Otolaryngol Head Neck Surg [JOURNAL]
Sun
200 papers
Mental Health Risk Factors for Postoperative Pain in Head and Neck Free Flap Reconstruction Patients.
Habib DRS, Sridhar S, Suh H … +6 more , Larson D, Swain BB, Vittetoe K, Sengstack D, Topf MC, Hicks MD
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42059182 · Full text
OBJECTIVE: Head and neck cancer (HNC) surgery is associated with postoperative pain and comorbid mental health disorders (MHDs). This study assessed predictors of postoperative pain and inpatient pain service consultatio...
OBJECTIVE: Head and neck cancer (HNC) surgery is associated with postoperative pain and comorbid mental health disorders (MHDs). This study assessed predictors of postoperative pain and inpatient pain service consultation following free flap reconstruction (FFR). STUDY DESIGN: Retrospective cohort. SETTING: Single-institution database. METHODS: Multivariable linear and logistic regressions identified predictors of postoperative day 5 (POD5) pain scores (0-10) and pain consultation, respectively. Propensity-matched analyses compared pain trajectories by MHD (depression or anxiety) and pain consultation. RESULTS: The cohort included 645 FFR patients. Higher POD5 pain was associated with MHD (β: 0.43; 95% CI: 0.03, 0.84), currently smoking (β: 0.58; 95% CI: 0.14, 1.03), being separated/divorced versus single (β: 0.71; 95% CI: 0.03, 1.39), osteocutaneous radial forearm free flap (OCRFFF) versus fasciocutaneous radial forearm free flap (RFFF) (β: 0.54; 95% CI: 0.02, 1.05), laryngeal site versus oral cavity (β: 0.59; 95% CI: 0.06, 1.13; P = .029), and non-oncologic indication (β: 0.86; 95% CI: 0.06, 1.67; P = .036). Pain consultation was associated with MHD (adjusted odds ratio [aOR]: 1.99; 95% CI: 1.13-3.52), preoperative narcotic use (aOR: 3.20; 95% CI: 1.77-5.79), OCRFFF (aOR: 3.42; 95% CI: 1.53-7.66), and private insurance (aOR: 3.09; 95% CI: 1.46-6.58). Among propensity-matched patients with an MHD, pain scores were not significantly different by pain consultation, while non-MHD patients with pain consultation reported higher pain across POD1-5 (P < .01). CONCLUSION: Psychosocial and clinical factors such as MHD diagnosis were independently associated with pain scores and pain service consultation after FFR. Patients with an MHD are particularly vulnerable. Identifying risk factors preoperatively may guide personalized perioperative pain management strategies.
Assessing the Impact of the Otolaryngology Core Curriculum (OCC): A Pre- and Post-Implementation Analysis.
Epperson MV, Lind MN, Thorne MC … +1 more , Kupfer RA
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42059152 · Publisher ↗
OBJECTIVE: Effective didactic education in otolaryngology residency programs is critical. This study evaluated resident and faculty perceptions before and after (Otolaryngology Core Curriculum) OCC implementation. STUDY...
OBJECTIVE: Effective didactic education in otolaryngology residency programs is critical. This study evaluated resident and faculty perceptions before and after (Otolaryngology Core Curriculum) OCC implementation. STUDY DESIGN: Prospective cohort study. SETTING: Single Otolaryngology residency program (2023-2025). METHODS: Anonymous pre- and post-OCC surveys with Likert-type items were distributed to residents and faculty. Resident surveys assessed weekly didactics preparation time, confidence in otolaryngology knowledge, curriculum effectiveness, comfort identifying educational resources, and perceived exam preparedness. Faculty surveys assessed preparation time, resident knowledge, and engagement. Paired t-tests, Wilcoxon Signed-Rank, and Mann-Whitney U tests were used for analysis. RESULTS: 24 and 19 residents completed the preimplementation and postimplementation survey, respectively. Weekly resident didactics preparation time increased from 16.3 ± 19.4 minutes to 83.9 ± 49.0 minutes (P < .00001). Resident confidence in knowledge improved (P = .015) with a large effect size (Cohen's d = 0.85; 95% CI [0.07, 1.62]). Perceived didactics effectiveness improved (P = .022) with a moderate-to-large effect size (Cohen's d = 0.79; 95% CI [0.01, 1.55]). Comfort identifying educational resources (P = .08) and perceived examination preparedness (P = .15) improved, nonsignificantly. Faculty preparation time decreased nonsignificantly, 105.0 ± 33.7 minutes to 90.0 ± 39.7 minutes (P = .35). Faculty-reported resident knowledge improved (P = .011) with a large effect size (Cohen's d = -1.44; 95% CI [-2.42, -0.43]). Faculty perception of resident engagement improved, nonsignificantly (P = .22). CONCLUSION: OCC implementation was associated with an increase in resident didactics preparation time, resident perceived knowledge, and faculty perception of resident knowledge, and increased didactics effectiveness.
