We describe a case of acute invasive fungal sinusitis (AIFS) in an immunocompetent, non-diabetic patient after endoscopic sinus surgery. The patient presented with retro-orbital pain progressing to vision loss and was treated with surgical debridement, systemic antifungal therapy, and transcutaneous retro-bulbar injection of amphotericin B resulting in resolution of her symptoms and improvement in her vision. To our knowledge, this is the first report of AIFS in an immunocompetent patient presumed to be secondary to a combination of local immune suppression via topical steroids and mucosal trauma.

This study aimed to evaluate the feasibility of using optical biopsy with confocal laser endomicroscopy to distinguish between benign and malignant mucosa during endoscopic sinonasal surgery. Our results demonstrated that healthy and inflamed mucosa could be differentiated from malignant lesions with an accuracy of 84.1%, a sensitivity of 85.4%, and a specificity of 83.1%, along with substantial interrater agreement (Fleiss κ = 0.62).

This study is the first to quantitatively analyze and compare the treatment of epistaxis, chronic sinusitis, sinus infection, allergic rhinitis, allergies, and nasal polyps across chatbots ChatGPT, ChatGPT Plus, Google Bard, and Microsoft Bing. The responses were analyzed on domains of readability, quality, understandability, actionability, accuracy, and comprehensiveness. On aggregate of the tested domains, our results suggest ChatGPT Plus and Google Bard are the most patient-friendly chatbots for the treatment of common pathologies in rhinology.

Some post-radiotherapy patients experience complete obliteration of the sphenoid or frontal sinuses, supposedly posing a risk for sinusitis or mucocele development. The objective is to comprehensively assess the natural history and outcomes of radiation-induced complete isolated sinus opacification. Our study revealed that a substantial number of post-radiation patients develop complete isolated sinus opacification, often in the frontal and sphenoid sinuses. These patients remained asymptomatic, and none required surgical intervention during nearly 5 years of follow-up.

Large animal models are needed to assess novel therapies for laryngotracheal stenosis (LTS) prior to human translation. In this manuscript, we describe a large ovine model for LTS and show that airway stenosis can be reliably and safely produced via combined chemo-mechanical injury. We additionally show that stent placement is feasible and safe.

A novel classification of FBCAs based on the relationship between lesions and the facial nerve in term of radiographic imaging findings was defined, and the corresponding surgical managements was introduced.

Functional rhinoplasty surgical techniques continue to evolve to address nasal valve compromise (NVC), but less is known about its underlying causes. This study found decreased glycosaminoglycan and increased collagen in the dorsal septal articulation cartilage of patients diagnosed with NVC.

Chondrocyte viability was similar between 1 mm diced cartilage, scaled cartilage, and positive control samples. Conversely, pate cartilage samples had significantly less viability compared to positive controls, diced samples, and scaled samples, and it had similar chondrocyte viability compared to negative controls. On computational modeling, cartilage viability decreased to 50%, 26%, and 11% as the diced sample was cut from 1 mm edge length to 0.7–0.8 mm, 0.55–0.65, and 0.4–0.5. Similarly, cartilage viability decreased to 26% at 0.55–0.65 mm, 11% at 0.4–0.5 mm, and <5% at <0.4 mm edge length.

This study compares patient-reported functional and aesthetic outcomes of split-thickness skin graft (STSG) versus hatchet flap closure of radial forearm free flapdonor site using the Patient-Observer Scar Assessment Scale and Michigan Hand Outcome Questionnaire. In total, 81 patients participated in the study (39 STSG patients and 42 hatchet flap patients). STSG appeared to have less compromise in activities of daily living, better satisfaction and improved scar quality than hatchet flap, but a higher rate of tendon exposure.

We report a case of upper parapharyngeal abscess arising from progression of a central skull base osteomyelitis, in a patient with poorly controlled diabetes mellitus. Our case is unusual for its presentation in an upper parapharyngeal location, involvement of the skull base, and poor response to medical treatment, hence requiring transnasal endoscopic surgical drainage to achieve definitive treatment. Here, we share our experience with a safe and effective technique of transnasal endoscopic drainage of a parapharyngeal abscess. Laryngoscope, 134:4274–4277, 2024

The primary aim of this study is to understand and validate the capacity of the modified frailty index (mFI-5) to predict outcomes for patients undergoing transoral robotic surgery for head and neck cancer. The results of this study provide compelling evidence of the link between increased frailty as defined by mFI-5 and various postoperative complications, including mortality, infection, and pneumonia better predicted than by age alone.

While pathologic staging is considered the gold standard in head and neck cancers, clinical staging guides initial treatment plans and patient counseling. This study aims to identify specific stages and primary tumor subsites where discordance between clinical and pathologic staging is high. We found that T2 Oral Cavity, T2 Oropharynx, T3 Larynx, and N1 Lymph Node had the highest discordance while T1 Larynx, T4 Oropharynx, N0 Lymph Node, and N3 Lymph Node had the lowest.

The medial sural artery perforator flap (MSAP) is a versatile free flap used for reconstruction of oral cavity defects. However, anatomy of the cutaneous perforators has not been well studied. Anatomical characterization of the MSAP flap using 3D analysis can assist reconstructive surgeons in understanding the relevant anatomy and optimizing the surgical technique for MSAP flap harvest.

