Itraconazole can be given as sole therapy for prolonged period of time to patients with allergic fungal rhinosinusitis who do not wish to take steroids or in whom steroids are contraindicated and in those who are waiting for surgery. It can result in symptomatic and radiological improvement and reduce the burden of disease. However, surgery still remains the definitive modality of treatment.

We have found the abnormal tight junction expression is possibly caused by aberrant nasal epithelial cells, neutrophils excessive infiltration, and imbalance of T-reg and TH1/TH2/TH17 cell responses in nasal inverted papilloma (NIP), which may improve the underlying pathogenesis of NIP patients.

This animal study revealed that differences in packing materials and placement durations affected wound healing of nasal mucosa. The appropriate packing materials and replacement duration should be essential for ideal wound healing.

In endoscopic sinus surgery, both levels of intraoperative hypotension (62.2 ± 2.3 mmHg vs. 74.0 ± 2.8 mmHg), combined with position adjustment and low-concentration adrenaline to constrict nasal mucosal blood vessels, provided acceptable surgical conditions, and there was no difference in the amount of bleeding or blood loss rate between the two groups. In addition, the individualized hypotension strategy was associated with lower blood lactate levels and more satisfactory awakening quality.

Pulmonary extension is a rare but morbid manifestation of recurrent respiratory papillomatosis with limited therapeutic options. In this study, we show that systemic bevacizumab is effective in stabilizing progression in even the most severe cases of recurrent respiratory papillomatosis, with both a dramatic reduction in laryngeal and tracheal disease as well as a stable-to-partial response of pulmonary involvement in a majority of patients.

Despite an association between earlier tracheostomy timing and shorter hospital length of stay, non-English speaking and female patients are more likely receive late tracheostomy. Standardized protocols for tracheostomy timing may help address bias in the referral and execution of tracheostomy and reduce unnecessary hospital days.

We describe an illustrative case of one patient with a retained screw from spinal hardware embedded in the posterior hypopharyngeal wall. After multiple failed attempts at removal, an otolaryngology team used the da Vinci single-port robot via a transoral approach to successfully remove the foreign body.

Critics of the h-index argue that it is reflective of the time a researcher has spent in the field, instead of impact. The relative citation ratio may reduce historic bias against women and younger otolaryngologists.

Current female otolaryngology resident physicians were surveyed to identify the most and least important factors they considered when choosing a residency program. The most important factors were, in fact, non-gender-related and reported to be camaraderie and happiness of current residents and the variety of clinical cases.

From 1996 to 2006, there was a 26.4% increase in fires followed by a 9.7% decrease in fires from 2007 to 2020 involving alcohol-based skin preparations. Warning label updates from 2006 to 2012 and increased awareness of the risks of these preparations likely contributed to the decrease in surgical fires.

Sialendoscopy is an effective procedure for relieving symptoms of sialadenitis, but recurrence related to post-treatment scarring is a problem. We report a new suture stent for use after sialendoscopy that can reduce rates of symptom recurrence in patients with sialadenitis. This stent is low cost and widely available across institutions for adoption.

Fifteen consecutive adult tonsillectomy surgeries were prospectively randomized to one of three tonsillectomy techniques—cold, monopolar electrocautery, or Coblation—and their environmental impact and cost analyzed comprehensively using life cycle assessment. Cold technique was found to have the lowest cost and environmental impact, and statistical significance was confirmed for this effect when evaluating the impact of disposable surgical equipment. High-yield areas for intervention to reduce the environmental impact of adult tonsillectomy included disposable surgical equipment and anesthetic medications.

As the literature grows in the field of otolaryngology, there is an increased need to surface those which have significantly altered the course or developed the field. We applied a recently developed bibliometric index (Disruption Index) to the otolaryngology literature. Herein, we report the publications with the highest disruption index and those with significant overlap with other bibliometric indices.

This survey-based study highlights URiM undergraduate student perspectives on summer research programs to provide feedback to otolaryngology departments that offer these programs. Students value, in order, mentorship, opportunities for clinical shadowing, and research opportunities. These perspectives may help to bolster programs aiming to support URiM students.

