JAMA otolaryngology-- head & neck surgery最新文献

{"title":"A Proposal for HPV-Associated Oropharyngeal Carcinoma in the Ninth Edition Clinical TNM Classification.","authors":"Shao Hui Huang, Jie Su, Shlomo A Koyfman, David Routman, Frank Hoebers, Houda Bahig, Eugene Yu, Eric Bartlett, Anna Spreafico, Jonathan Lee, Sarah Stock, Robin Davis, Neil M Woody, Kristoff Nelson, Danny Lavigne, Phuc Felix Nguyen-Tan, Laurent Létourneau-Guillon, Edith Filion, Alex A Nagelschneider, Daniel Ma, Kathryn M Van Abel, Alida A Postma, Walter M Palm, Ann Hoeben, William Lydiatt, Snehal G Patel, Melvin L K Chua, Wei Xu, Brian O'Sullivan","doi":"10.1001/jamaoto.2025.0848","DOIUrl":"10.1001/jamaoto.2025.0848","url":null,"abstract":"<p><strong>Importance: </strong>A subset of Union for International Cancer Control (UICC)/American Joint Committee on Cancer (AJCC) eighth edition TNM stage I and II human papillomavirus-positive oropharyngeal carcinoma has undesirable outcomes, which might have contributed to a lack of success in phase III deintensification trials. Refining clinical stage groups, especially in the overabundant cN1/stage I group, has become important for treatment selection.</p><p><strong>Objective: </strong>To assess the prognostic importance of pretreatment lymph node (LN) characteristics to optimize case distribution and outcome homogeneity within the N classification system.</p><p><strong>Design, setting, and participants: </strong>This is an international multi-institutional retrospective prognostic cohort study. Analysis of human papillomavirus-positive oropharyngeal carcinoma treated curatively from 4 institutions (International Collaboration of Oropharyngeal Cancer Network for N-Classification [ICON-N] dataset) provided a refined clinical staging proposal; an independent dataset (Centre Hospitalier de l'Université de Montréal [CHUM] dataset) validated the proposal. Neuroradiologists reviewed pretreatment computed tomography and/or magnetic resonance imaging for nodal features, including presence or absence of abnormal LN(s), retropharyngeal LN, laterality, number of abnormal LN, and imaging-detected extranodal extension (iENE). Data were collected from February to May 2023, and data were analyzed from June to July 2023.</p><p><strong>Exposures: </strong>Definitive chemoradiotherapy/radiotherapy or definitive surgery with or without postoperative chemoradiotherapy/radiotherapy.</p><p><strong>Main outcomes and measures: </strong>The primary end point was overall survival. A Cox proportional hazards multivariable model was used to estimate adjusted hazard ratios (AHRs) and to derive an optimal clinical TNM stage classification (AHR-stage schema) incorporating the strongest prognostic nodal features within the UICC/AJCC eighth edition TNM framework after confirming the prognostication of iENE status. The performance (according to overall normalized scores and ranking) of the AHR-stage schema against the current UICC/AJCC eighth edition TNM staging system was evaluated for hazard consistency, hazard discrimination, prognostic importance, and sample size balance. Validation was performed in the CHUM dataset.</p><p><strong>Results: </strong>The ICON-N dataset comprised 2053 patients, including 1898 (92.5%) with cN-positive disease and 155 (7.5%) with cN0 disease; a total of 298 (14.5%) were female, and the mean (SD) age was 60.6 (9.3) years. iENE-positive disease was identified in 710 of 1898 patients with cN-positive disease (37.4%). The median (range) follow-up was 5.1 (0.1-14.7) years. iENE was the strongest prognostic nodal feature in multivariable analysis; the AHR for iENE-positive vs iENE-positive disease was 2.43 (95% CI, 1.96-3.03) in the ICON-N dataset","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"655-664"},"PeriodicalIF":5.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017952","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":"Myocardial Injury After Major Head and Neck Surgery.","authors":"Phillip Staibano, Amit X Garg, Matthew T V Chan, Carisi A Polanczyk, Gareth L Ackland, S Danielle MacNeil, Ashaka Patel, Michael Xie, Han Zhang, Michael Au, Mohit Bhandari, Sameer Parpia, Jason W Busse, Diane M Heels-Ansdell, Benjamin van der Woerd, Michael K Gupta, David L Choi, Egehan Salepci, J E Young, P J Devereaux","doi":"10.1001/jamaoto.2025.0656","DOIUrl":"10.1001/jamaoto.2025.0656","url":null,"abstract":"<p><strong>Importance: </strong>Myocardial injury after noncardiac surgery (MINS) is associated with increased perioperative mortality; however, the incidence and prognostic impact of MINS after major head and neck surgery remains uncertain.