OBJECTIVES: Age-related vocal atrophy (ARVA) impacts voice and quality of life. In ARVA, vocal folds appear thin and bowed. Bowing Index (BI) is used to quantify vocal fold bowing. However, it remains unclear how abducti...OBJECTIVES: Age-related vocal atrophy (ARVA) impacts voice and quality of life. In ARVA, vocal folds appear thin and bowed. Bowing Index (BI) is used to quantify vocal fold bowing. However, it remains unclear how abduction and adduction of the vocal folds influence BI. The purpose of this study was to assess the relationship of BI to vocal fold task and angle. METHODS: Patients with ARVA were included (n = 22). Flexible video laryngostroboscopy was collected during an alternating voice-sniff task, during which vocal folds transition from adducted (closed) to fully abducted (open) positions. BI was measured at each non-phonatory frame. Two clinical raters then rated each subject by severity, and their ratings were compared to BI. RESULTS: Mean BI was higher during vocal fold abduction than adduction (8.15 ± 3.29, 6.34 ± 2.21, respectively, mean difference 1.81, 95% CI: 1.25-2.38, p < 0.0001). Mean BI was higher when vocal folds were between 40% and 60% of maximal abduction compared to 80%-100% (mean difference 2.61, 95% CI: 1.26-3.96, p < 0.0001). Mean BI increased with clinical severity (7.30 ± 1.85 mild; 8.90 ± 2.52 moderate), with a BI of 14.62 in the single severe case. CONCLUSION: Vocal fold bowing is influenced by the degree of opening and the adduction versus abduction tasks in patients with ARVA. Bowing was greater during the abducting task than during the adducting task, with the most pronounced bowing observed at a semi-abducted position. Future studies are warranted to further characterize these findings and to support standardization of BI measurement. LEVEL OF EVIDENCE: N/A.
OBJECTIVE: The Modified Frailty Index (mFI-5) is a validated preoperative risk stratification tool across surgical settings. This study evaluated the predictive value of the mFI-5 score for postoperative outcomes followi...OBJECTIVE: The Modified Frailty Index (mFI-5) is a validated preoperative risk stratification tool across surgical settings. This study evaluated the predictive value of the mFI-5 score for postoperative outcomes following total thyroidectomy. METHODS: This retrospective cohort study utilized the TriNetX U.S. Network to identify adults who underwent total thyroidectomy between 2006 and 2025. Patients were stratified by mFI-5 scores (0, 1, 2, ≥ 3) based on the presence of five ICD-10-coded comorbidities. Propensity score matching was used to control for demographic and clinical covariates. Postoperative complications-hypocalcemia, vocal fold paralysis, surgical-site infection, hematoma, tracheostomy, and mortality-as well as emergency department visits-were assessed within 30 days of surgery. Each mFI-5 group ≥ 1 was compared to the mFI-5 = 0 cohort using logistic regression to estimate odds ratios (ORs) with 95% confidence intervals (α = 0.05). RESULTS: Among 65,866 total thyroidectomy patients, postoperative complications increased significantly with higher frailty. Odds of hypocalcemia rose from mFI-5 = 1 (OR = 1.22 [95% CI, 1.14-1.32]) to mFI-5 ≥ 3 (OR = 1.59 [95% CI, 1.29-1.95]). Vocal fold paralysis was more likely at mFI-5 ≥ 3 (OR = 2.27 [95% CI, 1.49-3.46]). Emergency department visits increased progressively with frailty, from mFI-5 = 1 (OR = 1.36 [95% CI, 1.23-1.51]) to mFI-5 ≥ 3 (OR = 2.28 [95% CI, 1.72-3.03]). Surgical-site infection and tracheostomy were elevated at mFI-5 = 2 (OR = 1.93 [95% CI, 1.20-3.10] and OR = 2.00 [95% CI, 1.08-3.73], respectively), though mFI-5 ≥ 3 groups were limited by sample size. Postprocedural neck hematoma risk was significantly higher at mFI-5 ≥ 3 (OR = 2.60 [95% CI, 1.45-4.64]). Mortality events were rare and precluded reliable estimation. CONCLUSION: Higher mFI-5 scores were associated with increased postoperative complications after total thyroidectomy. Incorporating frailty assessment into preoperative evaluation may improve risk stratification and patient outcomes.
