JAMA otolaryngology-- head & neck surgery最新文献

{"title":"An Unusual Tongue Mass.","authors":"Alyssa Y Li, Hagen Klieb, Christopher M K L Yao","doi":"10.1001/jamaoto.2026.1394","DOIUrl":"10.1001/jamaoto.2026.1394","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"826-827"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pulsatile Peritonsillar Mass.","authors":"Jou-Erh Yang, Yu-Hsi Liu","doi":"10.1001/jamaoto.2026.1398","DOIUrl":"10.1001/jamaoto.2026.1398","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"828-829"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Weight Loss at a Cost-Sense and Sensibility.","authors":"Charles A Riley, Edward D McCoul","doi":"10.1001/jamaoto.2026.1704","DOIUrl":"10.1001/jamaoto.2026.1704","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"766-767"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"International Trends in Head and Neck Cancer Mortality.","authors":"Tsukasa Higashionna, Tatsuaki Takeda, Mariko Fujii, Nanami Sako, Keith Belangoy, Quynh Thi Vu, Ko Harada, Yoshito Nishimura, Hideharu Hagiya, Hirofumi Hamano, Michio Yamamoto, Yoshito Zamami, Toshihiro Koyama","doi":"10.1001/jamaoto.2026.1593","DOIUrl":"10.1001/jamaoto.2026.1593","url":null,"abstract":"<p><strong>Importance: </strong>Head and neck cancer (HNC) accounts for nearly 1 million new cases and approximately half a million deaths annually worldwide, representing a substantial global health burden. Despite an overall decline in mortality in many regions, patterns vary across anatomical subsites and countries.</p><p><strong>Objective: </strong>To evaluate international and national mortality trends in HNC and its major anatomical subsites from 2001 to 2023.</p><p><strong>Design, setting, and participants: </strong>This observational epidemiologic study analyzed population-based mortality data from the World Health Organization (WHO) Mortality Database for 73 countries between 2001 and 2023. Data collection was conducted in May 2025, and the data were analyzed between May and October 2025. Eligible countries had medium- to high-quality vital registration data. Age-standardized mortality rates (ASRs) were calculated using the new WHO World Standard Population. Country-specific trends from 2010 to 2023 were assessed using joinpoint regression among countries with at least 7 years of available data.</p><p><strong>Main outcomes and measures: </strong>ASRs and average annual percentage change in HNC mortality overall and by anatomical subsite using population-based analysis.</p><p><strong>Results: </strong>From 2001 to 2023, 2 000 066 HNC-related deaths (450 657 females; 1 549 409 males) were recorded. Internationally, ASRs decreased by 38.9%, with greater reductions among male individuals than among female individuals. Substantial divergence was observed across subsites: laryngeal cancer mortality decreased markedly (-50.1%), whereas increasing trends in oropharyngeal cancer mortality were observed in many countries in recent years, particularly in high-income countries such as the UK (average annual percentage change, 4.30%) and the US (average annual percentage change, 3.26%).</p><p><strong>Conclusions and relevance: </strong>Results of this study suggest that, although overall HNC-related ASRs have declined internationally, marked variation across subsites and countries persists. The contrasting trends between laryngeal and oropharyngeal cancers underscore the need for subtype-specific prevention strategies and continued global surveillance.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"810-815"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Quality of Life and Socioeconomic Disadvantage Among Patients With Head and Neck Cancer.","authors":"Kyle Leonard, Samantha Tam, Amy M Williams, Kylie Springer, Kimberly Oslin, Veronica Bernacchi, Tamer A Ghanem, Steven S Chang, Suhael Momin, Farzan Siddiqui, Eric Adjei Boakye","doi":"10.1001/jamaoto.2026.1268","DOIUrl":"10.1001/jamaoto.2026.1268","url":null,"abstract":"<p><strong>Importance: </strong>Lower socioeconomic status is a risk factor for poorer quality of life (QOL) among patients with head and neck cancer (HNC) after treatment; however, there is a paucity of literature describing baseline QOL in these patients, with much of the existing literature focused on financial characteristics rather than comprehensive, geographically based factors. Shifting focus to these factors could better capture the entire patient experience and allow clinicians to provide improved care.