European Archives Of Oto-rhino-laryngology[JOURNAL]
Sun
200 papers
Global research trends and knowledge gaps in chronic pharyngitis: A bibliometric analysis (2007-2025).
Tu H, Chen M, Zhu P … +2 more , Hong J, He L
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026296 · Publisher ↗
BACKGROUND: Chronic pharyngitis (CP) is a prevalent but poorly defined inflammatory disorder of the upper aerodigestive tract. Despite increasing attention, research in this field remains fragmented, with heterogeneous d...
BACKGROUND: Chronic pharyngitis (CP) is a prevalent but poorly defined inflammatory disorder of the upper aerodigestive tract. Despite increasing attention, research in this field remains fragmented, with heterogeneous diagnostic criteria and inconsistent therapeutic approaches. To clarify the intellectual landscape and inform research prioritization and hypothesis generation, we conducted the first comprehensive bibliometric analysis of CP research. METHODS: Publications on CP from 2007 to 2025 were retrieved from the Web of Science Core Collection. After screening, 185 eligible articles were analyzed using VOSviewer, CiteSpace, and the bibliometrix R package. Trends in publication output, citation impact, collaboration networks, and thematic evolution were systematically evaluated. RESULTS: Global publication output increased steadily, with a peak in 2021. China contributed the largest number of articles, whereas the United States demonstrated greater citation impact and broader international collaboration. Major research hotspots included laryngopharyngeal reflux, proton pump inhibitors, and chronic cough. In contrast, microbial biofilms, neurogenic inflammation, epithelial barrier dysfunction, and patient-centered outcomes were underexplored. CONCLUSIONS: This study reveals critical gaps in CP research: lack of standardized diagnostic frameworks, insufficiently powered multicenter clinical trials, and limited international collaboration. Future priorities include harmonizing diagnostic criteria, validating biomarkers, and expanding investigations into microbial and neurogenic mechanisms. Strengthening methodological rigor and fostering global cooperation will be essential to translate bibliometric insights into a more coherent research framework that can guide future clinical and translational research.
Trans-impedance matrix heatmap patterns in cochlear implant patients with different cochlear pathologies: meningitis, otosclerosis, and temporal bone fractures.
Alrushaydan D, Alsufyani AA, Alhussainan K … +4 more , Almuhawas F, Aljabr M, Yalcouy H, Alsanosi A
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026295 · Publisher ↗
PURPOSE: Transimpedance matrix (TIM) imaging is an electrical field-based modality that visualizes intracochlear current spread and may detect electrode malposition and subtle cochlear pathology beyond radiological resol...
PURPOSE: Transimpedance matrix (TIM) imaging is an electrical field-based modality that visualizes intracochlear current spread and may detect electrode malposition and subtle cochlear pathology beyond radiological resolution. This study aimed to evaluate etiology-specific TIM heatmap patterns in adult cochlear implant recipients and to assess the utility of TIM as an adjunct to conventional imaging. METHODS: This observational retrospective case series included 11 adult cochlear implant recipients (15 implanted ears) with defined etiologies: head trauma/temporal bone fracture (5 ears), post-meningitis deafness (5 ears), and cochlear ossification or otosclerosis (5 ears). Preoperative CT and/or MRI confirmed pathology, and postoperative X-ray verified electrode position. TIM measurements were obtained using Cochlear CustomSound EP software. A normal TIM pattern was defined as a continuous diagonal gradient from bottom-left to top-right. Deviations from this pattern were analyzed and correlated with etiology and radiological findings. RESULTS: Distinct etiology-related TIM deviations were identified. Trauma cases showed off-diagonal irregularities and signal dissociation suggestive of fractures or over-insertion, including one abnormal TIM with normal imaging. Post-meningitis ears commonly demonstrated off-diagonal signal loss or apical attenuation without radiological correlations. Severe ossification with under-insertion produced an Ocean Pattern of low potentials, whereas one otosclerosis case preserved a normal diagonal pattern configuration. CONCLUSION: TIM imaging is highly sensitive to changes in tissue conductivity and electrode-tissue interface integrity, enabling detection of early fibrosis or ossification not visible on standard imaging. TIM may serve as a useful adjunct in postoperative cochlear implant evaluation. Further prospective validation is required.
Comparative evaluation of four large language models (ChatGPT-5, Gemini 2.5 Pro, Claude Sonnet-4, and DeepSeek-R1) for diagnostic and therapeutic decision-making in real-world otolaryngology scenarios.
Subay EA, Pamuk E, Gökçınar Y … +2 more , Kaplan B, Kuşçu O
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026294 · Publisher ↗
PURPOSE: Artificial intelligence (AI) has become increasingly integrated into clinical medicine, with large language models (LLMs) showing growing potential for diagnostic and therapeutic reasoning. This study aimed to c...
