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Virtual Versus In-Person Interviews: The Impact of Perceived Success on the Applicant Experience 虚拟面试与面对面面试:感知成功对申请人体验的影响。
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-21 DOI: 10.1002/lio2.70288
Sacha Moufarrej, Andrew Yousef, Deborah Watson

Objectives

To comparatively assess otolaryngology residency applicant perspectives on virtual versus in-person interviews and identify associations between perceived application success and interview preferences during the 2023–2024 application cycle using a cross-sectional survey-based study from nationwide otolaryngology residency applicants to a single institution.

Methods

Applicants to an otolaryngology residency program completed a 36-item survey comparing their experience participating in virtual and in-person interviews. Demographics, medical school performance, and application cycle progress data were collected and analyzed for associations between application success and interview preferences. Participants' overall opinion of virtual interviews was calculated by summing their Likert-scale responses, with higher scores (maximum 30) indicating a greater preference for the virtual interview.

Results

A total of 81 applicants, 30% of those invited, completed the survey. An average of 41.1% (SD 18.6%) of respondents' total interviews were in-person. Opinions on the virtual interview were mixed (mean total score of 15.2 (SD 5.2)). Despite only 25.6% preferring virtual interviews, 62.9% supported their continued availability. Those with a higher interview yield were more likely to have a more positive opinion of virtual interviews (OR 1.05, p = 0.0002).

Conclusion

While applicants had mixed sentiments regarding the virtual interview, most indicated that the option for virtual interviews should continue to be available for otolaryngology programs. Participants with a higher interview yield preferred the virtual interview, suggesting applicants' preferences are partly informed by their overall feelings of success during the application cycle.

Level of Evidence

3.

目的:通过一项针对单一机构的全国耳鼻喉科住院医师申请人的横断面调查研究,比较评估耳鼻喉科住院医师申请人对虚拟面试和面对面面试的看法,并确定2023-2024年申请周期内感知申请成功与面试偏好之间的关联。方法:耳鼻喉科住院医师项目的申请人完成了一份36项的调查,比较他们参加虚拟和面对面访谈的经历。研究人员收集了人口统计学、医学院成绩和申请周期进展数据,并对申请成功与面试偏好之间的关系进行了分析。参与者对虚拟面试的总体看法是通过汇总他们的李克特量表反应来计算的,得分越高(最高30分)表明对虚拟面试的偏好越大。结果:共有81名申请人完成了调查,占被邀请者的30%。受访者的总访谈中,平均有41.1%(标准差18.6%)是面对面访谈。对虚拟访谈的意见不一(平均总分15.2分(SD 5.2))。尽管只有25.6%的人喜欢虚拟面试,但62.9%的人支持虚拟面试继续存在。面试收益高的人更有可能对虚拟面试有更积极的看法(OR 1.05, p = 0.0002)。结论:虽然申请人对虚拟面试有不同的看法,但大多数人表示虚拟面试的选择应该继续适用于耳鼻喉科项目。面试成功率较高的参与者更喜欢虚拟面试,这表明申请人的偏好在一定程度上是由他们在申请周期中对成功的整体感觉所决定的。证据等级:3。
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引用次数: 0
Characterizing the Patient Experience of Idiopathic Subglottic Stenosis in Pregnancy 妊娠期特发性声门下狭窄的特征分析。
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-21 DOI: 10.1002/lio2.70289
Sarah Benyo, Radhika Duggal, Daniela Schmulevich, Justin Lau, Katherine Miller, Anastasia Christ, Laurence Gascon, Katherine Singh, Rebecca C. Nelson, Paul C. Bryson, Michael S. Benninger, Robert R. Lorenz, William S. Tierney

Objective

To characterize surgical interventions in pregnancy and postpartum periods and compare them to baseline periods (outside of pregnancy/postpartum) for patients with idiopathic subglottic stenosis (iSGS).

Methods

A retrospective chart review was performed for patients undergoing endoscopic treatment for iSGS during pregnancy, postpartum, and baseline periods at The Cleveland Clinic between July 1, 2000 and January 1, 2025. Data collected included disease characteristics, surgery characteristics, and pregnancy history. The primary endpoint was the surgical interval between surgical interventions, defined as the number of days until the following surgical intervention during pregnancy, postpartum, and baseline periods.

Results

Nine patients were included in the analysis. Among these patients, there were 17 term deliveries, 1 pre-term delivery, 2 miscarriages, and 2 terminations. There was no statistically significant difference in the surgical interval for patients undergoing surgery during pregnancy when compared to their surgical interval in the one-year postpartum period (p = 0.69) or when compared to the same patients' baseline surgical interval (p = 0.69). Four patients (45%) experienced more surgical interventions following a pregnancy as compared to before pregnancy.

