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.
{"title":"Improved Nasal Airflow Is Associated With Olfactory Recovery in a Large Population of Patients With COVID-19-Related Olfactory Dysfunction","authors":"Alfonso Luca Pendolino, Paolo Boscolo-Rizzo, Davide Benussi, Bruno Scarpa, Peter J. Andrews","doi":"10.1002/lio2.70285","DOIUrl":"https://doi.org/10.1002/lio2.70285","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with reported C19OD received Sniffin’ Sticks extended set, peak nasal inspiratory flow (PNIF), and VAS for smell (sVAS) at baseline (T<sub>0</sub>). Subjects with a confirmed OD at T<sub>0</sub> were offered a second follow-up, averaged at 6 months (T<sub>1</sub>). All tests were repeated at T<sub>1</sub>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two hundred and five patients (median age 46) with a median length of OD of 1.1 years were seen at T<sub>0</sub>. One hundred and eleven dysosmics at T<sub>0</sub> were seen at T<sub>1</sub>. At T<sub>1</sub> 43 patients (38.7%) recovered their sense of smell. A statistically significant improvement was observed for PNIF (<i>p</i> = 0.001) and sVAS (<i>p</i> < 0.001) in the whole population at T<sub>1</sub>. A statistically significant difference was noted for all the olfactory scores and sVAS (<i>p</i> < 0.001 for all) between normosmic and dysosmic subjects at T<sub>1</sub>. When we looked at changes in the scores between T<sub>0</sub>–T<sub>1</sub>, statistically significant correlations were observed between changes (Δ) in PNIF and Δthreshold (rho = 0.24 and <i>p</i> = 0.015), ΔPNIF and ΔTDI (rho = 0.22 and <i>p</i> = 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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Improvement in nasal airflow can have a positive impact on smell recovery and on olfactory threshold in particular, highlighting its importance in persistent C19OD.</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":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70285","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317436","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}
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.
{"title":"Mitomycin C Induces Autophagy in Human Tracheal Fibroblasts and Suppresses Their Growth","authors":"Jeong-Mi Kim, Sungryeal Kim, Eun-Jeong Jeon, Jin-Mi Park, Seo-Young Park, Jeong-Seok Choi","doi":"10.1002/lio2.70251","DOIUrl":"https://doi.org/10.1002/lio2.70251","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>5.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317437","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}
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.
{"title":"Analysis of Mucosal Wave and Vibratory Patterns in Vocally Healthy Children and Adults","authors":"Bernhard Jakubass, Hamide Ghaemi, Maggie Lynn Stall, Dimitar D. Deliyski, Rita R. Patel","doi":"10.1002/lio2.70278","DOIUrl":"10.1002/lio2.70278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mucosal wave amplitude was highest in children, whereas adult males exhibited lower amplitudes (<i>p</i> < 0.05). Posterior-to-anterior (<i>p2a</i>) opening patterns dominated in all groups, especially among children and females, while men showed more variation (<i>p</i> < 0.001). Anterior-to-posterior (<i>a2p</i>) closing pattern was most common in girls and females, whereas simultaneous (<i>sim</i>) closure was predominant in boys (<i>p</i> < 0.01). Posterior glottal gap was more frequently visible in children and females, while most adult males showed no visible gap (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12521626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145309441","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}
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.
{"title":"FDA-Approved Biologics for CRSwNP: A Five-Year Analysis of the FDA Adverse Event Reporting System","authors":"Radhika Duggal, Mohamad R. Chaaban","doi":"10.1002/lio2.70133","DOIUrl":"https://doi.org/10.1002/lio2.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272430","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}
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.
