Clinical Otolaryngology最新文献

{"title":"Evaluation of the Management of Asymptomatic Unilateral Tonsillar Enlargement—Can We Avoid Diagnostic Surgery?","authors":"E. Tian Tan, Laura Simpson, Rory Braggins, Ovie Edafe","doi":"10.1111/coa.14218","DOIUrl":"10.1111/coa.14218","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"137-142"},"PeriodicalIF":1.7,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125048","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":"Normal Facial Function in the Sunnybrook Facial Grading System: Is the 100% Score too Restrictive?","authors":"Diane Picard, Remi Hervochon, Elodie Lannadere, Cloe Cabos, Loeiza Gourves, Frederic Tankere, Peggy Gatignol","doi":"10.1111/coa.14217","DOIUrl":"10.1111/coa.14217","url":null,"abstract":"<p>The Sunnybrook Facial Grading System (SFGS) is a widely recognized tool for assessing facial palsy and its subsequent recovery, offering a standardized approach for quantifying facial movements [<span>1</span>]. This scale compares the paralyzed hemiface to the healthy hemiface of patients using a total composite score between 0% and 100%, where 100% corresponds to full recovery of facial function. The SFGS evaluate five facial movements, symmetry at rest and the presence of synkinesis. The total composite score is calculated by subtracting the symmetry and synkinesis scores from the dynamic movement score.</p><p>This scale and total composite score have proven to be a gold standard in clinical practice and research [<span>2</span>]. Even if it has been shown to be more sensitive in detecting changes following therapeutic intervention, the SFGS remains largely subjective [<span>3</span>]. Moreover, the widespread assumption of achieving a perfect 100% may not deal with the natural variations of face symmetry observed in healthy individuals and in patients with facial palsy [<span>4</span>]. Indeed, there is valuable evidence of asymmetry in the production of facial expressions in the general population, even in the absence of facial palsy [<span>5</span>].</p><p>This study aims to provide a more comprehensive understanding of the natural range of SFGS scores among healthy participants, thereby redefining the normative standards and advocating for a more patient-centred and holistic approach to facial rehabilitation.</p><p>Upon analyzing the SFGS scores, it was observed that the range differed depending on whether the right or left hemiface was considered the reference. Taking the right hemiface as a reference, SFGS-Total scores ranged from 65% to 100% (median = 96, IQR [91–100]). When the left hemiface was considered as the reference, scores ranged from 78% to 100% (median = 95; IQR [90–100]). No participants showed any synkinesis. No significant differences between the SFGS-Total scores according to the reference hemiface were found on the whole sample (<i>p</i> = 0.517). The data are reported by age and gender in Table 1. Data distribution using violin plots is reported in Figure 1.</p><p>Consistency between evaluators were high for right and left SFGS-Total scores (respectively α = 0.953 and α = 0.926). Right and left SFGS-Rest scores showed also high inter-rater reliability (respectively α = 0.860 and α = 0.886) as well as right and left SFGS-Movement scores (respectively α = 0.957 and α = 0.816).</p><p>There was a slight negative correlation between age and SFGS-Total scores. Indeed, the older the participants, the lower their scores (right side as reference: ρ (109) = −0.37, <i>p</i> < 0.0001, 95% CI [−0.52, −0.20]; left side as reference: ρ (109) = −0.25; <i>p</i> = 0.009; 95% CI [−0.42, −0.06], Figure 2). Post hoc comparisons using Kruskall–Wallis test indicated that there was a significant difference in the SFGS-Total scores (right","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"132-136"},"PeriodicalIF":1.7,"publicationDate":"2024-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618270/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our experience: Pharyngeal Pouches, a Multimodal Approach to Treatment Under a Single Anaesthetic. A Retrospective Analysis of a Cohort of 105 Cases","authors":"Tom Bradish, David Hamilton, James O'Hara","doi":"10.1111/coa.14209","DOIUrl":"10.1111/coa.14209","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"833-836"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016514","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":"Modification of McGill Oximetry Score in Improving the Diagnostic Capability of Paediatric OSA","authors":"Wannitta E. Ting Wong,&nbsp;Jeyasakthy Saniasiaya,&nbsp;Nur Syazwani Mohd Salehuddin,&nbsp;Shih Ying H'ng,&nbsp;Anna Marie Nathan","doi":"10.1111/coa.14214","DOIUrl":"10.1111/coa.14214","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study aimed to devise a modified oximetry scoring system and calculate its diagnostic accuracy in detecting paediatric obstructive sleep apnoea syndrome (OSAS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>This prospective diagnostic accuracy study was divided into two phases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The study was conducted at a quaternary teaching hospital.