Otolaryngol Head Neck Surg [JOURNAL]
Sun
200 papers
Outcomes of Osia 2 Implantation With and Without Concurrent Microtia Reconstruction.
Nelson L, Losorelli S, Chang KW … +1 more , Truong MT
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41618827 · Publisher ↗
OBJECTIVE: The Cochlear Osia 2 system is a bone-conduction device (BCD) that is effective for conductive, mixed hearing loss, and single-sided deafness. Limited data exist on Osia 2 outcomes in pediatric patients with mi...
OBJECTIVE: The Cochlear Osia 2 system is a bone-conduction device (BCD) that is effective for conductive, mixed hearing loss, and single-sided deafness. Limited data exist on Osia 2 outcomes in pediatric patients with microtia. This study aimed to compare Osia 2 implantation performed concurrently with microtia reconstruction versus Osia 2 implantation alone, and to investigate surgical techniques and variables impacting complication rates and outcomes. STUDY DESIGN: Retrospective case series. SETTING: Pediatric tertiary care center. METHODS: Patients who underwent Cochlear Osia 2 device implantation between June 2020 and December 2024 were identified. Data was collected on postoperative complications, presence of prior BCD, incision type, coil placement location, and concurrent surgical procedures. Complications were classified as minor or major based upon need for operative intervention. RESULTS: Of the 113 included cases and 129 operated ears, 42.5% (n = 48) underwent Osia implantation alone, 37.2% (n = 42) underwent concurrent microtia repair, and 20.3% (n = 23) underwent other concurrent otologic procedures. Minor complication rate was 10.9%, major complication rate was 14.0%, and device explant rate was 10.1%. Complication rates did not significantly differ between concurrent microtia cases versus Osia alone (19.0% vs 33.8%, RD -14.8%, 95% CI: -35.4% to 9.4%; P = .092), between cases with prior BCD versus those without (42.3% vs 24.1%, RD 18.2%, 95% CI: -8.5% to 44.7%; P = .071), nor between subperiosteal versus subcutaneous coil placement (27.5% vs 27.9%, RD 0.4%, 95% CI: -56.7% to 1.2%; P = .966). CONCLUSION: Osia 2 implantation is safe to perform concurrently with microtia reconstruction. Factors including prior BCD, coil placement location, and implant physical characteristics may impact postoperative outcomes, however, further studies are needed to better characterize practices and patient factors that influence outcomes.
Effect of Nasoseptal Flap With Nasal Floor Extension on Postoperative Numbness and Recovery of Sensation.
Kim D, Lee C, Ryu G … +5 more , Kong DS, Lee WJ, Kim HY, Jung YG, Hong SD
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41614369 · Publisher ↗
OBJECTIVE: Nasoseptal flap (NSF) with floor extension provides wide coverage for skull base reconstruction but transects the nasopalatine nerve, potentially resulting in numbness of the front teeth and palate. The aim of...
OBJECTIVE: Nasoseptal flap (NSF) with floor extension provides wide coverage for skull base reconstruction but transects the nasopalatine nerve, potentially resulting in numbness of the front teeth and palate. The aim of this study was to evaluate the incidence of postoperative numbness, recovery of sensation, and anatomical predictors. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary center. METHODS: We retrospectively analyzed 160 patients who underwent endoscopic transseptal skull base surgery and categorized them as non-NSF (n = 75), NSF without floor extension (n = 7), and NSF with floor extension (n = 78). The primary outcome was patient-reported numbness of the front teeth or palate as assessed during hospitalization and at 3 months. The incisive canal, through which paired NPNs from the nasal cavities pass into the oral cavity, was classified on preoperative computed tomography (CT) as single (one channel receiving bilateral nerves), separated (two channels with bilateral separation), or intermediate (Y-shaped channel). RESULTS: Immediate numbness occurred in 5.3%, 14.3%, and 32.1% of those groups, respectively (P < .001). At 3 months, persistent numbness was reported, respectively, in 1.3%, 0%, and 10.4%, with a significant difference between non-NSF and NSF with floor extension (P = .034). Immediate numbness occurred in 29.7% of those with a single canal and 11.3% of those with a separated canal (P = .021). CONCLUSION: NSF with floor extension increased the incidence of numbness and should be avoided when possible. Patients with a single canal on preoperative CT require careful surgical attention.
Tonsillar Asymmetry and Malignancy: A Meta-analysis of Diagnostic Accuracy.
Gao EY, See ASY, Tan BKJ … +9 more , Chan SWD, Zhou Y, See A, Kiong KL, Chan CY, Koh LH, Tan HKK, Abhilash B, Lim CM
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41614350 · Publisher ↗
OBJECTIVE: To investigate the diagnostic utility of asymmetrical tonsils in detecting tonsillar malignancy. DATA SOURCES: PubMed, Embase, Scopus, and Cochrane Library; from inception until December 17, 2024. REVIEW METHO...
