An automated radiation modulator (ARM) was developed to enable a high-throughput radiation sensitivity test using patient-derived organoids (PDOs) as an in vitro diagnostic device. Treatment strategies for head and neck cancer include surgery and radiotherapy. However, patient responses to radiotherapy vary widely. To overcome limitations in efficiency and scalability, the ARM was developed to provide controlled, reproducible, and high-throughput radiation delivery. Its feasibility was validated by comparing it with conventional radiation methods using two HNSCC cell lines, as well as by applying it to PDO-based radiation sensitivity tests. The ARM successfully classified head and neck cancer PDOs into radiation-sensitive and radiation-resistant groups.OncoSensi, a radiation sensitivity screening method utilizing the ARM, was cross-validated with clinical radiotherapy outcomes, including recurrence status, in 14 patients with head and neck cancer. The multi-parameter OncoSensi model achieved a sensitivity of 80% and a specificity of 75%, demonstrating superior predictive performance compared to the single-parameter model, which yielded a sensitivity of 70% and a specificity of 50%. Statistically significant difference in recurrence-free survival (RFS) was observed between the OncoSensi-sensitive and -resistant groups. Therefore, ARM-based radiation sensitivity screening can serve as a practical tool for implementing precision medicine in radiotherapy for patients with head and neck cancer, ultimately contributing to improved treatment efficacy and patient prognosis.

OBJECTIVE:To characterize non-neural post-thyroidectomy dysphonia (PTD) by analyzing long-term voice outcomes in patients with no evidence of nerve injury on postoperative laryngoscopy and electromyography (EMG). STUDY DESIGN:Retrospective cohort study. SETTING:Tertiary referral center. METHODS:We reviewed 527 post-thyroidectomy patients with intact vocal fold mobility and normal EMG results at 2 to 3 months postoperatively. Voice evaluations, including acoustic analysis, voice range profile, aerodynamic study, and VHI-10, were performed preoperatively and 3 days, 2 weeks, 1, 3, 6, and 12 months postoperatively. Linear mixed models and machine learning were used to assess the effects of sex, age, surgical extent, and preoperative fundamental frequency (F0pre) on voice parameters. RESULTS:Fundamental frequency (F0) and speaking fundamental frequency (SFF) declined immediately after surgery, with more prolonged reduction in older patients (≥45 years) and those with high F0pre. VHI-10 increased during the early postoperative period, particularly after total thyroidectomy, but returned to near-baseline by 6 to 12 months. Older age was associated with delayed VHI-10 recovery. Maximum frequency (Fmax) decreased in the early period after total thyroidectomy. F0pre and age were main predictors of F0 and SFF at 1 and 3 months, while surgical extent predicted VHI-10 and Fmax at 1 month. CONCLUSIONS:Voice changes may occur even when the recurrent laryngeal nerve and the external branch of the superior laryngeal nerve are preserved during thyroidectomy. Although most alterations improve over time, some voice parameters may not fully recover, with outcomes influenced by sex, age, surgical extent, and F0pre. These findings may aid in counseling patients with non-neural PTD.

Background: Thyroid lobectomy is increasingly being performed on patients with low-risk papillary thyroid carcinoma (PTC) following the expanded guideline recommendations. However, the oncological safety of lobectomy for patients with intermediate-risk PTC remains uncertain. The present study aimed to compare recurrence-free survival (RFS) between lobectomy and total thyroidectomy in a large cohort of patients with intermediate-risk PTC. Methods: We retrospectively reviewed 1452 patients with intermediate-risk PTC who underwent thyroid lobectomy and total thyroidectomy at a tertiary referral center between 2016 and 2020. To address baseline heterogeneity, multivariable Cox proportional hazards regression and 1:1 propensity score matching (PSM) were performed based on age, sex, preoperative lymph node (LN) status, and tumor size. Results: Of the 1452 patients, 825 underwent lobectomy and 627 underwent total thyroidectomy. During a median follow-up period of 62.1 months, the recurrence rate was significantly lower in the lobectomy group than in the total thyroidectomy group (2.1% vs. 5.9%, P < 0.001). However, multivariable Cox regression analysis revealed that surgical extent was not significantly associated with RFS (hazard ratio [HR] 1.09, 95% confidence interval [CI] 0.53–2.27, P = 0.813). Male sex and preoperative suspicious LN metastasis (cN1) were the only significant predictors of RFS. Subgroup analyses, stratified by preoperative lymph node status, showed no difference in RFS between the lobectomy and total thyroidectomy groups in either the cN0 or cN1 subgroups. After PSM (424 matched pairs), there was also no significant difference in RFS between the lobectomy and total thyroidectomy groups (HR 0.75, 95% CI 0.26–2.16, P = 0.594). Conclusion: In this large cohort study of patients with intermediate-risk PTC, lobectomy showed no significant difference in recurrence rates compared to total thyroidectomy, regardless of preoperative LN status. These results suggest that, for appropriately selected intermediate-risk PTC patients, lobectomy with central LN dissection is a safe and feasible surgical option, offering reduced surgical morbidity and preserved thyroid function without compromising oncologic outcomes.

