European Archives Of Oto-rhino-laryngology[JOURNAL]
Sun
200 papers
Relative contributions of meteorological factors and atmospheric pollutants to childhood adenoid hypertrophy: A time-series study in Chongqing, China.
Nie L, Pan B, Liang J … +1 more , Hu D
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228105 · Publisher ↗
BACKGROUND: Adenoid hypertrophy significantly impacts children's health. While respiratory diseases are influenced by air pollution and meteorological factors, their effects on adenoid hypertrophy remain poorly understoo...
BACKGROUND: Adenoid hypertrophy significantly impacts children's health. While respiratory diseases are influenced by air pollution and meteorological factors, their effects on adenoid hypertrophy remain poorly understood. OBJECTIVE: To quantify the effects of meteorological factors and air pollutants on childhood adenoid hypertrophy hospital visits. METHODS: We analyzed 236,438 hospital visits for childhood adenoid hypertrophy (2014-2019, 2023-2024) in children < 18 years in Chongqing, China (2922 observation days) using distributed lag nonlinear models. Environmental exposures were assigned at the district level based on monitoring stations nearest to each patient's residential district. We quantified associations using standardized regression coefficients and attributable disease burdens, examining non-linear exposure-response relationships and seasonal variability. Environmental exposures included six meteorological factors (temperature, atmospheric pressure, humidity, wind speed, sunshine duration, rainfall) and six air pollutants (PM2.5, PM10, NO₂, SO₂, CO, O₃). RESULTS: Ozone demonstrated the largest model-based attributable burden, with an estimated 16,231 cases associated with IQR increases in exposure. Summer showed extraordinary disease concentration (79.5% of cases). These findings provide preliminary evidence for environmental associations with adenoid hypertrophy in subtropical basin settings, with ozone and summer season emerging as key factors. CONCLUSION: This time-series analysis identified strong environmental associations with childhood adenoid hypertrophy in a subtropical basin setting. Ozone demonstrated the largest model-based association with childhood adenoid hypertrophy hospital visits(16,231 attributable cases, 6.9% of burden), with extraordinary summer disease concentration (79.5% of cases). These findings provide important evidence linking environmental exposures to adenoid hypertrophy patterns, though causal confirmation through future studies would be needed before informing environmental health strategies in comparable subtropical basin regions.
Clinical features and efficacy analysis of idiopathic sudden sensorineural hearing loss in children: a single-center, retrospective study (2015-2025).
Bi J, Pen Y, Yu B … +4 more , Mo W, Han YY, Sun J, Fu Y
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228104 · Publisher ↗
PURPOSE: To summarize the clinical features, therapeutic effects, and related influencing factors of idiopathic sudden sensorineural hearing loss (ISSNHL) in children to optimize the clinical management plan for this dis...
PURPOSE: To summarize the clinical features, therapeutic effects, and related influencing factors of idiopathic sudden sensorineural hearing loss (ISSNHL) in children to optimize the clinical management plan for this disease. METHODS: A retrospective analysis was performed on the clinical data of 267 children with ISSNHL (318 ears) aged 5-18 years who were admitted to a single center between August 2015 and August 2025. An individualized comprehensive treatment regimen was adopted, and the primary efficacy endpoint was the hearing level 3 months after treatment. Correlation analysis was conducted to explore the associations between the therapeutic effect and different factors. RESULTS: Children aged 8-12 years old accounted for the highest proportion of cases (72.3%). Moderate-to-severe hearing loss was the main type of hearing impairment (85.3%), with total deafness accounting for 29.2% of cases. Tinnitus and vertigo were the most common accompanying symptoms. Patients aged 8-18 years old had better therapeutic outcomes than those aged 5-7 years old. Patients with accompanying tinnitus and vertigo had the best and worst therapeutic outcomes, respectively. A significant improvement in efficacy was observed when treatment was initiated within 7 days of onset. No significant correlations were found between the therapeutic effect and the time from onset to treatment or the affected ear. CONCLUSION: Individualized comprehensive treatment can improve the prognosis of children with ISSNHL, and stratified treatment strategies should be formulated for different patient populations.
Partner cancer risk in HPV-related oropharyngeal cancer: a systematic review of couples studies.
Karagoz T, Tanacan A
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228103 · Publisher ↗
BACKGROUND: Human papillomavirus (HPV)-related oropharyngeal cancer presents an epidemiological paradox: while HPV transmits between sexual partners, partner cancer development is extremely rare. Understanding this trans...
