JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Taiwan's Gene Therapy Lessons-Balancing Innovation and Cost.","authors":"Ching-Nung Wu, Wei-Chun Cheng, Chao-Hui Yang","doi":"10.1001/jamaoto.2025.1768","DOIUrl":"10.1001/jamaoto.2025.1768","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"826-827"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553594","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":"Otolaryngology and Public Health-Lessons in Hearing and Aging.","authors":"Sarah Y Bessen, Alexander Chern, Umamaheswar Duvvuri, Nicholas S Reed","doi":"10.1001/jamaoto.2025.1410","DOIUrl":"10.1001/jamaoto.2025.1410","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"739-740"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274913","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":"Radiotherapy With Cisplatin vs Carboplatin Paclitaxel for Head and Neck Squamous Cell Carcinoma.","authors":"Marin Abousaud, Saagar Pamulapati, Saad Rashid, Fabiola Lozano, Madeline Shepherd, Busola Fowowe, Yichun Cao, Pauline Kim, Yuan Liu, James E Bates, Mark McDonald, Soumon Rudra, William A Stokes, Jennifer Gross, Nicole C Schmitt, Mark W El-Deiry, Mihir R Patel, Anthea L Hammond, Yong Teng, Conor Steuer, Dong M Shin, Nabil F Saba","doi":"10.1001/jamaoto.2025.1706","DOIUrl":"10.1001/jamaoto.2025.1706","url":null,"abstract":"<p><strong>Importance: </strong>Despite the widespread use of carboplatin/paclitaxel (C/P) in concurrence with radiotherapy for patients with squamous cell carcinoma of the head and neck (SCCHN) who are ineligible to receive cisplatin, there is a lack of prospective or comparative analyses examining C/P vs cisplatin.</p><p><strong>Objective: </strong>To examine the clinical outcomes of patients with SCCHN receiving C/P vs cisplatin in concurrence with radiotherapy in the definitive and postoperative setting.</p><p><strong>Design, setting, and participants: </strong>This retrospective, single-center comparative effectiveness study included patients with SCCHN who received concurrent chemoradiotherapy with C/P or cisplatin from January 2010 to March 2021. Patients with human papillomavirus-related and unrelated disease were included. Data analysis was conducted in March 2022.</p><p><strong>Exposures: </strong>Patients received C/P or cisplatin. Most cisplatin patients received weekly cisplatin or C/P. Intensity-modulated radiotherapy was primarily used, with a median (range) total dose of 70 (66-70) Gy.</p><p><strong>Main outcomes and measures: </strong>Key efficacy end points were locoregional recurrence-free survival (LRFS), progression-free survival (PFS), distant metastasis-free survival (DMFS), overall survival (OS), and safety.</p><p><strong>Results: </strong>A total of 308 patients were included (66 female individuals [21.4%]; 60 African American individuals [19.5%], 9 Asian individuals [2.9%], 3 Hispanic individuals [1.0%], and 235 White individuals [76.3%]; median [range] age, 63 [24-89] years). Of these patients, 116 (37.7%) had never smoked, 117 (38.0%) formerly smoked, and 75 (24.4%) were active smokers. Primary sites were oropharynx (164 [53.2%]; 164 [84.7%] were human papillomavirus-positive), oral cavity (57 [18.5%]), and larynx (52 [16.9%]); a comparison of illness stage was T3/T4 (191 [62.0%]) vs T1/T2 (117 [38.0%]) and N1 to N3 (258 [83.8%]) vs N0 (50 [16.2%]). A total of 97 patients (31.5%) underwent surgery before concurrent therapy. No meaningful differences between cisplatin and C/P were observed for 3-year rates of LRFS (97.0% vs 96.2%; difference, -0.8%; 95% CI, -5.2% to 3.6%), PFS (77.5% vs 79.8%; difference, 2.3%; 95% CI, -7.4% to 12.0%), DMFS (83.4% vs 86.8%; difference, 3.4%; 95% CI, -5.3% to 12.1%), or OS (90.8% vs 92.9%; difference, 2.1%; 95% CI, -4.5% to 8.7%). C/P was associated with a higher rate of grade 3 to 4 leukopenia, anemia, and dermatitis and more feeding tube placements and hospitalizations.