Considering the favourable prognosis of thyroid tumours, the importance of quality of life, including functional and voice outcomes, is critically important. The impact of remote-access thyroidectomy on postoperative voice function remains unclear, and direct comparative data across major approaches are limited. This study compared patient-reported and objective voice outcomes following robotic transoral (TO), robotic retroauricular (RA), and open hemithyroidectomy. This retrospective observational cohort study included patients undergoing hemithyroidectomy between January 2022 and August 2025. Voice outcomes were evaluated preoperatively and at 3 months postoperatively using the Voice Handicap Index-10 and acoustic analysis. Between-group comparisons and multivariable general linear modelling were performed to identify factors associated with postoperative voice outcomes. A total of 150 patients were analysed (RA: 58; TO: 37; open: 55). Baseline VHI-10 and acoustic parameters were comparable across groups. The RA group demonstrated significantly higher postoperative VHI-10 scores and greater VHI-10 change scores compared with TO and open approaches (p < 0.01). No significant differences were observed in postoperative acoustic parameters, including jitter, shimmer, noise-harmonic ratio, soft phonation index, pitch range, or fundamental frequency. Female subgroup analysis demonstrated similar findings. On multivariable analysis, postoperative VHI-10 remained to be only affected by the type of surgical approach. All three surgical approaches showed comparable objective acoustic voice parameters. However, TO and open hemithyroidectomy were associated with better patient-perceived voice outcomes at 3 months compared with RA. When clinical conditions are comparable, TO may be considered as a viable robotic approach in patients who prioritise short-term subjective voice outcomes.

Abstract Worst pattern of invasion (WPOI), defined by the presence of dispersed satellite nodules ≥1 mm from the primary tumor, is strongly associated with LNM; however, the molecular features that functionally link invasive histopathology to metastasis are not fully characterized. We aimed to elucidate the relationship between histopathology invasion pattern and metastatic progression at the molecular level, and to determine whether invasion patterns share early metastatic features. Accordingly, we performed full-length single-cell mRNA sequencing using Spatially resolved Laser Activated Cell Sorting (SLACS), which isolates regions of histologically interest from Hematoxylin and Eosin (H&E) stained tissue slides and obtains transcriptomic and genomic while preserving pathological context. A total of 849 spatially annotated regions of interest (5-10 cells/ROI) were captured from matched tumor, WPOI, tumor-stromal interface, and lymph node metastasis sites from five OSCC patients. Integration of single-cell transcriptomic and genomic features revealed heterogeneous tumor characteristics associated with distinct pathological patterns. We identified a WPOI-associated malignant subpopulation (Cluster 2) characterized by upregulation of IQCE and SMPD2 and an elevated partial epithelial-to-mesenchymal transition (p-EMT) phenotype, indicative of invasive plasticity. In contrast, LNM-enriched populations exhibited re-acquisition of epithelial differentiation programs, including increased expression of CRNN and SPRR3, suggesting epithelial resurging following metastatic colonization. These findings support a dynamic invasion-metastasis continuum in OSCC, especially WPOI represents an intermediate state enabling metastasis in molecular level. We are ongoing reconstruct the evolutionary trajectories. A molecular understanding of pathological invasion patterns such as WPOI may inform precision stratification and guide personalized surgical and adjuvant strategies for OSCC patients. Citation Format: Seungeun Lee, Yeonbi Han, Dohoon Kim, Sumin Lee, Amos Chungwon Lee, Wonjae Cha, Jin-Ku Lee. Spatially resolved transcriptomic analysis revealed the molecular characteristics of the worst pattern of invasion in oral squamous cell carcinomas [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2026; Part 1 (Regular Abstracts); 2026 Apr 17-22; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2026;86(7 Suppl):Abstract nr 2120.

