Otolaryngol Head Neck Surg [JOURNAL]
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200 papers
Inferior Turbinate Outfracture Alone for Nasal Obstruction Has Not Been Studied in Randomized Trials.
Man LX, Schmale IL
Otolaryngol Head Neck Surg · 2026 Jul · PMID 41940684 · Publisher ↗
Abstract loading — click title to view on PubMed.
Outcomes of Direct Vocal Fold Testosterone Injections in Hormone-Naïve Adults: A Case Series.
Morton-Jones ME, Guo ZC, Bromfield J … +3 more , Lee K, Langenstein J, Stein AP
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41940679 · Publisher ↗
Two nonbinary testosterone-naïve individuals were seen at the Northwestern Memorial Hospital Voice Clinic. The objective was to determine the effectiveness of direct testosterone injections to the vocal folds for voice m...
Two nonbinary testosterone-naïve individuals were seen at the Northwestern Memorial Hospital Voice Clinic. The objective was to determine the effectiveness of direct testosterone injections to the vocal folds for voice masculinization in testosterone-naïve individuals. Both subjects underwent 4 direct testosterone injections to the bilateral vocal folds 2 weeks apart. Before each injection, and 1 and 3 months post final procedure, the following were completed: voice recordings, voice-related quality of life survey, and mini-mood and anxiety questionnaire. Serum hormone levels were assessed pretreatment and posttreatment. Linear regression indicated a significant decrease in mean F0 3 months postfinal injection in both participants. Both reported improved voice quality of life and voice qualities shifted towards prototypical male. No systemic side effects reported, and posttreatment testosterone and estradiol levels were similar to baseline. Direct testosterone injections into the vocal folds represent a promising therapeutic intervention for voice masculinization in testosterone-naïve individuals.
Tonsillectomy Complication Rates Are Comparable Among 2- and 3-Year-Old Children: A Systematic Review and Meta-Analysis.
Hurtado C, Elwell Z, Murrell A … +1 more , Liu CC
Otolaryngol Head Neck Surg · 2026 May · PMID 41910931 · Publisher ↗
OBJECTIVE: To determine whether children between 2 and 3 years of age are at higher risk of immediate (<24 hours) posttonsillectomy complications and, therefore, require routine overnight observation. DATA SOURCES: Ovid...
OBJECTIVE: To determine whether children between 2 and 3 years of age are at higher risk of immediate (<24 hours) posttonsillectomy complications and, therefore, require routine overnight observation. DATA SOURCES: Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Scopus, and ClinicalTrials.gov were searched from 1788 to 2023. METHODS: A systematic review was performed in accordance with PRISMA guidelines. Search strategies included terms for tonsillectomy, adenotonsillectomy, hospitalization, overnight stay, children, and infants. Records were checked for duplicates and screened against specific inclusion criteria. Data on immediate postoperative complications (ie, respiratory complications, bleeding, and decreased oral intake) were collected. Meta-analysis was performed using Stata 19.0 (StataCorp LLC). RESULTS: The search yielded 7587 studies, of which 39 met the inclusion criteria. The overall complication rate in children under 3 years was 12.0% (95% CI 8.0%-17.0%). The pooled odds ratio for immediate postoperative respiratory complication in this group was 2.97 (95% CI, 2.3-3.9). Among children aged 2 to 3 years, the overall complication rate was 8.0% (95% CI of 4.0%-13.0%), the respiratory complication rate was 1.0% (95% CI: 0.0%-3.0%), and the poor oral intake rate was 2.0% (95% CI: 1.0%-5.0%). CONCLUSION: Children between 2 and 3 years old have comparable rates of postoperative complications compared to children over 3 years old. As such, ambulatory adenotonsillectomy is likely safe in this age group.
Margin to Depth of Invasion Ratio on Oncologic Outcomes in Node-Negative Oral Tongue Cancer.
Yang KS, Lin YT, Chuang HC … +5 more , Chien CY, Fang FM, Yang CH, Lu H, Tsai MH
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41910924 · Publisher ↗
OBJECTIVE: To evaluate the prognostic significance of the margin-to-depth of invasion ratio (MDR) in pathological nodal negative (pN0) oral tongue squamous cell carcinoma (OTSCC). STUDY DESIGN: Case series with chart rev...
