Otolaryngol Head Neck Surg [JOURNAL]
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200 papers
Navigating Risk in Atrial Fibrillation and Hereditary Hemorrhagic Telangiectasia: Antithrombotic Versus Antifibrinolytic Therapy.
Adelman AE, Richardson L, Jackson L … +4 more , Mathavan A, Mathavan A, Ataya A, Justice J
Otolaryngol Head Neck Surg · 2026 May · PMID 41793285 · Publisher ↗
Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectasias and arteriovenous malformations, often complicated by chronic epistaxis. Patients with HHT and comorbid atrial fibrillation (A...
Hereditary hemorrhagic telangiectasia (HHT) is characterized by mucocutaneous telangiectasias and arteriovenous malformations, often complicated by chronic epistaxis. Patients with HHT and comorbid atrial fibrillation (AF) present a clinical challenge in the concurrent management of bleeding and clotting risks. We retrospectively reviewed HHT patients with AF to evaluate the tolerability of anticoagulant (AC), antiplatelet (AP), and TXA therapies. Of 33 patients, AC was attempted in 13 cases, with 62% requiring premature discontinuation due to bleeding. AP therapy was initiated in 9 patients, with 33% discontinued due to epistaxis. Fourteen patients who met criteria for AC/AP were not prescribed them due to bleeding concerns. TXA was administered in 11 patients for a mean of 16.6 months with no thrombotic events; 6 were not prescribed TXA due to AF-related concerns. Our findings suggest that antithrombotic therapy for AF is frequently withheld or discontinued in this population, while TXA may be safely tolerated.
Motion Exposure, Cognitive Impairment, and Risk Factors for Mal de Débarquement Syndrome.
Hughes CK, Kim JJ, Liu H … +8 more , Ayala MA, Ashman RE, Bin Lee J, Saxena A, Eliason MJ, de Cos V, Russ KR, Matsuoka AJ
Otolaryngol Head Neck Surg · 2026 May · PMID 41774616 · Publisher ↗
OBJECTIVE: Determine whether shipboard motion variability relates to simulator‑sickness symptoms, Mal de Débarquement syndrome (MdDS) features, and cognition, and whether migraine or motion‑sickness history modify these...
OBJECTIVE: Determine whether shipboard motion variability relates to simulator‑sickness symptoms, Mal de Débarquement syndrome (MdDS) features, and cognition, and whether migraine or motion‑sickness history modify these vestibular effects. STUDY DESIGN: Prospective observational cohort. SETTING: USNS Mercy (T‑AH 19) during Pacific Partnership 2024. METHODS: 38 Active‑Duty personnel were tested at baseline (land), after California-Hawaii (CA-HI; rougher), and after Chuuk-Hawaii (CHUUK-HI; calmer). A centrally mounted, inertial measurement unit (IMU) yielded per‑minute standard deviation of linear‑acceleration magnitude (IMU SD). OUTCOMES: Simulator Sickness Questionnaire (SSQ); MdDS calculator mapped to Bárány criteria; Rey-Osterrieth Complex Figure (ROCF); Symbol Digit Modalities Test (SDMT); Stroop Test; linear mixed-effects model using voyage leg and IMU SD as predictors of symptom outcomes and adjusted for migraine and motion‑sickness history. RESULTS: IMU SD was higher on CA-HI. SSQ totals were higher on CA-HI and increased with IMU SD. MdDS criteria counts, and cases were similar between legs; Migraine Disability Assessment Score (MIDAS) was positively associated with MdDS criterion burden, but not with SSQ. ROCF showed slower copy/recall and lower recall accuracy on CA-HI; SDMT and Stroop errors were largely unchanged. There were no statistical differences based on migraine or motion‑sickness history, but analyses were limited by small subgroup sizes. CONCLUSION: Rougher sea states (greater IMU variability) were linked to higher acute symptom burden and specific visuospatial memory impairments. The incidence of persistent MdDS did not differ by leg. IMU‑informed monitoring with brief, targeted cognitive tests may support future planning and post‑voyage screening to identify at-risk individuals.
Correction to "The Importance of Newborn Genetic Screening for Early Identification of GJB2 and SLC26A4 Related Hearing Loss".
Otolaryngol Head Neck Surg · 2026 May · PMID 41774603 · Publisher ↗
Abstract loading — click title to view on PubMed.
Vitamin D Status and Supplementation in Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.
Huang S, Li X, Wu H … +7 more , Chen X, Wu X, Huang Z, Chang L, Zhang Y, Li Y, Zhang G
Otolaryngol Head Neck Surg · 2026 May · PMID 41774579 · Publisher ↗
OBJECTIVES: To investigate the relationship between vitamin D (VD) levels and chronic rhinosinusitis (CRS), and to evaluate the therapeutic efficacy of VD supplementation for CRS. DATA SOURCES: Two independent reviewers...
