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Infracordal Stenosis: A Glucocorticoid-Responsive Subtype of Autoimmune Laryngotracheal Stenosis. 声带下狭窄:自身免疫性喉气管狭窄的糖皮质激素反应亚型。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-05 DOI: 10.1002/lary.70418
Brendan Denvir, Bridget Burgess, Kevin Motz, Simon R A Best, Lee M Akst, Brendan Antiochos, Philip Seo, Alexander T Hillel

Objective: As our understanding of autoimmune laryngotracheal stenosis (LTS) evolves, distinguishing patients who may benefit from systemic immunosuppression versus those needing only local treatment is increasingly important. In this study, we identify a distinct subset of autoimmune LTS characterized by edema of the inferior true vocal folds that extends to the superior aspect of the cricoid cartilage, termed "infracordal stenosis." The objective of this study is to characterize the clinical presentation and treatment outcomes of infracordal stenosis and compare it to typical autoimmune-related subglottic stenosis (AI-SGS).

Methods: We conducted a retrospective review of patients with autoimmune laryngotracheal stenosis evaluated by both rheumatology and otolaryngology at our institution to identify two groups: patients with infracordal stenosis and those with typical AI-SGS. Data on immunosuppressive treatments and airway dilation procedures were collected. Time to first dilation was compared between groups.

Results: Among 49 patients with autoimmune LTS, 11 had infracordal involvement. Six patients had isolated infracordal stenosis while five had concomitant subglottic involvement. Kaplan-Meier analysis showed longer time to first dilation in patients with infracordal involvement (median 792 vs. 44 days; p = 0.048). Four out of six patients with isolated infracordal stenosis required no dilations during their entire follow-up period.

Conclusion: Among autoimmune LTS patients referred to rheumatology, those with infracordal involvement experienced longer time to first dilation compared to those with typical AI-SGS. These findings suggest that infracordal stenosis may represent a distinct, glucocorticoid-responsive phenotype within autoimmune laryngotracheal stenosis, with implications for treatment selection and multidisciplinary care.

Level of evidence: 4:

目的:随着我们对自身免疫性喉气管狭窄(LTS)认识的发展,区分可能受益于全身免疫抑制的患者与只需要局部治疗的患者变得越来越重要。在本研究中,我们确定了一种独特的自身免疫性LTS亚群,其特征是真声带下端水肿,并延伸到环状软骨的上侧,称为“声带下狭窄”。本研究的目的是描述声带下狭窄的临床表现和治疗结果,并将其与典型的自身免疫相关的声门下狭窄(AI-SGS)进行比较。方法:我们对我院风湿病学和耳鼻喉科评估的自身免疫性喉气管狭窄患者进行回顾性研究,确定两组:声带下狭窄患者和典型的AI-SGS患者。收集免疫抑制治疗和气道扩张手术的数据。比较两组间首次扩张时间。结果:在49例自身免疫性LTS患者中,11例受累于声带下。6例患者有孤立的声带下狭窄,5例合并声门下受累。Kaplan-Meier分析显示,声带下受累患者首次扩张的时间较长(中位792天vs. 44天;p = 0.048)。在整个随访期间,6例孤立性蛛网膜下狭窄患者中有4例不需要扩张。结论:在涉及风湿病学的自身免疫性LTS患者中,与典型的AI-SGS患者相比,声带下受累的患者第一次扩张时间更长。这些发现表明,声带下狭窄可能在自身免疫性喉气管狭窄中代表一种独特的糖皮质激素反应表型,这对治疗选择和多学科护理具有重要意义。证据等级:4;
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引用次数: 0
Which Antibiotics Are First-Line to Prescribe in Pregnant Patients With Acute Bacterial Rhinosinusitis? 妊娠期急性细菌性鼻窦炎患者一线应开哪些抗生素?
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-05 DOI: 10.1002/lary.70420
Ashwini Sarathy, Richard V Smith, Barbara Dill
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引用次数: 0
Choice and Death: Analysis of Medical Assistance in Dying for Head and Neck Cancer in Ontario. 选择与死亡:安大略省头颈癌死亡的医疗援助分析。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-04 DOI: 10.1002/lary.70410
Tanika Curry, Emily Wener, Michael Odell, Lisa Caulley, Rashi Ramchandani, Alyssa Grant, Kednapa Thavorn, Andrea Lasso, Shaun Kilty

Objective: There is a paucity of information on the uptake of Medical Assistance in Dying (MAiD) for patients with head and neck cancer (HNC). Our study reports the prevalence, disease characteristics, and nature of the desire for MAiD in patients with HNC who underwent the process in Ontario. The aim is to better understand this population and identify gaps in our current system of care.

