Qiu J, Xu M, Zhang Q
… +9 more, Liu Y, Wu Q, Yao Y, Gong T, Chen L, Zhang Q, Fan M, Zhang Q, Zhang Z
Laryngoscope
· 2026 Jun · PMID 42337838
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OBJECTIVES: This study aims to quantitatively analyze vestibulo-ocular reflex (VOR) gain and saccade characteristics during video head impulse testing (vHIT) in patients with vestibular migraine (VM), providing evidence...OBJECTIVES: This study aims to quantitatively analyze vestibulo-ocular reflex (VOR) gain and saccade characteristics during video head impulse testing (vHIT) in patients with vestibular migraine (VM), providing evidence for clinical diagnosis. METHODS: This study included 30 definite VM patients (60 ears) and 30 healthy controls (60 ears). The function of six semicircular canals (SCCs) was evaluated by vHIT. Quantitative parameters of VOR gain and saccades were compared between groups. Benjamini-Hochberg correction was applied (q < 0.05 considered significant). RESULTS: No significant differences in VOR gains for all SCCs were found between groups (q > 0.05). However, in the analysis of saccade parameters, the VM group showed higher peak velocity (q = 0.03) and shorter latency (q = 0.03). No group differences were observed in saccade duration or frequency for lateral SCCs, nor in any saccade parameters for vertical SCCs. ROC analysis identified optimal cutoffs for the first lateral SCC saccade: peak velocity of 83.69°/s (AUC: 0.668, sensitivity: 0.586, specificity: 0.8) and latency of 295.45 ms (AUC: 0.666, sensitivity: 0.69, specificity: 0.582). CONCLUSION: Although VOR gains in VM patients fall within the normal range, they exhibit pathological microsaccades that differ from those of healthy individuals, characterized by lateral SCC saccades with "high velocity and short latency." These quantitative saccade parameters hold promise as supplementary objective indicators to complement traditional VOR gain, offering auxiliary evidence for the clinical diagnosis of VM.
Gartling G, Yoshimatsu M, Bing R
… +1 more, Branski RC
Laryngoscope
· 2026 Jun · PMID 42337831
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OBJECTIVES: To test whether unilateral recurrent laryngeal nerve (RLN) transection elicits side specific transcriptomic responses in rat vocal fold compartments. We compared the medial thyroarytenoid (MTA) muscle and muc...OBJECTIVES: To test whether unilateral recurrent laryngeal nerve (RLN) transection elicits side specific transcriptomic responses in rat vocal fold compartments. We compared the medial thyroarytenoid (MTA) muscle and mucosa on the left versus right, accounting for baseline laterality. METHODS: Unilateral RLN transection was performed in five adult rats (Left RLN: 2-males, 1-female; Right RLN: 1-male, 1-female). 5-weeks post-injury, the medial thyroarytenoid (MTA) muscle and vocal fold mucosa were harvested for RNA sequencing. Differential expression analysis compared Left-denervated versus Right-denervated tissues. A separate control Left-versus-Right analysis (1-male; 1-female) was used to assess baseline laterality and to contextualize TF transcription-factor inferences. TF activity was inferred using perturbation-based signatures, and baseline trends were used to classify overlapping signals as consistent with, opposite to, or distinct from baseline laterality. RESULTS: Left RLN denervation elicited distinct transcriptional responses in both compartments. In mucosa, TFs governing epithelial stability were reduced while regenerative cues were activated, suggesting impaired differentiation and recruitment of progenitor-like programs. In MTA, left-sided injury increased TFs consistent with stress signaling and mitochondrial compensation. TFs involved in epigenetic stability were reduced. Lateralized activity was observed in developmental regulators putatively related to positional memory or differential stress adaptation. Pathway analysis revealed enrichment of skeletal development processes in MTA and immune/matrix regulation in mucosa, indicating coordinated remodeling across muscle and epithelial compartments. CONCLUSION: RLN injury produces side-specific muscle and mucosal changes, with left-sided denervation showing stronger atrophy and stress responses. These results emphasize the importance of laterality and coordinated tissue adaptation. LEVEL OF EVIDENCE: NA.