OBJECTIVES: To investigate the relationship between vitamin D (VD) levels and chronic rhinosinusitis (CRS), and to evaluate the therapeutic efficacy of VD supplementation for CRS. DATA SOURCES: Two independent reviewers systematically searched PubMed, Embase, and the Cochrane Library to identify studies that assessed the association between CRS and VD, as well as the therapeutic effects of VD supplementation on CRS outcomes. REVIEW METHODS: Meta-analyses were conducted to compare VD levels between CRS patients and controls and to evaluate the efficacy of VD supplementation. Random- or fixed-effects models were applied as appropriate. Sensitivity and subgroup analyses were performed to investigate potential sources of heterogeneity. RESULTS: A pooled analysis of 15 studies showed significantly lower serum VD levels in CRS patients compared to controls (SMD = -0.98; P < .001). Both 25(OH)D3 and 25(OH)D assays showed lower VD levels in CRS patients (SMD = -1.24, P < .001 vs SMD = -0.77, P < .001). Subgroup analyses also revealed consistent reductions in both CRS with nasal polyps (CRSwNP; SMD = -1.05; P < .001) and CRS without nasal polyps (CRSsNP; SMD = -1.02; P < .001). Moreover, four randomized controlled trials indicated that VD supplementation significantly improved Sino-Nasal Outcome Test-22 (SNOT-22) scores at <3 months (MD = -1.44; P = .001); however, this benefit was not maintained at ≥3 months (MD = -6.52; P = .12). CONCLUSIONS: CRS patients show significantly lower serum VD levels than healthy controls. VD supplementation may provide short-term symptomatic improvement, although its long-term efficacy remains unproven.
Early Experience Treating Vestibular Migraine With Small Molecule CGRP Antagonists.
Patel EJ, Koziol K, Sharon JD
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41774573 · Publisher ↗
OBJECTIVES: Blocking the activity of calcitonin gene-related peptide (CGRP) has emerged as a possible method for the prevention of vestibular migraine (VM). We aimed to investigate the effectiveness of small molecule CGR...
OBJECTIVES: Blocking the activity of calcitonin gene-related peptide (CGRP) has emerged as a possible method for the prevention of vestibular migraine (VM). We aimed to investigate the effectiveness of small molecule CGRP antagonists (gepants) for the treatment of VM. STUDY DESIGN: Retrospective case series. SETTING: Tertiary academic center. METHODS: Adult patients diagnosed with VM who were treated with gepants were included. The gepants used included ubrogepant, rimegepant, atogepant, and zavegepant. A set of questionnaires was sent to patients including the Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM-PATHI), Dizziness Handicap Inventory (DHI), a survey regarding the details of their VM, and a survey focused on their experience with gepants. RESULTS: A total of 17 patients with VM who used gepants were included. Median age was 54.1 (SD 9.3) and the majority were female (70.6%). Vertigo was the most bothersome symptoms for 47.1% of patients. The most common gepant used was rimegepant (88.2%) followed by ubrogepant (58.8%), atogepant (23.5%), and zavegepant (5.9%). Seven patients (41.2%) took gepants in an abortive fashion, 3 patients (17.6%) used them as a preventative medication and 7 patients (41.2%) tried them as both a preventative or abortive medication. The majority of patients (76.5%) experienced relief of their most bothersome symptom after taking a gepant and 84.6% of this cohort claimed these medications helped quite a lot to manage their symptoms of VM. No serious adverse events were observed. CONCLUSIONS: Gepants are well-tolerated by patients and are promising agents for the treatment of vestibular migraine.
Impact of Immunosuppressive Medications on Chronic Rhinosinusitis and Endoscopic Sinus Surgery in Transplant Recipients.
Daniel H, Valencia-Sanchez BA, Wadei H … +2 more , Harnois D, Donaldson AM
Otolaryngol Head Neck Surg · 2026 May · PMID 41774565 · Publisher ↗
OBJECTIVE: To examine the impact of immunosuppressive regimens on chronic rhinosinusitis (CRS) development in kidney and liver transplant recipients. STUDY DESIGN: Retrospective cohort study. SETTING: Multisite study acr...
