The Annals Of Otology, Rhinology, And Laryngology[JOURNAL]
Sun
200 papers
Discrepancies Between Self-Reported Measures of Hearing With an Audiometric Measurement of Hearing and Associated Factors in Ethiopia National Ear and Hearing Survey.
Alebie HK, Meshesha A, Asfaw A … +1 more , Worku F
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 41020365 · Publisher ↗
BACKGROUND: Hearing is often assessed clinically using pure-tone audiometry, while self-reported hearing measures are commonly employed in population-based studies. Discrepancies between self-reported hearing and audiome...
BACKGROUND: Hearing is often assessed clinically using pure-tone audiometry, while self-reported hearing measures are commonly employed in population-based studies. Discrepancies between self-reported hearing and audiometric thresholds have been frequently observed, necessitating an understanding of the prevalence and factors influencing these inconsistencies. OBJECTIVE: To assess discrepancies between self-reported hearing with audiometric measurements and associated factors among adults in Ethiopia. METHOD: A cross-sectional study was conducted using data from the Ethiopian National Ear and Hearing Survey 2023. Data were collected from 5124 eligible participants using a data extraction template. Statistical analyses, including descriptive statistics and multinomial logistic regression, were performed using SPSS version 27. RESULT: Concordance between self-reported hearing and audiometric results was 86.3%. However, 11.1% underestimated their hearing impairment, while 2.5% overestimated it. Factors such as age (15-44 years), higher education, history of tinnitus, history of ear discharge, and abnormal tympanic membranes were significantly associated with reduced odds of underestimating hearing impairment. Conversely, the presence of earwax increased the likelihood of underestimation. Overestimation of hearing impairment was significantly associated to age (45-60 years), tinnitus, and earwax. CONCLUSION AND RECOMMENDATION: The study revealed significant discrepancies between self-reported and audiometric hearing assessments, although overall concordance was high. The findings emphasize the need for both subjective and objective assessments for accurate hearing diagnosis.
Granulomatosis With Polyangiitis Presenting as Acute Bilateral Facial Nerve Paralysis.
Toomey N, Done AJ, Sagiv D
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 41013970 · Publisher ↗
BACKGROUD: Granulomatosis with polyangiitis (GPA) is a rare systemic autoimmune disease characterized by necrotizing small-vessel vasculitis, commonly involving the head and neck region, facial palsy is an uncommon head...
BACKGROUD: Granulomatosis with polyangiitis (GPA) is a rare systemic autoimmune disease characterized by necrotizing small-vessel vasculitis, commonly involving the head and neck region, facial palsy is an uncommon head and neck presentation of GPA, and bilateral facial palsy is exceedingly rare. OBJECTIVE: We present the case of a patient who presented with bilateral acute facial paralysis with final diagnosis of GPA to raise awareness of this rare presentation of GPA. METHODS: retrospective chart review. CASE PRESENTATION: We present a case of a 52-year-old female, who presented with right-sided facial paralysis started 6 weeks earlier and left sided facial nerve paralysis started 5 days before presentation. In addition, patient suffered from severe bilateral mixed hearing loss and otorrhea. Physical exam revealed polypoid tissue occluding the ear canal and purulent otorrhea. Computed tomography showed completely opacified mastoids bilaterally without bony erosion, and without evidence of cholesteatoma on magnetic resonance imaging. No evidence of nasal, respiratory, or renal involvement was detected. Extensive lab work was within normal limits, besides elevated C-reactive protein and positive serine-proteinase 3 (PR3). Patient underwent left mastoidectomy with facial nerve decompression. The left middle ear space and mastoid were filled with dense granulation tissue. The facial nerve was decompressed and found to be intact to nerve stimulation. Pathology report was positive to PR3, confirming the diagnosis of GPA. She was started on rituximab and prednisone, and 6 weeks after surgery, the patient had improved otalgia, as well as significant improvement in left FN function to HB II, with right FN function at HBV. CONCLUSION: In the existing literature, there are 14 cases of bilateral facial palsy as a presentation of GPA, however, this presentation is the first in the existing literature without evidence of systemic involvement. This highlights that the absence of other systemic involvement and negative initial autoimmune workup does not exclude GPA as the etiology of facial palsy. Continued re-evaluation of systemic involvement and biopsies of middle ear contents is crucial in diagnosis.
Lingual Tonsil Hypertrophy in OSA: The Role of Prior Tonsillectomy and Associated Clinical Risk Factors.