Progress and Gaps: Two Decades of Female Authorship in High-Impact Otolaryngology Journals.
Powszok R, Haji R, Jeong J … +4 more , Primer G, Simon D, Patel KR, Stubbs VC
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42059091 · Publisher ↗
OBJECTIVE: To evaluate longitudinal trends in female authorship in high-impact otolaryngology journals and assess changes in representation across first and last author positions over a 20-year period. STUDY DESIGN: Cros...
OBJECTIVE: To evaluate longitudinal trends in female authorship in high-impact otolaryngology journals and assess changes in representation across first and last author positions over a 20-year period. STUDY DESIGN: Cross-sectional bibliometric analysis. SETTING: Three high-impact otolaryngology journals: JAMA Otolaryngology-Head & Neck Surgery, The Laryngoscope, and Otolaryngology-Head and Neck Surgery. METHODS: Research articles published in 2004 and 2024 were identified. First and last author genders were determined using publicly available sources. Descriptive statistics and proportional comparisons were performed to compare gender distribution across authorship positions and time points. RESULTS: A total of 3733 authors across 1948 original articles were analyzed. Overall female authorship increased from 15.5% in 2004 to 33.5% in 2024 (P < .001). Female first authorship more than doubled from 15.9% to 39.9% (P < .001), while female last authorship rose more modestly from 15.6% to 26.4% (P < .001). CONCLUSION: Female authorship in otolaryngology has grown substantially over the past 2 decades, reflecting progress in early-career scholarly participation. However, persistent underrepresentation in senior authorship positions highlights enduring barriers to academic advancement. Continued efforts to improve mentorship, sponsorship, and equitable promotion practices are essential to achieving gender equity in otolaryngology scholarship.
Associations Between Neighborhood Social Vulnerability and the Distribution of Rhinologists in the United States.
Park AC, Fehrenbach MP, Allawi RH … +3 more , Pracha SH, Ayo-Ajibola O, Hur K
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42059086 · Full text
OBJECTIVE: Assess the geographic distribution of US rhinologists in relation to neighborhood-level social determinants of health (SDoH) as measured by the Social Vulnerability Index (SVI). STUDY DESIGN: Cross-sectional....
OBJECTIVE: Assess the geographic distribution of US rhinologists in relation to neighborhood-level social determinants of health (SDoH) as measured by the Social Vulnerability Index (SVI). STUDY DESIGN: Cross-sectional. SETTING: United States. METHODS: The American Rhinologic Society directory was queried for US rhinologists and their practice addresses. The distribution of rhinologists was examined at the state and census tract level. SVI scores for each census tract were grouped into four quartiles across Overall SVI and four subthemes: socioeconomic status (SES), household composition and disability status (HH), racial-ethnic minority status (RE), and housing-transportation status (HT). The distance from each census tract to the nearest rhinologist was calculated and linear regression assessed associations between distance and SVI. RESULTS: A total of 808 rhinologists were included in this study. States with the greatest density of rhinologists included Wyoming, Vermont, and the District of Columbia; states with the lowest density included North Dakota, South Dakota, Alaska, and Maine. On multivariable analysis, higher vulnerability in SES (β = 1.517 [95% CI: 1.491, 1.544], P < .001) and HH (β = 1.487 [1.466, 1.509], P < .001) was associated with significantly increased distance to the nearest rhinologist. In contrast, higher vulnerability in RE (β = 0.347 [0.342, 0.353], P < .001) and HT (β = 0.926 [0.913, 0.940], P < .001) was associated with significantly decreased distance to the nearest rhinologist. CONCLUSION: Neighborhood-level distance to rhinologists in the United States is associated with neighborhood-level SDoH as measured by SVI. Future studies should assess the impact of rhinologist proximity on health outcomes.
Correction to "Cross-Cultural Adaptation of the Oral Frailty Index-8 for United States English-Speakers".
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42059066 · Publisher ↗
Abstract loading — click title to view on PubMed.
A Standardized Algorithm's Impact on Primary Detection in Head and Neck Carcinoma of Unknown Primary.
Townes TG, Martinez J, Gross ND … +20 more , Li G, Goepfert R, Myers J, Sikora AG, Choi K, Hutcheson KA, Song W, Lee A, Moran A, Lewis CM, Akhave N, Johnson F, De Sousa LG, Maniakas A, Wang JR, Su SY, Lai SY, Hanna E, Zhao X, Lango MN
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42059064 · Publisher ↗
OBJECTIVE(S): National guidelines for HPV-associated head and neck squamous cell carcinoma of unknown primary (HNSCCUP) were adapted into a standardized institutional diagnostic algorithm. This study evaluated the impact...
