Trends were noted, but improvements need to be made to sensitivity prior to utilizing DIN as a screening tool for pediatric CHL.</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":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145529754","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}
Coleton Evans, Benjamin Winters, Sandeep Rao, Sean Kelso, Peter Wickwire
Objective
This systematic review and meta-analysis evaluated how body mass index (BMI) influences surgical outcomes of hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea (OSA), specifically comparing patients with BMI ≥ 32 kg/m2 to those with BMI < 32 kg/m2.
Data Sources
PubMed, Embase, and Scopus were searched from January 2014 to April 2025 for prospective and retrospective cohort studies or case–control studies reporting HGNS outcomes stratified by BMI.
Review Methods
Following PRISMA guidelines, data were extracted on study design, demographics, baseline apnea–hypopnea index (AHI), and postoperative outcomes. Surgical success was defined using Sher or modified Sher criteria. Random-effects meta-analysis was performed using the DerSimonian and Laird method. Fixed-effect inverse-variance weights were first calculated, and between-study heterogeneity was quantified using Cochran's Q statistic and expressed as the I2 statistic. Study quality was assessed with the Newcastle–Ottawa Scale.
Results
Seven studies (n = 1572) were included in the qualitative synthesis; four were included in the meta-analysis. Qualitative findings were mixed, with some studies reporting poorer outcomes at higher BMI and others showing no difference. The pooled odds ratio for treatment success in the BMI ≥ 32 kg/m2 group versus < 32 kg/m2 was 0.87 (95% CI: 0.68–1.11). Between-study heterogeneity was low (Q = 4.11, df = 3, p = 0.25; I2 = 27%), indicating relatively consistent effect estimates across studies.
Conclusion
Elevated BMI was associated with a nonsignificant trend toward lower HGNS surgical success, but outcomes were broadly consistent across studies. Many patients with BMI ≥ 32 kg/m2 achieved meaningful objective and subjective improvements, challenging rigid BMI-based eligibility criteria and supporting individualized candidacy assessment.
{"title":"Body Mass Index and Hypoglossal Nerve Stimulation Outcomes: A Systematic Review and Meta-Analysis","authors":"Coleton Evans, Benjamin Winters, Sandeep Rao, Sean Kelso, Peter Wickwire","doi":"10.1002/lio2.70305","DOIUrl":"https://doi.org/10.1002/lio2.70305","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This systematic review and meta-analysis evaluated how body mass index (BMI) influences surgical outcomes of hypoglossal nerve stimulation (HGNS) for obstructive sleep apnea (OSA), specifically comparing patients with BMI ≥ 32 kg/m<sup>2</sup> to those with BMI < 32 kg/m<sup>2</sup>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>PubMed, Embase, and Scopus were searched from January 2014 to April 2025 for prospective and retrospective cohort studies or case–control studies reporting HGNS outcomes stratified by BMI.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>Following PRISMA guidelines, data were extracted on study design, demographics, baseline apnea–hypopnea index (AHI), and postoperative outcomes. Surgical success was defined using Sher or modified Sher criteria. Random-effects meta-analysis was performed using the DerSimonian and Laird method. Fixed-effect inverse-variance weights were first calculated, and between-study heterogeneity was quantified using Cochran's Q statistic and expressed as the <i>I</i><sup>2</sup> statistic. Study quality was assessed with the Newcastle–Ottawa Scale.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Seven studies (<i>n</i> = 1572) were included in the qualitative synthesis; four were included in the meta-analysis. Qualitative findings were mixed, with some studies reporting poorer outcomes at higher BMI and others showing no difference. The pooled odds ratio for treatment success in the BMI ≥ 32 kg/m<sup>2</sup> group versus < 32 kg/m<sup>2</sup> was 0.87 (95% CI: 0.68–1.11). Between-study heterogeneity was low (<i>Q</i> = 4.11, df = 3, <i>p</i> = 0.25; <i>I</i><sup>2</sup> = 27%), indicating relatively consistent effect estimates across studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Elevated BMI was associated with a nonsignificant trend toward lower HGNS surgical success, but outcomes were broadly consistent across studies. Many patients with BMI ≥ 32 kg/m<sup>2</sup> achieved meaningful objective and subjective improvements, challenging rigid BMI-based eligibility criteria and supporting individualized candidacy assessment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70305","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530057","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}
Benton Tullis, Jess C. Mace, Conner Massey, Stuart Batterman, Vijay R. Ramakrishnan, Daniel M. Beswick, Zachary M. Soler, Timothy L. Smith, Jeremiah A. Alt, Amarbir S. Gill
Background
Environmental factors, such as air irritants, may play an important role in chronic rhinosinusitis (CRS); however, no studies to date have examined the role of pollen in CRS disease severity. Here, we analyze the effects of pollen exposure on disease-specific and general quality-of-life (QOL) reports.
Methods
Patients were enrolled prospectively across four academic medical centers and completed the 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) surveys at enrollment. Mean annual pollen exposure over a 5-year period before enrollment was obtained from the National Allergy Bureau using residence zip codes. Unadjusted Spearman's correlation coefficients (rs) and 95% confidence intervals (CI) were calculated.
