JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Caution in Interpretation of Population Attributable Fractions-Reply.","authors":"Jason R Smith, Nicholas S Reed, Jennifer A Deal","doi":"10.1001/jamaoto.2025.2474","DOIUrl":"10.1001/jamaoto.2025.2474","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1010-1011"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954648","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":"In Defense of Palpation.","authors":"Edward D McCoul","doi":"10.1001/jamaoto.2025.2433","DOIUrl":"10.1001/jamaoto.2025.2433","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"911-912"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954604","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":"Socioeconomic Status, Voice Disorder Risk, and Voice-Related Handicap Across Childhood.","authors":"Robert Brinton Fujiki, Susan L Thibeault","doi":"10.1001/jamaoto.2025.2633","DOIUrl":"10.1001/jamaoto.2025.2633","url":null,"abstract":"<p><strong>Importance: </strong>Both voice disorders and socioeconomic deprivation can limit quality of life in pediatric populations. However, the association between socioeconomic status (SES), voice disorder prevalence, and voice-related handicap in children and adolescents has not been well understood.</p><p><strong>Objective: </strong>To examine the association between SES and voice disorder prevalence across childhood, as well as the association between SES and voice-related handicap.</p><p><strong>Design, setting, and participants: </strong>In this cross-sectional study, a sample of adolescents (age 13 to 17 years) and caregivers acting as proxies for school-aged children (age 4 to 12 years) were recruited from across the US and surveyed regarding vocal health between March and June 2023. Voice disorder prevalence was compared across SES proxies collected from caregivers, including annual household income, parent educational level, race and ethnicity, and residence information. Adolescents completed the Voice Handicap Index (VHI) and caregiver proxies completed the Pediatric Voice Handicap Index (P-VHI) on behalf of their school-aged children. Voice-related handicap was compared across participants with and without voice disorders as well as across SES proxies.</p><p><strong>Main outcomes and measures: </strong>Adolescents were surveyed regarding voice status, voice-related handicap, and proxies of SES.</p><p><strong>Results: </strong>Of 1656 children and adolescents in this study (mean [SD] age, 10.1 [4.1] years; 845 [51%] children identified as male, 792 [47.8%] female, 11 [0.7%] nonbinary, 5 [0.3%] transgender female, and 3 [0.2%] transgender male), those from homes making less than $30 000 annually were 82% more likely to report a voice disorder than those from homes making more than $100 000 annually (odds ratio, 1.82; 95% CI, 1.24-2.67). Both VHI and P-VHI scores were significantly larger in participants with voice disorders (mean [SD] VHI, 26.1 [22.3], mean [SD] P-VHI, 16.6 [15]) compared with those with healthy voices (mean [SD] VHI, 9.9 [15.1], Cohen d = 0.94; 95% CI, 0.73-1.15; mean [SD] P-VHI, 5.1 [10.1]; Cohen d = 1.06). In adolescents with voice disorders, VHI scores were significantly larger (worse) for those from homes making less than $30 000 (mean [SD], 35.3 [10.4]) compared with adolescents from homes making more than this amount (mean [SD], 23.6 [17.8]; Cohen d = 0.55; 95% CI, 0.34-0.75). For children, P-VHI scores were larger for those living in households making under $60 000 a year (mean [SD], 17.8 [7.5]) compared with children from higher-income homes (mean [SD], 11.3 [5.7]; Cohen d = 1.1; 95% CI, 0.90-1.29).</p><p><strong>Conclusions and relevance: </strong>In this study, children and adolescents from lower-SES homes reported higher voice disorder prevalence and greater voice-related handicap than their peers from higher-income homes. Future research is needed to elucidate the mechanisms underlying these findings an","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"967-975"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992505","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":"Contributing Factors to the Nonpublication of Head and Neck Cancer Clinical Trials.","authors":"Ethan Lewis, Paul Zolkind, Dorina Kallogjeri, Jay F Piccirillo","doi":"10.1001/jamaoto.2025.2549","DOIUrl":"10.1001/jamaoto.2025.2549","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1007-1009"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12395354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954639","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":"A Young Male With Enlarging Facial Swelling.","authors":"Pranjal Rai","doi":"10.1001/jamaoto.2025.2717","DOIUrl":"10.1001/jamaoto.2025.2717","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1005-1006"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144992522","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":"Age-Specific Risk of Second Primary Malignant Neoplasm After Radioactive Iodine Treatment for Differentiated Thyroid Cancer.","authors":"Julia J An, Mark S Choi, Chen Yang, Marita S Teng, Maaike van Gerwen","doi":"10.1001/jamaoto.2025.2626","DOIUrl":"10.1001/jamaoto.2025.2626","url":null,"abstract":"<p><strong>Importance: </strong>Radioactive iodine treatment for differentiated thyroid cancer has been associated with second primary malignant neoplasms, but age-specific risks remain poorly understood.