OBJECTIVE(S): National guidelines for HPV-associated head and neck squamous cell carcinoma of unknown primary (HNSCCUP) were adapted into a standardized institutional diagnostic algorithm. This study evaluated the impact of algorithm implementation on primary site detection, treatment selection, and oncologic outcomes. STUDY DESIGN: Retrospective implementation study. SETTING: Single tertiary-care cancer center. METHODS: We reviewed patients with clinically occult, PET/CT nonlocalizing HPV-associated HNSCCUP treated before (2014-2021) and after (2022-2023) implementation of the algorithm. RESULTS: Among 139 patients, those treated after algorithm implementation (n = 33) were more likely to undergo robotic ipsilateral lingual ± palatine tonsillectomy rather than bilateral palatine tonsillectomy, resulting in higher mucosal detection rates (88% vs 59%, P = .003). Postimplementation patients were more likely to receive primary surgical rather than nonsurgical treatment (54% vs 20%, P < .001) and unilateral radiotherapy without elective contralateral nodal irradiation (78% vs 43.5%, P = .002). Algorithm implementation was associated with a fourfold increase in the odds of primary site detection (OR 4.1, 95% CI 1.3-13.0, P = .018); however, detection rates also increased in HNSCCUPs not managed with robotic surgery, from 57% to 87% (P = .04). After implementation, 21.2% of patients received surgery alone compared with 5.7% prior, while postoperative chemoradiation was used in 9.1% versus 3.8%, respectively. No locoregional failures have occurred since implementation. CONCLUSION: Implementation of a standardized diagnostic algorithm for HPV-associated HNSCCUP significantly improved primary site detection and altered treatment without compromising disease control. Improvements in detection were not fully explained by the use of robotic surgery. Potential functional benefits warrant further study.
The Role of Thyroidectomy in the Management of Thyroglossal Duct Carcinoma: A Systematic Review.
IJtsma HH, van Dijk SPJ, Cunningham CE … +4 more , van Kemenade FJ, Peeters RP, Keereweer S, van Ginhoven TM
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42059047 · Publisher ↗
OBJECTIVE: The extent of surgical management of thyroglossal duct-associated differentiated thyroid carcinoma remains controversial. This study aims to evaluate the role of total thyroidectomy in patients with thyrogloss...
OBJECTIVE: The extent of surgical management of thyroglossal duct-associated differentiated thyroid carcinoma remains controversial. This study aims to evaluate the role of total thyroidectomy in patients with thyroglossal duct-associated differentiated thyroid carcinoma and provide insights to support individualized, evidence-based care. DATA SOURCES: A systematic literature search was conducted in MEDLINE, Embase, Web of Science, Cochrane CENTRAL, and Google Scholar from inception to January 2025. REVIEW METHODS: Screening was performed independently by two reviewers. Studies were included if they reported treatment details for patients with thyroglossal duct carcinoma, and excluded if they were letters, abstracts, reviews, or meta-analyses. The primary outcome consisted of recurrent disease. Secondary outcomes were presence of synchronous thyroid cancer, surgical treatments, and mortality. The study protocol was registered in PROSPERO (CRD-42023489730). RESULTS: Three hundred thirteen studies (243 case reports, 70 case series; range 1-26 patients per study) were included compromising 645 patients with differentiated thyroid carcinoma. Notably, no cohort studies were found. Recurrent disease occurred in 24/436 (5.5%) patients with reported follow-up (median, 35.5 months [12.0-80.0]). Among patients without preoperative suspicion for synchronous cancer in the thyroid, recurrence rates did not differ significantly between the Sistrunk-only group (n = 3/92 (3.3%), median follow-up 24 months [IQR, 12-48]) and the Sistrunk plus thyroidectomy group (n = 6/101 (5.9%), median follow-up 24 months [IQR, 12-69]; P = .502). CONCLUSIONS: The Sistrunk procedure alone may be sufficient in appropriately selected patients with thyroglossal duct carcinoma. The decision to perform total thyroidectomy should be individualized based on tumor characteristics and thorough thyroid assessment.
Irreversible Electroporation for Tonsillar Ablation in Adults.
Sarafoleanu C, Tanase I, Pascu MA … +2 more , Passali D, DeRowe A
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42059019 · Publisher ↗
OBJECTIVE: To evaluate the safety and efficacy of irreversible electroporation for non-thermal ablation of tonsils in adults. STUDY DESIGN: Prospective interventional case series of 24 adult patients referred for tonsill...
