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Flexible Endoscopic Septum Division for Zenker's Diverticulum Using 445 nm Blue Light Laser. 445nm蓝光激光用于Zenker憩室的柔性内窥镜分隔术。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-12-18 DOI: 10.1002/lary.70321
Brett Campbell, Lauren Schlegel, Pavan S Mallur

Treatment for Zenker's diverticulum has evolved to include flexible endoscopic approaches to septum division and cricopharyngeal myotomy. Here we demonstrate flexible endoscopic septum division using the blue light laser with attention to laser parameters, laser-tissue interactions, and procedural technique.

Zenker憩室的治疗已经发展到包括灵活的内窥镜下鼻中隔分割和环咽肌切开术。在这里,我们展示了使用蓝光激光进行灵活的内窥镜鼻中隔分割,并注意激光参数、激光与组织的相互作用和手术技术。
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引用次数: 0
Multi-Institutional Endoscopic Resection and Reconstitution for Idiopathic Subglottic Stenosis. 特发性声门下狭窄的多机构内镜切除术和重建术。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-11-27 DOI: 10.1002/lary.70155
Diana C Lopez, Ioan A Lina, Ryan Stepp, James J Daniero, Theresa Hennesy, Matthew Clary, Alexander Gelbard, Alexander T Hillel

Objectives: Endoscopic resection and mucosal reconstitution with epidermal grafting (i.e., ER, known as the Maddern procedure) is a minimally invasive surgery introduced 10 years ago to treat subglottic stenosis (SGS). Here we describe a multi-institutional case series to answer questions about durability, patient selection, and complications.

Methods: A retrospective review of idiopathic SGS patients who underwent ER at four institutions since 2016. Patients were stratified by primary definitive (only had previous dilations) and rescue (performed for recurrence after laser wedge resection, open surgery, or previous ER) procedures. Outcomes included complications, disease recurrence, need for tracheostomy, peak expiratory flow rates, and surgery-free period following the operation.

Results: Thirty-six ER procedures were performed in 33 females and 1 male. Average participant age was 49 (30-72) years and BMI 28.5 (19.1-41.5) kg/m2. Seven patients underwent tracheostomy with ER surgery, and five were confirmed to be decannulated afterwards. Recurrence was 21% (6/29) and 71% (5/7) in the primary definitive and rescue cohorts, respectively. Successful ER cases had a long-term post-ER surgery free interval of 61.6 months compared to 8.4 months pre-ER (p < 0.05), and peak expiratory flow rates of 97% expected post-ER compared to 55% expected pre-ER (p < 0.0005). These peak expiratory flow rates were maintained at 87% expected at last patient follow-up (p < 0.0005).

Conclusion: This multi-institutional series demonstrates that the minimally invasive ER procedure, when used as primary definitive surgery, provides durable outcomes for iSGS with a recurrence rate similar to that of open cricotracheal resection over the course of an 8-year follow-up period.

Level of evidence: 4:

目的:内镜切除和粘膜重建与表皮移植(即ER,被称为Maddern手术)是10年前引入的一种微创手术,用于治疗声门下狭窄(SGS)。在这里,我们描述了一个多机构的病例系列,以回答有关持久性、患者选择和并发症的问题。方法:回顾性分析自2016年以来在四家机构接受急诊治疗的特发性SGS患者。患者按原发性确诊(仅有既往扩张)和抢救(在激光楔形切除术、开放手术或既往急诊手术后复发)进行分层。结果包括并发症、疾病复发、气管切开术的需要、呼气流量峰值和手术后的无手术时间。结果:36例急诊手术,女性33例,男性1例。参与者的平均年龄为49岁(30-72岁),BMI为28.5 (19.1-41.5)kg/m2。7例患者行气管切开术并行急诊手术,5例患者术后确认为脱管。复发率分别为21%(6/29)和71%(5/7)。成功的ER患者术后无手术间隔为61.6个月,而ER术前为8.4个月(p结论:多机构的研究表明,微创ER手术作为主要的决定性手术,在8年随访期间为iSGS提供了持久的结果,复发率与开放式环气管切除术相似。证据等级:4;
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引用次数: 0
Voice Outcomes After Endoscopic Intervention in Subglottic Stenosis: A Systematic Review. 内镜介入治疗声门下狭窄后的语音结果:一项系统综述。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-09-19 DOI: 10.1002/lary.70145
Aida M Hasson, Megan Saltsgaver, Abbey Carlson, Inna A Husain

Objective: Endoscopic intervention is a common approach to improve airway patency and breathing outcomes in patients with subglottic stenosis, but effects on voice are underreported. This review aims to assess the current evidence on how endoscopic intervention influences voice outcomes in individuals with subglottic stenosis.

