Otolaryngol Head Neck Surg [JOURNAL]
Sun
200 papers
Coordinating Tracheostomy and Gastrostomy in Infants with Bronchopulmonary Dysplasia.
Szymczak A, Dodd A, Rowland M … +2 more , Goldstein SD, Hazkani I
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865278 · Publisher ↗
OBJECTIVE: Patients with bronchopulmonary dysplasia (BPD) often require both invasive respiratory support and durable enteral access. This study aims to identify variables associated with the concomitant placement of tra...
OBJECTIVE: Patients with bronchopulmonary dysplasia (BPD) often require both invasive respiratory support and durable enteral access. This study aims to identify variables associated with the concomitant placement of tracheostomy and gastrostomy tube (GT) in infants with BPD. STUDY DESIGN: Retrospective case-series study. SETTING: Tertiary-care children's hospital. METHODS: Demographic, clinical, and procedural variables were collected from the medical records of infants who underwent tracheostomy at age <2 between 1/2015 and 5/2024. RESULTS: Of 198 infants who underwent both tracheostomy and GT placement, 49 (24.7%) had BPD. Among these, median gestational age at birth was 25 weeks [IQR: 3], and age at tracheostomy was 6 months [IQR: 3]. Concomitant GT placement occurred in 21 (42.9%) of BPD patients. A short interval (≤30 days) between procedures was more common in BPD versus non-BPD patients (22.4% vs 11.4%, P < .001). Total time under anesthesia did not differ significantly when procedures were done concomitantly or staged (140 vs 156.5 min, P < .21). Concomitant placement was associated with a significantly shorter hospital stay (6.41 vs 9.42 months, P = .019). No significant differences were found in postoperative ileus, time to full feeds, or socioeconomic factors. CONCLUSIONS: In infants with BPD, the shorter time interval between tracheostomy and GT placement highlights an opportunity to further streamline care by coordinating these procedures at the same time. Our findings suggest that concomitant tracheostomy and GT placement are associated with comparable gastrointestinal complication rates and shorter hospital stays, supporting a combined surgical approach when feasible in this high-risk population.
Gender Based Salary Differences Among United States Academic Otolaryngologists.
Wang LW, Lubbers TE, Burdett KB … +5 more , Farlow JL, Su SY, Maxwell JH, Stubbs VC, Stepan KO
Otolaryngol Head Neck Surg · 2026 May · PMID 41865272 · Full text
OBJECTIVE: To evaluate differences in financial compensation between male and female academic otolaryngologists. STUDY DESIGN: Retrospective, cross-sectional analysis. SETTING: Multi-institutional United States public me...
OBJECTIVE: To evaluate differences in financial compensation between male and female academic otolaryngologists. STUDY DESIGN: Retrospective, cross-sectional analysis. SETTING: Multi-institutional United States public medical schools. METHODS: Twelve states with public salary data were identified, and otolaryngology salary data were extracted from associated academic institutions. Physician characteristics were extracted using Doximity, program website review, and direct faculty correspondence. Individual Medicare billing information was collected to account for differences in clinical effort. Univariable and multivariable linear regression models were performed to evaluate associations between gender and inflation-adjusted salary before and after adjusting for physician characteristics, as well as Medicare billing after adjusting for research effort and administrative titles. RESULTS: Data for 315 academic otolaryngologists was collected with 111 (35.2%) females and 204 males (64.8%). The median salary for females was $334,334 and $398,218 for males (P < .05). In the univariable linear regression setting, there was a significant difference in salary based on gender, with male surgeons making $90,000 more (P < .001). Following multivariable linear regression, faculty rank, number of publications as first or last author, and Medicare payment were all significantly associated with salary (P < .05). Male gender, number of publications as first or last author, and being a medical or residency/fellowship director were all associated with increased total Medicare payments in the multivariable linear regression setting. CONCLUSION: A significant difference in salary based on gender was observed for academic otolaryngologists in univariate analysis but not in multivariate analyses. However, total Medicare payment was significantly higher among men after controlling for physician characteristics.
Head and Neck Cancer Stage at Diagnosis and Survival Outcomes Among South Asian Patients.
Huynh JD, Halagur AS, Polkampally S … +3 more , Moon PK, Ma Y, Megwalu UC
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865270 · Publisher ↗
OBJECTIVE: To compare head and neck cancer (HNC) stage at diagnosis and survival outcomes between South Asian, Other Asian, and non-Hispanic white individuals in the United States. STUDY DESIGN: Retrospective population-...