Riestra-Ayora J, Vaduva C, López Riolobos C … +5 more , Fernández-Navarro C, Garrote Garrote M, Sánchez-Rodríguez C, Abad Fernández A, Martin-Sanz E
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 40996831 · Publisher ↗
BACKGROUND: Lingual tonsil hypertrophy (LTH) is increasingly recognized as a contributor to upper airway obstruction in obstructive sleep apnea (OSA). While several etiological factors have been proposed, the potential r...
BACKGROUND: Lingual tonsil hypertrophy (LTH) is increasingly recognized as a contributor to upper airway obstruction in obstructive sleep apnea (OSA). While several etiological factors have been proposed, the potential role of prior palatine tonsillectomy remains understudied in adult OSA populations. OBJECTIVE: To evaluate whether a history of tonsillectomy is independently associated with increased severity of LTH in adults with OSA, and to explore additional anatomical and clinical contributors. METHODS: A cross-sectional observational study was conducted including 117 adult OSA patients evaluated via clinical, endoscopic, and drug-induced sleep endoscopy protocols. Patients were grouped by prior history of tonsillectomy. LTH was graded using the Friedman scale. Chi-squared tests assessed differences in LTH severity between groups. An ordinal logistic regression model was applied to identify independent predictors, adjusting for BMI, age, smoking, positional OSA, GERD, rhinitis, Mallampati, and Angle classification. RESULTS: Among the participants (mean age 51.1 ± 11.1 years; 70.9% male), 26.5% had undergone tonsillectomy. Patients with prior tonsillectomy exhibited significantly greater LTH grades (χ = 5.88; = .015), with a 57% increased risk of grade III to IV hypertrophy (RR = 1.57; 95% CI = 1.06-2.33). In multivariate analysis, tonsillectomy remained independently associated with LTH severity (OR = 2.54; 95% CI = 1.02-6.33; = .045), as did smoking (OR = 2.50; = .032), and positional OSA (OR = 2.20; = .049). Age, BMI, GERD, rhinitis, Angle's classification, and Mallampati score were not significant predictors. CONCLUSION: A prior history of tonsillectomy is significantly associated with greater lingual tonsil hypertrophy in adult OSA patients, independent of obesity or craniofacial structure. These findings suggest a compensatory or immunological mechanism and support individualized evaluation in anatomically driven OSA phenotypes. LTH assessment should be considered in surgical and anesthetic planning, especially in non-obese patients with prior tonsillectomy or positional OSA.
The Association Between Extended High-Frequency Loss and Vestibular Function Among Young Earphone Users.
Saniasiaya J, Kulasegarah J, Seluakumaran K … +1 more , Prepageran N
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 40990829 · Publisher ↗
INTRODUCTION: Unsafe earphone listening habits can pose a risk of hearing loss, and early audiogram threshold shifts could occur at extended high frequencies (EHFs, 9-16 kHz) despite normal thresholds at the conventional...
INTRODUCTION: Unsafe earphone listening habits can pose a risk of hearing loss, and early audiogram threshold shifts could occur at extended high frequencies (EHFs, 9-16 kHz) despite normal thresholds at the conventional test frequencies (0.25-8k Hz). Preliminary reports also suggest that regular earphone users could suffer from vestibular impairment. This study investigated the vestibular function among young adult users with normal audiograms at the conventional test frequencies with and without EHF hearing loss. It is hypothesised that those with EHF loss from earphone usage suffer early deficits in vestibular function. METHODS: Regular earphone users aged 12 to 25 years were questioned regarding their earphone listening behaviours. Their audiogram thresholds were determined at conventional and EHFs and grouped into those with and without EHF loss. Each participant underwent cervical vestibular evoked myogenic potential (cVEMP), subjective visual vertical (SVV), and video Head Impulse Test (vHIT) to assess the function of their saccule, utricle, and semicircular canals, respectively. Results obtained from these parameters were compared between those with and without EHF loss. RESULTS: While all 131 subjects tested had normal audiogram thresholds at 0.5 to 8 kHz, 15.3% had EHF hearing loss. The average duration of earphone usage per day was significantly longer in those with EHF loss than those with normal EHF ( = .008), but their preferred listening volume and total years of listening were comparable. While there was no statistical significance in the findings of the SVV and VHIT test, a significant reduction of the amplitude cVEMP was noted ( < .001), suggesting that those with EHF hearing loss may also have early vestibular damage, particularly to the saccule. CONCLUSION: Earphone users with EHF loss may have concomitant early saccule damage. cVEMP may be an alternative tool to detect early noise-induced cochlear damage, although a large cohort study is required to justify this.
Development of a 3D-Printed Hybrid Simulation Model for Transnasal Flexible Endoscopy Using Cadaveric Laryngeal Specimens.