Data sources: A systematic review was conducted by searching PubMed and Cochrane for studies published through June 2025 on voice outcomes following endoscopic airway surgery for subglottic stenosis.

Review methods: Studies were reviewed by three authors, and data related to patient-reported outcome measures, auditory-perceptual characteristics, and acoustic and aerodynamic analysis were extracted and analyzed.

Results: A total of 2351 abstracts were screened, with 8 meeting inclusion to be included in the final analysis. All studies employed observational designs, primarily retrospective chart reviews and prospective cohort studies, with notable heterogeneity in outcome measures. Among 829 subjects, the mean age was 50.9 years, and 96.5% identified as female. Patient-reported outcome measures (VHI, VHI-10, V-RQOL, and GFI) demonstrated improvement of inconsistent statistical significance. Auditory-perceptual ratings assessed using GRBAS or CAPE-V scales were generally mild in dysphonia severity preprocedure and were generally preserved postprocedure. Acoustic measures of perturbation and aerodynamic laryngeal resistance suggested improvement postprocedure.

Conclusion: Endoscopic dilation shows potential in improving voice outcomes, though definitive conclusions are hindered by current evidence limitations in a heterogeneous disease process. Future research should focus on utilizing comprehensive, validated voice outcomes, controlling for surgical technique variability, and strengthening methodological rigor to support more robust analysis and facilitate patient counseling.

目的:内镜干预是改善声门下狭窄患者气道通畅和呼吸结果的常用方法,但对声音的影响被低估。本综述旨在评估内窥镜干预如何影响声门下狭窄患者语音预后的现有证据。数据来源:通过检索PubMed和Cochrane,对截至2025年6月发表的有关声门下狭窄内窥镜气道手术后语音结果的研究进行了系统回顾。综述方法:由三位作者对研究进行综述,并提取和分析与患者报告的结果测量、听觉感知特征以及声学和空气动力学分析相关的数据。结果:共筛选到2351篇摘要,其中8篇纳入最终分析。所有研究均采用观察性设计,主要是回顾性图表回顾和前瞻性队列研究,结果测量存在显著的异质性。829名受试者平均年龄为50.9岁,其中96.5%为女性。患者报告的结果测量(VHI、VHI-10、V-RQOL和GFI)显示出不一致的统计学意义。使用GRBAS或CAPE-V量表评估的听觉知觉评分在术前通常是轻度的,在术后通常是保留的。声学测量摄动和气动喉阻力提示术后改善。结论:内镜扩张显示了改善语音结果的潜力,尽管目前在异质性疾病过程中的证据限制阻碍了明确的结论。未来的研究应侧重于利用全面、有效的语音结果,控制手术技术的可变性,并加强方法的严谨性,以支持更可靠的分析和促进患者咨询。
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引用次数: 0
Impact of Obesity on the Structured Histopathology of Chronic Rhinosinusitis Patients. 肥胖对慢性鼻窦炎患者结构化组织病理学的影响。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-10-06 DOI: 10.1002/lary.70177
Daniel X Ma, Sushanth Neerumalla, Ali Baird, Russell A Whitehead, Peter Filip, Bobby A Tajudeen, Pete S Batra, Peter Papagiannopoulos

Objectives: Obesity is an established risk factor for asthma, which shares common inflammatory pathways with chronic rhinosinusitis (CRS). However, the link between obesity and CRS remains poorly understood. By identifying trends in the structured histopathology (SHP) of obese patients with CRS, we aim to better understand how changes in the tissue architecture of obese patients may contribute to CRS.

Methods: Retrospective chart review was conducted on 476 patients with CRS with and without nasal polyps who underwent functional endoscopic sinus surgery. Data were collected on SHP, demographics, and comorbidities. Chi-squared, logistic analyses, and multivariate analysis were performed.

Results: The patient cohort was 53.8% female. Mean age was 52.01 years and mean BMI was 29.74. A total of 290 (60.9%) patients were nonobese (BMI < 30), 100 (21.0%) were Class I obese (BMI 30-34.9), 40 (8.4%) were Class II obese (BMI 35-39.9), and 46 (9.7%) were Class III obese (BMI ≥ 40). It was found that class III obesity was associated with statistically significant increases in several histopathological markers, including hyperplastic/papillary changes (17.4% vs. 5.6%, p < 0.026), Charcot-Leyden crystals (17.4% vs. 6.6%, p < 0.037), and squamous metaplasia (26.1% vs. 17.6%, p < 0.028). Multivariate analysis was performed, controlling for asthma, smoking, CRS subtype, and diabetes mellitus status. None of the variables were identified as confounders.

Conclusion: Several SHP variables are significantly more prevalent in obese patients who underwent functional endoscopic sinus surgery. This may serve as a predictor of CRS severity and suggests CRS in Class III obese patients follows a non-type 2 inflammatory pathway.