</p><p><strong>Objective: </strong>To determine the incidence and clinical implications of MINS in patients after major head and neck surgery.</p><p><strong>Design, setting, and participants: </strong>This cohort study used data from the VISION (Vascular Events in Noncardiac Surgery Patients Cohort Evaluation; 2017) study, an international prospective cohort study that analyzed more than 35 000 patients who had noncardiac surgery. Of those, 648 patients (1.8%) underwent major head and neck surgery requiring at least 1-day hospital admission and screening for MINS via troponin T (TnT) concentrations measured during the first 3 postoperative days. MINS was defined as a high-sensitivity TnT (hsTnT) of 20 to 64 ng/L and absolute change more than 5 ng/L or hsTnT 65 ng/L or greater (ie, fifth-generation assay) and cardiac ischemia. When using fourth-generation assay, MINS was defined as non-hsTNT 0.04 ng/mL or greater and cardiac ischemia. Data analyses were performed from October to December 2024.</p><p><strong>Main outcomes and measures: </strong>MINS incidence and its association with 30-day mortality. All clinical outcomes were analyzed using Cox regression models and length of hospital stay (LOHS) was analyzed using multivariable linear regression.</p><p><strong>Results: </strong>Among 648 patients (265 [40.9%] female and 383 [59.1%] male; 376 [58.0%] aged 45 to 64 years), the incidence of MINS after major head and neck surgery was 11.9% (95% CI, 9.39%-14.4%), rising to 23.8% (95% CI, 15.7%-32%) among those aged 75 years or older. MINS occurred more often in patients with medical comorbidities. The proportion of MINS that would have gone undetected without TnT monitoring was 68.8% (95% CI, 57.3%-78.9%). In this cohort, 30-day and 1-year mortality were 1.9% (95% CI, 0.8%-2.9%) and 13.1% (95% CI, 10.5%-15.7%), respectively. MINS was associated with increased 30-day mortality (hazard ratio, 5.51; 95% CI, 1.75-17.36) and prolonged LOHS in patients with MINS with at least 1 ischemic feature (adjusted β, 3.15 days; 95% CI, 1.47-6.76 days).</p><p><strong>Conclusions and relevance: </strong>This cohort study found that myocardial injury was common among patients undergoing major head and neck surgery, especially those aged 75 years or older and those with comorbidities. Nearly 70% of MINS cases go undetected without TnT monitoring, and MINS may contribute to worse 30-day postoperative mortality and prolonged LOHS. Further prospective validation is needed to evaluate the role of MINS screening in improving clinical outcomes after major head and neck surgery.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"647-654"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12022864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996937","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":"Potential Disadvantages of the Modified Miami Criteria-Reply.","authors":"Phillip Staibano, Michael Au, Jesse D Pasternak","doi":"10.1001/jamaoto.2025.0917","DOIUrl":"10.1001/jamaoto.2025.0917","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"733-734"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119781","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":"Tympanoplasty With Eustachian Tube Balloon Dilation for Chronic Inflammatory Middle Ear Disease: A Randomized Clinical Trial.","authors":"Alexandra Gey, Clemens Honeder, Julia Reiber, Robert Honigmann, Jonas Zirkler, Andreas Wienke, Torsten Rahne, Stefan K Plontke","doi":"10.1001/jamaoto.2025.0904","DOIUrl":"10.1001/jamaoto.2025.0904","url":null,"abstract":"<p><strong>Importance: </strong>Eustachian tube balloon dilation (ETBD) is increasingly used to treat Eustachian tube (ET) dysfunction, but its benefit in patients requiring tympanoplasty for chronic inflammatory middle ear disease is unclear.</p><p><strong>Objective: </strong>To evaluate the efficacy of additional ETBD on the Eustachian Tube Score (ETS), hearing outcomes, and subjective ET function in patients with obstructive ET dysfunction undergoing tympanoplasty.