Conclusion

Surgical management of iSGS is safe during pregnancy, and although we observed no significant difference in the surgical interval during pregnancy, postpartum, and baseline periods, four patients did require more surgical interventions after pregnancy, highlighting the importance of counseling patients on the potential risk of iSGS recurrence after pregnancy and closely monitoring these patients during the postpartum period.

Level of Evidence

IV.

目的:探讨特发性声门下狭窄(iSGS)患者妊娠期和产后手术干预的特点,并将其与基线期(妊娠期外/产后)进行比较。方法:对2000年7月1日至2025年1月1日期间在克利夫兰诊所接受内窥镜治疗的iSGS患者的妊娠、产后和基线期进行回顾性图表回顾。收集的资料包括疾病特征、手术特征和妊娠史。主要终点是手术干预之间的手术间隔,定义为妊娠期、产后和基线期至下一次手术干预的天数。结果:9例患者纳入分析。其中足月分娩17例,早产1例,流产2例,终止妊娠2例。妊娠期手术患者的手术间隔与产后1年的手术间隔(p = 0.69)或同一患者的基线手术间隔(p = 0.69)比较,差异均无统计学意义。4名患者(45%)在怀孕后比怀孕前经历了更多的手术干预。结论:妊娠期iSGS的手术治疗是安全的,尽管我们观察到妊娠期、产后和基线期手术间隔无显著差异,但有4例患者在妊娠后确实需要更多的手术干预,这突出了对患者进行妊娠后iSGS复发潜在风险的咨询和产后密切监测的重要性。证据等级:四级。
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引用次数: 0
Medicare Reimbursement Trends in Zenker's Diverticulectomy Zenker憩室切除术的医疗保险报销趋势
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-18 DOI: 10.1002/lio2.70291
George S. Bebawy, Aman M. Patel, David Herz, Paul T. Cowan, Andrey Filimonov, Ghayoour S. Mir

Objective

To analyze Medicare reimbursement and utilization trends of Zenker's diverticulectomy from 2000 to 2024.

Study Design

Retrospective cross-sectional study.

Setting

Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule (2000–2024) and Part B Medicare Fee-For-Service National Summary Data (2000–2022).

Methods

Utilization and payment trends for open (Current Procedural Terminology [CPT] code 43130) and endoscopic (CPT code 43180, introduced in 2015) repair of Zenker's diverticulum were analyzed, with reimbursement rates adjusted for inflation using the Consumer Price Index (CPI). Linear regression analysis was performed to assess the relationship between reimbursement rates and time.

Results

From 2000 to 2022, the total number of Zenker's diverticulectomy procedures decreased by 14.8% (1775–1513), with a 72.1% decrease (1775–495) for open approach. There was a 22.5% increase (831–1018) in endoscopic approach from 2015 to 2022. By 2022, endoscopic procedures accounted for 67.3% of all Zenker's diverticulectomies, compared to 32.7% for the open approach. From 2000 to 2024, inflation-adjusted reimbursement for open procedures declined by 49.96% ($1586.26–$670.41), with an annual decrease of 2.08%. Endoscopic procedures, tracked separately from 2015 to 2024, saw a 29.32% decline ($773.24–$547.13) and an annual decrease of 3.26%. Unadjusted reimbursement for both approaches combined declined by an average of 0.88% per year, while inflation-adjusted rates decreased by 3.45% annually (p < 0.001).

Conclusion

There has been a downward trend in the Medicare reimbursement of Zenker's diverticulectomy, with an average adjusted decline of 3.45% annually. This trend raises concerns about the sustainability of such specialized procedures, potentially limiting access for elderly patients reliant on Medicare coverage.

Level of Evidence

4.