Level of evidence: 4:

Trial registration: ClinicalTrials.gov Identifier: NCT03816891.

肥胖是哮喘的一个确定的危险因素,哮喘与慢性鼻窦炎(CRS)有共同的炎症途径。然而,肥胖和CRS之间的联系仍然知之甚少。通过确定肥胖CRS患者的结构化组织病理学(SHP)趋势,我们旨在更好地了解肥胖患者组织结构的变化如何促进CRS的发生。方法:回顾性分析476例合并或不合并鼻息肉的CRS患者行功能性鼻内镜手术的资料。收集了SHP、人口统计学和合并症的数据。进行了卡方分析、logistic分析和多变量分析。结果:女性占53.8%。平均年龄52.01岁,平均BMI为29.74。结论:几个SHP变量在接受功能性内窥镜鼻窦手术的肥胖患者中更为普遍。这可能是CRS严重程度的预测因子,表明III级肥胖患者的CRS遵循非2型炎症途径。证据等级:4:试验注册:ClinicalTrials.gov标识符:NCT03816891。
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引用次数: 0
In Response to Chronic Rhinosinusitis With Nasal Polyps: The Effectiveness of Dupilumab in Mixed Endotypes. 对慢性鼻窦炎伴鼻息肉的反应:Dupilumab在混合内型中的有效性。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-09-27 DOI: 10.1002/lary.70159
Giuseppe Riva, Anastasia Urbanelli, Giancarlo Pecorari
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引用次数: 0
The Impact of Estrogen on Stromal Elements in the Proximal Airway in Idiopathic Subglottic Stenosis. 雌激素对特发性声门下狭窄近端气道间质成分的影响。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-11-14 DOI: 10.1002/lary.70216
Emily L Mace, Evan Clark, Edward Talatala, Maxim Litvak, Matthew A Buendia, Yash A Choksi, Hongmei Wu, Yueli Zhang, Alexander Hillel, Sam Collins, Quanhu Sheng, Jing Yang, Jason Park, Alexander Gelbard

Objectives: Idiopathic subglottic stenosis (iSGS) is an unexplained fibrosis of the proximal airway that predominantly impacts Caucasian women. Clinically, premenopausal patients suffer from higher recurrence rates, potentially implicating ovarian hormone 17B-estradiol (E2) in disease pathogenesis. Despite its relationship with disease phenotype and severity, the mechanistic role of E2 in subglottic fibrosis has not been investigated.

Methods: Primary human cell lines derived from the airway scar of iSGS patients were utilized for in vitro study to assess the impact of E2 on proximal airway cells (fibroblasts, epithelial cells, and endothelial cells). Alterations in RNA and extracellular matrix protein expression were assessed in fibroblasts (n = 5 primary cell lines) following E2 exposure. The impact of E2 on epithelial barrier function was assessed via transepithelial electrical resistance measurement (TEER) in iSGS-patient-derived epithelial primary cell lines (n = 3) grown via air-liquid interface (ALI) culture. The impact of E2 on iSGS-patient-derived endothelial lines was assessed using a Matrigel-based tube formation assay.

Results: There were no significant transcriptional changes induced in fibroblasts after exposure to E2 when compared to controls, nor was a difference in collagen production observed after E2 exposure. There was no significant difference in TEER measurements in airway epithelial cells grown at ALI following E2 exposure. Endothelial cells showed a significant increase in tube formation following E2 exposure.

Conclusion: In vitro models suggest E2 may have limited direct impact on fibroblasts and epithelial cells in iSGS. Instead, estrogen acts directly on airway endothelial cells to drive vascular remodeling, potentially contributing to mucosal fibrosis.

Level of evidence: NA.

