The Annals Of Otology, Rhinology, And Laryngology[JOURNAL]
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200 papers
Middle Ear Cleft Opacification in Acute Otitis Externa: Sequela or Incidentaloma?
Barzilai R, Merhav G, Cohen-Vaizer M … +4 more , Noy R, Gvozdev N, Eran A, Vaisbuch Y
Ann Otol Rhinol Laryngol · 2025 Oct · PMID 40411229 · Publisher ↗
BACKGROUND: The external and middle ear are anatomically distinct regions. Middle ear cleft opacification (MECO) observed following acute otitis externa (AOE) raises questions about its occurrence mechanism and clinical...
BACKGROUND: The external and middle ear are anatomically distinct regions. Middle ear cleft opacification (MECO) observed following acute otitis externa (AOE) raises questions about its occurrence mechanism and clinical significance. Previous animal studies have demonstrated that irritation of the external ear canal can lead to the development of middle ear effusion via Pars Flaccida cells. The literature lacks clinical information on middle ear involvement in AOE. METHODS: A retrospective analysis was conducted on 92 patients post-AOE who underwent brain imaging within 3 months post-uncomplicated AOE. Patients with anatomical disruptions between the external and middle ear were excluded. MECO rate and dynamics were evaluated. The involvement of middle ear cleft anatomic regions was assessed. RESULTS: MECO was identified in 38.0% (35/92) of post-AOE ears compared to 10.8% (10/92) of contralateral ears ( = .002). The prevalence of MECO in post-AOE patients decreased from 58.9% (23/39) within 2 weeks post-AOE to 8.0% (2/25) 3 months post-AOE. Over time, complete middle ear opacification gradually transitioned to partial opacification. Opacification was noted in the upper middle ear cleft (epitympanum/mastoid) in 94.2% (33/35). CONCLUSIONS: Middle ear effusion is a common, resolving sequela of AOE, rather than an indication of AOE deterioration or significant middle ear inflammatory involvement. This information is valuable for otolaryngologists as well as general practitioners who treat AOE patients, helping to better understand potential sequelae and avoid unnecessary treatments, and for radiologists who diagnose ME opacification in AOE patients. Further studies are warranted to explore the role of the pars flaccida in middle ear effusion.
The Influences of Nasal Saline Irrigation on Chinese Children with Allergic Rhinitis Plus Asthma.
Ji X
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40411220 · Publisher ↗
OBJECTIVE: To determine the influence of nasal saline irrigation on Chinese pediatric patients with allergic rhinitis plus asthma. METHODS: An attempt was made to randomly categorize 60 pediatric patients with allergic r...
OBJECTIVE: To determine the influence of nasal saline irrigation on Chinese pediatric patients with allergic rhinitis plus asthma. METHODS: An attempt was made to randomly categorize 60 pediatric patients with allergic rhinitis plus asthma, who were admitted to our hospital (June 2022-March 2023), into 2 groups (n = 30). Participants in the 2 groups were given routine treatment for allergic rhinitis plus asthma, while those in the observation group were additionally administered nasal saline irrigation. Thereafter, the overall effective rate, total adverse reaction rate, nasal sign scores, childhood asthma control test (C-ACT) scores, total nasal symptom scores (TNSS), airway inflammation index (fractional exhaled nitric oxide, FENO), and allergy indices (Total serum IgE, TIgE; eosinophils, EOS) underwent comparative analysis before and after the treatment between the 2 principal groups. RESULTS: A significantly escalated overall effective rate was noted in the observation group relative to the control group ( = .023). The lack of a significant difference, particularly in the total adverse reaction rate, was noteworthy between the 2 principal groups ( = 0.640). A comparable analysis of nasal sign scores, C-ACT score, TNSS score, FENO, and allergy indices was conducted between the 2 groups before treatment, which showed a lack of significant differences. Significantly attenuated nasal sign scores, TNSS score, FENO, and allergy indices were observed in the observation group following treatment, relative to both the control group and pre-treatment levels. Significantly elevated C-ACT scores were also noted compared to both the control group and pre-treatment levels ( = .019). CONCLUSION: Nasal saline irrigation proved remarkably effective, particularly in Chinese pediatric patients with allergic rhinitis plus asthma, showing advantages in alleviating disease-related symptoms and signs, reducing airway inflammation, and diminishing the severity of allergic reactions.