{"title":"Surgical Experience and Validation of the “Bow Tie” Trilayer Graft Technique for Closure of Anterior Skull Base Defects","authors":"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","doi":"10.1002/lio2.70281","DOIUrl":"https://doi.org/10.1002/lio2.70281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> = 0.018) and when intra-operative CSF leaks were encountered (<i>p</i> < 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 (<i>p</i> > 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</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":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70281","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273026","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}
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
{"title":"Head and Neck Cancer Incidence in the United States Following the Onset of COVID-19 Pandemic","authors":"Wesley L. Cai, Vanessa Helou, Matthew E. Spector, José P. Zevallos, Angela L. Mazul, Kevin J. Contrera","doi":"10.1002/lio2.70226","DOIUrl":"https://doi.org/10.1002/lio2.70226","url":null,"abstract":"<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","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70226","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272431","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}
Khang Win Vu, Martha Watson, Abdallah Attia, Ahmed Abdelmaksoud, Manal S. Fawzy, Eman A. Toraih
Objective
To compare short-term complications and long-term survival outcomes between surgical and non-surgical treatments for oropharyngeal cancer.
Methods
We conducted a large-scale retrospective cohort study using the TriNetX Global Collaborative Network, analyzing data from 154,494,403 patients across 128 healthcare organizations. After applying inclusion criteria and propensity score matching, we compared 2413 surgical patients with 2413 non-surgical patients. Primary outcomes included short-term complications at 6 months (dysphagia, gastrostomy tube placement, tracheostomy, respiratory complications) and 5-year all-cause mortality.
Results
At 6 months post-treatment, surgical patients showed higher rates of dysphagia (46.83% vs. 40.61%, RR = 1.15, 95% CI: 1.08–1.23) and respiratory complications (6.30% vs. 3.69%, RR = 1.71, 95% CI: 1.32–2.21). Non-surgical patients experienced increased rates of gastrostomy tube placement (17.86% vs. 6.09%, RR = 0.34, 95% CI: 0.29–0.41) and tracheostomy (7.34% vs. 3.61%, RR = 0.49, 95% CI: 0.38–0.63). Similarly, subgroup analysis of the advanced-stage cohort showed that non-surgical patients had higher rates of gastrostomy tube placement (5.5% vs. 17.5%, RR = 0.31, CI: 0.19–0.52) and tracheostomy (3.1% vs. 6.4%, RR = 0.48, CI: 0.23–0.99). At 5-year follow-up, surgical intervention was associated with significantly lower all-cause mortality (9.9% vs. 25.3%, HR = 0.43, 95% CI: 0.37–0.49). This survival benefit persisted in the advanced-stage subgroup (14.1% vs. 25.5%, HR = 0.53, 95% CI: 0.37–0.76) (p < 0.001).
Conclusions
While surgical treatment for oropharyngeal cancer was associated with higher rates of certain short-term complications, it demonstrated superior long-term survival outcomes compared to non-surgical interventions, including in patients with advanced disease. These findings provide valuable evidence to inform treatment selection and patient counseling in oropharyngeal cancer management.