Schmidtman DC, Blue MJ, Ali HM
… +1 more, Ekbom DC
Laryngoscope
· 2026 Jun · PMID 42334032
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Endoscopic CO laser diverticulectomy is an effective treatment for Zenker's diverticulum. This article details our technique for complete endoscopic diverticulectomy, which has demonstrated lower recurrence rates than ot...Endoscopic CO laser diverticulectomy is an effective treatment for Zenker's diverticulum. This article details our technique for complete endoscopic diverticulectomy, which has demonstrated lower recurrence rates than other endoscopic approaches in our institutional experience. Operative illustrations, endoscopic photographs, and supplemental video are provided to facilitate adoption of the technique.
Peng T, Swami P, Goldstein T
… +4 more, Neuwirth A, Grande DA, Smith LP, Scheffler P
Laryngoscope
· 2026 Jun · PMID 42332874
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BACKGROUND: Slide tracheoplasty and end-to-end anastomosis are two common reconstructive techniques for airway stenosis. While slide tracheoplasty is often preferred for its larger luminal diameter and reduced anastomoti...BACKGROUND: Slide tracheoplasty and end-to-end anastomosis are two common reconstructive techniques for airway stenosis. While slide tracheoplasty is often preferred for its larger luminal diameter and reduced anastomotic tension, its mechanical integrity relative to end-to-end repair remains incompletely characterized. This study aimed to compare tensile strength and elastic properties between the two repair techniques in an ex vivo porcine model. METHODS: Porcine tracheas were harvested, bisected, and reattached using either end-to-end anastomosis or slide tracheoplasty. Tensile testing was performed to a maximum load of 45 N using a uniaxial testing system. Load at failure, stress-strain behavior, and Young's modulus were calculated. Survival analysis was performed using the log-rank test to compare construct integrity between groups. Negative and positive pressure testing was performed. RESULTS: Seventy-five percent of slide tracheoplasty samples failed under tension, with a median failure load of 32.96 N, whereas none (0%) of the end-to-end repairs failed within the 45 N test limit (p = 0.0401). At equivalent strain, slide tracheoplasty constructs demonstrated lower stress compared with end-to-end anastomoses. Young's modulus was similarly reduced in the slide group. CONCLUSION: Slide tracheoplasty constructs demonstrated lower tensile strength and stiffness than end-to-end repairs, suggesting that the redistribution of mechanical forces across a larger surface area reduces localized stress but limits overall load-bearing capacity. This broader force dispersion may protect the anastomotic site from focal tension and dehiscence but results in susceptibility to elongation or deformation under chronic strain. These mechanical considerations are important for surgeons when selecting a repair technique and ensuring long-term postoperative airway stability. LEVEL OF EVIDENCE: N/A.
Cywka KB, Skarzynski PH, Baczyk M
… +2 more, Balwicka-Kowalczyk M, Skarzynski H
Laryngoscope
· 2026 Jun · PMID 42332362
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OBJECTIVES: Sentio (Oticon Medical) is an active bone-conduction implant approved in 2024. This study evaluates initial clinical outcomes, safety, and audiological efficacy of the Sentio in patients with conductive or mi...OBJECTIVES: Sentio (Oticon Medical) is an active bone-conduction implant approved in 2024. This study evaluates initial clinical outcomes, safety, and audiological efficacy of the Sentio in patients with conductive or mixed hearing loss. METHODS: A total of 28 patients (10 conductive, 18 mixed hearing loss) were implanted with Sentio. Preoperative assessments included pure-tone audiometry and speech recognition testing in unaided and aided conditions. Postoperative evaluations of hearing thresholds and speech recognition were performed in free field. Subjective benefit was assessed using the APHAB questionnaire before and after implantation. The first follow-up occurred 1 month after activation. RESULTS: All surgeries were completed without complications. One patient required revision surgery, which was successful. No other adverse events occurred. Mean hearing threshold improved from 56.3 dB HL (unaided) and 31.7 dB HL with Ponto on a softband to 25.3 dB HL post-activation and remained stable at 1-month follow-up (p < 0.001). Speech discrimination was 11.9% preoperatively (unaided) and 85.5% with Ponto. It reached 87.3% at activation and 93.3% at the follow-up (p < 0.001). Speech perception in noise was +1.97 dB SNR before implantation (unaided) and 2.22 dB SNR (aided), -2.04 dB SNR at implant activation and -2.67 dB SNR at the follow-up (p < 0.001 for implant conditions vs. unaided). APHAB global score decreased from 53.2 points preoperatively to 32.6 points postoperatively (p < 0.001). CONCLUSION: Sentio implantation appears effective and safe for the rehabilitation of conductive or mixed hearing loss. The first clinical results demonstrate audiological improvement and subjective benefit, supporting the potential of the system as a reliable bone-conduction hearing solution.
