Hearing loss is highly prevalent among older adults, affecting their quality of life. The aim of this study was to evaluate the audiological effectiveness of unilateral cochlear implantation (CI) in individuals over 60 years of age and to identify clinical and demographic factors influencing outcomes.
Material and methods
A single-center, longitudinal, observational, retrospective cohort study was conducted at a tertiary care hospital. Pure-tone average (PTA) thresholds and speech intelligibility (speech audiometry) were analyzed, complemented with the SSQ-12 and HISQUI-19 sound quality questionnaires. Non-parametric tests (Mann–Whitney, Kruskal–Wallis) were applied in the absence of normality, as well as Spearman’s rho correlation and linear regression to examine associations between clinical and demographic variables and audiological outcomes.
Results
A cohort of 278 cochlear implant recipients aged 60 years or older was assessed. The final sample included 99 participants (71 implanted at ≥ 60 years after stratified random sampling; 28 implanted between 55–59 years). The mean implantation age was 67.7 ± 5.8 years. The mean postoperative PTA was 37.65 ± 10.71 dB, with a functional gain of 63.6 dB compared to preoperative levels. Mean speech intelligibility reached 53 ± 24.57%. Although initial associations suggested that younger implantation age and shorter duration of auditory deprivation correlated with better audiological outcomes, subsequent regression analyses did not confirm a statistically significant independent association for these variables. Non-native Spanish language use was identified as a significant negative predictor of intelligibility. Poorer thresholds were associated with family history of hearing loss (p = 0.01) and lower body mass index (p = 0.005). Among complications (8.4%), the most relevant were three CI explantation/reimplantation cases (3%).
Conclusions
Unilateral cochlear implantation is highly effective in adults over 60 years, restoring functional hearing. Overall results are comparable to younger populations, supporting the indication of cochlear implantation in older adults. Speech intelligibility showed high interindividual variability, partially explained by non-native Spanish language use. Regression analysis showed that neither implantation age nor duration of auditory deprivation had an independent association with outcomes in this cohort, and therefore should not be considered contraindications for CI. The finding that 50.5% of cases had a family history of hearing loss suggests the need to expand genetic testing in adult CI candidates. The low complication rate (8.4%) confirms the safety of cochlear implantation.
{"title":"Effectiveness of unilateral cochlear implantation in people over 60 years","authors":"Beatriz Tena-García , Sergio Barrientos Trigo , Francisco Ropero Romero , Serafín Sánchez-Gómez","doi":"10.1016/j.otoeng.2025.512285","DOIUrl":"10.1016/j.otoeng.2025.512285","url":null,"abstract":"<div><h3>Background and objective</h3><div>Hearing loss is highly prevalent among older adults, affecting their quality of life. The aim of this study was to evaluate the audiological effectiveness of unilateral cochlear implantation (CI) in individuals over 60 years of age and to identify clinical and demographic factors influencing outcomes.</div></div><div><h3>Material and methods</h3><div>A single-center, longitudinal, observational, retrospective cohort study was conducted at a tertiary care hospital. Pure-tone average (PTA) thresholds and speech intelligibility (speech audiometry) were analyzed, complemented with the SSQ-12 and HISQUI-19 sound quality questionnaires. Non-parametric tests (Mann–Whitney, Kruskal–Wallis) were applied in the absence of normality, as well as Spearman’s rho correlation and linear regression to examine associations between clinical and demographic variables and audiological outcomes.