The Annals Of Otology, Rhinology, And Laryngology[JOURNAL]
Sun
200 papers
Understanding Non-Attendance in Pediatric Otolaryngology: A Retrospective Study of Demographics, Socioeconomics, and Pandemic Effects.
Puyo EM, Bayly H, Garg N … +5 more , Salvati LR, Kariveda RR, Carnino JM, Nathan AS, Levi JR
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40516103 · Publisher ↗
OBJECTIVE: The objective of this study is to identify factors associated with missed pediatric otolaryngology appointments at a large safety net hospital, focusing on demographic, socioeconomic, COVID-related, and appoin...
OBJECTIVE: The objective of this study is to identify factors associated with missed pediatric otolaryngology appointments at a large safety net hospital, focusing on demographic, socioeconomic, COVID-related, and appointment-related factors. METHODS: A retrospective chart review was conducted on children (<18 years old) with scheduled outpatient appointments in the otolaryngology department from May 1, 2015, to May 1, 2022. Data were extracted from the EMR, encompassing appointment-related factors (eg, status and type) and patient demographics (age, sex, race, ethnicity, and zip code). Statistical analyses utilized a binary mixed-effects model to identify predictors of appointment non-attendance across pre-COVID, during COVID, and post-COVID periods. RESULTS: Out of 13 868 patients, 3287 (19.2%) were classified as no-show. Older age increased the likelihood of missing appointments (OR = 1.015, 95% CI [1.003, 1.027]). Black/African American patients were more likely to not show up (OR = 1.676, 95% CI [1.376, 2.04]), and there was no significant difference in attendance by sex or ethnicity. Participants residing in regions outside of Boston and those with private insurance (OR = 0.549, 95% CI [0.460, 0.654]) were less likely to miss appointments. Patients with appointments after the COVID-19 pandemic were more likely to no-show compared to pre-pandemic (OR = 1.187, 95% CI [1.068, 1.319]). In-person appointments had a significantly higher no-show rate compared to telemedicine visits (OR = 63.953, 95% CI [26.696, 137.729]). CONCLUSIONS: Non-attendance in pediatric otolaryngology clinics is affected by various demographic and socioeconomic factors, revealing significant disparities among racial groups and age categories. The COVID-19 pandemic altered attendance patterns, indicating changes in healthcare dynamics and patient behavior and reinforcing the benefits of telemedicine. These findings underscore the need for future research to incorporate parental perspectives to understand barriers that caregivers face when bringing their children to clinic visits. Engaging families and exploring their specific challenges can inform targeted interventions aimed at improving appointment adherence in pediatric otolaryngology.
Diagnostic Accuracy of Fine Needle Aspiration and Observational Outcomes in Warthin Tumors of the Parotid Gland.
Baratz HQ, Ali HM, Staricha KL … +5 more , Yin LX, Tasche KK, Van Abel KM, Moore EJ, Price DL
Ann Otol Rhinol Laryngol · 2025 Nov · PMID 40509670 · Publisher ↗
BACKGROUND: The role of fine-needle aspiration (FNA) in diagnosing parotid tumors remains debated due to varying accuracy. This study evaluates FNA's accuracy in diagnosing Warthin's tumor (WT) and its safety in guiding...
BACKGROUND: The role of fine-needle aspiration (FNA) in diagnosing parotid tumors remains debated due to varying accuracy. This study evaluates FNA's accuracy in diagnosing Warthin's tumor (WT) and its safety in guiding observational management. STUDY DESIGN: Retrospective cohort study. SETTING: Single institution, Tertiary referral center. METHODS: Data from 2010 to 2022 including demographics, cytology, pathology, and surgical outcomes were extracted. Accuracy was assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). RESULTS: Among 808 patients with parotid tumors, 234 were WTs. Seventy-eight patients underwent surgery with pathology while 156 underwent observation. FNA sensitivity, specificity, PPV, and NPV for WTs were 98.2%, 98.1%, 91.8%, and 99.6% respectively. No observational patients developed clinical signs of malignancy, and the median change in tumor size was 0 cm (range -3.1 to 2.1). CONCLUSIONS: FNA is highly specific for WT but limited by nondiagnostic results. Observation is a safe approach with minimal risk of growth, malignancy, or infection.
The Rising Importance of Research Output in ENT Residency Applications Without Numeric Step 1 Scores.
Burmeister JR, Dimock E, Bohler F … +1 more , Haupert M
Ann Otol Rhinol Laryngol · 2025 Nov · PMID 40509642 · Publisher ↗
OBJECTIVE: To evaluate trends in research output (RO) among otolaryngology residency applicants following the transition of the United States Medical Licensing Examination (USMLE) Step 1 to pass/fail scoring, and to expl...