{"title":"Comparative Outcomes of Surgical vs. Non-Surgical Interventions in Advanced Oropharyngeal Cancer: A Large-Scale Retrospective Cohort Study","authors":"Khang Win Vu, Martha Watson, Abdallah Attia, Ahmed Abdelmaksoud, Manal S. Fawzy, Eman A. Toraih","doi":"10.1002/lio2.70279","DOIUrl":"https://doi.org/10.1002/lio2.70279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To compare short-term complications and long-term survival outcomes between surgical and non-surgical treatments for oropharyngeal cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a large-scale retrospective cohort study using the TriNetX Global Collaborative Network, analyzing data from 154,494,403 patients across 128 healthcare organizations. After applying inclusion criteria and propensity score matching, we compared 2413 surgical patients with 2413 non-surgical patients. Primary outcomes included short-term complications at 6 months (dysphagia, gastrostomy tube placement, tracheostomy, respiratory complications) and 5-year all-cause mortality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At 6 months post-treatment, surgical patients showed higher rates of dysphagia (46.83% vs. 40.61%, RR = 1.15, 95% CI: 1.08–1.23) and respiratory complications (6.30% vs. 3.69%, RR = 1.71, 95% CI: 1.32–2.21). Non-surgical patients experienced increased rates of gastrostomy tube placement (17.86% vs. 6.09%, RR = 0.34, 95% CI: 0.29–0.41) and tracheostomy (7.34% vs. 3.61%, RR = 0.49, 95% CI: 0.38–0.63). Similarly, subgroup analysis of the advanced-stage cohort showed that non-surgical patients had higher rates of gastrostomy tube placement (5.5% vs. 17.5%, RR = 0.31, CI: 0.19–0.52) and tracheostomy (3.1% vs. 6.4%, RR = 0.48, CI: 0.23–0.99). At 5-year follow-up, surgical intervention was associated with significantly lower all-cause mortality (9.9% vs. 25.3%, HR = 0.43, 95% CI: 0.37–0.49). This survival benefit persisted in the advanced-stage subgroup (14.1% vs. 25.5%, HR = 0.53, 95% CI: 0.37–0.76) (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While surgical treatment for oropharyngeal cancer was associated with higher rates of certain short-term complications, it demonstrated superior long-term survival outcomes compared to non-surgical interventions, including in patients with advanced disease. These findings provide valuable evidence to inform treatment selection and patient counseling in oropharyngeal cancer management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2b.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272500","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}
Aman M. Patel, Afash Haleem, Praneet C. Kaki, Rohini Bahethi, Soly Baredes, Richard Chan Woo Park
Objective
To investigate adjuvant therapy considerations, utilization, and associated overall survival (OS) following upfront laryngectomy for laryngeal squamous cell carcinoma (LSCC).
Methods
The 2010 to 2017 National Cancer Database was retrospectively reviewed for patients undergoing upfront laryngectomy (N = 3360). Kaplan–Meier, multivariable binary logistic, and Cox proportional hazards regression models were implemented.
Results
Among 2997 patients with consideration(s) for adjuvant radiotherapy (aRT) (i.e., pT3-4, pN2-3 classification, lymphovascular invasion, pathologic extranodal extension (pENE), and/or positive surgical margins [PSM]), 1176 (39.2%) did not undergo adjuvant therapy and were considered to have missed aRT. Among 992 patients with consideration(s) for adjuvant chemoradiotherapy (aCRT) (i.e., pENE and/or PSM), 169 (17.0%) underwent aRT alone and were considered to have missed aCRT. Older age and increased distance to the reporting facility were associated with higher adjusted odds of both missed aRT (p < 0.001) and missed aCRT (p < 0.025). Patients with pENE only (N = 343, 57.6%) and pENE and PSM (N = 96, 56.8%) underwent aCRT more frequently than those with PSM only (N = 97, 42.5%) (p < 0.001). Missed aRT was associated with worse OS among 2005 patients with consideration(s) for aRT alone (i.e., pT3-4, pN2-3 classification, and/or LVI without pENE or PSM) (aHR 1.23, 95% CI 1.05–1.44, p = 0.011) and among 992 patients with consideration(s) for aCRT (aHR 1.85, 95% CI 1.52–2.24, p < 0.001).
Conclusion
Missed aRT following upfront laryngectomy for LSCC occurs frequently and portends worse OS. Identifying patients at risk of off-guideline management may create opportunities for quality improvement in the multidisciplinary care of patients undergoing upfront laryngectomy for LSCC.
Level of Evidence
4.