OBJECTIVE: Are paired chemosensory stimuli with very short interstimulus-intervals (ISIs) more often perceived as distinct events when delivered synchronously with inspiration than when delivered asynchronously? METHODS:...OBJECTIVE: Are paired chemosensory stimuli with very short interstimulus-intervals (ISIs) more often perceived as distinct events when delivered synchronously with inspiration than when delivered asynchronously? METHODS: Twin stimuli (HS, phenylethyl alcohol [PEA], CO) were repeatedly administered intranasally to 40 participants using a constant-flow olfactometer, synchronized with inspiration, at varying ISIs. In the first part of the study, participants indicated whether they perceived one or two stimuli. In the second part, event-related potentials (CSERP) were recorded from 20 participants using only HS stimuli with very short ISIs (0.6-1.6 s). The CSERPs were then qualitatively and quantitatively evaluated based on whether stimuli were perceived or not. RESULTS: The perception rate of twin stimuli increased with increasing ISI. A plateau in the discrimination of separate twin stimuli, averaging 90%, was observed with CO or HS stimulation at ISIs between 1.6 and 3.0 s, respectively, up to 9.0 s. For PEA stimulation, a plateau of approximately 70% was observed between 3.0 and 9.0 s. CSERP detection rates were 100% for both perceived first and second twin stimuli, while non-perceived second stimuli showed a 70% rate. The latencies of the CSERPs did not differ across the three conditions. The amplitudes were larger for non-perceived second stimuli than for perceived first and second stimuli. CONCLUSION: Predominantly inspiration-synchronous stimulation allows higher detection of responses at both psychophysical and electrophysiological levels, even at very short ISIs. These findings may help to reduce the duration of clinical experiments and electrophysiological assessments of olfactory function.
Airway laser surgery carries a uniquely elevated risk for operating room fire because endotracheal tubes, surgical materials, an oxygen-enriched environment, and laser ignition sources can all coexist in the upper aerodi...Airway laser surgery carries a uniquely elevated risk for operating room fire because endotracheal tubes, surgical materials, an oxygen-enriched environment, and laser ignition sources can all coexist in the upper aerodigestive tract. This Best Practice review synthesizes evidence-based strategies to mitigate these risks, including endotracheal tube optimization, oxidizer control, careful energy delivery, and team-based preparedness for fire prevention and emergency response.
OBJECTIVE: Nasal septal perforation (NSP) repair using the anterior ethmoidal artery (AEA) flap is an emerging endoscopic technique. This systematic review aimed to provide a comprehensive overview of the AEA flap techni...OBJECTIVE: Nasal septal perforation (NSP) repair using the anterior ethmoidal artery (AEA) flap is an emerging endoscopic technique. This systematic review aimed to provide a comprehensive overview of the AEA flap technique, its variations, and its efficacy in repairing NSPs. DATA SOURCES: MEDLINE, Embase, CENTRAL, and Web of Science were searched. This study was reported per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from 1946 to 2026. REVIEW METHODS: The aforementioned search yielded 2838 results. Animal and cadaver studies, editorials, abstracts, and studies that did not address NSP repair with surgical flaps were excluded. After full-text review of 164 studies, 16 were included. RESULTS: A total of 249 patients were captured (223 adults, 26 pediatric). For adults, 175 patients underwent the original AEA flap technique with (N = 74) or without (N = 101) an interposition graft, such as tragal cartilage, acellular dermal, or porcine collagen grafts. All pediatric and 48 adult patients underwent various modified AEA flap techniques. For the original AEA flap, mean reported NSP size ranged from 12.8 to 22 mm and postoperative follow-up time ranged from 3 to 51 months. Overall, NSP closure success rate was 84.6% (N = 148/175) for the AEA flap. Closure success rate was 83.8% (N = 62/74) for those with an interposition graft and 85.1% (N = 86/101) for patients without a graft (p = 0.81, Cramer's V = 0.02). CONCLUSIONS: With an overall closure success rate of 84.6%, the AEA flap is a reliable endoscopic technique for repairing NSPs < 2.5 cm. Emerging AEA flap modifications may further improve outcomes, while enabling repair of larger perforations. LEVEL OF EVIDENCE: N/A.