Methods: This is a retrospective cross-sectional analysis for the period June 17, 2016 to December 31, 2022. Data were received from the Office of the Chief Coroner Ontario, Canada.

Results: Three hundred and fifty-six persons received MAiD. The average age was 72.4 years (SD 12.22) with 260 of the patients being men (73.03%). The most common HNC primary tumor site was the oral cavity 109 (30.6%). The most reported reason was inadequate control of symptoms other than pain (79.21%) followed by inadequate pain control or concerns about it (75%). The patient's private residence (55.62%) was the most common setting. Patients were more likely to live in wealthier neighborhoods and in large urban centers. Future prediction of MAiD uptake shows a linear year-by-year increase.

Conclusion: The use of MAiD in HNC has been steadily increasing since its legalization and is projected to continue increasing. There is a male predominance that is aligned with the incidence and prevalence of HNC nationally. Overall, MAiD is an increasingly employed choice for HNC patients receiving treatment for disease without curative intent.

Level of evidence: 4:

目的:关于头颈癌(HNC)患者接受临终医疗援助(MAiD)的信息缺乏。我们的研究报告了在安大略省接受MAiD手术的HNC患者的患病率、疾病特征和愿望的性质。目的是更好地了解这一人群,并确定我们当前护理系统中的差距。方法:对2016年6月17日至2022年12月31日进行回顾性横断面分析。数据来自加拿大安大略省首席验尸官办公室。结果:356人接受了MAiD治疗。平均年龄72.4岁(SD 12.22),男性260例(73.03%)。最常见的HNC原发肿瘤部位为口腔109例(30.6%)。报告的主要原因是对疼痛以外的症状控制不足(79.21%),其次是疼痛控制不足或担心(75%)。患者的私人住所是最常见的环境(55.62%)。患者更有可能生活在较富裕的社区和大城市中心。未来对MAiD的预测显示出逐年的线性增长。结论:自大麻大麻合法化以来,MAiD在HNC中的使用一直在稳步增加,并预计将继续增加。男性占多数,这与全国HNC的发病率和流行率一致。总体而言,对于接受无治愈意图疾病治疗的HNC患者,MAiD越来越多地被采用。证据等级:4;
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引用次数: 0
Preoperative Dacryo-CT Parameters as Predictors of Restenosis After Endoscopic DCR. 术前泪膜ct参数预测内镜下DCR后再狭窄。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-04 DOI: 10.1002/lary.70409
Sante De Santis, Stefania Galassi, Jacopo Cambi

Objective: To evaluate anatomical and structural parameters of the lacrimal sac and nasolacrimal duct system measured through dacryocystography with computed tomography (Dacryo-CT) in relation to restenosis after endoscopic dacryocystorhinostomy (DCR) in a cohort of patients.

Methods: This retrospective study included patients undergoing endoscopic DCR with preoperative Dacryo-CT imaging. Parameters analyzed included the dimensions of the lacrimal sac (vertical and horizontal axes), the thickness of the bone anterior to the lacrimal sac, the thickness of the sac walls, the ratio of nasolacrimal duct length to the extent of contrast medium descent, and the ratio of sac width to wall thickness. Restenosis was defined clinically and confirmed endoscopically within 18 months postoperatively. Multivariate logistic regression was performed to assess the association between Dacryo-CT parameters and restenosis.

Results: Of 100 patients, restenosis occurred in 28 (28%). Restenosis was significantly associated with a reduced vertical axis of the lacrimal sac (mean, 7.8 vs. 10.2 mm, p < 0.01) and increased sac wall thickness (mean, 1.5 vs. 1.2 mm, p = 0.02). A higher ratio of sac width to wall thickness correlated with a lower restenosis rate (p = 0.04). The thickness of the anterior bone and the nasolacrimal duct length/contrast descent ratio showed no significant correlation with restenosis risk.

Conclusion: Preoperative Dacryo-CT-derived parameters, particularly lacrimal sac dimensions and wall thickness, may predict restenosis risk after endoscopic DCR. These findings highlight the importance of detailed anatomical evaluation to optimize surgical outcomes.

