Laryngoscope [JOURNAL]
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200 papers
Safety Profile of Nebulized Ciprofloxacin-Dexamethasone After Pediatric Airway Surgery.
Landini AL, Abrahamson CW, Frost M … +6 more , Spielberg D, Hazkani I, Thompson DM, Ida JB, Maurrasse S, Valika T
Laryngoscope · 2026 May · PMID 42204776 · Publisher ↗
OBJECTIVE: To evaluate the safety profile and patterns of use of nebulized ciprofloxacin-dexamethasone (CPD) in pediatric patients undergoing airway surgery. METHODS: A retrospective chart review was performed of patient...
OBJECTIVE: To evaluate the safety profile and patterns of use of nebulized ciprofloxacin-dexamethasone (CPD) in pediatric patients undergoing airway surgery. METHODS: A retrospective chart review was performed of patients who underwent airway surgery at a tertiary pediatric center between 2019 and 2023 and received nebulized CPD 0.3%-0.1% postoperatively. Demographic, clinical, and procedural data were extracted. Exposure was defined as any postoperative nebulized administration. Adverse events were considered potentially CPD-related if they occurred during administration or within 30 days of discontinuation without a better explanation. Outcomes included endocrine, metabolic, infectious, pulmonary, and inflammatory complications. RESULTS: A total of 399 patients received nebulized CPD. Mean age was 46.2 months (range: newborn-20.7 years). Indications included subglottic stenosis (92.5%), post-laryngotracheal reconstruction (5.3%), airway foreign body (2.0%), and supraglottoplasty (0.3%). Comorbidities were frequent, including neurologic conditions (47.6%), cardiac anomalies (41.6%), and bronchopulmonary dysplasia (25.1%). Most patients (93.4%) received CPD in the inpatient setting, for a mean duration of 11.7 days. No cases of adrenal suppression, glucose abnormalities, or bronchial hyperreactivity were identified. One patient had suspected airway fungal infection while receiving chemotherapy, though pathology was negative. Among the 85.7% of patients who underwent postoperative endoscopic evaluation, no significant inflammatory findings were observed. CONCLUSION: Nebulized CPD Was Uniformly Incorporated Into Postoperative Airway Management in This Large Pediatric Cohort and Well Tolerated, With no Significant Adverse Events Observed. These Findings Support the Safety of CPD in Medically Complex Children and Highlight the Need for Multicenter Prospective Studies to Evaluate Efficacy and Optimize Dosing Protocols.
Comparison of Virtual and 3D-Printing Methods to Personalize Nasoseptal Flap Reconstruction.
Katsnelson B, Glennon A, Omay SB … +1 more , Rimmer RA
Laryngoscope · 2026 May · PMID 42191566 · Publisher ↗
OBJECTIVES: 3D-printed models can be used to personalize the length of nasoseptal flap (NSF) reconstruction of anterior skull base defects to preserve more anterior nasal septal mucosa. The objective of this study is to...
OBJECTIVES: 3D-printed models can be used to personalize the length of nasoseptal flap (NSF) reconstruction of anterior skull base defects to preserve more anterior nasal septal mucosa. The objective of this study is to evaluate the correlation between a previously described 3D-printed model method with an entirely virtual method of personalizing NSF length. METHODS: Twenty-eight patients with anterior skull base pathology were included. CT scans were segmented to produce a cavity that would replicate the surgical changes associated with endoscopic endonasal skull base surgery. In 3D-printed models, NSF length was estimated with felt strips as previously described. For the virtual method, a curve was generated using the Materialise 3-Matic Curve function along the lateral sphenoid sinus walls and clival recess corridors. Estimations were made in a blinded fashion and comparisons of NSF lengths were made between virtual and 3D-printed methods. RESULTS: Measurements between the 3D-printed and virtual methodologies were comparable. Mean virtual measurement was greater than the 3D-printed estimate by approximately 1 mm and was statistically significant (p 0.006) for the right lateral sphenoid wall route, but not for other routes. Linear regression analysis between the virtual and 3D-printed models demonstrated strong correlation coefficients for the right (0.85) and left (0.87) lateral sphenoid wall routes, and very strong correlation coefficients for the right (0.94) and left (0.93) clival recess comparisons. CONCLUSION: High correlation was demonstrated between the virtual and 3D-printed methods of NSF length estimation. Importantly, the virtual method does not generally underestimate NSF length compared to the 3D-printed method.
Technical Skills Development for Medical Students in an Otolaryngology Mentorship Program.