Hortobagyi D, Tanigami Y, Bowen A … +3 more , Bromet Z, Kruse C, Dailey S
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40990825 · Publisher ↗
INTRODUCTION: Transnasal endoscopic (TNE) procedures are gaining clinical importance in both diagnostic and therapeutic laryngology. Despite this growing relevance, there is currently no dedicated simulation model availa...
INTRODUCTION: Transnasal endoscopic (TNE) procedures are gaining clinical importance in both diagnostic and therapeutic laryngology. Despite this growing relevance, there is currently no dedicated simulation model available for training these techniques, which require high anatomical accuracy and realistic scope maneuverability. METHODS: We designed a 3D-printed anatomical framework based on a publicly available CT dataset, modified to allow realistic transnasal access and secure integration of excised cadaveric larynges. The model supports repeated use with interchangeable specimens and includes features for precise anatomical positioning. The setup was evaluated in 8 cadaveric larynges for anatomical realism and endoscope maneuverability by 2 experienced laryngologists. RESULTS: Key laryngeal landmarks, such as the vocal folds, arytenoid cartilages, and aryepiglottic folds, were clearly identifiable in all specimens during flexible endoscopy, closely resembling the view in awake patients. Scope navigation through the nasal cavity and hypopharynx was described as smooth and realistic. The total production cost of $388.25 makes the model a cost-efficient alternative to commercial simulators. Its design allows for repeated use and adaptation to different specimen types. DISCUSSION: We present the first simulation model specifically designed for training transnasal endoscopic laryngeal procedures. The hybrid model combines anatomical accuracy, realistic handling, and affordability, making it a valuable tool for surgical education and technique development. Its potential applications extend beyond laryngology, including anesthesiology and pulmonology, where transnasal access is also required.
Eliminating Disparities in Otolaryngology Resident Application Selection.
Bukowski EEK, Bisco SE, Yin LX … +4 more , Bayan SL, Romero-Brufau S, Carducci V, Stokken JK
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 40931850 · Publisher ↗
OBJECTIVE: To develop, implement, and evaluate a novel process used for residency application review that deemphasizes metrics known to create bias with the goal of interviewing and matching a more diverse resident cohor...
OBJECTIVE: To develop, implement, and evaluate a novel process used for residency application review that deemphasizes metrics known to create bias with the goal of interviewing and matching a more diverse resident cohort. METHODS: Between 2020 and 2023, a novel standardized rubric and application review process were developed and implemented at the authors' academic training program. The rubric deemphasized USMLE scores, honor society membership, and number of publications while utilizing an AI-driven pre-sort of applications, facilitating holistic review. This weighted applicant attributes identified in personal statements, life experiences, achievements in community, leadership roles, otolaryngology-specific impressions highlighted in letters of recommendation, and otolaryngology-specific research and publications similarly to academic metrics (clerkship grades and standardized test scores). Demographics of applicants interviewed and matched into our program were compared pre- and post-implementation using descriptive statistics. RESULTS: Using a standardized rubric to review residency applications that deemphasizes traditional metrics, the authors' otolaryngology residency program has interviewed, ranked, and matched more diverse candidates. As a result, from 2019 to 2022, the overall resident cohort has diversified from 4% historically marginalized residents to 24%, from 28% female residents to 44%, and from 33% of residents outside our geographic region to 66%. CONCLUSION: There is significant underrepresentation among otolaryngology residents. Selection based upon USMLE Step 1 scores, honor society membership, and number of publications have been shown to restrict diversity. Purposeful holistic review increases diversity in interviewed and matched resident cohort.
Pyriform Aperture Expansion: An Adjunct Technique to Functional Nasal Surgery.
Garg N, DeKloe J, Kumar A … +7 more , Xu V, Amin D, Sina EM, McCann A, Namocatcat ATJ, Krein H, Heffelfinger R
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 40847930 · Publisher ↗
OBJECTIVES: Functional nasal surgery is commonly performed to correct obstructed nasal airflow, and our institution implements pyriform aperture expansion (PAE) as an adjunct to surgical correction. The aim of this study...