To identify anatomical and clinical predictors of tunneling time during transoral robotic thyroidectomy via the vestibular approach (TORTVA) and to clarify the potential utility of body habitus-related predictors for case selection. We retrospectively reviewed 33 consecutive patients who underwent TORTVA between October 2023 and December 2024. Tunneling time was defined as the interval from vestibular incision to completion of the subplatysmal tunnel. Preoperative sagittal neck computed tomography (CT) images were used to measure linear distances and angles between the mentum, hyoid bone, thyroid cartilage, thyroid isthmus, and sternal notch, as well as anterior neck soft tissue thickness. Clinicopathologic data and CT measurements were analyzed using univariate and multivariate linear regression. The mean tunneling time was 25.3 min, with no significant difference observed between males (25.6 min) and females (25.2 min). In multivariate linear regression analysis, the skin-to-thyroid cartilage notch thickness (tST) (B=0.550, p=.024) and the mentum-to-thyroid cartilage notch distance (dMT) (B=0.347, p=.028) were significantly associated with tunneling time (p=.006). Tunneling time was associated with skin thickness over the thyroid cartilage notch and the mentum-to–thyroid cartilage notch distance. These exploratory findings may inform future studies on patient selection and technical difficulty in TORTVA, particularly for surgeons early in the learning curve.

OBJECTIVES:This pilot study investigated the safety and efficacy of pirfenidone (PFD) injection for vocal fold (VF) scarring after laser cordectomy in a canine model. We evaluated safe PFD concentrations and its preventive effects on postoperative VF scarring using laryngoscopic, histological, immunohistochemical (IHC), and high-speed imaging analyses. METHODS:To assess toxicity, 0.3 mL of saline or PFD solution at six serial concentrations (0, 0.5, 1.0, 2.5, 5.0, and 10.0 mg/mL; 0 mg/mL = saline) was injected into the VFs of three dogs, and histological evaluation was performed 2 weeks later. For efficacy testing, saline, 1.0 mg/mL PFD, or 2.5 mg/mL PFD was injected into the right VFs of three dogs before type III laser cordectomy. The left VFs remained untreated. Wound status was assessed by laryngoscopy at 4 and 8 weeks. At 8 weeks, vibratory function was assessed using high-speed imaging, followed by histological and IHC analyses for collagen type I (COL1) and α-smooth muscle actin (α-SMA). RESULTS:In the toxicity test, VFs injected with ≤ 2.5 mg/mL PFD showed complete epithelial healing, whereas those injected with ≥ 5.0 mg/mL PFD showed epithelial detachment from the lamina propria. In the efficacy test, high-speed imaging demonstrated greater vibratory amplitudes in PFD-injected VFs than in control VFs, with more pronounced improvement at 2.5 mg/mL PFD. Hematoxylin and eosin (H&E), Masson's trichrome, and Alcian blue staining showed that VFs injected with 2.5 mg/mL PFD exhibited reduced fibrotic changes and collagen deposition compared with saline- and 1.0 mg/mL PFD-injected VFs. IHC analysis showed attenuated α-SMA and COL1 immunoreactivity in PFD-treated VFs, particularly in the 2.5 mg/mL PFD-injected VF. CONCLUSION:This pilot study suggests that PFD injection before laser cordectomy may mitigate VF scarring and help preserve VF vibratory function in a canine model. These findings provide preliminary evidence supporting the potential of PFD as a preventive strategy against fibrosis during VF surgery.