Hunter MO, Quinn N, Erickson E … +5 more , Navari L, Katta J, Wiet G, Elmaraghy C, Sethia R
Laryngoscope · 2026 May · PMID 42187171 · Publisher ↗
OBJECTIVES: Fostering early experiences in otolaryngology is imperative for applicants' professional development. Our institution previously established the ENT Mentorship Program (ENTMP), which provides medical students...
OBJECTIVES: Fostering early experiences in otolaryngology is imperative for applicants' professional development. Our institution previously established the ENT Mentorship Program (ENTMP), which provides medical students with early clinical exposure, research opportunities, and mentorship. The objective of this study was to assess the program's effectiveness in developing medical students' technical skills with an established curriculum over the course of the ENTMP. METHODS: Students were administered self-reported confidence surveys and previously validated skills checklists for suturing, flexible laryngoscopy, and tympanostomy tube (TT) insertion using the 5-point Likert scale before beginning the ENTMP. Students were then instructed on how to perform these procedures by faculty throughout the ENTMP. At the conclusion of the ENTMP, the same evaluations were administered. Statistical analysis was performed using unpaired, heteroscedastic t-tests and paired t-tests. RESULTS: Using faculty-evaluated, previously validated assessments, significant improvements in suturing, TT insertion, and flexible laryngoscopy were observed in the all-student cohort, with the subgroup of students who attended both pre- and post-program sessions demonstrating significant improvements in nearly all domains for these skills. In student self-reported assessments, the all-student group demonstrated significant improvements across more domains than the subgroup analysis (14/14 vs. 6/14 domains, respectively). CONCLUSIONS: Following the implementation of a formalized technical skills component within the ENTMP, students demonstrated both subjective and objective improvements in technical skills, including suturing, flexible laryngoscopy, and TT insertion. We believe that early exposure to technical skills is important to prepare students for clinical rotations and career development. LEVEL OF EVIDENCE: N/A.
Evaluating Injection Laryngoplasty Skills Using a Foundation Model: A Feasibility Study.
Cheng AT, Elkhadrawy A, Setzen SA … +4 more , Li A, Biskaduros A, Kostas JC, Rameau A
Laryngoscope · 2026 May · PMID 42185941 · Publisher ↗
OBJECTIVES: To evaluate the construct validity of a commercially available multimodal foundation model (Google Gemini 2.5 Pro) in assessing simulated injection laryngoplasty. METHODS: Thirty video recordings of simulated...
OBJECTIVES: To evaluate the construct validity of a commercially available multimodal foundation model (Google Gemini 2.5 Pro) in assessing simulated injection laryngoplasty. METHODS: Thirty video recordings of simulated injection laryngoplasty procedures were stratified by operator experience (10 novice, 10 intermediate, and 10 expert participants). Videos were evaluated by Gemini 2.5 Pro using two prompt engineering strategies: zero-shot (rubric-based, no examples) and few-shot (rubric plus examples). Performance was compared against operator training level (ground truth). Model reliability and stability were assessed through 90 repeated inference trials. RESULTS: Under a zero-shot strategy, the model failed to discriminate between skill levels (Spearman's ρ = 0.12, p = 0.52). Conversely, few-shot prompting demonstrated a strong, positive correlation with operator experience (Spearman's ρ = 0.66, p = 0.0002) and successfully stratified skill levels (Kruskal-Wallis H = 12.4, p = 0.002). Pairwise analysis confirmed the few-shot model significantly differentiated experts from both novices (p = 0.002) and intermediates (p = 0.026). Additionally, few-shot prompting significantly improved precision, reducing mean absolute error by nearly half (0.74-0.41, p = 0.04). Reliability analysis revealed 100% ordinal consistency (75.6% exact match stability), indicating the model varied under identical conditions, but did not commit any gross classification errors. CONCLUSION: General-purpose multimodal models lack the intrinsic surgical judgment necessary to assess procedural skill. However, resource-efficient few-shot prompting successfully calibrates the model to distinguish expert from trainee performance. While promising as a scalable assessment tool, current models exhibit inherent variability that requires mitigation, such as averaging repeat model evaluations. LEVEL OF EVIDENCE: N/A.
The Natural History of Residual and Recurrent Disease in Advanced Juvenile Nasopharyngeal Angiofibroma: A Systematic Review.
Kumar SA, Petocz P, Campbell RG
Laryngoscope · 2026 May · PMID 42178599 · Publisher ↗
OBJECTIVE: This systematic review explores the natural history of residual and recurrent juvenile nasopharyngeal angiofibromas (JNAs) to inform clinical decision-making. DATA SOURCES: PubMed, Embase, Scopus, and Web of S...
