JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Persistent Oral Erosions in a 13-Year-Old Male.","authors":"Siqi Li, Xu Wang, Zhimin Yan","doi":"10.1001/jamaoto.2026.2448","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2448","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887512","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":"A Thyroid Nodule With Cervical Lymphadenopathy.","authors":"Fanrong Wang, Tingting He, Ning Zhou","doi":"10.1001/jamaoto.2026.2454","DOIUrl":"https://doi.org/10.1001/jamaoto.2026.2454","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":7.0,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887443","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":"Olfactory Impairment and Depression: A Systematic Review and Meta-Analysis.","authors":"Henry Bode, Linnea Sjöberg, Ingrid Ekström","doi":"10.1001/jamaoto.2026.1758","DOIUrl":"10.1001/jamaoto.2026.1758","url":null,"abstract":"<p><strong>Importance: </strong>Depression and olfactory impairment are both highly prevalent in older adults and associated with poor quality of life, cognitive decline, and increased mortality. Clarifying their association could identify olfactory dysfunction as a potential marker of late-life depression.</p><p><strong>Objective: </strong>To quantify the association of objective olfactory impairment (OOI) and subjective olfactory impairment (SOI) with subjectively and/or objectively determined depression in population-based studies, and to examine potential moderators.</p><p><strong>Data sources: </strong>PubMed, Embase, EBSCOhost, and Web of Science were searched from inception to July 11, 2024, without language restrictions. Reference lists of relevant publications were screened manually.</p><p><strong>Study selection: </strong>Eligible studies included population-based cross-sectional or longitudinal investigations of the association between OOI or SOI and depression in adults in the general population. Two reviewers independently applied inclusion criteria and resolved disagreements by consensus.</p><p><strong>Data extraction and synthesis: </strong>Data were extracted independently by 2 reviewers in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) reporting guideline. Risk of bias was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses were performed separately for OOI and SOI. Heterogeneity and publication bias were evaluated.</p><p><strong>Main outcomes and measures: </strong>Odds ratios (ORs) and 95% CIs for the association between OOI or SOI and depression.</p><p><strong>Results: </strong>A total of 23 studies representing 17 independent cohorts (N = 187 056 individuals; mean [SD] age, 63.6 [16.4] years; 63% female) were included. After excluding nonindependent cohorts, 7 and 11 independent studies remained for the primary analyses of SOI and OOI, respectively. SOI was associated with depression across the 7 studies (OR, 1.56 [95% CI, 1.19-2.05]; I2 = 79%). The association remained robust in low risk of bias studies (OR, 1.71 [95% CI, 1.18-2.46]), across age groups, and for subjective and objective depression. OOI showed an association with objective depression across the 11 studies (OR, 1.26 [95% CI, 1.02-1.56]; I2 = 53%) that attenuated after publication bias adjustment (OR, 1.12 [95% CI, 0.87-1.44]) but remained robust in older adults (≥65 years) and individuals with anosmia.</p><p><strong>Conclusions and relevance: </strong>In this systematic review and meta-analysis, SOI showed a consistent, moderate association with depression, likely reflecting negative self-perception and/or the evaluation of one's own olfactory decline rather than comparison with population norms. OOI is less consistently associated with objective depression but appears to be relevant in specific subgroups, particularly older and anosmic individuals, suggesting partially overlapping mechanisms ","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"841-850"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352184/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411812","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":"Circulating Tumor DNA in Head and Neck Cancer: A Review From the American Head and Neck Society.","authors":"Sagar Kansara, Kevin Contrera, Scott Roof, Anne C Kane, Rula Mualla, Eleni Rettig, Nishant Agrawal, Barry Wenig, Joseph Curry, Daniel Faden, Chris Holsinger","doi":"10.1001/jamaoto.2026.2045","DOIUrl":"10.1001/jamaoto.2026.2045","url":null,"abstract":"<p><strong>Importance: </strong>Despite gains in understanding head and neck cancer over the past several decades, the discovery of reliable biomarkers remains elusive. With the advent of human papillomavirus-associated oropharynx cancer and Epstein-Barr virus-associated nasopharynx cancer, circulating tumor DNA (ctDNA) and oncogenic viral DNA have emerged as potentially promising biomarkers.</p><p><strong>Observations: </strong>A review was conducted by the American Head and Neck Society to address the current utility of ctDNA. Ongoing clinical trials were reviewed, with discussion of its utility in monitoring treatment response and measuring minimal residual disease (MRD). Although ctDNA holds promise in the push for precision oncology, several questions remain regarding its routine clinical use, including test variability and implications of inaccurate test results. Optimized clinical trial designs and further research are necessary to bring ctDNA to the forefront of head and neck cancer management.