Level of evidence: 3:

目的:探讨泪囊ct (dacryocystorhinorstomtomy, DCR)术后泪囊及鼻泪管系统解剖结构参数与再狭窄的关系。方法:本回顾性研究纳入术前泪膜ct成像的内镜下DCR患者。分析的参数包括泪囊尺寸(纵、横轴)、泪囊前骨厚度、泪囊壁厚度、鼻泪管长度与造影剂下降程度之比、泪囊宽度与泪囊壁厚度之比。术后18个月内经内镜确认再狭窄。采用多因素logistic回归评估泪膜ct参数与再狭窄的关系。结果:100例患者中发生再狭窄28例(28%)。再狭窄与泪囊垂直轴减少显著相关(平均值7.8 vs 10.2 mm, p)。结论:术前泪囊ct衍生参数,特别是泪囊尺寸和壁厚,可以预测内镜下DCR后再狭窄的风险。这些发现强调了详细的解剖评估对优化手术结果的重要性。证据等级:3;
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引用次数: 0
The Head Mirror: How This Otolaryngological Instrument Became the Symbol for Physicians. 头镜:耳鼻喉科仪器如何成为医生的象征。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-04 DOI: 10.1002/lary.70401
Summer Xu, Daniel Russo, Todd Falcone

Objective: The head mirror was invented by Friedrich Hoffmann in 1841 and popularized by Anton von Troeltsch in 1855, whose design is still used today. Though it was primarily used by otolaryngologists, it is used ubiquitously as a symbol to represent doctors in the popular press and media. This investigation examines how the role of the head mirror throughout history has influenced medical symbolism in popular culture.

Data sources: Literature review was conducted including primary references exploring the history and development of the head mirror, followed by a secondary search of references cited by retrieved articles.

Review methods: The National Library of Medicine was used to search for historical texts. A Boolean search using "head mirror" AND "manual" was conducted. Primary sources such as cartoons and newspapers with depictions of the head mirror were also utilized.

Results: Doctors wearing head mirrors appear in a wide range of comic strips, television shows, paper and digital advertisements, as well as children's media and video games from the early 20th century up through the current day.

Conclusion: While history often leads us to understand how symbols arise, we can only postulate the cultural reasons why certain symbols persist. Perhaps it is the striking appearance, the visual humor, or the nostalgic aspect of the head mirror in combination with its historical significance that has been permanently etched into the image of the physician. While the everyday use of the head mirror has declined, its use in mainstream media is as pervasive as ever.

目的:头镜由Friedrich Hoffmann于1841年发明,Anton von Troeltsch于1855年推广,其设计至今仍在使用。虽然它最初是由耳鼻喉科医生使用,但它在大众媒体和媒体中被普遍用作代表医生的符号。本研究考察了头镜在整个历史中的作用如何影响流行文化中的医学象征主义。资料来源:进行文献综述,包括主要参考文献探讨头镜的历史和发展,其次是检索文章引用的参考文献。回顾方法:使用国家医学图书馆检索历史文献。使用“head mirror”和“manual”进行布尔搜索。第一手资料,如漫画和报纸上描绘的头镜也被利用。结果:从20世纪初至今,戴着头镜的医生在漫画、电视节目、报纸和数字广告、儿童媒体和电子游戏中广泛出现。结论:虽然历史经常引导我们理解符号是如何产生的,但我们只能假设某些符号持续存在的文化原因。也许是引人注目的外表,视觉上的幽默,或者是头镜的怀旧方面,以及它的历史意义,已经永久地蚀刻在医生的形象中。虽然头镜的日常使用已经下降,但它在主流媒体上的使用一如既往地普遍。
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引用次数: 0
Bleeding, Clotting, and Flap Failures: Management of Blood Thinners in Head & Neck Free Flaps. 出血、凝血和皮瓣失败:头颈部游离皮瓣血液稀释剂的处理。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-04 DOI: 10.1002/lary.70405
Megan Gillespie, Dylan Hood, Alok Kumar Dwivedi, Tabitha Galloway, Patrick Tassone

Objective: There is no consensus on blood thinner management in the perioperative period for head and neck free flap reconstructions. This study evaluated head and neck free flap outcomes in patients on baseline blood thinners, aspirin flap prophylaxis, and deep venous thrombosis (DVT) prophylaxis regimens.