Shinnawi S, Khoury M, Zhalka A
… +2 more, Elhija JA, Zahlaka M
Laryngoscope
· 2026 Jun · PMID 42381230
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OBJECTIVE: To synthesize clinical presentation, anatomic patterns, diagnostic evaluation, and treatment outcomes of laryngeal IgG4-related disease (IgG4-RD) and highlight features that may support earlier diagnosis in un...OBJECTIVE: To synthesize clinical presentation, anatomic patterns, diagnostic evaluation, and treatment outcomes of laryngeal IgG4-related disease (IgG4-RD) and highlight features that may support earlier diagnosis in unexplained laryngeal stenosis or mass-like lesions. DATA SOURCES: Systematic searches of PubMed/MEDLINE, Embase, Scopus, Web of Science, and the Cochrane Library were performed through January 1, 2026, limited to English-language human studies combining IgG4-RD with laryngeal and upper-airway terms. REVIEW METHODS: Eligible studies reported histopathologic or clinicopathologic confirmation of IgG4-RD involving the supraglottic, glottic, or subglottic larynx with data on presentation, diagnosis, treatment, or outcomes. Two reviewers independently screened records and extracted data. RESULTS: Twenty-seven publications met inclusion criteria, yielding 32 patients. Most were middle-aged with slight female predominance and presented with hoarseness, dyspnea, or stridor. Supraglottic and subglottic involvement predominated; multilevel airway disease occurred in about one third of cases. Endoscopy and imaging showed two main patterns: fibrostenotic circumferential narrowing resembling idiopathic subglottic stenosis and mass-like or polypoid lesions mimicking neoplasia. Histologic confirmation often required deep submucosal or repeat biopsy after nondiagnostic superficial sampling, and serum IgG4 levels were frequently normal despite biopsy-proven disease. Most patients received systemic glucocorticoids, often with additional immunosuppressive therapy and endoscopic dilation or airway surgery; relapse and progression to fixed fibrostenosis were common. CONCLUSION: Laryngeal IgG4-RD is an uncommon but underrecognized cause of airway obstruction and voice disturbance. Clinicians should include it in the differential diagnosis of unexplained laryngeal stenosis or submucosal masses and obtain adequately deep biopsies alongside long-term immunomodulatory and airway-preserving surgical strategies.
Laryngoscope
· 2026 Jun · PMID 42380039
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BACKGROUND: Open airway reconstruction is indicated for structural airway stenoses but may be associated with significant morbidity. While obesity influences perioperative outcomes in many surgical domains, its role in a...BACKGROUND: Open airway reconstruction is indicated for structural airway stenoses but may be associated with significant morbidity. While obesity influences perioperative outcomes in many surgical domains, its role in airway reconstruction remains unclear. This study evaluated associations between body mass index (BMI) and postoperative complications, intensive care unit (ICU) and hospital length of stay, and need for revision procedures following cricotracheal or tracheal resection. METHODS: A retrospective review of adults undergoing cricotracheal or tracheal resection between 2014 and 2025 was performed. Demographic, surgical, and postoperative data were analyzed. Associations between BMI (continuous and categorical) and postoperative outcomes-including complication rates, length of stay, reintubation, re-tracheotomy, restenosis, and death-were assessed using Poisson, Cox, negative binomial, and firth logistic regression. RESULTS: Among 93 patients (mean BMI 28.8 ± 6.1 kg/m), 70% were overweight or obese: 29 (31.2%) overweight (BMI 25-29.9), 24 (25.8%) Class I obesity (BMI 30-34.9), 6 (6.5%) Class II obesity (BMI 35-39.9), and 6 (6.5%) Class III obesity (BMI ≥ 40). Overall complication rate was 38.7%, with no significant difference across BMI categories (p = 0.99). BMI was not associated with ICU stay (IRR 1.01, p = 0.43) or total hospital stay (IRR 0.98, p = 0.12). Rates of specific complications-including hematoma, dehiscence, restenosis, and death-did not associate significantly with BMI. The only variable significantly associated with complications was resection length (p < 0.001). CONCLUSIONS: BMI and obesity class were not associated with increased complications or prolonged recovery after tracheal resection. Obesity alone should not be considered a contraindication to open airway reconstruction.