OBJECTIVE: To evaluate the safety and efficacy of irreversible electroporation for non-thermal ablation of tonsils in adults. STUDY DESIGN: Prospective interventional case series of 24 adult patients referred for tonsillectomy that were followed for 3 months. SETTING: Academic medical center. METHODS: The procedures were performed under general anesthesia or sedation. Irreversible electroporation was applied to the tonsils using the ENTire system. Pain was assessed daily using a pain scale for the first postoperative week. Tonsil sizes were assessed at baseline and 1 and 3 months postoperatively. The Tonsil and Adenoid Health Status Instrument and the Snore-Visual Analog Scale (VAS) questionnaires were administered at baseline and at 3 months. RESULTS: In total, 23 adult patients (mean age: 36.5 ± 14.0; mean body mass index [BMI]: 25.5 ± 4.1) completed the study. No bleeding was observed intra- or postoperatively. Procedural time was 7.98 ± 2.62 minutes. A pain scale score below 2 was reported 4.5 ± 1.7 days after intervention. Reduction in tonsillar size was observed from 2.4 ± 0.9 pre-intervention to 1.3 ± 1.0 at 3 months post-intervention (P < .001). Tonsil and Adenoid Health Status scores decreased from 17.7 ± 13.0 to 0.96 ± 1.7 (P < .001). The Snore- VAS score decreased by 72%. CONCLUSION: This is the first clinical study to investigate the use of irreversible electroporation for tonsillar ablation. Irreversible electroporation shows promise as a minimally invasive procedure for reducing the size of tonsillar hypertrophy and alleviating symptoms, with negligible bleeding and significantly less pain. Multicenter studies are in progress to evaluate long-term efficacy including in children.
Ratio of Height to Interincisor Distance (RHIID): Preoperative Assessment of Difficult Laryngeal Exposure.
Stevenson L, Hillig N, Alrassi J … +4 more , Huang ML, Naunheim M, Feng AL, Song P
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42047528 · Publisher ↗
OBJECTIVE: The ratio of height to interincisor distance (RHIID) is a new metric proposed for assessing laryngeal exposure. Anatomic ratios controlling for height, such as the ratio of height to thyromental distance (RHTM...
OBJECTIVE: The ratio of height to interincisor distance (RHIID) is a new metric proposed for assessing laryngeal exposure. Anatomic ratios controlling for height, such as the ratio of height to thyromental distance (RHTMD), are associated with difficult laryngeal exposure among anesthesiologists. This study examines the correlation between RHIID, RHTMD, and force metrics, as measured by the laryngeal force sensor (LFS), during suspension microlaryngoscopy (SML). STUDY DESIGN: Retrospective analysis of prospectively collected data. SETTING: Tertiary medical center. METHODS: Data from 476 adult patients (2017-2024) were analyzed to examine force metrics during suspension laryngoscopy. Height, thyromental distance (TMD), and interincisor distance (IID) were measured, and RHTMD and RHIID were calculated by dividing height (cm) by the respective variables (cm). Average and maximum forces (N) during direct laryngoscopy were recorded using the LFS. Multiple regression models were developed, and several linear models were selected as the best fit for identifying associations between these variables. RESULTS: RHIID's associations with force metrics were twice as strong as those observed with individual anatomical variables, including height, TMD, and IID. Patients with higher RHIID values exhibited significantly greater average and maximum forces during SML (P < .001). Although RHIID and RHTMD displayed comparable predictive strength for average force, RHIID consistently showed stronger correlations with maximum forces. CONCLUSION: RHIID is a new ratio that strongly correlates with force metrics, outperforming individual variables such as height, TMD, and IID. Incorporating these anatomic ratios into preoperative assessments provides clinicians with another tool for predicting laryngeal exposure during direct laryngoscopy.
Angular Insertion Depth for Cochlear Implantation: A Comparative Analysis on Precision of CT, MRI, and x-Ray.
Rader T, Bühler H, Fabritius MP … +2 more , Canis M, Spiegel JL
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42047524 · Full text
OBJECTIVE: Personalized medicine in cochlear implantation has advanced significantly with the advent of software tools that allow for detailed analysis of cochlear anatomy. This facilitates the selection of electrode arr...
