Otolaryngol Head Neck Surg [JOURNAL]
Sun
200 papers
Audiogram Configuration Predicts Treatment Response in Sudden Sensorineural Hearing Loss.
Guo L, Wang J, Gao Y … +3 more , Wu B, Ren X, Li Y
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42307984 · Publisher ↗
OBJECTIVE: To test whether the configuration of the initial pure tone audiogram (ascending, descending, flat or total-deaf) predicts complete recovery and to explore its value as a building block for prognostic models. S...
OBJECTIVE: To test whether the configuration of the initial pure tone audiogram (ascending, descending, flat or total-deaf) predicts complete recovery and to explore its value as a building block for prognostic models. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary care centre. METHODS: Adults with unilateral ISSNHL treated from January 2012 to December 2019 were categorised by audiogram configuration. Baseline characteristics and treatments were recorded. Multivariable logistic regression identified independent predictors of complete recovery; model performance was summarised by AUC and Nagelkerke R2. RESULTS: Among 487 patients (43.8% flat, 29.4% descending, 21.9% total-deaf, 4.9% ascending), 80 (16.4%) achieved complete recovery. Complete recovery occurred in 50.0% of ascending, 25.2% flat, 9.8% descending and 0% total-deaf. Descending (OR 0.25; 95% CI 0.15-0.42) and total-deaf (OR 0.05; 95% CI 0.01-0.22) configurations independently predicted worse outcomes. Age and higher initial PTA were also negative predictors. AUC = 0.78; Nagelkerke R = 0.32. CONCLUSION: The initial audiogram configuration is an independent prognostic marker in ISSNHL. Ascending and flat patterns confer better prognosis than descending and total-deaf patterns; such classifications should be integrated into clinical risk stratification and future predictive models.
Treatment Priorities in Patients With a History of Laryngeal Cancer: A Conjoint Analysis.
Upton MK, Sridhar S, Dennison AM … +9 more , Prasad K, Issa T, Kondapaneni R, Abemayor E, Mendelsohn AH, Sinard R, Rohde S, Tassone P, Topf MC
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42307983 · Publisher ↗
OBJECTIVE: To investigate patient priorities that may inform the choice of laryngeal cancer treatment. STUDY DESIGN: Multi-institutional, survey-based, conjoint analysis study focusing on seven attributes: lifespan, trea...
OBJECTIVE: To investigate patient priorities that may inform the choice of laryngeal cancer treatment. STUDY DESIGN: Multi-institutional, survey-based, conjoint analysis study focusing on seven attributes: lifespan, treatment type, cancer cure, self-image, mode of breathing, voicing, and swallowing. Patients with a history of treated laryngeal cancer (>6 months from treatment completion with no evidence of recurrent disease) were recruited. SETTING: Tertiary care medical centers. METHODS: Conjoint analysis yields utility scores, a quantitative measure of preference for an attribute. Higher utility scores indicate greater preference. Chi-squared, univariate logistic regression, and univariate linear regression analyses were used to evaluate associations between patient demographic and medical features with relative attribute preference. RESULTS: This study included 151 patients with previously treated laryngeal cancer. For the cohort, the mean importance scores (±standard deviation) were swallowing 25.7% (±8.4%), lifespan 21.5% (±9.3%), cancer cure 14.0% (±6.4%), mode of breathing 12.8% (±4.8%), voicing 9.2% (±3.5%), treatment type 9.1% (±5.0%), and self-image 7.7% (±4.4%). Patients who required salvage surgery after upfront chemoradiotherapy placed more value on cancer cure compared to the other treatment groups (coefficient 2.76, 95% CI 0.33-5.19). CONCLUSION: In patients with a history of treated laryngeal cancer, swallowing is the most important treatment priority, followed closely by lifespan. However, patients who underwent salvage surgery placed more value on cancer cure during decision-making. These findings demonstrate that patient treatment preferences are diverse and may change throughout the cancer care journey, with some patients placing a higher value on quality of life than lifespan and cancer cure.
Effectiveness of Over-the-Counter Hearing Aids Versus Professionally Fitted Devices: A Systematic Review and Meta-analysis.
De Sousa KC, Almufarrij I, Kruger M … +3 more , Manchaiah V, Munro KJ, Swanepoel W
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42307981 · Publisher ↗
OBJECTIVE: To systematically review and meta-analyze the clinical effectiveness of self-fitting over-the-counter (OTC) hearing aids compared with professionally fitted devices. DATA SOURCES: PubMed, Scopus, Web of Scienc...