Methods: Patients undergoing head and neck free flap reconstruction at a single tertiary, academic institution were included. Patients were grouped according to baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis regimens. The primary outcome was overall complication rate, while secondary outcomes included flap compromise, flap failure, bleeding, venous thrombotic events, and arterial thrombotic events. Statistical analysis was performed with Fisher's exact test and risk ratio (RR) regression analysis, using propensity score-adjusted models.

Results: Of 470 patients, 16.6% experienced postoperative complications. Longer preoperative holds (odds ratio [OR] = 1.81, p = 0.04) and delayed resumption of baseline blood thinners (OR = 1.56, p = 0.04) were associated with increased complication risk, particularly flap compromise. Unfractionated heparin was associated with higher complication rates compared to sequential compression devices (RR = 3.10, p = 0.018) and low molecular weight heparin (RR = 2.79, p < 0.001) for DVT prophylaxis. No other perioperative blood thinner regimens were significantly associated with postoperative complications.

Conclusions: Most regimens, including baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis, can be managed safely in the perioperative period. However, unfractionated heparin was associated with higher complication rates than other DVT prophylaxis regimens. While baseline blood thinners did not increase most complications, prolonged preoperative holding and delayed resumption may jeopardize flap viability-highlighting a modifiable point of intervention.

Level of evidence: 3:

目的:对头颈部游离皮瓣重建围手术期血液稀释剂的处理尚无共识。本研究评估了基线血液稀释剂、阿司匹林皮瓣预防和深静脉血栓形成(DVT)预防方案的患者头颈部游离皮瓣的结果。方法:选取在某高等院校接受头颈部游离皮瓣重建术的患者。患者根据基线血液稀释剂、阿司匹林皮瓣预防和DVT预防方案进行分组。主要结局是总并发症发生率,次要结局包括皮瓣受损、皮瓣失效、出血、静脉血栓事件和动脉血栓事件。统计学分析采用Fisher精确检验和风险比(RR)回归分析,采用倾向得分调整模型。结果:470例患者中,16.6%出现术后并发症。术前等待时间较长(比值比[OR] = 1.81, p = 0.04)和延迟恢复基线血液稀释剂(比值比[OR] = 1.56, p = 0.04)与并发症风险增加相关,尤其是皮瓣受损。与序贯压迫装置(RR = 3.10, p = 0.018)和低分子量肝素(RR = 2.79, p)相比,未分离肝素与更高的并发症发生率相关。结论:大多数方案,包括基线血液稀释剂、阿司匹林皮瓣预防和DVT预防,在围手术期可以安全管理。然而,与其他DVT预防方案相比,未分割肝素与更高的并发症发生率相关。虽然基线血液稀释剂不会增加大多数并发症,但术前长时间保持和延迟恢复可能会危及皮瓣的生存能力,这突出了一个可修改的干预点。证据等级:3;
{"title":"Bleeding, Clotting, and Flap Failures: Management of Blood Thinners in Head & Neck Free Flaps.","authors":"Megan Gillespie, Dylan Hood, Alok Kumar Dwivedi, Tabitha Galloway, Patrick Tassone","doi":"10.1002/lary.70405","DOIUrl":"https://doi.org/10.1002/lary.70405","url":null,"abstract":"<p><strong>Objective: </strong>There is no consensus on blood thinner management in the perioperative period for head and neck free flap reconstructions. This study evaluated head and neck free flap outcomes in patients on baseline blood thinners, aspirin flap prophylaxis, and deep venous thrombosis (DVT) prophylaxis regimens.</p><p><strong>Methods: </strong>Patients undergoing head and neck free flap reconstruction at a single tertiary, academic institution were included. Patients were grouped according to baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis regimens. The primary outcome was overall complication rate, while secondary outcomes included flap compromise, flap failure, bleeding, venous thrombotic events, and arterial thrombotic events. Statistical analysis was performed with Fisher's exact test and risk ratio (RR) regression analysis, using propensity score-adjusted models.</p><p><strong>Results: </strong>Of 470 patients, 16.6% experienced postoperative complications. Longer preoperative holds (odds ratio [OR] = 1.81, p = 0.04) and delayed resumption of baseline blood thinners (OR = 1.56, p = 0.04) were associated with increased complication risk, particularly flap compromise. Unfractionated heparin was associated with higher complication rates compared to sequential compression devices (RR = 3.10, p = 0.018) and low molecular weight heparin (RR = 2.79, p < 0.001) for DVT prophylaxis. No other perioperative blood thinner regimens were significantly associated with postoperative complications.</p><p><strong>Conclusions: </strong>Most regimens, including baseline blood thinners, aspirin flap prophylaxis, and DVT prophylaxis, can be managed safely in the perioperative period. However, unfractionated heparin was associated with higher complication rates than other DVT prophylaxis regimens. While baseline blood thinners did not increase most complications, prolonged preoperative holding and delayed resumption may jeopardize flap viability-highlighting a modifiable point of intervention.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146114889","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
Implementing the Palatal Plate for Robin Sequence Beyond the Originating Center: How I Do It. 在起始中心之外实现罗宾序列的腭板:我是怎么做的。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-03 DOI: 10.1002/lary.70411
Agnès Giuseppi, Nancy Vegas, Briac Thierry, Véronique Soupre, Alexandre Donatien, Pauline Adnot, Brigitte Fauroux, Alexandre Lapillonne, Romain Luscan