OBJECTIVE: To evaluate trends in research output (RO) among otolaryngology residency applicants following the transition of the United States Medical Licensing Examination (USMLE) Step 1 to pass/fail scoring, and to explore implications for equity and applicant experience. METHOD: This commentary analyzes publicly available data from the National Resident Matching Program (NRMP) Charting Outcomes in the Match reports from 2016 to 2022. The focus is on the average number of abstracts, presentations, and publications reported by matched and unmatched otolaryngology applicants. RESULTS: Between 2016 and 2022, the average number of research items reported by matched applicants increased from 8.4 to 17.2. In 2022, unmatched applicants reported an average of 11.0 items-similar to what matched applicants reported in 2020. This upward trend appears to align with the announcement and implementation of Step 1 pass/fail scoring. DISCUSSION: The increase in RO suggests that both programs and applicants are adapting to Step 1's scoring change by placing greater emphasis on scholarly productivity. However, this shift raises concerns about equity. Applicants without access to a home otolaryngology department or robust research infrastructure may face barriers to mentorship and publication opportunities. Financial costs associated with research presentation and the pressure to start research early in medical school further compound these disparities. The otolaryngology community must critically assess how RO is valued in the application process and develop strategies to ensure fair, meaningful engagement across diverse educational settings.
Reduced Receipt of Dedicated Computed Tomography With Implementation of a New Temporal Bone Fracture Protocol.
Patel AA, Tandler C, Sakai O … +1 more , Weber PC
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40509634 · Publisher ↗
INTRODUCTION: Temporal bone computed tomography (TBCT) is used to evaluate temporal bone fractures, but on average, it can result in additional radiation exposure and extra cost without clear clinical benefit. This study...
INTRODUCTION: Temporal bone computed tomography (TBCT) is used to evaluate temporal bone fractures, but on average, it can result in additional radiation exposure and extra cost without clear clinical benefit. This study aimed to determine whether a new protocol could decrease the receipt of dedicated TBCT without impacting temporal bone fracture management. METHODS: A retrospective review of patients sustaining temporal bone fractures at a level I trauma center from January 1, 2019 to January 1, 2024 was completed before and after the implementation of a protocol to reconstruct 0.625 mm thick images at 0.3 mm spacing TBCT from existing CT head instead of the immediate performance of TBCT (IRB H-44161). Primary outcomes included the incidence of dedicated TBCT and treatment and the incidence of otologic complications. RESULTS: During the study period, 17 of 69 patients who sustained temporal bone fractures were evaluated after protocol implementation. After implementation, patients had significantly lower odds of obtaining dedicated TBCT (OR = 0.077, 95% CI = 0.0158, 0.3726, = .0002) with no significant differences in medical ( = .5385) management. Otic capsule involvement ( = .3110) and otologic complications, including cerebrospinal fluid leak, facial nerve paresis, or hearing loss ( = 1), also did not differ significantly. Avoidance of dedicated TBCT reduced the effective radiation dose by 1.1 mSv. CONCLUSION: A protocol to reconstruct TBCT from previously obtained head CT scans has reduced the receipt of dedicated TBCT without differences in management or complication, reducing radiation exposure and decreasing healthcare costs.
Differences Between Adult and Pediatric Periorbital Cellulitis Secondary to Acute Rhinosinusitis.
Dewey J, Kais A, Nguyen J … +2 more , Ramadan HH, Makary CA
Ann Otol Rhinol Laryngol · 2025 Nov · PMID 40501313 · Publisher ↗
OBJECTIVE: To investigate the clinical differences between adult and pediatric patients presenting with periorbital cellulitis secondary to acute rhinosinusitis (ARS). STUDY DESIGN: Retrospective cohort study. SETTING: T...
OBJECTIVE: To investigate the clinical differences between adult and pediatric patients presenting with periorbital cellulitis secondary to acute rhinosinusitis (ARS). STUDY DESIGN: Retrospective cohort study. SETTING: Tertiary academic medical center. METHODS: Patients presenting to the emergency department with acute periorbital cellulitis secondary to ARS from 2012 to 2022 were reviewed, to include past medical history, treatment, hospital length of stay (LoS), and readmission rates. RESULTS: About 163 patients were identified on chart review and included of which 80 were adults (age > 18). Mean age in the pediatric cohort was 6.4 (±4.6) years versus 49.2 (±18.5) years in the adult cohort. Both adults and children had similar computed tomography (CT) Lund-Mackay scores (9.2 vs 10.2, = .191 respectively) and similar incidence of postseptal cellulitis (68.8% vs 65.1%, = .617 respectively). The adult patients were more likely to require surgical treatment (45% vs 21.7%, = .002), more likely to have neurological complications (11.3% vs 0%, = .002), had longer hospital stay (LoS; 6.9 days vs 3.6 days, = .002), and more likely to require readmission within 30 days (16.3% vs 6%, = .037). Multivariate analyses showed that the adult population was independently associated with requiring surgical treatment (OR = 2.7, 95% CI = 1.3-6) but not with a longer hospital LoS (Coef 1.1, 95% CI = -0.5 to 2.7). CONCLUSIONS: Adult patients presenting with acute periorbital cellulitis secondary to ARS are more likely to need surgical intervention and more likely to have longer hospital stay. Longer hospital stay in adult patients may be secondary to sequelae of the infection such as neurological complications.
