Clinical Otolaryngology最新文献

{"title":"Investigations for Suspected Head and Neck Squamous Cell Carcinoma of Unknown Primary (HNSCCUP): A National Cohort Study","authors":"John C. Hardman,&nbsp;James Constable,&nbsp;Andrew Williamson,&nbsp;Sian Dobbs,&nbsp;Christopher Hogan,&nbsp;Kate Hulse,&nbsp;Shivun Khosla,&nbsp;Kristijonas Milinis,&nbsp;Ben Tudor-Green,&nbsp;Vinidh Paleri,&nbsp;INTEGRATE (The UK ENT Trainee Research Network)","doi":"10.1111/coa.14272","DOIUrl":"10.1111/coa.14272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Head and neck squamous cell carcinoma from unknown primary (HNSCCUP) is a rare and challenging condition. This study aimed to investigate the diagnostic pathways of suspected HNSCCUP patients in the United Kingdom.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective observational cohort study was conducted, over 5 years from January 2015, in UK Head and Neck centres of consecutive adults undergoing 18F-Fluorodeoxyglucose-PET-CT (PET-CT) within 3 months of diagnosis with metastatic cervical squamous cell carcinoma. Patients with no primary site on examination and no previous head and neck cancer were eligible.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Data for 965 patients were received from 57 centres; 68.5% were HPV-related disease. Three investigation cycles were observed: ultrasound with biopsy, cross-sectional imaging (MRI and/or CT) and PET-CT, at median times of 17, 29.5 and 46 days from referral. No primary was identified on PET-CT in 49.8% (<i>n</i> = 478/960). Diagnostic tonsillectomy was performed in 58.2% (<i>n</i> = 278/478) and tongue base mucosectomy (TBM) in 21.7% (<i>n</i> = 104/479). Ipsilateral tonsillectomy carried the highest diagnostic yield (18.7%, <i>n</i> = 52/278), followed by TBM (15.4%, <i>n</i> = 16/104). Contralateral tonsillectomy, performed in 49.0% (<i>n</i> = 234/478), carried the lowest yield (0.9%, <i>n</i> = 2/234). PET-CT with concurrent MRI was associated with higher primary site detection than PET-CT with concurrent CT (<i>p</i> = 0.003). A minority of patients undergoing treatment with curative intent received first-definitive-treatment within 62 days of referral (15.2%, <i>n</i> = 77/505, median 92 days, IQR: 71–117).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most patients experienced a protracted diagnostic pathway and waited over 3 months for definitive treatment. Earlier PET-CT with concurrent MRI may expedite diagnosis. TBM appears more productive than contralateral tonsillectomy for primary site detection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"462-473"},"PeriodicalIF":1.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945815","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":"Evaluation of the Usability of ChatGPT-4 and Google Gemini in Patient Education About Rhinosinusitis","authors":"Çağrı Becerik,&nbsp;Selçuk Yıldız,&nbsp;Çiğdem Tepe Karaca,&nbsp;Sema Zer Toros","doi":"10.1111/coa.14273","DOIUrl":"10.1111/coa.14273","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Artificial intelligence (AI) based chat robots are increasingly used by users for patient education about common diseases in the health field, as in every field. This study aims to evaluate and compare patient education materials on rhinosinusitis created by two frequently used chat robots, ChatGPT-4 and Google Gemini.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>One hundred nine questions taken from patient information websites were divided into 4 different categories: general knowledge, diagnosis, treatment, surgery and complications, then asked to chat robots. The answers given were evaluated by two different expert otolaryngologists, and on questions where the scores were different, a third, more experienced otolaryngologist finalised the evaluation. Questions were scored from 1 to 4: (1) comprehensive/correct, (2) incomplete/partially correct, (3) accurate and inaccurate data, potentially misleading and (4) completely inaccurate/irrelevant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In evaluating the answers given by ChatGPT-4, all answers in the Diagnosis category were evaluated as comprehensive/correct. In the evaluation of the answers given by Google Gemini, the answers evaluated as completely inaccurate/irrelevant in the treatment category were found to be statistically significantly higher, and the answers evaluated as incomplete/partially correct in the surgery and complications category were found to be statistically significantly higher. In the comparison between the two chat robots, in the treatment category, ChatGPT-4 had a higher correct evaluation rate than Google Gemini and was found to be statistically significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The answers given by ChatGPT-4 and Google Gemini chat robots regarding rhinosinusitis were evaluated as sufficient and informative.