</p><p><strong>Conclusions and relevance: </strong>The results of this study suggest that there were no differences in LRFS, PFS, DMFS, and OS in patients with SCCHN receiving radiotherapy with C/P vs cisplatin. These results support the use of C/P as an alternative regimen in patients who cannot receive cisplatin.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"769-776"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12203394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496681","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":"Stellate Ganglion Block for the Treatment of COVID-19-Induced Parosmia: A Randomized Clinical Trial.","authors":"Nyssa Fox Farrell, Lara W Crock, Aseeyah Islam, Dean Adkins, Andrew M Peterson, Dorina Kallogjeri, Jay F Piccirillo","doi":"10.1001/jamaoto.2025.1304","DOIUrl":"10.1001/jamaoto.2025.1304","url":null,"abstract":"<p><strong>Importance: </strong>Smell distortion (parosmia) is a symptom of post-COVID-19 condition that persists and has immeasurable detriments on quality of life. To date, a standard criterion for treatment of this bothersome condition has not been identified.</p><p><strong>Objective: </strong>To determine whether stellate ganglion block (SGB) is effective and safe in improving olfactory dysfunction in patients with persistent COVID-19-induced parosmia.</p><p><strong>Design, setting, and participants: </strong>This was a randomized, double-blinded, placebo-controlled clinical trial conducted from October 2023 to September 2024 at a single center study (the Washington University in St Louis/Barnes Jewish Hospital). A volunteer sample of 192 individuals were screened; 57 were enrolled after meeting eligibility criteria (age 18-70 years with self-reported parosmia of ≥6 months since COVID-19 infection, and a screening score of ≥40 on the Parosmia Olfactory Dysfunction Outcomes Rating [DisODOR] scale). Of 135 excluded, the most common reasons were prior SGB (n = 42) and parosmia resolution or non-COVID-19-induced parosmia (n = 28). Data were analyzed from September to October 2024.</p><p><strong>Intervention: </strong>Ultrasonography-guided injection of 6 to 8 mL of active mepivacaine, 1%, or saline, 0.9%, at the right or left (randomized 1:1) stellate ganglion was performed by a board-certified anesthesiologist and pain medicine specialist.</p><p><strong>Main outcome and measure: </strong>Between-subject difference of 25% in proportion of responders (defined by a 15-point decrease in DisODOR score) from baseline.</p><p><strong>Results: </strong>The study evaluated 48 participants, 32 randomized to SGB (median [range] age, 45 [19-64] y; 25 [81%] female), and 16 to placebo (median [SD] age, 45 [26-64] y; 13 [81%] female). Time since COVID-19 infection was similar between groups (SGB, 35.3 vs placebo, 30.6 months; MD = -3.1 months; 95% CI, -10.9 to 3.7). Three-month response rate was 43% (n = 13) for SGB and 38% (n = 6) for placebo (difference, -5%; 95% CI, -32% to 33%). There was no between-group difference in clinical global impression of improvement.</p><p><strong>Conclusions and relevance: </strong>This randomized clinical trial found that SGB is not superior to placebo in treating COVID-19-induced parosmia, and thus, should not be recommended as treatment.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT06253806.