PURPOSE: Artificial intelligence (AI) has become increasingly integrated into clinical medicine, with large language models (LLMs) showing growing potential for diagnostic and therapeutic reasoning. This study aimed to compare the diagnostic and therapeutic performance of four distinct LLMs—ChatGPT-5, Gemini 2.5 Pro, Claude Sonnet-4, and DeepSeek-R1—within otolaryngology. METHODS: A total of 100 real patient cases representing multiple otolaryngologic subspecialties were evaluated by each model. Two board-certified otolaryngologists, independently and blindly reviewed and scored all diagnostic and therapeutic outputs using a structured 0–1–2 scale, with consensus scores serving as the gold-standard reference. RESULTS: All models achieved high diagnostic accuracy, with diagnostic accuracy rates of 99% for ChatGPT-5, 98% for Gemini 2.5 Pro, 94% for Claude Sonnet-4, and 92% for DeepSeek-R1. Therapeutic accuracy was comparatively lower, with Gemini 2.5 Pro achieving the highest rate of correct recommendations (86%), followed by DeepSeek-R1 and Claude Sonnet-4 (69% each), and ChatGPT-5 (64%). Overall differences in therapeutic performance among the four models were statistically significant (p = 0.0001). In pairwise comparisons, Gemini 2.5 Pro showed a statistically significant advantage over the other models. For each model, diagnostic performance was significantly higher than therapeutic performance (p ≤ 0.001 for each comparison). CONCLUSION: Large language models show great potential as clinical decision-support tools in otolaryngology, with Gemini 2.5 Pro demonstrating the most consistent and accurate therapeutic performance. However, the variability in treatment recommendations among models underscores the need for further refinement and continuous human oversight to ensure their safe and effective integration into clinical practice.
Serum otolin-1 levels in vestibular migraine and Ménière's disease: a comparative clinical study.
Elden H, Yilmaz MS, Altindis M … +3 more , Akca G, Cihan A, Vural G
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026293 · Publisher ↗
PURPOSE: This study aimed to evaluate serum Otolin-1 levels in patients with Ménière’s disease (MD) and Vestibular migraine (VM) and to investigate its potential diagnostic utility. METHODS: Ninety participants were recr...
PURPOSE: This study aimed to evaluate serum Otolin-1 levels in patients with Ménière’s disease (MD) and Vestibular migraine (VM) and to investigate its potential diagnostic utility. METHODS: Ninety participants were recruited, including 30 patients with MD, 30 with VM, and 30 healthy controls. Serum Otolin-1 levels were measured using Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: Otolin-1 levels differed significantly among the groups, with highest levels observed in VM (641.7 ± 106.2 pg/mL), intermediate levels in MD (539.9 ± 107.3 pg/mL), and lowest levels in controls (358.6 ± 208.8 pg/mL). ROC analysis for VM versus controls yielded an AUC of 0.918, with an optimal cutoff of ~ 553 pg/mL, providing 90.0% sensitivity and 83.3% specificity. CONCLUSION: These findings support Otolin-1 as a promising complementary biomarker for the differential diagnosis of recurrent vestibular syndromes. Larger multicenter prospective studies are needed to confirm diagnostic and prognostic applicability.
Association of preoperative hemoglobin levels with the risk of pharyngocutaneous fistula after surgery for laryngeal and hypopharyngeal squamous cell carcinoma.
Kong W, Bai Y, Luo Y … +2 more , He Y, Zou J
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42026292 · Publisher ↗
PURPOSE: Pharyngocutaneous fistula (PCF) is a common complication after head and neck surgery. Although preoperative hemoglobin levels have been implicated in PCF development, the nature of this relationship—particularly...
PURPOSE: Pharyngocutaneous fistula (PCF) is a common complication after head and neck surgery. Although preoperative hemoglobin levels have been implicated in PCF development, the nature of this relationship—particularly its potential nonlinearity—has not been fully elucidated. This study aimed to evaluate the association between preoperative hemoglobin levels and PCF risk, with emphasis on characterizing possible nonlinear effects. METHODS: We conducted a retrospective cohort study including 1,507 patients who underwent surgery for laryngeal or hypopharyngeal squamous cell carcinoma between 2000 and 2022. Univariable and multivariable regression models were employed to assess the association between hemoglobin level and PCF occurrence. Nonlinear relationships were examined using smooth curve fitting and generalized additive models (GAM). RESULTS: The overall rate of PCF was 8.09%. Patients who developed PCF had significantly lower preoperative hemoglobin levels (108.76 ± 26.53 g/L) compared to those without PCF (141.93 ± 17.39 g/L; p < 0.001). Each 1-g/L increase in hemoglobin was associated with a 9% reduction in the odds of PCF (OR 0.93, 95% CI: 0.93–0.94; p < 0.001). Multivariable analysis confirmed that hemoglobin was an independent predictor of PCF (adjusted OR 0.93, 95% CI: 0.91–0.94; p < 0.001). A nonlinear relationship was identified with an inflection point at 117 g/L. Below this value, each unit increase in hemoglobin was associated with a more pronounced reduction in PCF risk (OR 0.90, 95% CI: 0.88–0.93; p < 0.001), whereas above this threshold, the protective effect was attenuated. CONCLUSION: Preoperative hemoglobin level is an independent predictor of PCF development, with a particularly strong effect observed below 117 g/L. These findings provide a rationale for individualized perioperative management guided by preoperative hemoglobin levels.
Conventional vs. tunnelized facial artery myomucosal flaps in oral cavity reconstruction: a comparative analysis of outcomes and quality of life.