Analysis of Content Related to Retrograde Cricopharyngeal Dysfunction on TikTok: Opportunities for Patient Education and Advocacy.
Wright A, Hunter N, Jin V … +1 more , Tritter A
Ann Otol Rhinol Laryngol · 2025 Nov · PMID 40483672 · Full text
OBJECTIVE: TikTok has experienced exponential growth as a social media platform, with over 1 billion active users. Concurrently, retrograde cricopharyngeal dysfunction (RCPD) has seen a surge in awareness among patients...
OBJECTIVE: TikTok has experienced exponential growth as a social media platform, with over 1 billion active users. Concurrently, retrograde cricopharyngeal dysfunction (RCPD) has seen a surge in awareness among patients and on social media. Our objective was to characterize the most popular RCPD-related content on TikTok. METHODS: The top 50 videos associated with the following hashtags were analyzed: "RCPD," "noburp," "retrograde cricopharyngeal dysfunction," and "noburpsyndrome." Recorded metrics included views, likes, and comments, along with information regarding the creator's identity, gender, geographical location, and the video's purpose. RESULTS: One hundred and three videos were included in the final analysis, with a cumulative total of 32 284 962 views, 3 185 271 likes, and 54 664 comments. Over 90% of these videos were created by patients or the general public, with less than 5% attributed to physicians. The primary purpose of these videos varied, with 46.60% aimed at educating viewers about RCPD, 23.30% serving as post-treatment testimonies, and 14.56% demonstrating symptoms. CONCLUSION: TikTok is a highly popular platform for RCPD-related content. Patient education, treatment testimonies, and symptom demonstration were the most common primary purposes of these videos. Considering the limited representation of physician-generated content, this social media landscape represents an opportunity for otolaryngologists to leverage TikTok for educational outreach and patient advocacy.
Exploring Research Challenges in the Study of Sudden Sensorineural Hearing Loss: An Investigation Utilizing a Large Single Clinical Practice Database.
Hodge SE, Berliner KI, Grimes R … +2 more , Slattery W, Peng KA
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40474384 · Publisher ↗
OBJECTIVES: To analyze SSNHL patient data from a single large multi-physician institution to determine the nature of confounding factors that must be considered in designing adequate studies for improved diagnosis and tr...
OBJECTIVES: To analyze SSNHL patient data from a single large multi-physician institution to determine the nature of confounding factors that must be considered in designing adequate studies for improved diagnosis and treatment. METHODS: Retrospective review of a random sample of 330 patients (mean age = 61 yrs (19-96); 45% F) diagnosed with idiopathic SSNHL from 2013 to 2022 from a tertiary referral clinical practice. Data included demographics, treatment modality (oral prednisone only, intratympanic dexamethasone [IT Dex] only, or a combination of both) and regimen, time to treatment, and pure-tone averages (PTA) and word recognition scores (WRS). Different hearing outcomes were assessed, including recovery category (Complete, Partial, No Recovery) rates. RESULTS: Only 56% of patients had a >30 dB loss compared to the contralateral ear, while PTA and WRS both ranged widely (6 dB-NR; 0%-100%). Oral steroids were the most common treatment (83%), used alone in 32.4%, with IT Dex injections used in 68.8%, but as only treatment in 17%. 50.6% received both treatments. Hearing outcomes were generally poor, with small improvements in PTA (mean improvement = -9.5 dB, SD = 18.7) and WRS (mean improvement = 9.1%, SD = 27.7) across all subjects, with no statistically significant differences between treatment groups and a high rate of no recovery (76.2%). Pretreatment PTA followed by treatment timing (≤14 days, >14 days) and treatment type contributed significantly to predicting amount of change in PTA but accounted for only a small portion of the variability in regression analysis (R = .232, ≤ .001). CONCLUSIONS: Hearing outcomes with standard steroid treatments remain suboptimal. Patients presenting for treatment of SSNHL in clinical practice can vary greatly from the formal definition of SSNHL, and past studies may not be generalizable to the overall population of patients. This highlights the challenges in defining and treating SSNHL in a clinical environment and identifies confounding factors to be considered in future research designs.
