JAMA otolaryngology-- head & neck surgery最新文献

{"title":"The End of Medicare Telehealth Coverage for Audiology.","authors":"Peter R Dixon, Elizabeth Camposeo, Theodore R McRackan","doi":"10.1001/jamaoto.2024.4572","DOIUrl":"10.1001/jamaoto.2024.4572","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"185-186"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142893713","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":"Clarification Regarding Insurance Disparities Among Patients With Head and Neck Cancer-Reply.","authors":"Uchechukwu C Megwalu, Yifei Ma","doi":"10.1001/jamaoto.2024.4671","DOIUrl":"10.1001/jamaoto.2024.4671","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"282"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914790","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":"Not Enough Dentistry.","authors":"Leila J Mady, Wassim Najjar, Catherine Hayes, Rabie M Shanti","doi":"10.1001/jamaoto.2024.4851","DOIUrl":"10.1001/jamaoto.2024.4851","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"188-189"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023432","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":"Tympanostomy Tube With or Without Adenoidectomy.","authors":"Dmitry Tretiakow, Katarzyna Zyzynska, Agnieszka Kasprzyk-Tryk","doi":"10.1001/jamaoto.2024.4859","DOIUrl":"10.1001/jamaoto.2024.4859","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"284"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023447","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":"Errors in Table and Figures.","authors":"","doi":"10.1001/jamaoto.2025.0010","DOIUrl":"10.1001/jamaoto.2025.0010","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"285"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255678","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":"JAMA Otolaryngology-Head & Neck Surgery.","authors":"","doi":"10.1001/jamaoto.2024.3433","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.3433","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":"151 3","pages":"184"},"PeriodicalIF":6.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624623","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":"Enhanced Recovery After Surgery Compliance and Outcomes for Head and Neck Reconstructive Surgery.","authors":"Chad W Wagoner, Abby Thomas, Joseph C Dort, Gregg Nelson, Khara M Sauro","doi":"10.1001/jamaoto.2024.5393","DOIUrl":"10.1001/jamaoto.2024.5393","url":null,"abstract":"<p><strong>Importance: </strong>Few studies have examined the association between enhanced recovery after surgery (ERAS) compliance and postoperative outcomes within head and neck (HN) free flap reconstructive surgery. Doing so may inform future interventions to improve ERAS adoption and improve postoperative outcomes.</p><p><strong>Objective: </strong>To assess overall compliance with ERAS guidelines and its association with postoperative outcomes among individuals undergoing HN free flap reconstructive surgery.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study included patients who underwent ERAS-guided HN major reconstructive surgery in Alberta, Canada between January 2017 and September 2021. Data analysis occurred from May 2024 until August 2024.</p><p><strong>Main outcomes and measures: </strong>ERAS compliance was assessed for 17 ERAS care elements, and the total compliance score for each patient was a sum of the compliance for each ERAS care element. Compliance was categorized as low compliance (<53%), moderate compliance (53%-72%), and high compliance (>72%). Postoperative outcomes included hospital length of stay and hospital readmission and emergency department admissions within 30 days, intensive care unit readmission, complications, and severe complications. Unadjusted and adjusted models (using backward stepwise regression) assessed associations between ERAS compliance (exposure) and postoperative outcomes.</p><p><strong>Results: </strong>Of 257 patients, 90 (35.0%) were female, and the mean (SD) age was 62.4 (13.3) years. Overall, 196 (76.3%) had moderate compliance, 50 (19.5%) had low ERAS compliance, and 11 (4.3%) had high compliance. Preoperative (86%) and intraoperative (73%) ERAS compliance exceeded postoperative compliance (38%). Compliance for ERAS care elements varied widely, with the highest compliance observed for preincision antibiotic prophylaxis (99.6%) and the lowest compliance observed for postoperative early mobilization (10.2%). Postoperative hospital length of stay decreased by 0.71 days (95% CI, -1.34 to -0.08), and the odds of experiencing complications decreased by 28% (odds ratio, 0.72; 95% CI, 0.56-0.90) for each 1-unit increase in the total ERAS compliance score.</p><p><strong>Conclusions and relevance: </strong>This results of this cohort study suggest that higher overall compliance with ERAS guidelines was associated with improved postoperative outcomes for individuals undergoing major HN free flap reconstructive surgery. There also appeared to be discrepancies in compliance between preoperative and postoperative phases, suggesting areas for interventions designed to improve adherence to ERAS protocols and underscoring the need for proactive compliance monitoring for optimizing patient outcomes in major HN surgery.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515657","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 Abstract.","authors":"","doi":"10.1001/jamaoto.2025.0242","DOIUrl":"10.1001/jamaoto.2025.0242","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515660","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":"Online Intervention for Muscle Tension Dysphonia: A Pilot Randomized Clinical Trial.","authors":"Viann N Nguyen-Feng, Patricia A Frazier, Yuchen Liu, Erin Feddema, Benjamin Wils, Elizabeth Nikcevich, Ali Stockness, Kelvin O Lim, Amanda C Hu, Lisa Butcher, Stephanie Misono","doi":"10.1001/jamaoto.2024.5255","DOIUrl":"10.1001/jamaoto.2024.5255","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Voice-related perceived control is the extent to which a person feels they can control their voice condition and/or their response to it. Given the interaction of psychological factors and voice outcomes, an intervention targeting psychological