</div></div><div><h3>Results</h3><div>A cohort of 278 cochlear implant recipients aged 60 years or older was assessed. The final sample included 99 participants (71 implanted at ≥ 60 years after stratified random sampling; 28 implanted between 55–59 years). The mean implantation age was 67.7 ± 5.8 years. The mean postoperative PTA was 37.65 ± 10.71 dB, with a functional gain of 63.6 dB compared to preoperative levels. Mean speech intelligibility reached 53 ± 24.57%. Although initial associations suggested that younger implantation age and shorter duration of auditory deprivation correlated with better audiological outcomes, subsequent regression analyses did not confirm a statistically significant independent association for these variables. Non-native Spanish language use was identified as a significant negative predictor of intelligibility. Poorer thresholds were associated with family history of hearing loss (p = 0.01) and lower body mass index (p = 0.005). Among complications (8.4%), the most relevant were three CI explantation/reimplantation cases (3%).</div></div><div><h3>Conclusions</h3><div>Unilateral cochlear implantation is highly effective in adults over 60 years, restoring functional hearing. Overall results are comparable to younger populations, supporting the indication of cochlear implantation in older adults. Speech intelligibility showed high interindividual variability, partially explained by non-native Spanish language use. Regression analysis showed that neither implantation age nor duration of auditory deprivation had an independent association with outcomes in this cohort, and therefore should not be considered contraindications for CI. The finding that 50.5% of cases had a family history of hearing loss suggests the need to expand genetic testing in adult CI candidates. The low complication rate (8.4%) confirms the safety of cochlear implantation.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512285"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331084","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}
Unilateral vocal cord paralysis (UVCP) is a condition that directly affects laryngeal functions. While most cases have an organic cause, idiopathic cases have also been described. Patients with UVCP often experience symptoms that impact not only their vocal abilities but also their nutritional and social well-being. Our primary objective is to validate a self-assessment questionnaire for patients with UVCP and unilateral vocal immobility, incorporating questions that cover all possible symptoms of this condition, adapted to the Spanish spoken in Spain.
Methodology
This is a prospective observational study using the PVU-HI-10 questionnaire, which assesses the functional, physical, and emotional impact of UVCP-related symptoms. For validation, we statistically evaluated test-retest reliability, item-total correlation, internal consistency, concurrent validity, and discriminative validity, with sensitivity and specificity analysis. A total of 62 subjects participated: 33 patients (case group) and 29 healthy individuals (control group). All participants completed the PVU-HI-10 questionnaire twice, with a three-week interval between assessments and no treatment administered between them. The maximum phonation time (MPT) was used as the objective reference measure.
Results
The test-retest reliability was high, with an intraclass correlation coefficient (ICC) of 0.95. Internal consistency, measured using McDonald's omega coefficient, was 0.91 for the case group and 0.94 for the control group. The correlation between MPT and questionnaire scores was strong and inversely related (−0.61 and −0.67, respectively). Discriminative validity was demonstrated using the ROC curve, with a cutoff point of 12.1, yielding a sensitivity of 82% and a specificity of 93.1%.
Conclusions
In the management of unilateral vocal immobility, it is essential to consider the degree of disability caused by the symptoms. The PVU-HI-10 is a condition-specific questionnaire that has shown high reliability and validity. It is a brief, simple test that provides a numerical result, allowing for the quantification and comparison of treatment outcomes. This makes it a useful tool in the evaluation protocol for patients with unilateral vocal paralysis in Spanish-speaking populations.
