European Archives Of Oto-rhino-laryngology[JOURNAL]
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200 papers
Modeling residual cholesteatoma growth rate: a meta-analysis of individual participant data.
Körmendy B, Kálmán J, Illés K … +6 more , Fehérvári P, Wenning AS, Nagy R, Hegyi P, Simon F, Horváth T
Eur Arch Otorhinolaryngol · 2026 Jun · PMID 42223609 · Publisher ↗
PURPOSE: To create a model of residual cholesteatoma growth rate that can be used to estimate optimal timing of follow-up imaging. METHODS: Following the recommendations of the PRISMA-IPD guideline and after registering...
PURPOSE: To create a model of residual cholesteatoma growth rate that can be used to estimate optimal timing of follow-up imaging. METHODS: Following the recommendations of the PRISMA-IPD guideline and after registering our study protocol on PROSPERO (CRD42023465320), a systematic search was completed in September 2023 and updated in July 2024, conducted in PubMed, Web of Science, Embase, and Cochrane Library. Reference lists of the resulting articles were also searched for potential inclusions. Our search yielded 11,274 articles. Studies with patients of any age and sex diagnosed with residual cholesteatoma were included if data on cholesteatoma size at follow-up were available, collected from imaging results or through second-stage surgery. For statistical analysis, a Monte Carlo simulation approach was applied, and a baseline random-intercept mixed-effects model was fitted. RESULTS: We included 11 articles reporting individual data from 163 patients. All but one of these articles proved to be high risk of bias. Our simulation models suggest that 95% of cholesteatomas reach or grow past the size of 3 millimetres (threshold for imaging) after 28-35 months and 95% of reach or grow past the size of 5 millimetres (threshold for intraoperative identification) after 47-58 months. CONCLUSION: Analyzing previously published data suggests that residual cholesteatoma may only be radiologically detectable on non-EPI DWI MRI after 28-35 months postoperatively in 95% of patients, indicating delayed follow-up for average risk patients compared to current clinical practice. However, this simulation model, based on retrospective data, aims to uncover growth patterns rather than posing as a new guideline.
Speech and swallowing outcomes with infrahyoid myo cutaneous flap after compartmental tongue resection: a prospective observational study.
Kumar R, Sood R, Singh A … +6 more , Kumar R, Sagar P, Manchanda S, Singh CA, Bhalla AS, Thakar A
Eur Arch Otorhinolaryngol · 2026 May · PMID 42218322 · Publisher ↗
OBJECTIVES: Compartmental glossectomy has emerged as an oncologically sound approach for tongue carcinoma; however, it is often associated with the need for reconstruction due to the resulting floor-of-mouth defect. This...
OBJECTIVES: Compartmental glossectomy has emerged as an oncologically sound approach for tongue carcinoma; however, it is often associated with the need for reconstruction due to the resulting floor-of-mouth defect. This prospective study focuses on reconstruction, including its surgical and functional outcomes for speech and swallowing, using the Infra Hyoid Myocutaneous Flap (IHMCF) after compartmental resection for tongue squamous cell carcinoma. METHODS: A total of 36 patients with histologically proven squamous cell carcinoma of the lateralized tongue were enrolled during the study period from January 2021 to November 2022. Patients undergoing conventional compartmental resections were included in the study. The male-to-female ratio was 5:1, and the median age of the cohort was 43.5 years. The T-stage distribution for the study population was: T2-18; T3-16; and T4a - 2. Outcomes were assessed objectively using cine fluoroscopy for swallowing and subjectively for speech. The flap outcomes were evaluated for survival, partial necrosis, and complete necrosis. Partial necrosis was termed for superficial epithelial necrosis with preserved underlying muscle. RESULTS: Complete flap survival was seen in 83.3% cases (N = 30/36). Partial or complete flap loss was noted in 11.1% (n = 4/36) and 5.6% (n = 2/36), respectively. The cumulative flap survival in this study group was 94.4%. All patients could be started on oral feeds at an average of 3 weeks postoperatively (range 2 to 4.5 weeks). Cine fluoroscopy was used to evaluate swallowing, yielding acceptable results. Speech was comprehensible for all the patients and correlated with the extent of resection. CONCLUSION: Infrahyoid Myocutaneous flap is a viable option for tongue reconstruction after compartmental glossectomy with acceptable speech and swallowing outcomes.
Prevalence of Central Compartment Atopic Disease (CCAD): a systematic review and meta-analysis.
Falcon RMG, Diarota MA, Gammad RIT … +7 more , Grindulo RAD, Mata GAP, Porras CB, Remucal MJR, Wakit CFT, Nelson KMO, Cruz TLG
Eur Arch Otorhinolaryngol · 2026 May · PMID 42215785 · Publisher ↗
BACKGROUND: Central compartment atopic disease (CCAD) is a subtype of chronic rhinosinusitis characterized by polypoid edema and mucosal changes localized to the central sinonasal compartment, particularly the middle tur...
BACKGROUND: Central compartment atopic disease (CCAD) is a subtype of chronic rhinosinusitis characterized by polypoid edema and mucosal changes localized to the central sinonasal compartment, particularly the middle turbinate, superior turbinate, and posterosuperior nasal septum, in association with inhalant allergy. Despite increasing recognition, its epidemiologic burden remains poorly defined. METHODS: All studies reporting the proportion of CCAD among CRS were extracted from OVID Medline, Scopus, and EBSCO CINAHL. A review of title and abstracts was done independently by seven reviewers. The quality of the studies was assessed using the Newcastle-Ottawa scale. Meta-analysis was performed using R v.4.1.1, using the 'meta', 'tidyverse', and 'metafor' packages (version 4.19-0). RESULTS: Seven studies from the United States and Asia were included in the study. The pooled proportion of CCAD was 23.0% (95% CI 15.0%-33.0%). Subgroup analyses suggested variability by region being higher in Asia and sex, showing higher prevalence in males; however, these analyses were exploratory in nature and intended to identify potential sources of heterogeneity rather than establish definitive subgroup differences. CONCLUSION: CCAD represents a substantial proportion of chronic rhinosinusitis with nasal polyps (CRSwNP) cases globally, though estimates are limited by marked heterogeneity and inconsistent diagnostic criteria. Standardized case definitions and wider geographic surveillance are essential to better characterize the global burden and phenotypic diversity of CCAD.
Prevalence and risk factors of voice disorders among tour guides in Cappadocia.
Birol NY, Yaşar Gündüz E, Alkan F … +1 more , Tutuş Z
Eur Arch Otorhinolaryngol · 2026 May · PMID 42209812 · Publisher ↗
PURPOSE: This study aimed to determine the prevalence and risk factors of voice disorders among professional tour guides working in the Cappadocia region of Türkiye, a globally renowned tourism destination with high tour...
PURPOSE: This study aimed to determine the prevalence and risk factors of voice disorders among professional tour guides working in the Cappadocia region of Türkiye, a globally renowned tourism destination with high tourist density. METHODS: A cross-sectional quantitative design was employed. Eighty-five licensed tour guides (41 females, 44 males; mean age = 42.9 ± 12.2 years) participated by completing an online self-report questionnaire developed for the Cappadocia context. The 61-item survey assessed demographics, vocal symptoms, phonotraumatic behaviors, occupational, lifestyle, and health-related risk factors. Descriptive statistics, chi-square tests, and logistic regression analyses were conducted using SPSS 27. RESULTS: Voice problems were reported by 42.4% of guides during their careers (95% CI: 32.4-53.0) and 16.5% currently (95% CI: 10.1-25.8), while 23.5% experienced aphonia at least once annually (95% CI: 15.8-33.6). The most prevalent symptoms were throat dryness (77.6%), vocal fatigue (65.9%), and hoarseness (56.5%). Speaking loudly and continuing to talk despite voice problems were significantly associated with vocal complaints (p = .039 and p < .001, respectively). Environmental and health factors, including guiding noisy groups, long tour durations, and ear-nose-throat (ENT)-related conditions (sinus and other ENT disorders), increased the likelihood of voice problems. Logistic regression identified ENT disorders as an independent predictor (adjusted odds ratio [aOR] = 6.12, 95% CI: 1.33-28.17, p = .020). CONCLUSION: Voice disorders are common among Cappadocia tour guides and are associated with both occupational and health-related factors. These findings suggest that implementing voice hygiene education, ergonomic adaptations, and occupational health monitoring may help reduce risk and support vocal sustainability in this professional group.
Local inflammation as a determinant of recurrence in CRSwNP: the clinical value of nasal cytology.
Gelardi M
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165891 · Publisher ↗
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Correction: Does the cricoid resection increase the risk of complications in the surgical treatment of benign laryngotracheal stenoses?
Jović R, Samac Tovilović K, Dragičević D … +3 more , Tovilović V, Sivčev I, Bogdanović M
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165890 · Publisher ↗
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High sulfur and nitrogen foods are the main triggers of parosmia.
de Moura Volpi L, Hirata ET, Medina LHC … +3 more , Sant'Ana JP, de Siqueira BF, Miyake MM
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165889 · Publisher ↗
PURPOSE: Parosmia is a condition associated with a significant impact on quality of life. Although its pathophysiology remains poorly understood, certain aromas and fragrances are frequently reported as triggers. This st...
PURPOSE: Parosmia is a condition associated with a significant impact on quality of life. Although its pathophysiology remains poorly understood, certain aromas and fragrances are frequently reported as triggers. This study aimed to identify the primary triggers of parosmia and analyze their molecular similarities. METHODS: This cross-sectional study included individuals with current complaints of parosmia. Data were prospectively collected via an online survey that assessed the most commonly reported triggers and associated perceptions. A perfumer analyzed the molecular characteristics of these substances. RESULTS: A total of 102 individuals with parosmia were included. The most frequently reported triggers were onion (68%), garlic (62.9%), coffee (49.5%), and beef (48.5%). These substances share sulfur-containing, nitrogenous, and thioester components, characterized by high olfactory potency and sensory notes described as "rotten," "sulfurous," and "roasted/burnt." The most associated perceptions were sewage (71%) and burnt (37.6%). CONCLUSION: The primary triggers of parosmia appear to share significant molecular similarities. This knowledge may contribute to a better understanding of the pathophysiology of parosmia and serve as a preliminary step toward developing new therapeutic approaches for this disorder.
Efficacy of tezepelumab in chronic rhinosinusitis with nasal polyps: a systematic review and meta-analysis.
Kim DH, Jang DW, Hwang SH
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165888 · Publisher ↗
PURPOSE: To evaluate the efficacy of tezepelumab as an adjunctive treatment in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: PubMed, SCOPUS, Embase, Web of Science, and the Cochrane Library we...
PURPOSE: To evaluate the efficacy of tezepelumab as an adjunctive treatment in patients with chronic rhinosinusitis with nasal polyps (CRSwNP). METHODS: PubMed, SCOPUS, Embase, Web of Science, and the Cochrane Library were systematically searched from database inception through January 2026. Eligible studies compared tezepelumab with placebo or reported pre-post treatment outcomes in tezepelumab-treated cohorts. Outcomes included nasal and olfactory symptom measures (nasal congestion, nasal polyp score, olfactory testing, olfactory-related symptoms, and the Sino-Nasal Outcome Test-22 [SNOT-22]), asthma-related measures (pre-bronchodilator forced expiratory volume in 1 s [FEV] and the Asthma Control Questionnaire [ACQ]-6), and treatment-related adverse events. RESULTS: Four studies involving 702 participants met the inclusion criteria. Pre-post analyses demonstrated significant improvements following tezepelumab treatment in nasal congestion (mean difference [MD] 1.6859, 95% confidence interval [CI] [1.3882; 1.9836]), olfactory function (standardized mean difference [SMD] - 1.17, 95% CI - 1.39 to - 0.95), SNOT-22 scores (MD 28.6091, 95% CI [15.9241; 41.2940]), and asthma control (ACQ SMD 1.06, 95% CI 0.54-1.57). Both the asthma with nasal polyps and CRSwNP subgroups exhibited consistent symptom improvement. Changes in FEV were modest and did not reach statistical significance. CONCLUSION: Tezepelumab was associated with significant improvements in rhinologic and asthma-related outcomes in patients with CRSwNP. Larger, well-designed randomized controlled trials are warranted to confirm these findings and to define more accurately the long-term therapeutic role of tezepelumab in this population.
Botulinum toxin for vocal fold granuloma: a systematic review and meta-analysis of treatment outcomes and recurrence.
Aljohani IM, Al-Juaid EM, Abualjamal RY … +6 more , Baali MH, Alotaibi NA, Manzoor A, Ababtain RM, Alzyadi SM, Almalki ZA
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165887 · Publisher ↗
PURPOSE: To synthesize outcomes after botulinum toxin A (BTX-A) injection for vocal process granuloma (VPG), including remission, recurrence, time to resolution, and safety. METHODS: We pooled 18 studies (n = 1,146 patie...
PURPOSE: To synthesize outcomes after botulinum toxin A (BTX-A) injection for vocal process granuloma (VPG), including remission, recurrence, time to resolution, and safety. METHODS: We pooled 18 studies (n = 1,146 patients; 298 received BTX‑A) reporting clinical outcomes after BTX‑A injection for VPG. Random‑effects meta‑analysis produced pooled event rates with 95% confidence intervals; prespecified subgroup analyses compared primary versus refractory contact granulomas (CG) and intubation‑related granulomas (IG). RESULTS: Overall pooled complete remission after BTX‑A was 87.6% (95% CI 82.6-92.9%); most remissions occurred within 1-3 months. Subgroup pooled complete remission rates were 87.4% (95% CI 81.3-93.9%) for refractory CG, 91.1% (95% CI 79.8-103.9%) for primary CG, and 70.2% (95% CI 57.1-107.2%) for intubation‑related granulomas. Overall pooled Recurrence after initial remission was 6.9% (95% CI 3.1-15.5%); subgroup recurrence estimates were 9.4% for refractory CG, 5.7% for primary CG, and 19.8% for refractory IG. Pooled adverse‑event rates included hoarseness 9.1%, aspiration/choking 29.1%, and breathiness/dysphagia 29.4%; most events resolved within weeks to a few months. Objective voice‑quality measures were infrequently reported. CONCLUSION: BTX‑A injection achieves high short-term remission and low Recurrence in VPG, with mostly transient side effects. It shows good durability in contact granulomas but less so in intubation-related lesions. More randomized studies with validated voice outcomes are needed to determine optimal dosing and long-term effectiveness.
Vestibular deficit and recovery in rare forms of benign paroxysmal positional vertigo with downbeat nystagmus.
Ertugrul G, Califano L, Viola P … +6 more , Melillo MG, Astorina A, Petrolo C, Laria C, Fetoni AR, Chiarella G
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165886 · Publisher ↗
PURPOSE: The primary goals are to investigate the rate of vestibular deficit (VD) during the acute attack and to follow up on vestibular recovery (VR) after the resolution of BPPV in patients with rare forms of BPPV that...
PURPOSE: The primary goals are to investigate the rate of vestibular deficit (VD) during the acute attack and to follow up on vestibular recovery (VR) after the resolution of BPPV in patients with rare forms of BPPV that cause downbeat nystagmus. Second, to determine the effects of VD on dizziness severity in patients with rare BPPV forms and to compare all the results with those of typical posterior canal BPPV. METHODS: This prospective follow-up study included 23 patients (56.86 ± 12.21 years) with rare BPPV forms (5 anterior canal, 18 apogeotropic posterior canal) and 23 patients (50.75 ± 13.67 years) with typical posterior canal BPPV. Dix-Hallpike, McClure-Pagnini, Semont, and supine head-hanging diagnostic maneuvers were performed on all patients during the acute BPPV attack. All patients underwent an objective (vHIT and oVEMP) and subjective vestibular test (DHI) battery before the therapeutic maneuvers (Epley, Quick Liberatory Rotation, or Yacovino maneuvers). One month after complete resolution of BPPV, all vestibular evaluations were performed once again in both groups. RESULTS: In patients with rare forms of BPPV, 30.43% had canal deficit and 43.38% had utricular deficit on the affected side during an acute BPPV attack (p = 0.009, p = 0.001), whereas no patients in the typical BPPV group had vestibular deficit (0%). One month after BPPV resolution, the canal deficit of 26.09% and the utricular deficit of 34.78% had completely recovered in the rare forms of BPPV group. The rare BPPV forms group reported experiencing a higher level of dizziness during the acute attack and more residual dizziness one month after resolution, compared to the typical BPPV group, despite the fact that there are no statistically significant differences in dizziness levels between the groups (p > 0.05). CONCLUSION: It is possible that a VD may be seen in some patients with rare forms of BPPV and may not fully recover. It should be kept in mind that rare forms of BPPV may cause persistent VD in some patients, even if BPPV is resolved. The patients with both rare forms of BPPV (much more) and typical BPPV forms may describe residual dizziness after the resolution of BPPV. Additionally, canal deficit is a significant predictor of dizziness severity in all patients with BPPV.
Subjective-objective health literacy discrepancy, reduced healthcare utilization, and functional limitations associated with hearing loss.
Lee HG, Seo HW, Chung JH … +2 more , Lee SH, Han SY
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165885 · Publisher ↗
PURPOSE: Hearing loss is associated with various functional outcomes. However, its relationship with health literacy and healthcare utilization remains unclear. This study aimed to evaluate the associations of hearing lo...
PURPOSE: Hearing loss is associated with various functional outcomes. However, its relationship with health literacy and healthcare utilization remains unclear. This study aimed to evaluate the associations of hearing loss with health literacy and healthcare utilization. METHODS: Data from 3,013 adults were obtained from the Ninth Korea National Health and Nutrition Examination Survey (2023). Hearing status was classified as normal hearing (≤ 25 dB), mild hearing loss (> 25 to ≤ 40 dB), or moderate or worse hearing loss (> 40 dB). Subjective health literacy was assessed using a 10-item questionnaire, whereas objective health literacy was evaluated with a performance-based item. Healthcare utilization was assessed through participation in national health and cancer screening programs, and functional status was evaluated via self-reported activity limitations. Multivariable analyses were performed with adjustment for covariates. RESULTS: Hearing thresholds were not associated with low subjective health literacy. However, worse hearing thresholds were significantly associated with inadequate objective health literacy (p = 0.001), nonparticipation in general health screening (p = 0.001) and cancer screening (p = 0.004), and restrictions in daily and social activities (p = 0.046) in multivariable analyses. Sensitivity analyses confirmed the robustness of these associations, and the discrepancy between subjective and objective health literacy increased with hearing loss severity (both p < 0.05). CONCLUSION: Hearing loss was associated with measurable deficits in objective health literacy and reduced preventive screening participation, and functional limitations. However, individuals with hearing loss perceived their health literacy to be intact. Considering these discrepancies, tailored, multimodal communication is needed to enhance healthcare engagement.
Slide tracheoplasty versus tracheal resection anastomosis for acquired laryngotracheal stenosis: a prospective randomized controlled trial.
Abdou EH, Elkahwagi M, Elsobki AA … +1 more , Elshaer M
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165884 · Publisher ↗
BACKGROUND: Tracheal resection with end-to-end anastomosis remains the standard surgical treatment for acquired high-grade laryngotracheal stenosis. Slide tracheoplasty has emerged as an alternative reconstructive techni...
BACKGROUND: Tracheal resection with end-to-end anastomosis remains the standard surgical treatment for acquired high-grade laryngotracheal stenosis. Slide tracheoplasty has emerged as an alternative reconstructive technique that enlarges airway caliber while preserving tracheal length and vascularity, yet direct comparative evidence in acquired stenosis is limited. OBJECTIVE: To compare the clinical, surgical, and functional outcomes of slide tracheoplasty versus tracheal resection with end-to-end anastomosis in patients with acquired laryngotracheal stenosis. METHODS: In this prospective pilot randomized controlled trial, 30 patients with grade II-IV acquired tracheal stenosis were allocated 1:1 to slide tracheoplasty (n = 15) or tracheal resection with end-to-end anastomosis (n = 15). Randomization was performed using a computer-generated sequence with variable block sizes, and baseline characteristics were assessed for group comparability. The primary outcome was surgery-specific success, defined as successful decannulation without need for revision open surgery within 6 months. Secondary outcomes included operative time, decannulation time, complications, restenosis, postoperative interventions, hospital stay, dyspnea (MRC scale), voice quality (VHI-10), and swallowing function (GUSS, PAS). Analyses followed the intention-to-treat principle. RESULTS: A total of 30 patients were randomized and completed follow-up. Baseline characteristics were comparable between groups. Surgery-specific success was high in both arms (slide 93.3% vs resection 86.7%; RR 1.08, 95% CI 0.85-1.37; p > 0.99). Slide tracheoplasty required longer operative time (152.3 ± 15.7 vs 134.0 ± 17.5 min; p = 0.005) but resulted in earlier decannulation (12.3 ± 3.2 vs 16.3 ± 5.0 days; p = 0.013) and fewer postoperative balloon dilatations (13.3% vs 40%). Hospital stay and overall complication rates were similar. Both procedures significantly improved dyspnea and voice outcomes; however, postoperative MRC and VHI-10 scores favored slide tracheoplasty (p < 0.05). Early postoperative swallowing impairment occurred more frequently after resection, with full recovery in both groups by one month. No mortality occurred. CONCLUSIONS: In this pilot randomized controlled trial, both slide tracheoplasty and tracheal resection with end-to-end anastomosis were associated with high success rates and acceptable safety profiles in acquired laryngotracheal stenosis. Slide tracheoplasty demonstrated comparable success and was associated with earlier decannulation and a trend toward improved short-term functional recovery; however, findings should be interpreted cautiously given the exploratory nature of the study. Larger multicenter trials are required to confirm these preliminary observations. TRIAL REGISTRATION: Clinical Trials.gov (NCT06917222).
Frequency of electrode migration and other device-related complications in a large single-center cochlear implant cohort.
van de Loo J, Lang-Roth R, Müller V … +7 more , Kurzawa M, Mayer M, Sharaf K, Jansen L, Kourou S, Klussmann JP, Lüers JC
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165883 · Publisher ↗
BACKGROUND: Electrode migration and magnet dislocation are uncommon but clinically relevant complications following cochlear implant (CI) surgery. Most previously published studies are limited by small sample sizes, rest...
BACKGROUND: Electrode migration and magnet dislocation are uncommon but clinically relevant complications following cochlear implant (CI) surgery. Most previously published studies are limited by small sample sizes, restricting the ability to precisely estimate incidence rates and risk factors. OBJECTIVE: To determine the frequency, mechanisms, and clinical correlates of rare CI complications in one of the largest contemporary single-center CI cohorts. METHODS: This retrospective study analyzed 1,035 CI surgeries performed between 2015 and 2025 at a tertiary referral center. Clinical, demographic, surgical, and audiologic data were extracted from institutional databases. Electrode migration was confirmed via imaging and surgical exploration. RESULTS: Electrode migration occurred in 16 cases (1.55%). Affected patients were significantly older than the remaining cohort (56.4 ± 17.7 vs. 37.1 ± 27.7 years, p = 0.005). Time to diagnosis ranged from 1 week to 14 years following CI surgery. Magnet dislocation occurred in seven patients (0.68%), exclusively following MRI exposure. An exchange of an implant with consecutive electrode re-insertion for other causes was required in 53 patients (5.1%), predominantly due to device failure (77.4%). Almost exclusively straight electrodes were used in our cohort (95.5%). CONCLUSION: In this large CI cohort, electrode migration was rare but more frequent in older adults. Our findings highlight the need for standardized surgical anchoring techniques, structured postoperative surveillance, and future research on biomechanical risk factors to improve CI safety and long-term outcomes.
Predictors of multidisciplinary tumor board implementation in head and neck cancer: Global insights.
Maniaci A, Lechien JR, Chiesa-Estomba C … +13 more , Maso V, Kabagenyi F, Gengler I, Fagan JJ, Hao SP, Kowalski LP, Lyons B, Razif MYM, Marzouki HZ, Parisi FM, White M, Michel J, Fakhry N
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165882 · Publisher ↗
OBJECTIVE: To identify institutional and organizational determinants associated with the adoption of multidisciplinary tumor boards (MDTBs) in head and neck cancer management across diverse healthcare settings. METHODS:...
OBJECTIVE: To identify institutional and organizational determinants associated with the adoption of multidisciplinary tumor boards (MDTBs) in head and neck cancer management across diverse healthcare settings. METHODS: This cross-sectional analysis used data from 566 responses, corresponding to 457 unique centers across 101 countries participating in the IFOS-YO-IFOS global survey. Centers were categorized by income level, region, and case volume. Logistic regression identified predictors of systematic MDTB use. RESULTS: Among responding centers, MDTBs were systematic in 89.1% of North America, 88.9% of European and 87.5% of Oceanian centers, compared with 37.5% in Africa and 32.6% in MENA. High annual case volume (> 200 cases/year) (OR = 3.4, p < 0.001), university affiliation (OR = 2.7, p = 0.002), and access to intensity-modulated radiotherapy (OR = 2.1, p = 0.01) independently predicted full MDTB integration. Centers citing economic barriers showed a 65% reduction in odds of MDTB implementation. CONCLUSIONS: Our findings suggest that multidisciplinary management in head and neck oncology is strongly influenced by institutional resources and organizational models rather than geography alone. Strengthening MDTB frameworks in low- and middle-income regions could substantially narrow global care inequities.
Regenerating smell in neurodegenerative disease -translating theory into therapy.
Di Stadio A, Brenner MJ, De Luca P … +2 more , D'Ascanio L, Patel ZM
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165881 · Publisher ↗
PURPOSE: Quantitative and qualitative olfactory dysfunction are one of the earliest and most prevalent symptoms across neurodegenerative diseases, notably Parkinson's and Alzheimer's disease. These pathologies may spread...
PURPOSE: Quantitative and qualitative olfactory dysfunction are one of the earliest and most prevalent symptoms across neurodegenerative diseases, notably Parkinson's and Alzheimer's disease. These pathologies may spread bidirectionally between the peripheral olfactory system and central brain regions, supporting a model in which the olfactory system represents both an early marker and a conduit for disease propagation. This short communication aims to investigate the potential of Platelet Rich Plasma (PRP) to treat smell alteration in the neurodegenerative diseases. METHOD: We conducted a review of the literature to extract articles that discussed PRP use in the context of olfactory disorders. RESULTS: 12 studies were identified; 7 studies on COVID-19, 2 on unspecific smell loss, 1 on traumatic anosmia, 1 on nasal polyposis and 1 illustrated the use of PRP in long-term persistent anosmia (> 25 years). CONCLUSION: Post COVID-19 olfactory impairment has provided insights into mechanisms of smell loss and therapeutic strategies. While olfactory training remains the best studied intervention, its benefits are modest, inconsistent, and often limited in cases with central nervous system involvement. PRP has emerged as a promising candidate due to its growth factors and immunomodulatory properties. Preclinical studies demonstrate that intranasal PRP can enhance neurogenesis, reduce neuroinflammation, and improve olfactory and cognitive outcomes in animal models of Parkinson's and Alzheimer's disease. Early clinical observations also suggest potential benefit in longstanding anosmia of diverse etiologies. Future research should define optimal delivery routes, dosing, and long-term efficacy, with well-designed clinical trials needed to translate these experimental findings into therapeutic applications.
Subclinical hearing loss in women with polycystic ovary syndrome: a case-control study using extended high-frequency audiometry.
Tahir E, Küçüköner A, Çoban U
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165880 · Publisher ↗
OBJECTIVE: To determine whether women with polycystic ovary syndrome (PCOS) exhibit hearing loss and if so, to identify the specific frequencies involved using extended high-frequency audiometry. METHODS: This single-cen...
OBJECTIVE: To determine whether women with polycystic ovary syndrome (PCOS) exhibit hearing loss and if so, to identify the specific frequencies involved using extended high-frequency audiometry. METHODS: This single-centre, prospective, cross-sectional case-control study included 39 women with PCOS (diagnosed according to the Rotterdam criteria) and 39 age-matched controls. All participants underwent otoscopic examination, tympanometry, conventional pure-tone audiometry (250-8,000 Hz), and extended high-frequency audiometry (up to 12,500 Hz). Speech reception thresholds (SRT) and speech discrimination (SD) scores were also tested. RESULTS: No statistically significant between-group differences were detected at 1,000-8,000 Hz. Women with PCOS demonstrated significantly elevated thresholds at 250 Hz and 500 Hz in both ears (p < 0.05), and at 11,200 Hz (right: p = 0.004; left: p < 0.001) and 12,500 Hz (left: p = 0.008). SRT was significantly higher in the PCOS group in the right and left ears. (p = 0.020 and p = 0.002 respectively). Speech discrimination scores were significantly lower in the PCOS group bilaterally (right: p = 0.036; left: p = 0.005). CONCLUSION: Women with PCOS exhibit detectable but subclinical alterations in extended high-frequency hearing and speech performance despite normal conventional audiometric thresholds. The frequency-specific pattern of threshold elevation is consistent with cochlear involvement potentially mediated by metabolic, inflammatory, and hyperandrogenic mechanisms. Extended high-frequency audiometry may serve as a sensitive tool for detecting early auditory dysfunction in women with PCOS.
Basal cell adenocarcinoma of the parotid gland: prognostic factors and survival outcomes: a systematic review and pooled patient-level analysis.
Chiari F, Dalmazzini C, Fermi M … +3 more , Presutti L, Caporale CD, Guarino P
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165879 · Publisher ↗
BACKGROUND: Basal cell adenocarcinoma (BCAC) of the parotid gland is a rare low-grade malignancy with generally favorable prognosis but potential for late recurrence. This systematic review aimed to evaluate survival out...
BACKGROUND: Basal cell adenocarcinoma (BCAC) of the parotid gland is a rare low-grade malignancy with generally favorable prognosis but potential for late recurrence. This systematic review aimed to evaluate survival outcomes and prognostic factors in patients with parotid BCAC. METHODS: A PRISMA-compliant systematic review was conducted using Embase, PubMed, Scopus, and Cochrane Library (1990-2025). Case reports and case series providing individual patient data were included. A pooled patient-level analysis assessed local, regional, and distant disease control, as well as disease-free (DFS), disease-specific (DSS), and overall survival (OS). RESULTS: Twenty-three studies including 68 patients were analyzed. The mean age at diagnosis was 58.6 years. The 5-year DFS, DSS, and OS were 84.1%, 92.7%, and 88.3%, respectively. Overall recurrence occurred in 31% of cases, mainly at the primary site. The absence of adjuvant therapy and perineural invasion were significantly associated with reduced DFS. Positive surgical margins were associated with worse DSS, while facial nerve palsy at presentation associated with decreased OS. Advanced tumor stage showed a trend toward poorer outcomes. Late recurrences and distant metastases have been reported in the literature beyond 5 years of follow-up. CONCLUSIONS: Parotid BCAC generally demonstrates favorable survival; however, adverse pathological features negatively impact prognosis. Adjuvant radiotherapy may improve outcomes in high-risk patients. Prolonged follow-up beyond the conventional 5-year period may be considered, particularly in high-risk patients.
Voice over time: long-term effects of therapy in muscle tension dysphonia with a 24-month follow-up.
Altan E, Barmak E, Söylemez D
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165878 · Publisher ↗
OBJECTIVE: Muscle tension dysphonia (MTD) is the most common functional voice disorder worldwide, yet evidence on the long-term effectiveness of voice therapy remains scarce. This study aimed to evaluate the sustainabili...
OBJECTIVE: Muscle tension dysphonia (MTD) is the most common functional voice disorder worldwide, yet evidence on the long-term effectiveness of voice therapy remains scarce. This study aimed to evaluate the sustainability of therapeutic outcomes in patients with MTD over a treatment-free period of at least 24 months. METHODS: Fifty-five participants were included: 25 patients with MTD and 30 healthy controls. All patients with MTD underwent an eight-week structured voice therapy program consisting of vocal hygiene education, relaxation techniques, resonant voice therapy, and laryngeal manual therapy. Assessments included videolaryngoscopic examination, acoustic analysis (F0, jitter, shimmer, NHR, VTI, SPI), and self-reported measures (Voice Handicap Index-10, Vocal Tract Discomfort Scale). Evaluations were conducted pre-therapy, post-therapy, and at least 24 months after treatment completion. Statistical analyses were performed using independent samples t-tests, Mann-Whitney U, Wilcoxon signed ranks, and chi-square tests. RESULTS: At baseline, patients with MTD reported significantly higher VHI and VTDS scores compared to controls (p < 0.001), although acoustic parameters showed no significant differences. Following therapy, significant improvements were observed in jitter, shimmer, NHR, VTI, and all self-reported outcomes (p < 0.05). At the 24-month follow-up, most therapeutic gains were maintained, with no significant deterioration in acoustic parameters and sustained reductions in VHI and VTDS scores compared to baseline (p < 0.001). A subgroup of seven patients demonstrated resistance to therapy, with limited improvement in both early and long-term follow-up. CONCLUSION: Voice therapy yields significant and durable improvements in both acoustic and self-reported outcomes in MTD, with benefits sustained for at least 24 months after treatment. Early recognition of resistant cases is critical, as these individuals may require booster sessions or adjunctive therapeutic approaches.
Cochlear symptoms and MRI findings in vestibular migraine: a narrative review.
Cangiano I, Del Poggio A, Nobile A … +3 more , Latorre C, Gioffrè V, Teggi R
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165877 · Publisher ↗
PURPOSE: Menière's disease (MD) and vestibular migraine (VM) are two of the most common episodic vertigos. Both are diagnosed by clinical history, manifestations and for MD a typical pattern of hearing loss audiometrical...
PURPOSE: Menière's disease (MD) and vestibular migraine (VM) are two of the most common episodic vertigos. Both are diagnosed by clinical history, manifestations and for MD a typical pattern of hearing loss audiometrically confirmed is needed. The description of concomitant cochlear symptoms during acute VM attacks makes the differential diagnosis between the two conditions challenging. The aim of this study was to assess if the presence of cochlear symptoms withing vertigo attacks always address towards MD or if they may also be found in definite VM. METHODS: We performed a narrative review of the most recent literature on cochlear symptoms in probable and definite VM. RESULTS: Hearing loss is variably reported in the range from 5.9% to 46.7% of VM patients. Concomitant or interictal tinnitus between acute episodes of VM have been reported in the range 17.8% to 69% as well as for ear fullness (10.9% to 51%). Migraineurs more often show a deterioration of the hearing level, and mild and symmetrical hearing loss at high frequencies is a common finding, without or with only minor progression over time. Tinnitus and ear fullness do not have a standard presentation and both can be present as accompanying symptoms of an acute VM episode or during the interictal phase. CONCLUSION: Hearing loss, tinnitus, and aural fullness are common accompanying features of VM but do not reflect precise patterns and can occur in a variable manner. Episodic vertigo associated with cochlear symptoms does not necessarily suggest MD, and VM should also be taken into consideration.
The mediating role of healthy lifestyle in the association between higher socioeconomic status and an increased risk of allergic rhinitis: an analysis of NHANES.
Chen J, Lai Z, Wu J … +1 more , Chen W
Eur Arch Otorhinolaryngol · 2026 May · PMID 42165876 · Publisher ↗
BACKGROUND: The association between socioeconomic status (SES) and allergic rhinitis (AR) remains inconsistent, and the role of healthy lifestyle in mediating or modifying this relationship is not well characterized. MET...
BACKGROUND: The association between socioeconomic status (SES) and allergic rhinitis (AR) remains inconsistent, and the role of healthy lifestyle in mediating or modifying this relationship is not well characterized. METHODS: This cross-sectional study analyzed NHANES data from 3,463 U.S. adults collected in 2005-2006. Latent class analysis using education, PIR, occupation, health insurance, and marital status assessed SES. Healthy lifestyle scores were derived from smoking, drinking, physical activity, and diet. Associations were examined using logistic regression, interaction analysis, and mediation analysis. RESULTS: Among 3,463 participants, 616 had AR, yielding an approximate prevalence of 17.8%. After adjusting for covariates as well as lifestyle scores or SES, individuals with high socioeconomic status (SES) (OR: 1.323, 95% CI: 1.074-1.632) and those with 3 or 4 healthy lifestyle factors (OR: 1.396, 95% CI: 1.082-1.811) showed a higher risk of AR. No interaction was observed. The highest risk was observed among individuals with both high SES and 3-4 healthy lifestyle factors, compared to those with medium SES and 0-1 healthy lifestyle behavior. A healthy lifestyle statistically accounted for the association between SES and AR, explaining 28.57% of the total effect. This mediating role remained significant among subgroups including individuals aged under 47 years, males, Non-Hispanic whites, and those with comorbidities. CONCLUSIONS: Our findings indicated that higher SES and higher healthy lifestyle scores were both positively associated with the risk of AR, and that a healthy lifestyle statistically explained the observed the association between SES and AR.
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