JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Suprazygomatic Maxillary Nerve Block and Postoperative Opioid Use in Children Undergoing Adenotonsillectomy-Reply.","authors":"Ban C H Tsui, Steven Abboud, Carole Lin","doi":"10.1001/jamaoto.2024.3110","DOIUrl":"10.1001/jamaoto.2024.3110","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1041-1042"},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346869","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":"Peripartum and Pregnancy-Related Considerations in Residency.","authors":"Danielle R Larrow, Phoebe K Yu, Stacey T Gray","doi":"10.1001/jamaoto.2024.2790","DOIUrl":"10.1001/jamaoto.2024.2790","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1039-1040"},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287419","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":"Cutaneous Squamous Cell Carcinoma in Transketolase Deficiency.","authors":"Nicole Loranger, Anastasia Vishnevetsky, Michele Spencer-Manzon, Emily Karn, Wendy K Chung, Ansley Roche, Emily Stamell Ruiz","doi":"10.1001/jamaoto.2024.2489","DOIUrl":"10.1001/jamaoto.2024.2489","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1038-1039"},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346864","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 Everolimus Following Dilation in Idiopathic Subglottic Stenosis: A Phase 1 Nonrandomized Clinical Trial.","authors":"Raymond J So, Samuel L Collins, Sarah Collins, Laura Mafla, Yee Chan-Li, Ioan Lina, Alexander Gelbard, Kevin M Motz, Alexander T Hillel","doi":"10.1001/jamaoto.2024.2886","DOIUrl":"10.1001/jamaoto.2024.2886","url":null,"abstract":"<p><strong>Importance: </strong>Current medical therapies in idiopathic subglottic stenosis (iSGS) are insufficient in preventing the development and progression of scar tissue. An inhibitor of mammalian target of rapamycin, everolimus is an immunosuppressive medication shown to be effective in reducing fibrosis across a variety of fibroproliferative disorders, including preclinical models of iSGS.</p><p><strong>Objective: </strong>To evaluate the effect of oral everolimus on postoperative recurrence of stenosis in iSGS.</p><p><strong>Design, setting, and participants: </strong>This open-label, single-arm, phase 1, nonrandomized clinical trial analyzed 7 perimenopausal participants diagnosed with iSGS and followed-up at a tertiary care academic center for 6 months after dilation surgery. The trial was conducted from November 1, 2022, through May 15, 2024.</p><p><strong>Intervention: </strong>Participants took a 1.5-mg daily oral dose of everolimus for 42 days after surgery.</p><p><strong>Main outcomes and measures: </strong>The primary outcome measure was safety as determined by adverse events. Secondary outcome measures included change in peak expiratory flow from baseline through 180 days after surgery; change in the luminal area, measured by computed tomographic (CT) scan, from the 14th and the 180th day; and changes in quality-of-life scores.</p><p><strong>Results: </strong>Of the 8 perimenopausal participants, 7 (median age, 50 years [IQR, 45.0-52.5 years]) completed the study. Compared with baseline at all time points, there was an increase in peak expiratory flow. The median difference in liters per minute was 125 (95% CI, 90-270) on day 7 after surgery; 150 (95% CI, 110-290) on day 14; 138 (95% CI, 116-280) on day 28; 160 (95% CI, 100-270) on day 42; 155 (95% CI, 110-270) on day 60; 140 (95% CI, 100-270) on day 90; and 100 (95% CI, 20-240) on day 180. A decrease in the CT luminal area was observed from the day-14 measure to the day-180 measure (median stenosis, 7.2%; IQR, 1.9%-15.4%). During the trial, 1 participant (14.3%) each developed oral ulcers, a urinary tract infection, and a skin infection.</p><p><strong>Conclusions and relevance: </strong>In this interventional nonrandomized clinical trial of iSGS, adjuvant everolimus was well-tolerated with minor adverse events. Participants sustained postdilation peak expiratory flow for 13 weeks. These results support proceeding to a phase 2 trial to study drug efficacy and a more detailed investigation of adverse effects.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05153668.