The Annals Of Otology, Rhinology, And Laryngology[JOURNAL]
Sun
200 papers
Lingual Tonsillectomy for Resistant Obstructive Sleep Apnea in Children with Down Syndrome: A Systematic Review and Meta-Analysis.
Finnegan E, Campos L, Mulcahy A … +1 more , Doody J
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41482804 · Full text
INTRODUCTION: Obstructive sleep apnea (OSA) affects many children, particularly those with Down syndrome (DS), with prevalence estimates ranging from 50% to 100%. Although adenotonsillectomy is the traditional first-line...
INTRODUCTION: Obstructive sleep apnea (OSA) affects many children, particularly those with Down syndrome (DS), with prevalence estimates ranging from 50% to 100%. Although adenotonsillectomy is the traditional first-line treatment, individuals with DS frequently have residual OSA (rOSA) because to their complex airway architecture. Lingual tonsil hypertrophy has been found as a significant risk factor for rOSA; however, the role of lingual tonsillectomy (LT) in this population is uncertain. METHODS: We conducted a systematic review and meta-analysis according to PRISMA and Cochrane guidelines, registered with PROSPERO (CRD42024552955). We included studies of pediatric patients (≤18 years) with DS and rOSA who underwent LT. Primary outcomes were changes in apnea-hypopnea index (AHI), obstructive AHI (OAHI), and oxygen nadir (O₂). Secondary outcomes included postoperative complications. RESULTS: Three retrospective case series comprising 68 patients met the inclusion criteria. Pooled analysis demonstrated a mean improvement in oxygen nadir of 4.58% (95% CI: 2.73-6.43, = 0%). AHI and OAHI scores were decreased by -2.97 (95% CI: -8.88 to 2.94, = 24%) and -8.20 (95% CI: -13.46 to -2.94, = 0%) respectively. Complication rates were low but inconsistently reported. CONCLUSION: Lingual tonsillectomy appears effective in improving OSA severity in children with DS. While promising, outcome improvements may be less pronounced than in the general population, likely due to complex anatomical and physiological factors unique to this group. Standardized outcome measures and prospective studies are needed to better guide management in this high-risk group.
Pilot Study of Nasal Anatomic and Functional Contributions to Odor Identification Variability.
Chiang H, Lee YU, Frank-Ito DO
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41474007 · Publisher ↗
INTRODUCTION: The role of conductive factors on olfactory acuity has received little attention. The relationships between nasal anatomy, inspiratory airflow and olfaction remain unclear, including if nasal anatomic and f...
INTRODUCTION: The role of conductive factors on olfactory acuity has received little attention. The relationships between nasal anatomy, inspiratory airflow and olfaction remain unclear, including if nasal anatomic and functional factors account for some variabilities in odor identification in the absence of sensorineural defects. This preliminary study aimed to analyze olfactory cleft airflow dynamics using computational modeling techniques and to develop linear regression models linking smell identification scores to nasal anatomy and computational-derived functional metrics. MATERIALS AND METHODS: Computational fluid dynamics modeling was used to generate nasal airflow-related parameters based on radiographic images of 10 subjects with varying olfactory acuity, but without prior nasal surgery or nasal deformity. Olfaction was assessed using the University of Pennsylvania Smell Identification Test (SIT). RESULTS: Average olfactory airflow volume comprised only 2.43% of total nasal airflow volume. Higher olfactory resistance demonstrated strong associations with higher SIT scores. No one particular anatomic or functional parameter correlated strongly with SIT score. However, the 3-parameter linear regression model comprising bilateral nasal surface area-to-volume ratio, bilateral nasal resistance and olfactory resistance accounted for 82% of the variations in SIT scores ( = .01). Among 2-parameter linear regression models, the model comprising bilateral nasal surface area-to-volume ratio and bilateral nasal resistance accounted for 52% of SIT score variability ( = .08). DISCUSSION: These findings demonstrate that a significant portion of variability in SIT scores can be explained by the combination of nasal resistance, olfactory resistance, and nasal surface area-to-volume ratio, suggesting that nasal anatomy and airflow-related quantities contribute toward variability in olfaction. LEVEL OF EVIDENCE: III.
Thyroid Cartilage Hemangioma: Presentation, Imaging, Pathology, and Approach to Resection and Reconstruction.
Fitzgerald W, Thayer E, Robinson RA … +2 more , Maley J, Hoffman MR
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41472546 · Publisher ↗
BACKGROUND: Thyroid cartilage hemangiomas are exceedingly rare. We present a rare case of an expansile tumor within the right thyroid ala that was suspected to represent a chondrosarcoma but was found on pathology to rep...