目的:特发性声门下狭窄(iSGS)是一种不明原因的近端气道纤维化,主要影响白人女性。在临床上,绝经前患者的复发率较高,可能暗示卵巢激素17b -雌二醇(E2)在疾病发病机制中起作用。尽管E2与疾病表型和严重程度有关,但其在声门下纤维化中的机制作用尚未被研究。方法:利用iSGS患者气道瘢痕的原代人细胞系进行体外研究,评估E2对近端气道细胞(成纤维细胞、上皮细胞和内皮细胞)的影响。在E2暴露后,对成纤维细胞(n = 5个原代细胞系)中RNA和细胞外基质蛋白表达的变化进行了评估。通过气液界面(ALI)培养的isgs患者源性上皮原代细胞系(n = 3)的经上皮电阻测量(TEER)来评估E2对上皮屏障功能的影响。E2对isgs患者来源的内皮系的影响使用基于matrigel的管形成试验进行评估。结果:与对照组相比,暴露于E2后,成纤维细胞没有明显的转录变化,也没有观察到E2暴露后胶原生成的差异。暴露于E2后,ALI条件下生长的气道上皮细胞的TEER测量值无显著差异。E2暴露后,内皮细胞的管状形成明显增加。结论:体外模型提示E2对iSGS成纤维细胞和上皮细胞的直接影响有限。相反,雌激素直接作用于气道内皮细胞,驱动血管重塑,可能导致粘膜纤维化。证据等级:NA。
{"title":"The Impact of Estrogen on Stromal Elements in the Proximal Airway in Idiopathic Subglottic Stenosis.","authors":"Emily L Mace, Evan Clark, Edward Talatala, Maxim Litvak, Matthew A Buendia, Yash A Choksi, Hongmei Wu, Yueli Zhang, Alexander Hillel, Sam Collins, Quanhu Sheng, Jing Yang, Jason Park, Alexander Gelbard","doi":"10.1002/lary.70216","DOIUrl":"10.1002/lary.70216","url":null,"abstract":"<p><strong>Objectives: </strong>Idiopathic subglottic stenosis (iSGS) is an unexplained fibrosis of the proximal airway that predominantly impacts Caucasian women. Clinically, premenopausal patients suffer from higher recurrence rates, potentially implicating ovarian hormone 17B-estradiol (E2) in disease pathogenesis. Despite its relationship with disease phenotype and severity, the mechanistic role of E2 in subglottic fibrosis has not been investigated.</p><p><strong>Methods: </strong>Primary human cell lines derived from the airway scar of iSGS patients were utilized for in vitro study to assess the impact of E2 on proximal airway cells (fibroblasts, epithelial cells, and endothelial cells). Alterations in RNA and extracellular matrix protein expression were assessed in fibroblasts (n = 5 primary cell lines) following E2 exposure. The impact of E2 on epithelial barrier function was assessed via transepithelial electrical resistance measurement (TEER) in iSGS-patient-derived epithelial primary cell lines (n = 3) grown via air-liquid interface (ALI) culture. The impact of E2 on iSGS-patient-derived endothelial lines was assessed using a Matrigel-based tube formation assay.</p><p><strong>Results: </strong>There were no significant transcriptional changes induced in fibroblasts after exposure to E2 when compared to controls, nor was a difference in collagen production observed after E2 exposure. There was no significant difference in TEER measurements in airway epithelial cells grown at ALI following E2 exposure. Endothelial cells showed a significant increase in tube formation following E2 exposure.</p><p><strong>Conclusion: </strong>In vitro models suggest E2 may have limited direct impact on fibroblasts and epithelial cells in iSGS. Instead, estrogen acts directly on airway endothelial cells to drive vascular remodeling, potentially contributing to mucosal fibrosis.</p><p><strong>Level of evidence: </strong>NA.</p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"1349-1356"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Manometric Pattern Predicts the Outcome of Transoral Swallowing Surgery for Pharyngeal Dysphagia. 测压模式预测经口吞咽手术治疗咽部吞咽困难的结果。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-10-30 DOI: 10.1002/lary.70225
Shun-Ichi Chitose, Mioko Fukahori, Fumihiko Sato, Sachiyo Hamakawa, Takeharu Ono, Kiminobu Sato, Hirohito Umeno, Kiminori Sato

Objective: Transoral swallowing surgery (TOSS) based on endoscopic cricopharyngeal myotomy (ECPM) in combination with fat injection laryngoplasty (FIL) and/or pharyngeal flap surgery (PFS) is a useful treatment option for pharyngeal dysphagia. However, no quantitative evaluation method has been established to predict surgical outcomes. This study aimed to clarify swallowing pressure conditions that affect the outcome of TOSS for pharyngeal dysphagia.

Methods: Twenty-two patients with pharyngeal dysphagia who had undergone high-resolution manometry before and after TOSS were enrolled. TOSS procedures included ECPM alone in 8 patients, ECPM+FIL in 5, and ECPM+FIL + PFS in 9. Good surgical outcome (GS) was defined as achieving a functional oral intake scale (FOIS) level of ≥ 4 on a 7-point scale or an improvement in FOIS level by ≥ 2 for those with a preoperative level of 4 or 5. Manometric data in the nasopharyngeal, oropharyngeal, hypopharyngeal, oro-hypopharyngeal, and upper esophageal sphincter (UES) zones were compared between patients with and without GS (GS and non-GS groups, respectively) and by procedure.

Results: Mean pre- to postoperative FOIS levels in the GS group (n = 14) and non-GS group (n = 8) ranged from 2.6 to 5.7 and 3.3 to 3.8, respectively. There were significant differences between the GS and non-GS groups in distal contractile integrals (DCIs) of the oropharynx and oro-hypopharynx. All postoperative pharyngeal pressures and DCIs of the pharynx were increased, whereas those related to the UES were decreased.