Response Letter to Editor Letter From 26th February 2025 on "A Retrospective Single-Center Study in 20 Patients With Midline Nasal Masses: Which Site Has the Highest Risk of Recurrence?".
Yılmaz Topçuoğlu MS, Plinkert PK, Seitz A … +3 more , El Damaty A, Bächli H, Baumann I
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40411140 · Publisher ↗
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Letter to the Editor on "A Retrospective Single-Center Study in 20 Patients With Midline Nasal Masses: Which Site Has the Highest Risk of Recurrence?".
Ravichandran K
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40411136 · Publisher ↗
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Pediatric Otolaryngology Procedure Duration by Training Level: 12,704 Case Analysis.
Jabbour C, Aaronson NL, Zhang R … +1 more , Nardone HC
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40405516 · Publisher ↗
OBJECTIVE: To investigate the impact of resident involvement on pediatric otolaryngology procedure duration and study its financial implications on healthcare delivery. METHODS: A retrospective chart review of all patien...
OBJECTIVE: To investigate the impact of resident involvement on pediatric otolaryngology procedure duration and study its financial implications on healthcare delivery. METHODS: A retrospective chart review of all patients who underwent tonsillectomy, adenoidectomy, tonsillectomy and adenoidectomy, nasal cautery, closed nasal reduction, and bilateral myringotomy tube insertion from April 2016 to October 2023 at a tertiary care center. Procedure duration, patient demographics, American Society of Anesthesiology class, body mass index percentile, case schedule time, and surgeon type were collected. The financial investment in trainees was calculated based on the difference in procedure duration between attending physicians and trainees, and the institution's preset value for otolaryngology case revenue. RESULTS: Surgical time was greater for trainees compared to attending physicians in all procedures except for closed nasal reduction. When comparing trainees to attending physicians, surgical time was proportionally prolonged with increase in patient age in bilateral myringotomy tube insertion. Regarding tonsillectomy and adenoidectomy, American Society of Anesthesiology Class I, body mass index greater than 95th percentile and afternoon scheduling were associated with prolonged surgical time. Female sex was associated with increased surgical time when comparing trainees to attending physicians in patients who underwent an adenoidectomy alone. The financial investment was greatest for second year residents, recorded as $616.988 over the study period. CONCLUSION: Surgical time decreases with surgeon experience for most pediatric otolaryngology procedures. Sex, body mass index, American Society of Anesthesiology class, case schedule time, and age are variables that impact surgical time. Resident training comes with a significant, yet necessary, cost spread over several years.
Environmental Impact of Flexible Single-Use and Reusable Video Laryngoscopes.
Pasick LJ, Langlie J, Krishnan PS … +2 more , Bowers ER, Rosow DE
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40401533 · Publisher ↗
OBJECTIVES: The objective of this study was to evaluate and compare the environmental impact of single-use and reusable video laryngoscopes. METHODS: We performed life-cycle assessments of video laryngoscopes at a tertia...
OBJECTIVES: The objective of this study was to evaluate and compare the environmental impact of single-use and reusable video laryngoscopes. METHODS: We performed life-cycle assessments of video laryngoscopes at a tertiary-care academic center: single-use Ambu aScope 4 RhinoLaryngo Slim (Ambu Inc., Columbia, MD), single-use Video Rhino-Laryngoscope (Karl Storz, Tuttlingen, Germany), and reusable Storz Video Rhinolaryngoscope 1101HD. We collected data regarding lifecycle, manual reprocessing, and waste disposal at our institution. The lifetime carbon footprint of each device was calculated and included emissions related to manufacturing, transportation, sterilization, repair, and disposal. We then assessed carbon footprint of each device per procedure. RESULTS: The total estimated carbon footprint per procedure for single-use Ambu and Storz laryngoscopes is 7.46 and 5.49 kg CO, respectively. The mass of solid waste of single-use laryngoscopes and packaging contribute to carbon emissions of 0.173 and 0.40 kg CO for Ambu and Storz laryngoscopes, respectively. Reusable laryngoscopes are estimated to have a carbon footprint of 0.1137 kg CO per procedure at our institution. The greatest contributions to carbon footprint during reusable laryngoscope manual reprocessing include personal protective equipment solid waste and electrical energy (0.0859 and 0.016 kg CO, respectively). The carbon footprint of single-use laryngoscopes is estimated to range from 1.5-fold (based on solid waste alone) up to 66-fold greater than traditional reusable laryngoscopes, although the use of water and chemicals for reprocessing must also be considered. DISCUSSION: While single-use laryngoscopes have benefits of added convenience, cost effectiveness, and ease of use, they have a significantly greater environmental impact than resusable laryngoscopes. Otolaryngologists should consider the environmental impact of single-use laryngoscopes with goals of improving carbon footprint reduction.