Feng M, Qu R, Suresh A
… +2 more, Byun J, Fuller J
Laryngoscope
· 2026 Jun · PMID 42332340
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OBJECTIVE: Functional rhinoplasty can improve disease-specific quality of life (QoL) domains. However, less is understood about its association with global health-related QoL outcomes. The goal of this study is to evalua...OBJECTIVE: Functional rhinoplasty can improve disease-specific quality of life (QoL) domains. However, less is understood about its association with global health-related QoL outcomes. The goal of this study is to evaluate the relationship between disease-specific and long-term global QoL outcomes following functional rhinoplasty. METHODS: Prospective cohort study at a tertiary medical center of patients undergoing functional rhinoplasty for nasal airway obstruction. RESULTS: Fifty patients (58% female, 42% male), with a mean age of 38.5 (StD 14.7), were surveyed. Baseline and long term (> 6 months) follow up Euroqol-5D (EQ-5D) and Standard Cosmesis and Health Nasal Outcomes Survey (SCHNOS) questionnaires were collected. Mean baseline SCHNOS-Obstructive (SCHNOS-O) score improved from 77.5 (95% CI: 71.5-83.5) to 22.7 (95% CI: 14.4-31.1) at follow up. Mean SCHNOS-Cosmesis (SCHNOS-C) score improved from 44.9 (95% CI: 33.9-56.0) to 13.9 (95% CI: 8.9-21.1). A higher SCHNOS-O is a significant predictor for expressing pain/discomfort at follow up (p = 0.011). A higher SCHNOS-C is a significant predictor for expressing anxiety/depression at follow up (p = 0.019). There is no relationship between SCHNOS-O/SCHNOS-C and mobility, self-care, or activity. A greater improvement in SCHNOS-O is associated with less anxiety/depression (p = 0.03) and pain/discomfort (p = 0.02) at follow up. However, a greater improvement in SCHNOS-C is not significantly associated with anxiety/depression (p = 0.678) or pain/discomfort (p = 0.558) at follow up. Patients who expressed anxiety/depression at baseline are more likely to express anxiety/depression at follow up. CONCLUSION: Patients with long-term improvements in nasal obstruction, but not cosmesis, are less likely to report long-term anxiety/depression and pain/discomfort following functional rhinoplasty.