Reinholdt KB, Gade SD, Pikelis A … +1 more , Klug TE
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026291 · Publisher ↗
PURPOSE: The facial artery myomucosal (FAMM) flap (conventional FAMM flap) and the tunnelized FAMM island flap (tunnelized FAMM flap) are established techniques for oral cavity reconstruction. However, evidence on compli...
PURPOSE: The facial artery myomucosal (FAMM) flap (conventional FAMM flap) and the tunnelized FAMM island flap (tunnelized FAMM flap) are established techniques for oral cavity reconstruction. However, evidence on complications rates is limited to small cohorts, and long-term quality of life (QoL) data are lacking. This study aimed to (1) determine the prevalence of complications, (2) identify risk factors for complications, and (3) compare QoL outcomes between patients with conventional and tunnelized flaps. METHODS: This single-center, retrospective study included all patients, who underwent oral cavity cancer ablation with reconstruction using either a unilateral conventional or tunnelized FAMM flap between 2018 and 2025. Demographics, surgical details, complications, and EORTC QLQ-H&N35 scores at 12-, 24-, and 36-months were analyzed. Uni- and multivariate analyses were performed. RESULTS: In total, 141 patients were included, reconstructed with either conventional (n = 114, 81%) or tunnelized (n = 27, 19%) FAMM flaps. Complications occurred in 18 patients (13%), including partial (n = 7) or total (n = 5) flap necrosis, hematoma (n = 5), and infection (n = 1). Tunnelized FAMM flaps were associated with significantly higher complication rates (37%) compared with those receiving a conventional FAMM flap (7%; p < 0.001). Flap type was the only statistically significant risk factor for complications in multivariate analyses. Long-term QoL outcomes were similar between groups. CONCLUSION: Based on our cohort and surgical techniques (without including the facial vein in the tunnelized FAMM flap), the conventional FAMM flap was a safe and reliable flap, while the tunnelized FAMM flap was associated with increased risk of complications and without QoL benefits.
A comprehensive 10-year review of decannulation and perioperative complications in pediatric open airway reconstruction.
Chaushu H, Dorman A, Wasserzug O … +2 more , DeRowe A, Katz O
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42026290 · Full text
PURPOSE: To characterize perioperative morbidity, microbiologic findings and decannulation outcomes in pediatric open airway reconstruction. METHODS: All children undergoing open airway reconstruction between 2014 and 20...
PURPOSE: To characterize perioperative morbidity, microbiologic findings and decannulation outcomes in pediatric open airway reconstruction. METHODS: All children undergoing open airway reconstruction between 2014 and 2024 were included. Demographic characteristics, stenosis grade, surgical technique, staging strategy, stent use, graft configuration, postoperative complications, microbiological findings, and decannulation outcomes were analyzed. RESULTS: Forty-four children (mean age, 4.1 ± 2.9 years) underwent open airway reconstruction, most with high-grade stenosis (60% grade III, 34% grade IV). Procedures included laryngotracheoplasty (n = 35), cricotracheal resection (n = 7), and tracheal resection (n = 2). Single-stage reconstruction was performed in 24 patients (54.5%) and double-stage in 20 (45.5%). Airway stents were used in 31 of 44 patients (70.5%), with a significant decline over time (85.7% vs. 43.8%; P < .01). Overall, 70.5% achieved decannulation, including 68.2% within 6 months. Single-stage reconstruction was associated with a shorter median time to decannulation compared with double-stage reconstruction (median, 0.26 vs. 3.27 months; P = .004). All postoperative infections occurred in stented patients (29% vs. 0%; P = .03(, representing a more clinically complex subgroup. Multivariable analysis demonstrated an independent association between stenosis severity and delayed decannulation. CONCLUSION: Outcomes after pediatric open airway reconstruction were associated with surgical staging, stent use, and perioperative factors. These findings support individualized treatment strategies and outcome assessment beyond decannulation alone.
Improving clinician performance in ultrasound-guided thyroid FNA: a simulation-based training intervention with a custom phantom.
Lancaster A, Lancaster J, Chandaria V … +5 more , Murphy C, Steel DA, Paraschou K, Todsen T, Ofo ME
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026289 · Publisher ↗
PURPOSE: Ultrasound (US)-guided fine needle aspiration (FNA) is essential for evaluating indeterminate thyroid nodules. Limited hands-on opportunities for trainees and reliance upon senior supervision are barriers for tr...