OBJECTIVE: To evaluate the prognostic significance of the margin-to-depth of invasion ratio (MDR) in pathological nodal negative (pN0) oral tongue squamous cell carcinoma (OTSCC). STUDY DESIGN: Case series with chart review. SETTING: Tertiary academic medical center. METHODS: Patients with pN0 OTSCC who underwent primary radical surgery and high-quality neck dissection (lymph node yield ≥18) without positive margin (<1 mm) between 2007 and 2017 were retrospectively analyzed. Cox proportional hazards models were utilized to identify factors associated with survival outcomes, including cancer-specific survival (CSS) and relapse-free survival (RFS). RESULTS: A total of 296 patients were enrolled in this study. The optimal cutoff value for MDR was determined to be 0.29. For those with high MDR, the 5-year CSS and RFS were significantly superior compared to those with low MDR (CSS: 92.8% vs 71.5%, P < .001; RFS: 89.3% vs 67.9%, P < .001). In the multivariate Cox model, a low MDR remained an independent negative prognosticator of CSS (HR: 2.846, 95% CI: 1.229-6.593, P = .015) and RFS (HR: 2.661, 95% CI: 1.126-6.288, P = .026). In radical surgery without adjuvant therapy subgroup patients, patients with a low MDR had significantly poorer CSS and RFS than patients with a high MDR (both P < .001). CONCLUSION: Among pN0 OTSCC patients with negative surgical margins (≥1 mm), survival outcomes differed significantly between the high and low MDR groups. Patients with a low MDR had a markedly higher risk of recurrence and poorer cancer-specific survival, suggesting that adjuvant treatment may be warranted for this subgroup.
FDA Approval of Respiratory Biosimilars-Turning the Tide of Cost-Effectiveness?
Miller AL, Elmaraghy CA, Curtis CD … +1 more , Rathi VK
Otolaryngol Head Neck Surg · 2026 Jul · PMID 41904981 · Publisher ↗
In March 2025, the Food and Drug Administration (FDA) approved the first respiratory biosimilar: omalizumab-igec. FDA designated omalizumab-igec as "interchangeable" with the anti-IgE antibody omalizumab, which will perm...
In March 2025, the Food and Drug Administration (FDA) approved the first respiratory biosimilar: omalizumab-igec. FDA designated omalizumab-igec as "interchangeable" with the anti-IgE antibody omalizumab, which will permit pharmacists to perform substitution without consulting providers. This biosimilar will compete with blockbuster biologics indicated for the treatment of chronic rhinosinusitis with nasal polyposis (CRSwNP) and other inflammatory airway diseases. Biologics are presently not cost-effective for CRSwNP and should be reserved for patients who have not responded to conventional therapy (eg, nasal steroids and endoscopic sinus surgery) or are unfit for surgery. However, market entry of omalizumab-igec and other omalizumab biosimilars in late-stage clinical development may spur substantial price reductions if biosimilar manufacturers are able to overcome barriers such as patient and physician skepticism and restrictive state pharmacy laws (eg, requiring patient consent for biosimilar substitution). Comparative cost-effectiveness research is necessary to inform coverage policies and treatment decisions by patients and clinicians.
Intraoperative Parathyroid Hormone in Minimally Invasive Parathyroidectomy (MIP) for Primary Hyperparathyroidism With Concordant Localisation.
Chew BMH, Lim SSA, Gan TRX … +6 more , Sim SWH, Lau JWL, Oh HB, Chai YJ, Cheah WK, Tang MH
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41904980 · Publisher ↗
OBJECTIVE: There is increasing use of intraoperative parathyroid hormone (ioPTH) in minimally invasive parathyroidectomy (MIP). While ioPTH has improved cure rate, there is little evidence to suggest effectiveness in pri...
OBJECTIVE: There is increasing use of intraoperative parathyroid hormone (ioPTH) in minimally invasive parathyroidectomy (MIP). While ioPTH has improved cure rate, there is little evidence to suggest effectiveness in primary hyperparathyroidism (PHP) with concordant preoperative localisation. This study aims to determine if ioPTH improves cure rates in such cases. DATA SOURCES: A search of PubMed, Embase, and Cochrane databases identified studies that compared MIP with and without ioPTH, in patients with concordant preoperative imaging of ultrasonography and technetium-99m sestamibi (MIBI) scans. Inclusion criteria were comparative studies between years 2000 and 2023. REVIEW METHODS: Analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guidelines. Primary outcome was the overall cure rate. Secondary outcomes analyzed include operative duration, and conversion to neck exploration. RESULTS: Six studies involving 884 patients were eligible for inclusion. The overall cure rate was 97.3%, higher in those that had ioPTH than without, but this was not statistically significant (98.3% vs 96.0%, P = .18). Operative duration was reported in 2 studies, showing significantly longer duration in the ioPTH group. Overall conversion rate to bilateral neck exploration was 6.64% in the ioPTH group, with a success rate of 4.80%. CONCLUSION: Use of ioPTH in MIP with concordant localization did not result in statistically significant higher cure rates. Operative time is potentially longer with use of ioPTH. It is difficult to justify the routine use of ioPTH for such cases based on cure rates alone; considerations should also be given to center-specific case volume, surgical experience, and overall cost outcomes.