Conclusion: Our manometric analysis revealed that preoperative oropharyngeal pressure is a factor influencing the outcome of TOSS, regardless of UES pressure. TOSS can produce efficient postoperative pressure changes.

Level of evidence: 3:

目的:内镜环咽肌切开术(ECPM)为基础的经口吞咽手术(TOSS)联合脂肪注射喉成形术(FIL)和/或咽瓣手术(PFS)是治疗咽部吞咽困难的有效方法。然而,尚未建立定量评估方法来预测手术结果。本研究旨在阐明影响咽部吞咽困难的吞咽压力状况。方法:选取22例咽部吞咽困难患者,分别在折腾前后行高分辨率测压。TOSS手术包括单独ECPM 8例,ECPM+FIL 5例,ECPM+FIL + PFS 9例。良好的手术结果(GS)被定义为在7分制中功能性口服摄入量表(FOIS)达到≥4级,或术前FOIS水平为4或5的患者FOIS水平改善≥2级。在有和没有GS的患者(分别为GS组和非GS组)和按程序比较鼻咽、口咽、下咽、口-下咽和食管上括约肌(UES)区的压力测量数据。结果:GS组(n = 14)和非GS组(n = 8)术前至术后平均FOIS水平分别为2.6 ~ 5.7和3.3 ~ 3.8。在口咽和口下咽远端收缩积分(DCIs)上,GS组与非GS组差异有统计学意义。术后所有咽压和咽部DCIs均升高,而与UES相关的咽压和DCIs均降低。结论:我们的压力分析显示,术前口咽压力是影响TOSS结果的一个因素,与UES压力无关。TOSS可以产生有效的术后压力变化。证据等级:3;
{"title":"Manometric Pattern Predicts the Outcome of Transoral Swallowing Surgery for Pharyngeal Dysphagia.","authors":"Shun-Ichi Chitose, Mioko Fukahori, Fumihiko Sato, Sachiyo Hamakawa, Takeharu Ono, Kiminobu Sato, Hirohito Umeno, Kiminori Sato","doi":"10.1002/lary.70225","DOIUrl":"10.1002/lary.70225","url":null,"abstract":"<p><strong>Objective: </strong>Transoral swallowing surgery (TOSS) based on endoscopic cricopharyngeal myotomy (ECPM) in combination with fat injection laryngoplasty (FIL) and/or pharyngeal flap surgery (PFS) is a useful treatment option for pharyngeal dysphagia. However, no quantitative evaluation method has been established to predict surgical outcomes. This study aimed to clarify swallowing pressure conditions that affect the outcome of TOSS for pharyngeal dysphagia.</p><p><strong>Methods: </strong>Twenty-two patients with pharyngeal dysphagia who had undergone high-resolution manometry before and after TOSS were enrolled. TOSS procedures included ECPM alone in 8 patients, ECPM+FIL in 5, and ECPM+FIL + PFS in 9. Good surgical outcome (GS) was defined as achieving a functional oral intake scale (FOIS) level of ≥ 4 on a 7-point scale or an improvement in FOIS level by ≥ 2 for those with a preoperative level of 4 or 5. Manometric data in the nasopharyngeal, oropharyngeal, hypopharyngeal, oro-hypopharyngeal, and upper esophageal sphincter (UES) zones were compared between patients with and without GS (GS and non-GS groups, respectively) and by procedure.</p><p><strong>Results: </strong>Mean pre- to postoperative FOIS levels in the GS group (n = 14) and non-GS group (n = 8) ranged from 2.6 to 5.7 and 3.3 to 3.8, respectively. There were significant differences between the GS and non-GS groups in distal contractile integrals (DCIs) of the oropharynx and oro-hypopharynx. All postoperative pharyngeal pressures and DCIs of the pharynx were increased, whereas those related to the UES were decreased.</p><p><strong>Conclusion: </strong>Our manometric analysis revealed that preoperative oropharyngeal pressure is a factor influencing the outcome of TOSS, regardless of UES pressure. TOSS can produce efficient postoperative pressure changes.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"1357-1366"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145402327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterization of Self-Administered Olfactory Assessments Novel Olfactory Sorting Task (NOST) and Odor Dilution Sorting (ODS) in a Community-Based Population. 基于社区人群自我嗅觉评估的特征:新型嗅觉分类任务(NOST)和气味稀释分类(ODS)。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-10-08 DOI: 10.1002/lary.70190
Tiana M Saak, Renjie Zhang, Matthew D A Spence, Davangere P Devanand, Jeffrey N Motter, Jonathan B Overdevest

Objectives: Olfactory evaluation beyond conventional domain testing may inform how olfactory impairment presents among the general population. Recently reported assessments based on odor matching (NOST) and intensity sorting (ODS) may provide additional insight into olfactory function. Characterizing performance of these simple and self-administered tasks among a community-based population offers a valuable benchmark for subsequent evaluation in aging and cognition-impaired cohorts.