Immune checkpoint inhibitors (ICIs) have demonstrated remarkable efficacy in the treatment of various advanced and metastatic malignancies in recent years and have proven to be pivotal in contemporary oncological strategies. As the utilization of ICIs expands, so does the recognition of adverse effects, highlighting the need for vigilance in monitoring and reporting outcomes. We present a case series of two cases of supraglottitis in patients treated with ICIs, including management strategies, thus adding a novel dimension to the respiratory implications of these agents.

Thyroarytenoid myomectomy demonstrated significant improvement in patient reported outcomes from bilateral vocal fold immobility while not significantly altering glottal structure. Data from this study suggest thyroarytenoid myomectomy improves dyspnea symptoms in patients with bilateral vocal fold immobility without impairing voice.

Laryngeal transplantation is a complex procedure with significant morbidity but offers improved quality of life for selected patients with end-stage laryngeal disorders. An international registry is recommended for better quality pooled data. Future advancements may expand its application.

In our study, we trained a multi-instance learning (MIL)-based artificial intelligence (AI) model on multi-center white light imaging (WLI) and narrow band imaging (NBI) images. This model aims to assist in distinguishing the benign or malignant nature of vocal fold leukoplakia (VFL).

The current diagnosis and treatment of vocal cord leukoplakia is relatively chaotic, lacking effective high-risk assessment methods. This study established and validated a model for vocal cord leukoplakia risk stratification, it not only has high accuracy, but also has been developed into a public prediction platform, which can be used and tested by everyone, and has strong practicality. This study may provide significant assistance to otolaryngologists in the treatment of vocal cord leukoplakia.

A case of unilateral conductive hearing loss and normal acoustic reflexes and vestibular testing.

We describe the case of a patient who presented with sudden onset vertigo and bilateral deafness while under immune checkpoint therapy for metastatic lung cancer. The diagnostic workup confirmed bilateral sensorineural deafness and bilateral loss of vestibular function, while imaging revealed enhancement of the vestibulocochlear nerve. Initially, immunotherapy with PD-L1 antibody atezolizumab was the assumed cause of the described symptoms. However, further findings strengthened the suspicion of meningeosis neoplastica.

We describe the development and validation of a questionnaire for the assessment of quality of life in Meniere's disease, the MenQOL. The MenQOL is a simple, valid patient-reported outcome measure, which may be used to assess the effects of treatment on disease-specific quality of life in patients with Meniere's disease.

This study estimated costs of severe to profound hearing loss, including costs and cost-savings associated with cochlear implantation. The estimated lifetime cost of an individual born with severe to profound hearing loss is $484,274 with costs being lower for those who received a cochlear implant before 18 months of age compared to those who did not receive an implant. The annual societal costs for the US population with severe to profound hearing loss were estimated to be $37 billion.

(1) This study is the pioneering effort employing Mendelian Randomization (MR) analysis to elucidate the relationship between lipids, statins, and sensorineural hearing loss (SNHL). (2) Our findings establish a causal link between elevated triglyceride levels and an increased risk of SNHL. (3) Although statins have demonstrated potential in reducing the risk of SNHL, their primary mechanism of action might not solely hinge on lowering triglycerides.

This was the first study investigating small non-coding RNAs in human acquired cholesteatoma using NGS technique. We were able to identify new miRNAs and pathways related to cholesteatoma.

Micro-CT of the trachea in Down syndrome and non-Down syndrome fetuses showed that morphology is similar between 13 and 21 weeks of gestation. The narrowed tracheal diameter characteristic for Down syndrome may occur later in fetal development or results from postnatal intubation trauma. The narrowest part of the trachea is in majority of fetuses the middle third.

Early results show that injection medialization is safe and improves early objective swallowing outcomes in children <2 years old with VFI after congenital cardiac surgery.

CSCS, though uncommon, presents distinct regional involvement along with pathognomonic clinical and pathological features. CSCS is marked by a pale skin streak extending superiorly from the orifice—a diagnostic “skin streak sign.” Complete surgical excision constitutes an effective treatment modality for CSCS.

This protocol describes the method for creating 3D-printed trachea models for use in high-fidelity simulation-based training and advanced surgical planning for pediatric patients undergoing slide tracheoplasty. The goal is to provide a template and methodology to allow for replicability and more widespread dissemination of these models to improve clinical training and patient care. Laryngoscope, 134:4409–4413, 2024

The work illustrates a step-by-step surgical approach to demonstrate technical feasibility of a single-stage endoscopic repair for bilateral choanal atresia with adjuvant bioabsorbable steroid-eluting stent placement to safely mitigate unique perioperative challenges in the pediatric population. Laryngoscope, 134:4414–4417, 2024

A 47-year-old male patient diagnosed with severe obstructive sleep apnea (OSA) sought alternatives to positive airway pressure, prompting evaluation with drug-induced sleep endoscopy (DISE). He underwent a specialized DISE with nasal airflow and pharyngeal pressure monitoring. During obstructive apneas, airflow and pressure signals demonstrated dynamic, multilevel upper airway collapse, with shifting sites of airflow obstruction as respiratory effort increased. This case report illustrates how quantitative airflow and pressure measurements can complement the standard DISE exam and aid in surgical decision-making.

This cross-sectional study of differentiated thyroid carcinoma patients in the National Cancer Database demonstrates significant racial differences in disease presentation, treatment, and survival outcomes. The Affordable Care Act Medicaid was associated with improved survival outcomes.