Prasad SG, Clement E, Lequin MH
… +1 more, D'Arco F
Laryngoscope
· 2026 Jun · PMID 42376910
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This study aims to provide new insights in understanding the genetic association between sensorineural hearing loss with distal renal tubular acidosis (RTA) and to add ATP6V1B1 to the list of known genes causing "Pendred...This study aims to provide new insights in understanding the genetic association between sensorineural hearing loss with distal renal tubular acidosis (RTA) and to add ATP6V1B1 to the list of known genes causing "Pendred ear phenotype".
Cheon YI, Bang SY, Kim JM
… +6 more, Kwon HN, Lee M, Sung ES, Lee JC, Lee BJ, Shin SC
Laryngoscope
· 2026 Jun · PMID 42374811
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OBJECTIVE: Age-related vocal fold degeneration is characterized by alterations in the lamina propria, extracellular matrix remodeling, and reduced tissue viscoelasticity, contributing to presbyphonia. Ferroptosis, an iro...OBJECTIVE: Age-related vocal fold degeneration is characterized by alterations in the lamina propria, extracellular matrix remodeling, and reduced tissue viscoelasticity, contributing to presbyphonia. Ferroptosis, an iron-dependent form of regulated cell death driven by lipid peroxidation, is increasingly implicated in tissue aging. This study investigated the association between ferroptosis and vocal fold aging using ferrostatin-1 (Fer-1) in a rat model. METHODS: Thirty-six male Sprague-Dawley rats were assigned to three groups: Young, Old, and Old-Fer. Fer-1 (2.5 μmol/kg, 20 μL) was injected unilaterally into the left vocal fold at Weeks 0 and 2. At Week 3, vocal folds were harvested for histological, immunohistochemical, and biochemical analyses. Outcome measures included ferroptosis-related markers, lamina propria thickness, extracellular matrix morphology, collagen and hyaluronic acid distribution, and inflammatory cytokines. RESULTS: Compared with the Young group, the Old group showed increased lipid peroxidation, reactive oxygen species, and iron accumulation with reduced glutathione peroxidase 4 activity; these changes were attenuated in the Old-Fer group. The Old group also exhibited increased lamina propria thickness, enhanced collagen deposition, and reduced hyaluronic acid distribution, whereas the Old-Fer group demonstrated reduced collagen accumulation and preserved hyaluronic acid distribution. Transforming growth factor-β and interleukin-1β expression levels were elevated in the Old group and reduced following Fer-1 treatment. CONCLUSION: The results indicate that ferroptosis is involved in vocal fold aging. In addition, Fer-1 effectively suppressed ferroptotic pathways, which may be associated with the attenuation of aging-related extracellular matrix alterations in the vocal folds. LEVEL OF EVIDENCE: NA.
Laryngoscope
· 2026 Jun · PMID 42370518
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Antiviral therapy is recommended for infants with moderate-to-severe symptomatic congenital CMV, as randomized controlled trials have demonstrated improved audiologic and neurodevelopmental outcomes when treatment is ini...Antiviral therapy is recommended for infants with moderate-to-severe symptomatic congenital CMV, as randomized controlled trials have demonstrated improved audiologic and neurodevelopmental outcomes when treatment is initiated within the first month of life; for isolated SNHL, evidence remains limited, and treatment decisions should be individualized. Following medical management, children with severe-to-profound SNHL should undergo timely evaluation for hearing rehabilitation, including cochlear implantation when appropriate, as early access to auditory input may optimize speech, language, and communication outcomes. Although progress may be slower in children with neurologic comorbidities, most achieve meaningful improvements in hearing and communication.