PURPOSE: Ultrasound (US)-guided fine needle aspiration (FNA) is essential for evaluating indeterminate thyroid nodules. Limited hands-on opportunities for trainees and reliance upon senior supervision are barriers for traditional training methods. With a shift towards simulation-based educaday course was designed where participants received didactic teaching andtion (SBE) to overcome the steep learning curve of this procedure we evaluated the inclusion of a novel interventional neck phantom into a short US training course (to increase clinician confidence and competence). METHODS: A two-day course was designed where participants received didactic teaching and SBE on each day respectively. Participants were asked to complete an assessed FNA on the simulation phantom at the end of each day and complete a survey on their confidence and satisfaction. Assessment was carried out by Radiology residents using structured criteria and the results were compared before and after SBE. RESULTS: Twenty-five participants took part in the study, procedural scores (max 30) increased from a mean of 11.92 on day one to 22.32 on day two(p < 0.001). This improvement was significant in all domains (p < 0.01): applied knowledge of US equipment (2.72 to 3.88), image optimization (1.88 to 3.36), and systematic examination (2.48 to 3.60) FNA performance (5.64 on 11.48). Participant confidence in performing the procedure increased from 16% on day one to 80% on day two, and over 90% felt that the simulation phantom was straightforward to use and enhanced their practical skills. CONCLUSION: An US course incorporating SBE (with a novel FNA phantom) significantly improves clinician competency and confidence in performing US-guided FNA, addressing the need for improved training in this procedure.
Speech performance in TORCH-positive versus TORCH-negative cochlear implant candidates: a cap and sir score-based comparative study.
Farheen S, Das A, Choudhary A … +3 more , Hazra S, Mandal A, Sengupta A
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026288 · Publisher ↗
PURPOSE: The study aims to compare the prevalence of TORCH (Toxoplasma, Rubella, Cytomegalovirus and Herpes virus) IgG and IgM titres in hearing-impaired children with normal-hearing children within the 1 to 5 year age g...
PURPOSE: The study aims to compare the prevalence of TORCH (Toxoplasma, Rubella, Cytomegalovirus and Herpes virus) IgG and IgM titres in hearing-impaired children with normal-hearing children within the 1 to 5 year age group. It also seeks to examine long-term outcomes, in terms of speech using modified CAP (Categories of Auditory Performances) scores and SIR (Speech Intelligibility Rating) scores, for TORCH-positive versus TORCH-negative cochlear implant candidates in an age-specific manner. MATERIALS AND METHODS: The study was conducted between April 2022 and September 2023 in the outpatient department of a tertiary care teaching hospital, with children aged between 1 and 5 years. 550 hearing-impaired children were screened for TORCH IgG and IgM titres over 1.5 years. 385 TORCH-positive children (children who had detectable IgG or IgM antibodies to any of the TORCH pathogens) and 165 TORCH-negative children were enrolled in the study following the inclusion criteria. In our study, we defined TORCH-positive children as those who had detectable IgG or IgM antibodies to any of the TORCH pathogens. This is purely a serological conclusion, and most children were clinically asymptomatic. From these 385 TORCH-positive children, 50 were selected through random sampling after exclusion. From the 165 TORCH-negative children, another 50 children were selected following random sampling after exclusion. The 100 hearing-impaired children underwent cochlear implant and followed up for 1 year with auditory verbal therapy, and assessment of speech outcome was done using the modified CAP score and SIR score. One hundred normal-hearing children from OPD were tested for the prevalence of TORCH IgG and IgM titers according to convenient sampling, aged between 1 and 5 years. RESULTS: For TORCH-positive, hearing-impaired children, the highest prevalence was observed for Rubella IgG (n = 44, 88%) and Rubella IgM (n = 5, 10%), followed by CMV IgG (n = 41, 82%) and CMV IgM (n = 12, 24%). The TORCH IgG and IgM titres were significantly higher in hearing-impaired children than in children with normal hearing. Among TORCH-negative children, mean CAP scores were 2, 4, 7 and 8 at the end of the 3rd ,6th ,9th and 12th month respectively. Among TORCH-positive children, mean CAP scores were 3, 5, 7 and 9 at the end of 3rd, 6th ,9th and 12th months, respectively. SIR scores were 4 and 5 at the end of the 6th and 12th months for TORCH-negative children, and 2 and 3 for TORCH-positive children. Speech outcomes, using modified CAP scores and SIR scores, were compared in an age-specific manner between TORCH-positive and TORCH-negative cochlear implant candidates. No significant difference was found between the two groups. CONCLUSION: TORCH infection prevalence was higher in hearing-impaired children as compared to normal-hearing children. However, among cognitively normal cochlear implant recipients, no significant difference in modified CAP scores & SIR scores were observed between TORCH- positive and TORCH-negative groups.
Baseline salivary IL-6 as a predictive biomarker for complementary therapy response in radiation-induced oral mucositis.
Chang HC, Chen YW, Huang WY … +4 more , Tsai JT, Wu CY, Gautama MSN, Huang TW
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026287 · Publisher ↗
BACKGROUND: Radiation-induced oral mucositis requires predictive biomarkers for personalized therapy. We evaluated salivary IL-6 for predicting severe mucositis and response to food-grade bee products. METHODS: Secondary...
