Pub Date : 2026-01-01DOI: 10.1016/j.otorri.2025.512309
María Agustina Sevilla García , Carlos Miguel Chiesa-Estomba , Luz Barona-Lleó , Ángel Álvarez Sánchez , Carlos Martín de Argila
Introduction
Laryngopharyngeal reflux (LPR) represents a diagnostic and therapeutic challenge due to the nonspecific nature of its clinical manifestations and the absence of objective biomarkers. The aim of this work is to establish a national consensus on its definition, diagnosis, and treatment through a modified Delphi methodology that integrates the perspectives of otolaryngologists (ENT) and gastroenterologists (GI).
Materials and methods
A scientific committee composed of three ENTs and two GIs developed 117 items distributed across seven thematic sections. The Delphi process involved 73 panellists in the first round, of whom 65 (89%) completed both rounds of voting. Participants were representative of the Spanish autonomous communities, with an average of 17 years of clinical experience and a multidisciplinary profile (63.1% ENT; 36.9% GI).
Results
After two rounds of voting, positive consensus was reached on 67 items (64.9%), distributed as follows: 14 on definition and pathophysiology; 12 on symptoms and pharyngeal findings; 2 on associations with other ENT diseases; 10 on diagnostic methods; 3 on validated questionnaires; 15 on treatment and recommendations; and 11 on clinical follow-up.
Conclusion
The results of the consensus reflect the suitability and effectiveness of the Delphi methodology used to create a consensus document on the definition, presentation, diagnosis, and management of a condition that until now has been poorly defined, such as LPR. The aim is to support specialists in their daily clinical practice, and unlike previous efforts, it has succeeded in unifying within a single document the criteria of the two specialties most involved in managing these patients.
{"title":"Consenso multidisciplinar español para el diagnóstico y manejo del reflujo faringolaríngeo (Consenso ReFaL)","authors":"María Agustina Sevilla García , Carlos Miguel Chiesa-Estomba , Luz Barona-Lleó , Ángel Álvarez Sánchez , Carlos Martín de Argila","doi":"10.1016/j.otorri.2025.512309","DOIUrl":"10.1016/j.otorri.2025.512309","url":null,"abstract":"<div><h3>Introduction</h3><div>Laryngopharyngeal reflux (LPR) represents a diagnostic and therapeutic challenge due to the nonspecific nature of its clinical manifestations and the absence of objective biomarkers. The aim of this work is to establish a national consensus on its definition, diagnosis, and treatment through a modified Delphi methodology that integrates the perspectives of otolaryngologists (ENT) and gastroenterologists (GI).</div></div><div><h3>Materials and methods</h3><div>A scientific committee composed of three ENTs and two GIs developed 117 items distributed across seven thematic sections. The Delphi process involved 73 panellists in the first round, of whom 65 (89%) completed both rounds of voting. Participants were representative of the Spanish autonomous communities, with an average of 17<!--> <!-->years of clinical experience and a multidisciplinary profile (63.1% ENT; 36.9% GI).</div></div><div><h3>Results</h3><div>After two rounds of voting, positive consensus was reached on 67 items (64.9%), distributed as follows: 14 on definition and pathophysiology; 12 on symptoms and pharyngeal findings; 2 on associations with other ENT diseases; 10 on diagnostic methods; 3 on validated questionnaires; 15 on treatment and recommendations; and 11 on clinical follow-up.</div></div><div><h3>Conclusion</h3><div>The results of the consensus reflect the suitability and effectiveness of the Delphi methodology used to create a consensus document on the definition, presentation, diagnosis, and management of a condition that until now has been poorly defined, such as LPR. The aim is to support specialists in their daily clinical practice, and unlike previous efforts, it has succeeded in unifying within a single document the criteria of the two specialties most involved in managing these patients.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512309"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.otorri.2025.512287
Abobakr Mohammed Elbakry , Ahmed Nabil Selim , Alaa Abdelwahab Eldarawy , Abdallah Mahmoud Gad
Objectives
The aim of the study is comparing endoscopic coblation adenoidectomy and suction diathermy in terms of surgical duration, intraoperative blood loss, and postoperative complications such as foul odor, neck pain, and secondary bleeding, as well as patient recovery.
Patients and methods
Prospective randomized double blinded controlled trial involving 210 patients who presented with adenoid hypertrophy. Randomization was done in two groups group A including 105 patients who underwent endoscopic adenoidectomy by suction diathermy, Group B including 105 patients who underwent endoscopic adenoidectomy by coblation technique.