Incidental Findings on Paranasal Sinus Computed Tomography Scans and the Importance of Clinical Context.
Badash I, Hur K
Ann Otol Rhinol Laryngol · 2025 Nov · PMID 40470867 · Publisher ↗
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Breaking the Binary: Rethinking Sex-Matched Norms in Swallowing Assessments for Gender-Diverse Patients.
Patel N, Bhethanabotla RM, Schneider SL … +2 more , Young VN, Evans C
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40470862 · Full text
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The Use of Tranexamic Acid for Post-tonsillectomy Hemorrhage in Pediatric Patients: A Scoping Review.
Tesema N, Hasnie S, Wright-Powers L … +2 more , Earley M, April M
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40468688 · Publisher ↗
OBJECTIVE: Post-tonsillectomy hemorrhage is a highly studied outcome of tonsillectomy with serious consequences. The off-label use of tranexamic acid (TXA) is of growing interest to control post-tonsillectomy hemorrhage...
OBJECTIVE: Post-tonsillectomy hemorrhage is a highly studied outcome of tonsillectomy with serious consequences. The off-label use of tranexamic acid (TXA) is of growing interest to control post-tonsillectomy hemorrhage but has not been incorporated in management guidelines. STUDY DESIGN: Scoping review on the use of tranexamic acid for post-tonsillectomy hemorrhage. SETTING: N/A. METHODS: A comprehensive literature search was performed across the following research databases: PubMed, Embase, CINAHL, and Web of Science. The search was limited to English-language studies and patients without prior diagnosis of bleeding disorders. The articles were screened for relevance based on inclusion and exclusion criteria. Our initial search generated 131 articles. RESULTS: A total of 24 articles were identified, published in mostly otolaryngology journals. Over 96 000 tonsillectomy cases were included. There was variability in administration routes: intravenous, nebulized, oral, and topical. Intravenous was most used, particularly as prophylaxis for post-tonsillectomy hemorrhage, and nebulized administration was more common in therapeutic settings. Dosing regimens ranged between 5 and 15 mg/kg. We found mixed results across studies regarding peri-operative and post-operative bleeding outcomes, though multiple studies demonstrated decreased intraoperative bleeding. Many studies concurred that TXA was safe to use for post-tonsillectomy hemorrhage. CONCLUSION: The existing literature indicates TXA shows promising results in safety and reducing intraoperative blood volume loss. Further prospective and randomized controlled trials are needed to ensure the clinical benefits of TXA in tonsillectomy surgery prior to the inclusion in clinical practice guidelines.
The Effect of Passive Music Intervention on Health-Related Quality of Life After Tonsillectomy.
Zaubitzer L, Wassmer F, Kramer B … +6 more , Lammert A, Sadick H, Schell A, Scherl C, Rotter N, Haeussler D
Ann Otol Rhinol Laryngol · 2025 Nov · PMID 40458071 · Publisher ↗
INTRODUCTION: Measurement of health-related quality of life (QoL) is a firmly established method for evaluating therapeutic procedures. Studies have demonstrated positive effects of passive music interventions. To date,...
INTRODUCTION: Measurement of health-related quality of life (QoL) is a firmly established method for evaluating therapeutic procedures. Studies have demonstrated positive effects of passive music interventions. To date, however, no standardized approach to music therapy interventions after head and neck surgery has been developed. Furthermore, the effects of such interventions in the immediate postoperative phase following surgery in head and neck region have yet to be adequately investigated. METHODS: Patients undergoing tonsillectomy were consecutively included in a prospective randomized study. The intervention group received passive music therapy (60 minutes/day). QoL was recorded using the Glasgow Benefit Inventory (GBI) and Brief Pain Inventory (BPI) at 3 fixed time points after operation. In addition, the participants filled out a pain diary throughout the observation period using a Visual Analog Scale. RESULTS: Study sample comprised 31 patients. Fifteen patients (6 women and 9 men) were included in the intervention group and 16 (6 women and 10 men) in the control group. Participants' average ages were 28 years (intervention group) and 39 years (control group). Significant differences in QoL emerged 5 and 14 days after surgery ( = .049 and <.01). In addition, the BPI results differed significantly at time point 3 ( < .01). Significant differences were observed in the pain diary from day 8 after surgery. DISCUSSION/CONCLUSION: Complementary music interventions may improve QoL as well as patients' pain perception. Owing to its ubiquitous availability and cost-effectiveness, passive music interventions with their measurable positive benefits may be easily implemented into clinical routine.