OBJECTIVE: This systematic review explores the natural history of residual and recurrent juvenile nasopharyngeal angiofibromas (JNAs) to inform clinical decision-making. DATA SOURCES: PubMed, Embase, Scopus, and Web of Science. REVIEW METHODS: A systematic literature review was conducted according to PRISMA guidelines across PubMed, Embase, Scopus, and Web of Science from inception to February 20, 2025 and was re-run on September 21, 2025. Studies included patients with advanced JNA and documented follow-up of residual or recurrent disease. Descriptive statistics, chi-squared analysis, and analysis of variance were used to evaluate treatment outcomes across different modalities including surgery, radiotherapy, gamma knife surgery, and medical therapies. RESULTS: Twenty-one studies encompassing 131 male patients (mean age 16.3 years) were included. Residual or recurrent disease demonstrated complete involution in 41%, stable disease in 29%, and reduction in size in 25% of cases. Only 2% of patients had progressive disease. A statistically significant association was observed between treatment modality and outcome (p = 0.015), with radiotherapy, either alone, or as part of a multimodal approach, showing the highest rates of spontaneous involution. CONCLUSION: Residual and recurrent JNAs often remain stable or regress without further intervention. Close surveillance with imaging is a safe and effective strategy for asymptomatic patients, minimizing the risks of additional treatment in a young patient population with disease near critical anatomical structures.
Association of Immune Checkpoint Inhibitors With Otologic Symptoms: A Propensity Score-Matched Study.
Thompson ZE, Chwa J, Luong A … +2 more , Hong AT, Choi JS
Laryngoscope · 2026 May · PMID 42178511 · Publisher ↗
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Unique Natural History of Very Small Vestibular Schwannoma Substantiates Size Threshold Surveillance.
Carlson ML, Hunter JB, Marinelli JP … +7 more , Patro A, Lohse CM, Liu KH, Zalaquett NG, Khandalavala KR, Link MJ, Haynes DS
Laryngoscope · 2026 May · PMID 42175911 · Publisher ↗
OBJECTIVE: Management of vestibular schwannoma (VS) remains controversial. Very small VSs represent a pivotal group: on one hand, they pose the least risk to the patient from the perspective of being small; yet, not reco...
OBJECTIVE: Management of vestibular schwannoma (VS) remains controversial. Very small VSs represent a pivotal group: on one hand, they pose the least risk to the patient from the perspective of being small; yet, not recommending treatment may result in missing a critical window for achieving the best outcome. This debate fundamentally hinges on whether treatment improves upon the natural history of the disease. There is an unproven assumption that very small tumors behave similarly to the broader observed population. To address this central question, we conducted a multicenter retrospective review to compare the natural history of tumor growth and hearing for patients with very small VS (1-3 mm) with a referent cohort with larger tumors. METHODS: All patients diagnosed with sporadic VS 1-3 mm were reviewed at 3 large skull base referral centers and compared with a referent cohort of patients with tumors > 3 mm. Tumor growth-free survival rates, treatment-free survival rates, and rates of maintenance of class A, B, or C hearing were estimated using the Kaplan-Meier method. RESULTS: In total, 123 patients with very small VS and a referent cohort of 326 patients were studied. Seventeen patients with very small VS experienced tumor growth at a median of 3.2 years after diagnosis (IQR 2.6-5.1), demonstrating a median growth rate of 1.0 mm per year (IQR 0.9-1.8). In comparison, 167 of the patients in the referent cohort experienced tumor growth at a median of 1.7 years after diagnosis (IQR 0.8-3.1). Tumor growth-free survival rates (95% CI, number still at risk) at 5 years after diagnosis for the 2 cohorts were 84% (75-93, 39) and 45% (40-52, 100), respectively (p < 0.001). Six patients with very small VS underwent treatment after tumor growth at a median of 3.2 years after diagnosis (IQR 3.2-3.8), compared with 138 patients in the referent cohort at a median of 2.2 years after diagnosis (IQR 1.4-3.6). Treatment-free survival rates (95% CI, number still at risk) at 5 years after diagnosis for the 2 cohorts were 92% (86-98, 55) and 54% (49-61, 125), respectively (p < 0.001). Among the 105 patients with very small VS and class A, B, or C hearing at diagnosis, 3 progressed to class D. Comparatively, among the 225 patients in the referent cohort with class A, B, or C hearing at diagnosis, 70 progressed to class D at a median of 2.6 years after diagnosis (IQR 1.0-4.8). Rates of maintenance of class A, B, or C hearing (95% CI, number still at risk) at 5 years after diagnosis were 96% (92-100, 28) for patients with very small VS and 65% (57-73, 70) for the referent cohort (p < 0.001). CONCLUSIONS: The natural history of tumor growth and hearing for very small VS diverges favorably from the cumulative natural history data and provides a more appropriate benchmark to compare clinical outcomes of upfront surgery or radiosurgery for this population. At 5 years after diagnosis, 96% of very small VS maintained class A, B, or C hearing and only 8% received treatment for growth within this multicenter cohort. Cumulatively, these data substantiate initial wait-and-scan management via size threshold surveillance in this population.