Laryngoscope
· 2026 Jun · PMID 42325100
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OBJECTIVE: To investigate clinical outcomes, safety, and sustainability of humanitarian otolaryngology outreach programs in low- and middle-income countries (LMICs). DATA SOURCES: PubMed, Scopus, and Cochrane databases....OBJECTIVE: To investigate clinical outcomes, safety, and sustainability of humanitarian otolaryngology outreach programs in low- and middle-income countries (LMICs). DATA SOURCES: PubMed, Scopus, and Cochrane databases. REVIEW METHODS: Following PRISMA-ScR guidelines, two investigators searched databases for published studies reporting clinical, safety, and sustainability outcomes of otolaryngology outreach programs. Bias analysis used Methodological Index for Nonrandomized Studies (MINORS). RESULTS: Twenty-six studies involving 9283 subjects met inclusion criteria, predominantly from Anglophone Africa and South America. Most programs were conducted by US multidisciplinary teams in teaching or referral hospitals, focusing on general otolaryngology, otology, airway, or head and neck surgeries. Targeted populations included surgical candidates (N = 15), deaf populations (N = 6), and community screening subjects. Surgical outcomes demonstrated excellent success rates with low complications. Other otolaryngological fields and disease prevalence in rural populations were poorly investigated. Sustainability outcomes were reported in 12 studies using surgical volumes and narrative evaluations rather than validated instruments; only three maintained follow-up beyond 2 years. Key barriers included supply constraints (N = 11), insufficient staff training (N = 7), and inadequate infrastructure (N = 4). Seven studies evaluated new technologies for hearing assessment, demonstrating high concordance between physicians and trained nonphysician providers. Mean MINORS score was 7.9 ± 2.3, indicating low-to-moderate methodological quality. CONCLUSION: Most humanitarian initiatives focused on specific disease outcomes with inadequate long-term sustainability investigation. Emerging literature on new technologies-including teleotology, digital otoscopy, and artificial intelligence-based assessments-supports future skill transfer to nonphysician providers in regions with substantial practitioner shortages. LEVEL OF EVIDENCE: N/A.
Arora N, Ma Y, Young VN
… +3 more, Schneider SL, Rosen CA, Crosby TW
Laryngoscope
· 2026 Jun · PMID 42325050
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OBJECTIVE: Endoscopic vocal fold shortening (EVFS) often focuses on the anterior-posterior (AP) web dimension as a proportion of vocal fold (VF) length. We investigated the craniocaudal dimension to determine whether thi...OBJECTIVE: Endoscopic vocal fold shortening (EVFS) often focuses on the anterior-posterior (AP) web dimension as a proportion of vocal fold (VF) length. We investigated the craniocaudal dimension to determine whether thick infraglottic web geometry produces greater fundamental frequency (F0) elevation than thin webs of equivalent AP dimension. METHODS: Supraglottic structures were removed from eight porcine larynges. Compressed air passed through the glottis achieved phonation under three conditions: baseline, thin web, and thick web. Thin web sutures placed at a mean of 37% of VF length captured only the superior free edge; thick web sutures placed at the same AP position captured the entire infraglottic vibratory surface. F0 was extracted from audio recordings. Wilcoxon signed-rank tests with Bonferroni correction compared F0 elevation between conditions. RESULTS: Baseline F0 was 361.5 Hz (IQR: 308.7-392.0 Hz). Thin webs elevated F0 to 535.1 Hz (Hodges-Lehmann estimated shift [HL] +162.6 Hz [95% CI: -39.3-382.5 Hz]) but with high interspecimen variability (V = 29, p = 0.445). Thick webs produced a more consistent, significant elevation from baseline F0 to 652.0 Hz (V = 36, p = 0.023; HL +255.4 Hz [95% CI: 68.1-452.9 Hz]). Thick webs produced greater F0 elevation than thin webs but did not reach significance (V = 33, p = 0.117; HL +78.9 Hz [95% CI: 1.3-282.9 Hz]). CONCLUSION: This model demonstrates that EVFS three-dimensional web geometry impacts F0 elevation not only through its AP dimension but also through incorporation of the infraglottic vibratory surface. Deliberate infraglottic capture may represent a technically modifiable variable to optimize pitch elevation in gender-affirming voice surgery. LEVEL OF EVIDENCE: NA.