A 12-year-old male, who had suffered a motor vehicle trauma seven years prior, was diagnosed with a rare cerebrospinal fluid (CSF)-venous fistula (CVF) causing orthostatic, exertional headache and intracranial hypotension. The CVF was treated via a unique trans-nasal endoscopic approach after MRI and CT imaging failed to detect it, but digital subtraction myelography (DSM) confirmed the diagnosis. This case suggests the need for considering CVFs in the differential diagnosis of spontaneous intracranial hypotension, and the potential utility of DSM in diagnosing CVFs when traditional radiology results are inconclusive.

The greater saphenous vein can be harvested from the standard incision for an anterolateral free flap and used as a vein graft in complex head and neck reconstruction. Laryngoscope, 134:648–650, 2024

Handheld ultrasound devices can be used in revision rhinoplasty to evaluate the calcification of costal rib cartilage that is to be harvested for grafting. This article provides instructions on how to perform this technique. Laryngoscope, 134:651–653, 2024

Reconstruction of complex defects involving the supraorbital rim and orbital roof and adjacent skull base defects present a challenge to the reconstructive challenge. We describe a novel technique of vascularized fascia lata free flap with osseous rib grafting to reconstitute the bony structures and provide a barrier between sinonasal and intracranial cavities and the orbit.

Utilizing the 2000–2019 Medicare Fee-For-Services dataset, this article found that the incidence of facial fracture repair among the elderly has increased by over 93%, which was largely driven by nasal bone/septal fracture repairs. While this resulted in an increase in Medicare physician nominal payments from $2.6 million to $4.1 million, when adjusted for inflation, average reimbursement decreased 44.1% per procedure. These results have important implications as the population continues to age.

Musculocutaneous perforator dissection during anterolateral thigh free flap harvest can increase the mean pedicle length by 5.2 cm. This additional length gained can be particularly helpful in reconstructions in patients with previously surgically or radiation-treated necks with limited recipient vessels available for anastomosis.

Otolaryngologists remain a minority of surgeons performing primary cleft lip and palate repair overall. This has not significantly changed over the last decade. Cleft rhinoplasty is slowly, but increasingly being performed by Otolaryngologists.

Most aesthetic features related to the tip, except for nasolabial angle, were maintained up to 12 months after rhinoplasty, regardless of any addition of tip graft or the tip grafting method used.

Patients with head and neck cancer and who received interventional radiology treatment for carotid blowout were included to determine outcomes after interventional radiology treatment of carotid blowout. The majority of carotid blowout occurs within 6 months of surgery or radiation and many who survived died of cancer progression or medical illness. Carotid bypass with flap coverage may be a worthwhile treatment for carotid blowout and should be considered as an adjunct to endovascular treatment.

In this study of 452 patients with head and neck squamous cell carcinoma in the Bronx, NY, routine posttreatment follow-up in the first year was associated with a better chance of 5-year survival, whereas consistent follow-up over 5 years was not associated with improved survival.

We evaluated rates at which cancer was present in re-resection and its impact on oncologic outcomes. Only 29% of re-resections contained further malignancy, and final positive margins are often at anatomic sites different than the initial positive margin.

We instituted a “frozen section timeout” that centers around visualization of the paired resection specimen and surgical defect—facilitating effective, bidirectional exchange of information between surgeon and pathologist. Twenty-six frozen section timeouts were conducted intraoperatively. During the timeout, activities were halted, critical information was shared and documented, and annotated specimen and defect scans were displayed—clearly demonstrating the at-risk margins and the corresponding location and breadth of supplemental margins harvested.

5-ALA induces intraoperative fluorescence of squamous cell carcinoma, identifying positive margins, perineural invasion, and metastatic nodal disease. While no conclusions can about safety of this drug in the head and neck cancer population, our study parallels the extensive safety data in the neurosurgical literature.

We collected the latest head and neck tumor RCT. The survival time advantage and toxicity reaction of each drug were obtained.

This objective of this study is to determine if a cell-based outer vocal fold replacement (COVR) effectively restores vocal fold (VF) function when applied to existing scar. In a rabbit model, COVR implantation in both acutely injured and chronically scarred VFs demonstrate persistence of implanted cells, restored tissue biomechanics, and increased hyaluronic acid content.