Objective.:Oropharyngeal squamous cell carcinoma (OPSCC) has undergone a major epidemiologic transition, with high-risk human papillomavirus (HPV) emerging as the dominant etiologic factor. Although HPV-16 accounts for most HPV-positive OPSCC worldwide, a substantial minority of tumors harbor non-HPV- 16 genotypes, the clinical and prognostic significance of which remains uncertain, particularly in Asian populations. This study aimed to investigate HPV genotype distribution and survival outcomes in a singleinstitution cohort of HPV DNA-positive OPSCC regardless of p16 and to assess the prognostic significance of HPV genotype. Methods.:We retrospectively reviewed patients treated with curative intent for HPV-positive OPSCC at Seoul National University Bundang Hospital between 2003 and 2023. HPV status was determined using p16 immunohistochemistry and HPV DNA genotyping. Patients were classified as having HPV-16 or non-HPV-16 genotype. Overall survival (OS) and disease-free survival (DFS) were analyzed using Kaplan-Meier method and compared using the log-rank test. Results.:Of 254 eligible patients, 174 with HPV DNA-positive tumors and available HPV genotyping results were included in the final analysis. HPV-16 accounted for 74.7% of tumors, while non-HPV-16 genotypes comprised 25.3%, most commonly HPV-33, HPV-35, HPV-58, and HPV-18. A marked male predominance was observed across all genotypes. The clinical stage distribution did not differ significantly between the HPV-16 and non-HPV-16 groups overall; however, HPV-33-positive tumors showed higher nodal stage compared with HPV-16. OS and DFS were similar between the HPV-16 and pooled non-HPV-16 groups. In genotype-specific analyses, DFS did not differ significantly across groups, whereas HPV-35 was associated with poorer OS compared with HPV-16. Conclusion.:In this cohort, non-HPV-16 genotypes accounted for approximately one-quarter of HPV-positive OPSCC cases and demonstrated clinicopathologic heterogeneity with selected genotype-specific prognostic differences. Given the substantial proportion of non-HPV-16 genotypes and the marked male predominance observed in our cohort, our findings may have implications for future HPV prevention strategies.

OBJECTIVE:Accurate needle localization is a key challenge in the cricothyroid (CT) approach to vocal fold injection (VFI) due to invisibility. Real-time light-guided VFI (RL-VFI) was developed to enhance precision through simultaneous light guidance. This study aimed to evaluate safety and feasibility of office-based RL-VFI with hyaluronic acid (HA) in a large-scale (>300), consecutive patients with unilateral vocal fold paralysis (UVFP). STUDY DESIGN:Retrospective cohort study. SETTING:Tertiary referral center. METHODS:A total of 378 RL-VFI with HA were consecutively performed on 257 UVFP patients. Complications were monitored intraoperatively and for 4 weeks post-procedure. Voice outcomes were assessed using voice handicap index (VHI)-10, grade, roughness, breathiness, asthenia, and strain (GRBAS) scale, acoustic analysis, and aerodynamic study at baseline and 4 weeks postoperatively. RESULTS:Most cases involved left-sided paralysis (83.7%), primarily due to surgery (63.4%) or metastasis (26.1%). In all cases, HA was injected at the intended point in the paralyzed vocal fold under light guidance, with no superficial injection or mucosal penetration. Average procedure time was 114.0 ± 105.1 seconds for the initial injection and 80.6 ± 77.7 seconds for additional injections. No serious acute or delayed complications occurred. Among 180 cases with complete voice assessments, significant improvements were observed in voice-related parameters including VHI-10, GRBAS scale, maximum phonation time, mean expiratory airflow, jitter, shimmer, and noise-to-harmonics ratio. CONCLUSION:RL-VFI with HA is a feasible and safe technique for treating patients with UVFP. It enables precise confirmation of needle tip localization and facilitates accurate injection into the intended target during the CT approach.

Purpose:Diffuse sclerosing variant papillary thyroid carcinoma (DSV-PTC) is a rare and aggressive subtype of PTC. Preoperative diagnosis is challenging owing to the overlapping of imaging characteristics with those of other thyroid conditions. This study aimed to evaluate the accuracy of preoperative ultrasound (US) in predicting DSV-PTC and to identify significant diagnostic factors. Methods:This retrospective study analyzed 34 patients who were preoperatively suspected of having DSV-PTC based on US findings and later underwent thyroidectomy. Patients were divided into 2 groups based on the final histopathological diagnosis: DSV-PTC and non-DSV-PTC. Demographic, radiological, and pathological characteristics were also compared. Results:Only 32.4% of patients initially suspected of having DSV-PTC were confirmed postoperatively. Among the US features, the Korean Thyroid Imaging Reporting and Data System (K-TIRADS) score 5 was significantly associated with DSV-PTC (P = 0.038), whereas other radiological factors, including echogenicity and microcalcifications, were not. The histopathological features, such as tumor size, BRAF and TERT mutations, vascular invasion, and lymph node metastasis, showed no significant differences between the groups. Conclusion:Preoperative US has limited accuracy (32.4%) in diagnosing DSV-PTC. Because of the aggressive treatment recommendations based on preoperative suspicion, clinicians should carefully consider the limitations of imaging. Further studies incorporating fine-needle aspiration or core needle biopsy are required to improve diagnostic accuracy.