BACKGROUND: Thyroid cartilage hemangiomas are exceedingly rare. We present a rare case of an expansile tumor within the right thyroid ala that was suspected to represent a chondrosarcoma but was found on pathology to represent a hemangioma. Imaging and pathologic features are reviewed as well as approach to resection and reconstruction. CASE PRESENTATION: A 46-year-old male presented with progressive neck fullness and decreased vocal range. He was found to have an expansile mass within the right thyroid ala with associated supraglottic fullness on flexible laryngoscopy. Initial primary differential consideration was chondrosarcoma versus chondroma. He underwent open resection with reconstruction of the right thyroid ala using a rib graft and titanium plate which was used to secure the graft to the contralateral thyroid ala and the ipsilateral inner thyroid perichondrium. Intraoperative frozen sections indicated atypical cartilage cells, but final histopathology revealed a hemangioma with suspected reactive changes in the thyroid cartilage. CONCLUSION: This case highlights the diagnostic challenges associated with rare presentations of hemangiomas in atypical locations, such as the thyroid cartilage. It is one of the first reports of hemangioma occurring within the thyroid cartilage. Excision with reconstruction using a rib graft can be employed for large thyroid cartilage tumors.
Preoperative Embolization for Sinonasal Angiosarcoma Optimized Intraoperative and Postoperative Outcomes: A Case Report.
Al-Arman AM, Ebada HA, Elrakhawy MM … +1 more , Abd-Elfattah AM
Ann Otol Rhinol Laryngol · 2026 Jul · PMID 41472542 · Publisher ↗
BACKGROUND: Angiosarcoma is a rare and aggressive malignancy, representing less than 1% of head and neck cancers. Primary sinonasal angiosarcoma is exceedingly uncommon, with fewer than 40 cases reported. It carries a po...
BACKGROUND: Angiosarcoma is a rare and aggressive malignancy, representing less than 1% of head and neck cancers. Primary sinonasal angiosarcoma is exceedingly uncommon, with fewer than 40 cases reported. It carries a poor prognosis due to early recurrence and metastatic potential, and no standard treatment exists. CASE REPORT: A 33-year-old male presented with a 2-year history of progressive nasal obstruction, later accompanied by epistaxis, facial pain, and headache. Imaging revealed a large vascular sinonasal mass extending into the nasopharynx, sphenoid, and ethmoid sinuses with bone destruction. Histopathology and immunohistochemistry confirmed sinonasal angiosarcoma. Preoperative embolization of feeding vessels achieved near-complete devascularization, enabling safe endoscopic resection with negative margins. The patient received adjuvant radiotherapy and has remained disease-free for more than 65 months, representing one of the longest reported survivals for this tumor. CONCLUSION: Sinonasal angiosarcoma is a rare but aggressive tumor that should be included in the differential diagnosis of vascular sinonasal lesions. Preoperative embolization is an essential adjunct to reduce intraoperative bleeding and facilitate safe resection. Early diagnosis, multimodal treatment, and long-term follow-up are critical for improved outcomes.
Level of Hearing Loss and Associated Factors Among Individuals Aged 5 Years and Above in Ethiopia.
Birhanu W, Meshesha A, Bedilu A … +1 more , Geleta T
Ann Otol Rhinol Laryngol · 2026 May · PMID 41472536 · Publisher ↗
BACKGROUND: Hearing loss is a major public health concern, affecting more than 1.57 billion people globally in 2019. According to the disability index, it currently ranks fourth among the global causes of years lived. OB...
BACKGROUND: Hearing loss is a major public health concern, affecting more than 1.57 billion people globally in 2019. According to the disability index, it currently ranks fourth among the global causes of years lived. OBJECTIVE: to determine the level of hearing loss and its associated factors among individuals aged 5 years and above in Ethiopia. METHODS: A population-based National Ethiopian ear and Hearing Survey of 2023, descriptive statistics were used to summarize the sample and outcomes, while ordinal logistic regression models examined the relationship between hearing loss levels and potential predictors. RESULTS: the overall prevalence of hearing loss among individuals aged ≥ 5 years was 15.6%. Significant factors for the severity of hearing loss included older age (odds ratio [OR] = 1.02), ear discharge (OR = 1.84), and eardrum perforation (OR = 1.76). CONCLUSION: Key factors contributing to the level of hearing loss include age, ear discharge, and eardrum perforation. This underscores the need for enhanced ear health awareness and targeted interventions in primary care to address modifiable risk factors and mitigate the impact of hearing loss.
Frontal Sinus Surgery Simulation in Continuing Education for Practicing Otolaryngologists.
Latour M, Bryan E, Wormald PJ … +4 more , Takashima M, Chen PG, Ahmed OG, Yim MT
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41472535 · Publisher ↗
BACKGROUND: This study aims to assess the effectiveness of high-fidelity simulation training in enhancing skills for frontal sinus surgery (FSS) within the framework of continuing medical education. METHODS: A cross-sect...