Patients were compared regarding intraoperative blood loss and operative time and postoperative bleeding, postoperative neck pain, and halitosis.
Results
When comparing the two groups, Group B had notably longer surgeries but experienced less pain after the operation, recovered more quickly, and had a lower chance of bad breath. There was no significant difference between both the groups regarding intraoperative blood loss.
Conclusion
Both techniques are effective in management of adenoid hypertrophy, but results showed endoscopic adenoidectomy with coblation is favored over suction diathermy due to better postoperative outcomes.
{"title":"Coblation versus suction Diathermy in Endoscopic Pediatric Adenoidectomy: Randomized clinical trial","authors":"Abobakr Mohammed Elbakry , Ahmed Nabil Selim , Alaa Abdelwahab Eldarawy , Abdallah Mahmoud Gad","doi":"10.1016/j.otorri.2025.512287","DOIUrl":"10.1016/j.otorri.2025.512287","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of the study is comparing endoscopic coblation adenoidectomy and suction diathermy in terms of surgical duration, intraoperative blood loss, and postoperative complications such as foul odor, neck pain, and secondary bleeding, as well as patient recovery.</div></div><div><h3>Patients and methods</h3><div>Prospective randomized double blinded controlled trial involving 210 patients who presented with adenoid hypertrophy. Randomization was done in two groups group A including 105 patients who underwent endoscopic adenoidectomy by suction diathermy, Group B including 105 patients who underwent endoscopic adenoidectomy by coblation technique.</div><div>Patients were compared regarding intraoperative blood loss and operative time and postoperative bleeding, postoperative neck pain, and halitosis.</div></div><div><h3>Results</h3><div>When comparing the two groups, Group B had notably longer surgeries but experienced less pain after the operation, recovered more quickly, and had a lower chance of bad breath. There was no significant difference between both the groups regarding intraoperative blood loss.</div></div><div><h3>Conclusion</h3><div>Both techniques are effective in management of adenoid hypertrophy, but results showed endoscopic adenoidectomy with coblation is favored over suction diathermy due to better postoperative outcomes.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512287"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mucocutaneous leishmaniasis (MCL) is a rare and challenging clinical presentation of tegumentary leishmaniasis, primarily affecting the mucosal surfaces of the upper airway. It is often misdiagnosed due to its non-specific symptoms, which can mimic inflammatory, infectious, or neoplastic conditions. This study reports three autochthonous cases of MCL diagnosed between 2023 and 2024. The patients presented chronic symptoms such as dysphagia, odynophagia, lip edema, and ulcerative mucosal lesions. Diagnosis was established through mucosal biopsies, revealing intracellular Leishmania amastigotes via histopathological examination. Treatment varied across the cases and included liposomal Amphotericin B, Meglumine Antimoniate, and Miltefosine, reflecting the complexity of managing MCL. All patients achieved complete clinical remission after individualized therapeutic regimens and careful follow-up. These cases emphasize the importance of considering MCL in the differential diagnosis of persistent upper airway lesions in endemic regions. Early and accurate diagnosis, coupled with tailored treatment strategies, is essential for preventing disease progression and achieving successful clinical outcomes. Furthermore, these findings underscore the need for heightened clinical awareness and multidisciplinary collaboration in managing this rare but significant disease presentation.
{"title":"Mucocutaneous leishmaniasis with upper airway involvement: A report of three cases","authors":"Jaume Fiol Roig , Amaya Roldan Fidalgo , Fabián García Velasco , Meritxell Tomás Fernández , Daniela Mendizábal Cajal","doi":"10.1016/j.otorri.2025.512276","DOIUrl":"10.1016/j.otorri.2025.512276","url":null,"abstract":"<div><div>Mucocutaneous leishmaniasis (MCL) is a rare and challenging clinical presentation of tegumentary leishmaniasis, primarily affecting the mucosal surfaces of the upper airway. It is often misdiagnosed due to its non-specific symptoms, which can mimic inflammatory, infectious, or neoplastic conditions. This study reports three autochthonous cases of MCL diagnosed between 2023 and 2024. The patients presented chronic symptoms such as dysphagia, odynophagia, lip edema, and ulcerative mucosal lesions. Diagnosis was established through mucosal biopsies, revealing intracellular <em>Leishmania</em> amastigotes via histopathological examination. Treatment varied across the cases and included liposomal Amphotericin B, Meglumine Antimoniate, and Miltefosine, reflecting the complexity of managing MCL. All patients achieved complete clinical remission after individualized therapeutic regimens and careful follow-up. These cases emphasize the importance of considering MCL in the differential diagnosis of persistent upper airway lesions in endemic regions. Early and accurate diagnosis, coupled with tailored treatment strategies, is essential for preventing disease progression and achieving successful clinical outcomes. Furthermore, these findings underscore the need for heightened clinical awareness and multidisciplinary collaboration in managing this rare but significant disease presentation.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512276"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study evaluates the impact of cochlear implantation on cognitive function in older adults, focusing on executive function, processing speed, and memory.
