Ear,Nose & Throat Journal

To investigate the association between clinical sleep parameters and olfactory function (OF) in patients with obstructive sleep apnea (OSA) and to evaluate the therapeutic effect of 12-month continuous positive airway pressure (CPAP) on olfactory dysfunction (OD).

A total of 146 participants were included: 55 healthy controls, 68 untreated OSA patients, and 23 CPAP-treated patients. OSA severity was classified according to the apnea–hypopnea index (AHI). OF was assessed using the Sniffin’ Sticks test. Clinical variables, sleep parameters, and olfactory scores were compared among groups. Subgroup analysis between CPAP-treated and untreated OSA patients used the Mann–Whitney U test. Multivariate logistic regression identified predictors of olfactory improvement.

Our findings demonstrated that OD was correlated with the severity of OSA. Olfactory scores were significantly negatively correlated with AHI (r = −.544, P < .001), but positively correlated with average SpO₂% (r = .333, P = .006) and minimum SpO₂% (r = .449, P < .001). After 12 months of CPAP treatment, the mean olfactory score reached 13.87 ± 1.96, significantly higher than 9.78 ± 4.217 in the untreated group, demonstrating substantial functional recovery.

The results indicated a close relationship between OD and disease severity in patients with OSA and confirmed that long-term CPAP therapy can effectively improve OF. These findings provide new insights into the multisystem impact of OSA and suggest that olfactory assessment may serve as a complementary clinical tool for OSA evaluation.

To compare the effects of morning versus evening once-daily administration of intranasal mometasone furoate on nasal symptoms, sleep quality, daytime sleepiness, and quality of life in patients with moderate-to-severe seasonal allergic rhinitis (SAR).

This prospective, randomized, single-blind study included 120 adults with SAR who received intranasal mometasone furoate (200 μg once daily) either in the morning or in the evening for 15 days. Outcomes were assessed using the Total Nasal Symptom Score, Rhinitis Quality of Life Scale, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. Baseline-adjusted comparisons between treatment groups were performed using analysis of covariance.

Both treatment groups showed significant posttreatment improvements in nasal symptoms, sleep quality, daytime sleepiness, and rhinitis-related quality of life. After adjustment for baseline values, no statistically significant differences were observed between morning and evening dosing for any outcome measure (all P > .05). Baseline disease severity emerged as the primary determinant of posttreatment outcomes, accounting for a substantial proportion of outcome variability, whereas dosing time showed no clinically meaningful effect.

Once-daily intranasal mometasone furoate provides comparable clinical benefits regardless of whether it is administered in the morning or in the evening in patients with moderate-to-severe SAR. These findings suggest that dosing time has limited clinical relevance for long-acting intranasal corticosteroids, allowing treatment to be guided by patient preference without compromising efficacy.

Voice disorders caused by vocal fold lesions or mobility disorders are common, but current diagnosis depends on mildly invasive laryngoscopy.

To develop and validate a deep learning model for automatic classification of multiple voice disorder categories using non-invasive voice recordings.

We retrospectively analyzed 897 patients and healthy controls from a tertiary ENT center. Sustained Mandarin vowels (/a/, /e/, /o/, /i/, /u/, /v/) were recorded and converted to Mel spectrograms. A ResNet and feature pyramid network-based model was trained with weighted cross-entropy loss and evaluated on 3-class (normal, laryngeal lesions, vocal fold mobility disorders) and binary (high-risk vs benign laryngeal lesions) tasks.

For the 3-class task, the model achieved accuracy 0.795, sensitivity 0.818, specificity 0.900, precision 0.786, and F1 score 0.794. For the binary task, performance improved to accuracy 0.826, sensitivity 0.933, specificity 0.625, precision 0.824, and F1 score 0.876, indicating high sensitivity for detecting high-risk laryngeal lesions.

A deep learning model using multi-vowel Mel spectrograms can non-invasively classify common voice disorders with clinically meaningful accuracy and shows particular promise as a screening tool for high-risk laryngeal lesions.

To assess the relationship between nasal septal deviation characteristics, sinonasal variations, and nasolacrimal duct (NLD) obstruction in primary Acquired Nasolacrimal Duct Obstruction (PANDO) and chronic dacryocystitis.