OBJECTIVE: To investigate the diagnostic utility of asymmetrical tonsils in detecting tonsillar malignancy. DATA SOURCES: PubMed, Embase, Scopus, and Cochrane Library; from inception until December 17, 2024. REVIEW METHODS: We included observational studies of adult/pediatric patients undergoing excisional tonsillectomy or incisional tonsillar biopsy that reported at least one diagnostic accuracy outcome for tonsillar asymmetry in predicting malignancy. We pooled estimates using frequentist univariate random-effects generalized linear mixed models, examined and adjusted for publication bias via visual inspection, Egger's test, and trim-and-fill, performed influence and cumulative meta-analyses, and used a Bayesian bivariate model as a sensitivity analysis. Outcome measures included the following: sensitivity, specificity, positive/negative likelihood ratio (LR+/LR-), and positive/negative predictive value (NPV/PPV) with 95% confidence interval (95% CI). RESULTS: Twenty-nine studies (5178 participants) from 422 records were included. The risk of bias was low-moderate. The sensitivity and specificity of tonsillar asymmetry as a diagnostic marker for malignancy were 77.2% (95% CI: 68.6%-84.0%) and 96.4% (95% CI: 91.6%-98.6%), respectively. The LR- was 0.24 (0.17-0.34) and LR+ was 21.44 (8.05-57.0). The NPV and PPV were 99.8% (95% CI: 99.1%-99.9%) and 4.31% (95% CI: 1.83%-9.80%), without considering clinical risks. With concomitant high-risk clinical features such as lymphadenopathy, the PPV (probability of malignancy given asymmetrical tonsils) was 38.5% (30.3%-47.4%). Without other high-risk features, the PPV was 0.16% (0.15%-0.18%). The overall quality of evidence was high. CONCLUSION: Tonsillar asymmetry has a high specificity and moderate sensitivity for tonsillar malignancy. Due to the low prevalence of malignancy, the probability of malignancy is less than 1% if no other suspicious clinical features are present.
Open Partial Horizontal Laryngectomies: Functional and Oncologic Outcomes.
Rodrigáñez L, Gómez-Camacho H, Castro A … +3 more , Del Palacio A, Bernáldez R, Gavilán J
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41609393 · Publisher ↗
OBJECTIVE: Since the development of the chemoradiation protocols and the transoral technology-based procedures, the use of Open Partial Horizontal Laryngectomies (OPHL) has been discontinued in many centers. We aim to an...
OBJECTIVE: Since the development of the chemoradiation protocols and the transoral technology-based procedures, the use of Open Partial Horizontal Laryngectomies (OPHL) has been discontinued in many centers. We aim to analyze OPHL in terms of oncologic and functional results. STUDY DESIGN: Retrospective case series. SETTING: University-affiliated tertiary care center. METHODS: All patients with laryngeal squamous cell carcinoma who underwent open horizontal supraglottic laryngectomy (OHSL) and supracricoid partial laryngectomy (SCPL) between 2000 and 2020 at our institution were included. RESULTS: One hundred twelve patients were identified. 89% were male, with a mean age of 58 years old. Seventy had supraglottic tumors, while 42 had glottic tumors. OHSL was performed in 61 patients, while SCPL was in 51, of whom an arytenoid was resected in 9 patients and the epiglottis in 7. The series includes 30.4% T3-T4 classified tumors. Postoperative pneumonia appeared in 13.4% of patients. Decannulation was achieved in 93% of patients at a median of 14 days. The feeding tube was discontinued in 95% of patients at a median of 20 days. The mean follow-up was 91 months. The 5-year-LC rate was 90.2% in T1-T2 classified tumors and 80.9% in T3-T4 classified tumors. The 5-years-LEDFS was 72.1%. Total laryngectomy was performed in 14 patients: 11 following locoregional recurrence and the remaining 3 for functional reasons. Eleven patients maintained a tracheostomy or feeding tube for over 2 years. CONCLUSION: OPHL in selected patients with early and locally-advanced laryngeal tumors allows oncological results comparable to total laryngectomy while obtaining excellent stable functional results.
Treatment of P16-Negative/HPV-Negative Oropharyngeal Squamous Cell Carcinoma: A Survey of AHNS Membership.
Bulbul MG, de Almeida JR, Gross ND … +1 more , Turner MT
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41609382 · Publisher ↗
OBJECTIVE: To investigate practice patterns in the treatment of p16-negative/human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) among members of the American Head and Neck Society (AHNS). S...
OBJECTIVE: To investigate practice patterns in the treatment of p16-negative/human papillomavirus (HPV)-negative oropharyngeal squamous cell carcinoma (OPSCC) among members of the American Head and Neck Society (AHNS). STUDY DESIGN: Cross-sectional. SETTING: Online electronic survey. METHODS: An online survey was distributed via AHNS survey system. Participation was voluntary, and data were anonymously collected. RESULTS: 108 members (7.7% of AHNS members) responded. Most (65.7%) had ≥5 years of experience in the field. Few practitioners (23.2% always and 10.2% frequently) confirmed HPV-negative status with DNA/RNA in situ hybridization or PCR testing for p16-negative tumors. Most surgeons (60.2%) reported recommending TORS for identification of an unknown primary in a patient with p16-/HPV-negative neck mass. Similarly, at least half (56.5%) of surgeons indicated always or frequently treating resectable T1-T3 with TORS. The majority (73.2%) of surgeons indicated infrequently (59.3%) or never (13.9%) treating T3/T4 with traditional open surgery as first line. More than half of the surgeons (57.4%) believed survival is better with surgery compared to definitive nonsurgical therapy for HPV-negative OPSCC. There was wide variation in the use of treatment intensification (dual modality adjuvant treatment for T1-2N0, or tri-modality treatment for T1-T2N1), with 19.4% reporting never, 36.1% infrequently, 34.3% frequently, and 10.2% always doing so. CONCLUSIONS: A majority of AHNS surgeons (57.4%) believe survival for HPV-negative OPSCC is better with surgery. Most (56.5%) would treat resectable T1-T3 tumors with TORS, while the minority (26.8%) would frequently or always operate on T3-T4 tumors. There was wide variation in practice with respect to treatment intensifiication owing to remaining knowledge gaps in the field.