Patel N, Sajjadi A, Park A
… +6 more, Seth R, Heaton C, Xu MJ, Wai K, Likhterov I, Knott PD
Laryngoscope
· 2026 Jun · PMID 42318825
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OBJECTIVE: To compare operative metrics, postoperative complications, and radiographic osseous union among surgeon-specific plates (SSPs), patient-specific plates (PSPs), and conventional un-bent plates (CPs) in microvas...OBJECTIVE: To compare operative metrics, postoperative complications, and radiographic osseous union among surgeon-specific plates (SSPs), patient-specific plates (PSPs), and conventional un-bent plates (CPs) in microvascular mandibular reconstruction. METHODS: A retrospective review was performed of 171 patients who underwent osseous mandibular free flap reconstruction from January 2020-January 2025. Patients were stratified by plating technique: SSP (n = 52), PSP with computer-aided design/manufacture (CAD/CAM) (n = 58), and CP (n = 61). Primary outcomes included operative time, hospital length of stay, and postoperative complications. Secondary outcomes included osteotomy characteristics, CT-based radiographic osseous union, and time-to-Grade 2 union. Multivariate analysis evaluated factors associated with nonunion. RESULTS: Baseline demographics, defect characteristics, and radiation exposure were comparable across cohorts. Secondary reconstruction procedures were more frequent in the SSP cohort compared with the PSP cohort (p = 0.05), and SSPs were more commonly used in complete (angle to angle) mandibular reconstructions. Operative time, hospital length of stay, and ischemia time did not differ significantly by plating method. Postoperative complication rates were low and similar across groups, with no significant differences in infection, hematoma, or reoperation; however, low event rates may have limited power to detect small but clinically meaningful differences between cohorts. Radiographic nonunion was uncommon and did not differ by plating. Time-to-Grade 2 osseous union was similar across plating strategies. Multivariate analysis demonstrated a significant association between nonunion and postoperative complications. Inter-rater reliability for union grading was high. CONCLUSION: Microvascular mandibular reconstruction demonstrates comparable clinical and radiographic outcomes regardless of plate selection. Plate selection and CAD/CAM use should be driven by surgeon choice and reconstructive complexity.
Laryngoscope
· 2026 Jun · PMID 42318621
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OBJECTIVES: Adenoid cystic carcinoma (ACC) typically arises from salivary glands of the head and neck but also occurs in sites outside of the head and neck; however, data regarding nonsalivary ACC are scarce. We present...OBJECTIVES: Adenoid cystic carcinoma (ACC) typically arises from salivary glands of the head and neck but also occurs in sites outside of the head and neck; however, data regarding nonsalivary ACC are scarce. We present a comparison of the clinical behavior, treatment patterns, and survival outcomes of ACC of salivary and nonsalivary sites using the National Cancer Database (NCDB). METHODS: Retrospective analysis of patients diagnosed with ACC between 2004 and 2020 in NCDB. Patients were identified using the histology code 8200 and categorized by site based on primary site ICD-O-3 codes. Anatomic sites with more than 100 patients were included for analysis. RESULTS: A total of 16,962 patients with ACC from seven sites (major salivary, minor salivary, respiratory, skin, breast, female genital, and eye/orbit) were included in the final analysis. Among all sites, minor salivary gland tumors were most likely to present with locally advanced disease (T3 or T4) while those of the respiratory tract were most likely to present with regional (26%) or distant metastasis (11.1%). On multivariate analysis controlling for age, sex, treatment, T and N classification, only breast primaries had significantly different survival from major salivary primaries (HR 0.59, 95% CI 0.49-0.72). CONCLUSION: The clinical behavior of ACC varies significantly by anatomic primary site. Survival differences between the different anatomic sites appear to be driven largely by differences in the extent of disease at presentation, although patients with breast primaries had significantly better survival than salivary gland primaries even when controlling for these factors.
