{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T01:15:33Z","timestamp":1788225333171,"version":"build-2803163510"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T00:00:00Z","timestamp":1788134400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To characterize synchronous and metachronous contralateral second primary malignancy (SPM) rates across preoperatively defined risk strata in patients with HPV\u2010positive tonsillar squamous cell carcinoma (TSCC) undergoing unilateral versus bilateral tonsillectomy and to evaluate associated postoperative morbidity and functional outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>All patients with HPV\u2010positive TSCC who underwent surgery between 2000 and 2023 were retrospectively reviewed. Fisher's exact test, Kaplan\u2013Meier analysis, and log\u2010rank tests were used to compare morbidity and survival, and multivariable regression models were employed to control for confounders, including patient demographics, substance use, tumor staging, and adjuvant therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 163 patients, 123 (75.5%) underwent unilateral tonsillectomy, 30 (18.4%) low\u2010risk bilateral tonsillectomy, and 10 (6.1%) high\u2010risk bilateral tonsillectomy. Across all patients undergoing bilateral tonsillectomy, synchronous tonsillar SPMs were identified in 10.0%, with rates of 6.7% in the low\u2010risk bilateral group and 20.0% in the high\u2010risk bilateral group. Of the 123 patients who underwent unilateral tonsillectomy, 0.8% developed a metachronous contralateral TSCC at 181.6\u2009months. Among low\u2010risk bilateral patients undergoing prophylactic contralateral tonsillectomy, the NNT for identification of one occult synchronous SPM was 14 (95% CI: 5\u201350). Bilateral tonsillectomy did not significantly alter discharge diet, postoperative length of stay, hemorrhage rates, return to the operating room, or 30\u2010day emergency department visits. Disease\u2010free survival did not differ significantly across risk\u2010stratified groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Contralateral second primary TSCC clustered disproportionately among high\u2010risk patients. Bilateral tonsillectomy was not associated with significantly increased postoperative morbidity. These findings support a selective, risk\u2010stratified approach to bilateral tonsillectomy in HPV\u2010associated TSCC, balancing the potential benefit of occult contralateral disease detection against procedure\u2010related morbidity through shared decision\u2010making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>III.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70553","type":"journal-article","created":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:51:00Z","timestamp":1788223860000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk\u2010Stratified Bilateral Tonsillectomy for Unilateral\n                    <scp>HPV<\/scp>\n                    \u2010Associated Tonsillar\n                    <scp>SCC<\/scp>\n                    : Oncologic and Functional Outcomes From a Single Institution"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-7009-6931","authenticated-orcid":false,"given":"Tereza","family":"Vitkovska","sequence":"first","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal Z.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ishna","family":"Pandey","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5348-6928","authenticated-orcid":false,"given":"Maxwell L.","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauran K.","family":"Evans","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0612-3082","authenticated-orcid":false,"given":"Song Hon","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Wooten","sequence":"additional","affiliation":[{"name":"Department of Head &amp; Neck Surgery David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipti","family":"Sajed","sequence":"additional","affiliation":[{"name":"Department of Pathology David Geffen School of Medicine  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7068-9534","authenticated-orcid":false,"given":"Maie A. St.","family":"John","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2010Head and Neck Surgery Johns Hopkins University School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,31]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33588"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2018.08.015"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15164080"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.27988"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(195309)6:5<963::AID\u2010CNCR2820060515>3.0.CO;2\u2010Q"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23798"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2010.31.8311"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27563"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010015\u20103540\u2010x"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27876"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599820968800"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.29741"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.12981"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.24887"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2025.2235"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2025.107180"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097\u20100142(19941001)74:7<1933::AID\u2010CNCR2820740718>3.0.CO;2\u2010X"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27002"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.104475"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.3390\/v13061173"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2017.1408143"},{"key":"e_1_2_10_24_1","unstructured":"National Comprehensive Cancer Network \u201cNCCN Clinical Practice Guidelines in Oncology: Head and Neck Cancers \u201d2026 https:\/\/www.nccn.org\/guidelines\/guidelines\u2010detail?category=1&id=1437."},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoto.2025.1833"}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70553","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.70553","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70553","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:51:02Z","timestamp":1788223862000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,31]]},"references-count":24,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1002\/lio2.70553"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70553","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,31]]},"assertion":[{"value":"2026-02-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-31","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70553"}}