目的分析2000 - 2024年Zenker憩室切除术的医保报销及使用趋势。研究设计回顾性横断面研究。设置医疗保险和医疗补助服务中心(CMS)医师收费表(2000-2024年)和B部分医疗保险服务收费全国汇总数据(2000-2022年)。方法分析开放式(现行程序术语[CPT]代码43130)和内镜下(CPT代码43180,2015年推出)Zenker憩室修复的使用情况和支付趋势,报销率采用消费者价格指数(CPI)进行通货膨胀调整。采用线性回归分析评估报销率与时间的关系。结果从2000年到2022年,Zenker憩室切除术总数减少了14.8%(1775-1513例),其中开放入路减少了72.1%(1775-495例)。从2015年到2022年,内镜入路增加了22.5%(831-1018)。到2022年,内窥镜手术占所有Zenker憩室切除术的67.3%,而开放入路为32.7%。从2000年到2024年,经通货膨胀调整后的开放式手术报销额下降了49.96%(1586.26美元- 670.41美元),年降幅为2.08%。从2015年到2024年,内窥镜手术的费用下降了29.32%(773.24美元至547.13美元),年降幅为3.26%。两种方法的未经调整的报销费用平均每年下降0.88%,而通货膨胀调整后的报销费用每年下降3.45% (p < 0.001)。结论Zenker憩室切除术的医保报销呈下降趋势,调整后平均每年下降3.45%。这一趋势引起了人们对此类专业手术的可持续性的担忧,可能会限制依赖医疗保险的老年患者获得治疗的机会。证据级别4。
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引用次数: 0
Biologics for Chronic Rhinosinusitis With Nasal Polyposis: Current Landscape and Future Directions 慢性鼻窦炎伴鼻息肉病的生物制剂:现状和未来方向
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-18 DOI: 10.1002/lio2.70282
Jerlon Chiu, Judd Fastenberg, Charles Tong, Brianne Navetta-Modrov, Sonya Marcus

Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a type 2 inflammatory disease that often persists despite medical and surgical treatments. Recently, biologic therapies targeting key cytokines—interleukin (IL)-4, IL-5, IL-13—and immunoglobulin E (IgE) have transformed management options for patients with severe or recurrent disease. Dupilumab, omalizumab, and mepolizumab are FDA-approved biologics proven to reduce polyp size, improve symptoms, and enhance quality of life in clinical trials. Guidelines now endorse the use of biologics in select patients with evidence of type 2 inflammation and inadequate control after standard treatments. However, challenges remain, including high costs, uncertain treatment duration, lack of direct comparisons, and absence of validated biomarkers to guide selection. Additionally, the optimal role of biologics relative to endoscopic sinus surgery is not yet clear. Emerging therapies—including long-acting anti–IL-5 agents and new targets like TSLP and IL-33—may further broaden options. Research is also needed for patients with non-type two inflammation who respond poorly to current treatments. Ultimately, personalized approaches based on disease phenotype and biomarkers are crucial to optimizing outcomes. This review summarizes current evidence and future directions for biologic use in CRSwNP, focusing on efficacy, patient selection, surgery integration, and precision medicine opportunities.

慢性鼻窦炎伴鼻息肉病(CRSwNP)是一种2型炎症性疾病,尽管药物和手术治疗,但通常仍然存在。最近,针对关键细胞因子-白细胞介素(IL)-4、IL-5、IL-13和免疫球蛋白E (IgE)的生物疗法已经改变了严重或复发性疾病患者的治疗选择。Dupilumab, omalizumab和mepolizumab是fda批准的生物制剂,在临床试验中被证明可以减少息肉大小,改善症状并提高生活质量。指南现在认可在有2型炎症证据和标准治疗后控制不足的患者中使用生物制剂。然而,挑战仍然存在,包括高成本,不确定的治疗时间,缺乏直接比较,以及缺乏有效的生物标志物来指导选择。此外,生物制剂相对于内窥镜鼻窦手术的最佳作用尚不清楚。新兴疗法——包括长效抗il -5药物和像TSLP和il -33这样的新靶点——可能会进一步拓宽选择范围。对目前治疗效果不佳的非2型炎症患者也需要进行研究。最终,基于疾病表型和生物标志物的个性化方法对于优化结果至关重要。本文综述了CRSwNP生物应用的现有证据和未来方向,重点是疗效、患者选择、手术整合和精准医学机会。
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引用次数: 0
Improved Nasal Airflow Is Associated With Olfactory Recovery in a Large Population of Patients With COVID-19-Related Olfactory Dysfunction 在大量与covid -19相关的嗅觉功能障碍患者中,改善鼻气流与嗅觉恢复有关
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-16 DOI: 10.1002/lio2.70285
Alfonso Luca Pendolino, Paolo Boscolo-Rizzo, Davide Benussi, Bruno Scarpa, Peter J. Andrews

Objective

Nasal airflow is essential for delivering odorants to the olfactory epithelium. With increasing evidence demonstrating a strong link between nasal airflow and olfaction, we conducted a large multicenter retrospective study to further examine if nasal airflow can influence olfactory recovery in patients with COVID-19-related olfactory dysfunction (C19OD).

Methods

Patients with reported C19OD received Sniffin’ Sticks extended set, peak nasal inspiratory flow (PNIF), and VAS for smell (sVAS) at baseline (T0). Subjects with a confirmed OD at T0 were offered a second follow-up, averaged at 6 months (T1). All tests were repeated at T1.