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"456-461"},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945813","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":"Rebleeding After Secondary Post-Tonsillectomy Bleeding: Risk Factors Identified From a Single-Centre Retrospective Study of 448 Cases","authors":"Max Lee,&nbsp;Andrew Wood,&nbsp;Omid Ahmadi,&nbsp;Bert van der Werf,&nbsp;Kumanan Selvarajah","doi":"10.1111/coa.14275","DOIUrl":"10.1111/coa.14275","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"565-572"},"PeriodicalIF":1.7,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892448","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":"Local Application of Honey for Postoperative Pain Management and Associated Outcomes Following Tonsillectomy in Children: A Systematic Review and Meta-Analysis","authors":"Seyed Javad Hosseini,&nbsp;Seyed Reza Hosseini,&nbsp;Amirreza Jamshidbeigi,&nbsp;Gholam Reza Mahmoodi-Shan,&nbsp;Fatemeh Hajiabadi,&nbsp;Masoud Abdollahi,&nbsp;Mahbobeh Firooz","doi":"10.1111/coa.14276","DOIUrl":"10.1111/coa.14276","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigates the effect of locally applied honey on pain intensity, analgesia consumption, pain relief and nighttime awakenings in children following tonsillectomy, addressing conflicting evidence and the lack of differentiation between adult and paediatric populations in previous reviews.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search was conducted across multiple databases, including Cochrane Library, ClinicalTrials.gov, MEDLINE, Web of Science and Google Scholar. Randomised controlled trials (RCTs) comparing pain outcomes in children receiving honey in addition to standard treatments versus those receiving standard treatments alone were included. Pain intensity was measured with the VAS tool. Meta-analysis was performed using STATA version 14 software. Also, risk of bias and certainty of evidence were evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 537 articles, seven studies (<i>n</i> = 710) with RCT design met the inclusion criteria. The average duration for measuring pain intensity was 7.37 days. Pooled effect size showed a statistically significant reduction in pain intensity in the honey intervention group compared to the control group (WMD: −0.90, 95% CI [−1.32, −0.48], <i>p</i> &lt; 0.001, <i>I</i>\u0000 ²: 92.5%; certainty of evidence: low). Also, the results demonstrated that honey significantly decreased the average time required for pain relief and analgesic consumption in the intervention group compared to the control group. One study was deemed low risk of bias, four studies were of intermediate quality and two studies were evaluated as high.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>While honey shows promise in reducing post-tonsillectomy pain, cautious use is advised due to the limited quality of evidence. More robust RCTs are needed to address biases and reinforce confidence in the findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"427-437"},"PeriodicalIF":1.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892284","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":"Guidelines for Diagnosis of Noise-Induced Hearing Loss and Their Specificity","authors":"Mark E. Lutman,&nbsp;John de Carpentier,&nbsp;Kevin Green","doi":"10.1111/coa.14268","DOIUrl":"10.1111/coa.14268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>A recent paper by Moore, Lowe and Cox has proposed guidelines for diagnosing noise-induced hearing loss (NIHL). It is referred to here as the MLC guidelines. Our aim was to assess the specificity of those guidelines (i.e., freedom from false-positive outcomes) and compare with pre-existing guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We applied the MLC guidelines and pre-existing guidelines to three data sets composed of adults who do not have a history of material noise exposure and therefore cannot have NIHL.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>National Health Service (NHS) ENT clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Five hundred thirty-six patients with hearing difficulty and/or tinnitus who denied material noise exposure. Two large archival population studies of hearing were also assessed, which included 3250 participants without material noise exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure</h3>\u0000 \u0000 <p>False-positive outcome from guidelines.