Defining the Timing of Radiological Follow-Up for Detection of Cholesteatoma Recidivism: A Meta-analysis.
Wolfovitz A, Segal E, Murad H … +2 more , Agay N, Tessler I
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41904979 · Publisher ↗
OBJECTIVE: Non-echo-planar diffusion-weighted imaging (non-EPI DWI) magnetic resonance imaging (MRI) has revolutionized postoperative cholesteatoma follow-up, shifting from surgical to radiological evaluation. Yet, the t...
OBJECTIVE: Non-echo-planar diffusion-weighted imaging (non-EPI DWI) magnetic resonance imaging (MRI) has revolutionized postoperative cholesteatoma follow-up, shifting from surgical to radiological evaluation. Yet, the timing for postoperative imaging remains contentious. This meta-analysis assesses the optimal follow-up interval for postoperative MRI in detecting cholesteatoma recidivism. DATA SOURCES: PubMed, Embase, and Cochrane. REVIEW METHODS: We conducted a meta-analysis systematic review of PubMed, Embase and Cochrane between 2013 and 2024 following Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The positive MRI rate over time was estimated for each study separately and then pooled across studies using weighted averages of the ears studied. Data were plotted against time with a smoothed curve and 95% confidence intervals. Study quality was assessed using the Newcastle-Ottawa Scale. RESULTS: We identified 525 studies, of which 16 studies met the inclusion criteria, comprising 1187 patients. The pooled MRI positivity rates at standardized follow-up intervals were 12% at 1 month, 19% at 6 months, and 15% at 12 months. Positivity increased to 22% at 24 months, then declined to 12% at 36 months, followed by a secondary peak of 21% at 48 months, and 13% at 60 months. Canal wall up procedure demonstrated significantly higher MRI positive rates than obliteration procedures at both 12 months (22% vs 7%) and 36 months (18% vs 9%). At 12 months, the pooled MRI positivity rate was 16% (95% CI: 6%-38%, I = 91%) in adults and 20% (95% CI: 7%-47%, I = 88%) in children. CONCLUSION: Our findings support performing the first routine non-EPI DWI MRI at 12 to 24 months postoperatively. Given the slow-growing nature of cholesteatoma and stable recurrence rates beyond this period, follow-up imaging can be performed at 2-year intervals thereafter in patients with a negative initial scan, yet continued for at least 5 years.
Association of Preoperative Depression and Clinical Outcomes After Head and Neck Free Flap Reconstruction.
Sridhar S, Larson DP, Swain BB … +6 more , Suh H, Habib DRS, Vittetoe K, Sengstack D, Topf MC, Hicks MD
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41904978 · Publisher ↗
OBJECTIVE: Comorbid depression is a significant negative predictor of survival in patients with head and neck cancer (HNC). Prior studies have shown a prevalence of up to 40.1%; however, depression is often underdiagnose...
OBJECTIVE: Comorbid depression is a significant negative predictor of survival in patients with head and neck cancer (HNC). Prior studies have shown a prevalence of up to 40.1%; however, depression is often underdiagnosed in this patient population. STUDY DESIGN: Retrospective cohort. SETTING: Single-institution database. METHODS: Patients who underwent free flap reconstruction for HNC at our institution (January 2019-December 2023) were retrospectively reviewed. The primary outcome was overall survival (OS). Secondary outcomes included length of stay, discharge disposition, 30-day readmissions, and postoperative radiotherapy (PORT) delay. Kaplan-Meier and multivariate Cox proportional hazards models estimated the effect of preoperative depression on OS. Multivariate regression models examined the association of preoperative depression with secondary outcomes. RESULTS: 645 patients were included. Preoperative depression was present in 158 patients (24%) and 150 patients (23%) were on preoperative antidepressants. There was no difference in OS in depressed patients compared to nondepressed patients (adjusted hazard ratio [aHR] 1.07, 95% confidence interval [CI] 0.76-1.51). Preoperative antidepressant use was independently associated with discharge to rehabilitation or skilled nursing facilities compared to discharge home (adjusted odds ratio [aOR] 1.82, 95% CI 1.07-3.06). There were no associations of preoperative depression with length of stay, 30-day readmission rates, or PORT delay. CONCLUSION: Preoperative antidepressant use is associated with greater likelihood of discharge to rehabilitation facilities after free flap reconstruction. Preoperative depression was present at one-half the estimated rate in our patients, highlighting the need for improved preoperative screening and intervention.
Multicenter Comparison of Modern Plating Options in Fibula, Scapula, and Osteocutaneous Radial Forearm Free Flaps.