BACKGROUND: Radiation-induced oral mucositis requires predictive biomarkers for personalized therapy. We evaluated salivary IL-6 for predicting severe mucositis and response to food-grade bee products. METHODS: Secondary analysis of 51 head/neck cancer patients randomized to honey (n = 15), Taiwanese green propolis (TGP, n = 17), or usual-care (n = 19). Both interventions used standardized preparations (10 g in 20 mL water, 10 mL TID). Salivary cytokines were analyzed using ELISA at baseline and during early radiotherapy. RESULTS: Salivary IL-6 at week 3 of radiotherapy demonstrated superior predictive performance (AUC = 0.780, 95% CI: 0.610–0.950, p = 0.026) compared to other cytokines, with an optimal cutoff of 286.25 pg/mL (sensitivity 72%, specificity 81%, Cohen's d = 0.92). Patients with elevated IL-6 (≥ 286.25 pg/mL) showed enhanced response to interventions, with numbers needed to treat of 2.3 for honey and 2.6 for TGP versus 6.7 and 5.9 in low-risk patients. Longitudinal analysis revealed distinct anti-inflammatory patterns: honey suppressed IL-1β at week 3 (p = 0.022), while TGP affected TNF-α at week 2 (p = 0.047). Post-hoc power analysis indicated 70% power for the primary analysis, suggesting these findings represent preliminary evidence requiring validation. CONCLUSION: Salivary IL-6 provides promising preliminary evidence for risk stratification in radiation-induced OM. The 286.25 pg/mL threshold may guide selection of food-grade complementary therapies, with both honey and TGP showing enhanced efficacy in high-risk patients. While limited by moderate statistical power (70%), these findings support the potential for biomarker-guided personalized supportive care using accessible, food-grade interventions. Prospective validation in larger cohorts (N ≥ 100) is warranted to confirm the clinical utility of IL-6-guided therapy selection.
Unilateral endonasal kaposiform haemangioendothelioma in a newborn - a case report.
Lanzerstorfer D, Hochstöger J, Scala M … +2 more , Poier-Fabian N, Zwittag P
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026286 · Publisher ↗
INTRODUCTION: Kaposiform haemangioendothelioma (KHE) is a rare, borderline, vascular tumour occurring mostly during childhood. Literature provides reports of KHE in various body regions. To the best of our knowledge, thi...
INTRODUCTION: Kaposiform haemangioendothelioma (KHE) is a rare, borderline, vascular tumour occurring mostly during childhood. Literature provides reports of KHE in various body regions. To the best of our knowledge, this is the first report of an endonasal KHE. Expert panels recommend systemic pharmacotherapy as first line treatment. In this case, physicians opted for surgical excision of the tumour instead. This report presents therapeutic challenges in this unique case and the succesful course of treatment. MAIN SYMPTOMS/CLINICAL FINDINGS: The newborn patient presented with saturation drops below 80% SpO2 while breastfeeding, and recurrent episodes of bloody nasal secretions. Endoscopy showed a large, obstructing and highly vascularized tumour in the right nasal cavity. In imagery, the tumour extended from the olfactory fossa to the nasal floor and eroded the bony border of the medial orbit. MAIN DIAGNOSES/THERAPEUTIC INTERVENTIONS/OUTCOMES: In summary of the findings, physicians assumed teratoma or glioma as working diagnosis. During surgery, extensive haemorrhage required the transfusion of approximately 50% of the patient`s total blood volume. Following a satisfactory recovery, the patient was discharged five days after surgery. The patient presented well and tumour free in all follow-up examinations. Histopathological examination confirmed Kaposiform haemangioendothelioma as tumour entity. CONCLUSION: KHE in the upper airway can pose serious life-threats to newborns. Risks associated with diagnostic examination should be weighed up against the accepted level of uncertainty in treatment process decisions. Including caregivers in treatment decisions is recommendable. Despite the absence of KMP, haemorrhage can require transfusion of erythrocyte concentrates. Managing extensive haemorrhage requires preparation, equipment and skill.
Survival outcomes following isthmusectomy versus lobectomy and total thyroidectomy for papillary thyroid carcinoma: A propensity score-matched study.
Yan S, Cao Z, Zhang Q … +5 more , Chen B, Huang B, Kan Y, Cui X, Liu Z
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026285 · Publisher ↗
PURPOSE: Surgical extent for isthmus papillary thyroid carcinoma (PTC) remains debated. We evaluated the survival outcomes of thyroid isthmusectomy (TI). METHODS: PTC patients undergoing TI were identified from the Surve...
PURPOSE: Surgical extent for isthmus papillary thyroid carcinoma (PTC) remains debated. We evaluated the survival outcomes of thyroid isthmusectomy (TI). METHODS: PTC patients undergoing TI were identified from the Surveillance, Epidemiology, and End Results database. Overall survival (OS), disease-specific survival (DSS), and prognostic factors were analyzed. Survival outcomes of TI were compared with thyroid lobectomy (TL) and total thyroidectomy (TT) via propensity score matching (PSM). RESULTS: Among 308 TI patients, 10-year OS and DSS were 89.5% and 100.0%. Male sex, age ≥ 55 years, and T3–4 category were independent risk factors for poorer OS. After PSM, TI demonstrated comparable OS to TL (P = 0.80) and TT (P = 0.59). However, TT yielded superior OS in subgroups with T3–4 tumors, tumor size > 2cm, lymph node metastasis, and age ≥ 55 years. CONCLUSION: TI might be an oncologically safe option for younger patients with solitary isthmus PTC (cT1N0M0).
Comparative validation of current staging systems in sinonasal soft tissue sarcomas: a population-based analysis.