Incidentalomas in Paranasal Sinus Computed Tomographic Imaging: Frequency and Characteristics.
Williams MM, Shave SM, Mitchell MB … +2 more , Bartholomew RA, Bhattacharyya N
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40401327 · Publisher ↗
OBJECTIVES: As patient access to radiology reports increases, incidental findings can be a significant source of stress and an increasing burden for clinicians to address. This study analyzes the frequency and characteri...
OBJECTIVES: As patient access to radiology reports increases, incidental findings can be a significant source of stress and an increasing burden for clinicians to address. This study analyzes the frequency and characteristics of incidental findings on paranasal sinus computed tomography (CT) scans. METHODS: A retrospective review of a random sample of radiology reports for paranasal sinus CT scans in a metropolitan healthcare system in 2021 was conducted. Incidental findings were defined as unexpected findings which an otolaryngologist would not typically manage or would evaluate using different diagnostic modalities. Incidental findings were categorized based on anatomic location and etiology. Associations between incidental findings with age and sex were examined. RESULTS: Among 1000 scans, 385 (38.5%) yielded at least 1 incidental finding. Of these, 66% contained 1 incidental finding, 31% had 2 or 3 incidental findings, and 4% had 4 to 6 incidental findings (mean number of incidental findings = 1.5). Among incidental findings, 34.8% were dental-related, followed by 19.9% vascular, 15.3% intracranial, 11.2% unexpected non-sinonasal mass, 7.8% spine, 6.6% otologic/temporal bone, 1.5% orbit/ophthalmologic, 1.4% lymphadenopathy, and 1% thoracic-related. Increasing age was associated with incidental findings (mean age with incidental findings, 59.7 years vs 49.7 years without; < .001). Sex was not associated with the presence of incidental findings ( = .583). Importantly, 3.4% of findings were considered potentially clinically serious. CONCLUSION: Incidental findings are frequently reported on sinus CT scans, though the vast majority are not considered potentially serious. Further refinement of systems for denoting their clinical significance may minimize the burden for clinicians and worry for patients.
Development and Validation of a Hybrid Simulation Model for Septoplasty Training.
Kim J, Patel T, Helou V … +1 more , Jabbour N
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40396622 · Publisher ↗
OBJECTIVES: To develop, describe, and validate a novel hybrid training model for endoscopic septoplasty that combines pig ears with a 3D-printed model. METHODS: The pig ear was chosen for its similarity to the human sept...
OBJECTIVES: To develop, describe, and validate a novel hybrid training model for endoscopic septoplasty that combines pig ears with a 3D-printed model. METHODS: The pig ear was chosen for its similarity to the human septum and wide availability. A frame for the nasal septum substitute was designed to mimic the appearance of a human nose, securely anchor the septum, and create a bend to simulate a deviated septum. The external nose was 3D-printed using polylactic acid (PLA) filament. The model underwent validation with a group of 13 junior and 7 senior trainees who performed endoscopic septoplasties on the simulator and completed a subjective assessment tool; recordings of their procedures were also analyzed and graded in a blind manner. RESULTS: Overall, residents agreed that the simulator is a good training tool for knowledge of the steps of a septoplasty (mean = 4.67 ± 0.59), as well as for the skills required of the procedure (mean rating = 4.61 ± 0.50). Residents also agreed that the simulator had adequately realistic characteristics and features (mean = 4.13 ± 0.81). Junior residents more strongly agreed than the senior residents that the simulator improved their knowledge of performing a septoplasty (4.50 ± 0.90 vs 3.40 ± 0.55, < .01). Senior residents performed significantly better in all assessed domains and completed the procedure significantly faster than junior residents. CONCLUSION: This study describes the first endoscopic septoplasty simulator to combine a pig ear with a 3D-printed model. The model provides realistic tactile feedback of the human nasal septum while offering a precise, standardized, and reproducible construction at an affordable cost. Our findings support the validity of this simulator that can provide an opportunity for otolaryngology trainees to improve their septoplasty skills in a safe and effective manner.