Longitudinal SNOT-22 Symptom Changes With Sublingual Immunotherapy (SLIT).
Zheng W, Chang JL, Butrymowicz A
Laryngoscope · 2026 May · PMID 42174398 · Publisher ↗
OBJECTIVE: Despite widespread use of nasal corticosteroids and oral antihistamines, many patients with allergic rhinitis (AR) have persistent nasal congestion/obstruction and rhinorrhea with associated sleep disturbance...
OBJECTIVE: Despite widespread use of nasal corticosteroids and oral antihistamines, many patients with allergic rhinitis (AR) have persistent nasal congestion/obstruction and rhinorrhea with associated sleep disturbance and daytime fatigue. Sublingual immunotherapy (SLIT) is associated with reducing symptom burden and medication use. This study aims to evaluate time to clinical benefit and magnitude of first-year benefit after SLIT initiation. METHODS: Adult AR patients confirmed by skin or IgE testing who initiated allergen-directed SLIT were included. Sinonasal Outcome Test-22 (SNOT-22) and Rhinitis Control Assessment Test (RCAT) surveys were recorded at baseline, 1-6, and 6-12 months after SLIT. Longitudinal changes were assessed using repeated measures analysis of variance and minimal clinically important difference (MCID) thresholds. Exploratory analysis at 3 months was performed for a subset of patients. RESULTS: A total of 43 SLIT patients (mean age 42.1 ± 12.0 years; 40% female) were included and demonstrated significant reductions in total SNOT-22 scores at 1-6 months (-12.1 points; -35%) and 6-12 months (-12.5 points; -36%) (p < 0.01 from baseline). Nasal, sleep, and function SNOT-22 subscores each improved significantly from baseline, whereas the ear/facial subscore did not. MCID for total SNOT-22 was achieved by 54.3% of patients at 1-6 months. RCAT scores improved significantly at 1-6 months and 6-12 months. The proportion of patients with normal SNOT-22 score (≤ 8) increased from 4.7% at baseline to 24.1% at 6-12 months. CONCLUSIONS: SLIT was associated with symptom improvement within the first 6 months of therapy based on SNOT-22 and RCAT scores. Symptom score improvements persisted to 12 months, and findings support evidence of early nasal, sleep, and function symptom alleviation with SLIT.
Neuromodulation for Subjective Tinnitus: A Systematic Review and Meta-Analysis of Randomized Trials.
Kitsis D, Sideris G, Skouloudaki A … +2 more , Delides A, Vlastarakos P
Laryngoscope · 2026 May · PMID 42167925 · Publisher ↗
OBJECTIVE: To evaluate the effectiveness and safety of neuromodulation and bimodal stimulation for chronic subjective tinnitus in randomized controlled trials (RCTs). DATA SOURCES: PubMed/MEDLINE, Web of Science, and EMB...
OBJECTIVE: To evaluate the effectiveness and safety of neuromodulation and bimodal stimulation for chronic subjective tinnitus in randomized controlled trials (RCTs). DATA SOURCES: PubMed/MEDLINE, Web of Science, and EMBASE (January 2015-December 2025) searched per PRISMA 2020. REVIEW METHODS: Adult RCTs (≥ 18 years) with chronic subjective tinnitus (> 3 months) assessing validated outcomes (THI, TFI, TQ) for neuromodulation/bimodal interventions vs. sham/controls. Two-stage screening, Cochrane RoB-2 risk-of-bias assessment. Random-effects meta-analyses (REML) were performed when ≥ 3 comparable trials were available; effects reported as standardized mean differences (SMD) with 95% CIs. Main Outcomes and measures included change in tinnitus severity (THI/TFI/TQ) while secondary outcomes included loudness (VAS/NRS), durability, and adverse events. RESULTS: Twenty-six RCTs (n = 1576) met criteria: tES (11; n = 372), rTMS (8; n = 432), acoustic coordinated reset (1; n = 100), vagus nerve stimulation (2; n = 90), and bimodal stimulation (4; n = 582). Meta-analysis showed a nonsignificant pooled effect for tDCS (SMD -0.36; 95% CI -0.75 to 0.02; I = 51%) and rTMS (SMD -0.15; 95% CI -0.37 to 0.07; I = 0%). Single-trial evidence for coordinated reset showed no advantage over broadband noise. VNS demonstrated modest benefits with safety concerns limited to implanted approaches. Bimodal stimulation yielded consistent, clinically meaningful reductions (often ≥ 10-20 points on THI/TFI), with durability up to 12 months. Adverse events were mild/transient across noninvasive modalities. CONCLUSIONS: Noninvasive neuromodulation appears safe with average benefits; among modalities, bimodal stimulation shows the most consistent and durable clinical improvements. Standardized, adequately powered RCTs with harmonized protocols and long-term follow-up are needed to refine targets and dosing.
