JAMA otolaryngology-- head & neck surgery最新文献_第2页

Concerns Regarding Mouth Closure and Airflow in Obstructive Sleep Apnea-Reply.

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.5076

Daniel Vena, Hyung Chae Yang, Scott A Sands

引用次数: 0

Return to Work Up to 5 Years After the End of Treatment Among Patients With Head and Neck Cancer.

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.4991

Femke Jansen, Simone E J Eerenstein, Sara Arman, Birgit I Lissenberg-Witte, Jose A Hardillo, Robert P Takes, Ruud H Brakenhoff, Remco de Bree, Femke Lamers, Johannes A Langendijk, C René Leemans, Irma M Verdonck-de Leeuw

{"title":"Return to Work Up to 5 Years After the End of Treatment Among Patients With Head and Neck Cancer.","authors":"Femke Jansen, Simone E J Eerenstein, Sara Arman, Birgit I Lissenberg-Witte, Jose A Hardillo, Robert P Takes, Ruud H Brakenhoff, Remco de Bree, Femke Lamers, Johannes A Langendijk, C René Leemans, Irma M Verdonck-de Leeuw","doi":"10.1001/jamaoto.2024.4991","DOIUrl":"10.1001/jamaoto.2024.4991","url":null,"abstract":"Importance: Adverse effects of cancer and its treatment may hamper return to work (RTW) among patients with head and neck cancer (HNC).Objectives: To investigate RTW among patients with HNC from end of treatment to 5 years after treatment and associations of RTW with sociodemographic, clinical, work-related, personal, lifestyle, physical, and psychological factors and cancer-related symptoms.Design, setting and participants: This prospective, longitudinal, multicenter cohort study of patients with HNC used data from the Netherlands Quality of Life and Biomedical cohort. This study focused on patients younger than 65 years (with a subanalysis of patients younger than 60 years) from time of cancer diagnosis (March 2014 to June 2018) to 5 years after end of treatment (January 2019 to July 2023). Data analysis occurred from April 2023 to August 2024.Exposure: Standard clinical care.Main outcomes and measures: Work status was measured at 3 and 6 months, and 1, 2, 3, 4, and 5 years after treatment using an adjusted version of the Productivity Cost Questionnaire. Cox regression analyses were performed to investigate factors (baseline, 3 months, and 6 months) associated with time to RTW.Results: A total of 184 patients with HNC younger than 65 years (mean [SD] age, 55.4 [7.0] years; 146 men [79%]) were included and 77 (42%) had oropharyngeal cancer. RTW increased from 26% (42 of 160 individuals) at 3 months to 65% (89 of 137 individuals) at 1 year, after which it reduced to 52% (51 of 98 individuals) at 5 years. At 5 years after treatment, an additional 28 of 98 participants (29%) were retired. Minor surgery (vs major surgery) was associated with faster RTW from end of treatment onwards (hazard ratio [HR], 2.73; 95% CI, 1.17-6.37). Older age (HR, 0.97; 95% CI, 0.94-0.999) and more fatigue at 3 months (HR, 0.99; 95% CI, 0.98-0.995) were associated with slower RTW from 3 months onwards. Older age was also associated with slower RTW from 6 months onwards (HR, 0.96; 95% CI, 0.93-0.998). Among the 127 patients with HNC younger than 60 years, RTW was 72% (47 individuals) at 5 years after treatment. Advanced tumor stage (HR, 0.59; 95% CI, 0.39-0.90) and more fatigue (HR, 0.99; 95% CI, 0.98-0.999) were associated with slower RTW in this group.Conclusion and relevance: This cohort study found that the majority of patients with HNC in the Netherlands returned to work within 1 year and that certain sociodemographic and clinical factors and cancer-related symptoms were associated with time to RTW. These results may inform patients with HNC and provide insight into potential targets, such as fatigue, to improve RTW.","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255683","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}

引用次数: 0

JAMA Otolaryngology-Head & Neck Surgery.

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.3429

引用次数: 0

Frequency-to-Place Mismatch and Cochlear Implant Outcomes by Electrode Type. 频率-位置不匹配与电极类型的人工耳蜗植入结果。

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4158

Andrea DeFreese, Katelyn Berg, Jack Noble, Benoit Dawant, Jourdan Holder, Susan Amberg, Christine Brown, Emily Burg, Nichole Dwyer, Allyson Sisler-Dinwiddie, Tayler Sparrow, Linsey Sunderhaus, Stephanie Yaras, Marc Bennett, Taha Jan, Aaron Moberly, Matthew O'Malley, Ankita Patro, Elizabeth Perkins, Kareem Tawfik, David Haynes, René Gifford