BACKGROUND:Active surveillance (AS) has emerged as a viable management strategy for low-risk papillary thyroid microcarcinoma (PTMC), following pioneering trials at Kuma Hospital and the Cancer Institute Hospital in Japan. Numerous prospective cohort studies have since validated AS as a management option for low-risk PTMC, leading to its inclusion in thyroid cancer guidelines across various countries. From 2016 to 2020, the Multicenter Prospective Cohort Study of Active Surveillance on Papillary Thyroid Microcarcinoma (MAeSTro) enrolled 1,177 patients, providing comprehensive data on PTMC progression, sonographic predictors of progression, quality of life, surgical outcomes, and cost-effectiveness when comparing AS to immediate surgery. The second phase of MAeSTro (MAeSTro-EXP) expands AS to low-risk papillary thyroid carcinoma (PTC) tumors larger than 1 cm, driven by the hypothesis that overall risk assessment outweighs absolute tumor size in surgical decision-making. METHODS:This protocol aims to address whether limiting AS to tumors smaller than 1 cm may result in unnecessary surgeries for low-risk PTCs detected during their rapid initial growth phase. By expanding the AS criteria to include tumors up to 1.5 cm, while simultaneously refining and standardizing the criteria for risk assessment and disease progression, we aim to minimize overtreatment and maintain rigorous monitoring to improve patient outcomes. CONCLUSION:This study will contribute to optimizing AS guidelines and enhance our understanding of the natural course and appropriate management of low-risk PTCs. Additionally, MAeSTro-EXP involves a multinational collaboration between South Korea and Australia. This cross-country study aims to identify cultural and racial differences in the management of low-risk PTC, thereby enriching the global understanding of AS practices and their applicability across diverse populations.

Objectives. Salivary gland tumors present a diagnostic challenge, with preoperative false-negative results frequently leading to an unexpected diagnosis of malignancy after parotidectomy. This study was conducted to explore the clinical utility of preoperative core needle biopsy (CNB) in diagnosing malignancies before primary parotidectomy and to assess the prognostic implications of CNB for parotid gland cancers. Methods. This retrospective cohort study included 615 patients who underwent preoperative CNB and parotidectomy for primary parotid tumors from 2003 to 2023 at a tertiary referral hospital. Among these patients, 102 who were diagnosed with primary parotid malignancy following parotidectomy were examined regarding survival outcomes. Disease-free survival (DFS) and predictive factors were assessed through univariable and multivariable analyses. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy of CNB were determined. These metrics were then compared to those of a separate cohort of 547 patients who underwent ultrasound-guided fine needle aspiration (FNA) and parotidectomy within the same timeframe. Results. In the CNB group, the 5-year predicted DFS was 86.9% (95% CI, 79.2%-95.3%). Multivariable analysis identified male sex (hazard ratio [HR], 8.48; 95% CI, 1.05-68.76) and a CNB finding of malignancy (HR, 8.20; 95% CI, 1.01-66.15) as factors significantly associated with decreased DFS. CNB demonstrated significantly higher sensitivity (89.0%; 95% CI, 81.2%-94.4%) and NPV (97.6%; 95% CI, 95.7%-98.8%) compared to FNA, which had a sensitivity of 45.2% (95% CI, 33.5%-57.3%) and an NPV of 90.8% (95% CI, 87.7%-93.3%). Conclusion. Preoperative CNB may be predictive of parotid cancer prognosis. Patients receiving a diagnosis of malignancy on preoperative CNB demonstrated a worse prognosis compared to those with a "less-than-malignant" diagnosis. Additionally, CNB exhibited higher sensitivity than FNA in identifying malignancies of the parotid gland.