Headache or Facial Pain/Pressure in Rhinosinusitis: Subtle Clinical Patterns.
Inui T, Moriyama K, Takeichi N … +5 more , Taniuchi M, Suzuki E, Kikuoka Y, Terada T, Haginomori SI
Laryngoscope · 2026 May · PMID 42166221 · Publisher ↗
OBJECTIVES: To describe the prevalence and clinical characteristics of headache or facial pain/pressure among patients presenting with rhinosinusitis in otolaryngology practice and to identify associated clinical finding...
OBJECTIVES: To describe the prevalence and clinical characteristics of headache or facial pain/pressure among patients presenting with rhinosinusitis in otolaryngology practice and to identify associated clinical findings. METHODS: We retrospectively reviewed 304 patients with rhinosinusitis at a tertiary otolaryngology center. Among these patients, headache or facial pain/pressure was assessed in 202 cases with available documentation and analyzed in relation to symptom severity, sinus computed tomography, and nasal endoscopic findings. Multivariable analysis identified factors independently associated with headache or facial pain/pressure. RESULTS: Among the 202 patients, 42.1% reported headache or facial pain/pressure considered related to sinonasal inflammation. High-intensity facial pain/pressure was uncommon, with 6.5% reporting high SNOT-22 scores. Active migraine at presentation was rare (1.0%), and a history of migraine (10.4%) was comparable to the general population. In multivariable analysis with false discovery rate adjustment, middle meatal polyps were associated with lower odds of headache or facial pain/pressure (OR: 0.41; 95% CI: 0.19-0.92; adjusted p = 0.032). A maxillary sinus Lund-Mackay score of 2 showed a positive association in unadjusted analysis (OR: 1.49; 95% CI: 1.08-2.04; p = 0.007) but was not significant after correction (adjusted p = 0.056). Headache or facial pain/pressure was not assessed in 102 of the 304 patients. CONCLUSION: Headache or facial pain/pressure is common but often mild in patients with rhinosinusitis in otolaryngology practice. Variability in symptom assessment may contribute to differences in reported prevalence, highlighting the importance of systematic inquiry combined with endoscopic and radiologic evaluation.
Race and Ethnicity Affect Symptom and Endoscopy Associations in CT-Confirmed Chronic Rhinosinusitis.
Karp C, Figueroa M, Gao J … +4 more , Lin JS, Mubin Z, Albanese S, Hur K
Laryngoscope · 2026 May · PMID 42157379 · Publisher ↗
OBJECTIVES: To investigate demographic differences in the association between chronic rhinosinusitis (CRS) symptoms and endoscopic findings with CT-confirmed CRS. METHODS: Consecutive adult patients presenting to outpati...
OBJECTIVES: To investigate demographic differences in the association between chronic rhinosinusitis (CRS) symptoms and endoscopic findings with CT-confirmed CRS. METHODS: Consecutive adult patients presenting to outpatient rhinology clinics with chronic cardinal sinonasal symptoms who underwent nasal endoscopy and a sinus CT scan were included. Demographics, cardinal symptoms, SNOT-22, and Lund-Kennedy (LK) endoscopic scores were extracted from electronic medical records. Logistic regression was used to assess associations between predictors and CT-confirmed CRS (CT-CRS) with prespecified stratified analyses by race and ethnicity. RESULTS: Among 314 included patients (mean age 48 ± 17 years, 51% female), 228 met criteria for CT-CRS. Hyposmia and LK endoscopic scores were associated with CT-CRS. However, in subgroup analyses, the associations of hyposmia and LK endoscopic scores with CT-CRS were not significant among Asian and Hispanic patients. Among patients with a negative nasal endoscopy, 62.6% had CT-CRS. In this subgroup, patient-reported nasal discharge and the presence of ≥ 2 cardinal symptoms were associated with reduced odds of CT-CRS. CONCLUSIONS: Associations between symptoms and nasal endoscopy findings with CT-CRS were not significant among Asian and Hispanic patients, suggesting limitations of symptom and endoscopy-based assessments in these subgroups. Among patients with a negative nasal endoscopy, symptoms demonstrated limited ability to identify CT-CRS. These findings suggest CT imaging could be considered earlier in selected clinical contexts.