BACKGROUND: Human papillomavirus (HPV)-related oropharyngeal cancer presents an epidemiological paradox: while HPV transmits between sexual partners, partner cancer development is extremely rare. Understanding this transmission-disease disconnect is crucial for patient counseling. OBJECTIVES: To systematically review evidence from couples studies examining HPV transmission patterns and partner cancer risk in HPV-related oropharyngeal cancer, with emphasis on concordance rates, discordance patterns, and documented cases of partner cancer development. METHODS: Systematic literature search of PubMed, Embase, Web of Science, Scopus, and Cochrane Library following PRISMA 2020 guidelines. Search combined terms for HPV, oropharyngeal cancer, couples/partners, and transmission/concordance. Studies examining HPV infection patterns in heterosexual couples where at least one partner had HPV-related oropharyngeal cancer were included. Two independent reviewers performed screening, data extraction, and risk of bias assessment using Newcastle-Ottawa Scale and JBI checklists. Primary outcomes were partner HPV prevalence, type-specific concordance rates, and documented partner cancer cases. RESULTS: Thirty studies (12 cross-sectional, 10 cohort, 6 case-control, 2 case series) including 1,847 couples met inclusion criteria. Oral HPV prevalence in partners of HPV-positive cancer patients ranged from 3.7% to 29%. HPV16 type-specific concordance ranged from 0% to 15.4%, with observed-to-expected ratios of 1.5-8.9 confirming transmission above chance. However, no cases of sequential partner cancer development were documented during follow-up (total 4,231 couple-years). Only two case reports described concurrent cancers in couples [16]. Most partner infections were transient, with persistent infection documented in less than 5% of partners versus 52-65% in cancer patients. Higher viral load, oral-genital contact frequency, and shorter relationship duration predicted concordance. CONCLUSIONS: HPV transmission between partners occurs in 3.7-29% of couples, but partner cancer development is extraordinarily rare (no cases in 4,231 couple-years of follow-up). The transmission-disease disconnect likely reflects efficient immune clearance, low progression rates, and multi-decade latency. Partner cancer risk appears comparable to general population risk. These findings provide evidence-based reassurance for couples counseling.
Diagnostic potential of a panel of acoustic/aerodynamic voice markers in patients with dysphonia: a cluster analysis.
Franz L, Nicoletti L, Martinelli G … +9 more , Capovilla C, Di Salvio F, Tuon M, Biscaro A, Montino S, Lucchini E, de Filippis C, Zanoletti E, Marioni G
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228102 · Publisher ↗
PURPOSE: Dysphonia is a common condition impacting quality of life and requiring integrated/multidimensional clinical and therapeutic approaches. The main aim of this investigation was to develop a cluster analysis model...
PURPOSE: Dysphonia is a common condition impacting quality of life and requiring integrated/multidimensional clinical and therapeutic approaches. The main aim of this investigation was to develop a cluster analysis model to stratify dysphonic patients into homogeneous subgroups, based on a panel of acoustic voice markers. Secondary aims were assessing the association of clusters with clinical diagnoses and functional outcomes. METHODS: This retrospective study involved 268 dysphonic patients. Demographics, laryngological diagnosis (functional dysphonia, nodules, cysts, vocal fold paralysis, chronic laryngitis, polyps/focal edema, other), acoustic (fundamental frequency, Jitter, Shimmer) and aerodynamic (maximum phonation time) parameters, GIRBAS, and Voice Handicap Index-10 [VHI-10] scores were evaluated. A cluster analysis (K-mean partitioning) was conducted to identify 4 clusters, based on Jitter, Shimer, and MPT values. RESULTS: Diagnoses significantly varied across clusters (p < 0.0001). Dysfunctional dysphonia was most common in Clusters 1, 3 and 4, while in Cluster 2 vocal fold paralysis was more frequent. Higher prevalence of nodules was found in Cluster 3, while cysts were more frequent in Cluster 4, and chronic laryngitis was more common in Clusters 1 and 3. Perceptual voice parameters showed significant differences across clusters (p = 0.0001, p = 0.0025, p = 0.0001, p = 0.0001 for G, R, B and S parameters, respectively), with Cluster 2 having the less favorable scores. CONCLUSIONS: In this study, cluster analysis seemed to highlight subjects with vocal patterns more at risk of presenting with specific laryngeal conditions. To better characterize the clinical potential of cluster analysis models, based on acoustic/aerodynamic parameters, further studies, based on multicentric prospective series, are required.
Multi AI agents in otolaryngology: from passive assistance to structured clinical intelligence.
Aliyeva A
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228101 · Publisher ↗
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Development and validation of a machine learning model predicting post-tonsillectomy hemorrhage.
Stubberud A, Zahl SM, Myklebust TÅ … +1 more , Bugten V
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228100 · Publisher ↗
PURPOSE: To develop and validate machine learning models to predict post-tonsillectomy hemorrhage. METHODS: This was a machine learning analysis of a cohort of patients included in the Norwegian tonsil registry in Norway...