Lin RJ, Zeng PYF, MacInnis P
… +2 more, Horton G, Anderson J
Laryngoscope
· 2026 Jun · PMID 42370493
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OBJECTIVE: To compare clinical outcomes of a 445-nm blue light (BL) laser with the established 532-nm potassium titanyl phosphate (KTP) laser for office-based treatment of benign vocal fold lesions. METHODS: In this para...OBJECTIVE: To compare clinical outcomes of a 445-nm blue light (BL) laser with the established 532-nm potassium titanyl phosphate (KTP) laser for office-based treatment of benign vocal fold lesions. METHODS: In this parallel-group, open-label randomized controlled trial, adults (≥ 18 years) with benign vocal fold lesions underwent baseline VHI-10 and laryngeal stroboscopy, followed by in-office laser treatment. Pain visual analogue scale (VAS) scores were collected at baseline and daily for 7 days after the procedure. The primary outcome was the between-group difference in the change in Voice Handicap Index-10 (VHI-10) scores. Secondary outcomes included between-group comparisons of post-procedural pain and stroboscopic parameters at 90 days after treatment. Linear mixed-effects model assessed changes in VHI-10 and pain VAS over time, while Cochran-Mantel-Haenszel and logistic regression tests compared stroboscopy outcomes. RESULTS: Ninety-eight patients were enrolled (49 per group). Baseline characteristics were similar aside from a slightly younger age in the KTP group (p = 0.048). VHI-10 scores improved significantly in both groups at postoperative day (POD)7 (-5.98), POD30 (-9.28), and POD90 (-12.43) (all p ≤ 0.001), with no between-group differences (p = 0.596). Pain decreased significantly over time (p < 0.001), without group differences (p = 0.47). At POD90, complete vocal fold closure occurred in 91.2% (BL) and 85.7% (KTP) of patients (p = 0.74). Normal mucosal wave was observed in 79.4% (BL) and 81.0% (KTP), with no significant differences. CONCLUSION: BL laser demonstrated clinical outcomes comparable to KTP, with similar voice improvement, pain reduction, and stroboscopic results.
Laryngoscope
· 2026 Jun · PMID 42365536
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OBJECTIVE: To determine if post-operative infection rates after rhinoplasty differ based on use of autologous versus irradiated cadaveric costal rib grafting and use of prophylactic antibiotics. METHODS: Patients undergo...OBJECTIVE: To determine if post-operative infection rates after rhinoplasty differ based on use of autologous versus irradiated cadaveric costal rib grafting and use of prophylactic antibiotics. METHODS: Patients undergoing cosmetic or functional rhinoplasty or nasal valve repair with costal cartilage grafting during the years 2002-2025 were identified. Patients were separated into those who underwent autologous rib grafting versus irradiated homologous (cadaveric) costal cartilage grafting. Demographic data, rates of post-operative prescription of oral or IV antibiotics from post-operative day three to 30, and rates of return to OR for revision within the first 30 post-operative days were tabulated for each group and compared with chi-square and Fisher Exact tests. RESULTS: A total of 707 patients who underwent rhinoplasty with costal cartilage grafting were identified; 422 with autologous rib grafting (54% female; median age 48 years) and 285 with cadaveric costal cartilage grafting (52.6% female; median age 53 years). The rate of post-operative infection did not significantly differ between the autologous and cadaveric rib groups (2.3% vs. 2.3%, p = 0.99). One patient in the cadaveric group (0.34%) returned to the operating room for revision (washout of post-operative infection) within the first 30 post-operative days. Prescription of post-operative oral prophylactic antibiotics did not significantly decrease the post-operative infection rate (p = 0.13 for autologous group and p = 0.18 for cadaveric group). CONCLUSION: Post-operative infection rates after rhinoplasty did not significantly differ between patients undergoing cadaveric versus autologous rib grafting. The use of prophylactic antibiotics did not decrease the risk of post-operative infection.