Methods: Seventy community-based individuals completed Sniffin' Sticks TDI testing, NOST, and ODS. NOST is an odor matching task among twelve pairs of odorants, and ODS is an odor intensity scaling task. Scores were compared to TDI using Spearman correlations and Wilcoxon signed-rank tests.

Results: NOST median score was 6 (IQR: 4, 9) while ODS was 0.80 (0.70, 0.85). NOST correlated with TDI (r; [confidence interval]: 0.640, [0.47, 0.76]), threshold (0.342; [0.11, 0.54]), discrimination (0.556; [0.36, 0.70]), and identification (0.297, [0.06, 0.50]), but not with ODS. Participants performed significantly better on the ODS-Eugenol trial than on the ODS-PEA trial, with median scores of 0.90 (IQR: 0.80, 1.0) and 0.70 (0.50, 0.80), respectively (p < 0.001).

Conclusions: NOST correlates strongly with odor discrimination in this community-based population, while ODS shows no significant correlations with any TDI subdomains. The lack of several strong correlations on either assessment with overall TDI suggests these assessments may evaluate domains of smell and cognition not previously captured by standalone TDI testing. Continued validation of NOST and ODS across a broad population with ranging olfactory and cognitive statuses is needed to fully characterize the utility of these well-tolerated, self-administered olfactory tests.

Level of evidence: 2:

目的:嗅觉评估超越传统的领域测试可能会告诉嗅觉障碍是如何在普通人群中出现的。最近报道的基于气味匹配(NOST)和强度排序(ODS)的评估可能为嗅觉功能提供额外的见解。在以社区为基础的人群中描述这些简单和自我管理的任务的表现,为老年和认知障碍人群的后续评估提供了有价值的基准。方法:70名社区个体完成嗅探棒TDI、NOST和ODS测试。NOST是12对气味剂之间的气味匹配任务,ODS是气味强度尺度任务。使用Spearman相关和Wilcoxon符号秩检验将得分与TDI进行比较。结果:NOST中位评分为6 (IQR: 4,9), ODS为0.80(0.70,0.85)。NOST与TDI (r;[置信区间]:0.640,[0.47,0.76])、阈值(0.342,[0.11,0.54])、辨别力(0.556,[0.36,0.70])、识别力(0.297,[0.06,0.50])相关,与ODS无关。参与者在ODS-丁香酚试验中的表现明显优于ODS- pea试验,中位得分分别为0.90 (IQR: 0.80, 1.0)和0.70 (0.50,0.80)(p)。结论:NOST与社区人群的气味辨别有很强的相关性,而ODS与任何TDI子域没有显著相关性。两种评估与整体TDI之间缺乏几个强相关性,这表明这些评估可能评估嗅觉和认知领域,而不是以前单独的TDI测试所捕获的。需要在具有不同嗅觉和认知状态的广泛人群中继续验证NOST和ODS,以充分表征这些耐受性良好、自我管理的嗅觉测试的效用。证据等级:2;
{"title":"Characterization of Self-Administered Olfactory Assessments Novel Olfactory Sorting Task (NOST) and Odor Dilution Sorting (ODS) in a Community-Based Population.","authors":"Tiana M Saak, Renjie Zhang, Matthew D A Spence, Davangere P Devanand, Jeffrey N Motter, Jonathan B Overdevest","doi":"10.1002/lary.70190","DOIUrl":"10.1002/lary.70190","url":null,"abstract":"<p><strong>Objectives: </strong>Olfactory evaluation beyond conventional domain testing may inform how olfactory impairment presents among the general population. Recently reported assessments based on odor matching (NOST) and intensity sorting (ODS) may provide additional insight into olfactory function. Characterizing performance of these simple and self-administered tasks among a community-based population offers a valuable benchmark for subsequent evaluation in aging and cognition-impaired cohorts.</p><p><strong>Methods: </strong>Seventy community-based individuals completed Sniffin' Sticks TDI testing, NOST, and ODS. NOST is an odor matching task among twelve pairs of odorants, and ODS is an odor intensity scaling task. Scores were compared to TDI using Spearman correlations and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>NOST median score was 6 (IQR: 4, 9) while ODS was 0.80 (0.70, 0.85). NOST correlated with TDI (r; [confidence interval]: 0.640, [0.47, 0.76]), threshold (0.342; [0.11, 0.54]), discrimination (0.556; [0.36, 0.70]), and identification (0.297, [0.06, 0.50]), but not with ODS. Participants performed significantly better on the ODS-Eugenol trial than on the ODS-PEA trial, with median scores of 0.90 (IQR: 0.80, 1.0) and 0.70 (0.50, 0.80), respectively (p < 0.001).</p><p><strong>Conclusions: </strong>NOST correlates strongly with odor discrimination in this community-based population, while ODS shows no significant correlations with any TDI subdomains. The lack of several strong correlations on either assessment with overall TDI suggests these assessments may evaluate domains of smell and cognition not previously captured by standalone TDI testing. Continued validation of NOST and ODS across a broad population with ranging olfactory and cognitive statuses is needed to fully characterize the utility of these well-tolerated, self-administered olfactory tests.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"1118-1125"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145253478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of a De-Escalated Post-Operative Cochlear Implant Programming Protocol. 人工耳蜗术后降级规划方案的评价。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-10-11 DOI: 10.1002/lary.70172
Leena Asfour, Michelle Coppola, Samantha Espinal, Meredith A Holcomb