{"title":"Validation of the self-assessment questionnaire for patients with unilateral vocal cord paralysis (PVU-HI-10) in Spanish","authors":"Rosa Hernández-Sandemetrio , Natsuki Oishi , Isabel López , Cristina Rodríguez-Prado , Isabel García-Lopez , Enrique Zapater","doi":"10.1016/j.otoeng.2025.512271","DOIUrl":"10.1016/j.otoeng.2025.512271","url":null,"abstract":"<div><h3>Introduction and objective</h3><div>Unilateral vocal cord paralysis (UVCP) is a condition that directly affects laryngeal functions. While most cases have an organic cause, idiopathic cases have also been described. Patients with UVCP often experience symptoms that impact not only their vocal abilities but also their nutritional and social well-being. Our primary objective is to validate a self-assessment questionnaire for patients with UVCP and unilateral vocal immobility, incorporating questions that cover all possible symptoms of this condition, adapted to the Spanish spoken in Spain.</div></div><div><h3>Methodology</h3><div>This is a prospective observational study using the PVU-HI-10 questionnaire, which assesses the functional, physical, and emotional impact of UVCP-related symptoms. For validation, we statistically evaluated test-retest reliability, item-total correlation, internal consistency, concurrent validity, and discriminative validity, with sensitivity and specificity analysis. A total of 62 subjects participated: 33 patients (case group) and 29 healthy individuals (control group). All participants completed the PVU-HI-10 questionnaire twice, with a three-week interval between assessments and no treatment administered between them. The maximum phonation time (MPT) was used as the objective reference measure.</div></div><div><h3>Results</h3><div>The test-retest reliability was high, with an intraclass correlation coefficient (ICC) of 0.95. Internal consistency, measured using McDonald's omega coefficient, was 0.91 for the case group and 0.94 for the control group. The correlation between MPT and questionnaire scores was strong and inversely related (−0.61 and −0.67, respectively). Discriminative validity was demonstrated using the ROC curve, with a cutoff point of 12.1, yielding a sensitivity of 82% and a specificity of 93.1%.</div></div><div><h3>Conclusions</h3><div>In the management of unilateral vocal immobility, it is essential to consider the degree of disability caused by the symptoms. The PVU-HI-10 is a condition-specific questionnaire that has shown high reliability and validity. It is a brief, simple test that provides a numerical result, allowing for the quantification and comparison of treatment outcomes. This makes it a useful tool in the evaluation protocol for patients with unilateral vocal paralysis in Spanish-speaking populations.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512271"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214701","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}
Petrous bone cholesteatoma (PBC) is a rare, potentially life-threatening condition requiring surgical management to prevent severe complications. While classification systems, such as Sanna’s, are widely used to guide surgical planning, actual decision-making is often influenced by additional clinical factors beyond lesion type.
Material and methods
A retrospective analysis of 94 PBCs in 92 patients operated between 1995 and 2024 was conducted. Data included demographics, clinical presentation, PBC classification, surgical approach, use of endoscopic assistance, recurrence, follow-up, and hearing rehabilitation. The aim of this study is to describe the surgical strategies applied to different PBC types in a series of 94 cases, evaluate the practical utility of classification systems, and propose a decision-making approach based on inner ear involvement and other critical factors
Results
The most common PBC type was supralabyrinthine (40.43%), followed by massive (18.09%) and retrolabyrinthine-infralabyrinthine (11.7%). A total of 102 surgeries were performed using various approaches, including modified translabyrinthine (24.51%), subtotal petrosectomy (22.55%), and transotic approach (18.63%). Endoscopic assistance was used in 11 cases. Recurrence occurred in 8.51% of cases, with a median follow-up of 48.5 months. Cochlear implantation was used in 8 patients and bone conduction implants in 3.
Conclusions
PBC classification provides valuable insights for understanding lesion behavior and planning surgery, but it is insufficient alone for determining the optimal surgical approach. Decisions must be individualized, considering hearing status, inner ear and facial nerve involvement, contralateral ear function, lesion extension, and anatomical factors. A classification-based strategy complemented by these considerations ensures safer and more effective management of PBC.