Effect of Local Corticosteroid on Electrical Impedances after Cochlear Implantation in children: A Prospective Double-Blind Randomized Clinical Trial.
Ines K, Bouthaina H, Omar W … +5 more , Mariam BA, Imen Z, Imen A, Mohammed Amine C, Ilhem C
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40380789 · Publisher ↗
OBJECTIVES: The primary aim of this study is to determine the effects of associating local and systemic corticosteroids on electrical impedance of electrode contacts during the 6 months following cochlear implantation in...
OBJECTIVES: The primary aim of this study is to determine the effects of associating local and systemic corticosteroids on electrical impedance of electrode contacts during the 6 months following cochlear implantation in children. We assessed the effect of this association along the electrode array to evaluate its impact on both basal and apical electrodes. METHODS: In 2 different patient groups, the evolution of electrical impedances was investigated during 6 months post-implantation. Children in Group 1 received systemic corticosteroids (1 ml injection of 4 mg/ml Dexamethasone (DXM) intravenously 12 hours before the procedure followed by an injection of 1 ml of 4 mg/ml de DXM during the induction of anesthesia). Group 2 received the same systemic corticosteroids with local corticosteroid (intratympanic injection [ITI] of Methylprednisolone (MP) 40 mg/1 ml given at the start of the procedure). Impedances were assessed perioperatively, on the third post-operative day, at 1 week, 1 month, 2 months, 3 months, and 6 months after implantation. We compared the mean impedance values and the average impedance at the apical and basal electrodes between both groups. RESULTS: Impedances in Group 1 were significantly higher than those in Group 2, both perioperatively ( = .037) and on the third post-operative day ( = .027). Starting from the first week and throughout the 6 months post-implantation, the difference between both groups was not significant. When comparing impedances at the apical and basal electrodes between both groups, the mean impedance at the basal electrodes was significantly higher in Group 1 compared to Group 2 at 1 month ( = .042). CONCLUSION: The association of intratympanic and intravenous corticosteroids results in significantly reduced impedances during the early postoperative period. The basal electrodes have a more pronounced effect from this association. Based on these findings, this protocol is effective in lowering impedances in the short term but not in the medium term following cochlear implantation.
Unilateral Clear Thin Rhinorrhea: How Often Is It a Cerebrospinal Fluid Leak?
Mason W, Mackie H, Kulawczyk A … +2 more , Jin J, Craig JR
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40370059 · Publisher ↗
OBJECTIVES: Determine frequencies of conditions causing unilateral clear thin rhinorrhea (UCTR), and assess whether certain clinical features are associated with CSF rhinorrhea. METHODS: This was a retrospective review i...
OBJECTIVES: Determine frequencies of conditions causing unilateral clear thin rhinorrhea (UCTR), and assess whether certain clinical features are associated with CSF rhinorrhea. METHODS: This was a retrospective review identifying all patients presenting with UCTR to one rhinologist over a 6-year period. The conditions causing UCTR were recorded, and the following demographic or clinical variables were collected when available: body-mass index (BMI, kg/m2), gender, age, race, and self-reported drainage volume (whether the UCTR dripped out the nose and could be collected, or it felt like a wet nostril with intermittent running down lip that was unlikely to be collectable). RESULTS: Of 3,041 patients, 146 were identified with at least UCTR (4.8%). Mean age was 56.2 ± 17.6 years, and 65.8% were female. Amongst UCTR, nonallergic rhinitis (NAR) was the most common cause (45%), followed by CSF rhinorrhea (30%). On multivariate analysis, the following were significantly positively associated with CSF rhinorrhea: BMI≥30 (OR=4.95), ages 45-54 years (OR=3.67) and 55-64 years (OR=4.15), and self-reported UCTR dripping with collectability (OR=5.96)). CONCLUSIONS: NAR was the most common cause of UCTR, representing nearly 50% of cases. However, CSF rhinorrhea still represented 30% of cases, reinforcing that UCTR should be worked up for CSF rhinorrhea, ideally with B2-Tf testing. BMI ≥30, ages 45-64 years, and patient-reported higher volume UCTR were positively associated with CSF rhinorrhea. If B2-Tf testing is negative or unobtainable, or clinical suspicion for CSF leak is low, clinicians can consider starting medical therapy for rhinitis or rhinosinusitis before pursuing further invasive CSF confirmatory testing.