Bollig CA, Reddi S, Walia A … +17 more , Pipkorn PJ, Jackson RS, Puram SV, Rich JT, Paniello RC, Zevallos JP, Stevens MN, Wood CB, Rohde SL, Sykes K, Bur A, Wieser ME, Galloway TLI, Tassone P, Pluchino T, Jorgensen JB, Kakarala K
Otolaryngol Head Neck Surg · 2026 May · PMID 41886790 · Full text
OBJECTIVES: Evaluate the association of plating strategies with hardware removal and operative time, after adjusting for relevant clinical variables. STUDY DESIGN: Retrospective Review. SETTING: Multiple Academic Medical...
OBJECTIVES: Evaluate the association of plating strategies with hardware removal and operative time, after adjusting for relevant clinical variables. STUDY DESIGN: Retrospective Review. SETTING: Multiple Academic Medical Centers. METHODS: Patients undergoing osseous free flap reconstruction stratified based on the plating strategy [conventional plating with a hand-bent plate, precontoured plate, and virtual surgical planning (VSP) with patient-specific hardware and cutting guides]. Variables associated with hardware removal were analyzed using multivariable logistic regression. To evaluate the effect of plating strategy on operative time, a multivariable linear regression model was created. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) were calculated. RESULTS: 1022 patients were analyzed: 650 (63.6%) conventional plate, 163 (15.9%) precontoured plate, and 209 (20.5%) VSP. Compared to conventional plating (aOR: 1.00), VSP was independently associated with lower odds of hardware removal (aOR: 0.39, 95% CI: 0.23-0.68), while there was no difference with precontoured plates (aOR: 0.84, 95% CI: 0.52-1.38). Compared to conventional plates, precontoured plates were associated with a reduction in operative time of 31.13 minutes (95% CI: 2.93-59.33), and VSP was associated with a reduction in 76.87 minutes (95% CI: 50.15-103.57), adjusting for flap type and defect length. CONCLUSIONS: This multi-institutional study demonstrates that head and neck osseous reconstruction with customized, patient-specific hardware and VSP is associated with a lower rate of hardware removal and shorter operative time compared to precontoured or hand-bent hardware. Additionally, cases utilizing precontoured hardware were associated with shorter operative time, but similar rates of hardware removal compared to conventional plates.
Long-Term Health-Related Quality of Life in Oropharyngeal Squamous Cell Carcinoma: A Systematic Review.
Zarrella D, Chitnis O, Kim HE … +4 more , Wrozek T, Caraway JJ, Levett P, Orestes M
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41886789 · Publisher ↗
OBJECTIVE: Although short-term health-related quality of life (HRQoL) outcomes in survivors of oropharyngeal squamous cell carcinoma (OPSCC) are well characterized, long-term HRQoL outcomes (≥5 years posttreatment) are n...
OBJECTIVE: Although short-term health-related quality of life (HRQoL) outcomes in survivors of oropharyngeal squamous cell carcinoma (OPSCC) are well characterized, long-term HRQoL outcomes (≥5 years posttreatment) are not well established. This systematic review aims to assess long-term HRQoL in OPSCC survivors and identify potential predictors influencing these outcomes. DATA SOURCES: A comprehensive search of the literature was performed using PubMed, Embase, Web of Science, and Ovid All EBM Reviews (Cochrane). REVIEW METHODS: Studies met inclusion criteria if they were in English, included OPSCC patients ≥5 years posttreatment, and reported OPSCC-specific HRQoL outcomes measured by validated questionnaires. RESULTS: The literature search returned 2656 articles for initial review, of which 7 (771 participants, range 9-396) met inclusion criteria. Heterogeneous reporting and lack of raw data precluded meta-analysis. Across validated instruments, survivors demonstrated persistent dysphagia, xerostomia, and diet restriction; however, global HRQoL was generally preserved. Subgroup analyses indicated that single-modality treatment and p16 positivity were associated with better long-term QoL, while advanced stage, base of tongue primary site, chemotherapy use, PEG-tube dependence, smoking or alcohol use at diagnosis, older age, and lower educational attainment predicted poorer QoL outcomes. CONCLUSION: Long-term OPSCC survivors experience persistent functional impairments despite generally preserved global HRQoL. Standardized, longitudinal studies are needed to better characterize predictors of long-term HRQoL and inform targeted survivorship interventions.
Factors Associated With Provision of Allergy Services Within Otolaryngology.
Stoller E, Damask C, Roland LT
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41886788 · Publisher ↗
This study aimed to identify trends among otolaryngologists offering allergy services and barriers to implementation. A cross-sectional survey was distributed to members of the American Academy of Otolaryngology-Head and...
