{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:18:04Z","timestamp":1785406684613,"version":"3.56.0"},"reference-count":39,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T00:00:00Z","timestamp":1784592000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010792","name":"Tungs\u2019 Taichung MetroHarbor Hospital","doi-asserted-by":"publisher","award":["TTMHH-R1150070"],"award-info":[{"award-number":["TTMHH-R1150070"]}],"id":[{"id":"10.13039\/100010792","id-type":"DOI","asserted-by":"publisher"}]},{"award":["TTMHH-R1150070"],"award-info":[{"award-number":["TTMHH-R1150070"]}],"id":[{"id":"https:\/\/ror.org\/0452q7b74","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background\/Objectives: Hybrid operating rooms combine advanced intraoperative imaging, endovascular capabilities, and multidisciplinary resources within a single procedural environment. However, their use in otolaryngology remains insufficiently characterized. This study evaluated institutional patterns of hybrid operating room use, principal clinical indications, multidisciplinary involvement, and perioperative resource utilization in otolaryngology. Methods: We conducted a retrospective single-center study of eligible otolaryngologic procedures performed between 1 October 2018 and 31 December 2025. Patient characteristics, operative sites, hybrid operating room applications, multidisciplinary involvement, intraoperative blood loss, postoperative intensive care unit admission, and length of hospital stay were analyzed. Results: A total of 55 unique procedures were included. The median age was 46.0 years (interquartile range, 33.0\u201358.5 years; range, 5\u201376 years), and 33 patients (60.0%) were male. Computed tomography-based localization and navigation represented the predominant application, accounting for nearly three-quarters of procedures. The sinonasal cavity, nasopharynx, and skull base were the most frequently treated anatomical regions, comprising approximately 60% of operative sites. Angiography and endovascular intervention constituted the second most common application. Multidisciplinary collaboration, most frequently involving cardiovascular surgery and interventional radiology, was required in nearly one-quarter of procedures. Procedures relying primarily on intraoperative imaging were associated with a median estimated blood loss of 20 mL and a median hospital stay of 3 days. Cases requiring vascular, cardiopulmonary, or other advanced hybrid capabilities showed greater postoperative resource utilization, including more frequent intensive care admission and longer hospitalization. Conclusions: The hybrid operating room served as a versatile platform for image-guided, vascular, and multidisciplinary procedures in otolaryngology. Its capabilities were used during the management of anatomically complex and high-acuity cases, while differences in postoperative resource utilization appeared to reflect procedural complexity and baseline clinical risk.<\/jats:p>","DOI":"10.3390\/diagnostics16142273","type":"journal-article","created":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:14:27Z","timestamp":1784621667000},"page":"2273","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hybrid Operating Room Applications in Otolaryngology: A Seven-Year Single-Center Experience with Image-Guided and Multidisciplinary Procedures"],"prefix":"10.3390","volume":"16","author":[{"given":"Tzu-Chen","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao-Chun","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Medical Imaging, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shu-Wei","family":"Yeh","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Yo","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Medical Education, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Wen","family":"Nian","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"},{"name":"Department of Medical Research, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iva","family":"Lin","sequence":"additional","affiliation":[{"name":"Teachers College, Columbia University, New York, NY 10027, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chung-Hsiung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2694-1207","authenticated-orcid":false,"given":"Stella Chin-Shaw","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Tungs\u2019 Taichung MetroHarbor Hospital, Taichung 435403, Taiwan"},{"name":"Department of Post-Baccalaureate Medicine, National Chung Hsing University, Taichung 402202, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105853","DOI":"10.1016\/j.oraloncology.2022.105853","article-title":"Innovative applications of hybrid operating room in otolaryngology: A pilot study","volume":"128","author":"Tsai","year":"2022","journal-title":"Oral Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1002\/lio2.792","article-title":"Diagnostic usefulness of cone-beam computed tomography versus multi-detector computed tomography for sinonasal structure evaluation","volume":"7","author":"Han","year":"2022","journal-title":"Laryngoscope Investig. Otolaryngol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"104463","DOI":"10.1016\/j.oraloncology.2019.104463","article-title":"Navigation-guided osteotomies improve margin delineation in tumors involving the sinonasal area: A preclinical study","volume":"99","author":"Ferrari","year":"2019","journal-title":"Oral Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1007\/s00270-025-04041-7","article-title":"Preoperative Embolization Followed by Tumor Resection Without Time Interval in Advanced Juvenile Nasopharyngeal Angiofibroma","volume":"48","author":"He","year":"2025","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1007\/s10143-025-04009-8","article-title":"Salvage endovascular treatment in hybrid operating room for incidental internal carotid artery injury during neurosurgery: A single-center experience","volume":"49","author":"Jiao","year":"2025","journal-title":"Neurosurg. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"109397","DOI":"10.1016\/j.clineuro.2026.109397","article-title":"Neuroendovascular procedures in the hybrid operating room using a monoplane robotic C-arm-feasibility study","volume":"266","author":"Ferdowssian","year":"2026","journal-title":"Clin. Neurol. Neurosurg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"7591","DOI":"10.1016\/j.acra.2025.06.058","article-title":"Enhancing Microwave Ablation for Lung Lesions with Cone-Beam Computed Tomography Guidance and Intrapulmonary Fine Adjustment in a Hybrid Operating Room","volume":"32","author":"Chang","year":"2025","journal-title":"Acad. Radiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"101945","DOI":"10.1016\/j.jvscit.2025.101945","article-title":"Angiographic evaluation of lower extremity acute limb ischemia in an extracorporeal membrane oxygenation patient using bedside portable radiograph","volume":"11","author":"Zemela","year":"2025","journal-title":"J. Vasc. Surg. Cases Innov. Tech."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"147","DOI":"10.25259\/SNI_1251_2025","article-title":"Simultaneous endoscopic endonasal treatment of a GH-secreting PitNET and paraclinoid aneurysm in a hybrid operating room-2D operative video","volume":"17","year":"2026","journal-title":"Surg. Neurol. Int."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2343","DOI":"10.1007\/s00701-023-05756-7","article-title":"The use of hybrid operating rooms in neurosurgery, advantages, disadvantages, and future perspectives: A systematic review","volume":"165","author":"Gharios","year":"2023","journal-title":"Acta Neurochir."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1177\/0003489418801386","article-title":"Three-Dimensional Volumetric Evaluation of the Maxillary Sinuses in Chronic Rhinosinusitis Surgery","volume":"127","author":"Valtonen","year":"2018","journal-title":"Ann. Otol. Rhinol. Laryngol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Chen, L.C., Su, P.K., Hu, G.N., Malwade, S., Chung, W.Y., Chang, L.K., and Yang, S.M. (2026). Cone-beam computed tomography laser-guided transthoracic needle biopsy for pulmonary lesions in a hybrid operating room: Feasibility study by an interventional pulmonologist. Diagnostics, 16.","DOI":"10.3390\/diagnostics16020226"},{"key":"ref_13","unstructured":"Mammana, M., Zambello, G., Busetto, A., Cataldi, G., Zaraca, F., and Dell\u2019Amore, A. (2026). Step-by-step lung nodule localization in the hybrid operating room using a double marking technique with Lipiodol and indocyanine green. Multimed. Man. Cardiothorac. Surg., 2026."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1089\/end.2024.0785","article-title":"Intraoperative Cone Beam Computed Tomography Increases Single Procedure Stone-Free Rates in Percutaneous Nephrolithotomy: Results of a Randomized Controlled Trial","volume":"39","author":"Roemeling","year":"2025","journal-title":"J. Endourol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Suijker, C.A., Kingma, R.A., van Oort, I.M., and Roemeling, S. (2026). Exploratory Treatment-Selection Model of Intraoperative Cone-Beam Computed Tomography During Percutaneous Nephrolithotomy: Insights from RCT Data. J. Clin. Med., 15.","DOI":"10.3390\/jcm15093372"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"112553","DOI":"10.1016\/j.injury.2025.112553","article-title":"The use of 3D computer-assisted navigation and its influence on radiation exposure and operation time in the surgical treatment of fragility fractures of the pelvis","volume":"56","author":"Sola","year":"2025","journal-title":"Injury"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"342","DOI":"10.1007\/s00113-026-01704-z","article-title":"Retrograde posterior column acetabular screw: Robotically assisted and CT-guided minimally invasive procedure","volume":"129","author":"Haida","year":"2026","journal-title":"Unfallchirurgie"},{"key":"ref_18","first-page":"15S","article-title":"Endoscopic Retrieval of Displaced Maxillary Third Molar Crown: A Pediatric Endonasal Approach","volume":"104","author":"Hsue","year":"2025","journal-title":"Ear Nose Throat J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1563\/aaid-joi-D-16-00172","article-title":"Transnasal Endoscopy Removal of Dislodged Dental Implant: A Case Report","volume":"43","author":"Lim","year":"2017","journal-title":"J. Oral Implantol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"124922","DOI":"10.1016\/j.wneu.2026.124922","article-title":"Use of Advanced Intraoperative Navigation for Percutaneous Transorbital Inferior Ophthalmic Vein Access in Embolization of a Residual Type D Carotid-Cavernous Fistula","volume":"209","author":"Baig","year":"2026","journal-title":"World Neurosurg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1055\/a-2479-5297","article-title":"Combined One-Step Hybrid Treatment for a Pediatric Giant Internal Carotid Artery Aneurysm: A Case Report","volume":"87","author":"Pavesi","year":"2026","journal-title":"J. Neurol. Surg. A Cent. Eur. Neurosurg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1024\/0301-1526\/a001234","article-title":"Advantages of implementing a hybrid operating room for endovascular aortic aneurysm repair at a new vascular surgery centre","volume":"55","author":"Pitoulias","year":"2026","journal-title":"Vasa"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Bowman, K.M., Dawkins, D., Schaefer, S., Scheuermann, J., Sulaimanov, U., Ahmed, A.S., Niemann, D., Baskaya, M.K., and Aagaard-Kienitz, B. (2026). Intravenous 3-Dimensional Digital Subtraction Angiography: A Noninvasive, High-Quality Alternative to Cerebral Catheter Angiography. Oper. Neurosurg.","DOI":"10.1227\/ons.0000000000002018"},{"key":"ref_24","first-page":"854","article-title":"Hospital setting of endovascular repair influences procedural outcomes in blunt traumatic aortic injury","volume":"82","author":"Cabot","year":"2025","journal-title":"J. Vasc. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e266015","DOI":"10.1136\/bcr-2025-266015","article-title":"Selective intra-arterial indocyanine green video angiography in a hybrid operating theatre for a ruptured arteriovenous malformation involving Broca\u2019s area","volume":"18","author":"Colistra","year":"2025","journal-title":"BMJ Case Rep."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Ozcinar, E., Akca, F., Saricaoglu, M.C., Hasde, A.I., Dikmen, N., Buyukcakir, O., Guven, A., Durmaz, O., Boga, S.A., and Karacuha, A.F. (2025). Total Endovascular Aortic Arch Repair Using In Situ Needle Triple Fenestration and Selective Cerebral Perfusion: Single-Center Results. J. Clin. Med., 14.","DOI":"10.20944\/preprints202508.0932.v1"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"488","DOI":"10.5606\/tgkdc.dergisi.2025.27261","article-title":"Outcomes of endovascular aortic aneurysm repair in a long-term real-world cohort: Analysis from the first hybrid operating room in T\u00fcrkiye","volume":"33","author":"Yazman","year":"2025","journal-title":"Turk. Gogus Kalp Damar Cerrahisi Derg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9266","DOI":"10.21037\/qims-2024-2966","article-title":"Multimodal image fusion guidance for the treatment of structural heart disease and aortic dissection in hybrid operation room: A single-center case series in a hybrid operating room","volume":"15","author":"Zhao","year":"2025","journal-title":"Quant. Imaging Med. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Wu, H., Zhuo, K., and Cheng, D. (2023). Extracorporeal membrane oxygenation in critical airway interventional therapy: A review. Front. Oncol., 13.","DOI":"10.3389\/fonc.2023.1098594"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5176","DOI":"10.21037\/jtd-2019-ipicu-08","article-title":"The intersection of bronchoscopy and extracorporeal membrane oxygenation","volume":"13","author":"Lin","year":"2021","journal-title":"J. Thorac. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s41030-025-00326-x","article-title":"Peri-intubation cardiovascular collapse during emergency airway management","volume":"11","author":"Garcia","year":"2025","journal-title":"Pulm. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1090","DOI":"10.1097\/JS9.0000000000002008","article-title":"Extracorporeal membrane oxygenation as a life-saving bridge for patients with airway obstruction caused by neck and chest tumors to salvage procedures: An in-depth review","volume":"111","author":"Su","year":"2025","journal-title":"Int. J. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"538494","DOI":"10.2147\/JMDH.S538494","article-title":"The Influence of Age and Experience on Safety Climate Perceptions Among Healthcare Staff in Operating, Interventional Radiology, and Hybrid Operating Rooms: A Cross-Sectional Study","volume":"19","author":"Rhodin","year":"2026","journal-title":"J. Multidiscip. Healthc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1002\/wjs.70281","article-title":"Mind the Gap: Reported Versus Observed Surgical Safety Checklist Time-Out Adherence in the Hybrid Operating Room","volume":"50","author":"Rennie","year":"2026","journal-title":"World J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"693","DOI":"10.1016\/j.ejvs.2025.07.002","article-title":"Impact of a Massive Open Online Course on Radiation Safety in the Hybrid Operating Room","volume":"70","author":"Soenens","year":"2025","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_36","first-page":"299","article-title":"Understanding the costs of surgery: A bottom-up cost analysis of both a hybrid operating room and conventional operating room","volume":"11","author":"Patel","year":"2022","journal-title":"Int. J. Health Policy Manag."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1186\/s13017-020-00344-x","article-title":"Cost-effectiveness of a hybrid emergency room system for severe trauma: A health technology assessment from the perspective of the third-party payer in Japan","volume":"16","author":"Kinoshita","year":"2021","journal-title":"World J. Emerg. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e2108","DOI":"10.1002\/rcs.2108","article-title":"Design and control of an image-guided robot for spine surgery in a hybrid OR","volume":"16","author":"Balicki","year":"2020","journal-title":"Int. J. Med. Robot."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"2712","DOI":"10.21037\/jtd-21-1302","article-title":"Thoracic surgery in Taiwan","volume":"14","author":"Gao","year":"2022","journal-title":"J. Thorac. Dis."}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/14\/2273\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T08:36:06Z","timestamp":1784622966000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/14\/2273"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,21]]},"references-count":39,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["diagnostics16142273"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16142273","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,21]]}}}