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1029-1033"},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346867","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":"Effect of Olfactory Enrichment For Older Adults.","authors":"Michael Leon","doi":"10.1001/jamaoto.2024.3189","DOIUrl":"10.1001/jamaoto.2024.3189","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"1044"},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365242","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":"Determinants of Prognosis in Head and Neck Cutaneous Squamous Cell Carcinoma With Nodal Metastases.","authors":"Ardalan Ebrahimi, Ruta Gupta, Lachlan McDowell, Matthew J R Magarey, Paul N Smith, Klaus-Martin Schulte, Diana M Perriman, Michael Veness, Sandro Porceddu, Tsu-Hui Hubert Low, Allan Fowler, Jonathan R Clark","doi":"10.1001/jamaoto.2024.3103","DOIUrl":"10.1001/jamaoto.2024.3103","url":null,"abstract":"<p><strong>Importance: </strong>The eighth edition tumor, node, metastasis (TNM) staging for head and neck cutaneous squamous cell carcinoma (HNcSCC) is a poor predictor of survival in patients with lymph node metastases, possibly due to the inclusion of extranodal extension (ENE).</p><p><strong>Objective: </strong>To identify the key determinants of prognosis in patients with nodal metastatic HNcSCC and analyze the association of ENE with TNM stage and investigate for prognostic heterogeneity in ENE-positive disease.</p><p><strong>Design, setting, and participants: </strong>This retrospective, multicenter cohort study was conducted at 4 Australian tertiary referral centers using prospectively collected data in patients treated between 1980 and 2017 with a median (IQR) follow-up of 3.2 (3.9) years. The study population included 1309 consecutive patients with HNcSCC that was metastatic to parotid and/or cervical nodes. After excluding cases with perioperative mortality, missing data, or follow-up, the final study population included 1151 patients.</p><p><strong>Exposure: </strong>Curative intent surgery ± adjuvant radiotherapy.</p><p><strong>Main outcomes and measures: </strong>Differences in locoregional control (LRC), disease-specific survival (DSS), and overall survival were determined using Cox regression analysis.</p><p><strong>Results: </strong>Among 1151 patients, 976 (84.8%) were male and 175 (15.2%) female, with a median age of 73.3 years (range, 18-100 years). On multivariable analysis, immunosuppression (hazard ratio [HR], 2.48; 95% CI, 1.64-3.74), perineural invasion (HR, 1.69; 95% CI, 1.25-2.30), ENE (HR, 1.53; 95% CI, 0.95-2.44), size (>3-6 cm vs ≤3 cm [HR, 1.41; 95% CI, 1.03-1.93]; >6 cm vs ≤3 cm [HR, 5.01; 95% CI, 2.98-8.42]), and number of nodal metastases (3-4 vs 1-2 [HR, 1.54; 95% CI, 1.01-2.34]; ≥5 vs 1-2 [HR, 2.86; 95% CI, 1.99-4.11]) were associated with DSS. Similar results were found for LRC and overall survival. More than 90% of the population was categorized as TNM stage IV, with 32% attributable to ENE. In the ENE-positive subset (n = 860), DSS ranged from 8% to 88% based on stratification using other clinicopathological factors.</p><p><strong>Conclusions and relevance: </strong>The study results suggest that immunosuppression, perineural invasion, ENE, and size and number of nodal metastases are associated with reduced survival and LRC in HNcSCC with nodal metastases. The inclusion of ENE in HNcSCC staging needs to be reassessed, as it ascribes excessive importance to ENE and upstages most patients to TNM stage IV, despite many having a high chance of cure.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"986-994"},"PeriodicalIF":6.