{"title":"Decision-making in Petrous Bone Cholesteatoma (PBC): Surgical options according to PBC classification","authors":"Monica Rueda Vega , Montserrat Asensi-Diaz , Carolina López Granados , Carlos Martín Oviedo , Ignacio Arístegui Torrano , Miguel Arístegui Ruiz","doi":"10.1016/j.otoeng.2025.512277","DOIUrl":"10.1016/j.otoeng.2025.512277","url":null,"abstract":"<div><h3>Introduction</h3><div>Petrous bone cholesteatoma (PBC) is a rare, potentially life-threatening condition requiring surgical management to prevent severe complications. While classification systems, such as Sanna’s, are widely used to guide surgical planning, actual decision-making is often influenced by additional clinical factors beyond lesion type.</div></div><div><h3>Material and methods</h3><div>A retrospective analysis of 94 PBCs in 92 patients operated between 1995 and 2024 was conducted. Data included demographics, clinical presentation, PBC classification, surgical approach, use of endoscopic assistance, recurrence, follow-up, and hearing rehabilitation. The aim of this study is to describe the surgical strategies applied to different PBC types in a series of 94 cases, evaluate the practical utility of classification systems, and propose a decision-making approach based on inner ear involvement and other critical factors</div></div><div><h3>Results</h3><div>The most common PBC type was supralabyrinthine (40.43%), followed by massive (18.09%) and retrolabyrinthine-infralabyrinthine (11.7%). A total of 102 surgeries were performed using various approaches, including modified translabyrinthine (24.51%), subtotal petrosectomy (22.55%), and transotic approach (18.63%). Endoscopic assistance was used in 11 cases. Recurrence occurred in 8.51% of cases, with a median follow-up of 48.5 months. Cochlear implantation was used in 8 patients and bone conduction implants in 3.</div></div><div><h3>Conclusions</h3><div>PBC classification provides valuable insights for understanding lesion behavior and planning surgery, but it is insufficient alone for determining the optimal surgical approach. Decisions must be individualized, considering hearing status, inner ear and facial nerve involvement, contralateral ear function, lesion extension, and anatomical factors. A classification-based strategy complemented by these considerations ensures safer and more effective management of PBC.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512277"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058847","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.otoeng.2025.512273
Alberto Codina , Berta Alegre , Elena Hernández-Montero , Jorge Vega , Miguel Caballero-Borrego , Francisco Larrosa
Background and objective
The Chronic Otitis Media Questionnaire-12 (COMQ-12) and the Chronic Otitis Media Benefits Inventory (COMBI) seek to assess the quality of life related to chronic otitis media or its surgical treatment. The objective of this study was to determine and evaluate the scores of the Spanish versions of the COMQ-12 and the COMBI.
Materials and methods
Multicenter retrospective study. Mean scores of the Spanish versions (COMQ-12-Spa and COMBI-Spa) were compared in consecutive adult patients diagnosed with chronic otitis media (COM), with or without cholesteatoma, undergoing tympanoplasty with and/or mastoidectomy and in a separate cohort of unaffected adults.
Results
120 patients and 60 unnaffected adults completed the study. The mean score of the COMQ-12-Spa in patients with COM and in healthy adults was 22.95 ± 11.72 and 0.8 ± 1.3 respectively (p < 0.0001). COMQ-12-Spa did not discriminate between COM without (21.9 ± 10.45) and with cholesteatoma (23.82 ± 9.53) (P > 0.05). COMBI-Spa showed a mean postoperative score of 46.02 ± 9.08 and was not able to discriminate between tympanoplasty without mastoidectomy (48.01 ± 8.09) and mastoidectomy (45.32 ± 10.03) (P > 0.05).
Conclusions
The COMQ-12-Spa and the COMBI-Spa allow the pre- and post-intervention evaluation of the subjective severity of COM in adult patients in our setting, so their use is recommended.
{"title":"Results of the Spanish versions of the Chronic otitis media questionnaire-12 (COMQ-12) and Chronic otitis media benefit inventory (COMBI) in patients and controls in our environment","authors":"Alberto Codina , Berta Alegre , Elena Hernández-Montero , Jorge Vega , Miguel Caballero-Borrego , Francisco Larrosa","doi":"10.1016/j.otoeng.2025.512273","DOIUrl":"10.1016/j.otoeng.2025.512273","url":null,"abstract":"<div><h3>Background and objective</h3><div>The Chronic Otitis Media Questionnaire-12 (COMQ-12) and the Chronic Otitis Media Benefits Inventory (COMBI) seek to assess the quality of life related to chronic otitis media or its surgical treatment. The objective of this study was to determine and evaluate the scores of the Spanish versions of the COMQ-12 and the COMBI.</div></div><div><h3>Materials and methods</h3><div>Multicenter retrospective study. Mean scores of the Spanish versions (COMQ-12-Spa and COMBI-Spa) were compared in consecutive adult patients diagnosed with chronic otitis media (COM), with or without cholesteatoma, undergoing tympanoplasty with and/or mastoidectomy and in a separate cohort of unaffected adults.</div></div><div><h3>Results</h3><div>120 patients and 60 unnaffected adults completed the study. The mean score of the COMQ-12-Spa in patients with COM and in healthy adults was 22.95 ± 11.72 and 0.8 ± 1.3 respectively (p < 0.0001). COMQ-12-Spa did not discriminate between COM without (21.9 ± 10.45) and with cholesteatoma (23.82 ± 9.53) (<em>P</em> > 0.05). COMBI-Spa showed a mean postoperative score of 46.02 ± 9.08 and was not able to discriminate between tympanoplasty without mastoidectomy (48.01 ± 8.09) and mastoidectomy (45.32 ± 10.03) (<em>P</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>The COMQ-12-Spa and the COMBI-Spa allow the pre- and post-intervention evaluation of the subjective severity of COM in adult patients in our setting, so their use is recommended.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512273"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228332","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.otoeng.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 centre. 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 centre 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 min. 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 centres where sialendoscopy or lithotripsy is unavailable or has failed.