PURPOSE: To develop and validate machine learning models to predict post-tonsillectomy hemorrhage. METHODS: This was a machine learning analysis of a cohort of patients included in the Norwegian tonsil registry in Norway from 03.01.2017 to 01.05.2025. A perioperative assessment was used to describe the type of surgery performed, the surgical technique used, and the methods used to achieve hemostasis. Postoperative outcomes were assessed in questionnaires 30 days after surgery. Unsupervised models were used to explore the data. Supervised models were developed to predict post-tonsillectomy hemorrhage, defined as any postoperative bleeding necessitating admission. Predictors included in the model were age, sex, type of surgery, surgical technique and means to achieve hemostasis. Model performance was evaluated with the area under the receiver operating characteristics curve (AUC). The best model was evaluated in a held-out test set. The model was explained with a SHAP plot. A decision curve analysis was conducted to assess the potential clinical utility of the model. RESULTS: A total of 32,037 patients (mean [SD] age 17.84 [12.33]; 18,949 [59.15%] women) were included, with a mean bleeding rate of 6.17%. Unsupervised learning identified sub-groups with differences in bleeding rates. The best performing predictive model was the Adaboost classifier, achieving a test set AUC of 0.71 (95% CI 0.68-0.73). The most important predictors were middle or old age, bipolar diathermy for hemostasis and male sex. The predictive model was superior to alternative strategies in the decision curve analysis. CONCLUSION: Post-tonsillectomy hemorrhage could be predicted with moderate accuracy. More research is needed to assess if it has potential utility as a clinical decision-support tool.
Perception of body angular displacement while free-floating in microgravity during parabolic flight.
Clément G, Kuldavletova O, Quarck G … +2 more , Macaulay TR, Denise P
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42228099 · Publisher ↗
PURPOSE: Accurate perception of self-motion perception is critical for spatial orientation, especially in environments lacking visual or gravitational cues, such as during spaceflight. This study investigated how humans...
PURPOSE: Accurate perception of self-motion perception is critical for spatial orientation, especially in environments lacking visual or gravitational cues, such as during spaceflight. This study investigated how humans perceive passive whole-body rotation while free-floating in microgravity during parabolic flight. METHODS: Six study participants were passively rotated about their yaw, pitch, and roll axes by an operator. The rotation angles ranged from 30 degrees to 420 degrees, and participants reported their perceived angular displacement after each trial. Visual and auditory cues were eliminated, and motion was recorded using inertial sensors. RESULTS: Errors between perceived and actual amplitudes were generally larger for pitch and roll rotations than yaw. Participants tended to inaccurately estimate the amplitude of both pitch and yaw rotations, with errors becoming more pronounced at larger angular displacements. Perception gain (the ratio of perceived to actual rotation) showed greater variability for pitch and roll than yaw. Overall, perception gain was higher for roll than for pitch or yaw, although this may have been influenced by the slower average angular velocities of these roll rotations. CONCLUSION: These findings suggest axis-dependent differences in motion perception in microgravity, likely due to the absence of otolith input and changes in tactile feedback, which underscores the role gravity plays in perceiving pitch and roll motion. Errors in estimating rotations could pose operational challenges for astronauts performing orientation-dependent tasks in low-gravity environments. These findings may also inform rehabilitation strategies for vestibular patients by determining the roles of cues from the semicircular canals and tactile feedback when compensating for impaired sense of gravity.
Comment on "Application of oral midazolam for preoperative sedation in pediatric tonsillectomy and adenoidectomy and its effects on emergence delirium".
Binar M
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223622 · Publisher ↗
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Evaluating large language models in chronic rhinosinusitis: methodological constraints and the need for clinically grounded validation.
Tahir HN, Antar AS, Javed S … +1 more , Ali Y
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223621 · Publisher ↗
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Comparison of functional and anatomical parameters in patients with nasal obstruction: peak nasal inspiratory flow and computed tomography-based internal nasal valve angle.
Alpay M, Bulut F, Agirgol B … +3 more , Ozgen H, Kaymaz AE, Inan HC
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223620 · Publisher ↗
OBJECTIVE: The internal nasal valve (INV) is the narrowest segment of the nasal airway and plays a key role in nasal airflow resistance. This study aimed to evaluate the relationship between peak nasal inspiratory flow (...