Laryngoscope
· 2026 Jun · PMID 42348173
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OBJECTIVES: Chronic neurogenic cough (CNC) is prevalent in Otolaryngology settings and impactful. Targeted neuromodulators may offer benefits. This longitudinal study of CNC patients taking pregabalin evaluates success o...OBJECTIVES: Chronic neurogenic cough (CNC) is prevalent in Otolaryngology settings and impactful. Targeted neuromodulators may offer benefits. This longitudinal study of CNC patients taking pregabalin evaluates success of treatment, duration of treatment, and responses in relation to presence of other trigger conditions. METHODS: Ninety five patients (73% female, mean age 62y [12.5, SD]) treated with pregabalin for CNC were evaluated by patient-reported outcome measures, ratings of cough improvement and ability to discontinue therapy. RESULTS: Patients presented with mean 3.5 year [2.75 SD] cough duration. Seventy-eight percent of individuals administered pregabalin reported significant cough improvement or resolution, with mean 6.5 weeks [5, SD] of therapy. Significant reduction in HARQ from 32 [11, SD] to 22 [15, SD], [t-4.15, p = 0.0001, d = 0.60], and RSI scores from 21 [8, SD] to 14.4 [8.2, SD], [t = 6.71, p < 0.001, d = 0.75] were seen following treatment, with moderate effect sizes. 17% of patients taking pregabalin did not report improvement, with 1% reporting worsening cough. Side effects requiring discontinuation of therapy were reported in 4% of patients. Presence of hiatal hernia, dysmotility or reflux findings did not change the likelihood of positive response (75% [no findings] vs. 80% [positive findings]). Sex did not affect likelihood of improvement (female 82% vs. male 85%, p = n.s). CONCLUSION: Pregabalin is a well-tolerated neuromodulator providing relief of CNC symptoms in patients presenting to an Otolaryngology clinic. Treatment duration of 6 weeks provides relief to more than three quarters of patients and response to therapy occurs equally across genders and in those with gastrointestinal comorbidities.
Locatello LG, Manfredi S, Barzan E
… +2 more, Vetrugno L, Miani C
Laryngoscope
· 2026 Jun · PMID 42340088
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OBJECTIVE: Surgical tracheostomy can be performed either at the bedside in the ICU (OBST) or in the operating room (ORST). OBST represents an attractive yet underused alternative to ORST, especially for critically ill pa...OBJECTIVE: Surgical tracheostomy can be performed either at the bedside in the ICU (OBST) or in the operating room (ORST). OBST represents an attractive yet underused alternative to ORST, especially for critically ill patients, because it optimizes transport risks, healthcare resources, and costs. This study aimed to compare clinical outcomes and costs between OBST and ORST. METHODS: Retrospective analysis was conducted at our Institution for adult patients who underwent OBST or ORST between 2014 and 2024. Clinical and surgical data were collected and procedural complications were graded according to the Clavien-Dindo (CD) system. RESULTS: Out of 420 patients, 199 (47.4%) underwent OBST and 221 (52.6%) ORST. OBST patients had higher BMI (p = 0.004) and lower age-adjusted Charlson comorbidity index (CCI) (p = 0.001). There were no significant differences between the two groups in terms of operative time, surgeon's experience, and rates of intraoperative or postoperative complications. Multivariate analysis for CD ≥ 3 postoperative complications showed previous tracheostomy to be a significant predictor (p = 0.017) while the setting was not (p = 0.497). Unfavorable neck anatomy was the only independent predictive factor for intraoperative complications (p = 0.045). Bjork flap was found to be protective against all complications (p = 0.008). Additionally, OBST was associated with a 53.6% cost reduction. CONCLUSION: OBST and ORST demonstrated comparable intra- and postoperative safety. In particular, OBST was not an independent risk factor for major complications and therefore it should be considered the first choice wherever surgical tracheostomy is required.