Outcomes of Minimally Invasive Transoral Surgery in HPV-Negative Oropharyngeal Cancer.
Chang KW, Peterson AM, Tharakan T … +5 more , Puram SV, Pipkorn P, Zolkind PA, Harbison RA, Jackson RS
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41609367 · Publisher ↗
OBJECTIVE: To describe the clinical predictors of survival, disease control, and functional outcomes in patients with HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) who underwent primary transoral surgery (TO...
OBJECTIVE: To describe the clinical predictors of survival, disease control, and functional outcomes in patients with HPV-negative oropharyngeal squamous cell carcinoma (OPSCC) who underwent primary transoral surgery (TOS). STUDY DESIGN: Retrospective cohort study. SETTING: The study was conducted in a high-volume, NCI-designated tertiary care setting. METHODS: Patients with HPV-negative OPSCC who underwent primary definitive TOS with risk-adapted adjuvant therapy (1998-2020) were identified. The primary outcome measures were overall survival (OS) and recurrence-free survival (RFS). Secondary outcomes included postoperative gastrostomy tube (G-tube) rates, tracheostomy rates, and functional outcome swallowing scale (FOSS) scores. RESULTS: A total of 89 patients were treated with TOS for HPV-negative OPSCC. The majority of patients presented with late-stage disease (stage III/IV, 73%); 79% with early tumor stage (T1/T2) and 71% with positive nodal disease. Three-year estimates for OS and RFS for the entire cohort were 67.2% and 63.3% respectively. Advanced tumor stage predicted worsened OS [HR 3.23, 95% CI 1.75-5.95] and RFS [HR 2.38, 95% CI 1.13-5.01] on univariable analysis. Stage III/IV disease was associated with worsened OS [HR 2.16, 95% CI 1.01-4.63], but not RFS. Thirty-two patients (36%) recurred during the follow-up period; 19 (21%) failed locoregionally, and 13 (15%) failed distantly. Five patients (6%) were G-tube dependent and 3 patients (3%) were tracheostomy dependent at 1-year. CONCLUSION: Transoral surgery may be considered as a primary treatment in HPV-negative OPSCC with acceptable oncologic outcomes and the potential for improved functional outcomes.
Radiologic Evidence of Delayed Frontal Sinus Disease After Feminizing Frontal Cranioplasty.
Jain-Poster K, Annadata V, Shih C … +3 more , Kleinberger A, Brandstetter K, Liang J
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41609342 · Publisher ↗
OBJECTIVE: Feminizing frontal cranioplasty (FFC) is an essential technique in feminization of the upper third, often involving the violation of the anterior table of the frontal sinus. Though case reports document fronta...
OBJECTIVE: Feminizing frontal cranioplasty (FFC) is an essential technique in feminization of the upper third, often involving the violation of the anterior table of the frontal sinus. Though case reports document frontal sinus complications years after surgery, no studies to date examine the presence of delayed frontal sinus disease on long-term imaging after FFC. STUDY DESIGN: Case series. SETTING: Tertiary care center. METHODS: Adult patients who underwent FFC with type III forehead classification between August 2016 to December 2019 were offered postoperative computerized tomography (CT) scans. Preoperative and postoperative CTs were compared using the Lund-Mackay (LM) scoring system and assessed for frontal sinus disease. Retrospective chart review for demographic data and new diagnoses of sinusitis were extracted. RESULTS: A total of 40 transfeminine patients were included. The average time from surgery to postoperative CT scan was 71 months (median: 67.5 months; range: 56-96 months). The mean preoperative and postoperative total LM scores were 0.98 and 1.05 (P = .83), respectively. The mean frontal sinus-specific preoperative and postoperative LM scores were 0.2 and 0.15 (P = .64), respectively. Though 5 (12.5%) patients exhibited trace frontal sinus mucosal thickening on postoperative CT scans, significant frontal sinus pathology (eg, mucoceles, osteomyelitis, sinocutaneous fistula) was not found in any patient, and none required surgical treatment for sinus-related disease. CONCLUSION: FFC is a relatively safe procedure with low risk for frontal sinus-related complications within the first 6 years after surgery. Continued surveillance should be considered to detect serious frontal sinus pathology that may develop beyond this timeframe.
Role of Epigenetics in the Pathogenesis of Acquired Cholesteatoma-A State of the Art Review.
Brar T, Catanzarite A, Arya P … +2 more , White MS, Govil N
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41603588 · Publisher ↗
OBJECTIVE: Cholesteatoma is a leading cause of hearing loss. There is evidence that cholesteatoma has a heritable component. Treatment includes multiple and aggressive surgeries. Research on non-surgical treatments is cr...