OBJECTIVE: The internal nasal valve (INV) is the narrowest segment of the nasal airway and plays a key role in nasal airflow resistance. This study aimed to evaluate the relationship between peak nasal inspiratory flow (PNIF), bilateral INV angles measured on computed tomography (CT), and nasal examination findings in patients presenting with nasal obstruction. METHODS: This retrospective cross-sectional study included 94 patients who presented with nasal obstruction to the otorhinolaryngology outpatient clinic between January 2024 and September 2025. All patients underwent detailed nasal examination and septal deviation was classified according to the Baumann classification. Bilateral INV angles were measured on coronal paranasal sinus CT images. PNIF values were obtained from medical records. Statistical analyses were performed to assess correlations and group differences. RESULTS: The mean PNIF value was 68.1 ± 24.7 L/min, and the mean bilateral INV angle was 11.2 ± 3.2°. A moderate, significant positive correlation was observed between PNIF values and bilateral INV angles (rho = 0.290, p = 0.005). Patients with a bilateral INV angle below 9° had significantly lower PNIF values compared with those with angles ≥ 9° (p = 0.011). No significant differences in PNIF values or INV angles were found among different Baumann septal deviation subtypes. CONCLUSION: Narrower INV angles are associated with reduced functional nasal airflow as measured by PNIF. Assessment of the INV provides additional functional insight beyond septal deviation classification alone. PNIF represents a practical, noninvasive tool for functional evaluation of nasal obstruction and may support clinical decision-making and surgical planning.
Peritonsillar abscess as a clinical sign of oropharyngeal cancer - a Swedish national cohort study.
Gottlieb-Vedi E, Santoni G, Toppila-Salmi S … +3 more , Mäkitie A, Xie SH, Lagergren J
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223619 · Publisher ↗
PURPOSE: Patients older than 40 years with peritonsillar abscess may routinely undergo follow-up to detect oropharyngeal cancer, but this approach lacks scientific evidence. This study aimed to assess the hypothesis that...
PURPOSE: Patients older than 40 years with peritonsillar abscess may routinely undergo follow-up to detect oropharyngeal cancer, but this approach lacks scientific evidence. This study aimed to assess the hypothesis that oropharyngeal cancer is not overrepresented in patients with peritonsillar abscess. METHODS: This population-based, nationwide Swedish cohort study compared all patients diagnosed with peritonsillar abscess during 2005-2023 with an age-, date-, and sex-matched non-exposed group from the same cohort. Conditional logistic regression provided odds ratios (OR) with 95% confidence intervals (CI) for oropharyngeal cancer within 1 year after peritonsillar abscess diagnosis, or matching date. Except for the three matching variables, the OR were adjusted for tobacco smoking, alcohol overconsumption, and comorbidity in a multivariable model. RESULTS: Oropharyngeal cancer was diagnosed in 30 patients out of 64,244 occurrences of peritonsillar abscess (0.05%), compared to 9 out of 642,440 individuals in the comparison group (0.0014%). All 39 oropharyngeal cancers occurred in individuals aged 40 or older. Peritonsillar abscess was associated with an increased 1-year risk of oropharyngeal cancer (adjusted OR 3.51, 95% CI 2.75-4.26). In substrata of age, the strongest association was observed for patients aged 60 years and above (adjusted OR 4.54, 95% CI 3.07-6.02), corresponding to 2.8 cases per 1000 patients, while the age group 40-59 years had an OR of 2.76 (95% CI 1.80-3.72). CONCLUSION: Peritonsillar abscess may indicate an underlying oropharyngeal cancer only in rare cases. Given the low incidence of oropharyngeal cancer after peritonsillar abscess, routine follow-up is questionable or may be limited to older patients.
Incidence of mastoiditis complications in relation to prior community-based antibiotic treatment.
Sofer N, Hadar A, Choucroun G … +4 more , Tarnovsky Y, Perez R, Attal P, Shaul C
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223618 · Publisher ↗
OBJECTIVES: To evaluate the association between prior community-based antibiotic treatment for acute otitis media (AOM) and the incidence and severity of complications in children hospitalized with acute mastoiditis (AM)...
OBJECTIVES: To evaluate the association between prior community-based antibiotic treatment for acute otitis media (AOM) and the incidence and severity of complications in children hospitalized with acute mastoiditis (AM), noting that this design does not address whether prior antibiotic treatment prevents AM development. METHODS: This retrospective cohort study analyzed medical records of 522 children (age < 15 years) diagnosed with AM at a tertiary medical center between 2015 and 2025. Children were categorized by prior antibiotic exposure: those receiving antibiotics for > 48 h before hospitalization versus those receiving < 48 h or none. The primary outcome was the presence of complicated AM, defined as extracranial (subperiosteal abscess) or intracranial (epidural abscess, sigmoid sinus thrombosis, brain abscess, or meningitis) complications. RESULTS: Of 522 children, 110 (21%) received prior antibiotics and 412 (79%) did not. While the composite complication rate was higher in the prior treatment group (54.5% vs. 38.6%, unadjusted OR = 1.91, p = 0.003), prior antibiotic treatment was not significantly associated with specific complication types, including subperiosteal abscess (adjusted OR = 0.67, p = 0.37) or intracranial complications (adjusted OR = 1.74, p = 0.13). Inflammatory markers, hospitalization length, imaging use, and surgical intervention rates were comparable between groups. Fusobacterium necrophorum in blood cultures was significantly associated with complications regardless of prior antibiotic exposure. CONCLUSIONS: Among children hospitalized with AM, prior antibiotic treatment was not associated with increased rates of specific complications. The difference in composite outcomes likely reflects selection bias rather than a true treatment effect. Causal inference is limited by confounding by indication and unmeasured baseline severity differences.