OBJECTIVE: To compare head and neck cancer (HNC) stage at diagnosis and survival outcomes between South Asian, Other Asian, and non-Hispanic white individuals in the United States. STUDY DESIGN: Retrospective population-based cohort study. SETTING: Data from Surveillance, Epidemiology, and End Results Research Plus 17 database. METHODS: Patients diagnosed with squamous HNC from 2006 to 2020 were categorized as South Asian, Other Asian, and non-Hispanic white. Logistic regression assessed the association between race/ethnicity and advanced-stage disease (stage III/IV vs I/II). Overall survival (OS) and disease-specific survival (DSS) outcomes were evaluated using Kaplan-Meier analysis and Cox proportional hazards regression models, respectively. RESULTS: Among 92,664 patients (1066 South Asian, 3260 Other Asian, and 88,338 non-Hispanic white individuals), adjusted logistic regression showed South Asian individuals had a higher risk of advanced stage at diagnosis (odds ratio [OR] 1.48, 95% CI 1.29-1.70) than Other Asian (OR 1.13, 95% CI 1.05-1.22) and non-Hispanic white individuals. Adjusted Cox regression showed Other Asian (hazard ratio [HR] 0.89, 95% CI 0.84-0.94) individuals had improved OS, while South Asian individuals had similar OS (HR 1.09, 95% CI 0.99-1.21) as non-Hispanic white individuals. South Asian individuals had worse DSS (HR 1.30, 95% CI 1.16-1.46) than Other Asian (HR 1.05, 95% CI 0.98-1.12), and non-Hispanic white individuals. CONCLUSION: South Asian individuals with HNC are more likely to present with advanced disease stage and have worse survival compared with Other Asian and non-Hispanic white individuals, highlighting the importance of disaggregating Asian ethnic groups when assessing HNC outcome disparities.
Fluorescence Spectroscopy for Real-Time Intraoperative Detection of Middle-Ear Cholesteatoma.
Mahdjoub J, Gaiffe O, Altaisan R … +5 more , Zirganos N, Passilly N, Wacogne B, Ramasso E, Tavernier L
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865269 · Publisher ↗
OBJECTIVE: To evaluate whether autofluorescence spectroscopy (AFS) can reliably distinguish cholesteatoma from surrounding middle-ear tissues, and to develop a real-time intraoperative diagnostic tool. STUDY DESIGN: Pros...
OBJECTIVE: To evaluate whether autofluorescence spectroscopy (AFS) can reliably distinguish cholesteatoma from surrounding middle-ear tissues, and to develop a real-time intraoperative diagnostic tool. STUDY DESIGN: Prospective ex vivo study. SETTING: Besançon University Hospital, France (tertiary care center). METHODS: In this prospective ex vivo study, middle-ear tissue biopsies were collected during cholesteatoma surgeries and analyzed using autofluorescence following 405-nm laser excitation. Each sample was classified based on its spectral signature and confirmed by histopathology. A computer-assisted model was applied to differentiate cholesteatoma from noncholesteatoma tissues, and its performance was assessed using standard cross-validation. RESULTS: Thirty-six tissue samples from 23 patients were analyzed, generating nearly 3800 fluorescence spectra. The model correctly classified all samples, achieving 94.5% accuracy, 94.7% sensitivity, and 94.2% specificity. The system provided consistent performance across tissue types and returned results in real time, with a response time of 0.1 seconds per sample. Each output included a probability score indicating the likelihood of cholesteatoma presence. CONCLUSION: AFS demonstrated high accuracy in distinguishing cholesteatoma from other middle-ear tissues. Its speed, simplicity, and probabilistic feedback suggest strong potential for real-time intraoperative use. Once validated in vivo, this technology could assist surgeons by improving tissue discrimination and potentially reducing recurrence rates.
Fibrocytes as Key Mediators of Type 2 Inflammation in Asian Chronic Rhinosinusitis With Nasal Polyps.
Liao SC, Weng CM, Lin CF … +3 more , Lin YT, Kuo HP, Yeh TH
Otolaryngol Head Neck Surg · 2026 May · PMID 41865267 · Publisher ↗
CRSwNP exhibits distinct inflammatory patterns across populations, with type 2 (T2) inflammation predominating in Western but less frequent in Asian patients. Recent single-cell studies have highlighted fibroblast subset...
CRSwNP exhibits distinct inflammatory patterns across populations, with type 2 (T2) inflammation predominating in Western but less frequent in Asian patients. Recent single-cell studies have highlighted fibroblast subsets contributing to T2 inflammation; however, the role of fibrocytes remains unclear. In this study, nasal polyp tissues from 10 adult patients meeting EPOS/EUFOREA 2023 T2 criteria were analyzed using high-parameter spectral flow cytometry (Sony ID7000) to assess IL-4, IL-5, and IL-13 expression across epithelial and immune cell types. Fibrocytes demonstrated the highest IL-4 and IL-13 expression, comparable to T cells, whereas IL-5 expression showed no significant difference among cell types. These findings suggest that fibrocytes may be a previously underrecognized T2 cytokine-producing population in CRSwNP, and that fibrocytes, together with T cells, may be key drivers of type 2 inflammation and represent potential therapeutic targets in Asian patients with CRSwNP.
Place-Based Disparities in Treatment and Time-to-Initiation for Head and Neck Cancer.