factors may be a helpful adjunct to clinical voice care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To investigate the feasibility, acceptability, and potential efficacy of a perceived control intervention adapted for adult patients with muscle tension dysphonia and to compare its outcomes with those of a voice education program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, settings, and participants: &lt;/strong&gt;This was a pilot randomized clinical trial using mixed methods and including adults with muscle tension dysphonia from academic otolaryngology clinics from July 8, 2018, to December 8, 2019. Participants were randomized to the voice education program or the perceived control intervention, and feasibility and acceptability of both were assessed using quantitative and qualitative measures. Data analyses were performed from October 1, 2023, to March 5, 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Voice-related impairment was measured using the Voice Handicap Index-10 (VHI-10). Psychological factors were measured using the voice-related Perceived Present Control Scale, Brief Symptom Inventory-18 (BSI), and Perceived Stress Scale-4. Open-ended participant responses were analyzed following consensual qualitative research methods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In all, 50 participants (mean [SD] age, 51.0 [15.9] years; 34 women [68%]); 27 were randomly assigned to receive the voice education program and 23 were randomly assigned to the perceived control intervention. Forty participants (80%) completed the study, which demonstrated the feasibility of both options. Outcomes of both the perceived control intervention and the voice education program were acceptable. Change in VHI-10 was heterogeneous, modest overall, and similar in the perceived control (-2.44; 95% CI, -4.25 to -0.63) and education (-2.94; 95% CI, -4.12 to -1.76) arms. Perceived control (secondary outcome) was higher, and exploratory outcomes (ie, somatic concerns, depression, anxiety, and perceived stress) were lower overall between pretest and posttest assessments. Qualitative analyses showed an overall decrease in negative voice-related emotions, fatigue, and negative self-image over the course of the perceived control intervention, and an interest in curated information in the voice education program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This pilot randomized clinical trial indicates that both the perceived control intervention and voice education program appear promising for further development. Online interventions are of interest to people with voice disorders, and future work may benefit from taking individual differences into account.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;ClinicalTrials.gov Identifier: NC","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515664","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":"Allergic Contact Dermatitis Following Hypoglossal Nerve Stimulator Implant.","authors":"Akshay Tangutur, Katherine K Brown, Raj C Dedhia","doi":"10.1001/jamaoto.2024.5446","DOIUrl":"10.1001/jamaoto.2024.5446","url":null,"abstract":"<p><strong>Importance: </strong>Allergic contact reactions to medical implants are underrecognized and incompletely understood, particularly in hypoglossal nerve stimulation (HGNS), an increasingly popular and effective alternative to positive airway pressure therapy for patients with obstructive sleep apnea (OSA).</p><p><strong>Objective: </strong>To document a rare case of allergic contact reaction in a patient following implantation of an HGNS device for OSA.</p><p><strong>Design, setting, and participant: </strong>In this case report, the patient presented to a quaternary care academic medical center with localized erythema, swelling, and pustular drainage at the right neck incision site approximately 2 months following HGNS device implantation.</p><p><strong>Exposure: </strong>This patient underwent serial, bilateral HGNS device implantation and subsequent explantation.</p><p><strong>Main outcome and measure: </strong>The main outcomes were the findings from symptom monitoring and allergy patch testing.</p><p><strong>Results: </strong>A 64-year-old male patient with severe OSA (Apnea-Hypopnea Index, 54 events/h) underwent implantation of an HGNS device. His recovery was uneventful for 2 months until he reported localized erythema, swelling, and pustular drainage at the right neck incision site. HGNS device extrusion at the neck was noted approximately 3 months postoperatively, prompting device explantation. The patient underwent subsequent HGNS reimplantation in the left neck and chest 3 months after right-sided explantation. At postoperative day 10, swelling, erythema, and purulence were noted from neck and chest incisions. The device was re-explanted with odorless purulence noted in the chest and neck. The wound cultures were negative for infection, and at this time, the patient underwent allergy patch testing, which demonstrated a strong positive reaction to isophorone diisocyanate. Patch testing confirmed an allergy to isocyanates, evidenced by a strong positive reaction to isophorone diisocyanate, 1.0%, in petrolatum. This finding was further validated by the manufacturer, which confirmed isocyanates were used in the polyurethane components of the HGNS device.</p><p><strong>Conclusions and relevance: </strong>Isocyanates are low-molecular weight compounds used in the production of polyurethanes, which are commonly found in medical devices. HGNS is a widely available implantable medical device for treatment of patients with OSA. The literature regarding isocyanate allergies with medical implants is limited, and this may be the first confirmed case with an HGNS device. This case report highlights the importance of noninfectious causes of device reactions, especially when occurring outside of the postoperative wound infection window. Patch testing for isocyanate and other components can inform both patient and clinician regarding the cause of device implantation failure and have implications for future implantable devices.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143515656","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}