OBJECTIVES: Functional nasal surgery is commonly performed to correct obstructed nasal airflow, and our institution implements pyriform aperture expansion (PAE) as an adjunct to surgical correction. The aim of this study was primarily to describe the surgical technique of PAE and demonstrate its safety and feasibility in functional nasal surgery. METHODS: A retrospective review of patients who underwent functional nasal surgery including PAE from April 2022 to May 2023 was conducted. Demographic, intraoperative, postoperative complication, and outcome data were collected. The endonasal surgical technique is described and videography is provided. RESULTS: One hundred patients were included. In addition to PAE, patients underwent concurrent septoplasty (92%), septal cartilage harvest (61%), turbinate reduction (94%), nasal valve repair (87%), open reduction and internal fixation of nasal bones (44%), or endoscopic sinus surgery (5%). Complications included epistaxis (7%), septal hematoma (3%), nasal cellulitis (2%), nasal tip numbness (1%), adhesions (1%), and persistent or recurrent pyriform aperture narrowing (4%). Eighty-one percent of patients reported improvement in obstructive nasal symptoms ( < .001). Postoperative examination demonstrated adequate pyriform aperture expansion in 96% of patients. CONCLUSION: This study describes an endonasal approach to PAE, which utilizes an ultrasonic bone aspirator for maxillary reduction. It demonstrates that PAE is a safe and feasible adjunct to functional nasal surgery. With adequate surgical technique, PAE can be performed with relative ease in a timely fashion.
"Impact of Growth Factor Concentrate Versus Topical Steriods With Antibiotics in Type 1 Tympanoplasty".
Gowdlar Malleshappa R, Thimmaiah VB, Tarikere Jayaram R … +1 more , Ramabhadraiah AK
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40826905 · Publisher ↗
BACKGROUND: To evaluate and compare the treatment outcomes of using topical steroids combined with antibiotics versus growth factor concentrate in type 1 tympanoplasty for chronic otitis media (mucosal type) cases. MATER...
BACKGROUND: To evaluate and compare the treatment outcomes of using topical steroids combined with antibiotics versus growth factor concentrate in type 1 tympanoplasty for chronic otitis media (mucosal type) cases. MATERIALS AND METHODS: The study comprised patients with chronic otitis media mucosal type, who underwent type 1 tympanoplasty. Sixty six patients were randomly divided into 3 groups, each consisting of 33 patients. In Group A, topical steroids and antibiotics were used during the procedure, while in Group B, a growth factor concentrate was used. The outcomes were assessed through postoperative otoendoscopy and air bone gap at the end of the 1st and 3rd months. RESULTS: In this study, Group A (patients who underwent type 1 tympanoplasty with topical steroids and antibiotics) had a 12.1% rate of residual perforation and an 18.2% rate of reperforation after 3 months. In contrast, Group B (patients treated with growth factor concentrate) had significantly lower rates of both residual perforation (3%) and reperforation (3%). While the postoperative air-bone gap at the end of the 3rd month improved in Group B (13.58 ± 3.21 dB) compared to Group A (15.45 ± 5.11 dB), the difference was not statistically significant. CONCLUSION: Growth factor concentrate has shown better graft uptake than topical antibiotics and steroids, making it a promising treatment option for augmenting tympanic membrane repair. Its biocompatibility leads to more consistent outcomes, improving patient satisfaction, and supporting broader use in otologic surgeries.
Negative Pressure Wound Therapy: A Novel Technique for Treatment of Chylous Fistula After Neck Surgery.
Hansen F, Aldrich A, Dorneden A … +5 more , Esce A, Spafford M, Syme N, Olson G, Boyd N
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40826903 · Publisher ↗
OBJECTIVES: Chylous fistula or "chyle leak" is a rare complication of head and neck surgery that can be exceedingly difficult to manage. Traditional treatments include pressure dressings, dietary modification, octreotide...
OBJECTIVES: Chylous fistula or "chyle leak" is a rare complication of head and neck surgery that can be exceedingly difficult to manage. Traditional treatments include pressure dressings, dietary modification, octreotide administration, closed suction drainage, and revision surgery. In 2017, the Otolaryngology team at the University of New Mexico Hospital (UNMH) began implementing negative pressure wound therapy (NPWT) in conjunction with traditional conservative measures to treat chylous fistula. From our initial experiences implementing NPWT, an optimized protocol was developed and is now routinely used to manage chyle leaks at our institution. METHODS: A retrospective chart review was performed to identify all patients who were treated with negative pressure wound therapy at UNMH after undergoing neck surgery and developing a chylous fistula. These patients were compared to a control group of patients with chylous fistula who were treated with traditional approaches alone before NPWT was implemented at UNMH. RESULTS: Twenty-six patients were treated with NPWT for their chyle leak after neck surgery, 10 as part of the original protocol (Protocol 1) and 16 under an improved methodology (Protocol 2). No instances of great vessel desiccation were observed in any patient treated with NPWT. Protocol 2 was found to significantly reduce hospital length of stay as well as to reduce the duration of octreotide administration, dietary modification, and drain device placement compared to the control group treated by historical methods. CONCLUSION: NPWT is a novel and effective treatment approach that can be used in addition to traditional treatment modalities to treat chylous fistulae after neck surgery.