Methods
A prospective observational study was conducted on 15 older adults (mean age: 72.4 years) who underwent cochlear implantation at the ENT and Head and Neck Surgery Department. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT-A and TMT-B) pre- and post-implantation (6 and 12 months). Results were compared using statistical analyses, and correlations between cognitive improvement and speech perception outcomes were examined.
Results
Cognitive function significantly improved post-implantation, with MMSE scores increasing from 22.93 ± 3.2 at baseline to 24.6 ± 2.9 at 12 months (p < 0.05). TMT-A and TMT-B scores also improved significantly (p < 0.05), indicating enhanced executive function and processing speed. A moderate correlation (r = 0.52, p = 0.04) was observed between cognitive improvement and speech perception.
Conclusion
These findings support the hypothesis that cochlear implantation in older adults positively impacts cognitive function. This study adds to the growing body of evidence suggesting that auditory rehabilitation may help mitigate cognitive decline in aging populations.
目的评价人工耳蜗植入对老年人认知功能的影响，重点关注执行功能、处理速度和记忆。方法对在耳鼻喉科和头颈外科行人工耳蜗植入术的15例老年人（平均年龄72.4岁）进行前瞻性观察研究。在植入前后（6个月和12个月）采用简易精神状态检查（MMSE）和造径测试（TMT-A和TMT-B）评估认知功能。使用统计分析对结果进行比较，并检查认知改善与言语感知结果之间的相关性。结果植入后认知功能明显改善，MMSE评分从基线时的22.93±3.2分提高到12个月时的24.6±2.9分（p < 0.05）。TMT-A和TMT-B评分也显著提高（p < 0.05），说明执行功能和处理速度增强。认知改善与言语知觉之间存在中度相关（r = 0.52, p = 0.04）。结论这些发现支持了人工耳蜗植入对老年人认知功能有积极影响的假设。这项研究增加了越来越多的证据，表明听觉康复可能有助于减轻老年人的认知能力下降。
{"title":"Impact of cochlear implants on cognitive performance during aging","authors":"Fatima Ezzahra Rizkou , Youssef Lakhdar , Omar Oulghoul , Mohammed Chehbouni , Othmane Benhoummad , Youssef Rochdi , Abdelaziz Raji","doi":"10.1016/j.otorri.2025.512289","DOIUrl":"10.1016/j.otorri.2025.512289","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the impact of cochlear implantation on cognitive function in older adults, focusing on executive function, processing speed, and memory.</div></div><div><h3>Methods</h3><div>A prospective observational study was conducted on 15 older adults (mean age: 72.4 years) who underwent cochlear implantation at the ENT and Head and Neck Surgery Department. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) and the Trail Making Test (TMT-A and TMT-B) pre- and post-implantation (6 and 12 months). Results were compared using statistical analyses, and correlations between cognitive improvement and speech perception outcomes were examined.</div></div><div><h3>Results</h3><div>Cognitive function significantly improved post-implantation, with MMSE scores increasing from 22.93 ± 3.2 at baseline to 24.6 ± 2.9 at 12 months (<em>p < 0.05</em>). TMT-A and TMT-B scores also improved significantly (<em>p < 0.05</em>), indicating enhanced executive function and processing speed. A moderate correlation (<em>r = 0.52, p = 0.04</em>) was observed between cognitive improvement and speech perception.</div></div><div><h3>Conclusion</h3><div>These findings support the hypothesis that cochlear implantation in older adults positively impacts cognitive function. This study adds to the growing body of evidence suggesting that auditory rehabilitation may help mitigate cognitive decline in aging populations.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512289"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.otorri.2025.512288
Mayada Elsherif , Alia Elkaraksy , Dalia Eldeeb , Mirhan Eldeeb
Introduction and objectives
The diagnostic accuracy and reliability of the head pitch test in differentiating between different types of BPPV require further investigation. Studying the diagnostic accuracy of the head pitch test in BPPV diagnosis can aid in the development of targeted management strategies for patients presenting with BPPV.