OBJECTIVE: To systematically review and meta-analyze the clinical effectiveness of self-fitting over-the-counter (OTC) hearing aids compared with professionally fitted devices. DATA SOURCES: PubMed, Scopus, Web of Science, Food and Drug Administration (FDA) 510(k) and De Novo databases, and ClinicalTrials.gov were searched in March 2025 and updated in August 2025. Reference lists were screened, and manufacturers were contacted for unpublished data. REVIEW METHODS: Two reviewers conducted screening, full-text review, and risk-of-bias assessment. Eligible studies were field trials comparing FDA-cleared self-fitting OTC hearing aids or software with audiologist-fitted prescription devices in adults. A random-effects meta-analysis using Hedges' g was performed. Risk of bias was evaluated with RoB 2 and ROBINS-I, and certainty of evidence with GRADE. RESULTS: From 712 records, 24 were included, representing 15 unique studies with 774 participants (739 analyzed). Most were short-term field trials (10 days to 8 weeks) comparing self-fitting and professional fittings of the same device. Pooled analyses showed no significant differences between groups for the Abbreviated Profile of Hearing Aid Benefit (Hedges' g = -0.05; 95% CI, -0.19 to 0.09), Speech, Spatial and Qualities of Hearing Scale - 12 (g = 0.01; 95% CI, -0.33 to 0.36), International Outcome Inventory for Hearing Aids (g = 0.12; 95% CI, -0.35 to 0.59), and Quick Speech-in-Noise test (g = 0.03; 95% CI, -0.22 to 0.28). Risk of bias was moderate to high, and certainty of evidence was low. CONCLUSION: Based largely on patient-reported measures, self-fitting OTC hearing aids provide outcomes comparable to professionally fitted devices. Larger, independent trials within standard clinical pathways are warranted.
Impact of Life-Context Factors on Chronic Rhinosinusitis 22-Item Sinonasal Outcomes Test: Systematic Review + Meta-Analysis.
Jade KM, Scangas GA, Lee VS … +6 more , Man LX, McCoul ED, Guevara G, Nourmahnad A, Reynolds JM, Levine CG
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42299861 · Publisher ↗
OBJECTIVE: Chronic rhinosinusitis (CRS) affects all sociodemographic groups. While studies have explored social determinants of health (SDOH), sociodemographics, and health behaviors, their specific effects on CRS outcom...
OBJECTIVE: Chronic rhinosinusitis (CRS) affects all sociodemographic groups. While studies have explored social determinants of health (SDOH), sociodemographics, and health behaviors, their specific effects on CRS outcomes are unclear, making tailored care difficult. This review examines how these "Life-Context" factors influence 22-item Sinonasal Outcome Test (SNOT-22) scores before and after treatment. DATA SOURCES: A systematic review followed PRISMA guidelines, searching Medline, Embase, Cochrane CENTRAL, and Web of Science through 12/2024. REVIEW METHODS: Eligible CRS studies with comparison groups reporting SNOT-22 outcomes were reviewed. Mixed Methods Appraisal Tool assessed bias. Random-effects meta-analysis estimated the pooled effect on SNOT-22 when two studies reported comparable cohorts. RESULTS: Of 3180 records identified, 61 studies met inclusion criteria. Females had worse baseline SNOT-22 scores, but similar improvements postsurgery as males (baseline SMD = 0.30, 95% CI: 0.24-0.36; 2-years postsurgery: SMD = 0.04, 95% CI: -0.33-0.41). Younger patients often had higher baseline SNOT-22. Race and ethnicity data were limited and variable; no significant differences were found. Education and income showed inconsistent links to SNOT-22 scores. Medicaid and private insurance patients had worse baseline scores than Medicare (SMD = 0.81, 95% CI: 0.48-1.15 and 0.30, 95% CI: 0.10-0.49, respectively). Smokers had worse SNOT-22 (SMD = 0.37, 95% CI: 0.22-0.53). Environmental factors showed weak, inconsistent effects. There is limited data on food security, social support, and care access. CONCLUSION: Various Life-Context factors influence CRS and affect SNOT-22 outcomes. Specifically, factors like sex, ethnicity, insurance status, and smoking impact these outcomes. Variability in studies and reporting methods hinder clear conclusions. Standardized data collection on these factors is vital for improving understanding and ensuring equitable care.
Dupilumab Extended Interval Dosing in Chronic Rhinosinusitis With Nasal Polyps: A Systematic Review and Meta-analysis.
Alqutub A, Herzallah AI, Alqutub S … +2 more , Assiri SA, Herzallah IR
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42290623 · Publisher ↗
OBJECTIVE: To evaluate whether extending the dupilumab dosing interval beyond the standard every-two-weeks (Q2W) regimen maintains clinical, radiologic, and biomarker control in adults with chronic rhinosinusitis with na...