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11428024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142346865","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":"Association Between Olfactory Impairment and Frailty-Reply.","authors":"Brian Sheng Yep Yeo, Benjamin Kye Jyn Tan, Tze Choong Charn","doi":"10.1001/jamaoto.2024.3748","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.3748","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545491","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":"Optimizing Osteotomy Geometries in Posterolateral Mandibulectomies.","authors":"Hugh Andrew Jinwook Kim, Michael J De Biasio, Vito Forte, Ralph W Gilbert, Jonathan C Irish, David P Goldstein, John R de Almeida, Matthew M Hanasono, Peirong Yu, Douglas B Chepeha, Thomas Looi, Christopher M K L Yao","doi":"10.1001/jamaoto.2024.3246","DOIUrl":"10.1001/jamaoto.2024.3246","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Reconstructive stability after mandibulectomy with osseous autogenous transplant is influenced by masticatory forces and the resulting stress on the titanium plate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To determine an optimal geometry of mandibular osteotomy that minimizes undesirable loading of the reconstruction plate.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;In this combined in silico and in vitro basic science study, segmented computed tomography images of an adult male human mandible downloaded from the Visible Human Project were analyzed. Data were collected from July to November 2023.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Four posterolateral mandibular resections and bony transplants were modeled following (1) vertical, (2) angled, (3) step, and (4) sagittal osteotomies. Using SOLIDWORKS software, mastication was simulated under (1) incisal, (2) ipsilateral molar, and (3) contralateral molar loading. Mandible models were then 3-dimensionally printed, osteotomized, and plated. Masticatory loads were simulated using pulleys, and strains were measured using strain gauges.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;On the reconstruction plate, von Mises stresses were measured in silico, and strains were measured using strain gauges in vitro. Stress and strain are reactions of a material to loading that can result in irreversible deformation or fracture.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In silico, maximum plate stress was highest with the vertical osteotomy, followed by the angled osteotomy (median difference vs vertical: ipsilateral molar loading, 126 MPa; 95% CI, 18-172; incisal loading, -24 MPa; 95% CI, -89 to 31; contralateral molar loading, 91 MPa; 95% CI, 23-189), step osteotomy (median difference vs angled: ipsilateral molar loading, 168 MPa; 95% CI, 112-235; incisal loading, 80 MPa; 95% CI, 15-140; contralateral molar loading, -17; 95% CI, -115 to 83), and sagittal osteotomy (median difference vs step: ipsilateral molar loading, 122 MPa; 95% CI, 102-154; incisal loading, 197 MPa; 95% CI, 166-230; contralateral molar loading, 161 MPa; 95% CI, 21-232). An angled osteotomy had the lowest stress at 30° of angulation (median difference vs contralateral molar loading at 40° of angulation: 111 MPa; 95% CI, 4-186). In vitro, the vertical osteotomy had the highest maximum strain, followed by the angled osteotomy (mean difference vs vertical: incisal loading, 0.021 mV/V; 95% CI, 0.014-0.027; contralateral molar loading, 0 mV/V; 95% CI, -0.004 to 0.005), step osteotomy (mean difference vs angled: incisal loading, 0.015 mV/V; 95% CI, 0.003-0.028; contralateral molar loading, 0.021 mV/V; 95% CI, 0.016-0.027), and sagittal osteotomy (mean difference vs step: incisal loading, 0.006 mV/V; 95% CI, -0.006 to 0.018; contralateral molar loading, 0.020 mV/V; 95% CI, 0.015-0.026).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this study, the traditional vertical osteotomy resulted in less favorable plat","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545493","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":"Association Between Olfactory Impairment and Frailty.","authors":"Sahar Assi, Varun Vohra, Nicholas R Rowan","doi":"10.1001/jamaoto.2024.3751","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.3751","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545490","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":"Intraductal Carcinoma of the Salivary Gland With Extensive Bone Invasion.","authors":"Jonas Ver Berne, Joke De Ceulaer, Ignace Dalle, David Creytens, Lieve Vanwalleghem","doi":"10.1001/jamaoto.2024.3720","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.3720","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545492","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}