OBJECTIVE: Personalized medicine in cochlear implantation has advanced significantly with the advent of software tools that allow for detailed analysis of cochlear anatomy. This facilitates the selection of electrode arrays tailored to the individual cochlear duct length (CDL) and supports anatomy-based fitting strategies. Concurrently, various imaging modalities-both preoperatively and postoperatively-can be assessed in a plug-and-play manner. However, to date, no study has performed a direct, systematic comparison of all commonly used imaging modalities preoperative and postoperative computer tomography (CT), magnetic resonance imaging (MRI), and x-ray. STUDY DESIGN: Retrospective study. SETTING: Tertiary Referral Center. METHODS: In total, 31 cochlear implantations with preoperative high-resolution CT and MRI, and postoperative high-resolution CT were analyzed with the software OTOPLAN, as well as manual measures from Stenvers view x-ray. Cochlear anatomy values derived from the different modalities were compared and correlated. RESULTS: Postoperative CT and x-ray showed excellent correlation for angular insertion depth across all electrode contacts. In contrast, apical contact values for both preoperative CT and MRI deviated significantly from those derived from postoperative CT scans. CONCLUSION: This study is the first to directly correlate intracochlear electrode position estimates obtained from these four imaging modalities and observed a high correlation between postoperative CT and x-ray measurements across all electrode contacts. In contrast, notable variations were observed when comparing these postoperative results with preoperative imaging data. These findings highlight the potential of postoperative x-ray-based analysis as a feasible and efficient method for anatomy-based fitting, supporting its integration into routine clinical workflows.
Correction to "Sleep Disturbance in Vestibular Migraine and Meniere's Disease: A Comparative Analysis".
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42047517 · Publisher ↗
Abstract loading — click title to view on PubMed.
Association of GJB2 P.V37I With Sudden Sensorineural Hearing Loss and Endoplasmic Reticulum Stress.
Lien KH, Tsai CL, Lee YS … +5 more , Chen TY, Chao WC, Hu CY, Chang PH, Tsai CN
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42047511 · Publisher ↗
OBJECTIVE: This study aimed to investigate the association between the heterozygous GJB2 p.V37I variant and susceptibility to sudden sensorineural hearing loss (SSNHL), and to explore its potential involvement in endopla...
OBJECTIVE: This study aimed to investigate the association between the heterozygous GJB2 p.V37I variant and susceptibility to sudden sensorineural hearing loss (SSNHL), and to explore its potential involvement in endoplasmic reticulum (ER) stress. STUDY DESIGN: Genetic association study with in vitro functional validation. SETTING: Tertiary academic medical center. METHODS: We screened 145 SSNHL patients for 25 variants in GJB2, SLC26A4, OTOF, and 12S rRNA using the SNaPshot® Multiplex Assay. GJB2 p.V37I frequency was compared with the Taiwan Biobank, and associations with hearing severity and recurrence were analyzed. Functional studies in HEI-OC1 cells transfected with wild-type or p.V37I GJB2 assessed ER stress (GRP78, CHOP) under tunicamycin by Western blot and immunofluorescence. RESULTS: The GJB2 p.V37I variant was identified in 39/145 SSNHL patients (26.9%) and showed significant allele enrichment compared with the general Taiwanese population (8.6%; enrichment OR = 1.92; P < .001), suggesting a genetic susceptibility contribution. The variant was associated with a higher prevalence of moderate (OR, 1.94; P = .019) and severe (OR, 1.90; P = .013) SSNHL, as well as recurrent episodes (OR, 3.77; P = .008). In vitro, p.V37I-expressing HEI-OC1 cells, a mouse cochlear hair cell line, showed significantly elevated GRP78 and CHOP expression compared to wild-type under tunicamycin induced ER stress, as confirmed by both immunoblotting and immunofluorescence microscopy. CONCLUSION: Our findings indicate that the heterozygous GJB2 p.V37I variant is associated with increased susceptibility and recurrence of SSNHL, potentially through ER stress-related mechanisms, supporting genetic screening and further mechanistic studies.
Oropharyngeal Dysphagia in Lung Transplant Patients: A Systematic Review.
Kutler RB, Barilka M, Lahiff MJ … +2 more , Pitman MJ, Born HL
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42047493 · Publisher ↗
OBJECTIVE: Oropharyngeal dysphagia (OPD) and laryngeal dysfunction are underrecognized yet clinically significant complications of lung transplantation. This systematic review aimed to evaluate the incidence, risk factor...
OBJECTIVE: Oropharyngeal dysphagia (OPD) and laryngeal dysfunction are underrecognized yet clinically significant complications of lung transplantation. This systematic review aimed to evaluate the incidence, risk factors, and outcomes associated with posttransplant OPD and identify gaps in the existing literature. DATA SOURCES: A literature search was performed using PubMed, Embase, Web of Science, and Cochrane Library databases. REVIEW METHODS: A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Title, abstract, and full-text screening were performed by 2 reviewers with subsequent narrative synthesis. Given the heterogeneity of study design and methodology, meta-analysis was not performed. RESULTS: Of 1752 studies identified, 12 met inclusion criteria. Reported OPD incidence after lung transplantation ranged from 52% to 100%, with silent aspiration rates as high as 47% to 78%. Only one study included pretransplant swallowing assessments, revealing a 5-fold increase in OPD posttransplant. Risk factors were diverse, though intubation-related factors were most commonly cited. Outcome data were inconsistent, but several studies linked OPD to increased intensive care unit and total hospital length of stay, as well as higher mortality. CONCLUSIONS: Reported OPD incidence is higher in studies utilizing instrumental swallowing evaluation, suggesting that bedside assessment may underestimate disease burden. The current literature remains limited and heterogeneous, with minimal incorporation of both pretransplant and posttransplant assessments, underscoring the need for high-quality prospective studies to better characterize perioperative swallowing dysfunction.