</p><p><strong>Objective: </strong>To examine the associations between area-level deprivation, a marker of socioeconomic disadvantage, and QOL among patients with HNC before treatment initiation.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional single-institution study included patients diagnosed with HNC between 2015 and 2022 receiving care at a tertiary care center in a metropolitan setting who completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT-HN) questionnaire before starting treatment. Data were analyzed between December 2024 and May 2025.</p><p><strong>Exposure: </strong>Area-level deprivation (measured using the area deprivation index [ADI]), as designated by the patient's respective ADI quintile, with the first quintile being the least deprived or socioeconomically disadvantaged and the fifth quintile being the most deprived or disadvantaged.</p><p><strong>Main outcomes and measures: </strong>FACT-HN domains of social, emotional, functional, physical, HNC-specific, and overall well-being or QOL. Multivariable linear regression models (1 for each domain) were used to estimate associations between ADI quintiles and FACT-HN domains, adjusting for patient and clinical characteristics.</p><p><strong>Results: </strong>A total of 600 patients (mean [SD] age, 62.5 [11.4] years; 72.3% males [n = 434]) were included in the analysis. The ADI quintiles were equally distributed, with approximately 20% of patients in each quintile. Patients residing in the most disadvantaged areas reported lower HNC-specific well-being scores (β = -3.62; 95% CI, -6.23 to -1.01) compared with those residing in the least disadvantaged areas. Associations between ADI quintile and other well-being scores were weak and not clinically meaningful.</p><p><strong>Conclusions and relevance: </strong>In this cross-sectional study, greater socioeconomic disadvantage is associated with poorer baseline QOL among patients diagnosed with HNC. These findings could be used to identify patients at higher risk of lower QOL and support the equitable allocation of resources from multidisciplinary cancer care teams.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"744-752"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood Manganese and Risk of Squamous Cell Carcinomas of the Head and Neck.","authors":"Benjamin Clay, Nasir Bashir, Stephen Burgess, Paul Carter","doi":"10.1001/jamaoto.2026.1749","DOIUrl":"10.1001/jamaoto.2026.1749","url":null,"abstract":"<p><strong>Importance: </strong>Squamous cell carcinomas of the oral cavity (OCSCC), oropharynx (OPSCC), hypopharynx (HPSCC), and larynx (LSCC) are the most common forms of head and neck cancer globally. Epidemiological studies have identified variations in blood trace metal concentrations as potential risk factors for the development of these cancers, but these studies are susceptible to multiple biases.</p><p><strong>Objective: </strong>To determine if variations in genetically predicted blood manganese are associated with risk of OCSCC, OPSCC, HPSCC, and LSCC.</p><p><strong>Design, setting, and participants: </strong>This population-based 2-sample cis-mendelian randomization study used a genetic instrument for blood manganese derived from a meta-analysis of 3 individual-level genome-wide association study datasets of 6564 Scandinavian participants. Genetic associations for the development of the specified cancers were obtained from a nonoverlapping, multi-ancestral meta-analysis that combined individual-level genome-wide association study datasets comprising 38 857 healthy controls, 5596 case patients with OCSCC, 2212 case patients with human papillomavirus (HPV)-positive OPSCC, 1473 case patients with HPV-negative OPSCC, 898 case patients with HPSCC, and 4409 case patients with LSCC.</p><p><strong>Exposures: </strong>Increases in genetically predicted whole blood manganese concentration proxied by a genetic instrument including 2 cis-variants (single-nucleotide variants) selected due to their known functions in regulating manganese metabolism.