Lin J, Wen W, Wen Y
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026284 · Publisher ↗
PURPOSE: Optimal staging for sinonasal soft tissue sarcomas (SNSTS) remains unclear. The seventh edition of the American Joint Committee on Cancer staging system for soft tissue sarcoma (STS7) is size-based, while two ei...
PURPOSE: Optimal staging for sinonasal soft tissue sarcomas (SNSTS) remains unclear. The seventh edition of the American Joint Committee on Cancer staging system for soft tissue sarcoma (STS7) is size-based, while two eighth-edition alternatives, the head and neck soft tissue sarcoma system (STS8) and the sinonasal malignancy system (SNM8), incorporate anatomic invasion. None have been validated for SNSTS. This study compared their prognostic performance. METHODS: A retrospective cohort of 384 SNSTS cases was analyzed. STS7 was compared with STS8 and SNM8 across four performance dimensions using scoring measures: hazard consistency, hazard discrimination, prognostic accuracy, and T-category distribution. Time-dependent area under the curve and the Akaike information criterion were used to assess prognostic accuracy. RESULTS: STS8 showed better hazard consistency than STS7, while SNM8 lacked a monotonic survival gradient and demonstrated poor hazard discrimination. Prognostic accuracy was similar across current systems, but STS8 exhibited an uneven distribution, with 60.4% of cases classified as T4a. Overall performance was comparable between STS7 and STS8, while SNM8 was inferior. CONCLUSION: STS7 and STS8 showed similar prognostic utility, whereas SNM8 performed worse. These findings support the development of a staging system tailored to SNSTS. Prospective validation is warranted.
Surgical Approaches and Complications in OSIA: a Systematic Review.
Malas M, Alghtani A, Alabdulkarim I … +3 more , Kullab A, Hagr A, Almuhawas F
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026283 · Publisher ↗
BACKGROUND: The Osseointegrated Steady-State Implant (OSIA) is an active transcutaneous bone conduction system offering effective hearing rehabilitation via a piezoelectric actuator and osseointegrated anchor, while pres...
BACKGROUND: The Osseointegrated Steady-State Implant (OSIA) is an active transcutaneous bone conduction system offering effective hearing rehabilitation via a piezoelectric actuator and osseointegrated anchor, while preserving skin integrity. Despite the growing adoption of OSIA, the literature on optimal surgical approaches and complication patterns remains fragmented. OBJECTIVE: This is the first systematic review aimed at evaluating intraoperative and postoperative complications associated with OSIA implantation, with a specific focus on incision orientation, patient age, and prior surgical history. METHODS: A systematic review was registered with PROSPERO and conducted per PRISMA guidelines. PubMed, Embase, and CENTRAL were searched for studies published from January 2016 to April 2025. Fifteen eligible studies were included, encompassing 784 OSIA implants across prospective and retrospective cohorts. RESULTS: OSIA implantation was associated with a low pooled intraoperative complication rate of 0.77% and a postoperative complication rate of 5.25%. Most complications were mild and manageable, with no cases requiring permanent device removal. Incisions placed across the device had a significantly higher complication rate (14.4%) compared to incisions placed around the device (4.6%). Pediatric-predominant cohorts experienced more complications (10.2%) than adult-predominant cohorts (4.3%). Patients with prior mastoidectomy had a complication rate of 12.0%. CONCLUSION: OSIA is a generally safe hearing solution, but surgical planning should consider patient-specific factors and incision orientation. Incisions placed across the device are linked to higher complication rates. These findings support evidence-based risk stratification and preoperative counseling.
Validity and reliability of the total rating of eye, nasal, and dry-mouth (TREND) score.
Lechien JR, Chiesa-Estomba CM, Mayo-Yanez M … +12 more , Iannella G, Barillari MR, Guarino P, Lazzeroni M, Saibene AM, Cammaroto G, Salzano G, Andrianakis A, Hemptinne C, Saussez S, Maniaci A, Vaira LA
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42026282 · Publisher ↗
OBJECTIVE: To develop and validate the total rating of eye, nasal, and dry-mouth (TREND) score, which is a patient-reported outcome measure of upper aerodigestive tract mucosa dryness. METHOD: Patients with dry symptoms...
OBJECTIVE: To develop and validate the total rating of eye, nasal, and dry-mouth (TREND) score, which is a patient-reported outcome measure of upper aerodigestive tract mucosa dryness. METHOD: Patients with dry symptoms and findings of mouth, laryngopharynx, nose, and eyes were prospectively recruited between June 2024 to November 2025. Patients and healthy individuals completed TREND score within a 7-day period to assess test-retest reliability. Internal consistency was measured using Cronbach’s α for TREND items and sub- and total scores in patients and controls. For patients with dry vocal fold or reflux-related dry throat, validity was evaluated by comparing the TREND with the reflux symptom score (RSS) and the voice handicap index (VHI). Dry findings were collected. Pre-to posttreatment evolution of TREND was assessed to evaluate the responsiveness to change. RESULTS: A total of 164 consecutive patients with dry mucosa complaints completed evaluations (106 females), alongside 85 controls (44 females). Mean TREND sub-/total scores were significantly higher in patients versus controls, demonstrating adequate discriminant validity. External validity showed moderate-to-strong correlations between TREND and RSS in LPRD patients (rs=0.650;95%CI: 0.535–0.742;p = 0.001) and between TREND and VHI in hoarseness patients (rs=0.437;95%CI: 0.234–0.603;p = 0.001). Internal consistency was high (α = 0.856), with moderate-to-high test-retest reliability. ROC analysis suggested a TREND > 19 as pathological threshold in this population (AUC = 0.837;sensitivity:83.5%,specificity:54.8%; Youden index:0.383). CONCLUSION: TREND score is a valid and reliable patient-reported outcome questionnaire documenting dry throat, mouth, nose, and eye symptoms in otolaryngology. Future studies are needed to establish psychometric properties of TREND in several other dry disorders.