BACKGROUND: This study aims to assess the effectiveness of high-fidelity simulation training in enhancing skills for frontal sinus surgery (FSS) within the framework of continuing medical education. METHODS: A cross-sectional, within-subject study was conducted during a CME-accredited national frontal sinus surgery simulation course. Participants completed pre- and post-course surveys rating potential deterrents to FSS. Paired statistical analyses assessed changes in deterrent ratings, and correlational analyses evaluated relationships with surgical experience and case volume. RESULTS: Twenty-eight participants completed both pre- and post-course surveys. Mean time in practice was 14 years, with an average FSS volume of 2 cases per month. Baseline deterrence was moderate (mean 5.10/10), driven primarily by concern for skull base violation and technical difficulty. Following simulation, overall deterrence decreased significantly by 1.27 points (to 3.83; P < .05), with 7 of 9 deterrents showing significant reduction. The largest improvements were seen in apprehension regarding skull base injury, technical challenge, and adequacy of dissection. Factors related to operative time and prior experience showed minimal change. Case volume correlated with lower baseline and post-simulation hesitancy for select deterrents, while years in practice and interval since last FSS did not. All participants reported improved confidence, and the majority anticipated increased incorporation of FSS into their practice. CONCLUSIONS: Simulation-based CME significantly reduced modifiable deterrents and improved confidence among practicing otolaryngologists performing FSS, regardless of years in practice. These findings support simulation as a valuable adjunct for ongoing professional development, enabling experienced surgeons to recalibrate risk perception, refine technical judgment, and support lifelong surgical learning.
Chronic Bacterial and Sicca Laryngitis: A Retrospective Cohort and Systematic Review.
Howser LA, Shah AH, Curtis CJ … +3 more , Nguyen SA, Brown JM, Meenan KD
Ann Otol Rhinol Laryngol · 2026 May · PMID 41472361 · Publisher ↗
OBJECTIVE: Chronic bacterial laryngitis (CBL) and sicca laryngitis (SL) are difficult to differentiate as they present and respond to treatment similarly. There are no standardized diagnostic or treatment guidelines. Thi...
OBJECTIVE: Chronic bacterial laryngitis (CBL) and sicca laryngitis (SL) are difficult to differentiate as they present and respond to treatment similarly. There are no standardized diagnostic or treatment guidelines. This study aims to better define CBL and SL through a systematic review and retrospective cohort analysis. DATA SOURCES: PubMed, Scopus, and CINAHL. REVIEW METHODS: A systematic review was conducted across PubMed, Scopus, and CINAHL following PRISMA guidelines. Additionally, a retrospective chart review was conducted at a tertiary laryngology clinic, collecting data on symptoms, laryngoscopy findings, treatment, and outcomes. RESULTS: Fourteen studies (n = 718 patients) met inclusion criteria. There were no studies regarding sicca laryngitis; thus, the review reflects patients with CBL. Dysphonia was the most common presenting symptom (85.3%, 95% CI: 63.6-98.1). Common patient factors included proton pump inhibitor use (75.3%) and smoking (57.8% current or former). Frequently isolated pathogens included methicillin-sensitive Staphylococcus aureus (40.3%), methicillin-resistant Staphylococcus aureus (25.6%), and Klebsiella (33.3%). Among treated patients, complete symptom resolution was reported in 48.6%, while 50.2% required retreatment. In the retrospective cohort (n = 21), complete resolution occurred in only 9.5% of patients, with a 38% retreatment rate and 32% recurrence rate. Diabetes was associated with a higher likelihood of retreatment ( = .04). Antibiotics were the primary treatment strategy (71%), but outcomes were variable. CONCLUSIONS: CBL and SL are overlapping conditions that present significant diagnostic and therapeutic challenges. The variability in diagnosis and management highlights the need for standardized guidelines and targeted treatment strategies to improve patient care.
Evaluation of Pain Management in Acute Otologic Conditions by Otolaryngologists: A Case-Control Study.
Stoliar K, Mustafa GA, Saied SE … +2 more , Sapir A, Heilig Y
Ann Otol Rhinol Laryngol · 2026 Jun · PMID 41472326 · Publisher ↗
OBJECTIVE: This study aimed to evaluate pain management strategies implemented by otolaryngologists for acute infectious otologic conditions including Acute Otitis Externa (AOE), Acute Otitis Media (AOM) and Bullous Myri...
OBJECTIVE: This study aimed to evaluate pain management strategies implemented by otolaryngologists for acute infectious otologic conditions including Acute Otitis Externa (AOE), Acute Otitis Media (AOM) and Bullous Myringitis (BM). The primary objective was to evaluate pain assessment and treatment across these groups. Secondary objectives analyzed repeat visit rates and their association with incident pain, demographic and clinical characteristics. METHODS: A retrospective case-control study of 478 patients presenting to the ED between 01/2022 and 01/2023. Otologic cases were evaluated in the otolaryngology ED and included AOE (n = 316) and AOM / BM (n = 95). Controls consisted of patients with conservatively treated ureterolithiasis (n = 67). Data included demographic and clinical variables, along with a structured evaluation of pain documentation, treatment, and discharge plans. For high-scoring discharge plans, the specifics of prescribed medications were analyzed. RESULTS: Otologic patients had a mean visual analog scale (VAS) score of 5.0, compared to ureterolithiasis 6.7. Otologic pain management was less comprehensive, with ED treatment administered to 12% to 13%, compared to 72.6% of ureterolithiasis patients ( < .001). Similarly, only 6% to 14.8% of otologic patients received comprehensive analgesic discharge plans, compared to 71.2% in the ureterolithiasis cohort ( < .001). Opioid-based monotherapy was the primary treatment modality in the otologic groups (86%-90%) compare to more diverse and synergistic, NSAID based regimens in the ureterolithiasis cohort. No differences in ED revisits were observed. Age, sex, ethnicity, and comorbidities did not significantly correlate with pain levels or outcomes. CONCLUSION: This study reveals shortcomings in pain management in acute otologic conditions. Given the reported inadequacies in pain management training among Otolaryngology trainees, and continued neglect of pain recommendations proposed by specialty- specific clinical practice guidelines, there is an urgent need for analgesic awareness and standardized protocols to ensure consistent and effective care in these everyday conditions.