Decisional Conflict in Palliative Head and Neck Cancer Patients.
van den Besselaar BN, Herkendaal AF, Sewnaik A … +2 more , Baatenburg de Jong RJ, Offerman MPJ
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42037473 · Full text
OBJECTIVE: Head and neck cancer (HNC) patients may be subject to decisional conflict (DC). However, research on DC in the palliative phase remains limited. The primary objective of this study was to assess and describe D...
OBJECTIVE: Head and neck cancer (HNC) patients may be subject to decisional conflict (DC). However, research on DC in the palliative phase remains limited. The primary objective of this study was to assess and describe DC among patients with HNC in the palliative phase and explore the association between clinically significant DC and quality of life (QoL). STUDY DESIGN: Prospective cohort study. SETTING: Tertiary cancer center. METHODS: Patients with HNC entering the palliative phase between September 2022 and March 2024 were eligible. Patients were assessed in 2 cohorts: incurable HNC and refraining from curative treatment. DC was measured using the Decisional Conflict Scale (DCS). Other measures included patient, tumor, and palliative characteristics, and the EORTC QLQ-C15-PAL for QoL. RESULTS: Of 104 included patients, 72 patients had incurable HNC and 32 refrained from curative treatment. Clinically significant DC (score ≥25) was observed in 47 incurable HNC patients (65.3%) and 14 patients who refrained from curative treatment (43.8%), which was a significant difference. Tumor stage I/II was significantly predictive of less DC in patients who refrained from curative treatment. Three QoL domains showed large differences for incurable HNC patients when differentiating for clinically significant DC, and 6 for those who refrained from treatment. CONCLUSION: This study provides valuable insights into DC among palliative HNC patients. Clinically significant DC was more common in patients with incurable HNC than those who refrained from curative treatment. These findings highlight key differences between the cohorts, underscoring the need for tailored counselling to support patient-centered care.
Artificial Intelligence in Rhinology: A State-of-the-Art Review of Clinical Readiness and Implementation Pathways.
Hack S, Takashima M
Otolaryngol Head Neck Surg · 2026 Apr · PMID 42037445 · Publisher ↗
OBJECTIVE: To critically evaluate advances in artificial intelligence (AI) within rhinology, focusing on translational readiness, regulatory alignment, and clinical implementation pathways. DATA SOURCES: PubMed and Scopu...
OBJECTIVE: To critically evaluate advances in artificial intelligence (AI) within rhinology, focusing on translational readiness, regulatory alignment, and clinical implementation pathways. DATA SOURCES: PubMed and Scopus. REVIEW METHODS: PubMed and Scopus were searched using predefined Title/Abstract Boolean strategies with publication date (January 1, 2023-February 1, 2025), English-language, and human-study restrictions to support a structured state-of-the-art narrative synthesis. Major application domains were categorized as automated computed tomography (CT) analysis, endoscopic computer vision, phenotyping and endotyping in chronic rhinosinusitis, outcome prediction using patient-reported data, digital olfaction, and patient-facing language tools. Each domain was assessed for validation status, workflow feasibility, equity, and data-economics considerations, and alignment with regulatory pathways for software as a medical device. CONCLUSIONS: Automated sinus CT models have achieved multi-institutional external validation and appear closest to workflow translation. Endoscopic systems demonstrate promising performance in near real-time video but remain largely retrospective and require evaluation in live workflows. Predictive modeling using integrated clinical, molecular, or patient-reported data remains exploratory, while digital olfaction and language models lack standardized validation and regulatory oversight. Across domains, implementation barriers persist, including interoperability with electronic health records, economic disincentives to data aggregation, and risks of inequitable performance. IMPLICATIONS FOR PRACTICE: AI in rhinology is progressing toward integration into clinical care, with automated imaging applications leading adoption. Responsible deployment requires prospective multicenter trials, clinician-supervised workflows, transparency in performance across demographic groups, and evidence of improved patient outcomes. A structured readiness framework may guide stakeholders in prioritizing regulatory-feasible tools that offer measurable clinical value.
Factors Associated With Time to Postoperative Radiation Therapy in Veterans With Head and Neck Cancer.