Erickson A, Semprini J
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41865265 · Publisher ↗
OBJECTIVE: In the United States, 72,000+ adults are diagnosed with head and neck cancer (HNC) annually. Despite improving outcomes overall, place-based disparities persist. While existing evidence has emphasized disparit...
OBJECTIVE: In the United States, 72,000+ adults are diagnosed with head and neck cancer (HNC) annually. Despite improving outcomes overall, place-based disparities persist. While existing evidence has emphasized disparities at diagnosis, less is known about disparities in patterns of care that differ after diagnosis. STUDY DESIGN: Observational, repeated cross-sectional design. SETTING: Surveillance, Epidemiology, and End Results (SEER) case data (2018-2022). METHODS: We analyzed our first mutually exclusive set of binary outcomes related to the type of treatment received, which were categorized as surgery only, surgery with adjuvant radiotherapy, definitive chemoradiation, radiation or chemotherapy alone, or no treatment. Our second set of binary outcomes related to time from diagnosis to treatment initiation: 0 to 29, 30 to 59, 60 to 89, and 90+ days. Linear probability and multinomial regression models adjusted for tumor site, stage, sociodemographics, and geography to estimate the association between residing in a low-income county (<80k median household income) and differences in the probability of each outcome. RESULTS: Our sample included 70,468 HNC cases. We found no place-based differences for adjuvant or definitive treatment. Compared to patients in high-income counties, patients in low-income counties were 1.1% points less likely to receive surgery only (-2.2, -0.1) and 1.0% points more likely to receive radiation or chemotherapy alone (0.1, 1.8); and 2.1% points less likely to begin treatment within 0 to 29 days (-3.7, -0.4) and 1.4% points more likely to delay treatment until 60 to 89 days (0.5, 2.3). CONCLUSION: Our findings warrant implementing and evaluating system-level interventions to promote access to high-quality, timely HNC treatment in low-income communities.
Opioid Dependency After Craniomaxillofacial Trauma Surgery.
Hari-Raj A, Challapalli SD, Keller M … +4 more , Buss J, Kallogjeri D, Piccirillo JF, Spataro EA
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41848236 · Full text
OBJECTIVE: The opioid crisis has led to significant morbidity and mortality. A component of this is attributable to overdoses on prescribed opioids. A prior study estimated that 39% of opioid prescriptions after cranioma...
OBJECTIVE: The opioid crisis has led to significant morbidity and mortality. A component of this is attributable to overdoses on prescribed opioids. A prior study estimated that 39% of opioid prescriptions after craniomaxillofacial (CMF) trauma were potentially inappropriate prescriptions. The goal of this study was to identify factors associated with potentially inappropriate and prolonged opioid prescriptions in the postoperative CMF trauma patient population. STUDY DESIGN: Retrospective cohort. SETTING: Merative™ MarketScan® Commercial & Multi-State Medicaid Databases (2015-2022). METHODS: Patients undergoing CMF trauma surgery were identified and stratified based on whether they had commercial versus Medicaid insurance. The association of prolonged opioid prescription length with demographic, comorbid, and surgical factors was investigated. RESULTS: A total of 23,985 patients from 2015 to 2022 underwent CMF trauma surgery and received postoperative opioid prescriptions. The average prescription length was significantly lower in the commercially insured cohort versus the Medicaid cohort (24.6 days vs 33.7 days), and 22% of prescriptions were potentially inappropriate in nature. A diagnosis of chronic pain, as well as having 2 overlapping opioid prescriptions or an extended-release opioid prescription, had the highest adjusted odds of a prescription longer than 30 days. CONCLUSION: Although potentially inappropriate prescriptions after CMF trauma surgery decreased from a prior estimate (39% vs 22%), inappropriate prescribing practices are highly associated with prolonged opioid prescriptions. Providers must ensure patients do not have an existing opioid prescription before writing an additional one and should not dispense extended-release formulations in the acute postoperative setting.
Surgical and Voice Outcomes of Office-Based Recurrent Respiratory Papillomatosis Surgery: A Systematic Review.
Miri M, Hamdan AL, Huet K … +2 more , Delvaux V, Lechien JR
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41848235 · Publisher ↗
OBJECTIVE: To investigate the surgical and voice outcomes associated with office-based laryngeal surgery for the treatment of recurrent respiratory papillomatosis (RRP). DATA SOURCES: PubMed, Google Scholar, and Cochrane...