Satellite Clinics Increasingly Utilized by Academic Otolaryngology Departments in the United States.
Saraswathula A, Chen JH, Fakhry C … +3 more , Eisele DW, Ramanathan M, Desai SC
Ann Otol Rhinol Laryngol · 2026 May · PMID 41467778 · Publisher ↗
OBJECTIVES: Satellite clinics (ambulatory spaces separate from the main hospital campus), present a growing model of care delivery designed to optimize patient access, quality/safety, and revenue. Our objective was to ch...
OBJECTIVES: Satellite clinics (ambulatory spaces separate from the main hospital campus), present a growing model of care delivery designed to optimize patient access, quality/safety, and revenue. Our objective was to characterize perceptions of academic otolaryngology chairpersons on satellite clinics to clarify trends in academic practice management. STUDY DESIGN: Survey. SETTING/METHODS: Anonymized survey of US chairpersons of non-military academic otolaryngology departments sent out on May 19 and June 17, 2022 (52/106 [49.1%] response rate). RESULTS: The majority of responding chairpersons lead programs in the South Atlantic (11, 21.2%), Middle Atlantic (9, 17.3%), and Pacific (8, 15.4%), most with over 10 full-time faculty. Faculty seeing patients at satellite clinics are reportedly promoted at the same rate as other faculty in 85.4% of programs and publish as much as their peers at 60.4%. 38.2% (SD 24.8%) of ambulatory volume and 39.7% (SD 25.7%) of ambulatory revenue is reportedly derived from satellite clinics. Half of programs had a satellite clinic-associated ambulatory care center (ASC) handling an estimated 24.8% (SD 17.2%) of their ambulatory operative cases. 71.2% reported residents rotating at satellite clinics and ASCs. Programs unanimously plan to maintain/increase their satellite clinic volume. CONCLUSION: Satellite clinics represent a critical emerging element in most U.S. academic otolaryngology programs. While these data represent only academic chairpersons and not all faculty, they represent a clear relevance, both academically and financially, for satellite clinics within academic otolaryngology. Most programs plan to increasingly use these satellite clinics in the coming years to expand access for patients while improving clinical efficiency and resident education. LEVEL OF EVIDENCE: 5.
Rural-Urban Disparities in Access to Otolaryngology Care in Louisiana.
Bryan E, Latour M, Dewan K
Ann Otol Rhinol Laryngol · 2025 Dec · PMID 41466448 · Publisher ↗
OBJECTIVES: To highlight and quantify rural-urban disparities in access to otolaryngology care in Louisiana. STUDY DESIGN: Observational population study. METHODS: Louisiana parishes (county-equivalents) were categorized...
OBJECTIVES: To highlight and quantify rural-urban disparities in access to otolaryngology care in Louisiana. STUDY DESIGN: Observational population study. METHODS: Louisiana parishes (county-equivalents) were categorized by rurality using the National Center for Health Statistics 2023 urban-rural classification. Class levels range from I to VI, with lower class levels corresponding to more urban parishes and higher levels corresponding to more rural parishes. Otolaryngologist data was obtained upon request and fee to the Louisiana State Board of Medical Examiners and freely accessible residency program websites. Population data was obtained from the 2022 U.S. Census postcensal estimates. Travel burden was estimated by mean distance between parish centroid to the closest otolaryngology practice. Provider density was estimated by number of otolaryngologists per 100 000 population. Population-weighted linear regression models were fit using R version 4.5.1 to compare differences in mean distance and mean provider density per parish across NCHS class levels. RESULTS: There are 261 otolaryngologists in Louisiana and 91 practice locations. 61% of parishes lack an ENT provider. Overall statistical significance was found ((3, 60) = 9.10, < .0001) in comparison of miles to an otolaryngology provider across classes: Class III, 6.55; Class IV, 7.41 ( = .78); Class V, 17.99 ( < .05), Class VI, 29.92 ( < .0001). Overall statistical significance was found ((3,60) = 4.93, < .005) in comparison of number of otolaryngologists per 100 000 population across classes: Class III, 7.54; Class IV, 3.27 ( < .05); Class V, 1.67 ( < .05); Class VI, 0.98 ( < .05). CONCLUSION: There is a clear discrepancy in number of ENT providers located in urban and rural parishes, indicating a need to advocate for more evenly distributed resources and providers throughout the state. Additional clinical outreach, like remote outreach clinics, could help expand and more effectively streamline access to specialized otolaryngology care for patients in rural areas.