Objective: Cochlear implantation often requires frequent post-operative programming visits which can disrupt daily life, impose financial burdens, and delay access for new cochlear implant (CI) candidates. This study evaluated the feasibility of a de-escalated schedule of four programming appointments within the first year after surgery.

Methods: A retrospective review was completed for 236 patients aged 0-100 years who received CI from July 2022 to December 2023. Explants, reimplants and second CI within the study window were excluded. Collected data included demographics, schedule adherence, additional visit reason, and Consonant-Nucleus-Consonant (CNC) word scores for adults.

Results: A total of 201 CI recipients (mean age 46.9 years; 72.6% adults) met inclusion criteria. Most were male (53%), White (88%), Non-Hispanic (54.7%), and privately insured (56.2%). Overall, 53% adhered to the 4-visit protocol, 35% required 1-2 additional visits, and 12% required 3-6. Among those requiring additional appointments (n = 95), 28.4% followed the prior protocol of up to 10+ visits. Adherence to the new streamlined protocol improved by 43% over the study period. On multivariate analysis, each additional year of age at surgery reduced the odds of adherence by 3.4% (p < 0.05). No statistical or clinical differences were observed in 12-month CNC scores between patients with ≤ 4 versus > 4 visits.

Conclusions: A de-escalated post-CI programming schedule of four visits in the first year is feasible and does not compromise adult speech perception outcomes. Older patients may require closer follow-up. Successful implementation may require time for workflows and provider adoption.

Level of evidence: 3:

目的:人工耳蜗植入术通常需要频繁的术后规划访问,这可能会扰乱日常生活,增加经济负担,并延迟新的人工耳蜗(CI)候选人的访问。本研究评估了在手术后一年内减少四次编程预约的可行性。方法:对2022年7月至2023年12月期间接受CI治疗的236例0-100岁患者进行回顾性分析。排除研究窗口内的外植体、再植体和第二次CI。收集的数据包括人口统计数据、计划依从性、额外的访问原因和成人的辅音-核-辅音(CNC)单词得分。结果:共有201名CI接受者(平均年龄46.9岁,72.6%为成年人)符合纳入标准。大多数是男性(53%),白人(88%),非西班牙裔(54.7%)和私人保险(56.2%)。总体而言,53%的患者遵守4次就诊方案,35%需要1-2次额外就诊,12%需要3-6次。在需要额外预约的患者中(n = 95), 28.4%的患者遵循之前的方案进行了多达10次以上的就诊。在研究期间,新的简化方案的依从性提高了43%。在多变量分析中,手术年龄每增加一岁,坚持治疗的几率降低3.4%。结论:在第一年进行四次访问的逐步升级的ci后编程计划是可行的,并且不会损害成人语言感知结果。老年患者可能需要更密切的随访。成功的实现可能需要工作流程和提供者采用的时间。证据等级:3;
{"title":"Evaluation of a De-Escalated Post-Operative Cochlear Implant Programming Protocol.","authors":"Leena Asfour, Michelle Coppola, Samantha Espinal, Meredith A Holcomb","doi":"10.1002/lary.70172","DOIUrl":"10.1002/lary.70172","url":null,"abstract":"<p><strong>Objective: </strong>Cochlear implantation often requires frequent post-operative programming visits which can disrupt daily life, impose financial burdens, and delay access for new cochlear implant (CI) candidates. This study evaluated the feasibility of a de-escalated schedule of four programming appointments within the first year after surgery.</p><p><strong>Methods: </strong>A retrospective review was completed for 236 patients aged 0-100 years who received CI from July 2022 to December 2023. Explants, reimplants and second CI within the study window were excluded. Collected data included demographics, schedule adherence, additional visit reason, and Consonant-Nucleus-Consonant (CNC) word scores for adults.</p><p><strong>Results: </strong>A total of 201 CI recipients (mean age 46.9 years; 72.6% adults) met inclusion criteria. Most were male (53%), White (88%), Non-Hispanic (54.7%), and privately insured (56.2%). Overall, 53% adhered to the 4-visit protocol, 35% required 1-2 additional visits, and 12% required 3-6. Among those requiring additional appointments (n = 95), 28.4% followed the prior protocol of up to 10+ visits. Adherence to the new streamlined protocol improved by 43% over the study period. On multivariate analysis, each additional year of age at surgery reduced the odds of adherence by 3.4% (p < 0.05). No statistical or clinical differences were observed in 12-month CNC scores between patients with ≤ 4 versus > 4 visits.</p><p><strong>Conclusions: </strong>A de-escalated post-CI programming schedule of four visits in the first year is feasible and does not compromise adult speech perception outcomes. Older patients may require closer follow-up. Successful implementation may require time for workflows and provider adoption.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":"1453-1460"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Balloon Dilation of the Eustachian Tube for Adults With Chronic Obstructive Eustachian Tube Dysfunction: A Meta-Analysis. 成人慢性阻塞性耳咽管功能障碍的咽鼓管球囊扩张:一项荟萃分析。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-03-01 Epub Date: 2025-09-13 DOI: 10.1002/lary.70131
Poonam Raj, Tulasi Kota Karanth, Dennis Poe