Results

Two hundred and five patients (median age 46) with a median length of OD of 1.1 years were seen at T0. One hundred and eleven dysosmics at T0 were seen at T1. At T1 43 patients (38.7%) recovered their sense of smell. A statistically significant improvement was observed for PNIF (p = 0.001) and sVAS (p < 0.001) in the whole population at T1. A statistically significant difference was noted for all the olfactory scores and sVAS (p < 0.001 for all) between normosmic and dysosmic subjects at T1. When we looked at changes in the scores between T0–T1, statistically significant correlations were observed between changes (Δ) in PNIF and Δthreshold (rho = 0.24 and p = 0.015), ΔPNIF and ΔTDI (rho = 0.22 and p = 0.021). An increase in ΔPNIF of 77.4 L/min corresponded to a 65% probability of reaching the normosmic level, with olfactory threshold being the more sensitive to PNIF changes.

Conclusion

Improvement in nasal airflow can have a positive impact on smell recovery and on olfactory threshold in particular, highlighting its importance in persistent C19OD.

Level of Evidence

3.

目的鼻气流是将气味物质输送到嗅上皮的重要通道。随着越来越多的证据表明鼻腔气流与嗅觉之间存在密切联系,我们进行了一项大型多中心回顾性研究,以进一步研究鼻腔气流是否会影响covid -19相关嗅觉功能障碍(C19OD)患者的嗅觉恢复。方法报告的C19OD患者在基线(T0)时接受嗅探棒延长装置、峰值鼻吸入流量(PNIF)和嗅觉VAS (sVAS)。在T0时确诊OD的受试者进行第二次随访,平均随访时间为6个月。所有试验在T1时重复进行。结果25例患者,中位年龄46岁,中位OD长度为1.1年。在T1处观察到111个dysoics。在T1时,43名患者(38.7%)恢复了嗅觉。在T1时,整个人群的PNIF (p = 0.001)和sVAS (p < 0.001)有统计学意义的改善。正常和嗅觉障碍受试者在T1时的所有嗅觉评分和sVAS均有统计学显著差异(p < 0.001)。当我们观察T0-T1之间得分的变化时,观察到PNIF的变化(Δ)与Δthreshold (rho = 0.24, p = 0.015), ΔPNIF和ΔTDI (rho = 0.22, p = 0.021)之间具有统计学意义的相关性。ΔPNIF增加77.4 L/min,达到正常水平的概率为65%,嗅觉阈值对PNIF变化更为敏感。结论改善鼻腔气流对嗅觉恢复,尤其是嗅觉阈值有积极影响,对持续性C19OD具有重要意义。证据水平
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引用次数: 0
Mitomycin C Induces Autophagy in Human Tracheal Fibroblasts and Suppresses Their Growth 丝裂霉素C诱导人气管成纤维细胞自噬并抑制其生长
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-16 DOI: 10.1002/lio2.70251
Jeong-Mi Kim, Sungryeal Kim, Eun-Jeong Jeon, Jin-Mi Park, Seo-Young Park, Jeong-Seok Choi

Objective

Mitomycin C (MMC) is frequently used to prevent postoperative fibrosis in tracheal stenosis, yet its precise cellular mechanisms remain inadequately understood. This study aimed to elucidate the cytotoxic and autophagic effects of MMC on normal human tracheal fibroblasts (hTF) and human bronchial/tracheal epithelial cells (hTEC) to better understand its potential role in fibrosis regulation.

Methods

hTF and hTEC were exposed to MMC at concentrations of 0.01, 0.1, and 1 μg/mL for 24, 48, and 72 h. Cell proliferation, autophagy induction, and the expression of autophagy-related proteins were assessed using viability assays and Western blot analysis. Additionally, the effects of MMC on cell migration and fibroblast-to-myofibroblast transition were investigated.

Results

MMC partially reduced hTEC proliferation without inducing autophagy. In contrast, MMC significantly suppressed hTF growth in a dose- and time-dependent manner while promoting autophagy. Western blot analysis revealed increased expression of LC3, ATG5, and Rab7 in MMC-treated hTF, along with reduced cyclin D1 levels. Furthermore, MMC attenuated TGFβ-induced αSMA expression in fibroblasts, suggesting an inhibitory effect on fibrosis-related cellular transformation.

Conclusion

These findings indicate that MMC suppresses human tracheal fibroblast proliferation through autophagy-mediated cell death while sparing epithelial cells. This dual effect underscores its potential as a targeted antifibrotic agent for tracheal stenosis management. Further research is needed to optimize MMC's application and elucidate its long-term impact on airway remodeling.

Level of Evidence

5.