Methods
All patients who complained of positional vertigo for seconds underwent complete videonystagmography test using ICS Chartr 200 VNG/ENG system (Otometrics, Denmark) including : spontaneous nystagmus, complete occulomotor test battery, then the head pitch test was performed in two positions: first the patient’s head was bent 90 degrees forwards, then 60 degrees backwards for approximately 1 min each. If nystagmus was observed, its direction was recorded.1 All patients then underwent gold standard tests for positional vertigo including both Dix-Hallpike maneuver and the supine roll tests.
Results
The sensitivity (true positive cases) was defined as the head pitch (HPT) test being positive and showing the correct nystagmus for different categories of BPPV. The sensitivity of the experimental HPT was compared to the gold standard tests (100% sensitive) for diagnosis of different categories of vertical canal and lateral canal BPPV. It was highest (100%) for Lateral Cupulolithiasis patients (n = 12) and Anterior canal Canalithiasis (n = 3) and lowest (68%) for Typical Posterior Canalithiasis patients (n = 68).
Conclusion
This study supports the addition of the head pitch test in the routine assessment of patients with positional vertigo. As it could shorten the examination time and decrease the repositioning maneuvers which may cause severe autonomic symptoms.
{"title":"Diagnostic accuracy of the head pitch test in benign paroxysmal positional vertigo","authors":"Mayada Elsherif , Alia Elkaraksy , Dalia Eldeeb , Mirhan Eldeeb","doi":"10.1016/j.otorri.2025.512288","DOIUrl":"10.1016/j.otorri.2025.512288","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>The diagnostic accuracy and reliability of the head pitch test in differentiating between different types of BPPV require further investigation. Studying the diagnostic accuracy of the head pitch test in BPPV diagnosis can aid in the development of targeted management strategies for patients presenting with BPPV.</div></div><div><h3>Methods</h3><div>All patients who complained of positional vertigo for seconds underwent complete videonystagmography test using ICS Chartr 200 VNG/ENG system (Otometrics, Denmark) including : spontaneous nystagmus, complete occulomotor test battery, then the head pitch test was performed in two positions: first the patient’s head was bent 90 degrees forwards, then 60 degrees backwards for approximately 1 min each. If nystagmus was observed, its direction was recorded.<span><span><sup>1</sup></span></span> All patients then underwent gold standard tests for positional vertigo including both Dix-Hallpike maneuver and the supine roll tests.</div></div><div><h3>Results</h3><div>The sensitivity (true positive cases) was defined as the head pitch (HPT) test being positive and showing the correct nystagmus for different categories of BPPV. The sensitivity of the experimental HPT was compared to the gold standard tests (100% sensitive) for diagnosis of different categories of vertical canal and lateral canal BPPV. It was highest (100%) for Lateral Cupulolithiasis patients (<em>n</em> = 12) and Anterior canal Canalithiasis (<em>n</em> = 3) and lowest (68%) for Typical Posterior Canalithiasis patients (<em>n</em> = 68).</div></div><div><h3>Conclusion</h3><div>This study supports the addition of the head pitch test in the routine assessment of patients with positional vertigo. As it could shorten the examination time and decrease the repositioning maneuvers which may cause severe autonomic symptoms.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512288"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.otorri.2025.512275
Juan Ramón Gras-Cabrerizo , Juan Carlos Villatoro–Sologaistoa , Maria Casasayas-Plass , María Martel-Martín , Carolina Alfonso-Carrillo , Miguel Armengot-Carceller , María Sandra Domínguez-Sosa , Rafael Fernandez-Liesa , Ainhoa García-Lliberós , María Gil-Melcón , Xavier González-Compta , Fernando López-Álvarez , Mauricio López-Chacón , David Lobo-Duro , Nieves Mata-Castro , Irene Monjas-Cánovas , Ramon Moreno-Luna , Laura Pardo-Muñoz , Mayte Pinilla-Urraca , Alfonso Santamaría-Gadea , Isam Alobid
Introduction
Advances in endonasal endoscopic surgery have highlighted the need to unify and adapt sinonasal anatomical terminology. This study aims to translate and validate the anatomical terms proposed by the European Rhinologic Society into Spanish, in order to facilitate their use and dissemination.