</p><p><strong>Objective: </strong>To evaluate the association of age with increased risk of second primary malignant neoplasm after radioactive iodine treatment for differentiated thyroid cancer (DTC).</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study used data from 8 cancer registries in the US National Cancer Institute's Surveillance, Epidemiology, and End Results Program for 1975 to 2021. Patients who received radioactive iodine treatment for DTC were identified; those with fewer than 2 years of follow-up, missing follow-up data, or distant metastases at diagnosis were excluded. Included patients were categorized into 3 age groups: 15 to 44, 45 to 64, and 65 years or older. Among 5-year survivors, median (IQR) follow-up time was 14.7 (8.6-24.0) years in the 15- to 44-year age group; 8.3 (6.4-11.4) years in the 45- to 64-year group; and 9.3 (6.9-12.7) years in the 65 years or older group. Data were analyzed from May to July 2024.</p><p><strong>Exposure: </strong>Radioactive iodine vs no radioactive iodine.</p><p><strong>Main outcomes and measures: </strong>Relative risks (RR) and 95% CIs for solid and hematologic second primary malignant neoplasms, calculated using multivariable Poisson regression models adjusted for age, sex, and latency.</p><p><strong>Results: </strong>The study sample comprised 72 412 patients with nonmetastatic DTC, of whom 28 432 (39%) were age 15 to 44 years; 34 009 (47%), age 45 to 64 years; and 9971 (14%), 65 years or older. In the 15- to 44-year age group, radioactive iodine was associated with an increased risk of hematologic cancers (RR, 1.35; 95% CI, 1.02-1.80), specifically myeloma (RR, 4.22; 95% CI, 1.68-10.62). In the 45- to 64-year age group, the analyses showed increased risks of prostate cancer (RR, 1.61; 95% CI, 1.10-2.37), salivary gland cancer (RR, 10.22; 95% CI, 1.27-82.24), and nodal non-Hodgkin lymphoma (RR, 2.81; 95% CI, 1.34-5.89). The overall risk of a solid second primary malignant neoplasm was not elevated (RR, 0.94; 95% CI, 0.76-1.16), but hematologic second primary malignant neoplasm risk was elevated (RR, 1.73; 95% CI, 1.14-2.60). Patients in the group that was 65 years and older showed elevated risks of stomach (RR, 4.06; 95% CI, 1.05-15.81), esophagus (RR, 11.42; 95% CI, 1.40-93.3), nonepithelial skin cancers (RR, 10.52; 95% CI, 1.09-88.77), and acute myeloid leukemia (RR, 3.26; 95% CI, 1.15-9.24). The overall risk of a solid second primary malignant neoplasm was elevated (RR, 1.88; 95% CI, 1.59-2.21), whereas risk of hematologic malignant neoplasm was not (RR, 1.35; 95% CI, 0.97-1.87).</p><p><strong>Conclusions and relevance: </strong>This cohort study found that the risk of radioactive iodine-associated second primary malignant neoplasm among patients ","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"947-956"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371544/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954543","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":"Management of Postthyroidectomy Hypocalcemia Using Intraoperative Parathyroid Hormone Monitoring.","authors":"Anna M Reagan, Marina E Robson Chase, Anthony A Mangino, Cortney Y Lee, David A Sloan","doi":"10.1001/jamaoto.2025.2370","DOIUrl":"10.1001/jamaoto.2025.2370","url":null,"abstract":"<p><strong>Importance: </strong>Postthyroidectomy hypoparathyroidism is typically diagnosed with low serum calcium levels, often requiring patients to remain in the hospital for appropriate treatment. Given the short half-life of parathyroid hormone (PTH), can hypoparathyroidism be diagnosed intraoperatively when re-exploration and autotransplant are still possible?</p><p><strong>Objective: </strong>To determine whether intraoperative parathyroid hormone monitoring (ioPTH) permits the stratification of patients into appropriate tiers for postoperative supplementation.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included patients undergoing total or completion thyroidectomy and was conducted at a single academic center from January 2021 and December 2022. Analysis was completed in July 2024. To complete the planned threshold analysis, additional patients who had surgery between January 2020 to December 2020 and January 2023 to June 2023 and were discharged with calcium carbonate and calcitriol supplementation were included. Patients undergoing concomitant parathyroidectomy or lateral neck dissection were excluded.</p><p><strong>Exposures: </strong>All patients had a baseline PTH level drawn in the preoperative area. Additional ioPTH levels were drawn immediately and 10 minutes after thyroid excision. The exposure of interest was the absolute and relative change from baseline to immediate and 10-minute ioPTH.