目的丝裂霉素C (Mitomycin C, MMC)常用于预防气管狭窄术后纤维化,但其确切的细胞机制尚不清楚。本研究旨在阐明MMC对正常人气管成纤维细胞(hTF)和人支气管/气管上皮细胞(hTEC)的细胞毒性和自噬作用,以更好地了解其在纤维化调节中的潜在作用。方法hTF和hTEC分别于浓度为0.01、0.1和1 μg/mL的MMC中暴露24、48和72 h。细胞增殖、自噬诱导和自噬相关蛋白的表达通过活力测定和Western blot分析进行评估。此外,我们还研究了MMC对细胞迁移和成纤维细胞向肌成纤维细胞转化的影响。结果MMC部分抑制hTEC增殖,但不诱导自噬。相反,MMC在促进自噬的同时,以剂量和时间依赖的方式显著抑制hTF的生长。Western blot分析显示,mmc处理的hTF中LC3、ATG5和Rab7的表达增加,同时cyclin D1水平降低。此外,MMC还能减弱tgf β诱导的成纤维细胞中α - sma的表达,提示其对纤维化相关的细胞转化具有抑制作用。结论MMC通过自噬介导的细胞死亡抑制人气管成纤维细胞增殖,同时保留上皮细胞。这种双重作用强调了其作为气管狭窄治疗的靶向抗纤维化药物的潜力。需要进一步的研究来优化MMC的应用,并阐明其对气道重塑的长期影响。证据等级
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引用次数: 0
Analysis of Mucosal Wave and Vibratory Patterns in Vocally Healthy Children and Adults 口腔健康儿童和成人的粘膜波和振动模式分析。
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-14 DOI: 10.1002/lio2.70278
Bernhard Jakubass, Hamide Ghaemi, Maggie Lynn Stall, Dimitar D. Deliyski, Rita R. Patel

Objective

To conduct a systematic investigation and comparison of the mucosal wave of vocal fold oscillations, the longitudinal anterior–posterior (AP) vibratory patterns of opening and closing, and posterior glottal gap in vocally healthy children (girls and boys) and adults (women and men).

Methods

High-speed videoendoscopy (HSV) recordings of the sustained phonations of 40 subjects (10 men, 10 women, 10 boys, and 10 girls) were analyzed. For each recording, three sections of stable sustained phonation were selected. Two experts rated independently the anterior and posterior commissure points, the mucosal wave, and the AP vibratory patterns during the opening and closing phases of vocal fold vibration. A third rater mediated a consensus. Statistical significance between participant groups was evaluated using Pearson's chi-square test and post hoc Mann–Whitney U tests.

Results

Mucosal wave amplitude was highest in children, whereas adult males exhibited lower amplitudes (p < 0.05). Posterior-to-anterior (p2a) opening patterns dominated in all groups, especially among children and females, while men showed more variation (p < 0.001). Anterior-to-posterior (a2p) closing pattern was most common in girls and females, whereas simultaneous (sim) closure was predominant in boys (p < 0.01). Posterior glottal gap was more frequently visible in children and females, while most adult males showed no visible gap (p < 0.001).

Conclusion

This study identified age- and gender-related differences in vocal fold vibration. The findings offer key reference data for age-appropriate clinical visual-perceptual voice assessment.

目的:对声健康儿童(男女)和成人(男女)的声带振荡粘膜波、开闭纵向前后(AP)振动模式和声门后间隙进行系统的调查和比较。方法:对40例被试(男10例,女10例,男10例,女10例)的持续发声的高速视频内镜(HSV)记录进行分析。每次录音,选取稳定持续发声的三段。两名专家分别对声带振动开合阶段的前后连合点、粘膜波和AP振动模式进行了独立评分。一个三流人物调停达成共识。使用Pearson卡方检验和事后Mann-Whitney U检验评估参与者组间的统计学显著性。结果:儿童的粘膜波振幅最高,而成年男性则表现出较低的振幅(p p2a),所有组中以儿童和女性为主,而男性则表现出更多的变化(p a2p),女孩和女性最常见的关闭模式,而男孩则以同时关闭(sim)为主(p p)。研究结果为适合年龄的临床视知觉语音评估提供了关键的参考数据。
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引用次数: 0
FDA-Approved Biologics for CRSwNP: A Five-Year Analysis of the FDA Adverse Event Reporting System FDA批准的CRSwNP生物制剂:FDA不良事件报告系统的五年分析
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-11 DOI: 10.1002/lio2.70133
Radhika Duggal, Mohamad R. Chaaban

Objectives

Given the increasing utilization of biologics in the treatment of CRSwNP, it is important to characterize their adverse events (AEs). This study compares the AE profiles of FDA-approved biologics for CRSwNP when adjusting for potential confounders, such as prescription indication, age, and sex.