Laryngoscope
· 2026 Jun · PMID 42315354
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BACKGROUND: Peritonsillar abscess (PTA) is a common deep head and neck infection in younger adults. Because the condition can be difficult to distinguish from peritonsillar cellulitis on clinical examination, many patien...BACKGROUND: Peritonsillar abscess (PTA) is a common deep head and neck infection in younger adults. Because the condition can be difficult to distinguish from peritonsillar cellulitis on clinical examination, many patients undergo unnecessary diagnostic blind needle aspiration attempts. For this reason, transoral ultrasound has been suggested as a point-of-care imaging modality that may improve the diagnostic workup of PTA. This randomized clinical trial explores whether transoral ultrasound improves the management of patients with peritonsillar infection. METHODS: A multicenter randomized clinical trial was conducted at the departments of Otorhinolaryngology, Head and Neck Surgery at Copenhagen University Hospital-Rigshospitalet and Odense University Hospital in Denmark. Patients suspected of having a peritonsillar abscess were randomized to either standard clinical examination (control group) or standard clinical examination combined with transoral ultrasound (intervention group). RESULTS: Ninety-five patients (58 at Rigshospitalet and 37 at Odense University Hospital) were included in the study by 28 different physicians. Forty-seven patients were allocated to the intervention group and 48 to the control group. The diagnostic accuracy was 80.9% in the intervention group versus 72.9% in the control group (p = 0.50). In the control group, 18 (37.5%) underwent unsuccessful needle aspirations compared to 12 (26.0%) in the intervention group. The intervention group underwent 31.9% fewer needle aspiration attempts compared with the control group (p < 0.01). CONCLUSION: Transoral ultrasound can significantly decrease the number of needle aspiration attempts in patients with a suspected peritonsillar abscess. Still, we could not find any significant improvement in diagnostic accuracy or improved patient outcomes.
Conti C, Ajasllari G, Sentieri L
… +4 more, Presta A, Bertolini M, Bianchi B, Canevari FRM
Laryngoscope
· 2026 Jun · PMID 42308005
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Publisher ↗
This technical note describes two endoscopic transnasal techniques for pterygomaxillary junction detachment during total maxillectomy that preserve the integrity of the maxillary sinus. A lower cut at the level of the na...This technical note describes two endoscopic transnasal techniques for pterygomaxillary junction detachment during total maxillectomy that preserve the integrity of the maxillary sinus. A lower cut at the level of the nasal floor and an upper cut below the vidian canal are presented through cadaveric dissection and a clinical case. These sinus-sparing approaches enable direct visualization of the posterior maxillary osteotomy, facilitate assessment of posterior margins, and maintain the tumor within an intact maxillary sinus compartment.
Elias DA, Shaffer AD, Bennett Z
… +1 more, Whelan R
Laryngoscope
· 2026 Jun · PMID 42298976
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OBJECTIVE: We aimed to examine the prevalence and utility of obtaining a preoperative cardiac workup in children with very severe OSA prior to adenotonsillectomy (AT). METHODS: We conducted a review of children 2-18 year...OBJECTIVE: We aimed to examine the prevalence and utility of obtaining a preoperative cardiac workup in children with very severe OSA prior to adenotonsillectomy (AT). METHODS: We conducted a review of children 2-18 years with very severe OSA (Apnea-Hypopnea Index [AHI] ≥ 25) who underwent AT between 2018 and 2024. Wilcoxon rank-sum and Spearman's rho (ρ) tests were performed to determine associations between demographics, cardiac workup, polysomnography parameters, and length of stay [LOS]. RESULTS: Of 144 patients with very severe OSA, 38 patients (26.4%) underwent a preoperative cardiac workup. Three of 38 (7.9%) had abnormal findings; all three were obese, aged 13-16 years, and had preoperative AHI > 50. None underwent additional testing or were started on CPAP preoperatively. There was no association between a cardiac workup, obesity, sex, or age and improvement in AHI. Higher preoperative AHI and younger age correlated to longer LOS (p = 0.040, ρ = 0.17 and p = 0.0007, ρ = -0.28, respectively). CONCLUSION: In children with very severe OSA, obtaining a preoperative cardiac workup had a low yield of positive findings and was not associated with perioperative course. Adolescent patients with obesity and preoperative AHI > 50 events/h may be at highest risk for abnormal cardiac findings. Our study suggests that a more selective approach to preoperative cardiopulmonary workup may decrease healthcare expenses and minimize delays in care without deleterious effects on patient outcomes and management.