Management of Absent Upper Esophageal Sphincter Opening After Neurological Injury.
Rawat R, Abrahamson CW, Rogers K … +5 more , Langenstein J, Bromfield J, Seth A, Burns JA, Stein AP
Laryngoscope · 2026 May · PMID 42152494 · Publisher ↗
OBJECTIVES: To evaluate the effects of swallowing therapy and cricopharyngeus (CP) muscle surgery on upper esophageal sphincter (UES) opening, oral intake, and airway protection in patients with absent UES opening follow...
OBJECTIVES: To evaluate the effects of swallowing therapy and cricopharyngeus (CP) muscle surgery on upper esophageal sphincter (UES) opening, oral intake, and airway protection in patients with absent UES opening following neurological injury. METHODS: Retrospective review of seven patients managed between September 2021 and July 2024 with absent UES opening confirmed by Modified Barium Swallow Study (MBSS). All patients underwent swallowing therapy followed by at least one CP-targeted intervention, including balloon dilation, botulinum toxin injection, and/or myotomy. Swallowing outcomes were assessed using the Functional Oral Intake Scale (FOIS), Mann Assessment of Swallowing Ability (MASA), Penetration-Aspiration Scale (PAS), and pharyngoesophageal segment (PES) opening scores from the Modified Barium Swallow Impairment Profile. RESULTS: CP-targeted surgeries were associated with improved FOIS, MASA, and PES opening scores. PAS scores did not change substantially, with six patients demonstrating values greater than or equal to 7. Patients who underwent CP-directed intervention within 6 months of injury demonstrated greater FOIS improvements than those treated later (3.25 vs. 0.33). CONCLUSION: CP interventions can facilitate improved bolus passage and oral intake in patients with absent UES opening following neurological injury. However, persistent aspiration risk remains despite improved mechanical opening, highlighting the need for continued swallowing therapy. Finally, earlier intervention may optimize outcomes, though further research is needed to refine treatment for this rare condition.
Piezosurgery Versus Conventional Osteotomy in Prelacrimal Approach for Maxillary Sinus.
Esmail AG, Salem EH, Aziz AMA … +3 more , Khafagy YW, Elsharkawy AAE, Abdelmeguid AS
Laryngoscope · 2026 May · PMID 42144284 · Publisher ↗
INTRODUCTION: The prelacrimal recess approach (PLA) is a minimally invasive approach to maxillary sinus lesions, especially those of the anterior and inferior wall. Innovative advances, for example, the piezosurgery ultr...
INTRODUCTION: The prelacrimal recess approach (PLA) is a minimally invasive approach to maxillary sinus lesions, especially those of the anterior and inferior wall. Innovative advances, for example, the piezosurgery ultrasonic device (PZD), have been developed aiming at facilitating surgical procedures in terms of efficient hemostasis, dissection, safety, and reduction in surgical time. The current study aimed to evaluate the efficacy of piezosurgery versus conventional osteotomy while performing a prelacrimal approach. METHODS: A prospective randomized controlled study was conducted in the Otorhinolaryngology Department, Mansoura University, Egypt on 40 patients diagnosed with different maxillary sinus pathologies amenable to a prelacrimal approach. Patients were randomly allocated into two groups: Group A underwent piezosurgery while conventional osteotomy was used in Group B. RESULTS: Operative time was significantly higher in the PZD group (16.30 ± 2.16 vs. 9.05 ± 1.88; p = 0.001) whereas the blood loss was much less (14 ± 3.84 vs. 42 ± 16.81; p = 0.001). Postoperative pain, hypoesthesia, and epiphora were transient, significantly less in the PZD group (p < 0.001, p = 0.006, p = 0.002), and spontaneously resolved. Both groups witnessed a significant improvement in their NOSE and SNOT-22 scores in the 3-month and 6-month follow-up visits compared to the preoperative ones (p < 0.001). Other complications were comparable in both groups including cheek swelling, minimal epistaxis, dry nose, wound dehiscence, alar collapse, and recurrence of the original pathology. CONCLUSION: The PZD was associated with less bleeding, pain, hypoesthesia, and epiphora in comparison to traditional osteotomy. It also allowed for precise cutting with no bone loss; however, the procedure was time-consuming when compared to conventional osteotomy.
Partitioned Internal Auditory Canal: Association With Cochlear Aperture Anomalies.
Sennaroğlu L, Tahir E
Laryngoscope · 2026 May · PMID 42142061 · Publisher ↗
OBJECTIVE: To investigate the association between partitioned internal auditory canal (IAC) and other inner ear abnormalities. METHODS: The temporal bone computed tomography (CT) and magnetic resonance imaging (MRI) find...