OBJECTIVE: To investigate the surgical and voice outcomes associated with office-based laryngeal surgery for the treatment of recurrent respiratory papillomatosis (RRP). DATA SOURCES: PubMed, Google Scholar, and Cochrane databases. REVIEW METHODS: Two independent investigators search databases for studies reporting surgical or voice quality outcomes of patients treated with office-based surgery for RRP according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Primary outcomes consisted of surgical (safety, patient tolerance, recurrence, complications, number of interventions) and voice quality (subjective, aerodynamic, and acoustic measurements) outcomes. The bias analysis was conducted through the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: Fifteen studies (13 retrospective, 2 prospective) met inclusion criteria, accounting for 357 patients with RRP mainly treated with PDL, KTP, and Blue Laser office-based surgery. Surgical outcomes reported 50% to 95.8% lesion regression rates. The patient tolerance was good, with smokers reporting the low level of tolerance. The cumulative complication rate was low (1.62%). Voice quality assessments demonstrated significant improvements in subjective measures (VHI-10, GRBAS), while there was no study reporting multidimensional voice quality assessments including subjective, perceptual, aerodynamic, and acoustics measurements. Methodological quality of included studies was low-to-moderate (MINORS scores: 5-9), with inconsistent reporting of confounding factors. CONCLUSION: Office-based laser surgery is a safe and effective treatment for vocal fold RRP, with an effective reduction of disease burden, satisfactory regression, and a moderate rate of subsequent need for OR management. Future studies are needed to investigate the long-term multidimensional voice quality outcomes related to office-based procedures and to compare them with operating room procedures.
Large Language Models for Cochlear Implant Education: A Comparison of ChatGPT, Gemini, Claude, and DeepSeek.
Birinci M, Kilictas AU, Gül O … +6 more , Yemiş T, Erdivanlı B, Çeliker M, Özgür A, Çelebi Erdivanlı Ö, Dursun E
Otolaryngol Head Neck Surg · 2026 May · PMID 41848221 · Publisher ↗
OBJECTIVE: Artificial intelligence-supported large language models (LLMs) have become increasingly widespread in recent years in the health communication and patient education. Models such as ChatGPT, Claude, Gemini, and...
OBJECTIVE: Artificial intelligence-supported large language models (LLMs) have become increasingly widespread in recent years in the health communication and patient education. Models such as ChatGPT, Claude, Gemini, and DeepSeek are used to provide information on complex medical topics, thanks to their natural language processing capabilities. This study compares the responses of models to 5 frequently asked questions about cochlear implants in terms of content and communication quality. STUDY DESIGN: Comparative analysis of 4 LLMs using expert-evaluated responses to cochlear implant queries. SETTING: Virtual simulation with blinded specialist assessments. METHODS: Five of the most frequently searched cochlear implant questions on Google were selected. Each question was individually posed to ChatGPT-4, Gemini 2.0, Claude 3.7, and DeepSeek v3. The responses from each model were evaluated by 5 otolaryngology specialists using a 5-point scale based on content accuracy and communication appropriateness. One-way ANOVA and post hoc tests were used for statistical analysis. RESULTS: Statistically significant differences were identified among the models in both content and communication quality (P < .05). The DeepSeek model achieved the highest average scores in both areas, while the Claude model generally received the lowest scores. ChatGPT-4 demonstrated a balanced performance, while Gemini stood out in certain communication criteria. CONCLUSION: This study is one of the first comparative analyses evaluating the performance of 4 different large language models in the context of patient education about cochlear implants. Although some models appear more suitable for patient education, the findings indicate that these systems still have limitations when used without expert oversight.
Effect of Body Mass Index on Sinonasal Symptoms and Imaging Results.
Ghannam JY, Zhou AS, Stanlie A … +3 more , Prince AA, Eduardo Corrales C, Shin JJ
Otolaryngol Head Neck Surg · 2026 May · PMID 41815096 · Publisher ↗
While sinonasal inflammation and anatomy are known to be affected by obesity, its impact on symptom severity and objective imaging findings remain unknown. This study assessed whether body mass index (BMI) influences sin...
While sinonasal inflammation and anatomy are known to be affected by obesity, its impact on symptom severity and objective imaging findings remain unknown. This study assessed whether body mass index (BMI) influences sinonasal symptom severity, as measured by the 22-item Sinonasal Outcome Test (SNOT-22), and whether BMI modifies the relationship between SNOT-22 scores and Lund-Mackay (LM) CT scores. Analysis of 173 patients categorized by BMI revealed no significant differences in overall or domain-specific SNOT-22 scores. Additionally, BMI did not modify the association between symptom severity and imaging findings. These results suggest that, despite known mechanistic and epidemiologic associations between obesity and sinonasal symptoms, BMI alone does not impact the extent of sinonasal symptoms, nor does it influence the relationship between subjective symptoms and radiographic disease. Presenting these data, which may diverge from prior results, preempts the typical trend toward positive publication bias.
Inpatient Opioid Use in Head and Neck Microvascular Free Flap Reconstruction.
Timothee P, Bliss A, Blumenthal D … +6 more , Dowd J, Clementi E, Davidson B, Reilly M, Pierce M, Giurintano J
Otolaryngol Head Neck Surg · 2026 May · PMID 41815095 · Full text
OBJECTIVES: The primary objective is to determine whether patients undergoing osseous microvascular free flap reconstruction of head and neck defects have higher inpatient pain requirements than those undergoing nonosseo...