This study aimed to identify trends among otolaryngologists offering allergy services and barriers to implementation. A cross-sectional survey was distributed to members of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) between November and December 2024. In total, 106 of 136 respondents were at a practice that administered allergy services, 77.4% of which were male, 22.6% were female, 60.4% were aged between 45 and 65 years, and 84.0% were Caucasian. Practice location was significantly correlated with allergy service provision (χ(3, n = 136) = 7.98, P = .046), and as was practice type (Fisher's exact test, P < .01, n = 136). Single specialty groups in private practice were nine times (95% CI: 2.5-37.9) more likely to administer services compared to academic practices. For respondents who did not offer allergy services, the most common barrier was lack of office space (73.3%). These findings can help the AAO-HNS support its members in rendering allergy services.
A Pilot Study of Virtual Reality-Vestibular Physical Therapy for Refractory Dizziness.
Bourdillon AT, Patel EJ, Chae R … +3 more , Gann EJ, Dien A, Sharon JD
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41886787 · Publisher ↗
OBJECTIVE: To assess the tolerability and efficacy of Virtual Reality-Vestibular Physical Therapy (VR-VPT) in individuals with refractory symptoms after conventional vestibular rehabilitation. STUDY DESIGN: Prospective c...
OBJECTIVE: To assess the tolerability and efficacy of Virtual Reality-Vestibular Physical Therapy (VR-VPT) in individuals with refractory symptoms after conventional vestibular rehabilitation. STUDY DESIGN: Prospective cohort study. SETTING: Single institution tertiary care practice. METHODS: Participants were offered VR-VPT if they (1) still had symptoms after conventional vestibular physical therapy or (2) were considered to have a specific problem suited to VR-VPT. Treatment consisted of approximately 8 45-minute sessions, each directed by a physical therapist. Differences in baseline and posttreatment surveys, provider-based assessments, and presession and postsession Simulator Sickness Questionnaire (SSQ) scores were analyzed. RESULTS: Among our cohort of 18 participants, there were 10 individuals with vestibular loss (VL), 6 with vestibular migraine (VM), and 4 with Persistent Postural-Perceptual Dizziness (PPPD), with some participants having more than 1 diagnosis. Significant improvements were seen posttreatment in the Dizziness Handicap Inventory (n = 15, mean difference: -11.7, 95% CI: [-18.2, -5.2], P = .002) and the Functional Gait Assessment (n = 17, mean difference: 2.3, 95% CI: [0.8, 3.8], P = .005). Video head impulse testing and dynamic visual acuity improved in a subset of VL participants who underwent both baseline and posttreatment testing. VR-VPT sessions did not significantly provoke symptoms captured in SSQ responses, such as nausea (average difference: 0.32 ± 0.68) or general discomfort (average difference: 0.14 ± 0.68). CONCLUSION: This pilot study suggests that VR-VPT can be tolerated and may benefit many patients with refractory symptoms, with additional benefits in vestibular function observed in individuals with vestibular loss.
Comparing Hyoid Suspension Approaches in Multilevel Sleep Surgery: A Systematic Review and Meta-Analysis.
Weatherford D, James J, Smith H … +3 more , Graham S, Baker E, Gillespie MB
Otolaryngol Head Neck Surg · 2026 May · PMID 41886779 · Publisher ↗
OBJECTIVE: Hyoid suspension is a method used to address hypopharyngeal obstruction in multilevel surgery for obstructive sleep apnea (OSA). The procedure involves suspending the hyoid bone to either the mandible or thyro...
OBJECTIVE: Hyoid suspension is a method used to address hypopharyngeal obstruction in multilevel surgery for obstructive sleep apnea (OSA). The procedure involves suspending the hyoid bone to either the mandible or thyroid cartilage, determined by surgeon preference. This meta-analysis aims to compare the effectiveness of these two approaches in multi-level sleep surgery. DATA SOURCES: PubMed, Embase, Scopus, and The Cochrane Library. REVIEW METHODS: All studies underwent a 2-stage blinded screening, extraction, and evaluation process. Primary outcomes of the study included pre- and postoperative apnea hypopnea index (AHI), Sher surgical success rate (≥50% reduction in AHI and postoperative AHI < 20), and changes to Epworth Sleepiness Scale (ESS) Score. RESULTS: Database searches yielded 1502 studies with 74 full-text articles screened, and 21 studies ultimately included. In patients who underwent hyothyroidpexy and palatal surgery (n = 582), the average AHI was reduced 20.98 (confidence interval 16.87, 25.08), ESS score improved by 5.99 [4.35, 7.63], and 57.5% met Sher criteria for surgical success. Patients who received hyomandibular suspension (n = 141) achieved an average AHI reduction of 29.21 [20.87, 37.55], improvement in ESS by 4.4 [1.33, 7.51], and Sher success rate of 73.8%. Although improvement in AHI and ESS scores were not statistically significant between groups, the proportion of patients meeting Sher Criteria success was greater for hyomandibular suspension (P = .006) CONCLUSION: The results of this study show that both methods of hyoid suspension are effective in treating OSA when used as a component of multilevel sleep surgery but suggests that hyomandibular suspension may provide greater improvement than hyothyroidpexy.