Outcomes of Tinnitus Interventions: An Umbrella Review of Systematic Reviews with Meta-Analysis.
Chen K, Monaghan NP, Nguyen SA … +4 more , Chun WB, Mills JF, Brennan E, Meyer TA
Ann Otol Rhinol Laryngol · 2026 May · PMID 41461570 · Publisher ↗
OBJECTIVES: Tinnitus is a highly prevalent and challenging neurotologic condition affecting over 740 million individuals worldwide. Despite the growing number of studies, treatment approaches remain fragmented and incons...
OBJECTIVES: Tinnitus is a highly prevalent and challenging neurotologic condition affecting over 740 million individuals worldwide. Despite the growing number of studies, treatment approaches remain fragmented and inconsistent. This umbrella review aims to aggregate results from systematic review to comprehensively synthesize the available evidence. METHODS: Following PRISMA guidelines, we systematically searched CINAHL, COCHRANE Library, PubMed, and Scopus through April 2025. Systematic reviews with meta-analyses of primary tinnitus interventions were included. Outcomes focused on validated measures of tinnitus severity, distress, loudness, and quality of life. Study quality was assessed using AMSTAR-2. RESULTS: A total of 44 systematic reviews were included, covering 7 intervention domains. Cognitive behavioral therapy (CBT), hearing aids, tinnitus retraining therapy (TRT), and sound/music therapy consistently improved tinnitus-related outcomes (eg, THI reductions up to -14.50, < .001). Cochlear implantation yielded the largest effects (eg, THI -29.97) but is reserved for patients with moderate-to-profound sensorineural hearing loss who are not adequately helped by hearing aids. Neuromodulation and acupuncture showed modest or inconsistent benefits with high heterogeneity. CONCLUSIONS: This umbrella review provides the current and comprehensive analysis of tinnitus treatments. CBT, hearing aids, TRT, and sound/music therapy show consistent benefit. Cochlear implantation offers the greatest effect in patients with moderate-to-profound hearing loss unresponsive to hearing aids. Other therapies show mixed evidence. These findings offer a much-needed evidence framework to guide treatment decisions and future research.
Age-Specific Risk and Severity of CRS among Cystic Fibrosis Carriers: A Population-Based Cohort Study.
Miller AC, Boonstra DE, Cavanaugh JE … +5 more , Abou Alaiwa MH, Comellas AP, Hornick DB, Stoltz DA, Polgreen PM
Ann Otol Rhinol Laryngol · 2026 May · PMID 41461387 · Publisher ↗
BACKGROUND: Chronic rhinosinusitis (CRS) is an inflammatory disease characterized by congestion and nasal discharge, facial pain and pressure, and loss of smell, with symptoms lasting longer than 3 months. CRS is common...
BACKGROUND: Chronic rhinosinusitis (CRS) is an inflammatory disease characterized by congestion and nasal discharge, facial pain and pressure, and loss of smell, with symptoms lasting longer than 3 months. CRS is common among people with cystic fibrosis (CF) and CF carriers are also more at risk for CRS than non-CF carriers. We evaluate risk for CRS across the lifespan for CF carriers and determine how CF carriers with CRS may differ from non-CF carriers with chronic sinusitis. METHODS: Using 2001 to 2022 MarketScan data, we developed 2 study populations: (1) a matched cohort consisting of CF carriers who were matched to non-CF carriers, and (2) a cohort of patients with chronic sinusitis. We used the matched cohorts of CF carriers and non-CF carriers to estimate age-group-specific incidence rate ratios for experiencing chronic sinusitis. Next, we used the chronic-sinusitis cohort to compare the severity of chronic sinusitis events between CF carriers and non-carriers. Specifically, we estimated the odds of a sinus procedure or the receipt of antibiotic prescriptions to evaluate the severity and healthcare utilization among CF carriers and non-carriers with CRS. Finally, we compared the odds for developing other CF-related conditions among CF carriers with CRS to non-CF carriers with CRS. RESULTS: We found that CRS incidence for CF carriers relative to non-CF carriers was highest for those above 40 years of age. We also found that among people with CRS, CF carriers were more likely to undergo a diagnostic evaluation and endoscopic sinus surgery. CF carriers were also more likely to fill antibiotic prescriptions, use multiple antibiotics, and take antibiotics for longer periods. CONCLUSIONS: CF carriers are more likely than non-carriers to suffer from CRS, have more severe CRS, and to exhibit certain features of CF-associated CRS.
Quality of Life and Chemosensory Function in Post-COVID Patients: Adherence to Olfactory Training.
Wiederstein S, Grasl S, Rappold V … +4 more , Stueckler J, Schneeberger R, Mueller CA, Renner B
Ann Otol Rhinol Laryngol · 2026 Apr · PMID 41400140 · Full text
OBJECTIVE: To evaluate adherence to and effects of standardized olfactory training (OT) after COVID-19 infection. METHODS: In this prospective study, 475 patients (mean age 47.4/SD 9.5 years) with olfactory dysfunction (...