{"title":"Ultrasound-guided transfacial approach in the surgical management of impacted parotid stones: Beyond sialendoscopy","authors":"Carlos Miguel Chiesa-Estomba , Maria Landa-Garmendia , Aitor Vargas-Álvarez , Carlos Saga-Gutierrez","doi":"10.1016/j.otoeng.2025.512284","DOIUrl":"10.1016/j.otoeng.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 centre. 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 centre 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 min. 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 centres where sialendoscopy or lithotripsy is unavailable or has failed.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512284"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331094","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.otoeng.2025.512291
Juan Maza-Solano , Vicente Merino-Bohórquez , Ana Gómez-Bastero , Julio Delgado-Romero , Serafín Sánchez-Gomez
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease with a significant impact on quality of life. Benralizumab has shown efficacy in severe eosinophilic asthma, but there is limited evidence for CRSwNP. A prospective observational study was conducted in a tertiary hospital with six adults with severe CRSwNP, according to EPOS2020 criteria, treated for 52 weeks. All had multiple surgeries (mean 3.3) and high cumulative exposure to systemic corticosteroids. Initially, they presented a high symptom and endoscopic burden (SNOT-22: 72; NPS: 5.2). After 16 and 52 weeks, significant improvements were observed in SNOT-22 (40.3 and 28.8), NPS (4.3 and 2.7), corticosteroid use, and complete eosinophil depletion. VAS scores improved, especially in smell, rhinorrhea, and general condition. No significant adverse events occurred. These preliminary results suggest that benralizumab may be effective in CRSwNP without associated asthma, although larger controlled studies are needed.
{"title":"Real-life outcomes of benralizumab treatment in chronic rhinosinusitis with nasal polyps: The BenREALizumab study","authors":"Juan Maza-Solano , Vicente Merino-Bohórquez , Ana Gómez-Bastero , Julio Delgado-Romero , Serafín Sánchez-Gomez","doi":"10.1016/j.otoeng.2025.512291","DOIUrl":"10.1016/j.otoeng.2025.512291","url":null,"abstract":"<div><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease with a significant impact on quality of life. Benralizumab has shown efficacy in severe eosinophilic asthma, but there is limited evidence for CRSwNP. A prospective observational study was conducted in a tertiary hospital with six adults with severe CRSwNP, according to EPOS2020 criteria, treated for 52 weeks. All had multiple surgeries (mean 3.3) and high cumulative exposure to systemic corticosteroids. Initially, they presented a high symptom and endoscopic burden (SNOT-22: 72; NPS: 5.2). After 16 and 52 weeks, significant improvements were observed in SNOT-22 (40.3 and 28.8), NPS (4.3 and 2.7), corticosteroid use, and complete eosinophil depletion. VAS scores improved, especially in smell, rhinorrhea, and general condition. No significant adverse events occurred. These preliminary results suggest that benralizumab may be effective in CRSwNP without associated asthma, although larger controlled studies are needed.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512291"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145246093","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.otoeng.2025.512278
Carlos M. Chiesa-Estomba, Alfonso Rodriguez-Urzay, Maria Landa-Garmendia, Aitor Vargas-Alvarez, Ehkiñe Larruscain-Sarasola, Jose A. González-García, Maider Andueza-Guembe, Jon A. Sistaga-Suarez
Introduction
Hypopharyngeal squamous cell carcinoma (HPSCC) is a highly aggressive malignancy with poor prognosis due to late-stage diagnosis and complex anatomical challenges. Advances in minimally invasive techniques, particularly transoral laser microsurgery (CO2TOLMS), have demonstrated promise in improving oncologic and functional outcomes while preserving organ function.