Turbinate Surgery in Children With Sleep-Disordered Breathing: A Randomized Prospective Study.
Bharadwaj S, Vazifedan T, Baldassari CM
Otolaryngol Head Neck Surg · 2026 May · PMID 41879315 · Publisher ↗
OBJECTIVE: To assess whether submucosal ablation of turbinates (SAT) at the time of adenotonsillectomy (AT) confers benefit in the reduction of nasal obstruction compared to AT alone. STUDY DESIGN: A randomized, single-b...
OBJECTIVE: To assess whether submucosal ablation of turbinates (SAT) at the time of adenotonsillectomy (AT) confers benefit in the reduction of nasal obstruction compared to AT alone. STUDY DESIGN: A randomized, single-blinded study between 2014 and 2017. Children between 3 and 17 years with sleep-disordered breathing (SDB) and nasal obstruction were eligible. Patients had turbinate hypertrophy at baseline and were scheduled to undergo AT for SDB. The sinus and nasal quality of life survey (SN-5) and the visual analog scale (VAS) were measured. SETTING: Tertiary Children's Hospital. METHODS: Children were randomized to AT (control group) or AT with SAT. The study was powered to assess for changes in the SN-5 at 3 and 12 months. RESULTS: In total, 51 patients were randomly assigned: 18 in the control group and 33 in the AT with SAT group. The SAT group had higher preoperative SN-5 scores compared to the control group. Both groups experienced improvement in SN-5 scores at 3 and 12 months. There was no statistically significant difference in the reduction of the total SN-5 score at 3 months (51% vs 50.1%, P = .707) and 12 months (52.1% vs 43.6%, P = .225) between the AT with SAT group and the AT alone group. CONCLUSION: Children with nasal obstruction that undergo AT and SAT experience improvement in SN-5 scores. It remains uncertain whether SAT performed at the time of AT confers additional improvement in nasal symptoms compared to AT alone. Future research should include an assessment of SDB symptom burden to allow for a definitive determination of the role of turbinate surgery in children with SDB.
Effect of Penicillin Allergy Label on Antibiotic Treatment Outcomes in Adult Patients with Rhinosinusitis.
Levy DA, Green DGJ, Liu M … +3 more , Liau J, Chen PG, McCoul ED
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41879305 · Publisher ↗
OBJECTIVE: Rhinosinusitis (RS) is prevalent in the ambulatory setting. When indicated, treatment with penicillin is recommended. However, up to 25% of the US population has a penicillin allergy label (PAL) within their h...
OBJECTIVE: Rhinosinusitis (RS) is prevalent in the ambulatory setting. When indicated, treatment with penicillin is recommended. However, up to 25% of the US population has a penicillin allergy label (PAL) within their health record, which can result in treatment with second-line antibiotics. The study explored the effect of PAL on clinical outcomes in RS. STUDY DESIGN: Retrospective chart review. SETTING: Ochsner Medical Centre. METHODS: A chart review was performed in adult patients with RS who received antibiotics between 2011 and 2024. Treatment failure was defined as need for a second antibiotic within 30 days. Adverse events (AE) were indexed to a new diagnosis of diarrhea within 30 days. Odds ratio (OR) of success:AE was calculated and compared to standard of care, using Cohen's h to measure the effect size of nonpenicillin antibiotics. RESULTS: 335,015 subjects who received antibiotics for RS were included. Of these, 55,557 (16.6%) had PAL. These patients were more likely to receive a nonpenicillin antibiotic for initial therapy (87.8%). Patients with a PAL had a slightly greater rate of treatment success (78.2% vs 75.8%, h = 0.057), but a greater AE rate (1.8% vs 1.7%, h-0.015). Among second-line treatments for patients with PAL, tetracycline had a superior OR of success: AE (0.983, 95% CI 0.906-0.894) compared to fluoroquinolones (0.842, 95% CI 0.843-0.831). CONCLUSION: In patients with RS, PAL often leads to the prescription of a second-line antibiotic, which has decreased benefit-to-risk ratio compared to first-line treatment. This emphasizes the need for additional efforts to remove PALs from patients without true penicillin allergy.
Closure of Chronic Tracheoesophageal Fistula in Pediatrics Using Endoscopic Suturing.