Disease-specificity in correlations between speech audiometry, hearing-related quality of life, and varying calculation methods for pure tone average in middle ear diseases.
Grueninger I, van de Loo J, Alekuzei S … +14 more , Hansen KK, Henze A, Spiegel J, Polterauer D, Neuling M, Eckel HNC, Mayer M, Luers JC, Klußmann JP, Canis M, Müller J, Walger M, Rader T, Sharaf K
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223617 · Publisher ↗
PURPOSE: This study examined whether different methods for calculating pure tone average (PTA) yield clinically relevant differences in correlations with speech audiometry and hearing-related quality of life (QoL) in con...
PURPOSE: This study examined whether different methods for calculating pure tone average (PTA) yield clinically relevant differences in correlations with speech audiometry and hearing-related quality of life (QoL) in conductive and mixed hearing loss. Additionally, we investigated whether these associations vary among distinct middle ear pathologies: otosclerosis, acute otitis media (AOM) and chronic otitis media (COM). METHODS: In an ambispective cohort study at a tertiary referral center, 220 ears were analyzed. 194 ears were collected retrospectively. 26 patients were recruited prospectively. Inclusion criteria were adult age, confirmed diagnosis, near-normal bone conduction and conductive hearing loss without prior middle ear surgery. Pure-tone and Freiburg speech audiometry were analyzed along with the SSQ12 questionnaire in prospective patients. Multiple air conduction (AC) and air-bone gap (ABG) - PTA configurations were compared using linear regression and ANCOVA. RESULTS: Across all cohorts, PTA values strongly correlated with speech recognition at 65 dB SPL and with 50% number recognition thresholds (R up to 0.77). No clinically relevant differences were found between 4-frequency-PTAs using 3 kHz vs. 4 kHz. However, disease-specific patterns emerged: otosclerosis patients showed consistently poorer word recognition than AOM or COM patients at comparable PTA levels. QoL outcomes correlated significantly with AC-based PTAs but not with ABG-based PTAs or speech results. CONCLUSIONS: PTA calculation methods yield comparable correlations with speech understanding; inclusion of 3 or 4 kHz does not alter results meaningfully. Disease-specific discrepancies underscore the need for nuanced interpretation of PTA-speech relationships and support integrating both PTA and QoL measures in patient assessment. The study was conducted under clinical trial registration number DRKS00037758.
Comparison of the efficacy of different pharmacological treatments for laryngopharyngeal reflux: a systematic review and network meta-analysis.
Xu W, Xi L, Zhong J
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223616 · Publisher ↗
OBJECTIVE: Laryngopharyngeal reflux (LPR) is a common disease, and various medications are employed clinically for its management, with variable efficacy. Therefore, this study aimed to assess the efficacy of different p...
OBJECTIVE: Laryngopharyngeal reflux (LPR) is a common disease, and various medications are employed clinically for its management, with variable efficacy. Therefore, this study aimed to assess the efficacy of different pharmacological treatments for LPR, thereby providing evidence-based guidance for its treatment. METHODS: Embase, Web of Science, Cochrane Library, and PubMed were comprehensively searched from inception to July 31, 2025, for studies on LPR. Two reviewers independently reviewed full texts and appraised the quality of eligible studies using the RoB 2.0 tool and the Newcastle-Ottawa Scale. R version 4.5.1 was employed to analyze data. RESULTS: In total, 23 studies involving 1,958 individuals were included. The reflux symptom index (RSI) and reflux finding score (RFS) of these participants were analyzed at weeks 4, 8, and 12, respectively. According to league table results, for the RSI at week 4, compared with placebo, alginate yielded a weighted mean difference (WMD) of - 4.69 (95% credible interval [CrI]: - 8.97, - 0.28). For the RSI at week 8, compared with placebo, alginate yielded a WMD of - 6.27 (95% CrI: - 10.13, - 2.19). For the RSI at week 12, compared with placebo, proton pump inhibitors (PPIs) plus mucolytics yielded a WMD of - 9.75 (95% CrI: - 17.76, - 1.63). For the RFS at week 4, compared with potassium-competitive acid blockers (P-CABs), PPIs, and placebo, alginate yielded WMDs of - 3.55 (95% CrI: - 5.28, - 1.79), - 3.53 (95% CrI: - 4.83, - 1.90), and - 3.75 (95% CrI: - 4.87, - 2.56), respectively. For the RFS at week 8, compared with placebo, alginate yielded a WMD of - 4.12 (95% CrI: - 7.88, - 0.53). For the RFS at week 12, compared with placebo, alginate yielded a WMD of - 5.66 (95% CrI: - 10.25, - 1.14). According to the surface under the cumulative ranking curve (SUCRA), for the RSI at week 4, alginate ranked first (89.66%) and P-CABs ranked third (62.82%). For the RSI at week 8, alginate ranked first (84.50%). For the RSI at week 12, PPIs plus mucolytics ranked first (87.47%) and alginate ranked second (63.67%). For the RFS at week 4, alginate ranked first (99.43%). For the RFS at week 8, alginate remained the top-ranked treatment (88.30%). For the RFS at week 12, alginate ranked first (89.87%) and P-CABs ranked third (50.69%). CONCLUSION: This study revealed that alginate demonstrated the greatest efficacy in the treatment of LPR.