OBJECTIVE: To evaluate whether extending the dupilumab dosing interval beyond the standard every-two-weeks (Q2W) regimen maintains clinical, radiologic, and biomarker control in adults with chronic rhinosinusitis with nasal polyps (CRSwNP). DATA SOURCES: PubMed, Scopus, Cochrane Library, and Web of Science were systematically searched using predefined terms related to CRSwNP and dupilumab, with the final search in September 2025. Reference lists of included studies were also screened. REVIEW METHODS: Eligible studies enrolled adults with CRSwNP who transitioned from dupilumab 300 mg Q2W to extended intervals (≥Q4W). Two reviewers independently screened, extracted data, and assessed risk of bias using RoB2 and NIH tools. Random-effects meta-analyses synthesized sinonasal, radiologic, and biomarker outcomes. Subgroup analysis also compared switching after 6 versus 12 months of standard-dosing induction period. RESULTS: Nineteen studies met the inclusion criteria, and nine contributed to quantitative synthesis. Across 1075 patients, extended interval dosing preserved disease control. Pooled mean differences (Q4W vs Q2W) showed non-significant changes in 22-item Sinonasal Outcome Test (SNOT-22) (-0.56), nasal congestion (-0.73), olfaction (+0.23), nasal polyp score (-0.29), and Lund-Mackay score (-1.25). Eosinophils decreased significantly (-0.13 × 10/L; P = .047). Subgroup analysis revealed a non-significant difference in clinical outcomes of Q4W dosing when comparing the 12- and 6-month induction protocols. Real-world studies showed the feasibility of further extension (Q6W-Q12W) in selected patients. CONCLUSION: Dupilumab interval extension to Q4W maintains clinical stability after 6 to 12 months of standard dosing, with potential for longer intervals in selected patients. Further controlled trials are required to define optimal tapering strategies and identify predictors of successful dose spacing.
"I Don't Like How I Sound:" Ethics in Practice for Surgery for Vocal Dysmorphia.
Vukkadala N, Nuyen B
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42233634 · Publisher ↗
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Assessing HPV Vaccination Trends and Their Alignment with Evolving Recommendations.
Loheide SE, Lee BM, Taufique ZM … +1 more , Moses LE
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42233631 · Publisher ↗
OBJECTIVE: HPV vaccination recommendations have expanded to include both sexes and a broadened age range since approval in 2006. These changes and increasing HPV-related head and neck cancer rates support vaccination of...
OBJECTIVE: HPV vaccination recommendations have expanded to include both sexes and a broadened age range since approval in 2006. These changes and increasing HPV-related head and neck cancer rates support vaccination of older and male patients, necessitating changes in HPV education. We aim to analyze vaccination trends and to identify opportunities for increasing awareness. STUDY DESIGN: Cross-sectional study analyzing vaccination trends between 2007 and 2023. SETTING: US hospitals and clinics using Epic. METHODS: Using Epic Cosmos, a national database, vaccination trends for patients aged 9 to 45 were stratified by year, demographics, and administering provider specialty. RESULTS: 19.6 million HPV vaccinations were administered between 2007 and 2023. The inclusion of males aged 9 to 21 in the recommendations beginning in 2009 corresponded with an 836% increase in vaccinations in this group from 2010 to 2016. Males comprised 49.9% of vaccinated patients aged 9 to 18 in 2023, a percentage that increased annually since 2010. Head and neck cancer prevention became a designated vaccine indication in 2020. Despite broadened indications, total vaccination declined by 47.1% from 2016 to 2023 in patients aged 9 to 26. In 2012, 74.8% of vaccinations were administered in pediatrics and 18.3% in family medicine. In 2023, pediatrics administered 46.6%, family medicine 33.3%, OBGYN 7.1%, and primary care 6.8%. CONCLUSION: Expanding guidelines have had inconsistent impacts on vaccination trends, as rates decreased in target populations since 2016. Males contribute equally to pediatric but not adult vaccinations. Departments administering vaccines are diversifying, though pediatrics predominates. Gendered and outdated education and marketing could contribute to disparities and discordance with guidelines.
Comparative Outcomes of Fine Needle Aspiration and Core Needle Biopsy for Parotid Masses.
Buhler LEC, Prince A, Bunda N … +6 more , Oslin K, Smith J, Allevato M, Hershey E, Chinn SB, Prince MEP
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42233606 · Publisher ↗
OBJECTIVE: To compare the diagnostic accuracy and safety of ultrasound-guided fine needle aspiration (FNA) versus core needle biopsy (CNB) for parotid masses. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary a...