The Prevalence of Olfactory Dysfunction and Its Recovery in Chinese Young and Middle-Aged Group COVID-19 Patients.
Li C, Jiang T, Luo J … +5 more , Tu Y, Ji H, Wan Y, Yu L, Shi L
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40814731 · Publisher ↗
OBJECTIVES: Olfactory dysfunction (OD) is a common symptom of SARS-CoV-2 infection. This study aimed to determine the prevalence and clinical characteristics of OD, evaluate its recovery trajectory, and identify predicto...
OBJECTIVES: Olfactory dysfunction (OD) is a common symptom of SARS-CoV-2 infection. This study aimed to determine the prevalence and clinical characteristics of OD, evaluate its recovery trajectory, and identify predictors of its onset and persistence. METHODS: We conducted a prospective cohort study of 3477 participants recruited through an online questionnaire between December 1 and 31, 2022. Follow-up surveys were conducted over a 12-week period ending on March 31, 2023. RESULTS: Among 3010 eligible participants aged 14 to 40 years, 373 (12.39%) reported new-onset OD following COVID-19 infection. Multivariable logistic regression identified older age, a history of sinusitis or nasal polyps, prior nasal surgery, and symptoms including fatigue, rhinorrhea, dyspnea, ageusia, and pruritus as independent risk factors for OD. Conversely, fever and arthralgia were negatively associated with OD. The cumulative spontaneous recovery rates were 43.70%, 23.86%, 11.26%, 8.04%, 5.63%, and 1.88% at weeks 1, 2, 3, 4, 8, and 12, respectively. No demographic or clinical variables were significantly associated with recovery time. CONCLUSIONS: COVID-19 related OD occurred in 12.39% of young and middle-aged individuals in China. Several demographic and clinical factors were predictive of OD, although none were associated with recovery duration. Most patients experienced spontaneous resolution within the first month of symptom onset.
Thromboprophylaxis for Prevention of Venous Thromboembolism: Practice Patterns Among American Head and Neck Society Members.
Arnold K, Bernstein Z, Hughes E
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40808623 · Publisher ↗
OBJECTIVES: VTE is associated with significant morbidity and is the most common cause of preventable death in hospitalized patients. Although there are no society-specific guidelines for VTE prevention in otolaryngology,...
OBJECTIVES: VTE is associated with significant morbidity and is the most common cause of preventable death in hospitalized patients. Although there are no society-specific guidelines for VTE prevention in otolaryngology, there is evidence to support routine use of chemoprophylaxis in high-risk patients. The objective of this study is to evaluate current methods of perioperative thromboprophylaxis. STUDY DESIGN: Cross-sectional study. METHODS: An online survey addressing practices related to VTE prevention was distributed to AHNS members via Survey Monkey between July 9, 2024 and August 1, 2024. Physician and practice demographics, training, and patterns of thromboprophylaxis were characterized and evaluated. RESULTS: Complete survey responses were obtained from 56 AHNS members. Among these, 64% (n = 36) completed an AHNS-accredited fellowship and 57% (n = 32) practiced in an academic setting. Two-thirds of respondents (n = 38; 68%) routinely prescribe some form of chemoprophylaxis, the most common being low molecular weight heparin (n = 37; 66%), followed by unfractionated heparin (n = 9; 16%). Of the respondents who did not routinely prescribe chemical prophylaxis, common reasons included a perceived low rate of VTE (n = 5; 9%) and lack of clear recommendations for VTE prevention (n = 7; 13%). Despite this, 39% (n = 22) reported having at least 1 patient who experienced perioperative VTE in the past 12-months. CONCLUSIONS: Although the majority of AHNS respondents support routine perioperative chemoprophylaxis, there is a wide variety of practice patterns. Future prospective studies and development of otolaryngology-specific guidelines would serve to unify practice patterns and improve patient outcomes.
Anteriorly Based Middle Turbinate Flap for Skull Base Reconstruction: A Cadaveric Study and Case Series.
Okafor SI, Patel VM, Lazutkin A … +4 more , Jang DW, Goldstein BJ, Ramakrishnan J, Abi Hachem R
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40760929 · Publisher ↗
OBJECTIVE: To describe a novel flap, the anteriorly based middle turbinate flap (ABMTF), via a cadaveric dissection, as well as present our experience using the ABMTF in 13 patients. METHODS: Cadaver dissection study dem...
