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.
{"title":"Characterizing the Patient Experience of Idiopathic Subglottic Stenosis in Pregnancy","authors":"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","doi":"10.1002/lio2.70289","DOIUrl":"10.1002/lio2.70289","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>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).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> = 0.69) or when compared to the same patients' baseline surgical interval (<i>p</i> = 0.69). Four patients (45%) experienced more surgical interventions following a pregnancy as compared to before pregnancy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</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 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12539372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145349474","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}
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.
{"title":"Medicare Reimbursement Trends in Zenker's Diverticulectomy","authors":"George S. Bebawy, Aman M. Patel, David Herz, Paul T. Cowan, Andrey Filimonov, Ghayoour S. Mir","doi":"10.1002/lio2.70291","DOIUrl":"https://doi.org/10.1002/lio2.70291","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To analyze Medicare reimbursement and utilization trends of Zenker's diverticulectomy from 2000 to 2024.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Retrospective cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Centers for Medicare and Medicaid Services (CMS) Physician Fee Schedule (2000–2024) and Part B Medicare Fee-For-Service National Summary Data (2000–2022).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>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.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>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 (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>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.</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":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70291","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317665","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}
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.
{"title":"Biologics for Chronic Rhinosinusitis With Nasal Polyposis: Current Landscape and Future Directions","authors":"Jerlon Chiu, Judd Fastenberg, Charles Tong, Brianne Navetta-Modrov, Sonya Marcus","doi":"10.1002/lio2.70282","DOIUrl":"https://doi.org/10.1002/lio2.70282","url":null,"abstract":"<p>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.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145317666","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}
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}
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