OBJECTIVE: To compare the diagnostic accuracy and safety of ultrasound-guided fine needle aspiration (FNA) versus core needle biopsy (CNB) for parotid masses. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center, 2018 to 2023. METHODS: We reviewed 485 patients undergoing ultrasound-guided parotid biopsy (426 FNAs and 59 CNBs). Permanent histopathology served as the reference standard. Primary outcomes included diagnostic performance metrics for neoplasm, malignancy, and tissue-specific diagnosis. Secondary outcomes included nondiagnostic rates, complications, time to surgery, and technical factors (needle gauge, biopsy setting, and number of passes). RESULTS: CNB demonstrated superior sensitivity (80.0% vs 54.9%, P = .032), accuracy (86.4% vs 68.5%, P = .007), and positive predictive value (87.0% vs 56.4%, P = .01) for detecting malignancy compared to FNA. CNB had superior tissue-specific accuracy (67.8% vs 49.5%, P = .009), particularly for squamous cell carcinoma and mucoepidermoid carcinoma. FNA had a higher nondiagnostic rate (20.0% vs 5.1%, P = .004). Greater CNB accuracy correlated with ≥3 needle passes and use of 17 to 18 gauge needles. Complication rates were low and similar (3.4% CNB vs 2.1% FNA), with no facial nerve injuries or tumor seeding reported. Time to surgery was comparable (CNB 51 days vs FNA 42 days, P = .10) in cases of malignancy. CONCLUSION: CNB showed improved diagnostic accuracy and fewer nondiagnostic results than FNA for parotid masses, particularly for suspected malignancies and complex histologies, without added risk or delay. CNB should be considered in cases suspicious for malignancy or where tissue-specific diagnosis would inform operative planning.
Therapeutic Effects and Mechanisms of Olfactory Training in a Murine Model of Olfactory Dysfunction.
Qiao Y, Zhai B, Wang Z … +3 more , Xu Y, Zhang C, Qiao X
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42233601 · Publisher ↗
OBJECTIVE: To evaluate the therapeutic effects and mechanisms of olfactory training in a mouse model of olfactory dysfunction. STUDY DESIGN: Randomized controlled animal study. SETTING: Laboratory investigation. METHODS:...
OBJECTIVE: To evaluate the therapeutic effects and mechanisms of olfactory training in a mouse model of olfactory dysfunction. STUDY DESIGN: Randomized controlled animal study. SETTING: Laboratory investigation. METHODS: Thirty BALB/c mice were randomized into control, model, and olfactory training groups. Olfactory dysfunction was induced in the latter 2 groups via 3-methylindole injection. The training group was exposed to 4 distinct odors twice daily for 28 days. Olfactory function was assessed using a buried food pellet test. Olfactory mucosa and bulb tissues were analyzed histologically and for inflammatory markers. RESULTS: Compared to the training group, the model group exhibited significantly prolonged foraging latency, increased levels of inflammatory cytokines (IFN-γ, IL-6, TNF-α) in the olfactory bulb, and reduced olfactory marker protein (OMP) expression. Histology showed mucosal damage in model mice. Olfactory training significantly shortened foraging latency, lowered cytokine levels, increased OMP expression, and improved mucosal pathology. Apoptosis did not differ significantly between groups. CONCLUSION: Olfactory training improved olfactory function in mice, potentially through mechanisms involving reduced olfactory bulb inflammation, promotion of olfactory neuron regeneration, and amelioration of olfactory mucosal damage.
Effects of Asymmetric Auditory Deprivation in Sequential Cochlear Implant.
Farinazzo ES, de Brito Neto RV, Yamaguti EH … +2 more , Fornazieri MA, Lourençone LFM
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42233584 · Publisher ↗
OBJECTIVE: To evaluate the influence of auditory deprivation on sequential cochlear implants in postlingual patients, comparing the ear with shorter deprivation (ESAD), longer deprivation (ELAD), and the bilateral condit...
OBJECTIVE: To evaluate the influence of auditory deprivation on sequential cochlear implants in postlingual patients, comparing the ear with shorter deprivation (ESAD), longer deprivation (ELAD), and the bilateral condition (BIL). STUDY DESIGN: Retrospective study. SETTING: A tertiary referral center. METHODS: Postlingually deafened patients who underwent sequential bilateral implantation between 1990 and 2021. Auditory performance was assessed over 24 months after activation of each implant. Outcomes included free-field pure-tone average (PTA), speech detection threshold (SDT), and sentence recognition in quiet and in noise at +10 dB SNR. Secondary variables were interimplant interval, duration of preimplant hearing aid use, etiology, and electrode insertion depth. RESULTS: ESAD outperformed ELAD in quiet (73% [IQR 44-92] vs 37% [IQR 0-87]) and in noise (27% [IQR 0-62] vs 0% [IQR 0-45]) at 24 months (P < .001). BIL achieved superior results to both monaural conditions in quiet (97% [IQR 72.5-100], P < .001) and in noise (57% [IQR 23-86.5], P = .008), regardless of ESAD experience. Interimplant interval correlated positively with BIL performance (r = 0.450; P < .001). Longer hearing aid use was negatively associated with ESAD (r = -0.293; P = .020) and BIL performance (r = -0.312; P = .018). Partial electrode insertion in ELAD was linked to poorer BIL outcomes in quiet (P = .045). No correlations were found for age or etiology. CONCLUSION: Shorter auditory deprivation and interimplant intervals are associated with better outcomes. Bilateral stimulation enhances performance even with long deprivation in 1 ear, and auditory experience with the first implant improves results. Complete insertion favors the more deprived ear, whereas prolonged ineffective hearing aid use may compromise outcomes.