</p><p><strong>Conclusions and relevance: </strong>Liquid biopsy targeting viral ctDNA is a promising biomarker in the diagnostic and surveillance settings across head and neck cancer types. Ongoing clinical trials will help elucidate how ctDNA can be implemented to monitor treatment response, assess MRD, and frame treatment decisions to adapt treatment via a precision oncology approach.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"905-913"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620139","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":"Hypoglossal Nerve Stimulation.","authors":"Armita Norouzi, Megan L Durr","doi":"10.1001/jamaoto.2026.1774","DOIUrl":"10.1001/jamaoto.2026.1774","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"918"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411839","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":"Uncoded Tracheostomy Care-Impacting Care, Quality, and Research?","authors":"Philip A Weissbrod, Joshua R Bedwell, David O Francis","doi":"10.1001/jamaoto.2026.1769","DOIUrl":"10.1001/jamaoto.2026.1769","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"839-840"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148411828","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":"Spontaneous Cerebrospinal Fluid Leak as the Initial Presentation of Sinonasal Glomangiopericytoma.","authors":"Charo Béjar-Puerta, Miguel Lucas Herrera, Mª Elena Argente Del Castillo, Salvadora Martínez Vidal, Antonio Jesús Sánchez Guirao","doi":"10.1001/jamaoto.2026.1846","DOIUrl":"10.1001/jamaoto.2026.1846","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"916-917"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470686","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":"Team Behavior and Patient Outcome Changes After Human Factors Program in a Pediatric Airway Setting.","authors":"Barbara Cadre, Romain Luscan, Xiaoyi Chen, Nicolas Garcelon, François Simon, Briac Thierry","doi":"10.1001/jamaoto.2026.2049","DOIUrl":"10.1001/jamaoto.2026.2049","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Pediatric airway endoscopy is a high-risk procedure requiring close coordination among multidisciplinary teams. Communication failures and deficiencies in nontechnical skills are major contributors to adverse events, while structured human factors training is not routinely embedded in pediatric surgical practice.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate whether a multimodal human factors training program improves operating room communication, team behavior, and nontechnical skills during pediatric laryngotracheal endoscopy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This prospective quality improvement study with pretesting and posttesting was conducted at a tertiary university pediatric referral center over 3 consecutive phases: (1) pretesting of endoscopic procedures; (2) implementation of a human factors training program; and (3) posttesting. Team behaviors were assessed using observational metrics and the Non-Technical Skills for Surgeons (NOTSS) framework. Pediatric laryngotracheal endoscopic procedures were prospectively included. All procedures involved multidisciplinary teams including surgeons, anesthesiologists, and nursing staff. Data were collected from November 2021 to February 2023, and data were analyzed from September 2023 to March 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;A multimodal human factors training program combining a structured preoperative checklist, personalized identification caps, and simulation-based training inspired by aviation crew resource management.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Primary outcomes included adherence to communication practices, task interruptions, noise distribution, and NOTSS scores. Secondary outcomes included selected clinical indicators.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 80 pediatric laryngotracheal endoscopic procedures, including 44 before and 36 after program implementation, were included. Of 71 included patients, the median (range) age was 3.4 years (18 days to 17.8 years). Verbal use of the national surgical checklist increased from 9.1% (4 of 44) to 88.9% (32 of 36) after the intervention (difference, 79.8 percentage points; 95% CI, 61.2-88.5). Preoperative discussions between the surgeon and anesthesiologist occurred in 31 of 44 cases (70.5%) before the program vs 36 of 36 (100%) afterward (difference, 29.5 percentage points; 95% CI, 14.6-29.5), and postoperative debriefings increased from 56.8% (25 of 44) to 91.7% (33 of 36; difference, 34.8 percentage points; 95% CI, 15.8-43.2). Following the program, identification of key procedural phases was improved; task interruptions, particularly door openings and phone calls during critical phases, were reduced; noise levels became more evenly distributed; and overall NOTSS scores increased. There was no difference in incidence of oxygen desaturation and atropine use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This quality improvement study found that a st","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"895-902"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13448834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678625","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":"Postoperative Oral Dexamethasone and Pediatric Tonsillectomy Morbidity: A Randomized Clinical Trial.","authors":"Amber D Shaffer, Mahmoud Omar, Raymond C Maguire, Joseph E Dohar, Amanda L Stapleton, Dennis J Kitsko, Allison B J Tobey, Reema Padia, Jeffrey P Simons, Rachel L Whelan, Noel Jabbour, Jennifer L McCoy, Marina V Rushchak, Khoa Nguyen, Denise M Hall-Burton, David H Chi","doi":"10.1001/jamaoto.2026.1910","DOIUrl":"10.1001/jamaoto.2026.1910","url":null,"abstract":"<p><strong>Importance: </strong>Tonsillectomy is among the most painful otolaryngologic procedures. It is unclear whether a postoperative course of oral steroids reduces pediatric tonsillectomy pain and morbidity.