OBJECTIVE: To evaluate adherence to and effects of standardized olfactory training (OT) after COVID-19 infection. METHODS: In this prospective study, 475 patients (mean age 47.4/SD 9.5 years) with olfactory dysfunction (OD) after COVID-19 infection participated in OT on average 13 months (range 0-31 months) post-infection. Patients were assessed 3 times with an average interval of 3 months using questionnaires on quality of life (QoL), chemosensory functions, and OT adherence. RESULTS: Overall, 363 patients (76.4%) took part in the first 2 and 49.1% in all 3 testing sessions. Before the initial assessment, 32.8% had performed OT in the past without any instructions, so that merely 9.1% adhered to recommended standards. By the second evaluation, after standardized OT was introduced to the participants, 31.1% (n = 106) reported following the training as recommended, decreasing to 18.5% (n = 43) by the third assessment, indicating that most participants did not complete the recommended duration of at least 12, preferably 24 to 36 weeks of olfactory training. QoL and subjective olfactory acuity significantly improved between the first and following testing sessions ( < .001), but these improvements were not associated with adherence to OT. However, male sex ( = .035), non-medical profession ( = .025), increased age ( = .009), and reduced QoL ( = .027) were observed factors for advanced training adherence to recommended standards. CONCLUSION: Overall, only a small proportion of participants consistently followed OT. Higher adherence, however, was associated with male sex, non-medical profession, older age, and greater impairment in QoL. Nevertheless, on average there was a clear improvement in QoL and subjective sense of smell over the testing period.
Risk Factors for Infection After Otolaryngologic Surgery: An ACS-NSQIP Analysis.
Liu MY, Erwin DZ, Bayrak MN … +2 more , Jang DW, Chen PG
Ann Otol Rhinol Laryngol · 2026 May · PMID 41400097 · Full text
OBJECTIVE: To examine the incidence and risk factors of infection (CDI) after otolaryngologic surgery. METHODS: A retrospective cohort study of subjects undergoing otolaryngologic surgery was performed using the 2016 to...
OBJECTIVE: To examine the incidence and risk factors of infection (CDI) after otolaryngologic surgery. METHODS: A retrospective cohort study of subjects undergoing otolaryngologic surgery was performed using the 2016 to 2021 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP). The incidence of CDI and potential risk factors were assessed. RESULTS: One-hundred eighty-five surgical encounters experienced postoperative CDI out of 149 960, with a CDI incidence of 0.12% (8.8 cases per 10,000 patient-days). The greatest number of postoperative CDI was observed in head and neck reconstructive surgeries. On bivariate analysis, risk factors significantly and practically associated with the occurrence of CDI after otolaryngologic surgery were older age and longer operating times. Multiple logistic regression revealed that the CDI rate did not differ among otolaryngology subspecialties but was influenced by age, functional status, and operating times after controlling for relevant confounders. CONCLUSIONS: CDI after otolaryngologic surgery is a serious, costly complication with an incidence comparable to the national CDI rate. Knowledge of the preoperative risk factors associated with CDI may aid in the prevention of such infection after otolaryngologic procedures, thus decreasing patient morbidity and healthcare cost.
The Maxillary Lid Approach to Intra-Antral Pathology.
Anderson BJ, Graham SM, Andrews B … +2 more , Camargo JD, Kendrick DE
Ann Otol Rhinol Laryngol · 2026 May · PMID 41395765 · Publisher ↗
OBJECTIVES: The primary objective of this series is to describe the adaptation of a common dental procedure (the maxillary bony window approach) to clinical otolaryngology for a variety of pathologies affecting the maxil...
OBJECTIVES: The primary objective of this series is to describe the adaptation of a common dental procedure (the maxillary bony window approach) to clinical otolaryngology for a variety of pathologies affecting the maxillary sinus. While the sublabial approach to the maxillary sinus has been widely described, contemporary plating methods may reduce historical drawbacks which include oroantral fistula, maxillary sinusitis, and facial asymmetry. METHODS: Four patients underwent en bloc removal of the antero-lateral maxillary wall for removal of intra-antral pathology, with bony lid reconstruction using contemporary plating methods. Clinical course, complications, and follow-up information were examined. RESULTS: Diagnoses included keratocystic odontogenic tumor, foreign body (displaced tooth), bony cyst, and juvenile nasopharyngeal angiofibroma. All patients underwent successful surgery with excellent exposure of the maxillary sinus and reapproximation of the bony lid. Long-term follow-up radiograph of 1 patient showed excellent position of the bony lid with no mucosal thickening. CONCLUSIONS: Re-apposition of a bony lid after a sublabial approach to the maxillary sinus could ameliorate historical drawbacks of the procedure, possibly expanding its application. Larger cohorts and long-term follow-up will further characterize ideal indications and potential pitfalls of the approach.
Geographical and Temporal Trends in Industry Engagement Among Otolaryngologists 2017 to 2023.