Large Language Model Responses to Common Otolaryngological Questions: Evaluating Accuracy, Appropriateness, Readability, and Hallucinations.
Sakharkar M, Jalihal P, Chang S … +3 more , Patel P, Chavez M, Levi J
Otolaryngol Head Neck Surg · 2026 May · PMID 42212563 · Publisher ↗
OBJECTIVES: Artificial Intelligence (AI) is increasingly integrated into medicine, including otolaryngology. However, concerns remain regarding the accuracy of generated content and the tendency of large language models...
OBJECTIVES: Artificial Intelligence (AI) is increasingly integrated into medicine, including otolaryngology. However, concerns remain regarding the accuracy of generated content and the tendency of large language models (LLMs) to fabricate references. This study evaluates the accuracy, appropriateness, readability, and hallucination of references in 2 prevalent large language models, ChatGPT and Claude, in response to common otolaryngological questions. STUDY DESIGN: Prospective observational study. SETTINGS: Academic tertiary care center. METHODS: Thirty-six otolaryngologic questions were individually entered into ChatGPT 4.0 Plus and CLAUDE in separate sessions, with explicit instructions to avoid utilizing previous memories. To assess reproducibility, each query was submitted twice. Two otolaryngologists independently rated the accuracy of responses. Readability was evaluated using the Flesch Reading Ease (FRE) score. Reference hallucinations were assessed by analyzing the reference validity and relevance. RESULTS: ChatGPT and CLAUDE had an FRE of 47 and 25.2 out of 100, respectively. For patient readability, ChatGPT scored a 3.60 while Claude scored a 4.68 out of 5. Claude scored slightly higher on accuracy, receiving a score of 4.42 out of 5 while ChatGPT received a 3.81. Both models hallucinated at least half of their references, with some citations irrelevant or incorrectly formatted. Thematic analysis revealed frequent vagueness, poor clinical prioritization, and excessive jargon across both models. CONCLUSION: Both ChatGPT and CLAUDE often produced partially inaccurate, jargon-filled responses and failed to consistently provide valid references when answering common otolaryngologic patient questions. Our results highlight the need for better understanding and regulation of LLM limitations in clinical and patient-facing applications.
Evaluation of Prognostic Factors in Adult Sinonasal Rhabdomyosarcoma With Consideration of Resection Status.
Yi J, Cao L, Zhang JH … +2 more , Bai Y, Chen X
Otolaryngol Head Neck Surg · 2026 May · PMID 42212552 · Publisher ↗
OBJECTIVE: To evaluate R0 resection's prognostic significance and its association with induction chemotherapy (ICT) response in adult sinonasal rhabdomyosarcoma (SNRMS). STUDY DESIGN: Retrospective study. SETTING: Beijin...
OBJECTIVE: To evaluate R0 resection's prognostic significance and its association with induction chemotherapy (ICT) response in adult sinonasal rhabdomyosarcoma (SNRMS). STUDY DESIGN: Retrospective study. SETTING: Beijing Tongren Hospital and the National Cancer Hospital. METHODS: Fifty-one patients who met the inclusion criteria were identified through chart review. Patients were divided into 3 groups: a nonsurgical group and 2 surgical groups, 1 with a R0 resection and one with a positive margin. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier analysis. The Log-rank test and Cox regression analysis were performed to evaluate prognostic factors. The chi-square test was used to analyze associations. RESULTS: No differences in characteristics were observed among the groups. Patients with R0 resection had significantly higher OS and PFS than those with positive margins or nonsurgical (OS: P = .001, P = .016, respectively; PFS: P < .001, P = .005, respectively). There was no significant difference in OS or PFS between positive margins and nonsurgical group (P = .163, P = .059, respectively). Multivariate analysis revealed that R0 resection was an independent risk factor for OS (HR = 0.224, 95% CI: 0.079-0.639, P = .005). The R0 resection rate was significantly higher in the positive ICT response group than in the negative response group and the non-ICT group (χ² = 7.119, df = 2, P = .028). CONCLUSION: The overall treatment strategy for adult SNRMS should focus on achieving local tumor control through comprehensive, multidisciplinary treatment to achieve R0 resection.
The Long-Term Impact of Facial Palsy on the Quality of Life of Vestibular Schwannoma Patients.
van Vollenhoven WMA, Neve OM, Malessy MJA … +4 more , Koot RW, Wever CC, Jansen JC, Hensen EF
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42183953 · Full text
OBJECTIVE: To compare long-term quality of life (QoL) of vestibular schwannoma (VS) patients with and without facial palsy. STUDY DESIGN: Longitudinal cohort study. SETTING: Tertiary referral centre. METHODS: To assess Q...