A total of 142 patients (48 PANDO, 46 chronic dacryocystitis, 48 controls) who underwent paranasal sinus computed tomography were included. Septal deviation characteristics and sinonasal variations were evaluated. Associations with NLD obstruction were analyzed using univariate and multivariate logistic regression.

The septal deviation was significantly associated with NLD obstruction (p = 0.005). Multivariate analysis identified a higher classification of Mladina (OR = 1.37, 95% CI = 1.10–1.71; p = 0.006) and a lower coronal deviation (OR = 1.73, 95% CI = 1.00–2.99; p = 0.049) as independent predictors. Other deviation parameters and sinonasal variations were not independently associated with laterality or severity obstruction. In deviation-positive patients, morphological features did not predict the obstruction side.

Inferior septal deviation and higher Mladina scores showed independent associations with NLD obstruction; however, the general contribution of septal morphology appears limited. These findings may have implications for preoperative evaluation and surgical planning in patients with PANDO and chronic dacryocystitis.

Congenital pyriform fossa malformations (CPFM) are rare types of branchial anomalies. The management approach was previously anatomical, based on outlining the complete surgical excision of the vestige tract. Endoscopic obliteration of the pharyngeal opening of the tract evolved as an alternative to less invasive treatment. Although different techniques have been reported, long-term follow-up data are relatively deficient.

This is a retrospective analysis of patients with CPFM treated in a tertiary referral hospital. Direct laryngoscopy was the only diagnostic method used. Endoscopic radiofrequency ablation was done as described. Patients with at least 24 months of follow-up were included.

Fourteen patients met inclusion criteria, 10 males and 4 females, with a mean age of 8 years. Only one patient had an external cervical component. All patients had the pharyngeal opening in the left pyriform fossa except for one. Average follow-up period was 41.5 months. No complications or recurrences were reported during the follow-up period.

Endoscopic radiofrequency cauterization can be described as a safe, effective sole treatment of CPFM. The approach we adopted is simple, less demanding with long-term reliability.

Evaluation of the feasibility and surgical applicability of the ENDOFIXexo robotic endoscope holder (AKTORmed) in various ear, nose, and throat (ENT) procedures.

This study was conducted as a prospective single-center feasibility study involving 26 patients who underwent endoscopic ENT surgery between September 2022 and May 2025. The ENDOFIXexo system was used as a passive robotic assistant. The study assessed surgical performance, intraoperative handling, system limitations, and safety outcomes.

The device provides stable endoscopic visualization and allows truly bimanual operation in multiple procedures. It is particularly beneficial for orbital decompression, dacryocystorhinostomy, eustachian tube balloon dilation, and endoscopic ear and laryngeal surgeries. Nonetheless, its application is limited to narrow nasal cavities and highly hemorrhagic procedures. No adverse events were observed, and the setup time remained below 10 minutes.

The ENDOFIXexo is a safe and practical tool with the potential to enhance the quality of endoscopic ENT surgery by strongly facilitating bimanual techniques. Its utility is highly valuable in complex or assistant-limited procedures. However, further studies are necessary to strengthen these findings.

To compare the operative closure time and early postoperative outcomes between nasal septal retainer and trans-septal suturing techniques in patients undergoing septoplasty.

This single-center, prospective, open-label, randomized controlled trial included patients aged 18 to 65 years with nasal obstruction. Participants were randomized to trans-septal suturing or nasal septal retainer after septoplasty. The primary outcome was operative closure time. Secondary outcomes included symptom burden assessed by visual analog scale (VAS) at 48 hours postoperatively, Sino-Nasal Outcome Test-22 (SNOT-22) scores at baseline, 1 week, and 3 months, and postoperative complications.

A total of 23 patients were randomized (11 to trans-septal suturing and 12 to nasal septal retainer). Baseline characteristics were comparable between groups. The mean closure time was significantly shorter in the septal retainer group than in the trans-septal suturing group (18.1 ± 1.5 seconds vs 763.3 ± 59.9 seconds; P < .001). The nasal septal retainer group reported significantly higher VAS scores for nasal obstruction (3.83 ± 1.34 vs 1.91 ± 1.04), facial pressure (2.33 ± 1.30 vs 0.27 ± 0.65), and dysphagia (2.14 ± 1.98 vs 0.00 ± 0.00) compared to the trans-septal suturing group (all P < .05). No significant differences were observed in SNOT-22 scores or complication rates during follow-up.