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The MLC guidelines demonstrated moderate or high false-positive rates overall, the magnitude depending on the noise exposure scenario and whether clinical or population samples were considered. For the procedure applicable to steady broadband noise exposure, the false-positive rate averaged 56% in the population samples, compared to 31% for previous guidelines. For exposure to intense impulse sounds, the MLC guidelines take a different approach and the false-positive rate was about 70% in the population samples and even higher in the clinic sample. For exposure to intense tones, the MLC guidelines take yet another approach and the false-positive rate reached 80%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The MLC guidelines demonstrate poorer specificity than previous guidelines. Medical experts should be aware of their poor specificity and consequential likelihood of false-positive diagnoses of NIHL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"446-455"},"PeriodicalIF":1.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892274","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":"Comparing Treatment Choice in Acute Otitis Externa Between Primary and Secondary Care","authors":"Keshav Kumar Gupta,&nbsp;Justin Yeo,&nbsp;Cecily Young,&nbsp;Megan Nash,&nbsp;Matthew Weller","doi":"10.1111/coa.14274","DOIUrl":"10.1111/coa.14274","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"555-559"},"PeriodicalIF":1.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892254","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":"Odontogenic Sinusitis Management: Insights From a Retrospective Analysis","authors":"Shayan Shahidi,&nbsp;Musharrat Tasnuva Zaman Mim,&nbsp;Lima Gharbawi,&nbsp;Harish Viswanathan,&nbsp;Stephen M. Hayes,&nbsp;Tim C. Biggs","doi":"10.1111/coa.14277","DOIUrl":"10.1111/coa.14277","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"560-564"},"PeriodicalIF":1.7,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892287","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":"Redress and Reflection Regarding Socioeconomic Inequality in the Head and Neck Cancer Referral System","authors":"Thomas Hampton,&nbsp;Andrew Lau","doi":"10.1111/coa.14267","DOIUrl":"10.1111/coa.14267","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 3","pages":"586-587"},"PeriodicalIF":1.7,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892452","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":"Distraction Therapies for Office-Based Otolaryngology Procedures Performed on the Upper Airway","authors":"Tanika Curry,&nbsp;Andrea Lasso,&nbsp;Shaun Kilty","doi":"10.1111/coa.14270","DOIUrl":"10.1111/coa.14270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the effectiveness of auditory and visual distraction interventions on patient discomfort, pain and anxiety during office-based otolaryngologic upper airway procedures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>Literature searches were done through Cochrane Central Register of Controlled Trials, Lilacs, MEDLINE, Embase, PsycINFO and Cumulative Index to Nursing and Allied Health Literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>The protocol was registered in PROSPERO on August 17th 2022, under Registration number CRD42020204354.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 138 records; two randomised controlled trials using virtual reality as a distraction technique in adults and one in children were included. All studies had some concerns regarding risk of bias. In adults, anxiety was lower in the virtual reality group than in the standard of care, (mean difference −16.72, 95% CI −27.19 to −6.24, <i>p</i> = 0.002, <i>I</i>\u0000 ² = 0%). There was no difference in procedure related pain between groups, (mean difference −0.28, 95% CI −1.24 to 0.68, <i>p</i> = 0.57, <i>I</i>\u0000 ² = 10%). There was no difference in satisfaction between groups (standardised mean difference 0.18, 95% CI −0.22 to 0.58, <i>p</i> = 0.37, <i>I</i>\u0000 ² = 0%). Only one Paediatric study was included hence no meta-analysis was done. Anxiety and pain were lower and satisfaction was higher in the group using virtual reality.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of virtual reality distraction in addition to standard analgesia during office-based otolaryngology upper airway procedures reduced anxiety in adults. It did not decrease pain or increase the level of patient satisfaction. In the paediatric population, there is a reported benefit for procedural anxiety, pain and satisfaction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"241-248"},"PeriodicalIF":1.7,"publicationDate":"2024-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/coa.14270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142881409","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":"Should Diagnostic Rigid Oesophagoscopy Continue to Form Part of Panendoscopy?","authors":"S. A. R. Nouraei","doi":"10.1111/coa.14266","DOIUrl":"10.1111/coa.14266","url":null,"abstract":"","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":"50 2","pages":"396-398"},"PeriodicalIF":1.7,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142876249","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}