OBJECTIVE: To compare long-term quality of life (QoL) of vestibular schwannoma (VS) patients with and without facial palsy. STUDY DESIGN: Longitudinal cohort study. SETTING: Tertiary referral centre. METHODS: To assess QoL, VS patients completed the Penn Acoustic Quality of Life (PANQOL) questionnaire twice: at baseline and 6 years later. The results of patients with facial palsy were compared to those without. The effect of facial nerve function, sex and tumor size on PANQOL scores was assessed. RESULTS: 484 patients completed the PANQOL. At baseline, 94% of patients had no or mild facial palsy and a mean PANQOL score of 71 out of 100 points (±18), while patients with moderate to severe palsy (6%) scored 61 points (±19). After 6 years, the PANQOL total scores remained relatively stable (70 and 57, respectively). In the multivariate analysis, the difference between patients without and with facial palsy was similar (PANQOL scores of 71 and 60, respectively). These differences do not exceed the predefined minimal clinically important difference (MCID) of 12.5 points. When focussing on questions related to facial function, differences are considerably larger (84 vs 41), exceeding the MCID. CONCLUSION: VS patients with facial palsy have lower mean total PANQOL scores than those without facial palsy, which remains on the long term. The difference did not exceed the MCID, which could suggest a limited impact of facial palsy on QoL, however, it may also point towards a limited sensitivity of the total PANQOL score for facial palsy-related quality of life.
Osia Implantation in Patients With Prior Craniotomy for Skull Base Tumors.
Nowlen FM, Roarke M, Jukic A … +3 more , Prevost M, Flores N, Stevens SM
Otolaryngol Head Neck Surg · 2026 May · PMID 42171500 · Publisher ↗
OBJECTIVE: While the Osia active transcutaneous bone conduction device has been shown to be safe and effective, surgical placement of the device can be problematic in patients with a prior craniotomy for tumors of the po...
OBJECTIVE: While the Osia active transcutaneous bone conduction device has been shown to be safe and effective, surgical placement of the device can be problematic in patients with a prior craniotomy for tumors of the posterior fossa. This study reports on strategies and outcomes of Osia implantation in patients with previous lateral skull base surgery. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary institution. METHODS: All patients who underwent Osia 2 implantation (OSI200 or OSI300) with a surgical history of acoustic neuroma resection via craniotomy were included. Demographics and surgical design data were collected with surgical and audiometric outcomes. RESULTS: Seventeen patients/implants met criteria. The median age was 62.1 years. The craniotomies were 52.9% (n = 9) translabyrinthine and 47.1% (n = 8) retrosigmoid approach. The median time from craniotomy to implantation was 1.2 years (R: 0.7-20.0). Existing percutaneous bone-anchored hearing aid explantation was required for four patients with Osia conversion. Most surgical designs incorporated prior incisions (76.5%). The majority of implants were placed in an atypical location to avoid prior craniotomy sites with six requiring atypical angulation. Median follow-up duration was 15.7 months. The all-cause complication rate was 5.8%. Mean PTA4 gain (0.5, 1, 2, 4 kHz) was 34.7 ± 5.6 dB (P = .001). CONCLUSION: Osia implantation in patients with prior craniotomy for lateral skull base tumors is safe and effective. Outcomes approximate those described for typical Osia candidates. Specialized incisional designs and implant placement were required in all patients.
Image-Guided Excision of Oral Leukoplakia Using Narrow-Band Imaging Illumination and Two-Stage Local Anesthesia.
Yang SW
Otolaryngol Head Neck Surg · 2026 May · PMID 42171497 · Publisher ↗
This study evaluated the use of narrow-band imaging (NBI) to assist in achieving adequate excision of oral leukoplakia with complete removal of lesions. Use of lidocaine combined with a vasoconstrictor for local anesthes...
This study evaluated the use of narrow-band imaging (NBI) to assist in achieving adequate excision of oral leukoplakia with complete removal of lesions. Use of lidocaine combined with a vasoconstrictor for local anesthesia is standard practice in surgery. However, the blanching effect that follows injection can obscure the boundary between oral leukoplakia and the surrounding normal mucosa. A two-stage local anesthesia protocol was applied: plain lidocaine was first administered for anesthesia, after which the excision margin was defined under NBI illumination using a carbon dioxide laser, followed by lidocaine with epinephrine for resection. Twenty-one patients (18 men, 3 women) with 50 lesions were treated. All surgical margins were free of residual disease. During at least 12 months of follow-up, one recurrence occurred, and no malignant transformations were observed. In conclusion, NBI-guided excision with two-stage local anesthesia avoids the blanching effect and enhances visualization, facilitates precise margin delineation, and supports complete lesion removal.
Biomaterial Selection Regulates Tissue Remodeling and Collagen Deposition in Composite Tracheal Grafts.