This study sought to quantify superior thyroid artery (STA) geometry and blood flow velocity after dehydration and rehydration using in vivo magnetic resonance angiography (MRA) and ultrasound imaging in a rat model.

We present a novel approach to harvest epithelial cells from the mouse larynx using a dental brush. For forthcoming studies, these cells will be acquired following laryngeal injury induced by inhalation or other challenges and evaluated through downstream cellular and molecular assays, such as scRNA-seq, protein analyses, and cell-culture-based experiments.

This study surveyed idiopathic vocal process granuloma management by academic laryngologists in the United States. Though no gold standard treatment exists, there are many common opinions about etiology and management. This survey serves to provide guidance for further investigation and management of vocal process granuloma.

Comparison waste audit was conducted between in office laryngeal laser surgery and traditional operating room laser microlaryngoscopy for RRP. The waste audit demonstrated that in-office procedures have 13% of the total waste generated compared to in the operating room cases. Opportunities for further landfill diversion were also identified in our institutional practices.

This study engineered a decellularized, channel-laden xenogeneic cartilage graft that was tested in a proof-of-concept, first-of-its-kind neonatal porcine laryngotracheal reconstruction (LTR) model. After LTR, the decellularized graft showed significant tissue integration, airway expansion, and neocartilage formation. Our neonatal porcine LTR model coupled with decellularized cartilage graft technology is a novel approach to tissue-engineered pediatric LTR and sets the stage for “off-the-shelf” graft options.

Diagnostic odyssey refers to the patient experience from symptom onset to diagnosis of a rare disease. We investigated the drivers of odyssey length through semi-structured interviews, in an effort to improve health care for iSGS patients.

Idiopathic subglottic stenosis (iSGS) occurs in an overwhelmingly homogenous population: Caucasian, middle-aged women. Given this, we investigate whether there is a dose–response relationship between estrogen and disease progression and recurrence.

Quantitative measures of bowing index, normalized glottal gap area, and max abduction angle were collected from patient with age-related vocal atrophy before and after bilateral type 1 thyroplasty. Bilateral medialization thyroplasty resulted in improved vocal fold bowing, glottal gap, and CAPE-V scores. These findings suggest that bilateral thyroplasty improves vocal bowing and glottal gap area, and the improvement in vocal fold morphology and closure leads to improved voice quality.

Digital endoscopes are connected to a video processor that applies various operations to improve the image. One of those operations is edge enhancement that sharpens the image. Edge enhancement has a major impact on sharpness, noise, and the resulting perceived image quality. We conclude that ENT professionals benefit from this video processing and should verify if their equipment is optimally configured.

Bilateral functional electrical stimulation was applied to increase muscle volume and improve phonation characteristics of the aged sheep larynx. After 9 weeks of stimulation, an improvement in vocal efficiency as well as an increase in minimal muscle fiber diameter (type II fibers) was observed, compared with sham. Histology and gene expression analysis showed no significant muscle fiber type switching after stimulation.

By using the rat model of unilateral laryngeal recurrent nerve transection injury, we report a novel molecular mechanism of MuRF-1-mediated internal laryngeal muscle denervated atrophy, that MuRF-1 may mediate the ubiquitination of G-actin, leading to a disequilibrium of G-actin and F-actin in denervated muscle tissues.

Survey finds heterogeneity in iSGS patient management, with the rise of in-office steroid injections as primary treatment. Maddern procedure and endoscopic wedge resections are rarely offered. Algorithms vary based on experience/outcomes, and standardization is needed to improve clinical outcomes as more studies emerge.

Anonymous 22-item questionnaire survey of recent laryngology fellowship graduates experiences and challenges during fellowship training.

Exploring the use of cord-derived mesenchymal stem cells embedded within a collagen matrix as a method to restore vocal cord viscoelastic tissue.

We present a video of a tracheal resection and anastomosis performed on a patient affected by A-shaped tracheal stenosis. The condition was a consequence of a percutaneous tracheostomy following a Sars-Cov2 infection. Airways management during the surgery was obtained with the Tritube®, an innovative device with a very small lumen that combines stable lung parameters and good visualization of surgical field. Laryngoscope, 134:897–900, 2024

This study evaluated the sense of smell in children who had a previous COVID-19 infection and children who did not have a previous COVID-19 infection. It was observed that children with a history of COVID-19 infection had diminished sense of smell.