Materials and methods
A retrospective study analyzed 25 patients with histologically confirmed HPSCC treated with CO2TOLMS at a tertiary academic hospital (2016–2021). Patients underwent curative-intent CO2TOLMS, with outcomes assessed for survival, recurrence, and functional recovery.
Results
The 3-year overall survival and disease-specific survival rates were 72% and 84%, respectively. Surgical margins were disease-free in 76% of patients, while postoperative complications were minimal (persistent tracheostomy in 4%, long-term nasogastric feeding tube dependency in 4%). Local and regional recurrence rates were each 8%. Laryngeal preservation was achieved in 95% of cases, significantly enhancing quality of life. Histologic grade correlated with recurrence risk, though survival outcomes were consistent across tumor stages and surgical margin status.
Conclusions
CO2TOLMS offers an effective and minimally invasive treatment for early-stage HPSCC, achieving good oncological and functional outcomes. While it provides low morbidity and high organ preservation rates, further research is needed to refine multimodal treatment strategies for advanced-stage disease.
{"title":"Transoral CO2 laser microsurgery for early hypopharyngeal cancer: Still a viable option?","authors":"Carlos M. Chiesa-Estomba, Alfonso Rodriguez-Urzay, Maria Landa-Garmendia, Aitor Vargas-Alvarez, Ehkiñe Larruscain-Sarasola, Jose A. González-García, Maider Andueza-Guembe, Jon A. Sistaga-Suarez","doi":"10.1016/j.otoeng.2025.512278","DOIUrl":"10.1016/j.otoeng.2025.512278","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypopharyngeal squamous cell carcinoma (HPSCC) is a highly aggressive malignancy with poor prognosis due to late-stage diagnosis and complex anatomical challenges. Advances in minimally invasive techniques, particularly transoral laser microsurgery (CO<sub>2</sub>TOLMS), have demonstrated promise in improving oncologic and functional outcomes while preserving organ function.</div></div><div><h3>Materials and methods</h3><div>A retrospective study analyzed 25 patients with histologically confirmed HPSCC treated with CO<sub>2</sub>TOLMS at a tertiary academic hospital (2016–2021). Patients underwent curative-intent CO<sub>2</sub>TOLMS, with outcomes assessed for survival, recurrence, and functional recovery.</div></div><div><h3>Results</h3><div>The 3-year overall survival and disease-specific survival rates were 72% and 84%, respectively. Surgical margins were disease-free in 76% of patients, while postoperative complications were minimal (persistent tracheostomy in 4%, long-term nasogastric feeding tube dependency in 4%). Local and regional recurrence rates were each 8%. Laryngeal preservation was achieved in 95% of cases, significantly enhancing quality of life. Histologic grade correlated with recurrence risk, though survival outcomes were consistent across tumor stages and surgical margin status.</div></div><div><h3>Conclusions</h3><div>CO<sub>2</sub>TOLMS offers an effective and minimally invasive treatment for early-stage HPSCC, achieving good oncological and functional outcomes. While it provides low morbidity and high organ preservation rates, further research is needed to refine multimodal treatment strategies for advanced-stage disease.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512278"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058830","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}
Neonatal nasal obstruction, though rare, can be life-threatening due to the obligate nasal breathing pattern in newborns. Even partial obstruction may compromise ventilation and feeding.