Otolaryngology Education in Medical Training: A Literature Review of Current Practice, Challenges, and Future Directions.
Mughal Z, Gupta KK, Fruhstorfer B
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40458060 · Publisher ↗
INTRODUCTION: Concerns about the adequacy of ENT education are widespread, particularly in the UK. Limited exposure during undergraduate and postgraduate training are key factors. This review aims to synthesize the liter...
INTRODUCTION: Concerns about the adequacy of ENT education are widespread, particularly in the UK. Limited exposure during undergraduate and postgraduate training are key factors. This review aims to synthesize the literature on ENT education, identify gaps, and explore strategies for improvement. METHODS: A literature search was conducted on Ovid Medline, supplemented by bibliography and citation tracking. Studies focusing on ENT higher surgical training programs were excluded. A narrative synthesis was performed. RESULTS: Medical students and postgraduate doctors frequently reported insufficient ENT education, leading to under-preparedness for ENT practice. Undergraduate ENT curricula varied widely, with limited placement durations and inconsistent content delivery. Innovative educational interventions were found to enhance knowledge and confidence. However, students consistently valued direct patient interaction over technology alone. CONCLUSION: ENT education at the undergraduate level remains inconsistent, necessitating further action in the development of standardized curricula, and integration of technology with clinical exposure.
Omalizumab Efficacy in Chronic Rhinosinusitis Patients with Recurrent Nasal Polyps: An open-label, single-center, randomized, controlled study.
Noeiaghdam R, Esmaeilzadeh H, Faramarzi M … +5 more , Moshfeghinia R, Fallahi MS, Alyasin S, Nabavizadeh H, Mortazavi N
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40437843 · Publisher ↗
BACKGROUND: Chronic rhinosinusitis with nasal polyposis (CRSwNP) causes inflammatory nasal polyps, with an unknown cause. CRSwNP patients face a higher relapse risk, impacting their quality of life. This study assesses o...
BACKGROUND: Chronic rhinosinusitis with nasal polyposis (CRSwNP) causes inflammatory nasal polyps, with an unknown cause. CRSwNP patients face a higher relapse risk, impacting their quality of life. This study assesses omalizumab's efficacy in reducing nasal polyp recurrence, aiming to provide insights into managing CRSwNP and improving patient outcomes through potential therapeutic interventions. METHODS: The Iranian clinical trial (IRCT20220218054057N1) approved in January 2023 focused on adult patients (18-60 years) with CRSwNP. Participants were randomized into control and omalizumab groups. Before the intervention, demographic data, Sino-nasal outcome test (SNOT-22), Total nasal symptom score (TNSS), Nasal polyp score (NPS), and blood IgE levels were collected. An oral aspirin challenge diagnosed AERD. Both groups were monitored, completing questionnaires during and 12 months post-study initiation. Recurrence of nasal polyps was examined at the 1-year mark. SPSS version 25 was used for analysis. The trial aimed to assess omalizumab's impact on CRSwNP, considering various factors and long-term outcomes. RESULTS: In a study with 76 participants (50 control, 26 omalizumab), aged around 45.62 and 41.50 years, without significant difference in gender and number of polyp surgeries in both groups. Both groups experienced a notable decrease in NPS, with the omalizumab group showing a greater reduction (-1.31 vs -0.90, < .001). TNSS scores dropped more in the omalizumab group (-4.54) than in the control group (-2.04) at week 24. SNOT-22 scores decreased significantly from baseline to week 24 for both groups. Notably, nasal polyp relapse occurred in 9 control patients but none in the omalizumab group ( < .001). No significant differences were observed between AERD and non-AERD patients. CONCLUSION: Omalizumab is an effective treatment for CRSwNP, significantly improving the quality of life of patients post-surgery, especially TNSS score, and reducing regeneration of polyp tissue and relapse frequency in nasal endoscopy.
Surgical Management of Retropharyngeal Metastases From Papillary Thyroid Carcinoma: Transcervical and Transoral Robotic Approaches.
Agne GR, Bento GN, Belli M … +4 more , Rossi CB, Matos LL, Lira RB, Kowalski LP
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40437713 · Publisher ↗
BACKGROUND: Papillary thyroid carcinoma (PTC) typically has favorable outcomes, with surgery as the primary treatment. While metastases to central or lateral cervical lymph nodes are relatively common, retropharyngeal sp...