</p><p><strong>Design, setting, and participants: </strong>This parallel-group, single-blind, monocentric, randomized clinical trial included patients with chronic inflammatory middle ear disease and ET dysfunction seen at a tertiary referral center and scheduled for tympanoplasty between January 2015 and November 2019. Data were analyzed between June 2022 and December 2023.</p><p><strong>Intervention: </strong>Patients were randomized to tympanoplasty only or an additional ETBD of the affected side.</p><p><strong>Main outcomes and measures: </strong>The main outcome was the change in ETS, and secondary outcome measures were change in the air-bone gap (ABG) and Eustachian Tube Dysfunction Questionnaire (ETDQ-7) scores.</p><p><strong>Results: </strong>From 76 randomized participants, 68 were included in the intention-to-treat analysis. Of the 34 patients in the tympanoplasty group, 20 participants (59%) were female, and the mean (SD) age was 53.4 (12.5) years. Of the 34 patients in the tympanoplasty plus ETBD group, 13 participants (38%) were female, and the mean (SD) age was 51.4 (14.5) years. During the first 12 months after the procedure, the difference in mean ETS changes between the tympanoplasty (1.62 [95% CI, 0.66-2.59]) and the tympanoplasty plus ETBD group (1.41 [95% CI, 0.43-2.39]) was 0.21 (95% CI, -1.17 to 1.59). These results rule out the possibility of a clinically meaningful difference of 3 points or more in ETS. Twelve months after the procedure, ABG improved from 26.1 dB to 19.0 dB hearing loss in the tympanoplasty group and from 30.1 dB to 20.1 dB hearing loss in the tympanoplasty plus ETBD group. The difference in ABG changes between the groups was -2.8 dB (95% CI, -9.1 dB to 3.5 dB), and the difference in mean ETDQ-7 changes was -0.2 (95% CI, -3.4 to 3.1).</p><p><strong>Conclusions and relevance: </strong>In this randomized clinical trial, the addition of ETBD to tympanoplasty in patients with chronic inflammatory middle ear disease and ET dysfunction did not improve the outcome regarding ETS, ABG, or subjective long-term ET function. ETBD should, therefore, not be routinely performed as an add-on procedure to tympanoplasty for this indication. Larger multicentric randomized trials could provide more insights into the efficacy of ETBD in patients with chronic inflammatory middle ear disease undergoing tympanoplasty and would allow for specific subgroup analyses.</p><p><strong>Trial registration: </strong>German Clinical Trials Register Identifier: DRKS00031807.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"675-683"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078102","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":"The Challenge and Promise of Circulating Tumor HPV DNA for Minimal Residual Disease Detection-Catching the Unseen.","authors":"Nancy Y Lee, Glenn J Hanna, Daniel L Faden","doi":"10.1001/jamaoto.2025.0923","DOIUrl":"10.1001/jamaoto.2025.0923","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"672-674"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119782","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":"Association Between Acid Reflux Medication and Supraglottoplasty in Infant Laryngomalacia.","authors":"Habib Zalzal, Alisha Pershad, Hengameh Behzadpour, Md Sohel Rana, George Zalzal","doi":"10.1001/jamaoto.2025.1201","DOIUrl":"10.1001/jamaoto.2025.1201","url":null,"abstract":"<p><strong>Importance: </strong>Acid suppression therapy is frequently administered to infants with laryngomalacia presenting with stridor despite limited evidence in the literature reporting its efficacy for this subset of patients.</p><p><strong>Objective: </strong>To evaluate the frequency of supraglottoplasty in infants with nonsevere laryngomalacia treated with gastroesophageal reflux disease (GERD) medications.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included infants younger than 6 months with a clinical diagnosis of nonsevere laryngomalacia initially managed with either watchful waiting or GERD medications. Patients were recruited from 2014 to 2023 to a pediatric otolaryngology airway clinic at a tertiary care pediatric hospital.