Objective: Studies have shown balloon dilation of the Eustachian tube (BDET) to play a beneficial role in the treatment of obstructive Eustachian tube (ET) dysfunction in adults. This analysis was undertaken to clarify this role.

Data sources: Cochrane Central Register of Controlled Trials, PubMed, Embase Ovid, ClinicalTrials.gov, WHO-ICTRP, EU Clinical Trials Register, and Google Scholar.

Review methods: This review analyzed randomized controlled trials published through 29 February 2024, updated on 11 January 2025, comparing the effects of BDET with no treatment, medical treatment, or auto-inflation exercises. Outcomes included improvement in tympanogram, decrease in air-bone gap on audiometry, new ability to perform Valsalva, otoscopic confirmation of improvement in tympanic membrane retraction, or new documented mobility of the membrane on pneumatic otoscopy.

Results: Eleven trials were analyzed, four excluded with reasons and seven included in the analysis. On analysis of 315 participants from three trials who underwent BDET in comparison to control, the relative risk of benefit of post-operatively reaching Type A tympanogram was 4.68 (2.88-7.51) in comparison to control. BDET was also seen to offer significantly more closure in air-bone gap when performed along with tympanoplasty in patients with adhesive otitis media at both 3-month (air-bone gap closure of 3.82 dB [0.47-7.17 dB]) and 6-month (air-bone gap closure of 4.06 dB [1.78-6.34 dB]).

Conclusion: In adults with chronic ET dysfunction, BDET increased the chance of achieving a Type A tympanogram curve and significantly improved air-bone gap closure when performed along with cartilage tympanoplasty.

Level of evidence: 1a.

目的:研究表明,球囊扩张咽鼓管(BDET)在治疗成人咽鼓管梗阻性功能障碍中发挥了有益的作用。进行这项分析是为了澄清这一作用。数据来源:Cochrane Central Register of Controlled Trials, PubMed, Embase Ovid, ClinicalTrials.gov, WHO-ICTRP, EU ClinicalTrials Register,谷歌Scholar。综述方法:本综述分析了截至2024年2月29日发表的随机对照试验,并于2025年1月11日更新,比较了BDET与不治疗、药物治疗或自动充气锻炼的效果。结果包括鼓膜图改善,听力学气骨间隙减小,新的Valsalva能力,耳镜证实鼓膜收缩改善,或气动耳镜新记录的膜可移动性。结果:11项试验被分析,4项排除原因,7项纳入分析。在对来自三个试验的315名接受BDET的参与者进行分析后,与对照组相比,术后达到A型鼓室图的相对获益风险为4.68(2.88-7.51)。对于粘连性中耳炎患者,在3个月(气-骨间隙闭合3.82 dB [0.47-7.17 dB])和6个月(气-骨间隙闭合4.06 dB [1.78-6.34 dB])时,BDET与鼓室成形术同时进行时,也能显著改善气-骨间隙闭合。结论:在慢性ET功能障碍的成年人中,BDET与软骨鼓室成形术一起进行时,增加了获得a型鼓室图曲线的机会,并显著改善了气骨间隙的闭合。证据等级:1a。
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Laryngoscope
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