Methods
A Delphi methodology was employed, involving 24 nationally recognized rhinologists with extensive experience in endoscopic surgery. In the first round, Spanish equivalents were proposed for the 121 concepts included in the EPOS (European Position Paper on the Anatomical Terminology) supplement. In the second round, each participant selected a single preferred term among the most voted options. Finally, a panel of seven national experts reviewed and approved the definitive terms, including additional concepts not previously addressed in reference documents.
Results
In 61% (73/121) of the concepts, the expert panel ratified the term most voted by the group of rhinologists. In 31% (38/121), the most voted term was modified, and in 8% (10/121), a final decision was made in the event of a tie. The use of eponyms and latinisms was avoided whenever possible. The terminology selected aimed to accurately reflect the corresponding anatomical concepts. Moreover, relevant terms not included in the EPOS consensus documents or the Anatomical Terminology were incorporated.
Conclusion
The adaptation and validation of sinonasal anatomical terminology into Spanish enhances international communication and contributes to improving clinical practice in rhinology.
{"title":"Actualización y adaptación de la nomenclatura anatómica nasosinusal al castellano","authors":"Juan Ramón Gras-Cabrerizo , Juan Carlos Villatoro–Sologaistoa , Maria Casasayas-Plass , María Martel-Martín , Carolina Alfonso-Carrillo , Miguel Armengot-Carceller , María Sandra Domínguez-Sosa , Rafael Fernandez-Liesa , Ainhoa García-Lliberós , María Gil-Melcón , Xavier González-Compta , Fernando López-Álvarez , Mauricio López-Chacón , David Lobo-Duro , Nieves Mata-Castro , Irene Monjas-Cánovas , Ramon Moreno-Luna , Laura Pardo-Muñoz , Mayte Pinilla-Urraca , Alfonso Santamaría-Gadea , Isam Alobid","doi":"10.1016/j.otorri.2025.512275","DOIUrl":"10.1016/j.otorri.2025.512275","url":null,"abstract":"<div><h3>Introduction</h3><div>Advances in endonasal endoscopic surgery have highlighted the need to unify and adapt sinonasal anatomical terminology. This study aims to translate and validate the anatomical terms proposed by the European Rhinologic Society into Spanish, in order to facilitate their use and dissemination.</div></div><div><h3>Methods</h3><div>A Delphi methodology was employed, involving 24 nationally recognized rhinologists with extensive experience in endoscopic surgery. In the first round, Spanish equivalents were proposed for the 121 concepts included in the <em>EPOS</em> (<em>European Position Paper on the Anatomical Terminology</em>) supplement. In the second round, each participant selected a single preferred term among the most voted options. Finally, a panel of seven national experts reviewed and approved the definitive terms, including additional concepts not previously addressed in reference documents.</div></div><div><h3>Results</h3><div>In 61% (73/121) of the concepts, the expert panel ratified the term most voted by the group of rhinologists. In 31% (38/121), the most voted term was modified, and in 8% (10/121), a final decision was made in the event of a tie. The use of eponyms and latinisms was avoided whenever possible. The terminology selected aimed to accurately reflect the corresponding anatomical concepts. Moreover, relevant terms not included in the <em>EPOS</em> consensus documents or the <em>Anatomical Terminology</em> were incorporated.</div></div><div><h3>Conclusion</h3><div>The adaptation and validation of sinonasal anatomical terminology into Spanish enhances international communication and contributes to improving clinical practice in rhinology.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512275"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.otorri.2025.512292
A. Ángel-de-Miguel , A. Navarro , M. Sánchez-Pardo , A. García-Lliberós
{"title":"Paraganglioma maligno nasosinusal: un gran desafío clínico e histopatológico en una entidad infrecuente","authors":"A. Ángel-de-Miguel , A. Navarro , M. Sánchez-Pardo , A. García-Lliberós","doi":"10.1016/j.otorri.2025.512292","DOIUrl":"10.1016/j.otorri.2025.512292","url":null,"abstract":"","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512292"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146036979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.otorri.2025.512293
Eduardo Lehrer , Tomeu Alberto , Ada Cabero , Mónica Egea , Marina Paredes , Sara Jubés , Isabel Vilaseca
Background and objectives
The 445 nm blue laser has expanded therapeutic possibilities in the office. However, comparative studies with laser surgery in the operating room are scarce. The present study aims to analyse both techniques applied to the treatment of benign laryngeal lesions in terms of efficacy, tolerability, and efficiency.