Background The first step in transoral robotic thyroidectomy via the vestibular approach (TORTVA) is tunneling. Difficulty during this step can hinder subsequent surgical progress, necessitating careful patient selection. This study aimed to evaluate factors influencing tunneling in TORTVA. Methods From October 2023 to December 2024, a retrospective analysis was conducted on 33 patients who underwent TORTVA. Anatomical measurements, including various lengths and angles potentially related to the tunneling pathway, were obtained from sagittal neck CT images and analyzed for their correlation with tunneling time. Results The mean tunneling time was 25.3 minutes, with no significant difference observed between males (25.6 minutes) and females (25.2 minutes). In multivariate linear regression analysis, the skin-to-thyroid cartilage notch thickness (tST) (B = .550, p = .024) and the mentum-to-thyroid cartilage notch distance (dMT) (B = .347, p = .028) were significantly associated with tunneling time ( p = .006). Conclusions Tunneling time showed a significant correlation with both the thickness of the skin over the thyroid cartilage notch and the distance between the mentum and the thyroid cartilage notch. These insights would be particularly valuable for surgeons new to TORTVA, as they may help refine patient selection criteria and optimize surgical planning.

Laryngopharyngeal reflux disease (LPRD) is mainly treated with proton pump inhibitors (PPI) such as esomeprazole, which have shortcomings like delayed absorption and increased osteoporosis. Fexuprazan is a novel potent potassium-competitive acid blocker that inhibits gastric acid secretion with rapid onset and long duration of action. To assess the efficacy and safety of fexuprazan compared to esomeprazole in patients with LPRD. This prospective, randomized, double-blinded, multicenter, active-controlled trial was conducted in nine otolaryngologic clinics. Patients with reflux symptom index (RSI) ≥ 13 and reflux finding score (RFS) ≥ 7 were randomly assigned to the fexuprazan or esomeprazole groups, and received fexuprazan 40-mg or esomeprazole 40-mg once daily for 8 weeks. The outcomes were (1) mean change, change rate, and valid rate in RSI, RFS, and LPR-related questionnaires; and (2) adverse events. A total of 136 patients (fexuprazan n = 68, esomeprazole n = 68) were followed up for ≥ 1 month. Each parameter significantly improved after 4 and 8 weeks in each group, with no significant differences between the two groups. For those with severe symptoms (RSI ≥ 18), the fexuprazan group (n = 32) showed more improvement in the mean change and change rate in the RSI than esomeprazole group (n = 31) after 4 weeks (p = .036 and .045, respectively). This phenomenon was especially observed in hoarseness and troublesome cough. Fexuprazan improved symptoms and signs without no serious adverse events in patients with LPRD. In patients with severe symptoms, fexuprazan resulted in a faster symptom improvement than PPI. KCT0007251, https://cris.nih.go.kr/cris/search/detailSearch.do?seq=22100 .

Background/Aims:Proton pump inhibitors (PPIs) play a crucial role in managing laryngopharyngeal reflux (LPR), but the optimal dosing regimen remains unclear. We aim to compare the effectiveness of the same total PPI dose administered twice daily versus once daily in LPR patients. Methods:We conducted a prospective randomized controlled trial at a tertiary referral hospital, enrolling a total of 132 patients aged 19 to 79 with LPR. These patients were randomly assigned to receive either a 10 mg twice daily (BID) or a 20 mg once daily (QD) dose of ilaprazole for 12 weeks. The Reflux Symptom Index (RSI) and Reflux Finding Score (RFS) were assessed at 8 weeks and 16 weeks. The primary endpoint was the RSI response, defined as a reduction of 50% or more in the total RSI score from baseline. We also analyzed the efficacy of the dosing regimens and the impact of dosing and duration on treatment outcomes. Results:The BID group did not display a higher response rate for RSI than the QD group. The changes in total RSI scores at the 8-week and 16- week visits showed no significant differences between the 2 groups. Total RFS alterations were also comparable between both groups. Each dosing regimen demonstrated significant decreases in RSI and RFS. Conclusions:Both BID and QD PPI dosing regimens improved subjective symptom scores and objective laryngoscopic findings. There was no significant difference in RSI improvement between the 2 dosing regimens, indicating that either dosing regimen could be considered a viable treatment option.