Outcomes and Characteristics of Mesenchymal Tumors Involving the Parotid Gland.
Baratz HQ, Yin LX, Moore EJ … +4 more , Molligan J, Tasche KK, Van Abel K, Price DL
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40370050 · Publisher ↗
BACKGROUND: Malignant mesenchymal tumors involving the parotid gland are uncommon, characteristically aggressive, and little is known with few reports documented. STUDY DESIGN: Retrospective case series. SETTING: Single...
BACKGROUND: Malignant mesenchymal tumors involving the parotid gland are uncommon, characteristically aggressive, and little is known with few reports documented. STUDY DESIGN: Retrospective case series. SETTING: Single institution tertiary care center, 2010 to 2022. METHOD: Patients were identified from an institutional parotid tumor database. Patient history, demographics, pathologic diagnosis, treatment, and follow up were documented. RESULTS: Eight patients were identified, 3 were males. The average age was 61 years old, and the most common tumors identified were pleomorphic sarcomas (3 patients). Presenting symptoms included: preauricular/cheek mass in 7 patients, facial pain (4), otalgia (4), aural fullness (3), and numbness (1). All patients received a parotidectomy, and 4 patients received adjuvant therapy of either radiation or chemoradiation. Post-operatively, there were 3 cases of distant recurrence, 2 cases of regional recurrence, and 1 case of local recurrence. There were 2 reports of death. CONCLUSION: Malignant mesenchymal tumors of the parotid are rare, represent varied histologies. Due to their aggressive nature, surgical resection with radiation and close follow-up may be an appropriate treatment regimen in controlling the disease.
Simultaneous Labyrinthectomy and Cochlear Implantation in Patients With Refractory Ménière's Disease.
Macielak RJ, Harrigan ME, Kaul VF … +5 more , Hiss MM, Moberly AC, Dodson EE, Adunka OF, Ren Y
Ann Otol Rhinol Laryngol · 2025 Jul · PMID 40365654 · Publisher ↗
OBJECTIVE: To assess the efficacy and safety of simultaneous labyrinthectomy and cochlear implantation (CI) in patients with refractory Ménière's disease (MD). METHODS: A retrospective review of patients with definite re...
OBJECTIVE: To assess the efficacy and safety of simultaneous labyrinthectomy and cochlear implantation (CI) in patients with refractory Ménière's disease (MD). METHODS: A retrospective review of patients with definite refractory MD per American Academy of Otolaryngology-Head and Neck Surgery treated via simultaneous transmastoid labyrinthectomy and CI was performed at a tertiary referral center. Patients' clinical and audiometric outcomes were assessed and analyzed. RESULTS: Twenty-four patients underwent simultaneous transmastoid labyrinthectomy and CI between 7/2015 and 9/2023 (median age = 58 years [interquartile range (IQR) = 43.5-64.5], 54% female). Complete resolution of vertigo occurred in 23 patients (96%). Evaluating available data at ≥6 months postoperatively, both CNC (n = 9; 36% vs 40%, = .76) and AzBio scores (n = 13; 40% vs 62%, = .15) improved after surgery. When performing a sound localization task with the CI on, the median score in identifying the noise was 32% (IQR = 22%-56%) with a median degree error of 27.9 (IQR = 15.8-38.0) versus a median score with the CI off of 20% (IQR = 14%-42%) with a median degree error of 43.8 (IQR = 21.9-73.5) at a median of 9.8 months (IQR = 6.7-14.6) from surgery. CONCLUSIONS: The present study represents one of the largest cohorts of refractory MD patients undergoing simultaneous labyrinthectomy and CI. Combining these procedures appears safe, enables excellent control of vertigo, and expedites aural rehabilitation in appropriately selected candidates, but future study is warranted to continue to evaluate this treatment paradigm.