Rollins A, Boudreaux-Kelly MY, McCoy JL … +7 more , Spector ME, Brenner C, Nilsen M, Mazul A, Hall DE, Rogal SS, Maxwell JH
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42037392 · Publisher ↗
OBJECTIVE: Initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery for head and neck squamous cell carcinoma (HNSCC) is a National Comprehensive Cancer Network (NCCN) guideline and quality metric....
OBJECTIVE: Initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery for head and neck squamous cell carcinoma (HNSCC) is a National Comprehensive Cancer Network (NCCN) guideline and quality metric. However, guideline concordance in the Veteran population remains unknown. This study evaluates the effect of time to PORT on overall survival (OS) and factors associated with PORT delay among Veterans with HNSCC. STUDY DESIGN: This is a retrospective cohort study of Veterans with HNSCC. SETTING: Patients with HNSCC from 2012 to 2022, identified from the National Veteran's Affairs Database, were included. METHODS: Data were extracted for clinical/demographics, tobacco/alcohol use, area deprivation index, Elixhauser score, body mass index, rurality, travel distance, and location of radiation. Analyses conducted were bivariate comparisons via chi-square and Wilcoxon rank-sum test, as well as adjusted survival analyses and adjusted multivariable logistic regression modeling. RESULTS: Among 2719 HNSCC Veterans who received surgery and adjuvant radiation nationwide, 1638 (60.2%) received PORT within 6 weeks of surgery. On multivariable analysis, factors associated with PORT delay greater than 6 weeks included being unmarried (P = .0275), having an oral cavity primary subsite (P < .0001), and undergoing surgery at the VA and radiation in the community (P < .0001). Three-year OS was higher among those who received PORT within 6 weeks (70.2%) compared to those who received PORT greater than 6 weeks postoperatively (62.1%, P < .001). CONCLUSION: Veterans with HNSCC receive guideline-concordant PORT at a rate of 60.2%. Being unmarried, having oral cavity cancer, and community radiation were associated with PORT delay.
Adjuvant Radiotherapy and Survival in Parotid Gland Adenoid Cystic Carcinoma: A National Cancer Database Analysis.
Kominsky E, Ansari M, Moore M … +4 more , Sim M, Mantravadi A, Yesensky J, Farlow JL
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42037367 · Full text
OBJECTIVE: To determine the association of positive margins and adjuvant radiotherapy on overall survival in parotid gland adenoid cystic carcinoma. STUDY DESIGN: Retrospective cohort analysis. SETTING: National Cancer D...
OBJECTIVE: To determine the association of positive margins and adjuvant radiotherapy on overall survival in parotid gland adenoid cystic carcinoma. STUDY DESIGN: Retrospective cohort analysis. SETTING: National Cancer Database from 2004 to 2021. METHODS: The National Cancer Database was queried for patients diagnosed with adenoid cystic carcinoma of the parotid who underwent upfront definitive surgical excision. Kaplan-Meier and Cox proportional hazard modeling were used for data analysis. RESULTS: Of 1360 included subjects, the mean age was 56.1 years (range 18-90), 61.6% were female, and 80.4% were white. Negative margins were reported in 52.0%, with microscopic positive margins present in 29.4% of patients. Total parotidectomy was performed in 52.4%, with facial nerve sacrifice in 36.0%. Adjuvant radiotherapy was given to 78.2% and chemotherapy to 8.7%. Median follow-up was 83.4 months; 10-year overall survival was 63.1%. Patients with positive margins, older age, male sex, and advancing stage were associated with worse overall survival. Adjuvant radiotherapy did not improve overall survival in the entire cohort (P = .8) or in early-stage disease (pT1N0-pT2N0) (P = .15) or microscopically positive margin subgroups (P = .8). CONCLUSION: Surgically resected adenoid cystic carcinoma of the parotid gland frequently exhibits positive margins, with adjuvant radiotherapy given in the majority of cases. With the inherent limitations of retrospective analyses of the National Cancer Database, radiotherapy had no significant difference in 10-year overall survival.
Correlation of Electrocochleography SP/AP With Endolymphatic Hydrops in Unilateral Ménières Disease.
Deng W, Li Z, Tang X … +3 more , Zeng J, Zheng Y, Ou Y
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42037364 · Publisher ↗
OBJECTIVE: To determine the optimal cut-off value of the electrocochleography (ECochG) SP/AP ratio and evaluate its correlation with endolymphatic hydrops (EH) in patients with unilateral Ménière's disease (MD). STUDY DE...