Effect of donor-site rib stabilization on postoperative pain after autologous costal cartilage harvest in secondary rhinoplasty: a retrospective comparative study.
Kolbas I, Vuralkan E
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223615 · Publisher ↗
BACKGROUND: Secondary rhinoplasty often requires autologous costal cartilage harvest, and donor-site pain may influence recovery. This study evaluated whether rib stabilization is associated with improved postoperative p...
BACKGROUND: Secondary rhinoplasty often requires autologous costal cartilage harvest, and donor-site pain may influence recovery. This study evaluated whether rib stabilization is associated with improved postoperative pain control and reduced analgesic burden. METHODS: In this retrospective comparative study, records of 21 patients who underwent secondary rhinoplasty with costal cartilage harvest between January and December 2025 were reviewed. Patients were grouped by donor-site management (stabilization vs. no stabilization). Pain was assessed using visual analog scale scores on postoperative day 0, day 1, day 10, and day 30. Analgesic use, opioid requirement, and hospital stay were compared. Longitudinal pain trajectories were analyzed using RM-ANOVA. Baseline comparability and categorical analgesic outcomes were assessed between groups with appropriate parametric or nonparametric tests. RESULTS: Pain scores decreased significantly over time in both groups. Repeated-measures analysis showed a significant time effect and a significant time-by-group interaction, indicating different pain trajectories according to stabilization status. The stabilization group showed numerically lower VAS scores, shorter hospital stay, and fewer patients requiring opioids. Between-group differences in nonsteroidal analgesic use were borderline, whereas opioid requirement differed significantly. CONCLUSION: In this small, retrospective, non-randomized cohort, donor-site rib stabilization was associated with lower early postoperative pain scores and reduced opioid use after costal cartilage harvest in revision rhinoplasty. However, the observed associations cannot be interpreted as causal, and the findings should be regarded as preliminary and hypothesis-generating. Adequately powered prospective studies with standardized surgical and analgesic protocols are needed to confirm these results.
Melatonin and oxidative DNA damage in REM- and NREM-related obstructive sleep apnea: an exploratory analysis of sleep-stage phenotypes.
Saruhan E, Ispir E, Öztürk DA … +4 more , Sertoglu E, Unal Y, Bek S, Kutlu G
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223614 · Publisher ↗
PURPOSE: Obstructive sleep apnea is associated with intermittent hypoxia and oxidative stress. Whether oxidative and antioxidant biomarkers differ between rapid eye movement-related and non-rapid eye movement-related phe...
PURPOSE: Obstructive sleep apnea is associated with intermittent hypoxia and oxidative stress. Whether oxidative and antioxidant biomarkers differ between rapid eye movement-related and non-rapid eye movement-related phenotypes remains unclear. We compared circulating melatonin and oxidative stress markers across sleep-stage phenotypes and disease severity categories. METHODS: In this prospective case-control study, 165 participants (34 controls, 31 rapid eye movement-related obstructive sleep apnea, 100 non-rapid eye movement-related obstructive sleep apnea) underwent overnight polysomnography. Serum melatonin, 8-hydroxy-2'-deoxyguanosine, total oxidant status, and total antioxidant status were measured using enzyme-linked immunosorbent assay and colorimetric methods. The oxidative stress index was calculated as the ratio of total oxidant status to total antioxidant status multiplied by 100. Group comparisons were performed using nonparametric tests with appropriate post-hoc analyses. Additional analyses adjusted for age, body mass index, and sex using rank-transformed analysis of covariance. Correlations were evaluated using Spearman analysis with correction for multiple testing and formally compared between groups. RESULTS: In unadjusted analyses, melatonin and 8-hydroxy-2'-deoxyguanosine levels were lower in obstructive sleep apnea, particularly in non-rapid eye movement-related and moderate disease. However, these differences were no longer statistically significant after adjustment for body mass index and sex. Total oxidant status, total antioxidant status, and oxidative stress index did not differ significantly between groups. Descriptive differences in correlation patterns were observed, but formal comparison showed no statistically significant between-phenotype differences. CONCLUSION: Circulating redox biomarkers in obstructive sleep apnea show modest differences that appear largely influenced by body mass index and sex. These findings should be considered exploratory and hypothesis-generating rather than evidence of phenotype-specific biological mechanisms.