The nasal septal retainer significantly reduced operative closure time compared with trans-septal suturing, with comparable safety profiles and similar patient-reported outcomes at 1 week and 3 months postoperatively, suggesting that it may serve as a reasonable and efficient alternative to trans-septal suturing in septoplasty.

ChiCTR2300073690.

To explore the correlation between the posterior airway space (PAS) in children with adenoid hypertrophy and the acoustic impedance test indicators, in order to provide a reference for clinical assessment of middle ear dysfunction in these children.

A retrospective analysis was conducted on 160 children diagnosed with adenoid hypertrophy in the otolaryngology department of our hospital from January 2024 to January 2025. They were divided into 4 groups based on the PAS value (Grade 1: >12 mm, Grade 2: 8-12 mm, Grade 3: 5-8 mm, Grade 4: ≤5 mm), with 40 cases in each group. All underwent acoustic impedance testing, and the middle ear pressure, compliance, and distribution of the tympanogram were compared. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value.

There was no significant difference in the general data among the 4 groups (P > .05); as the PAS grade increased, the average absolute value of middle ear pressure increased (Grade 1: −3.48 ± 20.01 daPa, Grade 4: −124.03 ± 84.92 daPa, P < .001), the average compliance decreased (Grade 1: 0.68 ± 0.09 mL, Grade 4: 0.23 ± 0.04 mL, P < .001), the proportion of type B and C tympanogram increased (P < .01); the area under the curve (AUC) of type B and C tympanogram were 0.654 and 0.650 respectively (P < .01).

PAS was significantly correlated with the impedance index. The smaller the PAS value (indicating a more severe degree of adenoid hypertrophy), the more obvious the middle ear dysfunction.

Idiopathic sudden sensorineural hearing loss (ISSNHL) is a rapidly progressive disease that may cause permanent hearing loss. Standard primary treatments include oral corticosteroids (OCs) or intratympanic corticosteroids (ITCs). This study aimed to evaluate the effectiveness and safety of OCs versus ITCs as primary treatments for ISSNHL.

This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched Medline, Google Scholar, Web of Science, Embase, and Scopus, identifying 11 RCTs comprising 833 patients.

Both OCs and ITCs significantly improved hearing, with average pure tone audiometry (PTA) gains ranging from 12 to 40 dB. No significant between-intervention difference was observed in post-treatment PTA. Generally, combination therapy yielded the greatest improvements (>40 dB and >60% recovery). OCs caused systemic adverse effects, whereas ITCs produced mostly mild local effects.

Both treatment routes effectively improved hearing in patients with ISSNHL, with neither demonstrating clear superiority in overall efficacy. However, combination therapy may be associated with better hearing outcomes.

Lingual thyroglossal duct cysts (LTGDCs) are rare, and there is no clinical consensus on the use of transoral endoscopic resection assisted by radiofrequency plasma ablation for their treatment.

To evaluate the feasibility, safety, and perioperative outcomes of transoral endoscopic assisted by radiofrequency plasma ablation resection for LTGDCs.

We reviewed 17 patients aged 34 ± 12 years (range 12-61) who underwent transoral endoscopic resection assisted by radiofrequency plasma ablation for LTGDCs over 5 years. The procedure involved endoscopic exposure, circumferential dissection, cyst dome resection, fluid evacuation, multi-angle ablation, and cervical compression-aided ablation. Operative time, blood loss, complications, feeding recovery, and recurrence rates were analyzed.

All procedures were completed endoscopically, without conversions to open surgery or tracheostomy. The mean operative time was 75.0 ± 31.2 minutes, and the average intraoperative blood loss was 28.0 ± 9.2 mL. All patients resumed liquid diets on postoperative day 3 and semiliquid diets by day 5. No severe complications occurred. Over a 2 to 40 months follow-up, the recurrence rate was 29.4% (5/17).

Transoral endoscopic resection assisted by radiofrequency plasma ablation is a feasible and safe option for LTGDCs, with favorable cosmetic outcomes. However, the higher recurrence rate may limit its broader clinical applicability.