OBJECTIVE: To examine the impact of immunosuppressive regimens on chronic rhinosinusitis (CRS) development in kidney and liver transplant recipients. STUDY DESIGN: Retrospective cohort study. SETTING: Multisite study across Mayo Clinic Enterprise locations in Arizona, Florida, Minnesota, and Wisconsin. METHODS: Patients who underwent kidney or liver transplantation between November 1, 2021, and November 1, 2022, were included. Patients with documented sinonasal complaints before transplantation were excluded. Diagnoses were based on ICD-10 codes assigned by board-certified otolaryngologists, with follow-up extending through November 2024. Demographic data, relevant comorbidities, CRS diagnoses, and immunosuppressive regimens were collected. RESULTS: In total, 1459 transplant recipients (986 kidney, 473 liver) with a mean age of 55.1 years and M:F ratio of 1.5:1 were included. Kidney recipients who received anti-thymocyte globulin (ATG, Thymoglobulin®) for immunosuppressive induction had a greater risk of CRS compared to those who did not (odds ratio [OR] = 3.0, 95% CI [1.3, 6.9], P = .005). Among liver recipients, patients on cyclosporine, mycophenolate mofetil (MMF), and corticosteroids had a greater risk of CRS compared to those on tacrolimus-based regimens (OR = 6.0, 95% CI [1.5, 24.1], P = .027). Cyclosporine use was also associated with an increased rate of endoscopic sinus surgery (ESS) compared to tacrolimus (4.2% vs 0.3%, P = .015). CONCLUSION: Tacrolimus-based regimens are associated with significantly decreased rates of CRS compared to cyclosporine, suggesting that immunosuppressive choice is a modifiable risk factor for sinonasal morbidity in this population.
A Comparison of Outcomes in Adult Patients After Intracapsular Laser Tonsillotomy and Cold Steel Tonsillectomy.
Skaaraas GHES, Nordahl SHG, Jacobsen YM … +3 more , Wennberg S, Blindheimsvik MAB, Bugten V
Otolaryngol Head Neck Surg · 2026 May · PMID 41774564 · Publisher ↗
OBJECTIVE: This study compares selection criteria, 30-day complications, and 6-month outcomes between intracapsular tonsillotomy (TT) using carbon dioxide (CO) laser and traditional cold steel tonsillectomy (TE). STUDY D...
OBJECTIVE: This study compares selection criteria, 30-day complications, and 6-month outcomes between intracapsular tonsillotomy (TT) using carbon dioxide (CO) laser and traditional cold steel tonsillectomy (TE). STUDY DESIGN: A retrospective, observational study. SETTING: Laser TT was conducted at 6 different Norwegian hospitals or private clinics and 41 Norwegian hospitals or private clinics performed traditional cold steel TE. METHODS: We analyzed data from the Norwegian Tonsil Surgery Register (NTSR), including all adult patients (≥16 years) undergoing tonsil surgery from January 1, 2017, to June 30, 2023. No exclusion criteria were applied. The data are based on 3 questionnaires: one completed by surgeons on the day of surgery, and one completed by patients 30 days and 6 months after surgery. RESULTS: Laser TT was associated with significantly lower postoperative bleeding and fewer pain-related healthcare contacts. However, cold steel TE had higher symptom resolution at 6 months (P < .001). Men had a higher risk of bleeding (P < .001), while women more often sought help for pain (P < .001). Patients with recurrent or chronic tonsillitis had greater risks for both bleeding and pain-related contacts. Women were more likely to report persistent symptoms at 6 months (P = .01). CONCLUSION: Laser TT under local anesthesia is associated with fewer short-term complications but a higher rate of persistent symptoms compared to traditional cold steel tonsillectomy (TE). In this study, cold steel TE demonstrated significantly better long-term outcomes. Careful patient selection for laser TT is essential.
Prophylactic Intravenous Antibiotic Use in Thyroglossal Duct and Branchial Cleft Cyst Excision: A NSQIP-P Analysis.
Abrahamson CW, McClelland TQ, Fei-Zhang DJ … +4 more , D'Souza JN, Sheyn AM, Rastatter JC, Chelius DC
Otolaryngol Head Neck Surg · 2026 May · PMID 41774563 · Full text
OBJECTIVE: To identify patterns in prophylactic intravenous antibiotics (PIAB) usage for thyroglossal duct and branchial cleft cyst excisions, and to evaluate whether PIAB improve patient outcomes. STUDY DESIGN: Retrospe...
OBJECTIVE: To identify patterns in prophylactic intravenous antibiotics (PIAB) usage for thyroglossal duct and branchial cleft cyst excisions, and to evaluate whether PIAB improve patient outcomes. STUDY DESIGN: Retrospective cohort study. SETTING: American College of Surgeons National Surgical Quality Improvement Program-Pediatric (NSQIP-P) Surgical Antibiotic Prophylaxis Database. METHODS: The NSQIP-P database was queried for pediatric patients (≤18) from 2021 to 2023 who underwent thyroglossal duct or branchial cleft cyst excision. Multivariate regressions assessed associations between PIAB use and outcomes including surgical site infection, unplanned readmission, and reoperation while adjusting for clinicodemographic factors (age, sex, race/ethnicity, admission status, surgical specialty, ASA classification, and wound classification). RESULTS: Of 2106 TGDC and 2837 BCC patients, 83.5% and 68.0% received PIAB, respectively. Hispanic ethnicity, postoperative admission, and clean-contaminated wound classification were associated with increased PIAB use in both groups. In BCC patients, younger age and treatment by non-otolaryngologists predicted decreased PIAB use. While univariate analysis in TGDC cases showed lower infection rates with PIAB (OR, 0.52; 95% CI, 0.30-0.95; P = .025), this was not significant on multivariate analysis (0.59, 0.34-1.08, P = .074). PIAB did not significantly affect infection, readmission, or reoperation rates in either cohort on multivariate analysis. CONCLUSION: PIAB use in pediatric TGDC and BCC excisions varies with clinicodemographic factors but did not consistently reduce adverse outcomes. These findings underscore the need to reevaluate the necessity of PIAB and encourage further investigations to develop evidence-based guidelines for pediatric neck mass surgery.