Effect of tonsillar fossa suturing in adolescents and adults: a systematic review and meta-analysis.
Lee YC, Hsin LJ, Lee YH … +6 more , Lu YA, Fang TJ, Tsai YT, Su SC, Luo CM, Li HY
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223613 · Publisher ↗
PURPOSE: Tonsillectomy is one of the most frequently performed surgical procedures in otolaryngology. Postoperative hemorrhage (PTH) and pain remain major concerns, particularly in adolescents and adults, in whom complic...
PURPOSE: Tonsillectomy is one of the most frequently performed surgical procedures in otolaryngology. Postoperative hemorrhage (PTH) and pain remain major concerns, particularly in adolescents and adults, in whom complications are more severe. The role of tonsillar fossa suturing after tonsillectomy in reducing these complications is still controversial. METHODS: We conducted a comprehensive search of PubMed, Embase, and the Cochrane Library for studies comparing tonsillectomy with suturing (TS) versus without suturing (TNS) in patients older than 10 years. RESULTS: Seven studies involving 3051 patients were included. Meta-analysis showed that TS significantly reduced the risk of overall PTH (odds ratio [OR], 0.329; 95% confidence interval [CI], 0.145-0.751), primary PTH (OR, 0.140; 95% CI, 0.036-0.540), secondary PTH (OR, 0.310; 95% CI, 0.174-0.552), and minor PTH (OR, 0.193; 95% CI, 0.086-0.429). No significant difference was observed for major PTH (OR, 0.550; 95% CI, 0.138-2.187). Regarding postoperative pain, a possible delayed difference was observed, with lower pain scores in the TS group on postoperative day 7 (mean difference [MD], - 1.646; 95% CI, - 3.202 to - 0.090), whereas scores on days 1, 2, 3, and 14 were comparable between groups. CONCLUSION: These findings suggest that, in adolescents and adults, TS is associated with a reduced risk of PTH. Pain-related outcomes were exploratory and based on limited data. To our knowledge, this is the first meta-analysis focused on this higher-risk population, providing evidence to inform surgical decision-making.
Conservative management of functional middle ear disorders: a systematic review with narrative synthesis and conceptual clinical framework.
Henderson D, Djian C, Hautefort C … +1 more , Londero A
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223612 · Publisher ↗
OBJECTIVE: To systematically evaluate the efficacy and safety of conservative (non-surgical) interventions for functional middle ear disorders (FMEDs), including tinnitus, auditory tube dysfunction, middle ear myoclonus,...
OBJECTIVE: To systematically evaluate the efficacy and safety of conservative (non-surgical) interventions for functional middle ear disorders (FMEDs), including tinnitus, auditory tube dysfunction, middle ear myoclonus, and related functional auditory syndromes. DATA SOURCES: PubMed/MEDLINE, Scopus, Embase, and Web of Science were searched through June 21, 2025, using PRISMA 2020 guidelines. REVIEW METHODS: Eligible studies included adults or children diagnosed with FMEDs managed with pharmacologic, behavioral, or minimally invasive conservative therapies. Data on study design, interventions, outcomes, and adverse events were extracted. Methodological quality was assessed using the Cochrane RoB-2 tool and the Methodological Index for Non-Randomized Studies (MINORS). RESULTS: Twenty-four studies (n = 986 patients) were included: 3 systematic reviews, 12 prospective, 8 retrospective, and 1 cross-sectional. Tinnitus (n = 11 studies) auditory tube dysfunction (n = 11) were most common, followed by myoclonus (n = 2). Intratympanic steroids and auditory stimulation showed partial or complete tinnitus relief. Nasal saline instillation, paper patching, and topical agents achieved significant improvement in patulous auditory tube. Pharmacologic management of myoclonus (e.g., carbamazepine, clonazepam, baclofen) also yielded symptomatic benefit. Most interventions were well tolerated with minor, transient adverse effects. CONCLUSIONS: Conservative management offers potential symptomatic benefit with generally favorable safety profiles for FMEDs, particularly in pediatric and mild-to-moderate adult cases. FMEDs often present concomitantly and might be pathophysiologically interconnected. Thus, therapies targeting one disorder may confer improvement in others. Structured, stepwise treatment, beginning with education, counseling, and simple topical agents, and progressing to targeted pharmacologic or minimally invasive measures, may be used prior to surgical intervention, although comparative effectiveness per se was not assessed.
Diagnostic utility of audiologic parameters in sudden hearing loss: a multivariable logistic regression study.
Suloglu OF, Yuksel M, Ciprut A
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223611 · Publisher ↗
PURPOSE: Sudden hearing loss (SHL) complaints constitute a substantial proportion of admissions to audiology clinics; however, data on individuals presenting with suspected SHL prior to diagnosis remain limited. This stu...
PURPOSE: Sudden hearing loss (SHL) complaints constitute a substantial proportion of admissions to audiology clinics; however, data on individuals presenting with suspected SHL prior to diagnosis remain limited. This study aimed to describe the audiologic findings and symptoms of adult patients referred to our clinic with suspected SHL. METHODS: Medical records of patients referred with suspected SHL between January 2018 and December 2019 were retrospectively reviewed. A total of 106 participants (108 ears) were included. Participants were classified into four groups based on audiologic findings, and intergroup comparisons were conducted. Logistic regression analysis was used to identify variables most strongly associated with SHL diagnosis. RESULTS: The mean duration of hearing loss complaint was 8.8 days (SD = 8.8), and the mean pure-tone average (PTA) was 31.4 dB HL (SD = 19.9). Two participants (1.9%) had bilateral involvement, and 28.7% met the diagnostic criteria for SHL. The most frequently reported symptoms were tinnitus (63%) and ear fullness (42.6%). Logistic regression analysis indicated that the overall model was statistically significant (p < 0.001). Of all predictors, only the speech discrimination score (SDS) was independently associated with diagnosis (p < 0.05). CONCLUSION: The logistic regression model effectively differentiated individuals with and without SHL. Nearly half of the patients presenting with suspected SHL had normal hearing (45.4%), and 14.8% demonstrated findings consistent with middle ear pathology. These results highlight the substantial clinical burden associated with suspected SHL referrals and suggest that the coexistence of multiple symptoms may complicate the diagnostic process.
Investigation of the kinematics and proprioception in patients with benign paroxysmal positional vertigo compared to healthy controls: a cross-sectional study.
Jabarifard F, Abbasi L, Rezaei I … +2 more , Doosti A, Mohamadi M
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223610 · Publisher ↗
PURPOSE: This study aimed to investigate changes in cervical kinematics and proprioception in patients with history of recurrent idiopathic posterior canal benign paroxysmal positional vertigo (BPPV) compared to healthy...
PURPOSE: This study aimed to investigate changes in cervical kinematics and proprioception in patients with history of recurrent idiopathic posterior canal benign paroxysmal positional vertigo (BPPV) compared to healthy controls. METHOD: This was a cross-sectional study comparing patients with BPPV (cases) to healthy controls that was done at Orthopedic and Rehabilitation Research Center. Twenty-five patients with idiopathic posterior canal BPPV (41.08 ± 8.89 years) and 27 age-matched healthy controls (37.37 ± 7.31 years). Posterior canal BPPV confirmed by Dix-Hallpike maneuver, in subjects who last more than two weeks since the last of their vertigo episode, with Tampa Scale for Kinesiophobia (TSK) score < 37. Cervical kinematics (range of motion) were measured using synchronized electrogoniometer systems, while proprioception was assessed via laser-based joint position error testing. Data were analyzed using independent t-tests (normal distribution) and Mann-Whitney U tests (non-parametric data), with significance at p < 0.05. RESULTS: Twenty-five BPPV patients and 27 controls completed the study. BPPV patients had significantly lower maximum neck extension (28.32°±19.44° vs. 46.52°±23.05°, p = 0.004), flexion (21.01°±7.9° vs. 30.05°±9.12°, p < 0.0001), lateral bending to left (22.62°±6.27° vs. 32.22°±10.6°, p < 0.0001) and right (23.36°±8.31° vs. 29.66°±10.55°, p = 0.023). No significant differences were observed in rotation ROM (p > 0.05). Joint position error was significantly higher in the BPPV group for all directions (flexion, extension, right/left rotation; p < 0.0001).Furthermore, peak movement velocity was reduced in the BPPV group in the sagittal (16 ± 8 deg/s vs. 26 ± 11 deg/s, p < 0.0001) and frontal planes (17 ± 6 deg/s vs. 24 ± 7 deg/s, p = 0.001). CONCLUSION: It seems that patients with BPPV would have greater kinematic and proprioceptive deficits. These findings highlight a significant association between cervical musculoskeletal dysfunction and BPPV. The cross-sectional nature of this study cannot determine causality; therefore, future longitudinal or cohort studies are essential to investigate the temporal and potential causative relationship between these variables.
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