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"741-749"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12163713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274914","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":"Taiwan's Gene Therapy Lessons-Balancing Innovation and Cost-Reply.","authors":"Lauren E Miller, Oliver F Adunka, Vinay K Rathi","doi":"10.1001/jamaoto.2025.1771","DOIUrl":"10.1001/jamaoto.2025.1771","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"827"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553595","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":"Patient With Hemoptysis and a Laryngeal Mass.","authors":"Pollara A Cobb, Gregory S Hill, Wojtek K Mydlarz","doi":"10.1001/jamaoto.2025.1560","DOIUrl":"10.1001/jamaoto.2025.1560","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"817-818"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496680","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":"HPV Status and Survival Outcomes in Patients 70 Years and Older After Surgery for Oropharyngeal Carcinoma.","authors":"Paolo Boscolo-Rizzo, Marta Tagliabue, Jerry Polesel, Fabiola Giudici, Vittorio Rampinelli, Giacomo Spinato, Luigi Angelo Vaira, Pawel Golusinski, Didier Dequanter, Carlos Chiesa Estomba, Antonino Maniaci, Mario Lentini, Rita De Berardinis, Laura Iandolo, Daniele Borsetto, Mateusz Szewczyk, Francesco Bussu, Jerome R Lechien, Enzo Emanuelli, Cesare Piazza, Piero Nicolai, Mohssen Ansarin, Giancarlo Tirelli","doi":"10.1001/jamaoto.2025.1722","DOIUrl":"10.1001/jamaoto.2025.1722","url":null,"abstract":"<p><strong>Importance: </strong>The incidence of HPV-associated oropharyngeal squamous cell carcinoma (OPSCC) arising from the palatine tonsil and base of the tongue (BOT) is increasing among the older population. However, data on the prognostic impact of HPV status in patients 70 years and older who undergo up-front surgical treatment remain limited.</p><p><strong>Objective: </strong>To evaluate whether HPV status is associated with survival outcomes in patients 70 years or older undergoing surgical treatment for squamous cell carcinoma (SCC) of the tonsil or BOT.</p><p><strong>Design, setting, and participants: </strong>This was a retrospective cohort analysis including patients 70 years or older at the time of diagnosis with biopsy specimen-proven and surgically resectable SCC of the tonsil or BOT treated in 10 comprehensive cancer centers from January 1, 2010, to July 31, 2021, with a minimum follow-up period of 3 years. Data analysis was conducted from August 20 to December 23, 2024.</p><p><strong>Exposure: </strong>HPV status determined by p16 immunohistochemistry.</p><p><strong>Main outcomes and measures: </strong>Overall survival (OS) and disease-free survival (DFS) were compared between p16-positive and p16-negative groups using Cox proportional hazards models.</p><p><strong>Results: </strong>The analysis included 345 patients (mean [SD] age, 75.7 [4.8] years; 241 [69.9%] male), of whom 207 (60.0%) underwent a transoral surgical approach and 138 (40.0%), an open surgical technique. Of these, 155 patients (44.9%) had p16-positive and 190 (55.1%) had p16-negative test results. The median (IQR) follow-up duration was 55 (18-87) months. Patients with p16-positive tumors demonstrated significantly improved survival outcomes. Specifically, the 5-year OS rate was 71.4% for patients who had p16-positive vs 47.7% for p16-negative test results, with an absolute difference of 23.7% (95% CI, 13.0%-34.4%) and an adjusted hazard ratio (HR) for OS of 0.36 (95% CI, 0.23-0.57). Similarly, the 5-year DFS rate was 66.4% for patients who were p16-positive compared to 40.8% for those p16-negative, with an absolute difference of 25.6% (95% CI, 14.9%-36.3%) and an adjusted HR for DFS of 0.42 (95% CI, 0.28-0.63).</p><p><strong>Conclusions and relevance: </strong>This cohort study found that p16 positivity was associated with significantly improved survival outcomes, suggesting that HPV-associated tumors maintain their favorable prognosis even in patients 70 years and older who were surgically treated for SCC of the tonsil or BOT.