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were the risk of OCSCC, OPSCC (HPV positive and HPV negative), HPSCC, and LSCC, evaluated by estimating the odds ratio (OR) and 95% CI of each outcome per 1-SD increase in whole blood manganese concentration after rank-based inverse normalization transformation.</p><p><strong>Results: </strong>Genetically predicted higher blood manganese was found to have a statistically significant association with increased risk of OCSCC (OR, 1.25; 95% CI, 1.10-1.43; P < .001) and HPV-positive OPSCC (OR, 1.23; 95% CI, 1.04-1.45; P = .02). Associations between blood manganese and HPV-negative OPSCC (OR, 1.20; 95% CI, 0.95-1.50; P = .13), HPSCC (OR, 1.25; 95% CI, 0.75-2.07; P = .39), and LSCC (OR, 1.10; 95% CI, 0.92-1.32; P = .28) were directionally concordant but not statistically significant.</p><p><strong>Conclusions and relevance: </strong>This cis-mendelian randomization study demonstrates statistically significant associations between higher blood manganese concentrations and risk of OCSCC and HPV-positive OPSCC. Further work should aim to establish the pathophysiological mechanisms underlying this association to inform potential public health strategies for the prevention of these cancers.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"791-796"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Diet and Lifestyle Program With 3 Medication Approaches for Laryngopharyngeal Reflux Disease Management.","authors":"Jerome R Lechien","doi":"10.1001/jamaoto.2026.0577","DOIUrl":"10.1001/jamaoto.2026.0577","url":null,"abstract":"<p><strong>Importance: </strong>There are no studies comparing the primary therapeutic options for laryngopharyngeal reflux disease (LPRD).</p><p><strong>Objective: </strong>To compare the effectiveness of antireflux diet and 3 medication classes in patients with LPRD.</p><p><strong>Design, setting, and participants: </strong>This is a retrospective analysis of consecutive patients with LPRD who were prospectively recruited from April 2018 to February 2024 from 2 medical hospitals in Belgium and France. Data were analyzed in November 2025.</p><p><strong>Exposures: </strong>Strict antireflux diet and stress reduction activities, alginates, magaldrates, or proton pump inhibitors.</p><p><strong>Main outcomes and measures: </strong>Age, sex, pretreatment to posttreatment reflux symptom score (RSS), and reflux sign assessment (RSA) were prospectively collected in patients with an objective LPRD diagnosis at the 24-hour hypopharyngeal-esophageal multichannel intraluminal impedance-pH testing. The pretreatment to posttreatment clinical features (RSS, RSA, and therapeutic response rates) were compared across patient groups regarding treatment regimens.</p><p><strong>Results: </strong>Of 145 included patients, 84 (57.9%) were female, and the median (IQR) age was 53 (37.0-63.3) years. Patients treated with proton pump inhibitors (n = 32), antacids (n = 27), alginates (n = 38), and strict diet (n = 48) were comparable for median age, sex proportions, and baseline RSS and RSA. RSS and RSA demonstrated significant reduction in all groups. Linear mixed model analysis revealed a significant main effect of time on both RSS (F1,274 = 19.82; P < .001) and RSA (F1,219 = 26.47; P < .001), confirming symptom and sign improvement across all groups. For RSS, treatment group was significantly associated with RSS scores (F3,274 = 3.53; P = .02). The diet group had significantly lower estimated marginal mean RSS scores than the antacid group (mean difference, 38.73; 95% CI, 4.24-73.23). The change in RSS scores over time did not differ between groups. For RSA, neither the group effect nor the interaction reached significance. The diet group had the highest proportion of responders (diet, 39 of 48 [81.2%]; proton pump inhibitor, 18 of 32 [56.3%]; alginates, 22 of 38 [57.9%]; antacids, 20 of 27 [74.1%]), with proportion differences of 24.9 percentage points (95% CI, 4.6-45.4) compared with proton pump inhibitors, 23.4 percentage points (95% CI, 4.2-42.5) compared with alginates, and 7.2 percentage points (95% CI, -12.7 to 27.1) compared with antacids.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, adherence to an antireflux diet and stress-reduction activities may be associated with comparable or greater symptom relief at 3 months posttreatment compared with conventional medical therapies. Randomized clinical trials comparing the 4 regimens are needed.