OBJECTIVE: Cholesteatoma is a leading cause of hearing loss. There is evidence that cholesteatoma has a heritable component. Treatment includes multiple and aggressive surgeries. Research on non-surgical treatments is crucial to improve outcomes. Epigenetic changes can be inherited or environmentally acquired. These changes are pharmaceutically reversible, and epigenetic research has led to the FDA approval of several agents used in cancer treatment. Our goal was to review the literature investigating epigenetics in cholesteatoma to understand its role in pathogenesis and identify targets for epigenetic agents. DATA SOURCES: PRIMSA 2020 statement was used as the framework. Cochrane, Embase, PubMed/Medline, Scopus, and Web of Science were searched for keywords related to epigenetics and middle ear cholesteatoma until October 2025. REVIEW METHODS: Two reviewers (PA and AC) screened the records. Disputed records were resolved by a senior author (TB). 769 records were retrieved, 26 deemed eligible for inclusion. RESULTS: Most studies were from China. Only a few included pediatric subjects. Most investigated non-coding RNAs as the epigenetic mechanism; although one study investigated histone modifications and two investigated RNA methylation. Overall, there was differential expression of several noncoding RNAs in cholesteatoma. These noncoding RNAs are involved in regulation of cytokines and molecules that affect proliferation and apoptosis. CONCLUSIONS: Epigenetic changes may contribute to the pathogenesis of cholesteatoma through dysregulation of several biological pathways. Further studies identifying specific targets such as miRNA-21 and those investigating DNA methylation and histone modifications have the potential to develop biomarkers and targeted pharmaceutical agents for the treatment of cholesteatoma.
Multi-model Artificial Intelligence Evaluation in Sudden Sensorineural Hearing Loss.
Aliyeva A, Muradova A, Hashimli R … +1 more , Müderris T
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41603577 · Publisher ↗
OBJECTIVE: To compare the diagnostic accuracy, linguistic clarity, and user satisfaction of three large language models (ChatGPT-4.0, Claude 3.7 Sonet, and OpenAI Mini 3) in managing sudden sensorineural hearing loss. ST...
OBJECTIVE: To compare the diagnostic accuracy, linguistic clarity, and user satisfaction of three large language models (ChatGPT-4.0, Claude 3.7 Sonet, and OpenAI Mini 3) in managing sudden sensorineural hearing loss. STUDY DESIGN: Prospective, multi-domain comparative analysis using blinded expert evaluation. SETTING: Online artificial intelligence (AI) platforms accessed under standardized conditions. METHODS: Twenty-seven sudden sensorineural hearing loss-related questions-covering general knowledge, audiometric interpretation, and clinical case scenarios-were submitted to the three AI models. Responses were evaluated by 10 board-certified otolaryngologists using three validated tools: Quality Assessment of Medical Artificial Intelligence (QAMAI), Artificial Intelligence Performance Instrument (AIPI), and Artificial Intelligence Satisfaction and Performance Evaluation Questionnaire (AISPE-Q). Linguistic complexity was assessed using metrics such as word count, sentence length, lexical diversity, and clinical verb use. RESULTS: ChatGPT-4.0 demonstrated the highest scores in clinical accuracy (QAMAI: 4.57), completeness (4.53), and evaluator satisfaction (AISPE-Q: 94%). Claude 3.7 outperformed in clarity and sentence complexity, while OpenAI Mini 3 exhibited the highest lexical diversity and directive tone but scored lower overall. Inter-rater reliability was strong (intraclass correlation coefficient [ICC] > 0.85). Correlation analysis revealed a significant relationship between objective quality and subjective satisfaction (r > 0.76). CONCLUSION: ChatGPT-4.0 delivered the most clinically aligned and satisfactory responses, whereas Claude 3.7 provided linguistically refined outputs. Our findings support the context-specific application of hybrid large language model approaches in otolaryngology, particularly for patient education, diagnosis, and AI-driven triage. LEVEL OF EVIDENCE: 2-prospective comparative diagnostic accuracy study.
Does Smoking Influence Outcomes in Human Papillomavirus-Associated Oropharyngeal Cancer Treated with Transoral Robotic Surgery?
Tong JY, Bzhilyanskaya V, Molitoris JK … +6 more , Ferris MJ, Mehra R, Moyer K, Wolf J, Taylor R, Hatten KM
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41603566 · Full text
OBJECTIVE: Smoking has been identified as a risk factor for recurrence in HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) treated with definitive chemoradiation. Whether the same prognostic significance hold...
OBJECTIVE: Smoking has been identified as a risk factor for recurrence in HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) treated with definitive chemoradiation. Whether the same prognostic significance holds with surgical treatment such as transoral robotic surgery (TORS) is less well studied. STUDY DESIGN: Retrospective review. SETTING: Tertiary care academic center. METHODS: Patients with HPV-associated OPSCC treated with TORS from January 2016 to December 2023 were included. Demographics, smoking history, disease characteristics, treatment, and oncologic outcomes were collected. RESULTS: 156 patients were included. 87.2% were male with median age 60.0 years. Seventy-seven were never smokers, 63 former smokers, and 16 current smokers, with a median 20 pack-years among ever smokers. Three local, 6 regional, and ten distant metastases were identified, with 6 deaths, over a median 2.2 years of follow up. When comparing never, former, and current smokers, ever smokers demonstrated more advanced pathologic nodal staging (P = .03) and extranodal extension (P = .05). When comparing never and ever smokers, never smokers were younger (P = .04), and primary site differed with borderline significance (P = .05). Ever smokers again had more advanced nodal stage (P = .01) and extranodal extension (P = .02). There were no significant differences in adjuvant treatment, disease recurrence, or death by smoking history. There were no significant differences apart from age when analyzed using a 10 or 20-pack-year smoking history cutoff (P = .01, P = .02). CONCLUSION: Smoking history is associated with more advanced nodal stage and extranodal extension. However, smoking does not appear to influence recurrence or death in the setting of HPV-associated OPSCC definitively treated with TORS.