Digoy GP, Chun W, Nelson C
Otolaryngol Head Neck Surg · 2026 May · PMID 41874394 · Publisher ↗
Tracheoesophageal fistula repair, especially in pediatric cases, presents challenges with traditional thoracotomy due to significant morbidity and recurrence rates. We introduce a novel technique- transglottic endoscopic...
Tracheoesophageal fistula repair, especially in pediatric cases, presents challenges with traditional thoracotomy due to significant morbidity and recurrence rates. We introduce a novel technique- transglottic endoscopic suturing- for TEF repair in infants and young children. The method combines CO laser de-epithelialization and suturing with a modified Prolene suture. Demonstrated in three cases of failed thoracotomy repairs, the procedure shows promising outcomes, with improvements in pulmonary function, oral feeding, and symptom resolution. Postoperative monitoring includes repeat bronchoscopy and esophagram, with Prolene suture removal in a follow-up procedure. Comparisons with traditional approaches highlight potential benefits, such as reduced morbidity, and complications. Although we acknowledge the small sample size as limitation, this technique shows promise in enhancing endoscopic TEF repair success rates. It provides an alternative for challenging cases, where repeated thoracotomies present significant morbidity. This approach has the potential for improving clinical outcomes with reduced morbidity in pediatric TEF patients.
Long-Term Audiological Outcomes After Surgical Repair for Congenital Aural Stenosis.
Yeh CC, Young TC, Zhang BY … +1 more , Chan KC
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865284 · Publisher ↗
OBJECTIVE: To evaluate long-term hearing improvement and risk for deterioration following surgical repair of congenital aural stenosis (CAS) using an endaural approach. STUDY DESIGN: Retrospective cohort study. SETTING:...
OBJECTIVE: To evaluate long-term hearing improvement and risk for deterioration following surgical repair of congenital aural stenosis (CAS) using an endaural approach. STUDY DESIGN: Retrospective cohort study. SETTING: Patients who underwent modified meatoplasty with an endoaural-conchal incision combined with canaloplasty and tympanoplasty for CAS between 2014 and 2025. METHODS: Postoperative hearing improvement was assessed at 3, 6, 12, 18, 24, 36, 48, and >60 months. Longitudinal trends were analyzed using mixed-effects models. Hearing deterioration, defined as an air-conduction (AC) threshold increase exceeding 10 dB from the first postoperative audiogram, was analyzed using the Kaplan-Meier method and Cox regression. RESULTS: A total of 77 patients (78 ears; aged 4-48 years) were included. The mean (SD) follow-up duration was 25.2 (27.9) months, and the mean preoperative air-bone gap (ABG) was 52.1 dB. The average greatest ABG change (ΔABG) was 23.8 dB. Within the first postoperative year, 66.7% achieved an ABG ≤ 30 dB. Adjusted mixed-effects analysis showed no significant overall ΔABG during follow-up (P = .291). Postoperative ABG values were significantly better than preoperative values at all time points. The ABG at 12 months was higher than that at 3 months (P = .021). Hearing deterioration differed significantly between groups stratified by the median preoperative AC threshold (61.7 dB HL), which remained an independent predictor in the Cox analysis (P = .027). CONCLUSION: CAS repair yielded durable postoperative improvement. If deterioration occurred, it was mostly confined to the first year. Preoperative AC thresholds may help predict the risk for deterioration.
A Consensus-Driven Uniform Data Set for Head and Neck Cancer: Instrument Development and Evaluation Planning.
Sykes KJ, Lawrence A, Wang NC … +11 more , Ramesh UR, Feucht M, Duncheskie R, Wagoner SF, Bon-Nieves A, Boakye EA, Taylor RJ, Schmalbach CE, Massa S, Humphrey B, Villwock JA
Otolaryngol Head Neck Surg · 2026 May · PMID 41865283 · Publisher ↗
Social determinants of health (SDoH) are key drivers of disparities in head and neck cancer (HNC) outcomes, contributing to late-stage presentation and increased mortality. Current research primarily focuses on individua...
Social determinants of health (SDoH) are key drivers of disparities in head and neck cancer (HNC) outcomes, contributing to late-stage presentation and increased mortality. Current research primarily focuses on individual and healthcare system factors, with insufficient representation of broader societal influences. To address this gap, we developed a uniform data set (UDS) integrating multilevel SDoH measures with oncologic healthcare delivery metrics. In phase I, an expert advisory board used an iterative process to establish consensus on key data elements for the UDS. In phase 2, a multi-institutional pilot study was launched at six academic centers to evaluate its feasibility. We present the outcomes of the expert panel and the implementation of the pilot study. Our co-developed data collection instrument supports the establishment of a UDS for identifying drivers of disparities in HNC. While multi-institutional pilots remain challenging, cultivating networks of institutions and institutional review boards (IRBs) facilitates collaborative evaluation of healthcare disparities.