Materials and methods
Prospective, non-randomized observational study of 93 consecutive patients with benign laryngeal lesions treated in the office (TNFLS) or in the operating room using transoral blue laser microsurgery (TOBLM), (48 TNFLS, 38 TOBLM, 7 combined cases). Vocal outcomes were assessed using the abbreviated vocal handicap index (VHI-10), a visual analogue scale (VAS) and the acoustic voice quality index (AVQI) obtained from acoustic analysis, as well as the tolerability and efficiency of the procedures. The variables were evaluated before and 3 months after surgery.
Results
Both groups showed improvements at 3 months postoperatively in VHI-10, VAS, and AVQI, with no differences between techniques. TNFLS had a high tolerability rate (95.4%) and was significantly more cost-effective, with a cost-per-point of improvement in the VHI-10 of €86.30 vs. €200.42.
Conclusions
TNFLS with blue laser is an effective, well-tolerated, and cost-effective alternative to conventional surgery for benign laryngeal lesions. These results support its implementation in dynamic healthcare settings that prioritize efficiency.
{"title":"Del quirófano a la consulta: resultados funcionales, tolerabilidad y coste-efectividad del láser azul en la cirugía de la patología benigna de la laringe","authors":"Eduardo Lehrer , Tomeu Alberto , Ada Cabero , Mónica Egea , Marina Paredes , Sara Jubés , Isabel Vilaseca","doi":"10.1016/j.otorri.2025.512293","DOIUrl":"10.1016/j.otorri.2025.512293","url":null,"abstract":"<div><h3>Background and objectives</h3><div>The 445<!--> <!-->nm blue laser has expanded therapeutic possibilities in the office. However, comparative studies with laser surgery in the operating room are scarce. The present study aims to analyse both techniques applied to the treatment of benign laryngeal lesions in terms of efficacy, tolerability, and efficiency<em>.</em></div></div><div><h3>Materials and methods</h3><div>Prospective, non-randomized observational study of 93 consecutive patients with benign laryngeal lesions treated in the office (TNFLS) or in the operating room using transoral blue laser microsurgery (TOBLM), (48 TNFLS, 38 TOBLM, 7 combined cases). Vocal outcomes were assessed using the abbreviated vocal handicap index (VHI-10), a visual analogue scale (VAS) and the acoustic voice quality index (AVQI) obtained from acoustic analysis, as well as the tolerability and efficiency of the procedures. The variables were evaluated before and 3 months after surgery.</div></div><div><h3>Results</h3><div>Both groups showed improvements at 3 months postoperatively in VHI-10, VAS, and AVQI, with no differences between techniques. TNFLS had a high tolerability rate (95.4%) and was significantly more cost-effective, with a cost-per-point of improvement in the VHI-10 of €86.30 vs. €200.42.</div></div><div><h3>Conclusions</h3><div>TNFLS with blue laser is an effective, well-tolerated, and cost-effective alternative to conventional surgery for benign laryngeal lesions. These results support its implementation in dynamic healthcare settings that prioritize efficiency.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"77 1","pages":"Article 512293"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146037036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.otorri.2025.512284
Carlos Miguel Chiesa-Estomba , Maria Landa-Garmendia , Aitor Vargas-Álvarez , Carlos Saga-Gutierrez
Parotid lithiasis represent a frequent cause of salivary obstruction, especially complex when it involves the proximal third of Stensen's duct or when the stones are large than 7 mm. Although sialendoscopy have optimized its management, there are cases where these techniques fail or are unavailable. The ultrasound-guided transfacial approach emerges as a minimally invasive alternative. This retrospective study conducted between February 2024 and February 2025 aims to describe the technique and outcomes of ultrasound-guided transfacial surgery in a tertiary care center. Adults with stones ≥7 mm, located in the proximal third of Stensen's duct, secondary branches, or glandular parenchyma, who underwent surgery in a tertiary care center and had at least 6 months of follow-up, were included. A total of 9 procedures were performed in 8 patients (6 women, 2 men), with a mean age of 58 ± 13 years. The mean stone size was 9.22 ± 1.92 mm. Stones were mainly located in the main duct (6 cases), secondary branches (2 cases), and glandular parenchyma (1 case). The mean surgical time was 51 ± 14 minutes. No conversions to parotidectomy were required, and no facial nerve injuries were recorded. There was one case of salivary fistula, which resolved conservatively in 21 days. All patients preserved normal glandular function and reported aesthetic satisfaction. Our results suggests that the ultrasound-guided transfacial approach is safe, effective, and reproducible for treating large or proximal parotid stones, offering results comparable to combined techniques but without requiring complex equipment or radiation. It is a useful alternative in centers where sialendoscopy or lithotripsy is unavailable or has failed.