Digital Health Access and Use Among Patients Presenting to a Tertiary Rhinology Center.
Krippaehne E, Terry M, Bartho M … +6 more , Sabbaj M, Mace JC, Detwiller KY, Smith TL, Geltzeiler M, Pandrangi VC
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41603535 · Publisher ↗
OBJECTIVE: Digital tools in healthcare are rapidly expanding, but access and readiness remain concerns. We assessed digital health access, interest, and factors associated with higher readiness using these tools among pa...
OBJECTIVE: Digital tools in healthcare are rapidly expanding, but access and readiness remain concerns. We assessed digital health access, interest, and factors associated with higher readiness using these tools among patients at a tertiary rhinology center. STUDY DESIGN: Prospective study. SETTING: Single, academic center. METHODS: Patients presenting between February and October 2024 completed the Digital Health Readiness Questionnaire (DHRQ: range: 15-75) to evaluate digital access, use, and motivation. Demographics and types of digital device use were collected. Multivariate linear regression, directed by manual stepwise forward selection and backwards elimination (P < .100) procedures, was used to model independent predictors of high DHRQ scores. RESULTS: A total of 100 subjects were included (mean age: 57.9 [±16.1 years]). Overall, 66% of subjects felt that learning digital skills could positively impact their health. Final adjusted modeling found that age was inversely associated with DHRQ scores (per 1-year increase: β = -0.7; SE = 0.04; 95% CI: -0.2-0.01; P = .093), whereas daily smartphone use (β = 10.5; SE = 2.3; 95% CI: 5.9-15.1; P < .001), wearable device use (β = 7.3; SE = 1.5; 95% CI: 4.4-10.2; P < .001), daily computer/laptop use (β = 4.8; SE = 1.6; 95% CI: 1.6-7.9; P = .004) and female sex (β = 3.5; SE = 1.5; 95% CI: 0.9-6.7; P = .011) were associated with greater digital health readiness (higher DHRQ scores). CONCLUSION: Subjects presenting to a tertiary rhinology center exhibited strong digital health interest, with female sex and greater technology engagement reflecting greater readiness to integrate these tools. Digital health literacy screening and targeted skills-building may help close readiness gaps and facilitate integration of digital tools into care.
A National Analysis of Microscopic Positive Margins in Oropharyngeal Cancer Patients Undergoing Transoral Robotic Surgery.
Tucker A, Bollig CA
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41582733 · Full text
OBJECTIVE: The objective was to identify clinical variables associated with microscopic positive margins (PMs) during transoral robotic surgery (TORS) for oropharyngeal cancer (OPC) resection, and to explore the associat...
OBJECTIVE: The objective was to identify clinical variables associated with microscopic positive margins (PMs) during transoral robotic surgery (TORS) for oropharyngeal cancer (OPC) resection, and to explore the association of the receipt of adjuvant treatment with overall survival (OS) in this population. STUDY DESIGN: Retrospective cohort analysis. SETTING: 2019 Patient User File of the National Cancer Database. METHODS: Patients >18 years of age with OPC were stratified based on margin status. Multivariable logistic regression was used to identify clinical variables associated with PM. Survival analyses were performed using multivariable Cox proportional hazards models. Adjusted odds ratios (aORs) and hazard ratios (aHRs) with associated 95% confidence intervals (CIs) were generated. RESULTS: In total, 4294 patients met the criteria. The PM rate was 16.6%. Human papillomavirus (HPV)-negative squamous cell carcinoma (SCCa), salivary gland carcinoma, clinical T category, base of tongue primary site, and treatment at low-volume, nonacademic institutions were independently associated with PM. PMs were associated with increased mortality (aHR 1.67, 95% CI: 1.40-1.99). In patients with PM, but without extranodal extension (ENE), adjuvant radiation therapy (aRT) (aHR 0.29, 95% CI: 0.19-0.45) and adjuvant chemoradiotherapy (aCRT) (aHR 0.31, 95% CI: 0.21-0.45) were associated with an improvement in OS versus surgery alone; however, OS between aRT and aCRT was similar for both HPV-positive and HPV-negative SCCa. CONCLUSION: Histologic type, clinical T category, tumor subsite, and treatment at low-volume, nonacademic institutions were independently associated with TORS PM. aCRT did not confer a survival benefit over aRT in the overall cohort, or in subgroups of HPV-associated or HPV-negative SCCa patients with PM without ENE.
Optimal Timing of Cleft Lip Repair: Correlation With Scar Formation and Revision Rates.
Hayden J, Crafton CL, Keating J … +4 more , Rosen R, Wang H, Rabbani C, Gourishetti S
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41582726 · Publisher ↗
OBJECTIVE: To evaluate whether earlier timing of cleft lip repair (CLR) is associated with differences in the incidence of hypertrophic scar (HTS) formation and the need for revision surgery. STUDY DESIGN: Retrospective...