目的探讨喉部鳞状细胞癌（LSCC）术前切除后辅助治疗的考虑、使用和相关的总生存率（OS）。方法回顾性分析2010年至2017年国家癌症数据库中接受喉前切除术的患者（N = 3360）。采用Kaplan-Meier、多变量二元logistic和Cox比例风险回归模型。结果在考虑辅助放疗（aRT） （pT3-4、pN2-3分型、淋巴血管侵犯、病理性结外延伸（pENE）和/或手术缘阳性[PSM]）的2997例患者中，1176例（39.2%）未接受辅助治疗，被认为错过了aRT。在考虑辅助放化疗（aCRT）（即pENE和/或PSM）的992例患者中，169例（17.0%）单独接受了aRT治疗，被认为错过了aCRT。年龄越大和距离报告机构的距离越远，aRT漏诊（p < 0.001）和aCRT漏诊（p < 0.025）的调整后几率越高。单纯pENE患者（N = 343, 57.6%）和pENE合并PSM患者（N = 96, 56.8%）接受aCRT的频率高于单纯PSM患者（N = 97, 42.5%） （p < 0.001）。在考虑单独接受aRT治疗（即pT3-4、pN2-3分类和/或LVI不含pENE或PSM）的2005例患者（aHR 1.23, 95% CI 1.05-1.44, p = 0.011）和考虑接受aCRT治疗的992例患者（aHR 1.85, 95% CI 1.52-2.24, p < 0.001）中，错过aRT治疗与较差的OS相关。结论喉鳞癌术前喉切除术后aRT漏诊发生率高，预后较差。识别有偏离指南管理风险的患者，可能为LSCC术前喉切除术患者的多学科护理质量改善创造机会。证据级别4。
{"title":"Missed Adjuvant Therapy Following Upfront Laryngectomy for Laryngeal Squamous Cell Carcinoma","authors":"Aman M. Patel, Afash Haleem, Praneet C. Kaki, Rohini Bahethi, Soly Baredes, Richard Chan Woo Park","doi":"10.1002/lio2.70276","DOIUrl":"https://doi.org/10.1002/lio2.70276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate adjuvant therapy considerations, utilization, and associated overall survival (OS) following upfront laryngectomy for laryngeal squamous cell carcinoma (LSCC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2010 to 2017 National Cancer Database was retrospectively reviewed for patients undergoing upfront laryngectomy (<i>N</i> = 3360). Kaplan–Meier, multivariable binary logistic, and Cox proportional hazards regression models were implemented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 2997 patients with consideration(s) for adjuvant radiotherapy (aRT) (i.e., pT3-4, pN2-3 classification, lymphovascular invasion, pathologic extranodal extension (pENE), and/or positive surgical margins [PSM]), 1176 (39.2%) did not undergo adjuvant therapy and were considered to have missed aRT. Among 992 patients with consideration(s) for adjuvant chemoradiotherapy (aCRT) (i.e., pENE and/or PSM), 169 (17.0%) underwent aRT alone and were considered to have missed aCRT. Older age and increased distance to the reporting facility were associated with higher adjusted odds of both missed aRT (<i>p</i> < 0.001) and missed aCRT (<i>p</i> < 0.025). Patients with pENE only (<i>N</i> = 343, 57.6%) and pENE and PSM (<i>N</i> = 96, 56.8%) underwent aCRT more frequently than those with PSM only (<i>N</i> = 97, 42.5%) (<i>p</i> < 0.001). Missed aRT was associated with worse OS among 2005 patients with consideration(s) for aRT alone (i.e., pT3-4, pN2-3 classification, and/or LVI without pENE or PSM) (aHR 1.23, 95% CI 1.05–1.44, <i>p</i> = 0.011) and among 992 patients with consideration(s) for aCRT (aHR 1.85, 95% CI 1.52–2.24, <i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Missed aRT following upfront laryngectomy for LSCC occurs frequently and portends worse OS. Identifying patients at risk of off-guideline management may create opportunities for quality improvement in the multidisciplinary care of patients undergoing upfront laryngectomy for LSCC.</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":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272580","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}
To investigate the association between cardiovascular health, measured by Life's Essential 8 (LE8) score, and hearing loss and tinnitus among U.S. adults.
Methods
A cross-sectional analysis was conducted on 4624 adults (≥ 20 years) from NHANES 2005–2018 cycles. Cardiovascular health was assessed via the LE8 score, encompassing eight health behaviors and factors. Audiometry-measured speech-frequency hearing loss, defined as pure-tone average (PTA) ≥ 20 dB in the better ear at 500–4000 Hz, and subjective hearing loss and tinnitus were assessed using self-reported questionnaires. Multivariable logistic regression models adjusted for confounders examined associations between LE8 scores and auditory conditions. Additional analyses included restricted cubic spline regression, subgroup, and sensitivity analyses.