Hung C, Schlacter J, Morse E
Ann Otol Rhinol Laryngol · 2026 May · PMID 41384351 · Publisher ↗
OBJECTIVE: To identify trends in industry payments (IPs) to otolaryngologists from 2017 to 2023, particularly evaluating the impact of the COVID-19 pandemic. STUDY DESIGN: Cross-sectional retrospective analysis. SETTING:...
OBJECTIVE: To identify trends in industry payments (IPs) to otolaryngologists from 2017 to 2023, particularly evaluating the impact of the COVID-19 pandemic. STUDY DESIGN: Cross-sectional retrospective analysis. SETTING: Open Payments Database. METHODS: Non-research payments to otolaryngologists 2017 to 2023 were characterized by census region, nature of payment, submitting manufacturer, and temporal trends. RESULTS: 448,093 transactions worth $85.6 million were found with a median payment per physician of $47.81. Payments sharply decreased in 2020 during the COVID-19 pandemic ($17.4 million/year pre-pandemic 2017 to 2019 to $7.7 million in 2020) but partially rebounded to $13.7 million/year by 2023. High-value payments (>$10,000) increased significantly post-pandemic (mean 124/year, 2021-2023) compared to pre-pandemic (mean 75/year, 2017-2020, < .0001). Food and beverage were the most frequent payment type (88%; 17% of total value), but the greatest payment value came from consulting fees (2.6% of payments; 36% of total value). The top 5 states for industry payments (IPs) were California, Texas, New York, Florida, and Pennsylvania, accounting for 45% of nationwide IPs. The Northeast had the highest per-physician payments, whereas the South received the highest percentage (35%) of total funds. Twenty-six companies accounted for 80% of payments. CONCLUSIONS: The number of IPs decreased significantly during the COVID-19 pandemic but has approached pre-pandemic levels, driven by increased high-value payments. A small number of companies account for most payments. There is significant geographical heterogeneity, suggesting regional differences in physician-industry engagement and potentially disparate patient access to innovations. Future studies should clarify how industry funding influences otolaryngology clinical practice.
Investigation of the Effects of Hypothyroidism Duration on Hearing Function: An Experimental Animal Study.
Tatlıpınar A, Kutluhan A, Şerbetçioğlu B … +5 more , Özbeyli D, Büyükkal F, Eker P, Keskin S, Akakın D
Ann Otol Rhinol Laryngol · 2026 Apr · PMID 41367191 · Publisher ↗
OBJECTIVE: Congenital hypothyroidism is well known to impair auditory development and function. However, the effect of acquired hypothyroidism, particularly regarding its duration, has not been clearly defined. Data inve...
OBJECTIVE: Congenital hypothyroidism is well known to impair auditory development and function. However, the effect of acquired hypothyroidism, particularly regarding its duration, has not been clearly defined. Data investigating the relationship between prolonged hypothyroidism and hearing remain scarce. This experimental study aimed to evaluate the impact of different durations of hypothyroidism on hearing function and cochlear morphology in Wistar albino rats. MATERIALS AND METHODS: Four groups were established, each consisting of at least 8 Wistar albino rats. The groups included a control group and 3 hypothyroid groups exposed to 6-n-propyl-2-thiouracil (PTU) for 15, 30, and 45 days, respectively. PTU was administered intraperitoneally on a daily basis. Auditory evaluation was performed using otoacoustic emission (OAE) and auditory brainstem response (ABR) testing before and after the experimental period. Biochemical confirmation of hypothyroidism was obtained through measurement of serum T4 and TSH levels, collected from intracardiac blood samples prior to sacrifice. Additionally, cochlear tissue was examined histopathologically to assess possible structural alterations. RESULTS: ABR analysis revealed that the 15-, 30-, and 45-day hypothyroid groups exhibited increased auditory thresholds and prolonged wave latencies compared with baseline values ( < .05). Intergroup comparisons demonstrated significant differences in latency values across all groups ( < .05). OAE responses also showed reduced amplitudes in hypothyroid animals. Histopathological evaluation indicated marked structural changes in the cochlea in all hypothyroid groups when compared to controls ( < .05), consistent with the electrophysiological findings. CONCLUSION: Experimentally induced hypothyroidism adversely affects auditory function in a duration-dependent manner. The condition was found to impair both ABR and OAE outcomes, accompanied by histopathological changes in cochlear tissue. These findings confirm that thyroid hormones play a crucial role in preserving auditory physiology, and prolonged hypothyroidism may progressively disrupt hearing at both functional and structural levels.
Observation of Laryngeal Postures via High-Speed Videoendoscopy in Adductor Laryngeal Dystonia.
Marks KL, Vojtech J, Díaz Cádiz ME … +23 more , Toles LE, Feaster TF, Wrede A, Baranwal M, Haubrich A, Ito M, Li S, Little B, Lonergan S, Phan F, Siracusano G, Estrada A, Rojas JM, Buckley DP, Sauder CL, Keltz A, Lerner M, Mallur P, Grillone G, Noordzij P, Tracy LF, Mau T, Stepp CE
Ann Otol Rhinol Laryngol · 2026 Apr · PMID 41320962 · Full text
OBJECTIVE: Adductor laryngeal dystonia (AdLD) is a neurological disorder characterized by spasms of the laryngeal muscles during speech, resulting in acoustic discontinuities. High-speed videoendoscopy (HSV) has been use...