OBJECTIVES: The primary objective is to determine whether patients undergoing osseous microvascular free flap reconstruction of head and neck defects have higher inpatient pain requirements than those undergoing nonosseous reconstruction. Secondary aims include evaluating the impact of a multimodal analgesia (MMA) protocol and COVID-19 visitor restrictions on inpatient opioid administration. STUDY DESIGN: Retrospective chart review. SETTING: MedStar Georgetown University Hospital and MedStar Washington Hospital Center. METHODS: Narcotic doses administered during the perioperative inpatient hospitalization were converted to morphine-equivalent doses (MEDs) for comparison. 2-tailed t tests and χ analyses were used, with P ≤ .05 as the threshold for statistical significance. RESULTS: 318 patients (mean age 64 ± 12.3 years; 65% male) were included. Total inpatient MED was 224.48 and 173.88 in the osseous and nonosseous free flap cohorts, respectively (P = .127295). The total MED per day of hospitalization was 16.38 and 17.53, respectively (P = .671399). Implementation of an MMA protocol reduced daily MED from an average of 25.9 to 11.24 (P < .0001). During COVID-19 visitor restrictions, total and daily MEDs were 234.57 and 20.64, respectively, compared to 181.32 and 16.9 during unrestricted periods, though these differences were not statistically significant (P = .163232 and P = .251387, respectively). CONCLUSIONS: The findings suggest no significant difference in postoperative MME between patients undergoing osseous versus non-osseous free flap reconstruction, and inpatient opioid pain requirements did not differ between groups. MMA protocol implementation was associated with a significant reduction in inpatient narcotic use, while COVID-19 visitor restrictions had no significant effect.
Non-Neural Post-Thyroidectomy Dysphonia: Long-Term Voice Outcomes in 527 Patients.
Ji JY, Kim SY, Yoon J … +7 more , Park Y, Kim GH, Lee YW, Kim J, Chang JH, Jeong WJ, Cha W
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41810852 · Publisher ↗
OBJECTIVE: To characterize non-neural post-thyroidectomy dysphonia (PTD) by analyzing long-term voice outcomes in patients with no evidence of nerve injury on postoperative laryngoscopy and electromyography (EMG). STUDY...
OBJECTIVE: To characterize non-neural post-thyroidectomy dysphonia (PTD) by analyzing long-term voice outcomes in patients with no evidence of nerve injury on postoperative laryngoscopy and electromyography (EMG). STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. METHODS: We reviewed 527 post-thyroidectomy patients with intact vocal fold mobility and normal EMG results at 2 to 3 months postoperatively. Voice evaluations, including acoustic analysis, voice range profile, aerodynamic study, and VHI-10, were performed preoperatively and 3 days, 2 weeks, 1, 3, 6, and 12 months postoperatively. Linear mixed models and machine learning were used to assess the effects of sex, age, surgical extent, and preoperative fundamental frequency (F0) on voice parameters. RESULTS: Fundamental frequency (F0) and speaking fundamental frequency (SFF) declined immediately after surgery, with more prolonged reduction in older patients (≥45 years) and those with high F0. VHI-10 increased during the early postoperative period, particularly after total thyroidectomy, but returned to near-baseline by 6 to 12 months. Older age was associated with delayed VHI-10 recovery. Maximum frequency (F) decreased in the early period after total thyroidectomy. F0 and age were main predictors of F0 and SFF at 1 and 3 months, while surgical extent predicted VHI-10 and F at 1 month. CONCLUSIONS: Voice changes may occur even when the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve are preserved during thyroidectomy. Although most alterations improve over time, some voice parameters may not fully recover, with outcomes influenced by sex, age, surgical extent, and F0. These findings may aid in counseling patients with non-neural PTD.
Selective Harm Reporting in Inflammatory Sinonasal Trials: A Systematic Review of Registry-Publication Concordance.
Lutze T, Kirby K, Hazlitt R … +6 more , Sherry R, Elghzali A, Harris T, Archer D, Ford AI, Vassar M
Otolaryngol Head Neck Surg · 2026 May · PMID 41806298 · Publisher ↗
OBJECTIVE: To assess the completeness, consistency, and transparency of adverse event (AE) reporting in clinical trials of inflammatory sinonasal diseases by comparing data from ClinicalTrials.gov and corresponding peer-...