{"title":"Abordaje transfacial ecoguiado en el manejo quirúrgico de litiasis parotídeas impactadas: más allá de la sialoendoscopia","authors":"Carlos Miguel Chiesa-Estomba , Maria Landa-Garmendia , Aitor Vargas-Álvarez , Carlos Saga-Gutierrez","doi":"10.1016/j.otorri.2025.512284","DOIUrl":"10.1016/j.otorri.2025.512284","url":null,"abstract":"<div><div>Parotid lithiasis represent a frequent cause of salivary obstruction, especially complex when it involves the proximal third of Stensen's duct or when the stones are large than 7<!--> <!-->mm. Although sialendoscopy have optimized its management, there are cases where these techniques fail or are unavailable. The ultrasound-guided transfacial approach emerges as a minimally invasive alternative. This retrospective study conducted between February 2024 and February 2025 aims to describe the technique and outcomes of ultrasound-guided transfacial surgery in a tertiary care center. Adults with stones ≥7<!--> <!-->mm, located in the proximal third of Stensen's duct, secondary branches, or glandular parenchyma, who underwent surgery in a tertiary care center and had at least 6 months of follow-up, were included. A total of 9 procedures were performed in 8 patients (6 women, 2 men), with a mean age of 58<!--> <!-->±<!--> <!-->13 years. The mean stone size was 9.22<!--> <!-->±<!--> <!-->1.92<!--> <!-->mm. Stones were mainly located in the main duct (6 cases), secondary branches (2 cases), and glandular parenchyma (1 case). The mean surgical time was 51<!--> <!-->±<!--> <!-->14<!--> <!-->minutes. No conversions to parotidectomy were required, and no facial nerve injuries were recorded. There was one case of salivary fistula, which resolved conservatively in 21 days. All patients preserved normal glandular function and reported aesthetic satisfaction. Our results suggests that the ultrasound-guided transfacial approach is safe, effective, and reproducible for treating large or proximal parotid stones, offering results comparable to combined techniques but without requiring complex equipment or radiation. It is a useful alternative in centers where sialendoscopy or lithotripsy is unavailable or has failed.</div></div>","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512284"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-01DOI: 10.1016/j.otorri.2025.512272
Fabio Fernández-Mateos , Laura Yeguas-Ramírez , Víctor Rodríguez-Berrocal , Franklin Mariño-Sánchez , Alfonso Santamaría-Gadea
<div><h3>Introduction</h3><div>One of the main challenges in the development of endoscopic surgical techniques for the treatment of nasosinusal neoplasms and skull base pathology is the reconstruction of the defects resulting from these procedures. Endonasal flaps (with the nasoseptal flap as the primary option) are typically the first-line choice for managing such defects. Unfortunately, in some cases, these flaps are either unavailable or insufficient to adequately repair the defect. In such scenarios, the pericranial flap can be employed with excellent outcomes. However, large case series describing the endoscopic use of the pericranial flap for skull base reconstruction are lacking in the literature, and its reconstructive limits, indications, and outcomes remain to be clearly defined.</div></div><div><h3>Materials and methods</h3><div>We present a descriptive observational study involving a sample of 7 patients who, between 2019 and 2025, underwent surgery at our center in which a pericranial flap was used for skull base defect reconstruction. The surgical technique employed includes an endonasal approach with a Draf III procedure, combined with an external approach allowing flap harvesting and frontal sinus opening for its insertion into the nasal cavity. A bicoronal incision is made in the scalp, the skin and galea aponeurotica are elevated anteriorly up to 1<!--> <!-->cm above the orbital rim. The flap is then elevated from the calvarium and introduced through an external osteotomy in the superior region of the frontal sinus, identified via endoscopic transillumination («money box approach»). This allows the flap to be guided into the nasal cavity and positioned to cover the existing defect, with both intracranial and extracranial coverage.</div></div><div><h3>Results</h3><div>Eighty-five percent of patients were male, with a mean age at surgery of 62.5 years. In 85% of cases, the flap was required for primary reconstruction of a defect following extensive oncologic resection, with adenocarcinoma being the most frequent histology and the transcribriform approach the most commonly used. The mean anteroposterior diameter of the defect was 4.06<!