Response to Letter to the Editor on "Perioperative Outcomes of Branchial Cleft Sinus Tract Excision in Pediatric Patients Without the Use of Intraoperative Dye".
Habib DRS, Jamal NH, Patel K … +2 more , Wootten CT, Belcher RH
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40364518 · Publisher ↗
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Letter to the Editor on "Perioperative Outcomes of Branchial Cleft Sinus Tract Excision in Pediatric Patients Without the Use of Intraoperative Dye".
Ravichandran K
Ann Otol Rhinol Laryngol · 2025 Sep · PMID 40364485 · Publisher ↗
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Sialosis (Sialadenosis): A Sialographic Study with Clinical Correlates.
Wenzel PA, Molotkova E, Maley J … +4 more , Henkle K, Fick B, Thorpe R, Hoffman H
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40353512 · Publisher ↗
OBJECTIVE: Characterize radiographic findings and co-existing pathologic processes in the parotid glands of patients with swelling or pain identified on radiographic review to be consistent with sialosis (sialadenosis) e...
OBJECTIVE: Characterize radiographic findings and co-existing pathologic processes in the parotid glands of patients with swelling or pain identified on radiographic review to be consistent with sialosis (sialadenosis) employing dynamic infusion digital sialography correlated with computed tomography (CT). METHODS: Retrospective chart review of a consecutive series of 578 sialograms performed by the senior investigator over a 16-year period identified 39 patients with 1 or both parotid gland sialograms recorded as "sialosis" by radiologists' interpretation. After inclusion and exclusion criteria were applied, 20 patients remained for evaluation. A review of sialograms was conducted by a senior radiologist to identify co-existing pathologies (ex: stricture, sialectasis, sialolith) as well as characterize an overall aggregate impression and specific findings of ductal curvature, splaying, and truncation on a numerical scale from 1 (absent finding) to 10 (severely abnormal). Two normal sialograms served as controls. The density of each gland was assessed through CT measurement of Hounsfield units (HU). Variables collected included sex, age, symptoms, BMI, alcohol use, and comorbidities. RESULTS: Twenty patients with a total of 27 glands classified as "sialosis" on sialography and 2 patients with normal sialography findings were evaluated. Indications for sialography included pain (90%), fluctuation in swelling of the parotid gland(s) (65%), or xerostomia (35%). Sialographic analysis identified 7 glands (26%) with sialosis to have an additional co-existing pathology (2 with strictures, 5 with sialectasis). Consistent features in glands with sialosis included ductal curvature, splaying, and truncation. CT analysis of glands with sialosis identified a median HU measurement of -36 compared to +30 for glands identified as normal ( = .03). CONCLUSION: Sialography is useful in selected patients to evaluate for co-existing pathologies contributing to salivary symptoms. Sialography additionally demonstrates consistent findings (ductal curvature, splaying, and truncation) associated with sialosis that correlate with fat infiltration identified on CT imaging.
Oncological Efficacy and Postoperative Outcomes of Low Grade Mucoepidermoid Carcinoma Treated With Partial Parotidectomy.
Ali HM, Rourk KS, Byrne JO … +5 more , Tasche KK, Price DL, Van Abel KM, Yin LX, Moore EJ
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40320862 · Publisher ↗
OBJECTIVE: To assess the impact of extent of parotidectomy on surgical and oncologic outcomes in low grade mucoepidermoid carcinoma (LGMEC). METHODS: A retrospective chart review of all patients undergoing primary surgic...