OBJECTIVE: Adductor laryngeal dystonia (AdLD) is a neurological disorder characterized by spasms of the laryngeal muscles during speech, resulting in acoustic discontinuities. High-speed videoendoscopy (HSV) has been used to capture supraglottic compression and visual obstructions of the vocal folds during sustained phonation in speakers with AdLD. The purpose of this study was to investigate the co-occurrence of these laryngeal postures via HSV and acoustic discontinuities in speakers with and without AdLD during connected speech. METHODS: Speakers with (n = 16) and without (n = 16) AdLD read sentences while undergoing trans nasal laryngoscopy. Microphone and HSV signals were simultaneously recorded. Acoustic discontinuities and laryngeal postures via HSV were independently manually labeled. A multinomial logistic regression was performed to examine the relationship between the presence of acoustic discontinuities-labeled as phonatory break, creak, or frequency shift-and that of view of vocal fold obstruction and supraglottic compression. Additional fixed factors included in the regression model were group (AdLD, control), sex, and the interactions of group × obstruction and group × supraglottic compression. RESULTS: Factors that were significantly associated with the odds of an acoustic discontinuity included group, vocal fold obstruction, supraglottic compression, and the interaction of group × vocal fold obstruction. There was not a significant interaction effect of group on supraglottic compression events. CONCLUSIONS: These findings suggest that acoustic discontinuities co-occur with supraglottic compression and vocal fold obstructions. Understanding this relationship may lead to more effective voice assessment methods for individuals with AdLD.
Parotid Massage Facilitated by Straightening Stensen's Duct.
Molotkova E, Maley J, Hoffman H
Ann Otol Rhinol Laryngol · 2026 Apr · PMID 41292157 · Publisher ↗
Obstructive sialadenitis may be associated with acute angulation at the masseteric bend of Stensen's duct previously reported to be associated with masseter enlargement. We report the case of a 44-year-old male who prese...
Obstructive sialadenitis may be associated with acute angulation at the masseteric bend of Stensen's duct previously reported to be associated with masseter enlargement. We report the case of a 44-year-old male who presented with intermittent left parotid pain and swelling without identifiable etiology on ultrasound and computed tomography imaging but with sialography notable for an acute masseteric bend in Stensen's duct. Fluoroscopic imaging on removal of the sialogram catheter demonstrated straightening of the masseteric bend, prompting patient education toward similar straightening of the duct with anterior traction to the cheek to facilitate parotid massage. Interval evaluations up to 4 months later identified a consistent response to this maneuver to prevent the previously experienced episodes of salivary gland swelling and pain. This maneuver, termed the "Molotkova Maneuver" offers an adjunct to standard parotid massage as a conservative management strategy to improve parotid drainage for select patients.
Clinician Attitudes and Knowledge of Pediatric Sleep-Disordered Breathing.
Jungbauer WN, Barengo JH, Nietert PJ … +2 more , Ford ME, Pecha PP
Ann Otol Rhinol Laryngol · 2026 Apr · PMID 41288138 · Publisher ↗
OBJECTIVES: The goals of this study are to assess primary care provider (PCP) knowledge of and attitudes toward pediatric obstructive sleep apnea (OSA), and to identify variations in practice patterns. DESIGN: A cross-se...
OBJECTIVES: The goals of this study are to assess primary care provider (PCP) knowledge of and attitudes toward pediatric obstructive sleep apnea (OSA), and to identify variations in practice patterns. DESIGN: A cross-sectional survey including the Obstructive Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS) questionnaire was administered to PCPs from August to December 2021. Univariable analyses and multivariable linear regressions were performed to analyze associations between demographics and knowledge, attitudes, and screening frequency. RESULTS: Eighty-two PCPs completed the survey (age 43.4 ± 9.6 years, 69.6% female, 90.2% non-Hispanic White). Specialties included Pediatrics (65.9%) and Family Medicine (32.9%). Respondents answered a mean 84.9 ± 10.7% questions correctly on the knowledge portion. Years in practice, provider training, and academic affiliation were not associated with knowledge scores. Less than half (45.1%) of respondents screened for OSA "most of the time" (32.9%) or "always" (12.2%). Higher screening frequency was associated with clinics with higher Medicaid beneficiaries ( = .002) and a lower proportion of Black patients ( = .033). Providers who felt more confident in managing OSA were more likely to screen "most of the time" ( = 0.532, 95% CI [0.120-0.926], = .012), or "always" ( = 0.708, 95% CI [0.129-1.29], = .017). CONCLUSION: these results suggest guideline-recommended screening for OSA is low among PCPs. Higher confidence in OSA management was associated with higher screening rates. Further studies on interventions aimed to increase screening and confidence may improve equitable care.
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