Intraoperative ABR in Vibrant Soundbridge Surgery: Influence of Bone-Conduction Thresholds.
Alahmadi A, Ibrahim A, Shahadah N … +2 more , Yousef M, Alzhrani F
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026281 · Publisher ↗
BACKGROUND: Vibrant Soundbridge (VSB) has shown effective hearing rehabilitation for patients with conductive, mixed, or sensorineural hearing loss. However, optimal floating mass transducer (FMT) coupling is critical fo...
BACKGROUND: Vibrant Soundbridge (VSB) has shown effective hearing rehabilitation for patients with conductive, mixed, or sensorineural hearing loss. However, optimal floating mass transducer (FMT) coupling is critical for device performance. This study investigates the utility of intraoperative auditory brainstem response (ABR) for assessing coupling efficiency and guiding surgical decision-making, particularly in patients with normal bone conduction. METHODS: This retrospective cohort study included VSB patients with complete audiometric data. Coupling efficiency was assessed by comparing postoperative Vibrogram and intraoperative ABR thresholds with preoperative bone conduction (BC pre-op) thresholds (PTA3 at 1, 2, and 4 kHz). Segmented regression with breakpoint estimation was used to model the relationship between BC pre-op and ABR thresholds, accounting for variability at lower BC values. RESULTS: Thirty-six patients (mean age 23 ± 18 years) were evaluated. Postoperative functional gain averaged 32.6 ± 11.9 dB HL, with speech discrimination improvement by 22.3 ± 10.1%. ABR thresholds correlated moderately with Vibrogram thresholds (r = 0.481, p = 0.003). Vibrogram–BC differences (mean = 15.9 ± 13.3 dB) were consistently lower than ABR–BC (mean = 34.8 ± 14.8 dB; t(34) = 8.74, p < 0.001). Segmented regression identified a breakpoint at 18.3 dB (SE = 7.1). Below this value, the slope was non-significant (-0.21, p = 0.483), and mean ABR–BC difference was 39.84 dB. In contrast, above this value, a proportional relationship was observed (slope = 0.659) with difference of 21.67 dB. CONCLUSION: Intraoperative ABR provides adjunctive physiological information that may inform surgical judgment. However, its interpretation should account for preoperative BC thresholds, particularly in patients with normal BC levels.
The characteristics of chemosensory losses in the symptomatology of long-COVID.
Stanley HB, Bensafi M
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026280 · Publisher ↗
PURPOSE: Millions of cases of long-COVID have been identified worldwide since the beginning of the pandemic few years ago, with many affected individuals severely debilitated. Understanding the symptoms of long-COVID, ex...
PURPOSE: Millions of cases of long-COVID have been identified worldwide since the beginning of the pandemic few years ago, with many affected individuals severely debilitated. Understanding the symptoms of long-COVID, explaining how they are related to each other, and how the clinical course of the disease can be predicted based on these symptoms remains a significant challenge in the community. The aim of the present study is to address this challenge with a view to understanding the relative importance of loss of smell and taste, a common sensory deficit associated with the disease, in long COVID symptomatology. METHOD: To this end, we studied 525 people with COVID-19 resident in France via an online questionnaire reporting their symptoms together with their subjective assessment of recovery. Descriptive approaches and machine learning algorithms were then used to extract symptom associations and risk factors for long-COVID. RESULTS: Results revealed that olfactory/gustatory symptoms were not systematically correlated with other symptoms. We find two distinct groups of patients with olfactory/gustatory symptoms: one group that recovers rapidly and the other (older group) that develops long-COVID. Cognitive, cardiac and cutaneous/inflammatory symptoms were correlated and associated with long-COVID. CONCLUSION: Chemosensory losses are not systematically associated with the development of long COVID. Chronic olfactory losses may have a different disease mechanism to acute losses. Symptom profiles six weeks after diagnosis (particularly cognitive symptoms) can provide useful indications of how the disease will progress.
The role of concentrated growth factor (CGF) in type 1 tympanoplasty.
Tutar B, Berkiten G, Çelik C … +7 more , Doğan O, Horat SH, Bayraktar FG, Paltura C, Sarı H, Saltürk Z, Uyar Y
Eur Arch Otorhinolaryngol · 2026 Apr · PMID 42026279 · Publisher ↗
BACKGROUND: The aim of this study was to investigate the efficacy of concentrated growth factor (CGF) in type 1 tympanoplasty. METHODS: This study represents a retrospective analysis of a non-randomized interventional co...