Preservation Palatopharyngoplasty for Obstructive Sleep Apnea: Predictors and Clinical Outcomes.
Abdelwahab M, Alhussien A, Kassir MF … +3 more , Butehorn H, Munhall C, Nguyen SA
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41759003 · Full text
OBJECTIVE: To evaluate clinical outcomes of Preservation Palatopharyngoplasty (PPPP), in a broader cohort, and identify predictors significantly associated with improved surgical outcomes in patients with moderate to sev...
OBJECTIVE: To evaluate clinical outcomes of Preservation Palatopharyngoplasty (PPPP), in a broader cohort, and identify predictors significantly associated with improved surgical outcomes in patients with moderate to severe obstructive sleep apnea (OSA). STUDY DESIGN: A retrospective cohort study. SETTINGS: A tertiary care center. METHODS: The study was conducted on adult patients with moderate to severe OSA who underwent PPPP. Objective sleep parameters and subjective symptom scores including the Epworth Sleepiness Scale (ESS), Standardized List Evaluating Apnea (SLEAP), and Nasal Obstruction Symptom Evaluation (NOSE) scale were compared pre- and postoperatively. Linear regression was performed to identify predictors of AHI reduction. RESULTS: A total of 53 patients (mean age 49.8 ± 12.7 years, mean BMI 35.6 ± 7.8) were included. Surgical success and cure were achieved in 88.9% and 37% of patients, respectively. Significant postoperative improvements were observed in AHI, RDI, and ODI (all P < .001), as well as in ESS, SLEAP, and NOSE scores (all P < .05). Linear regression identified higher baseline BMI, higher preoperative AHI, larger palatine tonsils, lower NOSE scores, and lateral pharyngeal wall collapse on Müller's maneuver emerged as significant predictors of AHI reduction. CONCLUSION: The PPPP is a is a tissue-preserving, safe, and effective palatal surgical technique that significantly improves both objective and subjective outcomes in patients with moderate to severe OSA. Its effectiveness extends across a wide range of BMI and baseline disease severity.
Higher Force Metrics Associated With Known Risk Factors for Difficult Laryngeal Exposure.
Stevenson L, Fenton T, Feng A … +1 more , Song P
Otolaryngol Head Neck Surg · 2026 May · PMID 41759000 · Publisher ↗
OBJECTIVE: Several factors are reported as predictors of difficult laryngeal exposure (DLE). This study investigates force metrics associated with predictive factors of DLE during suspension microlaryngoscopy (SML) utili...
OBJECTIVE: Several factors are reported as predictors of difficult laryngeal exposure (DLE). This study investigates force metrics associated with predictive factors of DLE during suspension microlaryngoscopy (SML) utilizing data recorded by the laryngeal force sensor (LFS). We hypothesize that patient factors associated with DLE will record higher forces during laryngeal surgery. STUDY DESIGN: Prospective observational cohort clinical trial data examining secondary endpoints. SETTING: Tertiary medical center. METHODS: The LFS recorded maximum force and average force during SML in 214 laryngeal surgeries. Patient characteristics, and perioperative factors such as interincisor distance (ID), Mallampati scores, cervical spine stiffness, thyromental (TM) distance, and laryngeal grade view during intubation, were also recorded. RESULTS: Patients included ranged from 19 to 90 years, with a median age of 57 years. A higher Mallampati score corresponded to a higher average force and maximum force (P = .002, P = .003). Patients with an ID of ≤4.5 cm experienced nearly double the average force when compared to edentulous patients (P = .002). Height (P = .001) and a shorter TM distance were associated with higher force metrics. There was also a difference in force metrics between the sexes, with men experiencing a higher average force (P ≤ .001). CONCLUSION: Elevated force metrics during SML are correlated with predictive indicators for difficult intubation and laryngeal exposure. These metrics could help identify patients at higher risk of requiring increased force during both intubation and SML, leading to potential postoperative complications.
Topical Imiquimod for Oral Cavity Leukoplakia and Dysplasia: A Scoping Review.