Results
Higher LE8 scores, indicating better cardiovascular health, were significantly associated with lower odds of audiometry-measured speech-frequency hearing loss (adjusted OR: 0.84; 95% CI: 0.77–0.92), subjective hearing loss (adjusted OR: 0.82; 95% CI: 0.77–0.88), and tinnitus (adjusted OR: 0.88; 95% CI: 0.81–0.96). Subgroup analyses showed consistent associations for audiometry-measured hearing loss and tinnitus across demographic strata, while findings for subjective hearing loss varied by sex. Sensitivity analyses confirmed the robustness of the findings.
Conclusions
Better cardiovascular health, as measured by LE8 score, is associated with lower odds of hearing loss and tinnitus among U.S. adults. These findings suggest that the LE8 score may serve as a valuable integrated metric for evaluating cardiovascular health in relation to auditory outcomes.
{"title":"Association of Life's Essential 8 With Hearing Loss and Tinnitus in U.S. Adults","authors":"Xing Lin, Yuxi Lin, Siyi Tang, Huimin Cai, Heng Xiao, Chang Lin, Shengnan Ye","doi":"10.1002/lio2.70270","DOIUrl":"https://doi.org/10.1002/lio2.70270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the association between cardiovascular health, measured by Life's Essential 8 (LE8) score, and hearing loss and tinnitus among U.S. adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional analysis was conducted on 4624 adults (≥ 20 years) from NHANES 2005–2018 cycles. Cardiovascular health was assessed via the LE8 score, encompassing eight health behaviors and factors. Audiometry-measured speech-frequency hearing loss, defined as pure-tone average (PTA) ≥ 20 dB in the better ear at 500–4000 Hz, and subjective hearing loss and tinnitus were assessed using self-reported questionnaires. Multivariable logistic regression models adjusted for confounders examined associations between LE8 scores and auditory conditions. Additional analyses included restricted cubic spline regression, subgroup, and sensitivity analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Higher LE8 scores, indicating better cardiovascular health, were significantly associated with lower odds of audiometry-measured speech-frequency hearing loss (adjusted OR: 0.84; 95% CI: 0.77–0.92), subjective hearing loss (adjusted OR: 0.82; 95% CI: 0.77–0.88), and tinnitus (adjusted OR: 0.88; 95% CI: 0.81–0.96). Subgroup analyses showed consistent associations for audiometry-measured hearing loss and tinnitus across demographic strata, while findings for subjective hearing loss varied by sex. Sensitivity analyses confirmed the robustness of the findings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Better cardiovascular health, as measured by LE8 score, is associated with lower odds of hearing loss and tinnitus among U.S. adults. These findings suggest that the LE8 score may serve as a valuable integrated metric for evaluating cardiovascular health in relation to auditory outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2b.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272925","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}
Matteo Lazzeroni, Jèrôme René Lechien, Mario Lentini, Pasquale Capaccio, Alberto Maria Saibene, Michele Gaffuri, Antonio Mario Bulfamante, Luca Giovanni Locatello, Portelli Tancredi, Ingrassia Angelo, Federico Sireci, Antonino Maniaci
Objective
Extracorporeal septoplasty (ECS) is a surgical technique used to address severe nasal septal deviations, especially in patients in whom in situ septoplasty (ISS) is insufficient. This systematic review assesses the efficacy, safety, and clinical outcomes of ECS techniques, including conventional and modified ECS methods.
Data Sources
PRISMA-compliant systematic search of PubMed, Scopus, Web of Science, and Embase.
Methods
Studies on ECS techniques were included. Eligibility criteria were established using the PICOTS framework. Study quality was assessed using the Cochrane Risk of Bias 2 tool and the Newcastle-Ottawa Scale. Functional and aesthetic improvements were primary outcomes, while complication rates represented secondary outcomes.