Many patients with audiologic symptoms are found to have normal audiometric testing. This study demonstrates that the results of extended high frequency audiometric testing correlate with audiological complaints in patients with otherwise normal standard audiograms.

In one of the largest Bell's palsy cohorts to date (N = 2420), we characterize occult lesion diagnosis rates after initial Bell's Palsy diagnoses. We identified a 9.7% occult lesion diagnosis rate at a median 12 months post-Bell's Palsy diagnosis. This study underscores the importance of timely workup for occult lesions in cases of acute facial palsy with no signs of recovery.

Pediatric patients with moderate to profound sensorineural hearing loss underwent cochlear implantation, and standard performance measures were combined with measures of perceived benefit (The Speech Spatial and Qualities of Hearing Questionnaire modified for children (SSQ-C)) at 3, 6, 9, 12, 18, and 24 months post-activation. Parents reported significant improvement in perceived abilities immediately post-activation which were maintained over the 2-year monitoring period. Standard performance measures were not correlated with perceived benefit via SSQ-C.

This study used supervised machine learning in order to identify demographic and audiometric variables predictive of acoustic hearing preservation following cochlear implant surgery. The machine learning classifiers demonstrated accuracy and utility in this task. Applying appropriately validated predictive models to clinical practice may facilitate improved shared decision making and treatment outcomes.

This study examined the sensitivity and effectiveness of a new floating piezoelectric microphone (NFPM) designed for totally implantable cochlear implants (TICIs) in animal experiments and clinical trials. The NFPM is effective and without obvious body noise, making it feasible as an implantable middle-ear microphone for TICIs.

This human postmortem histological study shows that cochlear implantation via the round window membrane could limit local fibrous and bony tissue formation compared to cochlear implant insertions that involve drilling of the bony capsule to enter the cochlea.

Our study investigated the impact of neighborhood-level social vulnerability on pediatric tonsillectomy outcomes. After controlling for known covariates and individual-level factors (e.g., age, gender, race, comorbidities, and obstructive sleep apnea), we found that a higher social vulnerability index (SVI) was a significant factor in predicting both readmissions and complications. This elevated risk has potential implications for management for patients living in disenfranchised neighborhoods.

Double-Staged laryngotracheoplasty (dsLTP) is a procedure used to treat subglottic stenosis in the pediatric population, with decannulation being the ultimate goal of surgery. This study aims to determine how often initial postoperative airway endoscopy after stent removal predicts the likelihood of decannulation, time to decannulation, and number of endoscopic procedures needed after dsLTP. The study found that early airway findings correlate with likelihood of decannulation, and number of endoscopic procedures.

We randomized 16 PFAPA children in tonsillotomy group and control group (observation only). After 3 months of follow-up, 88% of the patients in tonsillotomy group and 25% in the control group were free from PFAPA flares (95% CI 13%–87%; p = 0.0021). Tonsillotomy was effective in treating PFAPA in this study.

While aspiration is the most common presenting symptom of a laryngeal cleft, it is important to consider that patients can have a cleft in the absence of dysphagia. We present two cases of type III laryngeal clefts that presented with upper airway obstruction without aspiration.

This is a retrospective cohort study of 332 adults to determine the association between soft palate shape and unilateral hypoglossal nerve stimulation (HNS) outcomes. Vertical palate shape and narrowing at the hard-soft palate junction are independently associated with lower HNS surgical success rates.

Longitudinal snoring changes can be captured using a mobile phone application. During hypoglossal nerve stimulator (HNS) therapy up-titration, increasing stimulation voltage was associated with reduced snoring frequency and intensity in this case series of six patients. Laryngoscope, 134:987–992, 2024

Hydrodissection of plane between thyroid and strap muscles and retraction of strap muscles using a low-cost indigenously made retractor are effective in overcoming technical difficulties in transoral endoscopic thyroid surgery. Laryngoscope, 134:993–994, 2024

In this article, we review the normal embryology of the thyroid gland, categorize the ways in which this embryology can fail, and describe how those failures manifest clinically and radiologically. Finally, we describe a new manifestation of abnormal thyroid embryology. Laryngoscope, 134:995–997, 2024