Clinical Otolaryngology最新文献

{"title":"Comparison of ChatGPT-4, Copilot, Bard and Gemini Ultra on an Otolaryngology Question Bank.","authors":"Rashi Ramchandani, Eddie Guo, Michael Mostowy, Jason Kreutz, Nick Sahlollbey, Michele M Carr, Janet Chung, Lisa Caulley","doi":"10.1111/coa.14302","DOIUrl":"https://doi.org/10.1111/coa.14302","url":null,"abstract":"<p><strong>Objective: </strong>To compare the performance of Google Bard, Microsoft Copilot, GPT-4 with vision (GPT-4) and Gemini Ultra on the OTO Chautauqua, a student-created, faculty-reviewed otolaryngology question bank.</p><p><strong>Study design: </strong>Comparative performance evaluation of different LLMs.</p><p><strong>Setting: </strong>N/A.</p><p><strong>Participants: </strong>N/A.</p><p><strong>Methods: </strong>Large language models (LLMs) are being extensively tested in medical education. However, their accuracy and effectiveness remain understudied, particularly in otolaryngology. This study involved inputting 350 single-best-answer multiple choice questions, including 18 image-based questions, into four LLMS. Questions were sourced from six independent question banks related to (a) rhinology, (b) head and neck oncology, (c) endocrinology, (d) general otolaryngology, (e) paediatrics, (f) otology, (g) facial plastics, reconstruction and (h) trauma. LLMs were instructed to provide an output reasoning for their answers, the length of which was recorded.</p><p><strong>Results: </strong>Aggregate and subgroup analysis revealed that Gemini (79.8%) outperformed the other LLMs, followed by GPT-4 (71.1%), Copilot (68.0%), and Bard (65.1%) in accuracy. The LLMs had significantly different average response lengths, with Bard (x̄ = 1685.24) being the longest and no difference between GPT-4 (x̄ = 827.34) and Copilot (x̄ = 904.12). Gemini's longer responses (x̄ =1291.68) included explanatory images and links. Gemini and GPT-4 correctly answered image-based questions (n = 18), unlike Copilot and Bard, highlighting their adaptability and multimodal capabilities.</p><p><strong>Conclusion: </strong>Gemini outperformed the other LLMs in terms of accuracy, followed by GPT-4, Copilot and Bard. GPT-4, although it has the second-highest accuracy, provides concise and relevant explanations. Despite the promising performance of LLMs, medical learners should cautiously assess accuracy and decision-making reliability.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of SARS-CoV-2 Infection on the Perioperative Period of Functional Endoscopic Sinus Surgery.","authors":"Wang Lili, Wang Xueping, Yuan Shanpeng, Wang Feiyu, Ba Yunpeng","doi":"10.1111/coa.14301","DOIUrl":"https://doi.org/10.1111/coa.14301","url":null,"abstract":"<p><strong>Objective: </strong>This study was aimed at exploring the safety and timing of functional endoscopic sinus surgery (FESS) in patients after mild-to-moderate SARS-CoV-2 infection.</p><p><strong>Methods: </strong>The study group comprised 63 adult inpatients who underwent FESS in our department after mild-to-moderate SARS-CoV-2 infection between December 2022 and February 2023. Sixty adult patients without prior SARS-CoV-2 infection were randomly selected as the control group. The surgical time, intraoperative bleeding, postoperative epithelialization time and postoperative complications in each group were recorded, and statistical analysis was conducted with independent sample t-tests.</p><p><strong>Results: </strong>Statistical analysis of the surgical time, intraoperative bleeding and postoperative epithelialization time showed no statistically significant differences between the study group and control group (p > 0.05). No postoperative complications were observed in either group.</p><p><strong>Conclusion: </strong>FESS is safe and effective for patients after mild-to-moderate SARS-CoV-2 infection if the symptoms have essentially resolved at least 15 days before surgery.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey on the Use of Surgical Navigation for Endoscopic Sinus Surgery in the UK.","authors":"Jacklyn Liu, Alsharif Fiher Alluhaymaq, Zi Jian Lau, Umar Rehman, Claire Hopkins, Santdeep Paun, Nick Eynon-Lewis, Matt Lechner","doi":"10.1111/coa.14303","DOIUrl":"https://doi.org/10.1111/coa.14303","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143596415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Analysis of Hearing Loss Induced by Cisplatin Versus Carboplatin in Locally Advanced Nasopharyngeal Carcinoma: Early to Mid-Term Findings.","authors":"Danfan Lin, Yanfei Li, Xiaoyan Han, Xiaofei Yuan, Shuting Wu, Wenxuan Lu, Zilu Chen, Xiaolan Jiang, Xiong Liu, Haoran Huang","doi":"10.1111/coa.14299","DOIUrl":"https://doi.org/10.1111/coa.14299","url":null,"abstract":"<p><strong>Introduction: </strong>To investigate the clinical course of ototoxicity induced by induction chemotherapy followed by concurrent chemoradiotherapy (iCRT), and to determine whether replacing cisplatin with carboplatin in iCRT can reduce hearing damage in patients with nasopharyngeal carcinoma (NPC).