BACKGROUND: Papillary thyroid carcinoma (PTC) typically has favorable outcomes, with surgery as the primary treatment. While metastases to central or lateral cervical lymph nodes are relatively common, retropharyngeal spread is rare. It often manifests as elevated serum thyroglobulin levels or iodine uptake in recurrent disease in asymptomatic patients. The resection through transcervical route offers good access but has potential complications. Transoral Robotic Surgery (TORS) has emerged as a viable alternative with reduced morbidity. OBJECTIVES: To describe a series of cases of PTC retropharyngeal metastasis treated with transcervical and transoral robotic surgical approaches, and to discuss the surgical therapeutic options. METHODS: In a retrospective cohort of 1315 patients who underwent thyroid carcinoma surgery, 4 presented with retropharyngeal metastases. RESULTS: In our study, 2 patients with retropharyngeal metastases were treated by open surgery (transcervical approach) and 2 by TORS. The mean patient age was 51.5 ± 12.4 years (3 females and 1 male). All cases involved classical PTC (1 microcarcinoma and 3 pT4). One patient had previously undergone total laryngectomy for laryngeal invasion. All cases were recurrences with the disease limited to the retropharyngeal space, diagnosed due to persistent high thyroglobulin levels. In all patients, prior lateral neck dissection had been performed. One patient had local recurrence after transcervical approach, the other evolved with successful oncological control. Patients who underwent robotic surgery experienced odynophagia during the first week but had no subsequent feeding difficulties. CONCLUSION: TORS offers potential advantages of being less invasive, associated with fewer complications, not leaving a visible scar, and maintaining favorable oncological outcomes. Patients who need concurrent lateral node dissection may benefit from a combined approach depending on the anatomical presentation of retropharyngeal metastasis.
Leveraging Large Language Models to Enhance Patient Educational Resources in Rhinology.
Shaari AL, Ho RA, Xu A … +3 more , Patil D, Berisha L, Hsueh WD
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40437711 · Publisher ↗
BACKGROUND: To compare the readability of patient education materials (PEMs) on rhinologic conditions and procedures from the American Rhinologic Society (ARS) with those generated by large language models (LLMs). METHOD...
BACKGROUND: To compare the readability of patient education materials (PEMs) on rhinologic conditions and procedures from the American Rhinologic Society (ARS) with those generated by large language models (LLMs). METHODS: Forty-one PEMs from the ARS were retrieved. Readability was assessed through the Flesch Kincaid Reading Ease (FKRE) and Flesch Kincaid Grade Level (FKGL), in which higher FKRE and lower FKGL scores indicate better readability. Three LLMs-ChatGPT 4.o, Google Gemini, and Microsoft Copilot-were then used to translate each ARS PEM to the recommended sixth-grade reading level. Readability scores were calculated and compared for each translated PEM. RESULTS: A total of 164 PEMs were evaluated, including 123 generated by LLMs. The original ARS PEMs had a mean FKGL of 10.28, while AI-generated PEMs demonstrated significantly better readability, with a mean FKGL of 8.6 ( < .0001). Among the AI platforms, Gemini was the most easily readable, reaching a mean FKGL of 7.5 and FKRE of 65.5. CONCLUSION: LLMs improved the readability of PEMs, potentially enhancing accessibility to medical information for diverse populations. Despite these findings, healthcare providers and patients should cautiously appraise LLM-generated content, particularly for rhinology conditions and procedures. LEVEL OF EVIDENCE: N/A.
Internal Superior Laryngeal Nerve Injections Through the Piriform Sinus for Laryngeal Neurosensory Disturbances: A Prospective Analysis.
Bowen AJ, McCalla M, Ring S … +7 more , Roitman A, Hortobagyi D, Yang Q, Francis DO, Davis RJ, McCulloch T, Dailey SH
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40432599 · Publisher ↗
OBJECTIVE: Internal superior laryngeal nerve (iSLN) injections demonstrate short term improvements in patients with laryngeal neurosensory disturbances (ie, chronic refractory cough and globus pharyngeus) that can requir...