OBJECTIVE: To assess the completeness, consistency, and transparency of adverse event (AE) reporting in clinical trials of inflammatory sinonasal diseases by comparing data from ClinicalTrials.gov and corresponding peer-reviewed publications. DATA SOURCES: ClinicalTrials.gov registry and MEDLINE-indexed journal articles reporting results of interventional trials focused on inflammatory sinonasal disease. REVIEW METHODS: We identified trials with posted results between 2014 and 2024 and matched registry records with corresponding publications. Data extraction included structured and narrative AE fields. Outcomes assessed were serious adverse events (SAEs), other adverse events (OAEs), mortality, and AE-related discontinuations. Reporting concordance was analyzed using descriptive statistics, Bland-Altman plots, funnel plots, and linear regression to evaluate temporal trends and reporting predictors. Only direct numerical matches were accepted; we made no inferences from narrative text. RESULTS: Among 108 included trials, 57 (52.8%) met criteria for likely applicable clinical trials (ACTs). AE reporting was more complete on ClinicalTrials.gov than in publications. For example, 94.7% of ACTs reported SAEs in the registry compared to 80.7% in corresponding publications, and death reporting increased from 38% to 100% in registry data following the 2017 Final Rule. However, publication reporting did not show corresponding improvement. Funnel plots revealed dispersion in AE rates among smaller trials, while linear regression showed modest gains in registry reporting over time. CONCLUSION: Despite regulatory improvements, publication-based AE reporting remains incomplete and inconsistent. Clinical trial registries remain an essential, yet underutilized, resource for harm-related evidence in sinonasal disease research.
Patient Perceived Experience of Automated Voice Assistants in Oral Cavity Cancer.
Baratz H, Renkert E, McDaniel J … +9 more , Li Y, Yeatts J, Montealegre DH, Yeoh M, Pietrowicz M, Yin L, Windon M, Ishikawa K, Orbelo D
Otolaryngol Head Neck Surg · 2026 May · PMID 41806179 · Publisher ↗
OBJECTIVE: Effective communication with humans and automated voice assistants (AVA) is essential for full participation in modern life. Because AVA relies on intelligible speech, individuals with speech impairments, such...
OBJECTIVE: Effective communication with humans and automated voice assistants (AVA) is essential for full participation in modern life. Because AVA relies on intelligible speech, individuals with speech impairments, such as those treated for oral cavity cancer (OCC), may face barriers when interacting with AVA. We assessed self-reported communication difficulty in patients treated for OCC related to AVA and humans. STUDY DESIGN: Prospective cross-sectional cohort study. SETTING: Out-patient clinics in two tertiary care centers. METHODS: This study was conducted between July 2024 and March 2025 and included adults (≥18 years) diagnosed with and surgically treated for OCC (experimental group) and those without speech impairments (controls). Participants completed the Speech Communication Experience Survey (SCES), which assessed perceived intelligibility when communicating with familiar partners, strangers, and AVA; and, as reported elsewhere, the Speech Handicap Index (SHI). RESULTS: In total, 159 participants were included (69 OCC, 90 controls). OCC participants were more likely to report that familiar partners, strangers, and AVA "almost always" or "always" had difficulty understanding their speech (P < .05). Free flap reconstruction and maxillectomy were associated with greater reported communication difficulty. AVA usage frequency and overall opinions toward AVA did not significantly differ between groups. CONCLUSION: Patients treated for OCC report significantly greater difficulty being understood by both AVA and human listeners compared to controls. These perceptions may inform peri-operative counseling and guide the development of more inclusive AVA technologies capable of accommodating diverse speakers.
Migraine Features in Patients With Sudden Sensorineural Hearing Loss.
Yazdani Y, Lee EJ, Francis A … +3 more , Nedjat S, Abouzari M, Djalilian HR
Otolaryngol Head Neck Surg · 2026 May · PMID 41800661 · Full text
OBJECTIVE: To investigate the prevalence of migraine features among patients with sudden sensorineural hearing loss (SSNHL) and evaluate potential clinical associations. STUDY DESIGN: Retrospective survey-based study. SE...
OBJECTIVE: To investigate the prevalence of migraine features among patients with sudden sensorineural hearing loss (SSNHL) and evaluate potential clinical associations. STUDY DESIGN: Retrospective survey-based study. SETTING: Single institution tertiary care center. METHODS: 168 adult patients with SSNHL were recruited. Migraine diagnosis was determined using International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria. Patient demographics, migraine-related features, and SSNHL characteristics were analyzed using univariate and multivariate logistic regression. RESULTS: Of 168 SSNHL patients, 77 (46%) met full ICHD-3 migraine criteria, which is higher than the general population. An additional 23% met the majority of the migraine criteria. Multivariate analysis revealed that aural fullness preceding hearing loss (P < .001), concordant laterality of hearing loss and headache (P < .001), hyperacusis (P = .006), otalgia (P = .01), and motion sickness (P = .03) were independently associated with migraine. Interestingly, 89% of patients with migraine headache and SSNHL had their SSNHL on the same side as their headaches. CONCLUSIONS: These findings reveal a high prevalence of migraine headache among patients with SSNHL. Clinical features, including aural fullness and concordant laterality (dominant headaches on the same side as SSNHL), were predictive of migraine in SSNHL patients. These findings support the hypothesis that migraine and SSNHL may share overlapping vascular and neurogenic mechanisms, highlighting the importance of identifying migraine features in SSNHL to optimize management and explore potential therapeutic strategies.
DiGeorge for the Otolaryngologist: A State-of-the-Art Review.