OBJECTIVE: To assess the impact of extent of parotidectomy on surgical and oncologic outcomes in low grade mucoepidermoid carcinoma (LGMEC). METHODS: A retrospective chart review of all patients undergoing primary surgical treatment for LGMEC from 2000 to 2022 was conducted. Clinical features collected included demographics, facial nerve function, operative techniques, postoperative complications/facial nerve function, and recurrence. RESULTS: 58 patients were included; 10 patients underwent partial parotidectomy (PP), 38 underwent superficial parotidectomy (SP), and 10 underwent near-total/total parotidectomy. PP and SP patients had smaller tumors and more superficial tumors compared to near-total/total parotidectomy group ( = .03). PP and SP were more likely to have negative margins and less locoregional disease compared to near-total/total parotidectomy patients ( < .01). Near-total/total parotidectomy were more likely to undergo facial nerve resection (20% vs 0% for PP & SP respectively) ( = .05). Immediate postoperative facial nerve function was significantly better among PP patients (73% HB I) compared to SP (44% HB I) and near-total/total parotidectomy patients (0% HB I) ( < .01). Most patients regained their facial nerve function although only 40% of the near-total/total parotidectomy patients had a HB I at the time of last follow up ( < .01). Patients were followed for a median of 6.2 years, during which only 1 patient (total parotidectomy) had a recurrence. CONCLUSIONS: PP offers a safe and effective approach for small LGMEC tumors, ensuring better facial nerve function postoperatively with minimal complications compared to more extensive surgery.
Outcomes of Salvage Surgery for Recurrent Cutaneous Squamous Cell Carcinoma of the Head and Neck Following Definitive Surgery and Radiation Therapy.
Bellamkonda N, Monroe MM
Ann Otol Rhinol Laryngol · 2025 Jul · PMID 40317175 · Publisher ↗
OBJECTIVE: To describe outcomes of patients with a history of cutaneous squamous cell carcinoma (cSCC) of the head and neck previously treated with definitive surgery and radiation therapy (RT), who undergo salvage surge...
OBJECTIVE: To describe outcomes of patients with a history of cutaneous squamous cell carcinoma (cSCC) of the head and neck previously treated with definitive surgery and radiation therapy (RT), who undergo salvage surgery for disease recurrence. There is minimal data available on this cohort of patients. METHODS: This was a retrospective case series. Patients evaluated for advanced cSCC of the head and neck between 2003 and 2022 were reviewed. Those with a history of surgery and adjuvant RT undergoing salvage surgery for recurrence were included in the main cohort. Comparisons were made to patients undergoing primary/initial treatment, and to those undergoing salvage surgery for recurrence but without a history of adjuvant RT. RESULTS: Of the 579 patients reviewed, 49 met inclusion criteria for the main cohort. Average length of follow up was 22 months. A total of 19 patients (38.8%) experienced recurrence, all within 14 months of salvage surgery. Among patents staged BWH T2b or T3, there was a 50% recurrence rate. Average overall survival following surgery was 35.6 months (95% CI = 24.7-46.4). CONCLUSION: Patients in this cohort have a high rate of recurrence and an overall survival of approximately 3 years.
The Role of Sucralfate in Post-Tonsillectomy Pain in Children: A Scoping Review.
Briggs EE, McCray LR, Patel JJ … +2 more , Nguyen SA, Parker NP
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40304217 · Publisher ↗
OBJECTIVES: The goal of this scoping review is to investigate the efficacy of sucralfate on postoperative pain following oropharyngeal surgery in the pediatric population using pain scales, analgesic use, diet toleration...
OBJECTIVES: The goal of this scoping review is to investigate the efficacy of sucralfate on postoperative pain following oropharyngeal surgery in the pediatric population using pain scales, analgesic use, diet toleration, and bleeding. Furthermore, we wanted to highlight the clinical importance of the limitations in the current literature. REVIEW METHODS: The search was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews. Results of included studies and a narrative summary of our findings are presented through descriptive statistics (frequency [%] for categorical variables and mean [range] for continuous variables with 95% confidence intervals [CI]). RESULTS: Of the 195 abstracts identified, 3 studies (N = 241) pertaining to sucralfate and post-operative pain in the pediatric population were included. Sucralfate group had a mean age of 6.13 (range = 3-12) versus 6.82 (range = 3-12) for control group. Sucralfate group had statistically significant reduction in pain scores than control group. Analgesic use was consistently lower in the sucralfate group compared to the control group. Two studies also showed a difference in diet tolerance between the 2 groups. CONCLUSIONS: Tonsillectomy is one of the most frequently performed procedures on children and the procedure results in an extended and painful recovery. The literature shows promising results of sucralfate in the reduction of post-tonsillectomy pain in the pediatric population; however, the literature is limited, and further investigation is warranted. LEVEL OF EVIDENCE: 2.