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Polysomnograms performed from 1 April 2014 to 31 December 2021 were included. In Phase 1, the parameters of 95 oximetry trend graphs were evaluated, and a modified scoring system was constructed. In Phase 2, the modified scoring system was employed in 272 oximetry trend graphs, and its diagnostic accuracy was determined. A logistic regression model was used to assess the ability of each scoring system to predict paediatric OSAS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 367 patients were recruited. In Phase 1, a four-tier severity classification system was constructed. In Phase 2, its diagnostic accuracy was found to be 53.3% sensitive, 97% specific, with positive predictive value of 98.5% and negative predictive value of 34.6%. The lowest detectable apnoea–hypopnoea index (AHI) was 4.5. The inter-rater reliability calculated was 80%. Logistic regression was applied to assess associations of the modified McGill score (MMS) or McGill oximetry score (MOS) with OSAS. The area under the receiver operating characteristic curve was higher for the MMS than for MOS (0.78 [95% CI 0.73–0.84] vs. 0.59 [95% CI 0.51–0.66]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated that our modified scoring system had increased sensitivity at detecting OSAS at a much lower AHI and showed a much greater ability to predict paediatric OSAS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"801-809"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035411","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":"Association of Patient and Tumor Characteristics With Outcomes in Young Head and Neck Squamous Cell Carcinoma Patients","authors":"Ronan W. Hsieh,&nbsp;William E. Gooding,&nbsp;Marci Nilsen,&nbsp;Mark Kubik,&nbsp;Zahra Kelly,&nbsp;Shaum Sridharan,&nbsp;Heath Skinner,&nbsp;Uzoma Iheagwara,&nbsp;Jose P. Zevallos,&nbsp;Umamaheswar Duvvuri,&nbsp;Seungwon Kim,&nbsp;Robert L. Ferris,&nbsp;Dan P. Zandberg","doi":"10.1111/coa.14215","DOIUrl":"10.1111/coa.14215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>We retrospectively studied young patients with head and neck squamous cell carcinoma (HNSCC) to identify factors associated with disease-specific survival (DSS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patient and tumor characteristics of patients aged ≤45 who received treatments for non-metastatic HNSCC were collected to identify factors associated with DSS. Proportional hazards regression was applied separately for surgical and non-surgical patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>230 patients were included. Surgical and non-surgical patients had similar DSS. Higher pathologic stages, positive margins, perineural invasion (PNI), extranodal extension and negative HPV status were associated with worse DSS for surgical patients and negative HPV status for non-surgical patients. In the multivariate analysis, pathologic stages, positive margins, and PNI were associated with worse DSS in surgical patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Pathologic stages, positive margins, and PNI are independently associated with worse DSS in young surgical HNSCC patients. PNI is a uniquely strong prognostic factor for young patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"15-21"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar Cautery as a Simple Yet Effective Technique for Epiglottopexy in Laryngomalacia","authors":"Mila Roode,&nbsp;Adam J. Donne","doi":"10.1111/coa.14216","DOIUrl":"10.1111/coa.14216","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 1","pages":"128-131"},"PeriodicalIF":1.7,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035410","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 Fistula Development After Parotid Gland Surgery: Lateral Parotidectomy Versus Extracapsular Dissection Technique","authors":"Nadia Sadok,&nbsp;Tobias Bastian,&nbsp;Noemi Voss,&nbsp;Kerstin Stähr,&nbsp;Diana Arweiler-Harbeck,&nbsp;Stephan Lang,&nbsp;Moritz Meyer","doi":"10.1111/coa.14213","DOIUrl":"10.1111/coa.14213","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The primary objective of this study was to explore the potential disparity in postoperative fistula occurrence rates between patients who undergo (partial) lateral parotidectomy and those who undergo the extracapsular dissection technique for the management of benign parotid gland tumours.