This study aims to describe rare anatomical causes of neonatal nasal obstruction, highlighting their clinical presentation, diagnostic evaluation, and management.
A retrospective review was conducted of four neonates with respiratory distress who were diagnosed with congenital nasal malformations through endoscopic examination and craniofacial imaging. The identified cases included bilateral choanal atresia in a patient with CHARGE syndrome, congenital nasal pyriform aperture stenosis (CNPAS) with a solitary median mega-incisor, isolated CNPAS with midnasal hypoplasia, and bilateral congenital dacryocystoceles. Symptoms ranged from noisy breathing to feeding intolerance. Management included both medical and surgical interventions depending on the severity of the obstruction.
Although infrequent, anatomical nasal anomalies should be promptly considered in neonates presenting with respiratory distress, as early diagnosis and appropriate treatment are essential to avoid complications and ensure favourable outcomes.
{"title":"Newborn nasal obstruction: Rare anatomical causes to consider","authors":"Montserrat Asensi-Diaz , Alejandro Lowy Benoliel , Juan Antonio Pasamontes Pingarron , Ismael Nieva Pascual , Pilar Cifuentes Canorea , Monica Hernando Cuñado","doi":"10.1016/j.otoeng.2025.512279","DOIUrl":"10.1016/j.otoeng.2025.512279","url":null,"abstract":"<div><div>Neonatal nasal obstruction, though rare, can be life-threatening due to the obligate nasal breathing pattern in newborns. Even partial obstruction may compromise ventilation and feeding.</div><div>This study aims to describe rare anatomical causes of neonatal nasal obstruction, highlighting their clinical presentation, diagnostic evaluation, and management.</div><div>A retrospective review was conducted of four neonates with respiratory distress who were diagnosed with congenital nasal malformations through endoscopic examination and craniofacial imaging. The identified cases included bilateral choanal atresia in a patient with CHARGE syndrome, congenital nasal pyriform aperture stenosis (CNPAS) with a solitary median mega-incisor, isolated CNPAS with midnasal hypoplasia, and bilateral congenital dacryocystoceles. Symptoms ranged from noisy breathing to feeding intolerance. Management included both medical and surgical interventions depending on the severity of the obstruction.</div><div>Although infrequent, anatomical nasal anomalies should be promptly considered in neonates presenting with respiratory distress, as early diagnosis and appropriate treatment are essential to avoid complications and ensure favourable outcomes.</div></div>","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512279"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058809","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.otoeng.2025.512272
Fabio Fernández-Mateos , Laura Yeguas-Ramírez , Victor 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 two 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 (such as transclival) with favorable outcomes. For this reason, it is recommended as the
{"title":"Pericranial flap for endoscopic reconstruction of skull base defects (“money box approach”): Experience at our center and literature review","authors":"Fabio Fernández-Mateos , Laura Yeguas-Ramírez , Victor Rodríguez-Berrocal , Franklin Mariño-Sánchez , Alfonso Santamaría-Gadea","doi":"10.1016/j.otoeng.2025.512272","DOIUrl":"10.1016/j.otoeng.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 two 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 (such as transclival) with favorable outcomes. For this reason, it is recommended as the ","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":"76 6","pages":"Article 512272"},"PeriodicalIF":0.0,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145214727","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 : 2025-10-17DOI: 10.1016/j.otoeng.2025.512296
Sofiya Yusina, Nupur Bhatt, Gabriel Pujol Cuevas, Michael Persky
{"title":"Massive neck lipoma causing severe upper aerodigestive tract compression and symptoms: a case report.","authors":"Sofiya Yusina, Nupur Bhatt, Gabriel Pujol Cuevas, Michael Persky","doi":"10.1016/j.otoeng.2025.512296","DOIUrl":"10.1016/j.otoeng.2025.512296","url":null,"abstract":"","PeriodicalId":93855,"journal":{"name":"Acta otorrinolaringologica espanola","volume":" ","pages":"512296"},"PeriodicalIF":0.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145331075","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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