</p><p><strong>Main outcomes and measures: </strong>Outcome groups were determined by supplementation tier. A control group that received no supplementation was compared with the groups that received calcium carbonate only or calcium carbonate plus calcitriol. Logistic regression models were used to analyze the threshold at which ioPTH could predict postoperative supplementation tier.</p><p><strong>Results: </strong>Of the 217 patients included (mean [SD] age, 49.94 [15.56] years; 193 female individuals [89%]; 15 patients [7%] were Black, and 197 patients [91%] were White), 100 (46.1%) received no supplementation, 61 (28.1%) received calcium carbonate, and 56 (25.8%) received calcium carbonate plus calcitriol. Ninety eight (45.2%) experienced temporary hypoparathyroidism, while 2 patients developed permanent hypoparathyroidism. The best model to predict any postoperative supplementation used a 30% decrease from baseline to immediate ioPTH with an overall accuracy rate of 78.20% (sensitivity, 74.78%; specificity, 82.29%). The best model to predict use of calcium carbonate plus calcitriol supplementation corresponded to an immediate ioPTH level of 22 pg/mL, with an overall accuracy rate of 73.91% (sensitivity, 70.00%; specificity, 78.18%).</p><p><strong>Conclusions and relevance: </strong>The results of the threshold analysis demonstrated the utility of ioPTH in guiding postoperative supplementation. ioPTH may also be a useful adjunct in guiding parathyroid autotransplant intraoperatively, potentially","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"923-930"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954646","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":"Error in Results Section.","authors":"","doi":"10.1001/jamaoto.2025.3613","DOIUrl":"10.1001/jamaoto.2025.3613","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":"151 10","pages":"1012"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12511987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251097","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":"Anteroposterior and Lateral Epiglottis-Related Obstruction in Adult Obstructive Sleep Apnea.","authors":"Eric J Kezirian","doi":"10.1001/jamaoto.2025.2051","DOIUrl":"10.1001/jamaoto.2025.2051","url":null,"abstract":"<p><strong>Importance: </strong>Epiglottis-related airway obstruction in obstructive sleep apnea is uniquely identified during drug-induced sleep endoscopy (DISE) and may be associated with poorer treatment outcomes.</p><p><strong>Objective: </strong>To determine whether specific demographic factors, awake physical examination, and DISE findings are associated with anteroposterior and/or lateral configurations of epiglottis-related airway obstruction during DISE.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study including adults with obstructive sleep apnea undergoing DISE with prospective data collection from 2015 to 2025 was performed at 2 academic medical centers. Statistical analyses were performed in November 2024 and May 2025.</p><p><strong>Exposures: </strong>Demographic (age, sex), awake physical examination (body mass index, Modified Mallampati Position, tonsil size, posterior displacement of the epiglottis off the tongue base during awake upright fiberoptic endoscopy), and DISE findings.</p><p><strong>Main outcome and measure: </strong>Presence and degree of anteroposterior or lateral epiglottis-related obstruction in the supine body position during DISE.</p><p><strong>Results: </strong>Among 708 study participants, the mean (SD) age was 52.5 (13.5) years, and 109 were female individuals (15%). Epiglottis-related obstruction occurred in 103 (16%), including 100 (14%) and 13 (1.8%) with anteroposterior and lateral configurations, respectively. Multivariable analysis showed that anteroposterior epiglottis-related obstruction was strongly associated with male sex (odds ratio [OR], 2.84; 95% CI, 1.20-6.73), lesser degree of velum-related obstruction (OR, 0.50; 95% CI, 0.29-0.84), and posterior epiglottis displacement (OR, 2.94; 95% CI, 1.73-4.99), and weakly associated with older age (OR, 1.04; 95% CI, 1.01-1.06). Lateral epiglottis-related obstruction was only seen in male individuals and the presence of oropharyngeal lateral-wall related obstruction; it was also associated with posterior epiglottis displacement.</p><p><strong>Conclusions and relevance: </strong>This study found that anteroposterior and lateral epiglottis-related obstruction are distinct, having many different risk factors. However, both configurations were associated with posterior epiglottis displacement during awake examination.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"984-991"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855255","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":"Can Chemotherapy Emerge From the Shadows in Resectable Cutaneous Squamous Cell Carcinoma?","authors":"Vasu Divi, A Dimitrios Colevas","doi":"10.1001/jamaoto.2025.2678","DOIUrl":"10.1001/jamaoto.2025.2678","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"945-946"},"PeriodicalIF":5.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144954518","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}