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A consecutive series of 363 patients treated with (partial) lateral parotidectomy and extracapsular dissection technique for benign parotid gland tumours at one tertiary centre between 2018 and 2022 were included. To evaluate the impact of the surgical technique and possible other risk factors (tumour location, tumour size, Body Mass Index, age, smoking, diabetes mellitus, arterial hypertension) for the development of fistulas, multivariate logistic regression analyses using backward lection were applied to estimate odds ratios (ORs) and 95%-confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In 363 patients, 21 patients (5.8%) developed a fistula. Patients who underwent (partial) lateral parotidectomy had three times higher chance of developing a fistula compared to patients who were operated using the extracapsular dissection technique (OR_adjusted = 2.6, 4.1% vs. 12.5%, <i>p</i> = 0.044). In the multivariate analyses, no other risk factors for the development of fistulas were statistically significant in this cohort. The incidence of facial nerve paralysis was not significantly different between the extracapsular dissection and lateral parotidectomy group (5/73 = 6.8% vs. 11/290 = 3.8%, <i>p</i> = 0.333).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Fistulas occur more often in patients treated by means of a (partial) lateral parotidectomy approach compared to patients treated using the extracapsular dissection technique. Therefore, surgeons should be vigilant about postoperative fistula risks in lateral parotidectomy and consider preventive measures.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"793-800"},"PeriodicalIF":1.7,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14213","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141981867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Outcomes of Intralesional Steroid Injection for Refractory Vocal Process Granuloma","authors":"Po-Jun Yu,&nbsp;Wei-Chen Hung,&nbsp;Chi-Te Wang","doi":"10.1111/coa.14210","DOIUrl":"10.1111/coa.14210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Vocal process granuloma (VPG) is a chronic condition resulting from a mucoperichondrial injury of vocal process. Initial conservative treatment typically involves vocal hygiene education and antireflux medication. Treatment challenges arise with refractory cases. Outcomes of second-line treatments such as surgical excision and botulinum toxin injections remain inconsistent. Thus, we propose this study to investigate the effectiveness of intralesional steroid injections for refractory VPG.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a retrospective review of 23 patients with VPG who showed no improvement after 3 months of proton pump inhibitors. These patients underwent one to three courses of monthly in-office intralesional steroid injections as a second-line therapy. Treatment outcomes were evaluated by measuring the size of the VPG relative to the length of the vocal folds before and after the final injection procedure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Results showed a significant reduction in VPG size from baseline of 27.74 ± 15.06 to 5.48 ± 8.95 (p &lt; .001). 15 out of 23 patients were responsive (size reduction ≥ 75%) to intralesional steroid injection. Alcohol consumption and longer symptom duration were associated with a poor response (size reduction &lt;75%), whereas prior intubation was associated with better response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>For refractory VPG not responding to conservative treatment, intralesional steroid injection appears to be a promising alternative option without significant adverse effects.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"822-826"},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970802","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":"Intraoperative Detection of Extracochlear Electrodes Using Stimulation Current Induced Non-Stimulating Electrode Voltage (SCINSEV) Measures (Transimpedance Measures)—A Case Series","authors":"Muhammed Ayas,&nbsp;Yu Chuen Tam,&nbsp;Dakota Bysouth-Young,&nbsp;Susan T. Eitutis,&nbsp;Marina Salorio-Corbetto,&nbsp;Patrick R. Axon,&nbsp;Neil P. Donnelly,&nbsp;James R. Tysome,&nbsp;Daniele Borsetto,&nbsp;Mathew E. Smith,&nbsp;Manohar L. Bance","doi":"10.1111/coa.14212","DOIUrl":"10.1111/coa.14212","url":null,"abstract":"&lt;p&gt;Cochlear implants (CIs) are prosthetic devices used to restore hearing sensation in people with severe to profound sensorineural hearing loss [&lt;span&gt;1&lt;/span&gt;]. The success of the CI surgery relies on the surgical placement of the electrodes within the scala tympani. Electrode migration post placement is well documented and could significantly affect the overall CI performance [&lt;span&gt;2&lt;/span&gt;]. Migration may result in extracochlear electrodes (EE). Notably, this is under-reported in the existing literature [&lt;span&gt;3, 4&lt;/span&gt;]. Routine intraoperative measures, such as contact impedances, may not indicate misplacement or extrusion of electrodes, particularly if there is an electrically conductive blood, fluid, or soft tissue around the EEs, which may result in the normal contact impedances. If the EE are in air, the contact impedances will show an open circuit and so are easier to detect [&lt;span&gt;5, 6&lt;/span&gt;]. Advanced measures