Scharner MK, Walker AM, Nguyen SA … +1 more , Kejner AE
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41758991 · Full text
OBJECTIVE: Imiquimod, a toll-like receptor 7 agonist, is currently FDA-approved for treatment of actinic keratoses, superficial BCC, and external genital warts. It has also demonstrated promise in off-label use in the tr...
OBJECTIVE: Imiquimod, a toll-like receptor 7 agonist, is currently FDA-approved for treatment of actinic keratoses, superficial BCC, and external genital warts. It has also demonstrated promise in off-label use in the treatment of oral cavity leukoplakia and dysplasia. The aim of this scoping review is to summarize the current literature on this novel treatment strategy. DATA SOURCES: CINAHL, Cochrane Library, PubMed, and SCOPUS. REVIEW METHOD: Data sources were searched from inception through December 2024. The search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. Studies reporting on oral leukoplakia or dysplasia treated with topical imiquimod were included, with primary outcome being lesion resolution or reduction. RESULTS: A total of 9 studies reporting on (N = 89) patients with (n = 99) lesions were included. The average age was 48.4 (range 43-66), and 48.6% were male. 5% topical imiquimod was used in varying treatment regimens, most commonly for 6 weeks in duration (7/9 papers). 34.3% of lesions had complete resolution, 43.4% had incomplete resolution, and 22.2% had no change in the lesion. The most commonly reported adverse effects were burning/soreness at the site (73.0%), fatigue (22.5%), oral lichen planus development or flare (11.2%), and flu-like symptoms (2.2%). CONCLUSION: Topical imiquimod for the treatment of oral cavity leukoplakia and dysplasia is a promising new treatment strategy. Efficacy has been demonstrated in reducing lesion size and even complete lesion resolution, with minimal adverse effects. Further research is needed on this innovative therapeutic approach.
Ethics in Practice: Immunotherapy at End of Life in Head and Neck Cancer.
Hack S, Karni RJ
Otolaryngol Head Neck Surg · 2026 Jun · PMID 41733110 · Publisher ↗
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The Association Between Allergic Rhinitis, Eosinophilic Inflammation, and Postoperative Recurrence in Nasal Polyps.
Zhong W, Xie S, He H … +4 more , Zhang H, Jiang W, Liao C, Xie Z
Otolaryngol Head Neck Surg · 2026 May · PMID 41733103 · Full text
OBJECTIVE: Although allergic rhinitis (AR) commonly co-occurs with chronic rhinosinusitis with nasal polyps (CRSwNP), its impact on tissue endotypes and prognosis remains unclear. This study examines the impact of AR on...
OBJECTIVE: Although allergic rhinitis (AR) commonly co-occurs with chronic rhinosinusitis with nasal polyps (CRSwNP), its impact on tissue endotypes and prognosis remains unclear. This study examines the impact of AR on CRSwNP, focusing on its links to tissue eosinophilic inflammation and postoperative recurrence risk. STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary referral center. METHODS: A retrospective analysis was conducted on CRSwNP patients who underwent functional endoscopic sinus surgery. Based on the presence of comorbid AR, patients were categorized into AR and non-AR groups. Baseline clinical data, peripheral and tissue eosinophil levels, and prognosis were analyzed. Multivariate Cox regression and Kaplan-Meier survival analyses were used to assess associations with postoperative recurrence. RESULTS: A total of 603 patients with CRSwNP were included; 202 had comorbid AR. Compared with non-AR patients, the AR group had higher rates of prior surgery and asthma and showed increased tissue eosinophil counts and percentages. During follow-up, patients who recurred had a higher prevalence of AR, elevated peripheral and tissue eosinophil levels, more prior surgery, and higher Lund-Mackay scores. Multivariable Cox regression and Kaplan-Meier analysis identified AR as an independent predictor of postoperative recurrence. Moreover, a high tissue eosinophil burden independently associated with recurrence; within the recurrence cohort, AR patients exhibited significantly higher tissue eosinophil counts and percentages than non-AR patients. CONCLUSION: Comorbid AR identifies a CRSwNP subgroup with marked tissue eosinophilia and increased risk of postoperative recurrence. It independently predicts earlier relapse and shorter recurrence-free survival, likely by amplifying local eosinophilic inflammation.
Procedural-Based Contemporary Management of Bell's Palsy Long-Term Sequelae: A Narrative Review.
Frederick RM, Kerr R, Dobratz E … +1 more , Dougherty W
Otolaryngol Head Neck Surg · 2026 May · PMID 41733100 · Full text
OBJECTIVE: To describe the long-term sequelae of Bell's palsy and summarize available treatment options, including recent advances, so that general otolaryngologists and other practitioners are aware of the clinical find...