OBJECTIVE: To describe a novel flap, the anteriorly based middle turbinate flap (ABMTF), via a cadaveric dissection, as well as present our experience using the ABMTF in 13 patients. METHODS: Cadaver dissection study demonstrating methodology of harvesting the ABMTF. Retrospective chart review of 13 patients from a tertiary rhinology referral center undergoing CSF leak repair using the ABMTF from January 2017 to August 2023. Five cadaveric specimens were utilized to complete the dissection of the ABMTF. Flap dimensions and surface area were measured. A step-by-step surgical technique was recorded to illustrate a video demonstration. Demographic data, BMI, pre and postoperative SNOT 22 scores, size and location of the skull base defect, and flap measurements on computed tomography (CT) were obtained from the electronic medical record. RESULTS: Five ABMTF were dissected and showed a mean flap surface area for the medial ABMTF of 3.45 cm with a range of 2.5 to 4.46 cm and a mean surface area for the lateral ABMTF of 2 cm. The mean surface area of the flap on CT scan measurements was 3.46 cm. Twelve patients were female, with an average BMI of 35.1 kg/m. Ten out of 13 patients were treated post-operatively with acetazolamide for management of presumed intracranial hypertension. Postoperative SNOT 22 scores significantly improved at the last follow up visit. All patients had excellent flap tissue integration at their latest follow up with no postoperative CSF leak. CONCLUSION: The ABMTF is a novel random flap, vascularized by branches of the anterior ethmoid artery, that is effective in skull base reconstruction and CSF leak repair emanating from the anterior skull base between the frontal recess and the posterior ethmoid artery along the ethmoid roof. This flap is versatile with limited morbidity.
Secondary Validation of the Parosmia Olfactory Dysfunction Outcomes Rating (DisODOR): Analysis of a Randomized Clinical Trial.
Peterson AM, Kallogjeri D, Islam AA … +3 more , Piccirillo JF, Crock LW, Farrell NF
Ann Otol Rhinol Laryngol · 2026 Feb · PMID 40728047 · Publisher ↗
BACKGROUND: The DisODOR is the only validated disease-specific patient-reported outcome measure (PROM) for patients with parosmia. No published data supports the use of the instrument to monitor response after an interve...
BACKGROUND: The DisODOR is the only validated disease-specific patient-reported outcome measure (PROM) for patients with parosmia. No published data supports the use of the instrument to monitor response after an intervention. The objective of this study was to secondarily analyze a randomized clinical trial (RCT) to assess the instrument's responsiveness to change. METHODS: A double-blinded, placebo-controlled RCT with parosmic patients undergoing stellate ganglion block was conducted. The DisODOR was completed at baseline and 3 months, and the Clinical Global Impression - Improvement (CGI-I) score, which is a 7-point Likert scale assessing response of smell distortion to treatment, was given at 3 months. The primary outcome measure of this study was the responsiveness to change of the DisODOR. The secondary outcome measures were the instrument's internal consistency measured via Cronbach's alpha and test-retest reliability calculated by Pearson correlation. RESULTS: A total of 46 participants with a mean (SD) age of 44 (12) years were analyzed. At 3-month follow-up, there was a mean (SD) change in DisODOR score of -47 (15) for participants reporting much improved (n = 5), -35 (17) for moderately improved (n = 9), -29 (20) for slightly improved (n = 3), and -4 (13) for no change (n = 25) (eta squared [η] = .63). Four patients reported worsening of parosmia with a mean (SD) change in DisODOR score of 11 (16). The internal consistency was excellent at .91 and test-retest reliability strong at .85 (95% CI = 0.68-0.93). CONCLUSION: This study provided RCT-level evidence for the DisODOR's strong responsiveness to change, internal consistency, and test-retest reliability. The instrument is an ideal PROM for both clinical use and research, particularly given the difficulty in otherwise quantifying parosmia severity.
Statins and Their Effect on Hearing: An All of Us Database Study.
Homer BJ, Kasthuri VS, Jain R … +3 more , Homer AS, Gjini E, Noonan KY
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40728037 · Publisher ↗
OBJECTIVE: Hearing loss affects approximately 23% of Americans and is associated with medical comorbidities including hyperlipidemia. Statins, commonly used for dyslipidemia, may protect against hearing loss in animal mo...