such as the stimulation current induced non-stimulating electrode voltage (SCINSEV- termed differently in various clinical software as transimpedance matrix (TIM) by Cochlear Corp, electric field imaging (EFI) by Advanced Bionics(AB) and impedance field telemetry (IFT) by MEDEL), could potentially be used to detect the extrusion EE. The application of SCINSEV measurements in cadaveric studies demonstrates a comparable and well-defined role in the identification of electrode EE, as detailed in the existing literature [&lt;span&gt;5, 6&lt;/span&gt;]. Here, we report three cases of intraoperative electrode extrusion detected using SCINSEV measures, subsequently performing corrective repositioning during the same surgical session which prevented the need for delayed revision surgery. This report further highlights the potential of SCINSEV as an important tool in intraoperative measures and enhancing CI surgical outcomes and reports for the first time their use in live patient surgery as determinants of EE and for intraoperative decision-making and correction.&lt;/p&gt;&lt;p&gt;Three paediatric patients are reported, implanted either bilaterally or unilaterally on the basis of multidisciplinary team decisions. All the 3 patients were females, with a mean age of 11 ± 3 years (Table 1). Preoperative magnetic resonance imaging (MRI) was performed to evaluate cochlear anatomical structures and assess the integrity of the auditory nerve. All the patients were implanted with AB HiRes Ultra 3D implants using the round window approach. After periosteal closure, intraoperative electrical impedance and other measurements were performed.&lt;/p&gt;&lt;p&gt;In our centre, the intraoperative test protocol follows a battery of tests including initial contact impedance measures, subsequent SCINSEV (termed EFI by AB) and Electrical Compound Action Potentials (ECAP). Following CI placement in the subperiosteal pocket and electrode insertion, the external coil is attached underneath the sterile surgical drapes and connected to a AB-AIM (active insertion monitoring) tablet system, and","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"827-832"},"PeriodicalIF":1.7,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14212","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Auscultation for Detecting Oropharyngeal Aspiration in Paediatric and Adult Populations: A Systematic Review and Meta-Analysis","authors":"Annelise C. Cron,&nbsp;Michael David,&nbsp;Jane Orbell-Smith,&nbsp;Anne B. Chang,&nbsp;Kelly A. Weir,&nbsp;Thuy T. Frakking","doi":"10.1111/coa.14202","DOIUrl":"10.1111/coa.14202","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Cervical auscultation (CA) involves listening to swallowing and respiratory sounds and/or vibrations to detect oropharyngeal aspiration (OPA). CA has shown promising diagnostic test accuracy when used with the clinical swallowing examination and is gaining popularity in clinical practise. There has not been a review to date analysing the accuracy of CA in paediatric and adult populations with meta-analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To determine the accuracy of CA in detecting OPA in paediatric and adult populations, when compared to instrumental assessments.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Search Methods</h3>\u0000 \u0000 <p>Databases searched included MEDLINE, PubMed, Embase, CINAHL, AustHealth, Cochrane and Web of Science. The search was restricted between 01 October 2012 and 01 October 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Selection Criteria</h3>\u0000 \u0000 <p>Inclusion criteria included (a) all clinical populations of all ages, (b) who have had an instrumental assessment and (c) CA. All study types were included.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Collection and Analysis</h3>\u0000 \u0000 <p>Studies were reviewed independently by two authors. The methodological quality of the studies was analysed using the QUADAS-2.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Results</h3>\u0000 \u0000 <p>Ten studies met the inclusion criteria for this review and meta-analyses. The pooled diagnostic performance of CA in detecting OPA was 0.91 for sensitivity and 0.79 for specificity. The area under the curve summary receiver operating curve (sROC) was estimated to be 0.86, thereby indicating good discrimination of OPA. Most studies scored high for risk of bias in at least one domain in the QUADAS-2, likely attributed to a lack of high-quality prospectively designed studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are promising diagnostic test accuracies for the use of CA in detection of OPA. Future research could include using CA in specific clinical populations and settings, and identifying standardised criteria for CA.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"49 6","pages":"713-724"},"PeriodicalIF":1.7,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14202","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}