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was the frequency of supraglottoplasty following nonsurgical management. Patients with nonsevere laryngomalacia were divided into 2 groups based on whether their laryngomalacia was managed with GERD medication therapy or observation alone. The aim was to assess the difference in supraglottoplasty rates between these 2 groups.</p><p><strong>Results: </strong>The medical records of 395 infants younger than 6 months (171 female, 224 male) with nonsevere laryngomalacia managed with observation after their initial otolaryngology evaluation were analyzed: observation (n = 320) and trial of GERD medications (n = 75). Baseline characteristics between the observation and GERD medication groups were similar. The overall supraglottoplasty rate was 4.1% (16/395), with a small increase in the use of surgical treatment between the observation and GERD medication cohorts (3.4% vs 6.7%; difference, -3.2% [95% CI, -10% to 3.6%]). The imprecision in the estimate prevents making a definitive conclusion regarding the observed difference.</p><p><strong>Conclusions: </strong>This study found that rates of supraglottoplasty in infants with nonsevere laryngomalacia with GERD managed with GERD medications were similar to those without reflux managed with watchful waiting. Female sex and severity of laryngomalacia based on endoscopic examination were the best predictors of receipt of supraglottoplasty after a period of watchful waiting.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"693-698"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173773","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":"Novel 3D Head-Mounted Display For Microsurgery Combined With an Exoscope Device.","authors":"Yuichi Ichikawa, Miho Tobita, Tomoyuki Ito, Shinichi Oba, Fumihiko Matsumoto, Anand Ramakrishnan, Hiroshi Mizuno","doi":"10.1001/jamaoto.2025.1128","DOIUrl":"10.1001/jamaoto.2025.1128","url":null,"abstract":"<p><strong>Importance: </strong>Three-dimensional (3D) monitor-assisted microsurgery, using images from an exoscope or digital microscope, offers ergonomic advantages for surgeons and facilitates educational collaboration. However, challenges remain with the placement of monitors and assistant positioning.</p><p><strong>Objective: </strong>To evaluate the usability of a new head-mounted 3D display, the 3D View Vision, combined with the existing exoscope device, ORBEYE, for improved ergonomic positioning for surgeons and compatible visualization in microsurgical procedures.</p><p><strong>Design, setting, and participants: </strong>A prospective observational study was conducted involving patients undergoing head and neck reconstruction requiring microvascular anastomosis at a single surgical center. The head-mounted 3D display was used in combination with the exoscope device during the procedures. This researcH was conducted from April 2023 to November 2023.</p><p><strong>Intervention: </strong>The surgeon and assistant used the head-mounted 3D display for 3D visualization of the surgical field without the need for both 3D monitor and conventional optical microscope.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was successful completion of microvascular anastomosis with with comparable time, adequate visualization, and subjective ergonomic improvement. Secondary outcomes included intraoperative complications and teamwork efficiency.</p><p><strong>Results: </strong>The patient mean (SD) age was 59.8 (9.1) years and all were male individuals. Microvascular anastomosis was successfully completed in all 5 patients. The use of the head-mounted 3D display allowed both the surgeon and assistant to position themselves ergonomically, facing each other directly, without concern of the positioning of monitors. End-to-end anastomosis for artery and end-to-side anastomosis for vein was conducted with a mean (SD) time of 23.0 (3.1) and 24.6 (6.9) minutes for each vessel type. Intraoperative reanastomosis was required in 1 patient due to arterial issues, but no other complications were reported.</p><p><strong>Conclusions and relevance: </strong>This study found that the integration of the head-mounted 3D display with the exoscope device subjectively improved ergonomics for the surgeon and better visualization compared with using a 3D monitor and exoscope. By eliminating the need for monitor positioning, this technology also declutters the theater workspace.