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"816-821"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13329737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148368412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Further Methodological and Clinical Reflections.","authors":"Sium Wolde Sellasie, Arnoldo Piccardo, Pierpaolo Trimboli","doi":"10.1001/jamaoto.2026.1409","DOIUrl":"10.1001/jamaoto.2026.1409","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"832"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Corticosteroids and Adverse Events in Chronic Rhinosinusitis With Nasal Polyps.","authors":"Seojin Moon, Myeongjee Lee, Inkyung Jung, Min-Seok Rha","doi":"10.1001/jamaoto.2026.1188","DOIUrl":"10.1001/jamaoto.2026.1188","url":null,"abstract":"<p><strong>Importance: </strong>Oral corticosteroids are commonly used in the management of chronic rhinosinusitis with nasal polyps to control inflammation. However, evidence on the long-term safety of repeated or high-dose oral corticosteroid exposure in this population remains limited.</p><p><strong>Objective: </strong>To investigate the association between oral corticosteroid exposure and systemic adverse events in patients with chronic rhinosinusitis with nasal polyps.</p><p><strong>Design, setting, and participants: </strong>A retrospective, nationwide, nested case-control study included adult patients (≥20 years) with incident chronic rhinosinusitis with nasal polyps, excluding those with prior immune-mediated diseases or outcome diagnoses, using the Korean Health Insurance Review and Assessment Service database (2010-2023). Data analysis was conducted from March 2025 to April 2026. Patients who developed adverse events (case patients) were matched 1:10 with controls by age, sex, and diagnosis date.</p><p><strong>Exposures: </strong>Oral corticosteroid exposure was quantified using 3 metrics: exposure intensity (annual duration: low [≤30 days], moderate [31-90 days], or high [>90 days]), cumulative dose (<0.5 g, 0.5-1.0 g, or ≥1.0 g prednisolone-equivalents per year), and prescription frequency.</p><p><strong>Main outcomes and measures: </strong>First occurrence of systemic adverse events. Adjusted odds ratios and 95% CIs were estimated using multivariable conditional logistic regression.</p><p><strong>Results: </strong>A total of 165 361 patients with chronic rhinosinusitis with nasal polyps who were prescribed at least 1 oral corticosteroid were identified. The matched cohort included 523 316 patients (51 647 case patients and 472 369 controls; mean [SD] midpoint approximated age, 47.1 [13.9] years; 39.7% women). High exposure intensity (>90 days per year) was associated with a significantly increased risk of avascular bone necrosis, osteoporosis, and pneumonia. A cumulative dose greater than 1.0 g per year was associated with a 23% higher overall adverse event risk (adjusted odds ratio, 1.23; 95% CI, 1.11-1.36) and increased risks of avascular bone necrosis, pneumonia, dyslipidemia, heart failure, hypertension, and type 2 diabetes. Prescription frequency was not independently associated with adverse event risk.</p><p><strong>Conclusions and relevance: </strong>In this nested case-control study within a nationwide cohort of patients with chronic rhinosinusitis with nasal polyps, higher oral corticosteroid exposure, in terms of annual duration and cumulative dose, was associated with an increased risk of systemic adverse events, particularly musculoskeletal and infection-related complications. These findings underscore the need for steroid-sparing treatment strategies for long-term management of chronic rhinosinusitis with nasal polyps.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"735-743"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13237707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error in Figure.","authors":"","doi":"10.1001/jamaoto.2026.1245","DOIUrl":"10.1001/jamaoto.2026.1245","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"729"},"PeriodicalIF":7.0,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13177187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147941377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}