OBJECTIVE: To describe the long-term sequelae of Bell's palsy and summarize available treatment options, including recent advances, so that general otolaryngologists and other practitioners are aware of the clinical findings and available interventions. DATA SOURCES: PubMed. REVIEW METHODS: A literature search was performed on December 18, 2024, via PubMed using keywords such as "synkinesis," "selective myectomy," "selective neurectomy," "botulinum toxin," "intervention" in the context of "Bell's palsy" with preference for articles published within the last 5 to 10 years but inclusion of select older articles that provided necessary context for the current topic. Articles included in the review were written in English or had available English translations and preference was given to meta-analysis and systematic review articles but included randomized control prospective clinical trials. CONCLUSIONS: Management of long-term Bell's palsy sequelae requires a multidisciplinary approach, with facial nerve specialists at the helm, offering procedural interventions aimed at restoring facial symmetry and improving a patient's quality of life. General practitioners should be aware of all available treatment options and promptly refer patients with persistent disease or those who develop long-term sequelae. IMPLICATIONS FOR PRACTICE: This review may help patients suffering from long-term Bell's palsy sequelae get earlier referrals to facial nerve specialists. General providers will be more aware of the specific signs and symptoms to monitor for in a Bell's palsy patient that warrant referral. Additionally, increased familiarity with available treatment options promotes informed counseling to patients on their disease course.
Prediction and Prognostication of Peripheral Blood Biomarkers in Head and Neck Cutaneous Squamous Cell Carcinoma.
Hubbard MG, Chestnut EH, Bhaskara MC … +5 more , Chen LW, Kennedy E, Lee A, Yesensky J, Farlow JL
Otolaryngol Head Neck Surg · 2026 May · PMID 41733096 · Full text
OBJECTIVE: While many with head and neck cutaneous squamous cell carcinomas (cHNSCC) respond well to surgery alone, there is a need to refine traditional staging systems. We aim to identify whether peripheral blood bioma...
OBJECTIVE: While many with head and neck cutaneous squamous cell carcinomas (cHNSCC) respond well to surgery alone, there is a need to refine traditional staging systems. We aim to identify whether peripheral blood biomarkers (PBBMs) may enhance current staging for prognostication and adjuvant treatment selection. STUDY DESIGN: Retrospective cohort study. SETTING: Single, tertiary academic referral center. METHODS: Preoperative and postoperative PBBMs and patient/disease characteristics were collected for adults surgically treated for cHNSCC at an academic center from 2016 to 2022. Pearson correlations and t-tests were utilized to correlate PBBMs with tumor characteristics. Univariate and multivariate analysis was performed to correlate predictors with overall survival. Staging systems were compared using Kaplan-Meier regression and Chi-square test for trend and independence. RESULTS: 409 patients (median age 75.4, 77% male, 99% White, median follow-up 34.5 months) underwent surgical resection for cHNSCC between 2016 and 2022. While several preoperative PBBMs correlated with tumor size and nodal burden, none were found to predict OS. On univariate analysis, high postoperative relative neutrophils and platelet-to-lymphocyte ratio (PLR) were associated with worse OS. High relative lymphocytes, total albumin, and prognostic nutritional index (PNI) were associated with improved OS. On multivariate analysis, no PBBM was significant for predicting OS. CONCLUSION: This is the first study to evaluate the prognostic value of PBBMs in cHNSCC. Preoperative PBBMs correlated with tumor size and nodal burden, while high CCI and low postoperative NLRs negatively predicted survival. Further prospective research is needed for validation.
Evaluating the Efficacy of Nebulized Ciprofloxacin-Dexamethasone Using a Novel Model of Airway Stenosis.
Swami PN, Peng T, Kaye R … +5 more , Kaplan S, Scheffler P, Saleem MI, Grande DA, Smith LP
Otolaryngol Head Neck Surg · 2026 May · PMID 41733082 · Publisher ↗
OBJECTIVE: Acquired airway stenosis lacks effective animal models for evaluating therapeutic interventions. This study aimed to establish a reproducible rabbit model of mixed mucosal and structural stenosis and quantify...
OBJECTIVE: Acquired airway stenosis lacks effective animal models for evaluating therapeutic interventions. This study aimed to establish a reproducible rabbit model of mixed mucosal and structural stenosis and quantify the therapeutic effects of nebulized ciprofloxacin/dexamethasone in mitigating airway stenosis. STUDY DESIGN: Controlled experimental animal study. SETTING: Preclinical research conducted in a laboratory setting using a rabbit model. METHODS: Twenty-eight rabbits underwent open-airway surgery, with a 1-cm longitudinal incision along the anterior of the trachea followed by mucosal abrasion using a nylon brush. Rabbits received nebulized ciprofloxacin/dexamethasone or served as untreated controls. Three weeks post-injury, tracheas were harvested for micro-computed tomography (CT) imaging. Intraluminal and inner tracheal areas were quantified using ImageJ software, and mucosal thickness was calculated. Statistical analysis was performed using GraphPad Prism. RESULTS: Twenty-six rabbits survived and developed significant airway stenosis confined to the injured region, validating model precision and reproducibility. In untreated rabbits, mucosal thickness was significantly greater at the injury site compared to the control site (P < .0001). Compared with untreated rabbits, the treatment group showed significantly reduced mucosal thickness (P = .0016) and a trend towards larger intraluminal area (P = .0571). No significant differences were observed in the inner tracheal area. CONCLUSION: This novel open surgical model reliably induces mixed mucosal and structural airway stenosis, offering precise control over the injury site. Additionally, this study provides the first quantitative evidence of therapeutic potential for nebulized ciprofloxacin/dexamethasone, demonstrating attenuated mucosal inflammation and airway narrowing, and presents a reproducible model for the preclinical evaluation of airway stenosis treatments.