--> <!-->±<!--> <!-->1.8<!--> <!-->cm, and the mean latero-lateral diameter was 1.86<!--> <!-->±<!--> <!-->0.44<!--> <!-->cm, resulting in a mean defect area of 7.53<!--> <!-->cm<sup>2</sup>. The median postoperative hospital stay was 10 days. Postoperative complications occurred in 2<!--> <!-->cases, but only one required surgical revision due to a cerebrospinal fluid leak, which was resolved by repositioning the flap.</div></div><div><h3>Conclusion</h3><div>When endonasal flaps are not viable, the pericranial flap, due to its size, robustness, and versatility, is a highly effective surgical tool for the reconstruction of complex defects throughout the entire ventral skull base. Although most experience to date relates to anterior approaches, its use can also be considered for posterior approaches (
{"title":"Colgajo de pericráneo para la reconstrucción endoscópica de defectos de base del cráneo (money box approach): Experiencia en nuestro centro y revisión de la literatura","authors":"Fabio Fernández-Mateos , Laura Yeguas-Ramírez , Víctor Rodríguez-Berrocal , Franklin Mariño-Sánchez , Alfonso Santamaría-Gadea","doi":"10.1016/j.otorri.2025.512272","DOIUrl":"10.1016/j.otorri.2025.512272","url":null,"abstract":"<div><h3>Introduction</h3><div>One of the main challenges in the development of endoscopic surgical techniques for the treatment of nasosinusal neoplasms and skull base pathology is the reconstruction of the defects resulting from these procedures. Endonasal flaps (with the nasoseptal flap as the primary option) are typically the first-line choice for managing such defects. Unfortunately, in some cases, these flaps are either unavailable or insufficient to adequately repair the defect. In such scenarios, the pericranial flap can be employed with excellent outcomes. However, large case series describing the endoscopic use of the pericranial flap for skull base reconstruction are lacking in the literature, and its reconstructive limits, indications, and outcomes remain to be clearly defined.</div></div><div><h3>Materials and methods</h3><div>We present a descriptive observational study involving a sample of 7 patients who, between 2019 and 2025, underwent surgery at our center in which a pericranial flap was used for skull base defect reconstruction. The surgical technique employed includes an endonasal approach with a Draf III procedure, combined with an external approach allowing flap harvesting and frontal sinus opening for its insertion into the nasal cavity. A bicoronal incision is made in the scalp, the skin and galea aponeurotica are elevated anteriorly up to 1<!--> <!-->cm above the orbital rim. The flap is then elevated from the calvarium and introduced through an external osteotomy in the superior region of the frontal sinus, identified via endoscopic transillumination («money box approach»). This allows the flap to be guided into the nasal cavity and positioned to cover the existing defect, with both intracranial and extracranial coverage.</div></div><div><h3>Results</h3><div>Eighty-five percent of patients were male, with a mean age at surgery of 62.5 years. In 85% of cases, the flap was required for primary reconstruction of a defect following extensive oncologic resection, with adenocarcinoma being the most frequent histology and the transcribriform approach the most commonly used. The mean anteroposterior diameter of the defect was 4.06<!--> <!-->±<!--> <!-->1.8<!--> <!-->cm, and the mean latero-lateral diameter was 1.86<!--> <!-->±<!--> <!-->0.44<!--> <!-->cm, resulting in a mean defect area of 7.53<!--> <!-->cm<sup>2</sup>. The median postoperative hospital stay was 10 days. Postoperative complications occurred in 2<!--> <!-->cases, but only one required surgical revision due to a cerebrospinal fluid leak, which was resolved by repositioning the flap.</div></div><div><h3>Conclusion</h3><div>When endonasal flaps are not viable, the pericranial flap, due to its size, robustness, and versatility, is a highly effective surgical tool for the reconstruction of complex defects throughout the entire ventral skull base. Although most experience to date relates to anterior approaches, its use can also be considered for posterior approaches (","PeriodicalId":7019,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512272"},"PeriodicalIF":1.1,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145486433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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