OBJECTIVE: To evaluate whether earlier timing of cleft lip repair (CLR) is associated with differences in the incidence of hypertrophic scar (HTS) formation and the need for revision surgery. STUDY DESIGN: Retrospective cohort study. SETTING: TriNetX Analytics Network, a federated database of de-identified health records from multiple healthcare institutions. METHODS: Infants who underwent primary CLR before 1 year of age were identified using ICD-10 and CPT codes. Patients were categorized into early cleft lip repair (ECLR, <3 months) and traditional cleft lip repair (TLR, 3-12 months) groups. Propensity score matching was performed. Rates of HTS and revision surgery were compared between groups using chi-squared tests and regression analyses. RESULTS: Among 6786 patients, 4321 underwent ECLR and 2465 underwent TLR. HTS was significantly less common in the ECLR group (3.2%) than in the TLR group (5.2%, P = .002). Increasing age at repair was positively correlated with HTS incidence (r = 0.58, P = .048). However, revision surgery was more frequent following ECLR (6.6%) compared to TLR (2.6%, P < .001) with age inversely correlated to revision rate (r = 0.52, P = .104). These differences persisted after propensity score matching for demographic and clinical variables. CONCLUSION: Earlier CLR (<3 months) is associated with a lower rate of hypertrophic scarring but a higher rate of revision surgery. These findings underscore a trade-off in timing decisions and may guide shared decision-making for surgical planning in patients with cleft lip.
Genomic Characterization of Oncocytic Carcinoma of the Thyroid Using a Large Multi-Institutional Database.
Hsia B, Dongre R, Veluvolu VD … +6 more , Kuzniar J, Bitar G, Alshaka SA, Bastien AJ, Patel VA, Khaku A
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41582704 · Publisher ↗
OBJECTIVE: Characterize the somatic mutations in Oncocytic Carcinoma of the Thyroid (OCA) using a large, multi-institutional database to identify potential therapeutic targets and gain insights into tumor biology. STUDY...
OBJECTIVE: Characterize the somatic mutations in Oncocytic Carcinoma of the Thyroid (OCA) using a large, multi-institutional database to identify potential therapeutic targets and gain insights into tumor biology. STUDY DESIGN: Cross-sectional study. SETTING: Retrospective nationwide database review. METHODS: Genomic data from 130 OCA samples, representing 124 adult patients, were retrieved from the American Association for Cancer Research (AACR) Project Genomics, Evidence, and Neoplasia Information Exchange (GENIE) database (v17.0-public). Analysis focused on nonsynonymous somatic mutations identified via whole-genome, whole-exome, or targeted panel sequencing after standardized filtering. Mutation frequencies, enrichment based on gender and metastatic status (primary vs. metastatic), and patterns of co-occurrence or mutual exclusivity were statistically evaluated. RESULTS: The most frequently mutated genes were TERT (33.1%, predominantly promoter mutations), TP53 (20.0%), DAXX (16.2%), KMT2D (13.1%), NF1 (12.3%), and PTEN (10.0%). Significant gender-specific enrichment was identified, notably MST1R mutations exclusive to females (10.7%) and PRKDC mutations exclusive to males (16.7%). Mutations in PC, PCLO, MEN1, and TSC2 were significantly enriched in metastatic samples. DAXX and CDKN1A mutations exhibited significant co-occurrence, whereas TERT mutations were mutually exclusive with DAXX alterations. CONCLUSION: The genomic landscape of OCA is marked by frequent TERT promoter mutations and distinct mutational patterns associated with patient gender and tumor metastatic status. These findings highlight potential molecular subtypes, reveal pathways potentially driving metastasis (eg, involving MEN1/TSC2), and identify novel sex-specific alterations (MST1R, PRKDC), offering avenues for improved development of targeted therapeutic strategies for OCA.
Safety and Efficacy of Systemic Corticosteroids in Children With Orbital Complications of Acute Sinusitis.
Wei K, Buzi A, Phung C … +3 more , Yu Y, Rizzi MD, Binenbaum G
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41582702 · Publisher ↗
OBJECTIVE: To determine the safety and efficacy of systemic steroids for children with orbital complications of sinusitis. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary children's hospital, January 2017 to...
OBJECTIVE: To determine the safety and efficacy of systemic steroids for children with orbital complications of sinusitis. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary children's hospital, January 2017 to June 2023. METHODS: Hospitalized children were classified by whether they received systemic corticosteroids, in addition to systemic antibiotics, prior to any surgery. Primary outcomes were length of admission, need for orbital/sinus surgery, readmission, vision loss, and fungal infection. Multivariable regression controlled for potential confounders, including severity of disease on initial imaging study. RESULTS: Of 222 children with orbital cellulitis (mean age 8.6 years), 26 (12%) received steroids: 17 (65%) intravenous methylprednisolone or dexamethasone, 9 (35%) oral steroids; 16 (62%) 1 day and 10 (38%) 2 to 4 days of steroids. Children receiving steroids more often had proptosis (58% vs 37%, P = .045) and orbital abscess on CT (81% vs 69%, P = .004). Steroid use was associated with decreased orbital or sinus surgery (19% vs 37%; OR = 0.3, 95% CI: 0.1-0.9; P = .03). There were no differences in length of stay (P = .2), readmission (P = .4), or vision loss (no cases) between the study groups or fungal or secondary infection (no cases). CONCLUSION: Systemic steroid use in children with orbital cellulitis was not associated with adverse outcomes, such as vision loss or readmission, and may offer potential benefits, including avoidance of surgery in some cases. A majority received only 1 day of steroids in our study; further research might evaluate the effects of longer courses and the subjective experience of children who have periocular swelling and pain.