Jaw-in-a Day: Process Improvement and Outcomes.
Benites C, Davila CE, Conrad DJ … +5 more , Lam A, Reschly W, Nessif R, Motwani K, Dziegielewski PT
Otolaryngol Head Neck Surg · 2026 May · PMID 41711575 · Publisher ↗
OBJECTIVE: Describe the evolving institutional experience with Jaw-in-a-Day reconstruction and evaluate the functional, oncologic, and surgical outcomes of an efficient and reproducible model that can be used for both be...
OBJECTIVE: Describe the evolving institutional experience with Jaw-in-a-Day reconstruction and evaluate the functional, oncologic, and surgical outcomes of an efficient and reproducible model that can be used for both benign and malignant cases. STUDY DESIGN: Retrospective case series. SETTING: Tertiary academic referral center and an affiliated private practice. METHODS: A retrospective review of Jaw-in-a-Day reconstructions performed between January 2023 and January 2024 was conducted. All patients undergoing fibula or scapula free flap reconstruction with immediate dental implantation and provisional prosthesis were included. Operative times and prosthetic workflows were compared by prosthesis capture method (in situ vs at the head) and team composition (single vs integrated two-surgeon teams). Outcomes measured were operative time, flap and implant survival, perioperative complications, Functional Oral Intake Scale (FOIS) scores, and prosthesis use. RESULTS: 33 patients (median age 66; range 13-83) underwent Jaw-in-a-Day reconstruction, 20 malignant disease cases, and 13 benign or traumatic cases. Fibula free flaps were used in 32 cases and scapula in one. Median operative time was 12h19m. Prosthesis capture in situ trended toward shorter operative and prosthetic times but did not reach significance. The two-surgeon approach significantly reduced operative time by 4h24m (P < .001) and prosthodontic time by 2 hours (P = .01). All flaps survived. Implant survival was 97%, with three failures in 2 patients. At 12 months, 32 patients used definitive prostheses and median FOIS was 7. CONCLUSION: The Jaw-in-a-Day surgical approach is feasible for benign and malignant reconstruction with high flap and implant survival. Early institutional adoption shows a learning curve, but efficiency improves with process refinements, particularly a two-surgeon workflow.
Sarcopenia Risk is Associated With Decreased Swallow Safety in Patients With Dysphagia.
Nativ-Zeltzer N, Ashkenazi Y, Halaby LS … +5 more , Hayat L, Wasserzug O, Oestreicher-Kedem Y, Muhanna N, Nachalon Y
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41705460 · Full text
OBJECTIVE: Sarcopenia, characterized by the loss of skeletal muscle mass and strength, is associated with adverse health outcomes in older adults. This study aimed to evaluate the relationship between sarcopenia risk, ha...
OBJECTIVE: Sarcopenia, characterized by the loss of skeletal muscle mass and strength, is associated with adverse health outcomes in older adults. This study aimed to evaluate the relationship between sarcopenia risk, handgrip strength, and swallowing function in patients with dysphagia undergoing Fiberoptic Endoscopic Evaluation of Swallowing (FEES). STUDY DESIGN: Retrospective chart review. SETTING: A tertiary dysphagia clinic. METHODS: Medical records of individuals aged 65 years and older who attended the dysphagia clinic over a 6-month period were reviewed. Data collected included demographics, clinical symptoms, handgrip strength, SARC-F (Strength, Assistance in walking, Rise from a chair, Climb stairs, and Falls) scores, Penetration Aspiration Scale (PAS) scores, and Yale residue scale scores from FEES. Critically weak grip strength was defined using previously established thresholds. Correlations between sarcopenia indicators and swallowing outcomes were analyzed using Spearman's rho. RESULTS: Thirty-three patients were included (mean age 77.6 ± 7.5 years; 52% male). Twenty-five (76%) demonstrated critically weak grip strength, and 9 (27%) had SARC-F ≥ 4, indicating sarcopenia risk. SARC-F scores were negatively correlated with Functional Oral Intake Scale (FOIS) (rs = -0.45, P = .01) and positively correlated with liquid PAS (rs = 0.41, P = .02). Handgrip strength was negatively correlated with age (rs = -0.39, P = .03). CONCLUSIONS: Most older adults undergoing FEES exhibited critically weak grip strength, suggesting high sarcopenia risk. Higher sarcopenia risk correlated with worse swallowing safety and reduced oral intake. These findings highlight the importance of assessing and addressing nutritional and muscle strength deficits in dysphagic older adults.