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"710-713"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12123528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144173787","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":"Presbycusis and Age-Related Hearing Loss are Really Sociocusis and Noise-Induced Hearing Loss in Elderly Individuals.","authors":"Daniel Fink","doi":"10.1001/jamaoto.2025.0784","DOIUrl":"10.1001/jamaoto.2025.0784","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"731"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025013","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":"Hearing Aid Service Models, Technology, and Patient Outcomes: A Randomized Clinical Trial.","authors":"Yu-Hsiang Wu, Elizabeth Stangl, Kjersten Branscome, Jacob Oleson, Todd Ricketts","doi":"10.1001/jamaoto.2025.1008","DOIUrl":"10.1001/jamaoto.2025.1008","url":null,"abstract":"<p><strong>Importance: </strong>The poor affordability of hearing aids (HAs) limits their adoption. To justify higher costs, HAs fitted by audiologists (AUD service model) and high-end HAs should deliver better outcomes than over-the-counter (OTC) service models and low-end HAs.</p><p><strong>Objective: </strong>To determine the effect of HA service models (AUD, OTC, and a hybrid OTC+ model) and technology levels (high end and low end) on patient outcomes.</p><p><strong>Design, setting, and participants: </strong>This randomized clinical trial was conducted at the University of Iowa and Vanderbilt University Medical Center in research laboratories from February 2019 to December 2023 and included adults older than 55 years with mild to moderate hearing loss and no previous HA experience who were randomly assigned to 1 of 6 parallel groups, representing factorial combinations of 3 service models and 2 technology levels. The data were analyzed between January 2024 and March 2024.</p><p><strong>Interventions: </strong>The trial included 3 service models: AUD, in which audiologists fitted prescription HAs following best practices; OTC+, in which audiologists provided limited services for OTC HAs; and OTC, in which participants independently used OTC HAs. OTC HAs were simulated using prescription HAs. Two models of prescription HAs were used throughout the trial: a high-end HA with advanced features and a low-end HA.</p><p><strong>Main outcomes and measures: </strong>The primary outcome measure was the Glasgow Hearing Aid Benefit Profile (GHABP), which was administered using ecological momentary assessment (EMA). EMA-GHABP was conducted preintervention and throughout the seventh week postintervention.</p><p><strong>Results: </strong>A total of 245 participants completed the study (121 women [49.4%]; mean [SD] age, 67.7 [8.1] years). After controlling for preintervention scores, the postintervention EMA-GHABP global score (ranging from 1 to 5) for AUD was significantly higher (indicating better outcomes) than for OTC+ and OTC by 0.33 points (95% CI, 0.14-0.52) and 0.32 points (95% CI, 0.13-0.51), respectively. The difference between OTC+ and OTC was not significant (0.02 points, 95% CI, -0.21 to 0.18). Nevertheless, EMA-GHABP global scores for OTC+ and OTC were close to 4 points, indicating positive outcomes. The effect of technology level and interaction between service model and technology level were not significant.</p><p><strong>Conclusions and relevance: </strong>The trial results suggest that while OTC+ and OTC were effective, they did not achieve the same outcomes as AUD. As high-end and low-end HAs yielded similar outcomes, support for the higher cost of high-end HAs was not identified for individuals with mild to moderate hearing loss.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT03579563.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"684-692"},"PeriodicalIF":5.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12082484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078084","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":"Potential Disadvantages of the Modified Miami Criteria.","authors":"Michael C Singer, David J Terris","doi":"10.1001/jamaoto.2025.0920","DOIUrl":"10.1001/jamaoto.2025.0920","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"733"},"PeriodicalIF":6.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119780","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}