Laryngoscope
· 2026 Jun · PMID 42339571
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OBJECTIVES: Petroclival and temporal bone meningiomas are rare neoplasms that mimic vestibular schwannomas in presentation. However, surgical approaches for their resection are often more complex, largely due to the nece...OBJECTIVES: Petroclival and temporal bone meningiomas are rare neoplasms that mimic vestibular schwannomas in presentation. However, surgical approaches for their resection are often more complex, largely due to the necessity of resecting pathologic dura. Although several classification and staging systems for petroclival meningiomas have been proposed, they are rarely cited and none are reliably correlated with surgical outcomes. We present a descriptive framework and hypothesize that it is predictive of surgical outcomes. METHODS: Medical records of patients seen at a tertiary referral center with a diagnosis of petroclival meningioma were reviewed. Patients were stratified into four tiers: tier 1, meningioma confined to internal auditory canal (IAC) only; tier 2, meningioma confined to cerebellopontine angle (CPA) only; tier 3, meningioma involving CPA and IAC; and tier 4, meningioma involving cavernous sinus, internal carotid artery or jugular bulb, or crossing midline. Tier 4 was subdivided into 4A (no carotid involvement) and 4B (carotid involvement). Outcomes of observation, radiation, and surgery were analyzed. RESULTS: Of 64 qualified patients, tier 2 was most commonly encountered (41%); the remainder of patients were classified as tier 1, 3, and 4 (3%, 33%, 23%). Among patients indicated for resection, combined petrosal approach was utilized in 64% of cases. Simpson grade of resection, complication rate, and rate of residual/recurrent tumor were statistically significantly associated with tumor tier. Tier and postoperative House-Brackmann score showed no significant correlation. CONCLUSION: The proposed framework demonstrates the potential clinical utility of an outcome-predictive staging system, helping to guide surgeon and patient expectations.
Jang DW, Lee HJ, Abi Hachem R
… +5 more, Goldstein BJ, Witsell DL, Godley F, Collins T, Coles T
Laryngoscope
· 2026 Jun · PMID 42338261
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OBJECTIVES: Facial pain or pressure is often non-rhinogenic but is frequently misdiagnosed as sinusitis, leading to inappropriate treatment with antibiotics and surgery. The objective of this study was to develop and val...OBJECTIVES: Facial pain or pressure is often non-rhinogenic but is frequently misdiagnosed as sinusitis, leading to inappropriate treatment with antibiotics and surgery. The objective of this study was to develop and validate a brief self-administered questionnaire, the Sinus Headache Screener (SHS), to help differentiate chronic rhinosinusitis (CRS) from non-rhinogenic facial pain or pressure (NRFP). METHODS: Patients presenting to the rhinology clinic with a chief complaint of facial pain or pressure completed an 89-item questionnaire bank developed previously through qualitative methods. A diagnosis of CRS or NRFP was given based on imaging criteria. Psychometric analysis and logistic regression were utilized to select items and create a scoring system that could reliably differentiate the two conditions. Predictive performance was evaluated through the area under the receiver operating characteristic curve (AUC) with bootstrapping. RESULTS: Of 251 patients enrolled, 114 had CRS and 137 had NRFP. Mean (SD) age was 50 (16), and 69.3% were women. Eight items with scoring weights were included in the SHS. Scores ranged from -4 to 9, with higher positive values predictive of NRFP. With a score cutoff of > 0, the SHS had a sensitivity/specificity of 0.87/0.64, and positive/negative predictive values of 0.74/0.80 for NRFP. The optimism-corrected AUC was 0.798 (95% CI: 0.766, 0.877). CONCLUSION: In patients presenting with sinus headache, the SHS accurately differentiated NRFP from CRS. The use of the SHS as a point-of-care clinical tool can improve diagnostic accuracy and facilitate cost-effective management.
Clements AC, Pan C, Bhatt NK
… +3 more, Roth M, Barber B, Marchiano E
Laryngoscope
· 2026 Jun · PMID 42337848
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We report the first case of titanium mesh reconstruction of the thyroid cartilage following resection of papillary thyroid carcinoma with preservation of the laryngeal mucosa. This technique provided excellent functional...We report the first case of titanium mesh reconstruction of the thyroid cartilage following resection of papillary thyroid carcinoma with preservation of the laryngeal mucosa. This technique provided excellent functional outcomes while maintaining oncologic resection in a patient with locally advanced disease.