OBJECTIVE: To investigate the association between partitioned internal auditory canal (IAC) and other inner ear abnormalities. METHODS: The temporal bone computed tomography (CT) and magnetic resonance imaging (MRI) findings of ears with partitioned IAC were retrospectively analyzed. The IAC was considered narrow if its mid-portion diameter < 2 mm. Cochlear aperture (CA) was classified as normal (diameter more than 1.5 mm), stenotic (diameter < 1.5 mm), or atretic. The MRI images examined the cochlear nerve (CN). The CN's diameter was compared with the ipsilateral facial nerve to determine if it was normal, hypoplastic, or aplastic. RESULTS: Partitioned IAC was observed in 1.1% of ears with normal CA, 14.9% of ears with stenotic CA, and 20.9% of ears with atretic CA. Forty-eight right and 37 left ears with partitioned IAC were examined. The most common CA anomaly accompanying partitioned IAC was CA stenosis, while more than half of the cochleae were of normal size. IAC was mostly narrow in ears with partitioned IAC. When the CN was examined, partitioned IAC was almost always accompanied by CN aplasia (more frequently) or hypoplasia. CONCLUSION: This study demonstrates that CN deficiency, associated with CA abnormalities, may cause the aberrant location of the meatal segment of the facial nerve in a separate bony canal. Partitioned IAC is an inner ear malformation characterized by CN deficiency.
Ambient Artificial Intelligence Scribes: A Scoping Review With Implications for Otolaryngology.
Nallapaneni S, Crafton CL, Cabrera CI … +4 more , Mosca C, Rodriguez K, Rangarajan SV, D'Anza B
Laryngoscope · 2026 May · PMID 42141955 · Publisher ↗
BACKGROUND/OBJECTIVE: Ambient artificial intelligence scribing, "ambient AI," is expanding across ambulatory specialties. Despite adoption, the impact on documentation efficiency, usability, and implications for otolaryn...
BACKGROUND/OBJECTIVE: Ambient artificial intelligence scribing, "ambient AI," is expanding across ambulatory specialties. Despite adoption, the impact on documentation efficiency, usability, and implications for otolaryngology remain poorly understood. This scoping review evaluates ambient AI utilization in multiple specialties in four areas (documentation efficiency, burnout, usability, workflow impact) to identify research gaps and apply findings from general ambulatory care to otolaryngology. SOURCES OF EVIDENCE: PubMed, Web of Science, Embase, and Scopus. ELIGIBILITY/CHARTING METHODS: A PRISMA-ScR compliant scoping review was conducted of studies published between January 2022 and July 2025, using search terms related to ambient AI scribe technology. Two reviewers independently screened articles and assessed quality using the Newcastle-Ottawa Scale (NOS). Data were synthesized narratively and stratified into subcategories. RESULTS: We identified 164 articles and 12 met the inclusion criteria. Four studies included otolaryngology providers, but their experiences were not reported separately. Time-saved-per-note and after-hours reductions ranged from 0.2 to 2.1 and 1.6 to 15.2 min, respectively. Documentation usability scores post-implementation were high, ranging from 69.01 to 78.8/100. Perceived workflow efficiency score improved from 3.63/7 to 5.03/7. Validated instruments showed significant burnout reduction (Stanford PFI: 4.16-3.16/10, p = 0.005; NASA-TLX mental demand decreased 6.12 points, p < 0.001). CONCLUSIONS: Available literature on Ambient AI use in ambulatory settings does not define experiences of otolaryngologists but does report time savings, improved perceptions of usability, and reduced burnout. However, gaps must be addressed in reporting AI model performance and consistent outcome measures. Future studies must include special otolaryngology populations that have communication challenges. LEVEL OF EVIDENCE: N/A.
How I Do It: A Novel Case Series of Office-Based Laser Complete Excision of Vocal Fold Cysts.
Tam AKY, Chu TSM, Wei Y … +3 more , Wang Z, Law T, Chan JYK
Laryngoscope · 2026 May · PMID 42141701 · Publisher ↗
Office-based complete excision of vocal fold cysts using Trublue laser via transnasal flexible endoscopy is a technically feasible alternative to conventional marsupialization, enabling en bloc removal under local anesth...
Office-based complete excision of vocal fold cysts using Trublue laser via transnasal flexible endoscopy is a technically feasible alternative to conventional marsupialization, enabling en bloc removal under local anesthesia with excellent procedural tolerability.
Identifying High-Risk Children Safe for Same-Day Discharge After Tonsillectomy.