OBJECTIVE: To determine the optimal cut-off value of the electrocochleography (ECochG) SP/AP ratio and evaluate its correlation with endolymphatic hydrops (EH) in patients with unilateral Ménière's disease (MD). STUDY DESIGN: Retrospective study. SETTING: Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University. METHODS: This retrospective study enrolled 162 patients with unilateral MD. EH was assessed using gadolinium-enhanced MRI, and ECochG was performed to measure the SP/AP ratio. The correlation between SP/AP and EH severity was analyzed. RESULTS: The mean pure-tone average (PTA) threshold was significantly higher in affected ears than in unaffected ears (51.0 ± 17.9 dB vs 21.4 ± 10.6 dB, P < .001). The ECochG SP/AP ratio was also elevated in affected ears (0.41 ± 0.17 vs 0.24 ± 0.12, P < .001) and showed significant correlations with cochlear (r = 0.483, P < .001) and vestibular EH (r = 0.476, P < .001). Receiver operating characteristic (ROC) analysis revealed an area under the curve (AUC) of 0.79 for distinguishing affected ears, with an optimal SP/AP cut-off value of 0.305 (sensitivity = 83.33%, specificity = 72.22%). CONCLUSION: The ECochG SP/AP ratio demonstrates strong diagnostic utility for MD and correlates significantly with EH severity. A cut-off value of 0.305 provides a reliable objective marker for early MD diagnosis and EH assessment, particularly in settings where MRI is unavailable. ECochG serves as a valuable adjunctive tool for clinical decision-making in MD management.
Nonlinear Association Between Alcohol Intake and Hearing Among Older Adults: Evidence From NHANES 2015 to 2023.
Gong W, Pan G, Pan S … +3 more , Chen X, Shi W, Zhang J
Otolaryngol Head Neck Surg · 2026 Jul · PMID 42037313 · Publisher ↗
OBJECTIVE: This study aimed to investigate the potential nonlinear association between alcohol intake and hearing loss among older adults. STUDY DESIGN: A cross-sectional analysis based on nationally representative surve...
OBJECTIVE: This study aimed to investigate the potential nonlinear association between alcohol intake and hearing loss among older adults. STUDY DESIGN: A cross-sectional analysis based on nationally representative survey data. SETTING: Data were drawn from four cycles of the National Health and Nutrition Examination Survey (NHANES) conducted between 2015 and 2023. METHODS: A total of 2169 US adults aged 60 years and older were included. We used weighted multi-variable regression to examine the relationship of daily alcohol consumption (g/day) and hearing loss scores. We examined nonlinear associations using smoothing curves, and then threshold effects using 2 piecewise-linear regression equations. We also performed separate analyses stratified by sex to check robustness of associations. RESULTS: A non-linear, inverted U-shaped association was observed between alcohol intake and hearing loss scores, with an inflection point at approximately 23 g/day. Alcohol intake below this level was associated with lower hearing loss scores (β = -1.16, 95% CI: -1.83 to -0.49), whereas intake above the threshold was associated with higher scores (β = 1.01, 95% CI: 0.51 to 1.51). Sex-stratified analyses showed a similar nonlinear pattern among men (inflection point ≈ 14 g/day) but not among women. CONCLUSION: These findings indicate a sex- and age-specific, nonlinear association between alcohol intake and auditory function among older adults within the observed range of alcohol consumption. Moderate levels of alcohol intake were associated with lower hearing loss scores, whereas higher levels of intake were associated with higher hearing loss scores.
Electroencephalographic Spectral Power Characteristics of Ménière's Disease: A Pilot Study.
Li Y, Li J, Shi Z … +4 more , Yu D, Zhou H, Lu W, Shi H
Otolaryngol Head Neck Surg · 2026 Jun · PMID 42021743 · Publisher ↗
OBJECTIVE: This study investigates resting-state neural oscillatory features in patients with Menière's disease (MD). STUDY DESIGN: Cross-sectional study. SETTING: Single tertiary care hospital. METHODS: Thirty-two MD pa...
OBJECTIVE: This study investigates resting-state neural oscillatory features in patients with Menière's disease (MD). STUDY DESIGN: Cross-sectional study. SETTING: Single tertiary care hospital. METHODS: Thirty-two MD patients and 29 healthy controls were enrolled. Clinical evaluations included symptom questionnaires, pure-tone audiometry, and vestibular function tests. EEG power across multiple brain regions and frequency bands was compared between groups, and clinical relevance was examined through correlation analyses. RESULTS: MD patients demonstrated a significant increase in whole-brain average power spectral density (PSD) in the alpha band (P < .05). Regionally, theta-, alpha-, and beta-band PSDs were elevated in the prefrontal cortex, while gamma-band PSD was reduced in central and parietal areas. Correlation analyses revealed negative associations between altered PSD and balance performance, especially under challenging conditions. Additionally, prefrontal and frontal alpha-band PSD showed negative correlations with vestibular subdomain scores. CONCLUSIONS: This study identified distinct spectral power alterations in MD patients and explored their clinical relevance. Our findings highlight the neurophysiological features of MD in specific regions and frequency bands, suggesting their potential role in disease severity and balance impairment.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe