The Annals Of Otology, Rhinology, And Laryngology[JOURNAL]
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200 papers
Safety of Topical Epinephrine Compared with Oxymetazoline in Pediatric Functional Endoscopic Sinus Surgery: A Retrospective Cohort Study.
Quinn N, Schafer A, McNutt M … +2 more , Kistler I, Elmaraghy CA
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41904615 · Publisher ↗
OBJECTIVE: To assess the safety of topical epinephrine during pediatric functional endoscopic sinus surgery (FESS). METHODS: After obtaining IRB approval, electronic medical records of patients aged 0 to 14 undergoing FE...
OBJECTIVE: To assess the safety of topical epinephrine during pediatric functional endoscopic sinus surgery (FESS). METHODS: After obtaining IRB approval, electronic medical records of patients aged 0 to 14 undergoing FESS in 2021 were retrospectively reviewed and divided into 2 cohorts based on the topical vasoconstrictive agent utilized during the case: oxymetazoline or epinephrine. Patients without documentation of vasoconstrictor utilization or those who received both or neither vasoconstrictive agent were excluded. Outcome variables consisted of preoperative and maximum intraoperative heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, as well as administration of intraoperative propofol, fluids, and antihypertensive medications. Patients without documented preoperative HR, SBP, and DBP were additionally excluded from the study. Mean differences and adjusted mean differences were estimated using linear models adjusted for baseline. RESULTS: Among a total cohort of 123 FESS patients, 57 met inclusion criteria and were primarily male (63%, n = 36) with a median age at procedure of 10.94 years (IQR 7.66, 13.31). Oxymetazoline was administered to 71.93% (n = 41) of the cohort, while 28.07% (n = 16) received epinephrine. The unadjusted and adjusted mean differences between all preoperative and intraoperative hemodynamic parameters were not significantly different between cohorts ( > .05 in all cases). No intraoperative antihypertensives were administered to patients in the study. CONCLUSION: Topical epinephrine and oxymetazoline have similar risk profiles in pediatric functional endoscopic sinus surgery. A prospective study should be developed to evaluate the efficacy of topical epinephrine and to further assess its safety profile.
Minimal Clinically Important Difference of the Sinonasal Outcome Test in Sinonasal Malignancy.
Maoz SL, Lee M, Fischer JL … +32 more , Choby G, Hwang PH, Wang EW, Kuan EC, Adappa ND, Geltzeiler M, Getz AE, Humphreys IM, Le CH, Pinheiro-Neto CD, Chan EP, Roozdar P, Abuzeid WM, Chang EH, Jafari A, Kingdom TT, Kohanski MA, Lee JT, Lazor J, Nabavizadeh A, Nayak JV, Palmer JN, Patel ZM, Resnick AC, Smith TL, Snyderman CH, St John MA, Storm PB, Suh JD, Wang MB, Sim MS, Beswick DM
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41881811 · Publisher ↗
BACKGROUND: Sinonasal malignancies (SNM) are rare cancers associated with poor prognosis and impaired quality of life (QOL). The 22-question Sino-Nasal Outcome Test (SNOT-22) has been used to assess QOL in patients with...
BACKGROUND: Sinonasal malignancies (SNM) are rare cancers associated with poor prognosis and impaired quality of life (QOL). The 22-question Sino-Nasal Outcome Test (SNOT-22) has been used to assess QOL in patients with SNM. OBJECTIVE: To determine the minimal clinically important difference (MCID) for the SNOT-22 in patients with SNM. METHODS: About 264 patients with SNM were drawn from a prospective, longitudinal, multi-institutional study. SNOT-22 scores were collected at pre-treatment baseline and follow-up through 5 years post-treatment. Cronbach's alpha was used to assess the internal consistency of the SNOT-22. Distribution-based approaches were used to estimate the MCID. Multivariable regression identified factors associated with SNOT-22 improvement exceeding the determined MCID. RESULTS: Cronbach's alpha was >.85. The estimated MCIDs were: 1.44 (Cohen's effect size), 1.32 (standard error of the mean), 10.45 (1/2 of baseline standard deviation), and 3.67 (minimum detectable change). The mean MCID across methods was 4.22. Multivariable regression demonstrated higher odds of clinically meaningful improvement from baseline in patients with early-stage disease (odds ratio (OR) 3.510, = .035), no neck irradiation (OR 11.050, = .014), and neoadjuvant therapy (OR 16.667, = .047). CONCLUSIONS: The SNOT-22 MCID was estimated as 4.22 in a large multi-center cohort of patients with SNM, suggesting that relatively small QOL changes are clinically relevant. When applying the MCID to the current cohort, advanced stage, treatment of neck disease, and not requiring neoadjuvant therapy were predictive of worse QOL.
Surgical Management of Recurrent Tracheal Stenosis in the Setting of Riedel's Thyroiditis.
Sheth SS, Monge FA, Meiklejohn DA … +1 more , Spafford MF
Ann Otol Rhinol Laryngol · 2026 Mar · PMID 41863031 · Publisher ↗
OBJECTIVES: Riedel's thyroiditis (RT) is a rare, severe IgG4-related fibrosing inflammatory process of the thyroid gland that may present with airway obstruction, dysphagia, and/or dysphonia. Most published reports of tr...
OBJECTIVES: Riedel's thyroiditis (RT) is a rare, severe IgG4-related fibrosing inflammatory process of the thyroid gland that may present with airway obstruction, dysphagia, and/or dysphonia. Most published reports of treatment of airway obstruction from RT focus on thyroid isthmectomy to relieve compressive or restrictive symptoms, however tracheal stenosis from direct invasion is a more unusual cause of obstruction. Our objectives were to report surgical management of a case of severe, recurrent tracheal stenosis secondary to RT and to review the management of this rare condition. METHODS: Case report of single patient with recurrent, severe tracheal stenosis secondary to RT, with literature review of similar cases. RESULTS: We report a case of severe recurrent tracheal stenosis in the setting of RT managed with bilateral subtotal thyroidectomy and slide tracheoplasty, a previously unreported intervention. Review of the literature identified a single case report in which stenosis secondary to RT was successfully managed with endoscopic dilation. CONCLUSIONS: Tracheal stenosis is an extremely rare complication of RT. In patients with recurrent or severe tracheal stenosis secondary to RT, slide tracheoplasty may be considered after failure of endoscopic dilation.
Adolescent Type 1 Cartilage Tympanoplasty: Factors Affecting Surgical Outcome.
Taylan Cebi I, Cekic E, Yasar H
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41840899 · Publisher ↗
OBJECTIVES: This study aims to evaluate the success rate of type 1 cartilage tympanoplasty in adolescents and identify the factors influencing surgical outcomes. MATERIALS AND METHODS: The medical records of 70 adolescen...
OBJECTIVES: This study aims to evaluate the success rate of type 1 cartilage tympanoplasty in adolescents and identify the factors influencing surgical outcomes. MATERIALS AND METHODS: The medical records of 70 adolescent patients, who underwent cartilage type 1 tympanoplasty between 2018 and 2023, were reviewed retrospectively. Age, gender, size and type of tympanic membrane perforation, status of the opposite ear, middle ear status, history of previous ventilation tube (VT) insertion and adenoidectomy, preoperative and postoperative hearing levels, anatomical and functional success rates were analyzed. RESULTS: Eighty-four ears of 70 patients were enrolled in the study. Anatomical success was achieved in 83.3% and surgical success was achieved in 67.9% of all ears. Adhesive otitis media, previous VT insertion and the size of perforation were detected to be the most important negative prognostic factors affecting the surgical outcome ( < .001, = .012 and = .046, respectively). No correlation between surgical success and risk factors such as age, gender, perforation type or location, status of the opposite ear was detected. CONCLUSION: Tympanoplasty in adolescent age group has high success rates with correct technique and detail-oriented surgery. Given its impact on outcomes, careful evaluation and potentially staged treatment for adhesive otitis media may enhance the success rate. Cartilage should be the graft material of choice in such patients because of its durability and resistance to retraction.
Patient Reported Outcome Measures in Sinonasal Malignancies and Beyond.
Liu MY, Chen PG
Ann Otol Rhinol Laryngol · 2026 Mar · PMID 41840794 · Publisher ↗
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Exparel (Bupivacaine Liposome Injectable Suspension) as Adjunctive Pain Control in Adult Tonsillectomy: Reducing Post-Operative Opioid Use.
Dermody SM, Harvey R, Fischer IP … +1 more , Hoff PT
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41763725 · Publisher ↗
OBJECTIVES: To evaluate the effects of using Exparel bupivacaine liposome suspension 1.3% (13.3 mg/mL) as an adjunct to standard of care medication in adult tonsillectomy patients. STUDY DESIGN: Randomized controlled tri...
OBJECTIVES: To evaluate the effects of using Exparel bupivacaine liposome suspension 1.3% (13.3 mg/mL) as an adjunct to standard of care medication in adult tonsillectomy patients. STUDY DESIGN: Randomized controlled trial. SETTING: Community Hospital. METHODS: The study arm (n = 22) received Exparel bupivacaine liposome suspension 1.3% (13.3 mg/mL) as an adjunct to the standard of care (SOC) medication bupivacaine HCl 0.25% (2.5 mg/mL) with epinephrine (5 μg/mL). The control group (n = 20) received SOC bupivacaine HCl 0.25% with epinephrine (5 μg/mL). All injections were administered after the excision of the tonsil, prior to conclusion of the operative procedure. Pre- and post-operative clinicopathologic variables of interest were collated from electronic medical records and daily pain diaries. Results were analyzed via standard univariate statistics, linear mixed models, and Poisson regression. RESULTS: The Exparel + SOC group experienced significantly less pain at post operative day (POD) 3 compared to the control group ( < .05). Mean pain score on average by 1.23 points in the Exparel + SOC group and on average by 0.39 points in the control group (adj. -value < .001). Similarly, analysis showed that maximum pain score decreased on average by 0.64 points in the Exparel + SOC and increased on average by 0.61 points the control group (adj. -value < .001). There was a statistically significant decrease in dose of oxycodone use between POD 3 and POD 5 within the Exparel + SOC group (16.39 vs 7.22 mg, -value = .035). The relative proportion of patients who took oxycodone was less in the Exparel + SOC group compared to the control group across all PODs. CONCLUSION: Use of Exparel in adult tonsillectomy may decrease post-operative opioid use compared to standard of care treatment. These findings may serve as guidance for best practices in adult tonsillectomy.
Outcomes Following Surgical Management of Advanced Oral Cavity Cancers in Patients with Scleroderma: A Case Series.
Luo WL, Saibaba S, Tripathi NV … +3 more , Reilly MJ, Pierce M, Giurintano JP
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41761578 · Publisher ↗
OBJECTIVES: To evaluate the surgical outcomes and perioperative complications in patients with systemic sclerosis (SSc) undergoing surgical resection with free flap reconstruction for advanced oral cavity squamous cell c...
OBJECTIVES: To evaluate the surgical outcomes and perioperative complications in patients with systemic sclerosis (SSc) undergoing surgical resection with free flap reconstruction for advanced oral cavity squamous cell carcinoma (OCSCC). METHODS: Retrospective review of SSc patients who underwent surgical resection with free flap reconstruction for oral cavity SCC from 2008 to 2023. Data extracted included demographics, SSc subtype, cancer characteristics, surgical details, postoperative complications, and long-term outcomes. RESULTS: Four female patients over age 50 were identified; 2 had diffuse SSc and 2 had limited SSc. All presented with pathologic stage IV OCSCC. Free flap reconstruction included scapular (n = 2), radial forearm (n = 1), and fibular (n = 1) flaps. No patients experienced flap failure. All patients experienced at least 1 postoperative complication. Major morbidity, defined as prolonged ICU admission (>7 days), prolonged tracheostomy dependence (>30 days), cardiopulmonary arrest, or death within 1 year, occurred exclusively in patients with diffuse SSc (50%). Both diffuse SSc patients required hospitalization exceeding 35 days and died within 1 year of surgery. Patients with limited SSc had shorter stays and more favorable outcomes. CONCLUSIONS: Microvascular free flap reconstruction is feasible in SSc patients with OCSCC; however, those with diffuse SSc may experience higher morbidity and mortality. SSc subtype should be considered in preoperative planning. Further multicenter studies are needed to guide management in this high-risk population.
Impact of Calvarial Burring in Squamous Cell Carcinoma of the Scalp Without Gross Calvarial Involvement.
Baratz HQ, Schmidtman DC, Yin LX … +4 more , Moore EJ, Tasche KK, Van Abel KM, Price DL
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41761567 · Publisher ↗
BACKGROUND: To compare oncologic and postoperative outcomes in patients with scalp squamous cell carcinoma with periosteal, but not gross calvarial, involvement, treated with margin-clearing excision including either cal...
BACKGROUND: To compare oncologic and postoperative outcomes in patients with scalp squamous cell carcinoma with periosteal, but not gross calvarial, involvement, treated with margin-clearing excision including either calvarial burring or periosteal excision alone. STUDY DESIGN: Retrospective cohort study. SETTING: Single tertiary academic referral center. METHODS: We retrospectively reviewed surgical cases from January 2001 to January 2025. INCLUSION CRITERIA: patients ≥18 years with biopsy-proven scalp squamous cell carcinoma involving the periosteum without cortical invasion on imaging. Management of the deep margin included either burring of the outer table or periosteal excision alone. Demographic, surgical, and oncologic outcomes were collected and analyzed descriptively. RESULTS: Twenty patients met inclusion criteria. Median age was 70 (range 56-92), and 18 (86%) were male. Thirteen (65%) patients underwent calvarial burring, 7 (35%) underwent periosteal excision. Local recurrence occurred in 31% and 29% of the burring group and non-burring group. Disease-free survival at 2 years was 46% and 57% in the burring and non-burring group, respectively. Overall survival at 2 years was 77% and 86% in the burring and non-burring group. Three patients in the burring group had local recurrences with intracranial extension, 1 died of disease, 1 died with disease and concurrent meningitis, 1 is alive with disease recurrence currently on palliative treatment. There were 7 disease-related deaths. CONCLUSION: Burring did not confer a significant oncologic advantage compared to periosteal excision alone when there was no gross cortical invasion. Local recurrence in patients undergoing calvarial burring was associated with intracranial extension of disease.
Airways Without Borders: Establishing Global Airways Units for Integrated Care.
Conti DM, Spuches RB, Correa EJ
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41731691 · Publisher ↗
Chronic respiratory diseases continue to be managed within fragmented specialty-based structures despite robust evidence supporting the "global airways" concept, which recognizes allergic rhinitis, chronic rhinosinusitis...
Chronic respiratory diseases continue to be managed within fragmented specialty-based structures despite robust evidence supporting the "global airways" concept, which recognizes allergic rhinitis, chronic rhinosinusitis, and asthma as interconnected manifestations of a shared inflammatory continuum. Advances in endotype-driven classification, the treatable traits framework, and the cross-efficacy of biologic therapies have reinforced the scientific and therapeutic rationale for integrated care; however, implementation remains largely theoretical. This editorial advocates for the establishment of Global Airways Units (GAUs), a pragmatic, multidisciplinary model in which otolaryngologists, pulmonologists, and allergists jointly evaluate patients within a unified diagnostic and therapeutic framework. By aligning healthcare organization with established pathophysiological knowledge and evolving guideline recommendations, GAUs represent a feasible, cost-effective strategy to operationalize precision medicine across the entire airway spectrum and translate consensus into tangible clinical benefit.
Auditory Localization Skills of Adult Cochlear Implant Users: Self-Report Assessment Results.
İkiz Bozsoy M, Çiçek Çınar B
Ann Otol Rhinol Laryngol · 2026 May · PMID 41689812 · Publisher ↗
OBJECTIVES: Auditory localization, an essential skill for survival and communication, enables individuals to identify the source of sounds in their environment. Hearing loss (HL) in one or both ears often disrupts binaur...
OBJECTIVES: Auditory localization, an essential skill for survival and communication, enables individuals to identify the source of sounds in their environment. Hearing loss (HL) in one or both ears often disrupts binaural hearing mechanisms, compromising auditory localization abilities. This study aimed to compare auditory localization abilities among unilateral cochlear implant (UnCI) users, bimodal cochlear implant (BimCI) users, and individuals with normal hearing (NH). METHODS: This study included a total of 119 participants: 50 with NH, 46 UnCIs, and 23 BimCIs. The Auditory Localization Scale was used to compare the participants' localization abilities. The scale consists of 24 items across 5 subdimensions: traffic zone, outdoor situations, indoor situations, psychological aspects, and quiet situations. On this scale, higher scores represent greater difficulty with hearing and sound localization, whereas lower scores correspond to better performance in these situations. RESULTS: A statistically significant difference was observed among the 3 groups across all subsections of the Auditory Localization Scale (traffic-zone, < .001; outdoor situations, < .001; indoor situations, < .001; psychological aspects, = .001; quiet situations, < .001), as well as in the total score ( < .001). Post-hoc analyses revealed no significant difference between the bimodal and unilateral CI users ( > .017). However, the NH group obtained significantly lower scores across all subsections and in the total score compared with both CI groups. ( < .017). CONCLUSIONS: While bimodal hearing is advantageous for providing binaural signals, it may not be adequate for auditory localization; consequently, further endeavors are required to enhance subjective benefits and hearing outcomes in adult CI users.
Prevalence of Pneumococcal and Hemophilus Influenza Type B Antibody Deficiency in Children With Persistent Ear, Nose, and Throat Infections.
Babin KC, Martin C, Wadsworth M … +1 more , Carron J
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41618088 · Publisher ↗
OBJECTIVE: The primary objective of this study is to determine the prevalence of Hib and Pneumococcal antibody deficiencies in pediatric patients with persistent or recurrent ENT infections, namely recurrent otitis media...
OBJECTIVE: The primary objective of this study is to determine the prevalence of Hib and Pneumococcal antibody deficiencies in pediatric patients with persistent or recurrent ENT infections, namely recurrent otitis media and recurrent sinusitis, following ear tube placement or adenoidectomy. STUDY DESIGN: This is an IRB approved, single institution, retrospective chart review using the electronic medical record at University of Mississippi Medical Center from January 2013 to December 2023. SETTING: University of Mississippi Medical Center, a tertiary referral hospital. METHODS: This study included 43 patients who had undergone either ear tube placement or adenoidectomy with a history of PCV and Hib titers data. Demographic data was obtained and complete vaccination records were confirmed. Prevalence of PCV and Hib titer deficiency was calculated, and statistical analysis was performed using Chi-square tests, Fischer exact test or independent t-test, depending on the variables. RESULTS: More than half (55%) of these patients were found to be indeterminate or have non-protective titers against Hemophilus influenzae type B, and 43% had titers considered non-protective against Pneumococcus. Given vaccination response rates are approximately 95% for the Hib vaccine and 97% to 100% for Prevnar vaccine, this demonstrates that children with recurrent ENT infections are approximately 11 times more likely to have indeterminate or non-protective titers to Hib and 14 times more likely to have non-protective titers to Pneumococcus. CONCLUSION: This study highlights the potential role of testing these titers in pediatric patients with recurrent ear and sinus infections despite surgical management, and sheds light on the potential role of booster vaccinations in this population.
Middle Ear Neuroendocrine Tumors: A Case Series Highlighting Diagnostic and Management Challenges.
Lukkes S, Minneker E, Castro OV … +5 more , Hoi KK, Diaz RC, Meiklejohn K, Kohlberg G, Sagiv D
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41587918 · Publisher ↗
OBJECTIVE: Middle ear neuroendocrine tumors (MeNETs) are rare lesions that may mimic more common middle ear pathology. Although typically indolent, they have potential for local invasion and delayed recurrence. This stud...
OBJECTIVE: Middle ear neuroendocrine tumors (MeNETs) are rare lesions that may mimic more common middle ear pathology. Although typically indolent, they have potential for local invasion and delayed recurrence. This study aims to expand understanding of MeNETs by characterizing their presentation, management, histopathology, and long-term outcomes. STUDY DESIGN: Retrospective case series. SETTING: Two tertiary, university-affiliated medical centers. METHODS: Five patients with histologically confirmed MeNETs were identified through retrospective chart review. Data collected included demographics, presenting symptoms, imaging, operative reports, pathology, and follow-up. Histological evaluation involved hematoxylin and eosin staining and immunohistochemistry. RESULTS: All patients presented with unilateral middle ear symptoms such as hearing loss, tinnitus, or otalgia. Imaging demonstrated soft tissue masses in the middle ear cavity, occasionally with ossicular erosion. All underwent tympanomastoidectomy, and each required at least 1 additional operation, either a second-look or revision for residual or recurrent disease. Histopathology confirmed low-grade neuroendocrine tumors with characteristic immunostaining, and no metastases were identified. Two patients developed delayed local recurrence years after initial surgery. CONCLUSION: MeNETs are uncommon, low-grade tumors that can be mistaken for other middle ear lesions. Management requires surgical excision, and revision surgery is frequently necessary. While overall prognosis is favorable, the potential for delayed recurrence underscores the importance of long-term follow-up and consideration of a planned second-look procedure. This case series contributes to the limited literature guiding diagnosis and treatment of these rare tumors.
Autoimmune Disorders Affecting the Larynx: Review of Laryngoscopic Findings and Approach to Multidisciplinary Management.
Kotla A, Thayer E, Gheriani GA … +3 more , Moore AE, Simpson CB, Hoffman MR
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41587910 · Publisher ↗
The prevalence of autoimmune diseases has been increasing globally. Many disorders have manifestations within the larynx and patients may present initially to the otolaryngologist with breathing, voice, or swallow concer...
The prevalence of autoimmune diseases has been increasing globally. Many disorders have manifestations within the larynx and patients may present initially to the otolaryngologist with breathing, voice, or swallow concerns. This review focuses on the laryngotracheal manifestations of various autoimmune diseases and associated laryngoscopic abnormalities that commonly occur with autoimmune disease, including infraglottic stenosis, bamboo nodules, cricoarytenoid joint ankylosis, supraglottic stenosis, and multilevel airway stenosis. Commonly implicated autoimmune disorders including granulomatosis with polyangiitis (GPA), ANCA-negative GPA, rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus (SLE), pemphigus vulgaris, ankylosing spondylitis, sarcoidosis, relapsing polychondritis, and IgG4-related disease are reviewed with emphasis on clinical presentation, typical laryngoscopic findings, diagnostic criteria, and therapeutic options specific to the larynx. A systematic multi-disciplinary approach between the otolaryngologist and rheumatologist is presented. Prompt identification of a laryngeal abnormality as being potentially related to autoimmune disease and direct communication with rheumatology colleagues can offer patients medical treatment options in addition to procedural intervention and may offer long-term benefits to laryngeal function and overall disease-specific health.
Correction of Arytenoid Malrotation with Non-Selective Reinnervation for Unilateral Vocal Cord Palsy: A Functional Outcome Study.
Sheeja A, Menon JR, Issac ME … +1 more , Aravindakshan R
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41581007 · Publisher ↗
BACKGROUND: Unilateral vocal fold paralysis (UVFP) causes denervation of intrinsic laryngeal muscles in varying degrees and results in different types of glottal configurations. While the primary goal of surgery is to im...
BACKGROUND: Unilateral vocal fold paralysis (UVFP) causes denervation of intrinsic laryngeal muscles in varying degrees and results in different types of glottal configurations. While the primary goal of surgery is to improve vocal function, outcomes are strongly influenced by how effectively the underlying laryngeal physiology and alignment are restored. Denervation of the posterior cricoarytenoid (PCA) muscle causes the arytenoid to fall anteriorly and medially. Static procedures such as medialization thyroplasty does not address this. This study evaluates the impact of non-selective laryngeal reinnervation (LR) on arytenoid position and vocal function. METHODS: A retrospective study was conducted on 41 patients with UVFP who underwent Non selective reinnervation between 2021 and 2024 at a tertiary care hospital. Arytenoid prolapse was graded using a 3-point scale from laryngoscopy videos pre- and 6 months post-operatively. Voice outcomes were assessed using Maximum Phonation Duration (MPD) and Voice Handicap Index-10 (VHI-10). RESULTS: Improvement in arytenoid position was defined as an upgrade by at least one grade in the prolapse grading system.70.7% of the patients showed improvement in arytenoid position 6 months post non selective reinnervation surgery. Significant postoperative improvements were observed in both MPD and VHI-10 scores ( < 0.01), correlating with arytenoid stabilization and improved phonatory function. CONCLUSION: Non-selective reinnervation not only improves vocal quality but also restores arytenoid position, addressing a key component of glottic insufficiency in UVFP. These findings support reinnervation as a physiologic, durable solution with functional and anatomic advantages over static medialization.
Neonatal Suppurative Sialadenitis With Bilateral Gland Involvement in a Preterm Infant: A Rare Complication of Bacteraemia.
Ghosal A, Bastianpillai J, Dimitriadis PA
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41574684 · Publisher ↗
INTRODUCTION: Neonatal suppurative sialadenitis (NSS) is an uncommon but serious complication of salivary gland infection, with few cases reported in literature, most often affecting preterm infants. Typical cases involv...
INTRODUCTION: Neonatal suppurative sialadenitis (NSS) is an uncommon but serious complication of salivary gland infection, with few cases reported in literature, most often affecting preterm infants. Typical cases involve the parotid gland and are caused by infection. Contributing factors include prematurity, dehydration, prolonged hospitalisation, and immature immunity. Sequential bilateral gland involvement through haematogenous spread is rare, and presents significant management challenges in prematurity. PRESENTATION: We report the case of a preterm infant, born at 30 weeks gestation, who spontaneously developed acute left-sided parotid swelling at 3 weeks old in NICU. Inflammatory markers were significantly elevated and blood cultures grew . Initial treatment was with broad-spectrum intravenous antibiotics, and after no significant improvement, confirmatory ultrasound, and subsequent bedside percutaneous drainage was performed by ear, nose, and throat (ENT) surgeons. Subsequently, they developed a second abscess in the contralateral submandibular gland, needing further bedside aspiration. Pus cultures isolated , and they improved with culture-driven antibiotics. DISCUSSION: We highlight the importance of combining early antimicrobial therapy with minimally invasive procedural intervention in managing NSS, as well as the rarity of multiple, sequential gland involvement. Early drainage limits progression when empirical treatment fails and helps guide antimicrobial choice. It minimises the need for more invasive surgical intervention, which is complex in preterm infants. CONCLUSION: A high index of suspicion, early minimally invasive drainage and prompt initiation of targeted antibiotics, are key to optimal outcomes in NSS, particularly in preterm infants at higher risk of severe disease.
Tinnitus, Dizziness and Hearing Status During Hypertension Diagnosis and Treatment.
Kandemir H, Kandemir S, Öztürk S
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41574676 · Publisher ↗
OBJECTIVE: High blood pressure (BP) or hypertension (HTN) can impair hearing, causes tinnitus and dizziness. We hypothesized that there is an association between increased BP and hearing impairment (HI), tinnitus and diz...
OBJECTIVE: High blood pressure (BP) or hypertension (HTN) can impair hearing, causes tinnitus and dizziness. We hypothesized that there is an association between increased BP and hearing impairment (HI), tinnitus and dizziness, and decrease in BP improves these parameters and symptoms. METHODS: The study included 100 newly-diagnosed HTN patients (systolic BP (SBP) ≥140 mmHg and/or diastolic BP (DBP) ≥90 mmHg) and 100 patients without HTN. Tinnitus and dizziness were evaluated through Tinnitus Handicap Inventory (THI) and Dizziness Handicap Inventory (DHI). The auditory status of all patients was assessed for both right ear (RE) and left ear (LE). BP measurements, THI, DHI, and audiometry tests were repeated at follow-up visit during treatment in HTN patients and delta (Δ) values were obtained. RESULTS: The median of THI and DHI score and thresholds for hearing parameters were higher in HTN group. At follow-up visit, SBP, DBP, THI, DHI, and most of the hearing parameters significantly improved. ΔSBP significantly correlated with ΔRE average and ΔLE average in partial correlation analysis adjusted for age and Brinkman index. Multivariate linear regression analysis yielded an independent association of ΔRE average (Beta Coefficient (BC): 12.07, 95% Confidence Interval (CI): 1.86-22.29, = .021) and ΔLE average (BC: 14.89, 95% CI: 5.45-24.33, = .003) with ΔSBP. However, none of the parameters demonstrated an independent association with ΔDBP. CONCLUSION: HTN patients suffer from tinnitus, dizziness and HI, and BP decrease is associated with improvements in these symptoms and hearing status. Decrease in SBP rather than DBP is associated with improvements in hearing status.
A Prospective Multicenter Observational Study Investigating the Concordance Between Patient-Reported Hearing Loss and Commonly Used Ototoxicity Grading Systems in Patients Treated with Platinum-Based Chemotherapy.
Burger AVM, Duinkerken CW, Theunissen EAR … +16 more , Schaeffers AWMA, Hauptmann M, Hoetink AE, Balm AJM, de Boer JP, Maas-Bannink E, Exterkate L, Slingerland M, Jansen JC, Stokroos RJ, de Bree R, Devriese LA, Dreschler WA, Bruintjes TD, van Sluis KE, Zuur CL
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41549346 · Publisher ↗
PURPOSE: This study aims to compare the accuracy of the TUNE, American Speech-Language-Hearing Association (ASHA), and Common Terminology Criteria for Adverse Events (CTCAE) grading systems in reflecting the severity of...
PURPOSE: This study aims to compare the accuracy of the TUNE, American Speech-Language-Hearing Association (ASHA), and Common Terminology Criteria for Adverse Events (CTCAE) grading systems in reflecting the severity of treatment-related hearing loss, as measured by pure-tone audiometry and patient-reported hearing loss using the Speech, Spatial, and Qualities of Hearing scale compare questionnaire (SSQ). METHODS: This study is a prospective, multicenter, cross-sectional, and observational study from 2018 to 2024 conducted at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Amsterdam, Leiden University Medical Center, and University Medical Center Utrecht. In this trial, 109 patients with an indication for curative platinum-based chemotherapy (dose ≥ 200 mg/m) were included, of whom 74 were eligible for analysis. Standard frequency and extended high-frequency pure tone audiometry were measured at baseline and follow-up. The SSQ was administered at follow-up to assess patient-reported outcome measures for hearing loss. The TUNE, ASHA, and CTCAE criteria were derived from audiometry. Concordance and Spearman's correlations were evaluated between all 3 grading systems and the SSQ. RESULTS: The concordance of TUNE with the SSQ was 81%. The concordance of CTCAE and ASHA with the SSQ was 73% and 68%, respectively. A statistically significant Spearman's correlation coefficient of -.35 ( = .01) was found between TUNE and the SSQ. The Spearman's correlation coefficient with CTCAE or ASHA and SSQ was -.10 ( = .10) and .04 ( = .75), respectively. CONCLUSION: This study found that the TUNE is better in reflecting platinum-related patient-reported hearing loss compared to the CTCAE and ASHA.
Workforce Trends and Evolving Roles of Physician Assistants in Otolaryngology: A National Longitudinal Survey.
Hayes H, Lenze N, Ritz HJ … +3 more , Pandian V, Brenner MJ, Yalamanchi P
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 41518225 · Publisher ↗
OBJECTIVE: To characterize contemporary workforce trends among physician assistants in otolaryngology-head & neck surgery in the United States. METHODS: Longitudinal analysis of annual survey of the Society of Physician...
OBJECTIVE: To characterize contemporary workforce trends among physician assistants in otolaryngology-head & neck surgery in the United States. METHODS: Longitudinal analysis of annual survey of the Society of Physician Assistants in Otorhinolaryngology-Head & Neck Surgery (SPAO-HNS) data, collected 2015 to 2024. The survey captured self-reported practice patterns, compensation models, and clinical responsibilities. Statistical analyses included linear and logistic regressions to evaluate temporal trends and differences by practice setting. RESULTS: A total of 1227 survey responses were analyzed. Most respondents were physician assistants (93.7%), predominantly working in private stand-alone otolaryngology practice environments (66.8%). Majority of respondents reported working an average of 40 hours per week with salary-based compensation (71.8%), though productivity-based bonuses rose over the study period ( =< .001). Common procedures performed independently included cerumen removal, foreign body extraction, and nasal endoscopy or flexible fiberoptic laryngoscopy. Practice setting influenced patient volume and scope of responsibilities, with stand-alone practices reporting higher outpatient volumes. The proportion of respondents planning to leave otolaryngology within 5 years nearly doubled from 17% in 2015 to 29% in 2024. CONCLUSION: This 10-year longitudinal analysis highlights the integral and evolving contributions of physician assistants and nurse practitioners to otolaryngology care across diverse practice settings. The findings document an expanding role in enhancing access to care and performing office procedures independently. However, the rising proportion of respondents intending to leave the field signals emerging workforce sustainability challenges. Proactive strategies to support recruitment, retention, and professional development are needed to ensure a stable and effective otolaryngology workforce capable of meeting growing patient needs.