Hack S, Hayu D, Peralta F … +1 more , Zalzal HG
Otolaryngol Head Neck Surg · 2026 May · PMID 41800660 · Publisher ↗
OBJECTIVE: To provide a state-of-the-art, otolaryngology-focused review of 22q11.2 deletion syndrome (22q11.2DS), emphasizing recent developments in the understanding of airway, hearing, velopharyngeal, sleep, and periop...
OBJECTIVE: To provide a state-of-the-art, otolaryngology-focused review of 22q11.2 deletion syndrome (22q11.2DS), emphasizing recent developments in the understanding of airway, hearing, velopharyngeal, sleep, and perioperative manifestations that directly influence contemporary ENT practice. DATA SOURCES: PubMed, Scopus, and Cochrane Library were searched for English-language publications from January 2018 to September 2025. Additional data were identified through reference lists of key guidelines and landmark cohort studies. REVIEW METHODS: A narrative review approach was used to synthesize recent literature addressing the epidemiology, anatomy, diagnostic advances, and management of otologic, palatal, airway, sleep, swallowing, vascular, immune, and perioperative features of 22q11.2DS. Priority was given to studies published within the past 5 years, multicenter analyses, updated clinical practice guidelines, and investigations describing evolving surgical and diagnostic paradigms. Articles focusing solely on cardiac, endocrine, or psychiatric aspects were excluded unless directly relevant to otolaryngologic care. CONCLUSIONS: 22q11.2DS presents a uniquely high burden of ENT disease across the lifespan, including chronic otitis media, elevated cholesteatoma risk, persistent velopharyngeal dysfunction, multilevel airway anomalies, sleep-disordered breathing, dysphagia, and perioperative vulnerability due to vascular, immunologic, and hematologic anomalies. Emerging imaging techniques, updated pediatric and adult guidelines, and expanded genotype-phenotype data have reshaped diagnostic and surgical strategies. IMPLICATIONS FOR PRACTICE: Otolaryngologists play a central role in lifelong care of individuals with 22q11.2DS. Structured surveillance, genotype-informed imaging, proactive sleep and airway assessment, and multidisciplinary perioperative planning are essential for improving outcomes. Standardized pathways and longitudinal, ENT-specific research are urgently needed to guide evidence-based management.
Effects of Environmental Factors on Incidence of Allergic Rhinitis and Chronic Rhinosinusitis: A Comparative Study.
Luo X, Lu H, Chen J … +12 more , Deng S, Chao M, Zhang H, Wu T, Chen J, Li T, Chen J, Liu Z, Huang X, Shi Z, Zhang Y, Yang Q
Otolaryngol Head Neck Surg · 2026 May · PMID 41800620 · Publisher ↗
OBJECTIVE: To investigate the associations of air pollutants and meteorological factors with outpatient visits for allergic rhinitis (AR) and chronic rhinosinusitis (CRS) in Southern China. STUDY DESIGN: Retrospective ti...
OBJECTIVE: To investigate the associations of air pollutants and meteorological factors with outpatient visits for allergic rhinitis (AR) and chronic rhinosinusitis (CRS) in Southern China. STUDY DESIGN: Retrospective time-series study. SETTING: Two representative tertiary hospitals in Guangzhou, China, from 2014 to 2019. METHODS: Daily outpatient visits for AR and CRS, along with air pollutant concentrations and meteorological data, were analyzed using quasi-Poisson generalized additive models and distributed lag nonlinear models with quasi-Poisson distribution. RESULTS: A total of 135,817 outpatient visits were included. Increases in NO₂, SO₂, PM, PM₁₀, and O₃ concentrations were significantly associated with higher AR visits, while NO₂, SO₂, PM, PM₁₀, and CO were linked to elevated CRS visits. AR patients were sensitive to cold, wet, and dry effects, with RRs of 1.52 (1.09-2.10), 1.20 (1.03-1.40), and 2.55 (1.71-3.79), respectively. CRS patients were more susceptible to air pollutants, whereas AR patients were more affected by meteorological conditions. CONCLUSION: Air pollutants and meteorological factors significantly influence the incidence of AR and CRS in Southern China, with distinct susceptibility patterns between the 2 diseases.
Medicare Utilization and Reimbursement Trends for Free Flaps in Otolaryngology, Plastic Surgery, and Maxillofacial Surgery.
Polen K, Napole A, Turner G … +2 more , Brody RM, Carey RM
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41793296 · Publisher ↗
Free flap procedures are important components of reconstructive surgery in otolaryngology, plastic surgery, and maxillofacial surgery. This research investigates trends in utilization, charges, and Medicare reimbursement...