Results
Twenty-two studies (retrospective, prospective, and RCTs) met the inclusion criteria. ECS was associated with significant functional improvement, as assessed by nasal obstruction scores measured by NOSE scores, acoustic rhinometry, and rhinomanometry. Aesthetic results were also satisfactory, with a significant improvement in the nasofrontal angle, nasolabial angle, and the tip projection index, as well as good patients' satisfaction. Complications were rare, with few cases of septal perforation, graft resorption, or residual nasal obstructive symptoms. Evidence strength was limited considering the majority of included studies were retrospective, with inherent bias risks, small sample sizes, and inconsistent follow-up durations.
Conclusions
ECS may be a successful and safe method for severe septal deviation correction, providing functional and aesthetic results with a low complication rate. More high-quality, multicenter RCTs with long-term follow-up will be required for a standardization of surgical protocols and outcome measures.
Level of Evidence
2.
目的体外鼻中隔成形术（ECS）是一种用于治疗严重鼻中隔偏曲的手术技术，特别是在原位鼻中隔成形术（ISS）不足的患者中。本系统综述评估了ECS技术的有效性、安全性和临床结果，包括传统的和改进的ECS方法。数据来源：PubMed， Scopus， Web of Science和Embase的prisma兼容系统搜索。方法纳入ECS技术的研究。使用PICOTS框架建立资格标准。使用Cochrane风险偏倚2工具和Newcastle-Ottawa量表评估研究质量。功能和美观的改善是主要结果，而并发症率是次要结果。结果22项研究（回顾性、前瞻性和随机对照试验）符合纳入标准。通过鼻塞评分、声学鼻测量和鼻流测量来评估，ECS与显著的功能改善相关。美观效果也令人满意，鼻额角、鼻唇角、鼻尖投影指数均有明显改善，患者满意度良好。并发症很少，很少有鼻中隔穿孔、移植物吸收或残留的鼻塞症状。考虑到纳入的大多数研究是回顾性的，具有固有的偏倚风险，样本量小，随访时间不一致，证据强度有限。结论ECS是一种安全有效的重度鼻中隔矫治方法，具有良好的功能和美观性，并发症发生率低。需要更多高质量、多中心、长期随访的随机对照试验来标准化手术方案和结果测量。证据级别2。
{"title":"Extracorporeal Septoplasty for Severe Nasal Septal Deviation: A Systematic Review","authors":"Matteo Lazzeroni, Jèrôme René Lechien, Mario Lentini, Pasquale Capaccio, Alberto Maria Saibene, Michele Gaffuri, Antonio Mario Bulfamante, Luca Giovanni Locatello, Portelli Tancredi, Ingrassia Angelo, Federico Sireci, Antonino Maniaci","doi":"10.1002/lio2.70280","DOIUrl":"https://doi.org/10.1002/lio2.70280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Extracorporeal septoplasty (ECS) is a surgical technique used to address severe nasal septal deviations, especially in patients in whom in situ septoplasty (ISS) is insufficient. This systematic review assesses the efficacy, safety, and clinical outcomes of ECS techniques, including conventional and modified ECS methods.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>PRISMA-compliant systematic search of PubMed, Scopus, Web of Science, and Embase.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Studies on ECS techniques were included. Eligibility criteria were established using the PICOTS framework. Study quality was assessed using the Cochrane Risk of Bias 2 tool and the Newcastle-Ottawa Scale. Functional and aesthetic improvements were primary outcomes, while complication rates represented secondary outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-two studies (retrospective, prospective, and RCTs) met the inclusion criteria. ECS was associated with significant functional improvement, as assessed by nasal obstruction scores measured by NOSE scores, acoustic rhinometry, and rhinomanometry. Aesthetic results were also satisfactory, with a significant improvement in the nasofrontal angle, nasolabial angle, and the tip projection index, as well as good patients' satisfaction. Complications were rare, with few cases of septal perforation, graft resorption, or residual nasal obstructive symptoms. Evidence strength was limited considering the majority of included studies were retrospective, with inherent bias risks, small sample sizes, and inconsistent follow-up durations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>ECS may be a successful and safe method for severe septal deviation correction, providing functional and aesthetic results with a low complication rate. More high-quality, multicenter RCTs with long-term follow-up will be required for a standardization of surgical protocols and outcome measures.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272924","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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