Otolaryngology (ENT)

Large series supports in-office TNE–Seldinger secondary TEP as highly effective and safe

Among 378 post-laryngectomy patients, in-office secondary TEP with TNE and Seldinger technique achieved a 99.2% procedural success rate. Immediate voicing after prosthesis placement occurred in 93.4% of patients, enabling rapid functional rehabilitation. Complications were rare: pneumothorax requiring admission occurred in 0.5%, with no false passages, esophageal perforations, or bleeding events reported. Only 0.5% of procedures were aborted for intolerance, suggesting broad tolerability in an outpatient setting. 1

Muscle index, age, and LDH stratify PD-1 benefit and discontinuation risk in R/M HNSCC

In 179 recurrent or metastatic HNSCC patients treated with anti–PD-1 therapy, immune-related adverse events occurred in 35.2% and were linked to better survival. High lumbar skeletal muscle index independently predicted irAE development, while low LSMI was associated with fewer irAEs and worse outcomes. Within the low-LSMI subgroup, age ≥77 years and LDH ≥240 U/L independently predicted permanent ICI discontinuation, with an AUC of 0.87. A simple score combining age and LDH in low-LSMI patients identified those at highest discontinuation risk, supporting individualized counseling and monitoring. 2

Post–cycle 1 EBV DNA level refines risk stratification in locoregionally advanced NPC

This study followed 273 stage III–IVA nonkeratinizing NPC patients receiving gemcitabine–cisplatin induction followed by RT or CCRT. EBV DNA after the first induction cycle predicted progression with C-indices around 0.68–0.70 at 1–3 years, outperforming baseline EBV DNA. Patients with post–cycle 1 EBV DNA ≥450 copies/ml had substantially worse 2-year PFS than those with lower levels. Only post–cycle 1 EBV DNA and overall TNM stage remained independent PFS predictors in multivariable models. Among patients with post–cycle 1 EBV DNA <450 copies/ml, IC + RT alone produced similar 2-year PFS as IC + CCRT but with reduced toxicity. 3

Genetic screening in 11,509 neonates shows many high-risk deafness genotypes escape physiologic screening

Among 11,509 newborns carrying at least one pathogenic variant in GJB2, SLC26A4, MT-RNR1, or GJB3, genotype–phenotype relationships were analyzed. Two major high-risk groups were identified: 5.67% with biallelic GJB2 variants and 0.98% with MT-RNR1 m.1555A>G or m.1494C>T. Only 58 infants had confirmed hearing loss, and 15.52% of them passed the initial physiologic hearing screen. Sanger sequencing reclassified 23.08% of presumed heterozygotes with hearing loss as compound heterozygotes, altering counseling and risk estimates. GJB2 c.235del homozygotes had higher incidence and greater severity of hearing loss than GJB2 c.109G>A homozygotes, underscoring variant-specific prognostic differences. 4