Free flap procedures are important components of reconstructive surgery in otolaryngology, plastic surgery, and maxillofacial surgery. This research investigates trends in utilization, charges, and Medicare reimbursements for free flap procedures performed across these specialties. CMS Medicare Physician & Other Practitioners Data (2013-2022) were analyzed using CPT codes 15757 and 20969 for free skin flaps and osteocutaneous flaps, respectively. Trends in procedure utilization, average charges, average reimbursements, and charge-to-reimbursement ratios (CRRs) were assessed across these specialties. A total of 4920 free flap procedures were reported between 2013 to 2022. Otolaryngology utilization increased by 73.6% while plastic and maxillofacial surgery volumes remained stable. Otolaryngology reimbursements and charges showed significant declines while the CRR remained stable around 7.65 (0.58). Plastic and maxillofacial surgery exhibited the greatest CRRs in 2022 at 9.54 and 8.87, respectively. These data demonstrate the evolving finances of free flap procedures, laying the groundwork for further investigation and discussion.
Apple Hearing Test Feature for the AirPods Pro 2: Accuracy, Reliability, and Time-Efficiency.
Kruger M, Manchaiah V, Swanepoel W
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41793292 · Publisher ↗
OBJECTIVE: To evaluate the accuracy, test-retest reliability, and time-efficiency of Apple's Hearing Test Feature (HTF) compared to reference standard pure-tone audiometry (PTA). STUDY DESIGN: Cross-sectional validation...
OBJECTIVE: To evaluate the accuracy, test-retest reliability, and time-efficiency of Apple's Hearing Test Feature (HTF) compared to reference standard pure-tone audiometry (PTA). STUDY DESIGN: Cross-sectional validation study. SETTING: Single-center study at a university clinic. PTA was performed in a sound-treated booth. HTF testing occurred in a quiet room. METHODS: A sample of 25 adults (mean age 50.1 years [SD 14.2]; 68% female) with self-reported mild-to-moderate hearing loss participated. Each contributed 16 thresholds, yielding 400 comparisons. Participants underwent PTA by an audiologist, followed by two independent HTF assessments (start and end of session) using Apple AirPods Pro 2 paired with an iPhone 13. Outcomes included threshold accuracy versus PTA, test-retest reliability, and test duration. RESULTS: Across 400 comparisons, 86.5% of HTF thresholds were within 10 dB HL of PTA. Root mean square deviation (RMSD) values ranged from 3.3 to 7.9 dB HL (left ear) and 5.8 to 9.7 dB HL (right ear), meeting minimally acceptable accuracy (≤10 dB HL). Test-retest was reliable, 84.1% of thresholds within 5 dB HL and 96.6% within 10 dB HL. Desired reliability (≤6 dB HL) was met at all frequencies except 250 Hz (left ear), which met minimum acceptable level. HTF was significantly faster (median 5.5 minutes) than PTA (10.0 minutes; P < .001). CONCLUSION: Apple's HTF demonstrated clinically acceptable accuracy and reliability, with improved time-efficiency compared to PTA. Findings support its potential for consumer-led hearing monitoring and OTC hearing aid self-fitting. Further research should assess inter-device reliability and integration with Apple's Hearing Aid Feature.
Rate of Hearing Loss in Platinum-Naïve Patients Receiving Immune Checkpoint Inhibitors.
Brooks KA, Gidley CG, Grimley O … +9 more , Wang C, Jivani S, Roberts D, Naing A, Phan J, Hutcheson K, Wang X, Gidley PW, Nader ME
Otolaryngol Head Neck Surg · 2026 May · PMID 41793286 · Full text
OBJECTIVE: Hearing loss from immune checkpoint inhibitors (ICIs) has been documented in case reports and case series. We present the largest retrospective study investigating the rate of ICI-related ototoxicity in a moni...
OBJECTIVE: Hearing loss from immune checkpoint inhibitors (ICIs) has been documented in case reports and case series. We present the largest retrospective study investigating the rate of ICI-related ototoxicity in a monitored cohort of platinum-naïve patients. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary-care center. METHODS: Patients treated with ICI between January 1, 2017, and December 31, 2022, with baseline and post-treatment audiograms, were included. Patients with a history of platinum-based chemotherapy were excluded. Demographics, oncologic diagnosis, ICI treatment details, and temporal bone irradiation (TBRT) were recorded. Audiometric thresholds were compared before and after ICI therapy. The primary outcome measure was a change in hearing as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). Secondary outcome measures included changes in hearing using the American Speech-Language-Hearing Association (ASHA) and TUNE criteria. RESULTS: Among 15,390 ICI recipients, 29 platinum-naïve patients met the inclusion criteria. Six of 29 patients (20.7%) experienced a CTCAE grade 1 or higher hearing loss. The proportions of hearing loss as defined by ASHA and TUNE criteria were 44.8% and 27.6%, respectively. The length of time between baseline and follow-up audiograms was significantly longer among patients with hearing loss (mean difference [days]: CTCAE: 590.3, P < .01; ASHA: 280.9, P = .05; and TUNE: 122.1, P = .46). No other potential covariates believed to be confounders were significantly associated with the outcome. CONCLUSION: A significant proportion of our monitored platinum-naïve ICI patients met hearing-loss criteria. Prospective studies with standardized audiologic surveillance are needed to further quantify the true incidence of ICI ototoxicity.
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