The treatment of upper airway obstruction in newborns with Robin sequence (RS) is challenging. We report our experience implementing the minimally invasive Tübingen palatal plate in a pediatric tertiary care center, detailing a step-by-step protocol and clinical outcomes from our first patient series. Despite a learning curve and need for multidisciplinary coordination, the palatal plate can be safely and effectively integrated outside its center of origin.

新生儿罗宾序列(Robin sequence, RS)上呼吸道阻塞的治疗具有挑战性。我们报告我们在儿科三级保健中心实施微创宾根腭板的经验,详细介绍了一步一步的方案和我们第一个患者系列的临床结果。尽管学习曲线和需要多学科的协调,腭板可以安全有效地整合在其起源中心外。
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引用次数: 0
Effect of Mepolizumab on Middle Ear Disease and Hearing Outcomes in CRSwNP. Mepolizumab对CRSwNP中耳疾病和听力结局的影响。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-03 DOI: 10.1002/lary.70399
Anne-Sophie Homøe, Jens Tidemandsen, Kasper Aanæs, Vibeke Backer, Ramon G Jensen

Objective: Otitis media with effusion (OME) is frequently observed in patients with severe Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)-yet it remains underrecognized. Both conditions are debilitating and may share type 2 inflammatory mechanisms. This study investigates the prevalence of OME (measured by tympanometry) in patients with CRSwNP and evaluates the effect of biologic treatment with mepolizumab, with or without combined FESS, on hearing outcomes as well as otologic symptoms.

Methods: Secondary analysis of a randomized controlled trial (RCT) (n = 58) comparing FESS and mepolizumab versus mepolizumab alone in patients suffering from severe CRSwNP. Tympanometry, audiometry, and patient-reported outcomes (SNOT-22 and COMOT-15) were assessed at baseline and after 6 months.

Results: At baseline, 22.8% (13/57) of patients had pathological tympanometry (OME), consistent with previous prevalence estimates. After 6 months, the proportion decreased to 14% (p = 0.07). No significant changes were observed in pure tone averages (PTA). In contrast, self-reported outcomes improved significantly, with reductions in both COMOT-15 and SNOT-22 scores (p < 0.05), independent of baseline tympanometry status.

Conclusion: Mepolizumab treatment was associated with a trend toward reduced middle ear symptoms and significant improvement in self-reported otologic symptoms, supporting the concept of global type 2 airway inflammation and the clinical relevance of assessing ear disease in CRSwNP.

Level of evidence: 2:

目的:中耳炎伴渗出性中耳炎(OME)常见于重度慢性鼻窦炎伴鼻息肉(CRSwNP)患者,但仍未得到充分认识。这两种情况都使人衰弱,并可能共享2型炎症机制。本研究调查了CRSwNP患者中OME(通过鼓室测量)的患病率,并评估了mepolizumab生物治疗,联合或不联合FESS对听力结局和耳科症状的影响。方法:对一项随机对照试验(RCT) (n = 58)进行二次分析,比较FESS和mepolizumab与mepolizumab单独治疗严重CRSwNP患者。在基线和6个月后评估鼓室测量、听力测量和患者报告的结果(SNOT-22和COMOT-15)。结果:在基线时,22.8%(13/57)的患者有病理性鼓室测量(OME),与之前的患病率估计一致。6个月后,该比例降至14% (p = 0.07)。纯音平均值(PTA)无明显变化。相反,自我报告的结果显著改善,COMOT-15和SNOT-22评分均降低(p结论:Mepolizumab治疗与中耳症状减轻和自我报告的耳科症状显著改善的趋势相关,支持全局2型气道炎症的概念和评估CRSwNP中耳部疾病的临床相关性。证据等级:2;
{"title":"Effect of Mepolizumab on Middle Ear Disease and Hearing Outcomes in CRSwNP.","authors":"Anne-Sophie Homøe, Jens Tidemandsen, Kasper Aanæs, Vibeke Backer, Ramon G Jensen","doi":"10.1002/lary.70399","DOIUrl":"https://doi.org/10.1002/lary.70399","url":null,"abstract":"<p><strong>Objective: </strong>Otitis media with effusion (OME) is frequently observed in patients with severe Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)-yet it remains underrecognized. Both conditions are debilitating and may share type 2 inflammatory mechanisms. This study investigates the prevalence of OME (measured by tympanometry) in patients with CRSwNP and evaluates the effect of biologic treatment with mepolizumab, with or without combined FESS, on hearing outcomes as well as otologic symptoms.</p><p><strong>Methods: </strong>Secondary analysis of a randomized controlled trial (RCT) (n = 58) comparing FESS and mepolizumab versus mepolizumab alone in patients suffering from severe CRSwNP. Tympanometry, audiometry, and patient-reported outcomes (SNOT-22 and COMOT-15) were assessed at baseline and after 6 months.</p><p><strong>Results: </strong>At baseline, 22.8% (13/57) of patients had pathological tympanometry (OME), consistent with previous prevalence estimates. After 6 months, the proportion decreased to 14% (p = 0.07). No significant changes were observed in pure tone averages (PTA). In contrast, self-reported outcomes improved significantly, with reductions in both COMOT-15 and SNOT-22 scores (p < 0.05), independent of baseline tympanometry status.</p><p><strong>Conclusion: </strong>Mepolizumab treatment was associated with a trend toward reduced middle ear symptoms and significant improvement in self-reported otologic symptoms, supporting the concept of global type 2 airway inflammation and the clinical relevance of assessing ear disease in CRSwNP.</p><p><strong>Level of evidence: 2: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108203","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
Exploring Real-Time Tracking of Vocal Fold Polyps in Video-Stroboscopy Using Deep Learning. 利用深度学习探索视频频闪镜对声带息肉的实时跟踪。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-02 DOI: 10.1002/lary.70396
Sanjana Kaza, Abhinita S Mohanty, Aisha Serpedin, Jenny Yau, Yeo Eun Kim, Rachel B Kutler, Olivier Elemento, Lucian Sulica, Pegah Khosravi, Anaïs Rameau

Objective: To develop and evaluate a deep learning object detection system for identifying vocal fold polyps in stroboscopic video frames using You Only Look Once (YOLO), and to assess the added benefit of temporal tracking on detection performance.

Methods: A retrospective dataset of 12,742 annotated frames from 55 laryngoscopy video recordings was annotated with bounding boxes identifying vocal fold polyps. Pretrained YOLO11 and YOLO12 models were fine-tuned to detect the polyps in the frames. A temporal tracking algorithm was further developed to propagate missed detections across adjacent frames.

Results: YOLO12 outperformed YOLO11 across all metrics. On the hold-out test set, YOLO12 reached a precision of 83.1% and an F1 score of 67.6%, with a mean average precision at 0.5 (mAP@0.5) of 64.1%. By comparison, YOLO11 achieved a precision of 67.3% and an F1 score of 56.2%, with a mAP@0.5 of 56.0%. Incorporating temporal tracking increased mAP@0.5 to 70.4% with YOLO 12, while maintaining a detection speed of 21.4 frames per second (fps), close to real time (30 fps).

Conclusions: Using YOLO 12 for vocal fold polyp detection in stroboscopy was enhanced with temporal tracking, achieving a mAP@0.5 of 70.4% with near real time performance. These results demonstrate the potential of real-time AI-assisted detection of vocal fold lesions.