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"795-805"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553592","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":"Nosebleeds in Children.","authors":"Alexandra G Espinel","doi":"10.1001/jamaoto.2025.1252","DOIUrl":"10.1001/jamaoto.2025.1252","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"828"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274912","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":"Adjuvant Chemoradiotherapy for Oral Cavity SCC With Minor and Major Extranodal Extension.","authors":"Mirko Manojlovic-Kolarski, Susie Su, Ilian Weinreb, Robert Calvisi, Bayardo Perez-Ordonez, Stephen Smith, Snehal Patel, Cristina Valero, Bin Xu, Ronald Ghossein, Nora Katabi, Jonathan Clark, Tsu-Hui Hubert Low, Ruta Gupta, Evan Graboyes, Joel Davies, Mary Richardson, David Goldstein, Shao Hui Huang, Brian O'Sullivan, Weu Xu, Aaron Hansen, John R de Almeida","doi":"10.1001/jamaoto.2025.1721","DOIUrl":"10.1001/jamaoto.2025.1721","url":null,"abstract":"<p><strong>Importance: </strong>Extranodal extension (ENE) in oral cavity squamous cell carcinoma (OSCC) is a poor prognostic feature and an indication for adjuvant chemoradiotherapy. ENE is stratified into minor (≤2 mm) or major (>2 mm) extent. The role of adjuvant chemoradiotherapy, particularly for the minor ENE subgroup, is unclear.</p><p><strong>Objective: </strong>To determine the impact of adjuvant chemoradiotherapy on oncological outcomes depending on the extent of ENE.</p><p><strong>Design, setting, and participants: </strong>This retrospective, multicenter cohort study was conducted across 4 high-volume head and neck surgery centers in Australia, the US, and Canada. The study included patients with surgically resected OSCC with pathologic positive nodal disease treated between 2005 and 2018. Statistical analysis took place between 2022 and 2025; final follow-up was in 2022.</p><p><strong>Exposures: </strong>Extent of ENE was restaged on archived tissue. Adjuvant radiotherapy or chemoradiotherapy was recommended per standard guidelines.</p><p><strong>Outcomes: </strong>Univariable and multivariable analysis were used to assess the effect of chemotherapy for the entire group and for propensity score-matched cohorts on locoregional control (LRC), disease-free survival (DFS), and overall survival (OS) stratified by minor vs major ENE.</p><p><strong>Results: </strong>A total of 755 patients (mean [SD] age, 61.7 [12.9] years; 36% female) were included in the study: 126 (17%) with minor ENE and 243 (32%) with major ENE. A total of 50 (39.7%) patients with minor ENE and 116 (47.8%) with major ENE received adjuvant chemotherapy. On multivariable analysis, chemotherapy was not associated with improved LRC (hazard ratio [HR], 1.07 [95% CI, 0.49-2.32]), DFS (HR, 0.96 [95% CI, 0.56-1.66]), or OS (HR, 0.97 [95% CI, 0.55-1.73]) in patients with minor ENE. However, in patients with major ENE, chemotherapy improved DFS (HR, 0.58 [95% CI, 0.41-0.81]) and OS (HR, 0.61 [95% CI, 0.38-0.98]). In propensity score-matched cohorts, chemotherapy did not improve LRC (71% vs 75%; difference, 4% [95% CI, -18% to 26%]), DFS (56% vs 56%; difference, 0% [95% CI, -25% to 25%]), or OS (57% vs 57%; difference, 0% [95% CI, -25% to 25%]) for patients with minor ENE, but improved DFS (33% vs 11%; difference, 22% [95% CI, 5%-38%]) and OS (41% vs 15%; difference, 26% [95% CI, 8%-44%]) but not LRC (61% vs 62%; difference, 1% [95% CI, -17% to 21%]) in patients with major ENE.</p><p><strong>Conclusions: </strong>This multicenter cohort study found that in patients with OSCC, adjuvant chemotherapy is beneficial in patients with major ENE, but may not be beneficial in patients with minor ENE.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"785-794"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325724","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":"An Adolescent With a Tracheal Mass.","authors":"Amanda J Bastien, Matthew T Brigger, Z Jason Qian","doi":"10.1001/jamaoto.2025.1638","DOIUrl":"10.1001/jamaoto.2025.1638","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"819-820"},"PeriodicalIF":5.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553591","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}