{"title":"Frequency-to-Place Mismatch and Cochlear Implant Outcomes by Electrode Type.","authors":"Andrea DeFreese, Katelyn Berg, Jack Noble, Benoit Dawant, Jourdan Holder, Susan Amberg, Christine Brown, Emily Burg, Nichole Dwyer, Allyson Sisler-Dinwiddie, Tayler Sparrow, Linsey Sunderhaus, Stephanie Yaras, Marc Bennett, Taha Jan, Aaron Moberly, Matthew O'Malley, Ankita Patro, Elizabeth Perkins, Kareem Tawfik, David Haynes, René Gifford","doi":"10.1001/jamaoto.2024.4158","DOIUrl":"10.1001/jamaoto.2024.4158","url":null,"abstract":"Importance: Speech recognition outcomes with a cochlear implant (CI) are highly variable. One factor suggested to correlate with CI-aided speech recognition is frequency-to-place mismatch, or the discrepancy between the natural tonotopic organization of the cochlea and the electric frequency allocation of the CI electrodes within the patient's cochlea.Objective: To evaluate the association between frequency-to-place mismatch and speech recognition outcomes in a large cohort of postlingually deafened adult CI users, while controlling for various clinical factors known to be associated with those outcomes.Design, setting, and participants: This retrospective cohort study used data from a CI program at a tertiary medical center and included CIs from postlingually deafened adult CI users. After excluding patients whose data were not logged, patients with implantations occurring between 2016 and 2023 were included in the analysis. The data were extracted in November 2023.Main outcomes and measures: Results of the Consonant-Nucleus-Consonant (CNC) monosyllabic word recognition test measured in the CI-aided alone condition 1 month, 3 months, 6 months, and 12 months after activation served as the main outcome. The independent variables included frequency-to-place mismatch, electrode array type, mean modiolar distance, electrode position, age at implantation, biological sex, contralateral hearing abilities, time since CI activation (test interval), and daily device use.Results: In 498 CIs from 447 postlingually deafened adults (mean [SD] age, 63.1 [17.1] years; 271 [54.4%] CIs with male users), frequency-to-place mismatch was negatively correlated with CI-aided speech recognition outcomes, but the association was only significant for precurved electrode arrays and not straight electrode arrays. In the linear mixed effects model for straight electrode arrays, only test interval (β = 1.14 [95% CI, 0.90-1.38]) and daily device use (β = 0.90 [95% CI, 0.42-1.38]) were correlated with the improvement of word recognition over the first year of device use. In the model for precurved electrode arrays, mismatch at 1500 Hz (β = -0.011 [95% CI, -0.011 to -0.006]), scalar location (β = 16.37 [95% CI, 9.01 to 23.74]), test interval (β = 1.18 [95% CI, 1.18-1.41]) and daily device use (β = 1.65 [95% CI, 1.15-2.14]) all were significantly associated with the improvement of word recognition over the first year of device use.Conclusions and relevance: In this cohort study of postlingually deafened adult CI users, including both straight and precurved electrode arrays, daily device use and time since CI activation were found to be significantly associated with improved CI-aided speech recognition outcomes. Frequency-to-place mismatch at 1500 Hz and scalar location were associated with word recognition only for precurved arrays. These fin","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"135-142"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813140","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}

引用次数: 0

Oropharyngeal Necrotizing Fasciitis in a Previously Healthy Patient. 一名健康患者的口咽坏死性筋膜炎

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.3987

Oleksandr Butskiy, Gina Trinh

引用次数: 0

Musicality as a Health-Relevant Factor for Hearing Outcomes. 音乐性是听力结果的健康相关因素。

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4157

Srishti Nayak, Aaron C Moberly, Terrin N Tamati

引用次数: 0

A Large Sinonasal Mass in a Male Patient. 一名男性患者的巨大鼻窦肿块

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4005

Sei Y Chung, Parker Lawson, Anne C McLean

引用次数: 0

Patient and Caregiver Experience of Diagnosis, Treatment, and Living With Recurrent Oropharyngeal Cancer. 复发性口咽癌患者和护理者的诊断、治疗和生活经验。