Histological Impact of Rhinophototherapy Compared to Intranasal Corticosteroids on Inflammatory Cells and Nasal Mucosa in Allergic Rhinitis.
Ramasamy K, Gendeh HS, Wan Hamizan AK … +7 more , Md Pauzi SH, Zahedi FD, Megat Ismail NF, Alfian N, Abdul Razak NN, Chinna K, Husain S
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41501617 · Publisher ↗
OBJECTIVE: To assess the effect of rhinophototherapy (RPT) on nasal mucosa and inflammatory cells in allergic rhinitis compared to intranasal corticosteroids (INCS). METHODS: Adult patients (≥18 years) with newly diagnos...
OBJECTIVE: To assess the effect of rhinophototherapy (RPT) on nasal mucosa and inflammatory cells in allergic rhinitis compared to intranasal corticosteroids (INCS). METHODS: Adult patients (≥18 years) with newly diagnosed perennial allergic rhinitis (AR) were randomly divided into 2 groups, RPT and INCS. Treatment was administered for 2 weeks. Primary outcome was evaluation of the inflammatory cells and mucosal damage via inferior turbinate biopsy, performed post-treatment. Secondary outcomes measured were visual analogue score (VAS) of clinical symptoms (overall, runny nose, sneezing, nasal block, nasal itchiness and ocular itchiness) and nasal patency using rhinomanometry and peak nasal inspiratory flow (PNIF). RESULTS: Thirty-five patients were included, with 18 patients randomized into RPT and 17 patients into INCS. The mean age of patients was 31.3 ± 9.6 (range: 19-57). There was no statistically significant difference observed in terms of inflammatory cells in both groups. Similarly, both groups had no differences in mucosal damage parameters. Patients in RPT group showed statistically significant improvement for overall and specific symptoms VAS score ( < 0.05). Comparing both groups, patients using INCS reported bigger effect size for overall VAS score and specific VAS score for runny nose, sneezing, nasal and eye itchiness. Both groups showed improvement in PNIF reading post-treatment although only RPT group showed statistical significance ( = .015). In terms of rhinomanometry, both groups showed significant improvement in post-treatment nasal flow rate ( < .05). There was decrease in total nasal resistance observed in both groups, albeit with RPT being statistically significant ( = .004). There were no adverse events reported in both groups. CONCLUSION: There is no significant difference in inflammatory cells of inferior turbinate mucosa and mucosal damage between RPT and INCS. RPT is a safe and suitable short-term alternative (2 weeks) for AR patients who are contraindicated for or unable to tolerate INCS. CLINICAL TRIAL NUMBER: The study was registered with ClinicalTrials.gov with the ID: NCT05919316.
Risk Factors of Persistent Opioid Use After Forehead Flap Reconstruction.
Barna AJ, Sharma RK, DeSisto NG … +3 more , Stephan SJ, Patel PN, Yang SF
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41499198 · Publisher ↗
PURPOSE: To assess the risk of persistent opioid use after forehead flaps with preserved vascular pedicles. MATERIALS AND METHODS: This multi-center cohort study used the TriNetX, LLC US Collaborative Network to identify...
PURPOSE: To assess the risk of persistent opioid use after forehead flaps with preserved vascular pedicles. MATERIALS AND METHODS: This multi-center cohort study used the TriNetX, LLC US Collaborative Network to identify patients undergoing forehead flaps with preservation of the vascular pedicle. Patients were grouped based on whether they received an opioid prescription within 1 week of surgery. Propensity matching controlled for age, race, sex, pain diagnoses, and previous opioid use. Baseline characteristics were analyzed with -tests and chi-squares. Risk ratios assessed associations between variables and development of new persistent opioid use (new opioid prescription 3-9 months after forehead flap reconstruction). RESULTS: Overall, 7214 patients (3280 female [45.5%]) underwent forehead flap reconstruction with preservation of the vascular pedicle and 2660 (36.9%) receive a postoperative opioid prescription. Unadjusted analysis demonstrated a statistically significant association between gender and receipt of a postoperative opioid prescription, with male patients more likely than female patients to receive an opioid prescription (χ = 14.94, < .001). After propensity score matching, 1352 patients (588 women [43.3%]) with a mean (SD) age of 67.3 (14.7) years, were included for analysis. Patients who receive a postoperative opioid prescription were at 3.21 times greater risk of developing new persistent opioid use compared to patients not prescribed postoperative opioids (RR = 3.21; 95% CI (2.27, 4.52)). CONCLUSIONS: Patients who receive postoperative opioid prescriptions after forehead flap reconstruction may be at greater risk of developing new persistent opioid use.
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