OBJECTIVE: Internal superior laryngeal nerve (iSLN) injections demonstrate short term improvements in patients with laryngeal neurosensory disturbances (ie, chronic refractory cough and globus pharyngeus) that can require multiple injections. A more targeted iSLN injection approach could provide greater effectiveness. This study prospectively evaluated whether transnasal endoscopic iSLN injections that target the internal iSLN as it transverses the piriform sinuses was effective at treating laryngeal neurosensory disturbances. METHODS: This was a prospective cohort analysis performed at a single tertiary care center. Patients with laryngeal neurosensory disturbances underwent transnasal endoscopic iSLN injections bilaterally using triamcinolone-40 mg/mL. Demographics, clinical history, and exam findings were recorded, along with post-injection complications. The primary outcomes were the Leister Cough Questionnaire (LCQ), Reflux Symptom Index (RSI), and the Voice Handicap Index-10 (VHI-10) collected at pre-injection, 3-weeks post-injection, and 2-months post-injection that were examined with linear mixed modeling. RESULTS: Eighteen patients with laryngeal sensory disturbances (11 with chronic cough and 7 with globus sensation) underwent the procedure. There were significant improvements in LCQ scores (all greater than 1.3 points) and RSI scores (all greater than 7-point improvement) at both 3-week and 2-month timepoints ( < .05). When stratified into globus sensation patients alone, there was significant improvements in LCQ at 3 weeks (3.92 points, = .02) as well as across both 3-week and 2-month timepoints (14 points, < .001; 7.4 points, = .04). There were no aspiration events or major complications. CONCLUSIONS: Targeted transnasal endoscopic iSLN injections of the piriform sinus mucosa appears to be a safe and effective way of treating laryngeal neurosensory disturbances. The technique provides a visual target for injection of the iSLN which may allow for exploration of alternative neuromodulating medicines for use in this patient population.
The Development and Validation of Novel 3-Dimensional Models for Simulation Training in Sinonasal and Skull Base Surgery.
Rehman U, Okhovat S, Woods R … +12 more , London NR, Verillaud B, von Buchwald C, Gallia GL, Omay SB, Bennett W, Abhinav K, Choby G, Nayak JV, Leong SC, Vyskocil E, Lechner M
Ann Otol Rhinol Laryngol · 2025 May · PMID 40426328 · Publisher ↗
INTRODUCTION: As the demand for otolaryngologists increases, there is a need to address workforce and training challenges. Technological advancements, such as high-fidelity 3-dimensional (3D) simulations, may help train...
INTRODUCTION: As the demand for otolaryngologists increases, there is a need to address workforce and training challenges. Technological advancements, such as high-fidelity 3-dimensional (3D) simulations, may help train the future workforce-particularly for conditions with limited exposure, such as sinonasal and skull base cancers. AIMS: This study aimed to develop and validate a high-fidelity head and neck model, created using proprietary 3D printing technology, to simulate sinonasal and skull base surgery. METHODOLOGY: The sinonasal and skull base models were designed and produced using proprietary 3D printing technology (Fusetec). 3D printed models were incorporated into a 2-day dissection course. Surveys were completed by delegates and faculty on the course, with delegates having their surgical performance assessed using the Objective Structures Assessment of Technical Skills (OSATS). RESULTS: A total of 21 delegates and 10 faculty had utilized the 3D printed models for sinonasal and skull base surgery training. Overall, 71.4% of delegates (n = 15) and 70.0% (n = 7) of faculty rated the realism of the models as very good/excellent. The mean pre course OSATS score was 22.57/40 (SD ±6.88) and the post course OSATS score was seen to be 25.7/40 (SD ±4.70; < .0001). The total confidence reported by delegates prior to the course was 25.8/45 (SD ±7.00) and following the course the self-reported confidence was 33.6/45 (SD ±3.62; < .001). CONCLUSION: This study developed and validated a novel 3D model for simulating sinonasal and skull base surgery, which improved surgical performance amongst participants. This offers a potential training solution to address workforce challenges in Otolaryngology.
Health-Related Quality of Life Metrics in Patients With Retrograde Cricopharyngeus Dysfunction.
Jacobs D, Duffy JE, Lerner BA … +1 more , Lerner MZ
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40420548 · Publisher ↗
OBJECTIVE: We sought to objectively characterize functional quality of life and social anxiety metrics in patients with retrograde - cricopharyngeus dysfunction (R-CPD) using validated questionnaires. METHODS: A survey w...
OBJECTIVE: We sought to objectively characterize functional quality of life and social anxiety metrics in patients with retrograde - cricopharyngeus dysfunction (R-CPD) using validated questionnaires. METHODS: A survey was posted to a private R-CPD Facebook group and a public R-CPD Reddit group. The survey contained demographic and clinical questions, as well as the PROMIS-29 questionnaire and the Social Anxiety Questionnaire (SAQ). The PROMIS-29 questionnaire contains 7 subdomains of quality of life functioning and is scored against a national average. The SAQ is a 30-item questionnaire with 5 subdomains of social anxiety. Comparisons of means were performed using -tests and logistic regressions. RESULTS: Survey results from 239 respondents were included. The majority of respondents were young (<30 years, 51.1%) and female (73.6%). Two hundred twenty (92.1%) reported all 3 cardinal R-CPD symptoms and were included in the analysis of PROMIS-29 and SAQ results. On the PROMIS-29 questionnaire, respondents reported high levels of anxiety (71.0%), depression (55.1%), fatigue (66.8%), sleep impairment (43.0%), social avoidance (54.3%), and pain impairment (58.8%). The mean SAQ score was 96.4, with 52.0% of respondents scoring above the cutoff for social anxiety. Reported anxiety was highest in interactions with strangers (71.1%, 95% confidence interval [CI]: 64.3%-77.9%) and lowest in interactions with the sex 1 is attracted to (44.5%, 95% CI: 37.0%-52.0%). CONCLUSIONS: Patients with R-CPD have high levels of anxiety and other impairment. Results may help clinicians understand and treat patients with R-CPD, and provide benchmarks by which clinicians may better monitor response to therapy, and provide benchmarks for clinicians to better monitor therapy response.