</p><p><strong>Methods: </strong>This retrospective study aimed to evaluate hearing loss in patients with locally advanced NPC treated with carboplatin or cisplatin-based iCRT. Bone conduction hearing thresholds were measured before treatment and at 1 week, 3-6 months and 12-18 months following treatment. Changes in hearing loss were assessed using bone conduction threshold values, threshold shifts from baseline, as well as the Common Terminology Criteria for Adverse Events (CTCAE) grading system.</p><p><strong>Result: </strong>A total of 156 ears were examined. After iCRT, hearing loss was observed immediately after the conclusion of treatment, peaking at 3-6 months and partially recovering at 12-18 months. At high frequencies, the shifts in hearing thresholds were more pronounced in the cisplatin group compared to the carboplatin group 3-6 months after treatment (p = 0.005), with median hearing threshold shifts of 15 (5.30) dB and 10 (0.15) dB respectively. However, no significant difference was observed at the end of the follow-up period. Similarly, a statistically significant difference in CTCAE scores was observed between the two groups only at 3-6 months following treatment (p = 0.047); patients in the cisplatin group experienced poorer hearing outcomes.</p><p><strong>Conclusion: </strong>In patients with NPC treated with iCRT, cisplatin is associated with a slightly higher incidence of early high-frequency hearing loss compared to carboplatin. However, this difference diminishes during the mid-term follow-up period, making the substitution of carboplatin unnecessary.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Findings in Symptomatic Patients With Radiologically Isolated Sphenoid Sinus Disease: A Systematic Review and Meta-Analysis.","authors":"Zahir Mughal, Keshav Kumar Gupta, Karan Jolly, Thomas Beech, Satvir Minhas, Nicholas Turner","doi":"10.1111/coa.14300","DOIUrl":"https://doi.org/10.1111/coa.14300","url":null,"abstract":"<p><strong>Objective: </strong>To explore the clinical presentations of isolated sphenoid sinus disease (ISSD).</p><p><strong>Setting and design: </strong>A literature search was conducted on 23 December 2023 across electronic databases including Medline, Embase, Web of Science, and Cochrane. We performed a meta-analysis of proportions using a random-effects model to determine the prevalence of clinical findings in patients who presented with symptoms and had ISSD on radiological imaging. Sensitivity and subgroup analyses were employed to investigate sources of heterogeneity. The PRISMA guideline was followed.</p><p><strong>Participants: </strong>This study included patients with clinically significant isolated sphenoid sinus opacification on cross-sectional imaging.</p><p><strong>Main outcome measure: </strong>The pooled prevalence of clinical symptoms and signs.</p><p><strong>Results: </strong>A total of 18 studies met the eligibility criteria, encompassing over 1000 patients. The prevailing symptoms were headache in 67.9% (95% CI 62.9-72.7), nasal symptoms 29.7% (95% CI 25.2-34.4), and visual disturbance 14.0% (95% CI 9.3-19.3). Subgroup analysis revealed a significant difference between neoplastic and inflammatory diagnoses concerning the development of visual symptoms (38.3% versus 15.5%, p = 0.0005). A negative nasendoscopic examination was found in 52.0% (95% CI 41.0-62.8) of cases.</p><p><strong>Conclusions: </strong>Headache emerged as the primary symptom of ISSD, followed by nasal and visual symptoms. Nasendoscopy had a high false negative rate, highlighting its limitation in assessing this condition. Our study highlights the key clinical findings associated with ISSD, which may indicate the need for imaging.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review and Meta-Analysis of Audiometric Parameters for Assistive Hearing Technology for Adults and Children With Tympanic Membrane Perforation.","authors":"Thomas Hampton, Alan Sanderson, Kevin Mortimer, Mahmood Bhutta","doi":"10.1111/coa.14295","DOIUrl":"https://doi.org/10.1111/coa.14295","url":null,"abstract":"<p><strong>Introduction: </strong>Tympanic membrane perforation can cause hearing impairment with detrimental effects on communication and quality of life, and is a problem affecting an estimated 250 million people. To date, there is little analysis to inform public policy on options for assistive hearing technology rehabilitation in this group.</p><p><strong>Methods: </strong>We undertook a systematic review and meta-analysis of six electronic databases registered with PROSPERO and reported in accordance with PRISMA 2020 standards. The primary outcome was the mean air and bone conduction hearing threshold associated with tympanic perforation.</p><p><strong>Results: </strong>Of 720 studies identified, 16 contained data for meta-analysis. Mean air conduction threshold was 48.3 dB HL in adults and 31.9 dB HL in children. Mean bone conduction was 26.6 dB HL in adults and 9.5 dB HL in children. The prediction interval was -1.7 to 46.7 dB HL for bone conduction and 15.0-70.5 dB HL for air conduction.</p><p><strong>Conclusions: </strong>The majority of adults and children with tympanic perforation have air conduction thresholds within the range of rehabilitation with air conduction hearing aids. The majority also have good sensorineural hearing reserve, meaning bone conduction devices are also suitable. Our analysis can guide the development of affordable technology for the rehabilitation of those with tympanic perforation.