Effects of Aging on Superior Laryngeal Sensory and Motor Function in a Rat Model.
Jaleel Z, Aboueisha M, Adcock K … +5 more , Leong S, Martinez V, Kinney G, Perkel DJ, Bhatt NK
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41582699 · Full text
OBJECTIVE: Aging is a risk factor for diminished laryngeal sensation, dysphagia, and aspiration events; however, the mechanisms underlying age-related swallow dysfunction are not well understood. Some of these changes ar...
OBJECTIVE: Aging is a risk factor for diminished laryngeal sensation, dysphagia, and aspiration events; however, the mechanisms underlying age-related swallow dysfunction are not well understood. Some of these changes are thought to be mediated through superior laryngeal nerve (SLN) dysfunction. The purpose of this study was to measure the effects of aging on SLN motor and sensory function in a rat model. STUDY DESIGN: Animal study. SETTING: Tertiary-care center. METHODS: Evoked response studies were performed by SLN stimulation. Outcome measures included compound motor (CMAP) and sensory nerve action potential (SNAP) measurements recorded from the cricothyroid muscle and the internal branch of the SLN, respectively. Swallow force measurements were recorded by stimulating the SLN and quantifying the hyoid elevation force. Additionally, force and frequency of electrically and tactile-stimulated swallow reflex were analyzed. These measures were collected in adult Sprague-Dawley rats aged 4, 18, and 24 months. RESULTS: Compared to non-aged rats, advanced age was associated with significantly longer SNAP latency and total duration with a mean difference (95% CI) of 1.23 milliseconds (1.06-1.40) and 2.24 milliseconds (1.89-2.59), respectively. CMAP latency and total duration were also increased by 0.27 milliseconds (0.23-0.31) and 1.5 milliseconds (1.14-1.87), respectively. Advanced age was associated with decreased electrical and tactile-stimulated swallow frequency with a mean difference of 3.3 swallows/10 seconds (95% CI 1.1-5.5) and 2.1 swallows/10 seconds (95% CI 0.71-3.5), respectively. CONCLUSION: Advanced age was associated with longer SNAP and CMAP duration and decreased swallow frequency. The results suggest delayed nerve conduction as a potential mechanism for age-related swallow dysfunction in our rat model. Our work has implications in humans with the hopes for developing targeted therapies for age-related swallow dysfunction. LEVEL OF EVIDENCE: N/A.
Exploration of Therapeutic Targets Using CDK4 Inhibitors for Head and Neck Mucosal Melanoma.
Hattori T, Fujii M, Ueda T … +12 more , Ishikawa A, Mine Y, Xu B, Suehiro T, Hattori M, Tahara H, Sato Y, Chikuie N, Taruya T, Hamamoto T, Ishino T, Takeno S
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41568999 · Full text
OBJECTIVE: Mucosal melanoma (MM) is an extremely aggressive malignant tumor in the head and neck region associated with a poor prognosis. In the present study, we conducted cell proliferation assay and western blotting u...
OBJECTIVE: Mucosal melanoma (MM) is an extremely aggressive malignant tumor in the head and neck region associated with a poor prognosis. In the present study, we conducted cell proliferation assay and western blotting using cell lines derived from MM and the immunohistochemical analysis of pathological MM tissues to identify novel therapeutic targets. Herein, we report on the potential of cyclin-dependent kinase 4 (CDK4) inhibitors as molecular targeted therapies for MM. STUDY DESIGN: Retrospective cohort study and laboratory analysis. SETTING: A tertiary referral center. METHODS: MTT assay and western blotting were performed on the HMV-II (RCB0777) and GAK (JCRB0180) cell lines, treated with the CDK4 inhibitors abemaciclib (LY2835219) and palbociclib (PD-0332991). This retrospective cohort study included patients with head and neck MM; immunohistochemistry was performed on clinical specimens. RESULTS: Abemaciclib and palbociclib showed concentration-dependent cytostatic effects on HMV-II and GAK cells at 72 hours in the MTT assay. In western blotting, they exhibited concentration-dependent inhibitory effects on phosphorylated RB1 in HMV-II and GAK cells at 24 hours. Of 23 patients, 18 (78.3%) had positive results on CDK4 immunostaining. No clinicopathologic factors were significantly associated with CDK4 status. CONCLUSION: Abemaciclib and palbociclib may suppress MM cell proliferation. The CDK4 signaling pathway is a potential target for molecular-targeted therapies in MM.
Diagnosis and Management of Isolated Laryngeal Sarcoidosis: A Systematic Review.
Malhotra R, Celidonio J, Hamilton N … +3 more , Filipkowski A, Yan K, Kaye R
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41566931 · Full text
OBJECTIVE: This study reviews the existing literature on patients diagnosed with sarcoidosis isolated to the larynx to improve our understanding of the diagnosis and management of this rare condition. DATA SOURCES: Embas...