Chan O, Calyeca J, Hussein Z … +5 more , Liu L, Dharmadhikari S, Li K, Johnson J, Chiang T
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42171329 · Publisher ↗
OBJECTIVE: Airway collapse is a life-threatening complication of tracheal grafting, yet no definitive strategy to prevent this exists. Composite tracheal grafts (CTG) that incorporate biodegradable splints can promote st...
OBJECTIVE: Airway collapse is a life-threatening complication of tracheal grafting, yet no definitive strategy to prevent this exists. Composite tracheal grafts (CTG) that incorporate biodegradable splints can promote structural support and host integration. This study evaluated how electrospun splint composition modulates submucosal remodeling and collagen deposition in partially decellularized tracheal grafts (PDTG). STUDY DESIGN: Case-control study using a microsurgical mouse model. SETTING: Research institute affiliated with a tertiary pediatric hospital. METHODS: PDTG were orthotopically implanted onto mice trachea. To create CTG, electrospun splints composed of polyglycolic acid (PGA), poly(l-lactide-co-ε-caprolactone) (PLCL), or a PGA/PLCL hybrid were integrated onto PDTG. Grafts were harvested at 2 weeks. Splint resorption, submucosal thickness, and collagen deposition were accessed via quantification of Masson's trichrome images. Cellular infiltration and fibroblast recruitment were evaluated using DAPI and vimentin immunofluorescence, respectively. Quantification was completed in the midgraft region using ImageJ, and statistical analysis was performed using GraphPad Prism 10. RESULTS: Splints demonstrated clear differences in the degree of resorption at 2 weeks. PGA splints demonstrated the greatest resorption, PLCL the lowest, and hybrid PGA/PLCL an intermediate degree. Compared to PDTG alone, PGA and PLCL splints resulted in decreased submucosal thickness, while collagen deposition was increased only in the PGA splint composition. Vimentin staining confirmed fibroblast recruitment into the submucosal layer, which qualitatively varied with biomaterial type. CONCLUSION: Electrospun biodegradable splints exhibited degradation dynamics and influenced tissue remodeling of engineered tracheal grafts. Material selection may improve graft integration and long-term viability.
Hypoxia and Oxidation Pathway Crosstalk in Head and Neck Squamous Cell Carcinoma.
Adil AA, Gensterblum-Miller E, Owen JH … +3 more , Buchakjian MR, Brenner CJ, Heft-Neal ME
Otolaryngol Head Neck Surg · 2026 May · PMID 42171285 · Publisher ↗
OBJECTIVE: Treatment resistance remains a significant challenge in head and neck squamous cell carcinoma (HNSCC). Alterations in oxidative stress and hypoxia pathways predict poor therapeutic outcomes. The nuclear factor...
OBJECTIVE: Treatment resistance remains a significant challenge in head and neck squamous cell carcinoma (HNSCC). Alterations in oxidative stress and hypoxia pathways predict poor therapeutic outcomes. The nuclear factor erythroid 2-related factor 2 pathway is the key regulator of oxidative stress response and an established mediator of treatment resistance. There is emerging evidence suggesting that its activation may influence hypoxia-inducible factor 1α (HIF-1α) signaling. However, this relationship remains poorly defined in HNSCC. STUDY DESIGN: Translational research. SETTING: University-based research laboratory. METHODS: This study utilized bioinformatic and experimental approaches to investigate the relationship between NRF2 and HIF-1α expression. Correlations among KEAP1, NFE2L2 (NRF2), and HIF1A (HIF-1α) mRNA were examined using The Cancer Genome Atlas (TCGA) and RNA-sequencing data from patient-derived HNSCC cell lines. Functional validation was performed using siRNA-mediated KEAP1 knockdown in vitro, followed by quantitative polymerase chain reaction (PCR) and Western blot analysis. RESULTS: TCGA analysis revealed that HIF1A mRNA positively correlated with NFE2L2 (NRF2), though the expression did not differ between NRF2 pathway-mutant and wild-type tumors. No significant correlation between HIF1A and NFE2L2 or KEAP1 mRNA was observed in HNSCC cell lines. KEAP1 knockdown achieved >90% transcript reduction and significantly increased the expression of the NRF2 target gene NQO1. Although NFE2L2 and HIF1A transcripts were unchanged, Western blot analysis demonstrated increased NRF2 and HIF-1α protein levels, suggesting a post-translational relationship. CONCLUSION: KEAP1 knockdown promotes NRF2 upregulation and HIF-1α protein accumulation in HNSCC independent of mRNA changes, suggesting protein-level or redox-mediated crosstalk between oxidative stress and hypoxia pathways.
Use of Lighted Urologic Guide Wires in Sialendoscopy: A Proof-of-Concept Study.
Dewey J, Freiser ME
Otolaryngol Head Neck Surg · 2026 May · PMID 42171266 · Publisher ↗
In combined approach sialendoscopy surgery, the sialendoscope tip may be used to illuminate the duct and serve as a visual target during cut down dissection. While this can assist in identifying the location of the duct...