OBJECTIVE: Hearing loss affects approximately 23% of Americans and is associated with medical comorbidities including hyperlipidemia. Statins, commonly used for dyslipidemia, may protect against hearing loss in animal models, but human studies show mixed results. This study aims to investigate statins and their effect on hearing loss and tinnitus. METHODS: This study is a retrospective cohort study using the All of Us database. All of Us is a NIH-funded research database representing more than 710,000 participants in the United States. Patients with hyperlipidemia were labeled based on their exposure to at least 1 statin and additionally labeled for diagnoses of sensorineural hearing loss and/or tinnitus. Logistic regressions were performed with independent variables of statin use, aspirin use, diagnosis of hypertension and diabetes, age, race, and sex at birth and dependent variables of hearing loss and tinnitus. RESULTS: A total of 90 271 patients with hyperlipidemia were included in this study. The analysis showed an association between the use of statins and sensorineural hearing loss (OR = 1.60, < .01) as well as tinnitus (OR = 1.36, < .01). In the individual statin analysis, simvastatin was associated with the strongest correlation with hearing loss (OR = 1.56, < .01) and tinnitus (OR = 1.50, < .01) while fluvastatin was the least associated both hearing loss (OR = 1.15, < .01) and tinnitus (OR = 1.02, = .68). Atorvastatin, the most used statin, was also associated with hearing loss (OR = 1.27, < .01) and tinnitus (OR = 1.21, < .01). CONCLUSION: In this study, the All of Us database was used to investigate the relationship between statins and hearing loss/tinnitus. Results indicate a potential ototoxic association of statins on hearing and tinnitus.
Role of Neighborhood Deprivation on the Quality of Life of Adults With Chronic Rhinosinusitis.
Ziltzer RS, Hunt C, Cui R … +2 more , Chaiban R, Makary CA
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40708464 · Publisher ↗
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3D Printing of the Pediatric Sinuses: Defining the Frontal Outflow Tract and Sinonasal Pathology.
Melder K, Piston H, Hammersley E … +2 more , Ghodadra A, Stapleton AL
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40665839 · Publisher ↗
OBJECTIVES: To assess the utility of 3-dimensional printing for both trainee education in frontal sinus anatomy and preoperative surgical planning in complex sinonasal pathology. METHODS: A quasi-experimental pre/postsur...
OBJECTIVES: To assess the utility of 3-dimensional printing for both trainee education in frontal sinus anatomy and preoperative surgical planning in complex sinonasal pathology. METHODS: A quasi-experimental pre/postsurvey study was performed at a tertiary care center pediatric rhinology clinic. Four otolaryngology residents and 1 pediatric attending at an academic otolaryngology program were included. Eleven 3D printed models of the pediatric sinuses were created from CT maxillofacial scans. Six models were used to define the frontal outflow pathway. Five additional 3D models were created for pre-surgical planning. The models were dissected in the lab to facilitate surgical planning, technique, and instrumentation selection. Pre- and post-survey evaluations of the training experience were completed by participants. Cost analysis data was collected from the home institution's 3D printing program. RESULTS: Models were accurate to the actual CT scan that they were created from; however, the consistency of the 3D printed models was more firm than true anatomic specimens. Painting sinonasal pathology and the frontal outflow pathway in a distinct color was extremely helpful in identification. Participant post-simulation survey results showed that 60% of participants found the simulation moderately valuable and 40% found it valuable or very valuable as a training tool. A cost analysis was also performed with an average final production cost of $420.52 ± $239.52 per model. CONCLUSION: 3D printed models are a useful tool to study and plan for uncommon sinonasal pathology. They can also serve as a useful trainee tool for learning frontal sinus anatomy. This feasibility study shows that 3D sinus models are affordable and accurate in preserving and identifying important anatomical landmarks. The cost-effectiveness, reusability, and customization of these models support their potential for broader implementation in pediatric surgical training curriculum.
Quality of Life Assessment Following Botulinum Toxin Injection in Patients with Adductor Spasmodic Dysphonia Using the 5-Factor Glasgow Benefit Inventory.
Cirelli MA, Marino MJ, Lott DG … +2 more , Adler CH, Bansberg SF
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40665832 · Publisher ↗
OBJECTIVES/HYPOTHESIS: Botulinum neurotoxin type-A (BoNT-A) injection into the true vocal cords is an effective treatment for restoring vocal functionality in adductor spasmodic dysphonia (AdSD). The Glasgow Benefit Inve...