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bespoke Septal Prosthesis for Nasal Septal Perforation: A Retrospective Review of Patient Outcome.","authors":"Simon Morris, Steve Hollisey-McLean, Lawrence Dovgalski, Peter Llewellyn Evans, Heikki Whittet","doi":"10.1111/coa.14297","DOIUrl":"https://doi.org/10.1111/coa.14297","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Difference in Pain or Febrile Episodes With the Use of Post-Operative Antibiotics in Paediatric Coblation Intracapsular Tonsillectomy for Sleep-Disordered Breathing or Recurrent Tonsillitis: A Prospective Randomised Trial.","authors":"Netanel Eisenbach, Igor Yakubovich, Ahmad Bader, Ephraim Rinot, Abeer Dabbah Miari, Samah Khalil, Rania Faris, Eyal Sela, Maayan Gruber","doi":"10.1111/coa.14296","DOIUrl":"https://doi.org/10.1111/coa.14296","url":null,"abstract":"<p><strong>Objective: </strong>Coblation technology is gaining wide acceptance and use as a contemporary surgical technique for tonsil surgeries due to less post-operative morbidity compared to the more traditional total tonsillectomy. Previous articles examined the role of post-operative antibiotics for traditional total tonsillectomy; however, this is the first study which explores the role of post-operative prophylactic antibiotic treatment among children undergoing coblation intracapsular tonsillectomy.</p><p><strong>Methods: </strong>A prospective randomised study included 100 children (aged 1-16) who were divided into two subgroups: with and without post-operative antibiotics. Post-operative follow-up of patients included assessment for 7 days of pain levels, fever, return to diet, bleeding and halitosis. In addition, the children's caregivers completed the Parents'-Postoperative-Pain-Measure (PPP-M) questionnaire on Days 1 and 7.</p><p><strong>Results: </strong>The (+) antibiotic subgroup had substantially less halitosis on Days 2-6 after surgery. Prophylactic antibiotic treatment did not yield any differences between the two subgroups in the incidence of fever, return to regular diet or drinking, pain as measured by the Wong Baker Faces Pain scale, or pain as reported by the parents on the PPP-M questionnaire.</p><p><strong>Conclusions: </strong>This prospective study highlights that routine prophylactic post-operative antibiotic use has a limited clinical benefit in paediatric intracapsular tonsillectomy. Improvement in halitosis was significant with antibiotic treatment; however, various other clinical parameters did not differ between the two subgroups, so the routine use of post-operative antibiotics in the above setting is discouraged.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutaneous Allodynia and Photophobia in Vestibular Migraine and Other Vestibular Disorders: A Prospective Study in a Tertiary Centre.","authors":"Jawad Abdulla, David Moreno-Ajona, María Dolores Villar Martínez, Stefania Maniataki, Peter Goadsby, Louisa Murdin","doi":"10.1111/coa.14294","DOIUrl":"https://doi.org/10.1111/coa.14294","url":null,"abstract":"<p><strong>Introduction: </strong>Photophobia (PP) and cutaneous allodynia (CA) are sensory sensitivity symptoms recognised as features of migraine. The prevalence of PP and CA in vestibular migraine (VM) and other vestibular disorders (OVD) is unknown.</p><p><strong>Aim: </strong>The aim of this study is to measure the prevalence of PP and CA in VM compared with OVD.</p><p><strong>Methodology: </strong>Consecutive patients in a dizziness clinic were classified as either VM or OVD. Patients with chronic migraine with VM (VMCM) and without VM (NVCM) presenting to a tertiary headache clinic were included. All completed validated questionnaires: Leiden Visual Sensitivity Scale (L-VISS) for PP and Allodynia Symptom Checklist (ASC-12) for CA.</p><p><strong>Results: </strong>Ninety participants provided responses (age 23-82 years; 71 females and 19 males; 27 with VM, 21 with VMCM, 19 with NVCM and 23 with OVD). The PP mean scores were similar between VM, VMCM and NVCM, and higher in those three groups compared to OVD (ANOVA, p < 0.0005). The mean rank for CA was higher in those three groups compared to OVD (Kruskal-Wallis, p < 0.05), but not significantly different with other group combinations. CA was much more specific for VM, VMCM and NVCM (83%) compared to 4% for PP. The odds of VMCM, NVCM and VM patients having CA were 99.353, 47.595 and 16.708 times that for OVD, respectively (ordinal logistic regression, p < 0.005).</p><p><strong>Conclusion: </strong>VM can be distinguished from OVD by ASC-12 and L-VISS questionnaires with high specificity for CA. CA might be an under-recognised symptom of VM.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Should Concurrent White-Light and Virtual Chromoendoscopy of Pre-Defined Mucosal Stations Be the Standard of Care for Panendoscopy?","authors":"S A R Nouraei","doi":"10.1111/coa.14290","DOIUrl":"https://doi.org/10.1111/coa.14290","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}