Level of evidence: 4:

目的:开发和评估一种使用You Only Look Once (YOLO)技术识别频闪视频帧中声带息肉的深度学习目标检测系统,并评估时间跟踪对检测性能的额外好处。方法:回顾性数据集,来自55个喉镜视频记录的12,742个注释帧,用边界框标记声带息肉。对预训练的YOLO11和YOLO12模型进行微调,以检测帧中的息肉。进一步开发了一种时间跟踪算法,在相邻帧之间传播遗漏检测。结果:YOLO12在所有指标上都优于YOLO11。在hold-out测试集上,YOLO12的准确率为83.1%,F1得分为67.6%,平均准确率为0.5 (mAP@0.5),为64.1%。相比之下,YOLO11的准确率为67.3%,F1得分为56.2%,mAP@0.5得分为56.0%。结合时间跟踪,YOLO 12将mAP@0.5提高到70.4%,同时保持21.4帧/秒(fps)的检测速度,接近实时(30帧/秒)。结论:在频闪镜下使用YOLO 12进行声带息肉检测,时间跟踪增强,准确率mAP@0.5为70.4%,接近实时。这些结果证明了实时人工智能辅助检测声带病变的潜力。证据等级:4;
{"title":"Exploring Real-Time Tracking of Vocal Fold Polyps in Video-Stroboscopy Using Deep Learning.","authors":"Sanjana Kaza, Abhinita S Mohanty, Aisha Serpedin, Jenny Yau, Yeo Eun Kim, Rachel B Kutler, Olivier Elemento, Lucian Sulica, Pegah Khosravi, Anaïs Rameau","doi":"10.1002/lary.70396","DOIUrl":"https://doi.org/10.1002/lary.70396","url":null,"abstract":"<p><strong>Objective: </strong>To develop and evaluate a deep learning object detection system for identifying vocal fold polyps in stroboscopic video frames using You Only Look Once (YOLO), and to assess the added benefit of temporal tracking on detection performance.</p><p><strong>Methods: </strong>A retrospective dataset of 12,742 annotated frames from 55 laryngoscopy video recordings was annotated with bounding boxes identifying vocal fold polyps. Pretrained YOLO11 and YOLO12 models were fine-tuned to detect the polyps in the frames. A temporal tracking algorithm was further developed to propagate missed detections across adjacent frames.</p><p><strong>Results: </strong>YOLO12 outperformed YOLO11 across all metrics. On the hold-out test set, YOLO12 reached a precision of 83.1% and an F1 score of 67.6%, with a mean average precision at 0.5 (mAP@0.5) of 64.1%. By comparison, YOLO11 achieved a precision of 67.3% and an F1 score of 56.2%, with a mAP@0.5 of 56.0%. Incorporating temporal tracking increased mAP@0.5 to 70.4% with YOLO 12, while maintaining a detection speed of 21.4 frames per second (fps), close to real time (30 fps).</p><p><strong>Conclusions: </strong>Using YOLO 12 for vocal fold polyp detection in stroboscopy was enhanced with temporal tracking, achieving a mAP@0.5 of 70.4% with near real time performance. These results demonstrate the potential of real-time AI-assisted detection of vocal fold lesions.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108222","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
Natural History of Sensorineural Hearing Loss in Children With STRC Mutations. STRC突变儿童感音神经性听力损失的自然史。
IF 2 3区 医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Pub Date : 2026-02-02 DOI: 10.1002/lary.70404
Kenny H Chan, Emily E Nightengale, Setareh Ekhteraei, Ericka Schicke, Suhong Tong, Austin Zhu, Barbara K Burton

Introduction: The most common genes responsible for autosomal recessive nonsyndromic hearing loss (AR-NSHL) are GJB2 and STRC. STRC mutations are associated with mild-to-moderate sensorineural (SNHL) hearing loss and a lack of progression. However, our institutional experience suggested otherwise, prompting this review.

Methods: A 10-year retrospective chart review was performed at a tertiary children's hospital after the University of Iowa added STRC to its OtoSCOPER panel in 2013. Subjects with positive OtoSCOPER results underwent audiologic review. Hearing progression was defined based on pure-tone average changes, and mutation subtypes were categorized.

Results: Of 354 subjects undergoing OtoSCOPER testing, 181 (51.1%) carried a pathogenic mutation; GJB2 (28.7%) and STRC (16.6%) were most common. The STRC cohort included 30 subjects (21 males, 9 females) with hearing loss severity classifiable in 26 subjects and the highest proportion in the mild-to-moderate range (n = 46 ears; 88.5%). Hearing progression was observed in 12/24 subjects (20 ears: 8 bilateral, 4 unilateral). Median annual progression was 1.1 dB (range -3.5 to 18.7 dB). Two STRC subjects had substantial progression requiring cochlear implantation (one performed, one recommended). Genetic subtyping revealed seven categories, including six males with STRC/CATSPER2 deletions (deafness-infertility syndrome). No association between subtype and severity or progression was identified.