Methods

We retrospectively reviewed AEs reported in the FDA Adverse Events Reporting System (FAERS) from 2019Q1 to 2023Q2. AEs were categorized and compared between biologics for comparison of AE type and severity. Chi-square tests compared outcomes between groups and regression modeling identified predictors of a serious adverse event (SAE).

Results

We identified ~79,000 AE logs consisting of ~226,000 individual adverse reactions (IARs). Most dupilumab IARs were dermatologic or administration/medical error related. Most mepolizumab were administration/medical error related or pulmonary. Most omalizumab were pulmonary or dermatologic. Compared to dupilumab, we found that mepolizumab (OR 3.61, 95% CI: 3.29–3.98) and omalizumab (OR 15.33, 95% CI: 13.98–16.81) had a greater odds of a reported AE being an SAE. Though more females reported having any AE, male sex, increasing age, and a prescription indication of asthma were associated with a significantly increased odds of an AE being an SAE.

Conclusion

We found potential predictors associated with SAEs to FDA approved biologics including gender (male > female), age (increasing age), and prescription indication (asthma > asthma + CRSwNP > CRSwNP). This data is important to prescribers educating their patients to potential AEs.

鉴于生物制剂在CRSwNP治疗中的应用越来越多,对其不良事件(ae)进行表征是很重要的。本研究比较了fda批准的用于CRSwNP的生物制剂在调整潜在混杂因素(如处方适应症、年龄和性别)后的AE谱。方法回顾性分析FDA不良事件报告系统(FAERS)中2019年第一季度至2023年第二季度报告的不良事件。对AE进行分类,比较不同生物制剂AE的类型和严重程度。卡方检验比较各组之间的结果,回归模型确定严重不良事件(SAE)的预测因子。结果共鉴定出约79000例AE日志,其中包括约226000例个体不良反应(IARs)。大多数dupilumab IARs与皮肤或给药/医疗错误有关。大多数美泊珠单抗与给药/医疗错误有关或肺部。大多数奥玛单抗是肺部或皮肤疾病。与dupilumab相比,我们发现mepolizumab (OR 3.61, 95% CI: 3.29-3.98)和omalizumab (OR 15.33, 95% CI: 13.98-16.81)报告的AE为SAE的几率更大。尽管更多的女性报告有任何AE,但男性、年龄增长和哮喘的处方指征与AE为SAE的几率显著增加相关。结论:我们发现与FDA批准的生物制剂相关的潜在预测因素包括性别(男性>;女性)、年龄(年龄增加)和处方适应证(哮喘>;哮喘+ CRSwNP >; CRSwNP)。这一数据对于开处方者教育患者了解潜在不良事件很重要。
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引用次数: 0
Surgical Experience and Validation of the “Bow Tie” Trilayer Graft Technique for Closure of Anterior Skull Base Defects “领结”式三层骨移植修复前颅底缺损的手术经验与效果验证
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-11 DOI: 10.1002/lio2.70281
Jacquelyn K. Callander, Taylor S. Erickson, Hasan Abdulbaki, Philip V. Theodosopoulos, Manish K. Aghi, Ezequiel D. Goldschmidt, Ivan H. El-Sayed, Jose G. Gurrola II

Objectives

Multiple reconstruction techniques exist to repair defects arising from expanded endonasal approach (EEA) surgeries targeting anterior skull base tumors. These repairs aim to minimize post-operative complications such as cerebrospinal fluid (CSF) leak. In 2022, our group described the “Bow tie” trilayer graft, a repair method that incorporates two layers of a collagen matrix graft stitched to a fat graft. The initial data demonstrated a reduction in the rate of CSF leaks following the adoption of this method. This study evaluates the surgical practice of a single surgeon with access to the trilayer technique and the post-operative outcomes.

Methods

Retrospective chart review encompassing all EEAs to anterior skull base tumors performed by a single otolaryngologist (JGG) from January 2019 to September 2024 at a tertiary care center.

Results

Of 250 cases meeting inclusion criteria, 42 (16.8%) involved bow tie graft reconstruction. Postoperative CSF leaks occurred in 3 subjects (1.2%), with none of these cases involving bow tie grafts. Trilayer grafts were used more frequently in revision cases (p = 0.018) and when intra-operative CSF leaks were encountered (p < 0.0001). There was no difference in average age, sex, BMI, maximum tumor dimension, or the frequency of lumbar drain insertion between the groups with and without trilayer grafts (p > 0.05).

Conclusion

The trilayer graft is an efficient and useful tool in the armamentarium of an anterior skull base surgeon. This technique may decrease rates of postoperative CSF leak with limited additional morbidity. Larger multicenter studies are warranted to validate this potential benefit given the relative rarity of this complication.

Level of Evidence

4.