OBJECTIVE: This study reviews the existing literature on patients diagnosed with sarcoidosis isolated to the larynx to improve our understanding of the diagnosis and management of this rare condition. DATA SOURCES: Embase, PubMed, Web of Science. REVIEW METHODS: We conducted a systematic review of published literature pertaining to patients diagnosed with isolated laryngeal sarcoidosis (LS). Demographics, symptomatology, diagnostic evaluation, management, and outcome details were recorded for patients diagnosed with isolated LS. RESULTS: 21 articles with 39 patients (11 male, 28 female, mean age: 33) were included (mean follow-up: 33 months). The most common presentations were dyspnea (74%), dysphonia (67%), and dysphagia (49%). The supraglottic region was most involved (n = 37, 95%). Systemic steroids were the most used initial treatment, leading to symptom resolution in 27% of patients treated as such. 64% of all patients underwent further treatment for refractory symptoms, most commonly surgical excision with intralesional steroid injection. All patients (n = 8) who underwent initial treatment with systemic steroids followed by surgical excision with intralesional steroid injection experienced complete symptom resolution. Emergent tracheostomy was required in 8 (21%) patients during treatment and maintenance therapy was required in 11 (28%) patients. Long-term outcomes (follow-up mean: 33 months; range: 2-192 months) showed 71% complete improvement, 19% partial symptom improvement, and 10% no improvement. CONCLUSION: Isolated LS most commonly affects middle-aged women. Patients primed with a course of systemic steroids before undergoing surgical excision with intralesional steroid injection demonstrated the best outcomes. We recommend long-term follow-up of these patients for surveillance of symptoms and extra-laryngeal sarcoidosis manifestations.
The Hidden Burden of Polysensitization in Allergic Rhinitis: A Propensity-Matched Real-World Analysis of Subcutaneous Immunotherapy.
Yuan X, Liu L, Xie S … +6 more , Meng L, Zhong W, Jia J, Zhang H, Jiang W, Xie Z
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41566908 · Publisher ↗
OBJECTIVE: To compare the efficacy and safety of house dust mite (HDM) subcutaneous immunotherapy (SCIT) between monosensitized and polysensitized allergic rhinitis (AR) patients, and evaluate the independent impact of p...
OBJECTIVE: To compare the efficacy and safety of house dust mite (HDM) subcutaneous immunotherapy (SCIT) between monosensitized and polysensitized allergic rhinitis (AR) patients, and evaluate the independent impact of polysensitization on SCIT outcomes. STUDY DESIGN: Large retrospective real-world cohort study. SETTING: Tertiary referral center. METHODS: AR patients completing a 3-year HDM-SCIT regimen between January 2011 and January 2019 were included. Based on allergen profiles, patients were classified as monosensitized or polysensitized. Propensity score matching balanced baseline characteristics. SCIT efficacy and adverse events were compared before and after matching. Multivariable regression assessed the independent effect of polysensitization on SCIT outcomes. RESULTS: 1584 patients were enrolled (994 monosensitized and 590 polysensitized). Before matching, polysensitized patients exhibited higher baseline symptom scores, older age, longer AR duration, more frequent dose modifications, greater prevalence of family history of allergy, and increased asthma comorbidity. After matching, polysensitized patients showed significantly less symptom improvement and lower overall efficacy at both SCIT 1 and 3 years (P < .05). The incidence of local reactions (LRs) was also significantly higher (P < .05), while systemic reaction rates did not differ. Multivariable regression confirmed polysensitization as an independent risk factor for reduced SCIT efficacy and increased LRs (P < .05). CONCLUSION: Polysensitization was linked to reduced SCIT efficacy and a higher risk of LRs. These results underscore the value of allergen profiling and support personalized SCIT strategies and closer monitoring for polysensitized patients.
Nationwide Adherence to Bell's Palsy Clinical Practice Guidelines: Retrospective Analysis Using a Large-Scale EHR Database.
Favre N, Harsinay A, Rosi-Schumacher M … +2 more , Sorenson K, Sherris D
Otolaryngol Head Neck Surg · 2026 Mar · PMID 41566907 · Publisher ↗
OBJECTIVE: This study aimed to evaluate nationwide adherence to American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines for Bell's palsy management using a large electronic health record (EHR) datab...
OBJECTIVE: This study aimed to evaluate nationwide adherence to American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines for Bell's palsy management using a large electronic health record (EHR) database. STUDY DESIGN: Retrospective cohort study. SETTING: U.S. Network in TriNetX. METHODS: A retrospective cohort study was conducted using the TriNetX global EHR database, identifying patients diagnosed with Bell's palsy (ICD-10 code G51.0) from 2004 to 2024. Data collected included corticosteroid administration within 72 hours of diagnosis, antiviral use (valacyclovir or acyclovir), and the performance of imaging (computed tomography [CT]/magnetic resonance imaging [MRI] of the head or face) or Borrelia burgdorferi serologic testing. Outcomes were compared in cohorts before and after 2013, the year the AAO-HNS guidelines were published. RESULTS: Steroid administration within 72 hours of diagnosis increased significantly after guideline publication, from 4798 (20.4%) patients before 2013 to 78,096 (33.8%) patients after 2013 (P < .001). However, the use of non-recommended practices also increased. Imaging use rose from 32.9% to 41.0% (P < .001), and serologic testing for Borrelia increased from 1% to 5% (P < .001). Antiviral use, considered optional by the guidelines, increased from 11.8% to 23.5% (P < .001) over the same 72-hour time period. CONCLUSION: Following the publication of the AAO guidelines, early steroid use for Bell's palsy improved significantly. However, the concurrent rise in imaging and laboratory testing-practices explicitly discouraged by the guidelines-highlights ongoing gaps in adherence and suggests areas for further provider education and quality improvement.
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