Surgical Treatment Outcomes in the Management of Rhinitis: A Systematic Review and Meta-Analysis.
Ripp AT, Patel PA, Nguyen SA … +4 more , Schafer IV, Duffy AN, Soler ZM, Schlosser RJ
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40417957 · Publisher ↗
BACKGROUND: Rhinitis can present with symptoms including severe nasal obstruction, rhinorrhea, nasal itching, and sneezing. Surgical treatment options include inferior turbinate procedures, thought to target nasal conges...
BACKGROUND: Rhinitis can present with symptoms including severe nasal obstruction, rhinorrhea, nasal itching, and sneezing. Surgical treatment options include inferior turbinate procedures, thought to target nasal congestion, and posterior nasal nerve (PNN) procedures, for relief of rhinorrhea. This review intends to quantify the degree of resolution of symptoms related to rhinitis from various procedures and guide clinical decision making. METHODS: A literature search identified studies reporting rhinitis symptoms at baseline and following surgical treatment. Outcomes of interest were the 4-item Total Nasal Symptom Score (TNSS) and VAS equivalents for "rhinorrhea," "nasal obstruction," "nasal itching," and "sneezing." Postnasal drip (PND) scores were additionally collected when available. RESULTS: A total of 20 studies (N = 1408) were analyzed. The TNSS fell by 50% (mean difference 3.86 points [95% CI 3.03-4.69]), with all 4 symptoms undergoing significant amelioration across all procedure types. Nasal congestion, rhinorrhea, and PND saw the largest improvement, with reductions ranging from 1.2 to 1.5 points. VAS scoring followed a similar pattern, with nasal obstruction and runny nose undergoing the largest changes. Turbinate and PNN procedures led to similar improvements in congestion and rhinorrhea, with average score reductions of 56.8% and 57.6% ( = 0.7168), respectively. Nasal itching and PND underwent differential improvement, with greatest improvements from PNN procedures (mean differences of 14.2% [95% CI: 4.7-23.4% and 31.6% [95% CI: 21.2-40.6%], < .0001). CONCLUSION: All surgical treatments for rhinitis improve patient symptom burden, having the most drastic effect on nasal congestion and rhinorrhea. PNN procedures result in greater improvements in nasal itching and PND but otherwise perform similarly to inferior turbinate surgeries.
Audiological Outcomes in Mild to Moderate Post-COVID-19 Patients: A Longitudinal Study in a South Indian Tertiary Care Hospital.
Saldanha M, Winston JS, Kuniyil N … +1 more , Poral AS
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40417810 · Publisher ↗
OBJECTIVE: The audio-vestibular symptoms commonly reported after COVID-19 usually presents within 6 weeks post infection. This study aimed to assess the effect of COVID-19 infection on the auditory status. METHODS: This...
OBJECTIVE: The audio-vestibular symptoms commonly reported after COVID-19 usually presents within 6 weeks post infection. This study aimed to assess the effect of COVID-19 infection on the auditory status. METHODS: This longitudinal prospective study included 74 patients diagnosed with mild to moderate COVID- 19 infection using PCR. Audiological assessment using Pure tone audiometry (PTA), speech audiometry, immittance evaluation, and transient evoked otoacoustic emissions (TEOAE) were done at 2 weeks post infection and 4 weeks following. RESULTS: PTA showed a significant difference in the AC thresholds but not for the BC thresholds across 2 visits. Impedance audiometry revealed a significant difference over 2 visits for A tympanogram ( = .006). TEOAE was affected only at 1000 Hz ( < .05)Conclusion:Audio-vestibular symptoms are infrequent in COVID-19 infection. There is a conductive nature of hearing impairment, as evidenced in the initial and follow-up evaluations. The TEOAE changes at 1000 Hz raises the possibility of subclinical cochlear involvement.
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