Discussion: STRC is the second most common cause of childhood NSHL and the leading contributor to mild-to-moderate SNHL. Unlike most published literature, 50% of our STRC cohort exhibited progression, and 17.6% of progressing subjects had substantial unilateral loss. We recommend long-term audiometric monitoring and standardized genomic reporting for this population.

Level of evidence: 4:

常染色体隐性非综合征性听力损失(AR-NSHL)最常见的基因是GJB2和STRC。STRC突变与轻度至中度感音神经性(SNHL)听力损失和缺乏进展相关。然而,我们的机构经验表明并非如此,促使我们进行了这次审查。方法:2013年爱荷华大学将STRC纳入其耳镜检查小组后,在一家三级儿童医院进行了10年回顾性图表回顾。耳镜检查结果阳性的受试者接受听力学检查。根据纯音平均变化定义听力进展,并对突变亚型进行分类。结果:354名接受耳镜检测的受试者中,181人(51.1%)携带致病性突变;GJB2(28.7%)和STRC(16.6%)最为常见。STRC队列包括30名受试者(21名男性,9名女性),其中26名受试者的听力损失严重程度可分为轻度至中度,比例最高(n = 46耳,88.5%)。24例受试者中有12例(20只耳朵:8只双侧,4只单侧)出现听力进展。中位数年进展为1.1 dB(范围为-3.5至18.7 dB)。2例STRC患者进展明显,需要人工耳蜗植入(1例已实施,1例推荐)。遗传亚型分型显示为7类,包括6例男性STRC/CATSPER2缺失(耳聋-不育综合征)。亚型与严重程度或进展之间没有关联。讨论:STRC是儿童NSHL的第二大常见原因,也是轻度至中度SNHL的主要原因。与大多数已发表的文献不同,我们的STRC队列中有50%表现出进展,17.6%的进展受试者有严重的单侧损失。我们建议对这一人群进行长期的听力监测和标准化的基因组报告。证据等级:4;
{"title":"Natural History of Sensorineural Hearing Loss in Children With STRC Mutations.","authors":"Kenny H Chan, Emily E Nightengale, Setareh Ekhteraei, Ericka Schicke, Suhong Tong, Austin Zhu, Barbara K Burton","doi":"10.1002/lary.70404","DOIUrl":"https://doi.org/10.1002/lary.70404","url":null,"abstract":"<p><strong>Introduction: </strong>The most common genes responsible for autosomal recessive nonsyndromic hearing loss (AR-NSHL) are GJB2 and STRC. STRC mutations are associated with mild-to-moderate sensorineural (SNHL) hearing loss and a lack of progression. However, our institutional experience suggested otherwise, prompting this review.</p><p><strong>Methods: </strong>A 10-year retrospective chart review was performed at a tertiary children's hospital after the University of Iowa added STRC to its OtoSCOPE<sup>R</sup> panel in 2013. Subjects with positive OtoSCOPE<sup>R</sup> results underwent audiologic review. Hearing progression was defined based on pure-tone average changes, and mutation subtypes were categorized.</p><p><strong>Results: </strong>Of 354 subjects undergoing OtoSCOPE<sup>R</sup> testing, 181 (51.1%) carried a pathogenic mutation; GJB2 (28.7%) and STRC (16.6%) were most common. The STRC cohort included 30 subjects (21 males, 9 females) with hearing loss severity classifiable in 26 subjects and the highest proportion in the mild-to-moderate range (n = 46 ears; 88.5%). Hearing progression was observed in 12/24 subjects (20 ears: 8 bilateral, 4 unilateral). Median annual progression was 1.1 dB (range -3.5 to 18.7 dB). Two STRC subjects had substantial progression requiring cochlear implantation (one performed, one recommended). Genetic subtyping revealed seven categories, including six males with STRC/CATSPER2 deletions (deafness-infertility syndrome). No association between subtype and severity or progression was identified.</p><p><strong>Discussion: </strong>STRC is the second most common cause of childhood NSHL and the leading contributor to mild-to-moderate SNHL. Unlike most published literature, 50% of our STRC cohort exhibited progression, and 17.6% of progressing subjects had substantial unilateral loss. We recommend long-term audiometric monitoring and standardized genomic reporting for this population.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":49921,"journal":{"name":"Laryngoscope","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146108179","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
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Laryngoscope
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