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.3757

Grainne Brady, Justin Roe, Vinidh Paleri, Pernilla Lagergren, Mary Wells

{"title":"Patient and Caregiver Experience of Diagnosis, Treatment, and Living With Recurrent Oropharyngeal Cancer.","authors":"Grainne Brady, Justin Roe, Vinidh Paleri, Pernilla Lagergren, Mary Wells","doi":"10.1001/jamaoto.2024.3757","DOIUrl":"10.1001/jamaoto.2024.3757","url":null,"abstract":"Importance: The management of recurrent oropharyngeal cancer (rOPC) is complex. Curative options carry considerable risk of morbidity with overall poor prognosis. Little data exist on function and quality of life (QoL) outcomes for noncurative treatments. Even less is known about patient and carer experiences of function and QoL change over time when undergoing curative or noncurative treatment(s) for rOPC.Objective: To investigate the patient and caregiver experience of diagnosis, treatment, and living with recurrent oropharyngeal cancer and changes to function/QoL.Design, setting, and participants: A longitudinal prospective and retrospective qualitative study was carried out at a specialist cancer center in the United Kingdom. Participants with a biopsy proven diagnosis of recurrent OPC and their caregivers were included. Participants were recruited between December 2022 and November 2023. Concurrent data analysis took took place between November 2023 and January 2024.Exposure: Curative salvage surgery or noncurative immunotherapy, chemotherapy, or clinical trials of investigational agents.Main outcomes: A framework-approach thematic analysis of semistructured, in-depth interviews.Results: Twenty-two patients and 7 caregivers were recruited. Demographic data was collected via medical record review. The longitudinal sample included 8 male and 2 female individuals, and the median age was 62 (range, 47-77) years. The retrospective sample included 11 male individuals and 1 female individual, and the median age was 64 (range, 59-70) years. Eleven participants (50%) underwent curative treatment, and 11 (50%) noncurative treatment.Treatments included salvage surgery, immunotherapy, chemotherapy, or clinical trials. Patients and their caregivers contextualize their experience of recurrent disease in their past experience of primary disease diagnosis and treatment. Patients want to survive and when the options to choose between are cure or functional outcomes impacting health-related QoL, cure appears to be favored. However, when cure is not an option, patients appear to want to survive as long as possible. However, as the prognosis gets shorter there appears to be a shift in priorities where function/QoL take precedence over survival.Conclusions and relevance: This qualitative study found that treatment decision-making is extremely complex in the setting of rOPC. Quite often, decisions are made based on what is perceived by health care professionals to be functionally \"too morbid\" with salvage surgery, or \"kinder\" with life-prolonging noncurative treatments. However, patients are not always fully involved in these decisions and so shared decision-making does not always happen. To facilitate shared decision-making and informed consent, patients need to be given clear and accurate information","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"97-104"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681992","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}

引用次数: 0

Patient-Reported Distress in Individuals With Head and Neck Cancer. 头颈癌患者报告的痛苦。

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4357

Melissa C White, Cheyenne Corbett, Trinitia Y Cannon, Tammara L Watts, Rong Jiang, Nosayaba Osazuwa-Peters

{"title":"Patient-Reported Distress in Individuals With Head and Neck Cancer.","authors":"Melissa C White, Cheyenne Corbett, Trinitia Y Cannon, Tammara L Watts, Rong Jiang, Nosayaba Osazuwa-Peters","doi":"10.1001/jamaoto.2024.4357","DOIUrl":"10.1001/jamaoto.2024.4357","url":null,"abstract":"Importance: Distress is common among patients with cancer, and evidence of disparities associated with distress has been mixed. Head and neck cancer (HNC) is one of the most emotionally distressing cancers and is also a highly disparate disease. However, it is unknown whether there are disparities associated with patient-reported distress in HNC.Objective: To examine racial and sociodemographic factors associated with clinically meaningful distress in a cohort of patients with HNC.Design, setting, and participants: This retrospective cohort study analyzed data from a single tertiary institution at a National Cancer Institute-designated comprehensive cancer center in the Southeastern US. Participants included adult patients from January 2017 to December 2022 with confirmed diagnoses of head and neck squamous cell carcinoma who received radiation therapy up to 5 weeks from initial diagnosis.Main outcomes and measures: The outcome of interest was clinically meaningful distress (score of at least 4 on the distress thermometer). The distress thermometer is a single-item, self-reported tool used to measure a person's level of psychological distress over the past week, represented on a scale from 0 (no distress) to 10 (extreme distress). Patients were included in the study if they had visits with clinicians in the radiation oncology department within 5 weeks of diagnosis. Sociodemographic factors were race and ethnicity, age, sex, marital status, and health insurance status. Clinical variables (stage of presentation, anatomical subsites, smoking, and alcohol history) and problem list domain items were included in the adjusted model. Using multivariable logistic regression analysis, odds of meaningful distress by sociodemographic factors were estimated, adjusting for clinical factors and problem list domains.Results: A total of 507 patients met the inclusion criteria. The study population included 389 male patients (76.7%). The median (IQR) age of participants was 63 (56-71) years, with a racial distribution of 89 Black patients (17.6%), 385 White patients (75.9%), and 33 patients of other categories (6.9%), including Asian, Native American, multiracial, declined to respond, and unknown. Overall, 232 patients (45.8%) had meaningful distress. The median (IQR) DT score for the entire cohort was 3 (0-6). Black patients had the highest rate of physical concerns (n = 31 [34.8%]) compared to the other racial groups (78 White patients [20.3%] and 7 persons of other race [21.2%]). However, in the final multivariable model, race was not significantly associated with clinically meaningful distress (Black compared with White: adjusted odds ratio [aOR], 0.76 [95% CI, 0.45-1.28]; other compared with White: aOR, 0.85 [95% CI, 0.37-1.94]). Compared to those married, unmarried patients were significantly more likely to report distress (aOR, 1.61 [95% CI, 1","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"160-169"},"PeriodicalIF":6.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854225","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}

引用次数: 0

Firm Gingival Enlargement in the Anterior Maxilla. 上颌前部坚固的牙龈增生

IF 6 1区医学

JAMA otolaryngology-- head & neck surgery Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4012

Michael Schiappa, Molly Housley Smith, Nicholas F Callahan

引用次数: 0