Ho A, Kou YF, Liu C … +7 more , Wang CS, Lenes-Voit F, Chorney SR, Lee K, Ulualp S, Mitchell RB, Johnson RF
Laryngoscope · 2026 May · PMID 42135615 · Publisher ↗
OBJECTIVE: Current guidelines recommend overnight admission for children with severe obstructive sleep apnea (OSA) and obesity undergoing tonsillectomy, although most have uneventful postoperative courses. We aimed to id...
OBJECTIVE: Current guidelines recommend overnight admission for children with severe obstructive sleep apnea (OSA) and obesity undergoing tonsillectomy, although most have uneventful postoperative courses. We aimed to identify low-risk subgroups within this high-risk population who may be candidates for same-day discharge. METHODS: Retrospective cohort study of children aged 2-18 years with obesity (≥ 95th BMI percentile) and severe OSA (AHI ≥ 10 events/h and/or SpO nadir < 80%) undergoing tonsillectomy at a tertiary children's hospital (2021-2024). The primary outcome was a severe perioperative event: ICU admission, prolonged hospitalization (> 48 h), or need for advanced respiratory support. Bayesian logistic regression using informative priors identified predictors. Model-based risk stratification and simplified clinical rules were evaluated using sensitivity, specificity, and negative predictive value. RESULTS: Among 304 children, 36 (11.8%) experienced a severe event. SpO nadir was the strongest predictor (β = -0.668, 95% CrI [-1.164, -0.172], directional probability 99.6%), followed by Class III obesity (97.0%) and AHI (95.0%). Model-derived stratification identified 33% of patients with < 5% predicted probability of severe events. A clinical rule combining AHI < 25 events/h and SpO nadir > 85% showed sensitivity 85.7% and negative predictive value 99.5%, corresponding to an observed event rate < 5%. CONCLUSION: Most obese children with severe OSA do not experience severe perioperative events. Simple polysomnographic criteria can identify very low-risk patients who may be candidates for same-day discharge planning. These findings support a more individualized approach to postoperative admission; prospective validation is needed before implementation.
Trends in Industry-Sponsored Research Payments to Otolaryngologist Principal Investigators.
Leu G, Hammadeh Z, Cheaib JG … +3 more , Su ZT, Han M, Gourin CG
Laryngoscope · 2026 May · PMID 42130080 · Publisher ↗
OBJECTIVES: Research payments constitute the largest payment category in the Centers for Medicare and Medicaid Services (CMS) Open Payments program (OPP). We sought to characterize the distributions of and trends in indu...
OBJECTIVES: Research payments constitute the largest payment category in the Centers for Medicare and Medicaid Services (CMS) Open Payments program (OPP). We sought to characterize the distributions of and trends in industry-sponsored research payments (ISRPs) to otolaryngologists. METHODS: OPP data was used to identify ISRPs to otolaryngologists between January 1, 2015 and December 31, 2023. ISRPs were stratified by recipient entity as covered teaching hospitals, covered physicians, and non-covered entities (NCEs) and evaluated using descriptive analysis and multivariable linear regression. RESULTS: ISRPs increased 132% from $15.6 million in 2015 to $36.2 million in 2023 (p < 0.001). Payments to NCEs with an otolaryngologist principal investigator (PI) constituted most payments (80%). Male otolaryngologist PIs decreased by -0.2%, while female otolaryngologist PIs increased by 86% (p < 0.01). Annual median payment values per otolaryngologist PI within NCEs increased 111% from $15,239 in 2015 to $32,097 in 2023 (p < 0.001). Among male otolaryngologist PIs within NCEs, total ISRPs increased 109% from $12.9 million in 2015 to $27.0 million in 2023, and median payment value per PI increased 93% from $17,144 in 2015 to $33,155 in 2023 (p < 0.01). Among female otolaryngologist PIs within NCEs, total ISRPs increased 125% from $0.5 million in 2015 to $1.1 million in 2023, but median payment value per PI only increased 14% from $11,973 in 2015 to $13,614 in 2023 (p = 0.1). CONCLUSIONS: ISRPs to otolaryngologists more than doubled from 2015 to 2023, with most payments directed to PIs within NCEs. Median payments to female otolaryngology PIs did not increase, despite an increase in female otolaryngologist PIs. LEVEL OF EVIDENCE: N/A.
Should a Drain Be Routinely Placed After Type I Medialization Thyroplasty?
Tracy LF, Burns JA
Laryngoscope · 2026 May · PMID 42130022 · Publisher ↗
Abstract loading — click title to view on PubMed.
In Reference to Validation of Non-Soundproof Tablet Audiometry in Pediatrics: Comparison With Traditional Audiometry.
Luo Y, Zhang C, Chen F
Laryngoscope · 2026 May · PMID 42125991 · Publisher ↗
Abstract loading — click title to view on PubMed.
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