In combined approach sialendoscopy surgery, the sialendoscope tip may be used to illuminate the duct and serve as a visual target during cut down dissection. While this can assist in identifying the location of the duct and any obstruction, it also runs the risk of damaging the endoscope. In this prospective single-arm trial, we investigated the safety of an infrared ureteral stent as a means of identifying the path of the salivary ducts. Five patients were enrolled to test the feasibility and safety of this device while undergoing sialendoscopy, which was trialed in 2 submandibular glands and 4 parotid glands. There was 1 instance of device failure which required intraductal exploration to rectify. Infrared light was able to be identified through tissue both transorally and transcutaneously, and in some instances was capable of identifying duct location when visible light was not. Future development in this technology targeting sialendoscopy may provide significant clinical utility for otolaryngologists.
Clinical Features and Surgical Outcomes in Patients With Central Skull Base Osteomyelitis.
Jung JH, Kang SH, Kim JH
Otolaryngol Head Neck Surg · 2026 May · PMID 42171261 · Publisher ↗
OBJECTIVES: Central skull base osteomyelitis (CSBO) is a rare but potentially life-threatening condition primarily involving the sphenoid or occipital bones, with reported mortality rates of 30% to 50%. Owing to its low...
OBJECTIVES: Central skull base osteomyelitis (CSBO) is a rare but potentially life-threatening condition primarily involving the sphenoid or occipital bones, with reported mortality rates of 30% to 50%. Owing to its low incidence, evidence-based diagnostic and treatment guidelines remain limited. This study aimed to characterize the clinical features, microbiologic spectrum, and treatment outcomes of patients with CSBO. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary referral center. METHODS: This study included 22 patients diagnosed with CSBO between November 2013 and December 2022. Clinical data, including presenting symptoms, comorbidities, surgical interventions, microbiologic findings, antimicrobial regimens and duration, hospitalization length, and clinical outcomes, were analyzed. RESULT: Diabetes mellitus was the most common underlying condition (n = 15, 68.2%). The predominant symptoms were headache (n = 14, 63.6%) and otologic complaints (n = 5, 22.7%). Surgical specimen cultures identified bacterial pathogens in 7 patients (32.0%), fungal pathogens in 9 (41.0%), and mixed bacterial-fungal pathogens in 5 (23.0%). Nineteen patients (83.4%) underwent surgical debridement; earlier debridement was correlated with a shorter duration of antimicrobial therapy (R = 0.545, P = .016). Complete remission was achieved in 19 patients (83.4%), and the overall mortality rate was 13.6%. CONCLUSION: Pathogen identification through surgical sampling is crucial for the effective management of CSBO, enabling timely and targeted antimicrobial therapy. Surgical debridement appears to improve clinical outcomes and reduce treatment duration. Prompt diagnosis and early surgical intervention may therefore be essential for achieving a favorable prognosis in patients with CSBO.
Adverse Airway Events Following Head and Neck Cancer Reconstruction Without Elective Tracheostomy.
Young TC, Tsai TY, Chan KC
Otolaryngol Head Neck Surg · 2026 May · PMID 42171258 · Publisher ↗
OBJECTIVE: Prior literature has examined characteristics associated with the decision to perform elective tracheostomy (ET); however, the risk of adverse airway events (AAEs) in patients managed without ET remains unclea...
OBJECTIVE: Prior literature has examined characteristics associated with the decision to perform elective tracheostomy (ET); however, the risk of adverse airway events (AAEs) in patients managed without ET remains unclear. We aimed to identify predictors of AAEs in patients managed without ET and to evaluate postoperative outcomes associated with ET. DATA SOURCES: Embase, PubMed, Web of Science, Scopus, and Ovid MEDLINE (January 1, 2009-January 6, 2026). REVIEW METHODS: A systematic review and meta-analysis were conducted following PRISMA guidelines. Risk of bias was assessed for included studies. AAE predictors were analyzed using pooled odds ratios (ORs). Postoperative outcomes associated with ET were evaluated by converting pooled ORs into number needed to harm. RESULTS: Overall, 25 studies (N = 5987) were included. The pooled AAE incidence in patients managed without ET was 10.3% (95% CI, 6.7%-15.6%). Compared with other oral cavity subsites, tumors of the floor-of-mouth (OR, 5.96) and oropharynx (OR, 2.60) were associated with higher AAE odds. Similarly, AAE risk was higher in patients with bilateral neck dissection (OR, 6.36) and higher American Society of Anesthesiologists class (OR, 1.51). ET was associated with increased risk of flap complications (OR, 2.15), unplanned return to the operating room (OR, 1.73), and prolonged time to oral feeding (mean difference, 5.86 days). CONCLUSION: Key predictors of AAEs were identified, supporting early risk recognition to guide selective ET in vulnerable patients. However, ET was also associated with increased postoperative morbidity and should be used selectively in perioperative airway planning.
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