BACKGROUND: The aim of this study was to investigate the efficacy of concentrated growth factor (CGF) in type 1 tympanoplasty. METHODS: This study represents a retrospective analysis of a non-randomized interventional cohort study, included 60 patients who underwent primary type 1 tympanoplasty between November 2024 and July 2025. The patients were divided into those who received only a cartilage graft (n = 30) and those who received a cartilage graft and CGF (n = 30). The incidence rates of residual tympanic membrane perforation, audiological outcomes, and postoperative infection rates were compared. RESULTS: The incidence rate of residual perforation was significantly lower in the CGF group than in the cartilage-only group. The audiological outcomes showed no significant differences between the groups. Postoperative infection was observed less frequently in the CGF group. CONCLUSION: CGF may represent a promising adjunct in type 1 tympanoplasty by potentially supporting graft integration and reducing residual perforation rates.
Identifying electrode migration post cochlear implantation in children and its correlation with speech outcome.
Das A, John M, Asif SK … +4 more , Varghese AM, Thomas P, Das SK, Nappoly R
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42026278 · Publisher ↗
OBJECTIVE: This study aims to identify early electrode migration after cochlear implant (CI) surgery using imaging, mapping, and postoperative auditory and speech scores in order to enhance the performance of the implant...
OBJECTIVE: This study aims to identify early electrode migration after cochlear implant (CI) surgery using imaging, mapping, and postoperative auditory and speech scores in order to enhance the performance of the implant and its outcome. STUDY DESIGN: A prospective study involving the bilaterally profound hearing-impaired children who underwent cochlear implantation from January 2021 to February 2024. SETTING: Patients who attended the paediatric hearing clinic in a tertiary care hospital for follow-up after 6 months to 1 year were recruited. METHODS: After a minimum of 6 months of cochlear implantation surgery, a ‘modified Stenver’s view’ and a ‘cochlear view’ mastoid x-ray was done to determine the electrode position, insertion depth and degree of insertion and compared with the x-ray taken on post-operative day one. The electrode position was then correlated with electrically evoked compound action potential (ECAP), impedance, CAP-12 (Categories of auditory performance) score and speech intelligibility rating (SIR). RESULTS: Out of 35 patients who enrolled for the study, 3 patients were found to have electrode migration, of which one patient had poor speech and auditory outcome. The cochlear view was found to be superior to modified Stenver’s view. CONCLUSIONS: Electrode migration is a rare but not uncommon complication that may not be easily picked up with ECAP and impedance monitoring in the post-operative period, warranting regular imaging such as cochlear view x-ray that is fast, cheap and has low radiation exposure to children. It also gives good electrode visibility and can determine the electrode position, angular insertion depth and electrode migration.
Longitudinal correlations of subjective, functional, and objective voice parameters following radiotherapy for early glottic carcinoma.
Al-Rashidi AM, El Dessouky HM, ELdemerdash AM … +2 more , Abdel-Hady AF, Shohdi SS
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42026277 · Publisher ↗
OBJECTIVE: Multi-dimensional voice assessment is critical for monitoring recovery in patients treated with radiotherapy (RT) for early glottic carcinoma. This study investigated the longitudinal cross-parametric correlat...
OBJECTIVE: Multi-dimensional voice assessment is critical for monitoring recovery in patients treated with radiotherapy (RT) for early glottic carcinoma. This study investigated the longitudinal cross-parametric correlations between subjective (AVHI-10), functional (LVS), and objective (acoustic) voice measures at baseline and 6 months post-RT. METHODS: Thirty-seven patients with T1–T2N0M0 glottic carcinoma were prospectively evaluated. Spearman correlation matrices (ρ) were employed to analyze the relationships between the Voice Handicap Index-10 (AVHI-10), laryngeal videostroboscopy (LVS), and acoustic parameters (HNR, Jitter, Shimmer and MPT). RESULTS: All parameters showed significant clinical improvement at 6 months (P < 0.001). Post-RT, the AVHI-10 demonstrated exceptionally strong concordance with objective efficiency measures, specifically HNR (ρ = − 0.893) and MPT (ρ = − 0.844), as well as robust correlations with perturbation metrics (Jitter: ρ = 0.761; Shimmer: ρ = 0.753). In contrast, while functional LVS parameters remained significantly correlated with acoustic output, these associations were more moderate (ρ ranging from = 0.41 to 0.67). Glottic closure was the most prominent functional predictor of acoustic spectral purity (ρ = − 0.674 with HNR), whereas mucosal wave parameters (Phase Symmetry and Periodicity) exhibited a relative weakening in their correlation with acoustic instability, suggesting a complex interplay following radiation-induced tissue changes. CONCLUSION: Subjective handicap (AVHI-10) serves as a highly reliable surrogate for objective acoustic efficiency in the post-RT larynx. While functional laryngeal dynamics improve universally, the attenuation of correlations observed between mucosal wave parameters and acoustic output highlights the complex, non-linear impact of radiation-induced fibrosis. Residual glottic closure remains the primary functional determinant of vocal efficiency, emphasizing its role as a key clinical biomarker for post-treatment success.
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