Results
One hundred and three patients were included and 55% had a history of allergy. Higher 5-year mean ragweed pollen exposure correlated with worse presenting SNOT-22 (rs = 0.24; 95% CI: 0.033, 0.42; p = 0.019) and SF-6D scores (rs = −0.21; 95% CI: −0.40, −0.0054; p = 0.039). Higher 5-year weed pollen exposure correlated with worse SNOT-22 scores (rs = 0.20; 95% CI: 0.00054, 0.38; p = 0.043).
Conclusion
This multi-institutional pilot study suggests that weed and ragweed pollen may negatively impact the QOL of patients with CRS, but further studies are needed to confirm these findings.
{"title":"Pollen Exposure and Chronic Rhinosinusitis Quality of Life Disease Severity","authors":"Benton Tullis, Jess C. Mace, Conner Massey, Stuart Batterman, Vijay R. Ramakrishnan, Daniel M. Beswick, Zachary M. Soler, Timothy L. Smith, Jeremiah A. Alt, Amarbir S. Gill","doi":"10.1002/lio2.70309","DOIUrl":"https://doi.org/10.1002/lio2.70309","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Environmental factors, such as air irritants, may play an important role in chronic rhinosinusitis (CRS); however, no studies to date have examined the role of pollen in CRS disease severity. Here, we analyze the effects of pollen exposure on disease-specific and general quality-of-life (QOL) reports.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients were enrolled prospectively across four academic medical centers and completed the 22-item SinoNasal Outcome Test (SNOT-22) and Medical Outcomes Study Questionnaire Short-Form 6-D (SF-6D) surveys at enrollment. Mean annual pollen exposure over a 5-year period before enrollment was obtained from the National Allergy Bureau using residence zip codes. Unadjusted Spearman's correlation coefficients (<i>r</i><sub><i>s</i></sub>) and 95% confidence intervals (CI) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and three patients were included and 55% had a history of allergy. Higher 5-year mean ragweed pollen exposure correlated with worse presenting SNOT-22 (<i>r</i><sub><i>s</i></sub> = 0.24; 95% CI: 0.033, 0.42; <i>p</i> = 0.019) and SF-6D scores (<i>r</i><sub><i>s</i></sub> = −0.21; 95% CI: −0.40, −0.0054; <i>p</i> = 0.039). Higher 5-year weed pollen exposure correlated with worse SNOT-22 scores (<i>r</i><sub><i>s</i></sub> = 0.20; 95% CI: 0.00054, 0.38; <i>p</i> = 0.043).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This multi-institutional pilot study suggests that weed and ragweed pollen may negatively impact the QOL of patients with CRS, but further studies are needed to confirm these findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Clinical trial registration ID: NCT02720653 (www.clinicaltrials.gov)</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70309","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145530064","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}
Nikhil Bellamkonda, Anne Naumer, Luke O. Buchmann, Hilary C. McCrary, Mana Espahbodi, Neil S. Patel
Introduction
The objective of this study was to determine the proportion of patients over the age of 50 who have HNPGL related to an SDH PV.
Methods
Patients seen at a single, tertiary-care academic medical center diagnosed with a new HNPGL over the age of 50 were included and analyzed.
Results
One hundred and eleven individuals (155 tumors) were included. Eighty (72%) patients underwent genetic testing. Twenty-one PVs of known significance were identified (SDHA in 1, SDHB in 11, SDHC in 5, SDHD in 3, and FH in 1). The rate of SDH PVs in the tested group was 25%. The median age in patients with a PV was 60 years (IQR: 54–67) years, compared to 67 years (IQR: 59–71) in those without.
Conclusions
Patients diagnosed with a HNPGL over the age of 50 are still at risk for having an SDH PV. Older patients with HNPGL and their families should still be referred for genetic testing.
{"title":"Succinate Dehydrogenase Pathogenic Variants Among Older Adults With Head and Neck Paragangliomas","authors":"Nikhil Bellamkonda, Anne Naumer, Luke O. Buchmann, Hilary C. McCrary, Mana Espahbodi, Neil S. Patel","doi":"10.1002/lio2.70302","DOIUrl":"10.1002/lio2.70302","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The objective of this study was to determine the proportion of patients over the age of 50 who have HNPGL related to an SDH PV.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients seen at a single, tertiary-care academic medical center diagnosed with a new HNPGL over the age of 50 were included and analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and eleven individuals (155 tumors) were included. Eighty (72%) patients underwent genetic testing. Twenty-one PVs of known significance were identified (<i>SDHA</i> in 1, <i>SDHB</i> in 11, <i>SDHC</i> in 5, <i>SDHD</i> in 3, and <i>FH</i> in 1). The rate of <i>SDH</i> PVs in the tested group was 25%. The median age in patients with a PV was 60 years (IQR: 54–67) years, compared to 67 years (IQR: 59–71) in those without.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Patients diagnosed with a HNPGL over the age of 50 are still at risk for having an SDH PV. Older patients with HNPGL and their families should still be referred for genetic testing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 6","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12606041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514697","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}
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}
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