目的针对前颅底肿瘤的扩鼻入路(EEA)手术后的缺损,目前存在多种重建技术。这些修复旨在减少术后并发症,如脑脊液(CSF)泄漏。2022年,我们的团队描述了“领结”三层移植,这是一种将两层胶原基质移植物缝合到脂肪移植物上的修复方法。初步数据表明,采用该方法后脑脊液泄漏率降低。本研究评估了单个外科医生使用三层技术的手术实践和术后结果。方法回顾性分析2019年1月至2024年9月在某三级保健中心由一名耳鼻喉科医生(JGG)对前颅底肿瘤进行的所有eea手术。结果在250例符合纳入标准的病例中,42例(16.8%)行领结移植重建。术后3例(1.2%)患者发生脑脊液渗漏,这些病例均未涉及领结移植物。在翻修病例(p = 0.018)和术中遇到脑脊液泄漏时(p < 0.0001),三层移植的使用频率更高。三层移植物组与非三层移植物组在平均年龄、性别、BMI、最大肿瘤尺寸、腰椎引流管插入频率等方面无差异(p > 0.05)。结论三层骨移植是一种有效的前颅底外科手术器械。该技术可以降低术后脑脊液泄漏的发生率,并限制额外的发病率。考虑到这种并发症的相对罕见性,需要更大规模的多中心研究来验证这种潜在的益处。证据级别4。
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引用次数: 0
Head and Neck Cancer Incidence in the United States Following the Onset of COVID-19 Pandemic 2019冠状病毒病大流行后美国头颈癌发病率
IF 1.7 4区 医学 Q2 OTORHINOLARYNGOLOGY Pub Date : 2025-10-11 DOI: 10.1002/lio2.70226
Wesley L. Cai, Vanessa Helou, Matthew E. Spector, José P. Zevallos, Angela L. Mazul, Kevin J. Contrera
<p>Head and neck cancer (HNC) remains a significant health concern, with an estimated 71,000 new cases expected in the United States (US) in 2024 [<span>1</span>]. The COVID-19 pandemic altered healthcare delivery, causing a 10% drop in overall cancer incidence in the US in 2020 compared to 2019 [<span>2</span>]. While prior studies have examined pandemic-related incidence disruptions during the pandemic [<span>3</span>], the specific trajectory of HNC incidence following the pandemic warrants further investigation. Understanding these trends is essential for optimizing cancer screening and delivery in future public health crises. This study aims to provide insights into HNC incidence trends during and after the COVID-19 pandemic.</p><p>This National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) registry, updated on April 17, 2024, was used [<span>4</span>]. Age-adjusted incidence data (per 100,000 people) were extracted based on ICD-O-3 codes for lip, tongue anterior, gum, floor of mouth, palate excluding soft and uvula, buccal mucosa, mouth other, major salivary glands, nasopharynx, oropharynx, hypopharynx, pharynx and oral cavity other, nasal cavity and paranasal sinuses, sinus other, and larynx cancers. No institutional review board approval or informed consent was required as the data is publicly available and de-identified. Data on “localized,” “regional,” and “distant” disease was obtained using the SEER Combined Summary Stage (2004+) variable, with staging based on organ site.</p><p>Age-adjusted incidence rates were obtained, and data were selected by sex, race, and origin, and combined summary stage. Annual percent change (APC) was calculated using the average change in lower and upper confidence intervals of incidence rates. Data analysis was conducted using R 4.4.0 with data.table, ggplot2, ggrepel packages. Plots were visualized using ggplot2.