Venous Thromboembolism in Otolaryngology-Head and Neck Surgery: Systematic Review and Meta-Analysis.
Wu SS, Kandathil CK, Saltychev M … +3 more , Losorelli S, Fu BJ, Most SP
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865282 · Publisher ↗
UNLABELLED: Venous thromboembolism (VTE) is a serious perioperative complication associated with morbidity and mortality. Although otolaryngology-head and neck surgery (OHNS) has lower rates of VTE than other surgical sp...
UNLABELLED: Venous thromboembolism (VTE) is a serious perioperative complication associated with morbidity and mortality. Although otolaryngology-head and neck surgery (OHNS) has lower rates of VTE than other surgical specialties, VTE rates and risk factors by subspecialty are not well characterized. This systematic review and meta-analysis aims to synthesize the published evidence on VTE in OHNS. DATA SOURCES: Medline, Embase, CINAHL, Central, Scopus, and Web of Science databases were searched from inception to 10/06/2025. REVIEW METHODS: Clinical and observational studies of adult patients who underwent otolaryngologic surgery were included. Outcome measures included VTE, deep venous thrombosis (DVT), and pulmonary embolism (PE) rates. Three independent reviewers evaluated each abstract and article. Heterogeneity and bias across studies were evaluated. RESULTS: Of 4329 studies identified, 212 met inclusion criteria, comprising 2,779,113 patients. The overall event rates were 0.008 for VTE (I = 99%, prediction interval [PI] 0.001-0.100), 0.006 for DVT (I = 99%, PI 0.000-0.066), and 0.005 for PE (I = 97%, PI 0.001-0.045). On subspecialty analysis, VTE rates were highest for rhinology (0.013), followed by otology (0.010), head and neck (0.010), FPRS (0.006), comprehensive (0.004), sleep surgery (0.003), and laryngology (0.002). There was no correlation between chemoprophylaxis rates and either VTE or bleeding. Risk factors identified included prolonged procedure duration, free flap, lower extremity donor sites, and lumbar drain, among others. CONCLUSION: VTE rates in OHNS are overall low but may be further optimized. Development of an OHNS specialty-specific chemoprophylaxis guideline may improve perioperative risk stratification and reduce morbidity and mortality from VTE.
Individual-Level Brain Network Predictors and Distinct Reorganization Mechanism in Sound Therapies for Tinnitus.
Li J, Tong Z, Cai W … +12 more , Xu Q, Huang X, Xiong B, Ye W, Fang C, Chen X, Deng C, Zhao F, Salvi R, Chen G, Chen YC, Cai Y
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865279 · Publisher ↗
OBJECTIVE: To investigate brain network reorganization in tinnitus patients undergoing tailor-made notched music training (TMNMT) or tinnitus retraining therapy (TRT) and assess whether baseline network characteristics p...
OBJECTIVE: To investigate brain network reorganization in tinnitus patients undergoing tailor-made notched music training (TMNMT) or tinnitus retraining therapy (TRT) and assess whether baseline network characteristics predict treatment outcomes. STUDY DESIGN: A randomized, single-blind, controlled trial. SETTING: The study was conducted at Sun Yat-sen Memorial Hospital. METHODS: Patients aged 18 to 70 years with tinnitus lasting more than 6 months were randomly assigned to receive either TMNMT or TRT for 3 months. Electroencephalogram (EEG) assessed brain functional and effective connectivity at baseline and after treatment. Additionally, 46 normal controls with a single EEG scan were included for baseline comparison to assess treatment normalization of brain networks. RESULTS: A total of 80 patients (TMNMT group: 40 [50.0%]; mean [SD] age: 42.2 [12.0] years; 19 males [47.5%]; TRT group: 40 [50.0%]; mean [SD] age: 41.9 [14.6] years; 21 males [52.5%]) and 46 normal controls (mean [SD] age: 39.37 [12.92] years; 23 males [50.0%]) were analyzed. In tinnitus patients who responded to TMNMT or TRT, tinnitus severity reduction was associated with reorganization of multiple brain networks. Predictive analysis showed that increased effective connectivity from the posterior cingulate cortex and insula to the auditory network predicted TMNMT responders (area under the curve [AUC] = 0.820, 95% CI 0.697-0.944), while increased connectivity from the medial prefrontal cortex to the dorsolateral prefrontal cortex predicted TRT non-responders (AUC = 0.875, 95% CI 0.777-0.974). CONCLUSION: Both TMNMT and TRT induced neural effects on tinnitus. Baseline brain networks distinguished responders from non-responders and predicted treatment outcomes.
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