Analysis of Sociodemographics in Follow-Up Post-Tympanostomy Tube Placement.
Gochman GE, Drozdowski-Nuccio V, Hubbell RD
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40289374 · Publisher ↗
OBJECTIVE: To determine if disparities exist in patient follow-up post-bilateral myringotomy with tympanostomy tube placement. INTRODUCTION: Bilateral myringotomy with tympanostomy tube placement (BMT) is the most common...
OBJECTIVE: To determine if disparities exist in patient follow-up post-bilateral myringotomy with tympanostomy tube placement. INTRODUCTION: Bilateral myringotomy with tympanostomy tube placement (BMT) is the most common surgery performed in children in the U.S. The current literature suggests there are no demographic differences in treatment of otitis media, however these studies have limited data on postoperative follow-up. This study aims to assess socioeconomic and other factors that affect follow-up after BMT. METHODS: A retrospective chart review of pediatric patients seen at a tertiary medical center who underwent BMT was conducted. Demographic, medical, and socioeconomic information was collected. Fisher's exact test was used to estimate association between follow-up with all nominal responses. Logistic regression was used to estimate association between follow-up with quantitative responses. RESULTS: A total of 750 patients (62.1% male) were included with 37.7% of patients identifying as non-Caucasian and 30.6% as Hispanic. The mean (SD) age at time of surgery was 5.1 (4.4) years. Patients undergoing a concurrent tonsillectomy and adenoidectomy (T&A) were less likely to follow-up than those with BMT alone. This was true even after adjusting for age and distance from medical center (OR = 0.46, 95% CI = 0.27-0.79; = .01). Race, type of insurance, medical-comorbidities, indication for surgery, and distance from clinic did not affect rate of follow-up ( > .05). Those who underwent multiple BMTs and those with developmental delay may also be less likely to follow-up, although this finding did not meet statistical significance ( < .1). DISCUSSION: Our study demonstrates socioeconomic variables, indication for surgery, and co-morbidities were not statistically significant factors in determining rates of follow-up after BMT. Interestingly, concurrent T&A was associated with lower rates of follow-up. Findings in this study suggest large medical centers with diverse patient populations see similar rates of follow-up post-BMT across a variety of variables. LEVEL OF EVIDENCE: 3.
Tracheobronchial Foreign Body Extraction in a Preterm Infant via Choledochoscope: A Case Report and Literature Review.
Prstačić R, Pasini M, Sindičić Dessardo N … +2 more , Đenović M, Grizelj R
Ann Otol Rhinol Laryngol · 2025 Aug · PMID 40285618 · Publisher ↗
OBJECTIVES: Tracheobronchial foreign body (TFB) extraction in premature neonates poses unique challenges due to their delicate respiratory system, making the TBF extraction a critical and high-stakes intervention. TFBs i...
OBJECTIVES: Tracheobronchial foreign body (TFB) extraction in premature neonates poses unique challenges due to their delicate respiratory system, making the TBF extraction a critical and high-stakes intervention. TFBs in this patient population are mostly iatrogenic. There are only a few reports in the literature describing the management of TFBs in premature neonates. To the best of our knowledge, this represents the first report using a flexible choledochoscope for TFB extraction. METHODS: A retrospective chart review was conducted on a case of a preterm infant who underwent successful extraction of a tracheobronchial foreign body. RESULTS: A premature neonate born at 25 weeks 2/7 days gestation with a birth weight of 780 g was intubated after delivery. Following extubation to non-invasive ventilation, a control chest radiograph revealed atelectasis of the right lower lobe and a TFB of tubular structure measuring 20 mm × 1.5 mm in the right main bronchus. Diagnostic flexible bronchoscopy was performed and extraction with graspers via rigid bronchoscope was attempted but failed. Subsequently, a bedside procedure in the Neonatal intensive care unit (NICU) was performed using a 7.5 Fr flexible choledochoscope through the endotracheal tube (ETT). TFB was successfully extracted with graspers and upon extraction, it was confirmed to be the distal 2 cm segment of the closed-circuit endotracheal suction system. The infant made full recovery. CONCLUSION: We report a method that provides a safe means of TFB extraction with a successful outcome. The insights gathered from this review are intended to contribute valuable knowledge that can enhance the management of TFBs in preterm infants.
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