OBJECTIVES/HYPOTHESIS: Botulinum neurotoxin type-A (BoNT-A) injection into the true vocal cords is an effective treatment for restoring vocal functionality in adductor spasmodic dysphonia (AdSD). The Glasgow Benefit Inventory was developed to measure quality of life change following any otolaryngologic intervention and was recently revised to a 5-factor subdomain (GBI-5F) questionnaire to improve clinical utility. The study aim was to utilize the GBI-5F to measure patient-reported quality of life change in AdSD patients following BoNT-A injection. METHODS: The GBI-5F questionnaire was administered to patients diagnosed with AdSD who received a BoNT-A vocal cord injection between December 2022 and May 2023. All patients had received multiple prior injections. GBI-5F subdomains and demographics were analyzed to identify areas for patient-reported improvement. RESULTS: Sixty-six patients completed the GBI-5F. There were 52 (78.7%) females and average age was 69.4 years. The median total benefit score was +40.0 (interquartile range [IQR], 20.0). Median subdomain scores were +83.3 (IQR, 50.0) for quality of life, +50.0 (IQR, 50.0) for self-confidence, +33.3 (IQR, 33.3) for social involvement, +16.7 (IQR, 50.0) for support, and 0.0 (IQR, 16.7) for general health. Differences in the individual subdomain scores were statistically significant ( < .0001). No significant differences were found in the total GBI-5F score or any subdomain according to sex or presence of vocal tremor (all > .05). A moderately positive correlation was noted between median total score and percent functional improvement (r = 0.46, < .001). CONCLUSION: Botulinum injection therapy for AdSD provides overall benefit to patients as measured by the GBI-5F, with particular improvement observed for perceived quality of life, self-confidence, and social involvement. Sex, presence/absence of vocal tremor, and age do not appear to modify benefit, though degree of functional improvement is positively correlated with total score.
Five-Year Graft Outcomes and Complications of Endoscopic Cartilage-Perichondrium Sandwich Myringoplasty for Large Central Perforations.
Jiang Z, Mao R
Ann Otol Rhinol Laryngol · 2025 Dec · PMID 40652319 · Publisher ↗
OBJECTIVE: We evaluated the 5-year graft success rate and incidence of iatrogenic cholesteatoma following endoscopic cartilage-perichondrium sandwich myringoplasty for the repair of large central tympanic membrane perfor...
OBJECTIVE: We evaluated the 5-year graft success rate and incidence of iatrogenic cholesteatoma following endoscopic cartilage-perichondrium sandwich myringoplasty for the repair of large central tympanic membrane perforations. MATERIALS AND METHODS: This retrospective study included patients with large central perforations who underwent endoscopic cartilage-perichondrium sandwich myringoplasty. Graft integrity and the presence of iatrogenic middle ear cholesteatoma were assessed at a 5-year postoperative follow-up. RESULTS: In total, 86 patients were included in the final analysis. The mean follow-up duration was 6.4 ± 1.2 years (range, 5-7 years). The graft take rates were 96.5% at 3 months, 94.2% at 6 months, and 93.0% at 5 years postoperatively. At 6 months postoperatively, 2.44% of patients demonstrated no change in hearing, whereas 3.66% experienced a deterioration in conductive hearing. In the remaining 93.90% of patients, the improvement in hearing was statistically significant; the mean air-bone gap decreased from 25.1 ± 4.6 dB preoperatively to 14.9 ± 3.1 dB postoperatively ( < .05). At the 5-year follow-up, high-resolution computed tomography (HRCT) revealed well-pneumatized mastoid and middle ear cavities in 93.02% of patients, eliminating the need for magnetic resonance imaging (MRI). HRCT revealed soft tissue opacities in the mastoid region in 4 patients who had undergone canal wall up mastoidectomy (CWUM) and in 2 patients without CWUM; however, subsequent MRI excluded mastoid cholesteatoma in all 6 cases. Notably, a small graft cholesteatoma was detected in 1 patient (1.16%). CONCLUSIONS: Five-year imaging follow-up demonstrated that endoscopic cartilage-perichondrium sandwich myringoplasty, performed without removal of the epithelium from the tympanic membrane remnant, achieved a stable graft success rate in the repair of large central perforations. The procedure was associated with a minimal risk of graft cholesteatoma and no observed risk of middle ear cholesteatoma.
Comment on "Health-Related Quality of Life Metrics in Patients With Retrograde Cricopharyngeus Dysfunction": Highlighting the Psychosocial Burden of R-CPD.
Burmeister JR, Walkon LL
Ann Otol Rhinol Laryngol · 2025 Dec · PMID 40652317 · Publisher ↗
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Comment on "Leveraging Large Language Models to Enhance Patient Educational Resources in Rhinology": Implications for ENT Education and Equity.
Burmeister JR, Bohler F
Ann Otol Rhinol Laryngol · 2026 Jan · PMID 40652316 · Publisher ↗
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