Background and Objectives Most laryngeal imaging modalities used continuous light source. However, videostroboscopy adopted the unique stroboscopic flashing light triggered externally and is consistent with fundamental voice frequencies. If laryngeal stroboscopic effect could be obtained in the field of continuous illumination, it woud be more compatible with conventional video. In this study, we established the mathematical algorithm for stroboscopic effect with continuous light and tried to determine the feasibility of laryngeal stroboscopic effect with conventional laryngoscopy using continuous light in the mechanical model.Materials and Method The mechanical model of fan motor system was used to validate to the present study. Rotational images of the fan motor were captured using conventional laryngoscope with continuous light source.Results On the basis of the mathematical model, the optimal ranges of the frequency for stroboscopic effect were expected as (multiples of sampling rate [S])±(S/5). In the fan motor model, the stroboscopic effects could be confirmed on the basis of the mathematical model using conventional videolaryngoscopy with continuous light source.Conclusion Laryngeal stroboscopic effect with continuous light source might be feasible. The stroboscopic effect with continuous light would be expected to provide greater compatibility to integrate with the other imaging modalities for the vocal folds.

Purpose: For tonsillar cancer with multiple ipsilateral neck lymph nodes, the safety and efficacy of unilateral radiotherapy (RT) have long been a topic of debate. We performed retrospective analyses of patients having ipsilateral neck lymph nodes treated with unilateral RT in two tertiary referral hospitals. Materials and Methods: This study accrued 29 patients who were diagnosed as well-lateralized tonsillar cancer with multiple ipsilateral neck lymph nodes and underwent unilateral RT from March 2000 to March 2020. Patients underwent treatment with one of the following options or a combination of them: induction chemotherapy, surgery, RT, and concurrent chemoradiotherapy. We analyzed the recurrence pattern and survival with special attention to contralateral neck failure. Also, treatment-related toxicities were compared with a 1:1 matched cohort of those who received bilateral RT, using propensity score matching analysis. Results: At a median follow-up of 68 months, no contralateral neck failure was observed. Five-year actuarial locoregional recurrence-free survival, distant metastasis-free survival, and overall survival were 85.6%, 91.8%, and 92.7%, respectively. Both the acute and chronic grade 2 xerostomia occurred in 10.3% of the patients. When the toxicity for unilateral RT was compared to that of bilateral RT using a propensity score-matched cohort, a significantly lower rate of acute xerostomia was observed in unilateral RT group (55.1% vs. 82.7%, p=0.002), primarily at grade 2 level (10.3% vs. 51.7%, respectively) Conclusion: The results of our study suggest that unilateral RT can be safely performed in well-lateralized tonsillar cancer patients with multiple ipsilateral neck lymph nodes.

OBJECTIVE:Unilateral vocal fold paralysis (UVFP) following open thoracic aortic surgery increases pulmonary complications and hospital stays. An intervention protocol with early injection laryngoplasty (IL) and swallowing maneuvers was developed for acute UVFP following thoracic aortic surgery. This study aimed to compare the incidence of complications and length of medical care between the non-VFP and the IL-UVFP group managed under this protocol. METHODS:Patients who underwent open thoracic aortic surgery from March 2020 to February 2023 were included, excluding those with preoperative VFP or postoperative bilateral VFP. Under the protocol, patients with UVFP and incomplete glottic closure received IL and swallowing maneuvers within one week after diagnosis, while those without a glottic gap started a soft diet along with swallowing maneuvers. Postoperative complications, including reintubation, ICU re-transfer, pneumonia, stroke, delirium, wound infection, and bleeding, as well as hospital and ICU stay, were assessed. RESULTS:Of the 355 patients included in the study, 51 (14.4%) developed postoperative UVFP, while 304 (85.6%) had normal VF function. In the UVFP group, 42 patients underwent IL, while 9 patients without a glottic gap did not undergo IL. The incidence of complications and length of medical care were analyzed in the non-VFP and the IL-UVFP groups. The IL-UVFP group had a longer median hospital stay compared to the non-VFP group (20.5 vs. 16.0 days), though this difference was not statistically significant (P = .0681). ICU stay (P = .5396) and ICU re-transfer rates (P = 1.00) were also comparable between the groups. There was no significant difference in the incidence of pneumonia between the IL-UVFP group (4.8%) and the non-VFP group (9.5%) (P = .4003). Additionally, no significant differences were observed in the incidence of stroke, delirium, wound infection, or bleeding between the groups. No IL-related complications were reported. CONCLUSIONS:The protocol with early IL appears to help reduce complication rates in acute UVFP patients following thoracic aortic surgery to levels comparable to those in patients without VFP. This protocol could serve as a guideline for otolaryngologists in managing UVFP patients. LEVEL OF EVIDENCE:2b/Individual cohort study.