Obiri-Yeboah D, Marinelli JP, Pais A
… +11 more, Epperson MV, Michalopoulos G, Hagan MKA, Dang D, Dornhoffer JR, Driscoll C, Carlson ML, Celda MP, Link MJ, Neff B, Van Gompel JJ
Laryngoscope
· 2026 Jun · PMID 42298667
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BACKGROUND: Cerebrospinal fluid (CSF) leak after retrosigmoid vestibular schwannoma resection remains a challenging complication. Historically, surgeons reopened the prior retrosigmoid incision for transmastoid repair be...BACKGROUND: Cerebrospinal fluid (CSF) leak after retrosigmoid vestibular schwannoma resection remains a challenging complication. Historically, surgeons reopened the prior retrosigmoid incision for transmastoid repair because the safety of creating a separate postauricular incision was uncertain, with concerns regarding wound breakdown and infection. However, limited data support this practice, and a focused mastoid incision may offer improved access and patient tolerance. This study evaluated wound healing outcomes following transmastoid repair using a new postauricular incision for persistent CSF leak after retrosigmoid surgery in patients without serviceable hearing. METHODS: We retrospectively reviewed 27 patients who underwent transmastoid repair for persistent postoperative CSF leak after retrosigmoid craniotomy for vestibular schwannoma (2000-2025). Demographics, operative details, timing of leak diagnosis and repair, wound complications, readmissions, antibiotic use, and culture results were analyzed. RESULTS: Median age was 48 years (IQR 41-56); 67% were male, and mean BMI was 29.0 kg/m. Mastoid obliteration was performed in 96%, with fat grafting in 93%. A new postauricular incision was used in all cases. Median time to leak diagnosis was 13 days (IQR 4-79), and median time to repair was 2 days (IQR 1-5). One patient (3.7%) developed a superficial wound abscess; no dehiscence or flap necrosis occurred. At median follow-up of 34 months (IQR 2.9-87.7), all wounds were healed. CSF leak recurred in two patients (7.4%) and three (11.1%) required reoperation. CONCLUSION: A separate postauricular incision for transmastoid CSF leak repair was not associated with increased wound morbidity. Durable wound healing was achieved in all patients, with 93% legal control, supporting this anatomy-driven approach.
Atipas K, Ungkanont K, Tanphaichitr A
… +2 more, Vathanophas V, Wannarong T
Laryngoscope
· 2026 Jun · PMID 42298364
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Publisher ↗
OBJECTIVES: To characterize morphology and opening pattern of the Eustachian tube (ET) in children with and without cleft palate (CP), and to examine the associations between endoscopic findings and otologic outcomes. ME...OBJECTIVES: To characterize morphology and opening pattern of the Eustachian tube (ET) in children with and without cleft palate (CP), and to examine the associations between endoscopic findings and otologic outcomes. METHODS: This cross-sectional study included children aged 4-12 years with CP (n = 25) and without CP (n = 25) who underwent transnasal endoscopy for clinical indications. Endoscopic evaluation assessed adenoid, torus tubarius, tubal tonsil, discharge at the opening, ET opening visibility and movement, and the Eustachian Tube Inflammation Scale (ETIS). Findings were compared between groups using the chi-square or Fisher's exact test. Associations between endoscopic findings and middle ear outcomes were analyzed using Spearman's rank correlation. RESULTS: Torus tubarius anomalies were more frequent in children with CP than in non-CP children (52% vs. 20%, p = 0.02), with all anomalies involving the posterior lip of the torus tubarius. Copious discharge at the ET opening was observed more frequently in children without CP (p = 0.04). Adenoid size, dynamic ET opening visibility, and ETIS grades showed significant correlations with both middle ear status and the rate of myringotomy in children with CP, whereas discharge-related findings were more associated with middle ear status in children without CP. CONCLUSION: Transnasal endoscopy provides important insights into ET opening in children with CP, in whom torus tubarius anomalies are common. Associations between adenoid size, ET lumen visibility, and middle ear disease highlighted the potential role of ET opening assessment for individualized management in this population.