</p><p>In 2021, there were 28,154 new HNC cases, resulting in an incidence rate of 14.6 new cases per 100,000 individuals. From 2020 to 2021, incidence increased by 14.0%, corresponding to an APC of +4.5%. This follows a decline from 2019 to 2020, with an APC of −6.9% (Figure 1A). The largest increases by anatomical site from 2020 to 2021 were observed in “sinus other” (+30.7%), “floor of mouth” (+21.2%), “gum” (+20.6%), and “buccal mucosa” (+17.9%) (Figure 1B).</p><p>The APC trends were consistent across racial groups, showing a decline in 2020 followed by an increase in 2021. The largest increase occurred in Asian American and Pacific Islander (AAPI) (+16.0%), followed by Hispanics (+14.1%), non-Hispanic Whites (+11.4%), and non-Hispanic Blacks (NHB) (+10.4%). Examining the data by sex, increases were + 10.3% in females and +11.8% in males.</p><p>Of the 28,154 new cases, 9202 (32.7%) were local, 13,832 (49.1%) were regional, and 3458 (12.3%) were distant. The incidence of all three stages increased from 2020 to 2021. The largest APC rise was in localized cases (+23.0%), fo
头颈癌(HNC)仍然是一个重大的健康问题,预计2024年美国(US)将有71,000例新病例。2019冠状病毒病大流行改变了医疗保健服务,导致2020年美国癌症总发病率比2019年下降了10%。虽然先前的研究已经检查了大流行期间与大流行相关的发病率中断,但大流行后HNC发病率的具体轨迹值得进一步调查。了解这些趋势对于在未来的公共卫生危机中优化癌症筛查和提供至关重要。本研究旨在深入了解COVID-19大流行期间和之后的HNC发病率趋势。美国国家癌症研究所监测、流行病学和最终结果(SEER)登记处于2024年4月17日更新,使用[4]。根据ICD-O-3编码提取年龄调整后的发病率数据(每10万人),包括唇、舌前、牙龈、口腔底、腭(不包括软腭和小舌)、颊粘膜、口腔其他、主要唾液腺、鼻咽部、口咽部、下咽、咽和口腔其他、鼻腔和鼻窦、鼻窦其他、喉癌。不需要机构审查委员会的批准或知情同意,因为数据是公开的,并且是去识别的。使用SEER联合总结分期(2004+)变量获得“局部”、“区域”和“远处”疾病的数据,并根据器官部位进行分期。获得年龄调整后的发病率,并根据性别、种族、来源和合并汇总阶段选择数据。使用发病率的上、下置信区间的平均变化来计算年百分比变化(APC)。采用r4.4.0软件对数据进行分析。表,ggplot2, ggrepel包。使用ggplot2将图可视化。2021年,新发HNC病例28154例,发病率为每10万人14.6例。从2020年到2021年,发病率增加了14.0%,相当于APC +4.5%。从2019年到2020年,APC下降至- 6.9%(图1A)。从2020年到2021年,解剖部位增幅最大的是“其他鼻窦”(+30.7%)、“口腔底部”(+21.2%)、“牙龈”(+20.6%)和“颊粘膜”(+17.9%)(图1B)。APC的趋势在不同种族群体中是一致的,在2020年下降,然后在2021年上升。增幅最大的是亚裔美国人和太平洋岛民(AAPI)(+16.0%),其次是西班牙裔(+14.1%)、非西班牙裔白人(+11.4%)和非西班牙裔黑人(+10.4%)。按性别分析数据,女性增加了10.3%,男性增加了11.8%。28154例新发病例中,本地9202例(32.7%),区域13832例(49.1%),异地3458例(12.3%)。从2020年到2021年,所有三个阶段的发病率都有所增加。APC增幅最大的是局部病例(+23.0%),其次是区域病例(+6.9%)和远处病例(+4.8%)。我们的分析表明,从2020年到2021年,美国的HNC发病率有所上升,反映了从2020年观察到的下降的复苏。然而,总体发病率仍低于大流行前的水平。这可能反映了HNC发病率多年来呈下降趋势,以及医疗服务中断的持续和挥之不去的影响。这些发现与先前的研究一致,这些研究记录了在大流行早期由于医疗保健中断而导致癌症诊断减少,随后逐渐恢复[5,6]。尽管HNC发病率和APC在不同种族群体中有所增加,但差异仍然存在,NHB患者的HNC发病率增加幅度最小。一项系统综述强调了影响HNC[7]的NHB患者在获得护理和社会经济地位方面的显著差异,这可能解释了我们分析中观察到的发病率变化较小的原因。相反,亚太裔人口统计学与HNC bbb患者总生存率的提高有关。虽然这一发现可能反映了潜在的生物学差异,但它可能受到更多获得护理机会的影响。需要进一步的研究来调查这些差异。新冠肺炎疫情对癌症筛查的影响引发了人们对延迟诊断的担忧。我们的研究发现,从2020年到2021年,局部HNC病例显著增加,而远程和区域病例的增加则不太明显。这表明,大流行期间诊断率的下降主要影响到早期疾病,而不是导致晚期疾病的增加。然而,我们的分析没有包括超过SEER总结期的肿瘤分期,因此无法评估局部肿瘤是否更晚期。这些趋势对长期结果的影响需要进一步调查。该研究强调了2020年至2021年HNC发病率趋势的变化,强调了在大流行相关下降后早期诊断的反弹。 未来的研究应侧重于延迟诊断的长期后果,以及在突发公共卫生事件期间维持筛查和诊断服务的卫生保健系统的必要性。需要制定战略,以缩小高死亡率方面的差距,并在未来的公共卫生危机中防止癌症护理延误。作者没有什么可报告的。作者没有什么可报告的。作者声明无利益冲突。
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引用次数: 0
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Laryngoscope Investigative Otolaryngology
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