Effects of Wrist Support on Fatigue and Cognitive Load in Simulated Otologic Surgery.
Gao S, Shankar A, Wei O … +1 more , Galaiya DJ
Otolaryngol Head Neck Surg · 2026 May · PMID 41705438 · Publisher ↗
OBJECTIVE: To investigate the effects of wrist support on muscle fatigue and cognitive load in otologic surgery. STUDY DESIGN: Cross-over experimental trial. SETTING: Tertiary Academic Medical Center. METHODS: Ten otolar...
OBJECTIVE: To investigate the effects of wrist support on muscle fatigue and cognitive load in otologic surgery. STUDY DESIGN: Cross-over experimental trial. SETTING: Tertiary Academic Medical Center. METHODS: Ten otolaryngology trainees drilled 3D-printed phantom temporal bones with and without wrist support while wearing sEMG sensors on the dominant arm. Muscle fatigue was derived from sEMG measurements and subsequently correlated with survey responses, including the NASA Task Load Index, a validated measure of cognitive load. Drilling performance was rated with a validated mastoidectomy scale. RESULTS: A total of 15 muscle groups were fatigued during trials with support, compared to 19 during trials without support. Across all trials, the upper trapezius had the highest proportions of fatigue (55%). Support trials showed significantly lower activation in the anterior deltoids (13.5% vs 16.3%, P = .049) and biceps (4.7% vs 7.9%, P = .004). Support trials also had significantly reduced mental demand (P = .022), temporal demand (P = .014), and overall workload (P = .025), and higher self-reported ergonomics ratings (P = .026). Moreover, trials with biceps fatigue were rated as less representative of typical OR positioning (U = 12.0, P = .003). Drilling performance did not significantly differ between support conditions; however, support trials tended to be shorter in duration (516.6 vs 595.1 seconds). CONCLUSIONS: This study highlights a first step in quantifying the relationship between wrist support, fatigue, and workload in otologic surgery. Results suggest that absent wrist support and unfamiliar positioning may significantly contribute to greater fatigue and cognitive demand.
Multicenter Clinical Validation of an Artificial Intelligence Diagnostic Classification Model for Laryngoscopy Images.
Sampieri C, Mora F, Peretti G … +14 more , Larrosa M, Vilaseca I, Avilés-Jurado FX, Ioppi A, Bellini E, Alegre B, Ruiz-Sevilla L, Srivastava R, Sakellaridis AC, Razou A, Kotsis GP, Moccia S, Mattos LS, Baldini C
Otolaryngol Head Neck Surg · 2026 Apr · PMID 41696998 · Full text
OBJECTIVE: To develop and externally validate a computer-aided diagnosis (CADx) model using artificial intelligence (AI) for classifying laryngeal lesions from laryngoscopy images into high-risk (HR), low-risk (LR). STUD...
OBJECTIVE: To develop and externally validate a computer-aided diagnosis (CADx) model using artificial intelligence (AI) for classifying laryngeal lesions from laryngoscopy images into high-risk (HR), low-risk (LR). STUDY DESIGN: Retrospective multicenter development of a CADx model and external validation on independent cohorts. SETTING: Multicenter tertiary referral hospitals (Italy, India, China, Greece, and Spain). METHODS: Over 20,000 images derived from laryngoscopic examinations were retrieved. Images were annotated based on histopathology or expert consensus. A deep learning model was trained using an internal dataset and evaluated on 2 external datasets to assess generalizability. The CADx model classifies only images containing visible lesions, discriminating between LR and HR categories. Diagnostic performance was measured using standard metrics, including accuracy, precision, recall, F1-score, and area under the receiver operating characteristic curve (AUC). Model performance was compared with physicians of varying expertise and ChatGPT-4o. RESULTS: The computer-aided diagnosis model achieved a similar performance across internal and external datasets in distinguishing HR from LR lesions, with accuracy/AUC of 0.90/0.89 internally, 0.85/0.85 on the Greek dataset, and 0.88/0.88 on the Spanish dataset. The model's accuracy was statistically noninferior to that of otolaryngologists and expert laryngologists, and superior to general practitioners and ChatGPT-4o. CONCLUSION: This is a large multicenter clinical validation of a CADx model for laryngeal endoscopy, demonstrating generalizability and performance comparable to clinicians in discriminating between LR and HR lesions. The model's success supports its potential role in augmenting diagnostic capabilities, especially in resource-limited settings. A prospective multicenter clinical trial is underway to assess real-world clinical implementation.
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