</p><p><strong>Objective: </strong>To determine whether a postoperative course of oral dexamethasone reduces postadenotonsillectomy pain in children.</p><p><strong>Design, setting, and participants: </strong>This was a parallel-design quadruple-blinded randomized clinical trial conducted at a single tertiary academic center that enrolled pediatric patients (3-17 years of age) undergoing adenotonsillectomy from August 2021 to May 2023, with 14 days of follow-up for pain and 5 to 9 weeks for adverse events. Data were analyzed from October 2023 to May 2026.</p><p><strong>Intervention: </strong>Oral dexamethasone (0.5 mg/kg; maximum dose, 20 mg) or placebo on postoperative days 2, 4, and 6.</p><p><strong>Main outcome and measure: </strong>Mean (SD) pain score before medication administered during days 2 to 8 postoperatively.</p><p><strong>Results: </strong>Of 763 children screened, 209 participants (median [IQR] age, 7.1 [5.8] years; 99 females [47.4%] and 110 males [52.6%]) were included (104 to the steroid arm and 105 to placebo) in analyses of adverse events and health care utilization. Of these, 131 (61 steroid arm and 70 placebo) completed pain diaries and were included in primary outcome (pain) analysis. Mean (SD) pain before acetaminophen or ibuprofen on days 2 to 8 was 0.72 (95% CI, 0-1.44) points lower in the dexamethasone group (4.12 [2.00]) than placebo (4.84 [2.15]), but wide 95% CIs and differences in pain prior to taking the study medication prevented making definitive conclusions. The dexamethasone group had less pre- and postanalgesic pain on postoperative days 12 and 13 (mean difference, 0.96-2.37 points) and a considerable decrease in odds of receiving an opioid prescription (odds ratio [OR], 0.23; 95% CI, 0.06-0.84) or having an emergency department visit for pain (OR, 0.12; 95% CI, 0.003-0.91). However, the precision of these estimates limits interpretability. Differences in readmissions, nursing telephone calls, posttonsillectomy hemorrhage, and return to normal diet between groups were small and clinically meaningless.</p><p><strong>Conclusions and relevance: </strong>In this randomized clinical trial, postoperative oral dexamethasone was associated with a modest reduction in pain after pediatric adenotonsillectomy, a considerable reduction in opioid prescriptions, and no increase in complications, supporting its use as an analgesic adjunct.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT04879823.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"885-894"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561942","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":"Mechanisms Underlying an Enhanced Navigation-Based Intervention to Improve Timely Adjuvant Therapy: A Secondary Analysis of the NDURE Randomized Clinical Trial.","authors":"Maya N Elhage, Emily Kistner-Griffin, Reid DeMass, Bhisham S Chera, Katherine R Sterba, Chanita Hughes Halbert, Elizabeth G Hill, Brian Nussenbaum, Anthony J Alberg, Megan T Nguyen, Jason G Newman, W Greer Albergotti, Alexandra E Kejner, Judith M Skoner, Dauren Adilbay, Michael Bobian, Jennifer L Harper, John Kaczmar, Savannah A Zimmerman, Stacy Stewart, Taylor McLeod, Vlad C Sandulache, David J Hermandez, Ryan S Jackson, Sidharth V Puram, Russel Kahmke, Nosayaba Osazuwa-Peters, Gail Jackson, Garrett T Wasp, Sue S Yom, Evan M Graboyes","doi":"10.1001/jamaoto.2026.1891","DOIUrl":"10.1001/jamaoto.2026.1891","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Initiation of postoperative radiation therapy (PORT) within 6 weeks of surgery is part of National Comprehensive Cancer Network guidelines for head and neck squamous cell carcinoma (HNSCC), yet more than 50% of patients experience a delay. In a randomized clinical trial of patients with locally advanced HNSCC undergoing surgery, Navigation for Disparities and Untimely Radiation Therapy (NDURE), an enhanced navigation-based intervention that targets PORT-related care steps, improved timely PORT relative to usual care (UC) navigation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To examine the mechanisms by which NDURE improved timely PORT relative to UC navigation among patients with HNSCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This randomized clinical trial was conducted at a single US academic medical center and enrolled adults with locally advanced HNSCC undergoing surgery and PORT. Data were collected from May 2020 to January 2024, and data were analyzed from May 2025 to January 2026.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary end point was initiation of PORT within 6 weeks of surgery. Five PORT-related care steps were evaluated as mediators: (1) preoperative radiation oncology consultation, (2) preoperative dental evaluation, (3) timely postoperative radiation oncology evaluation (within 21 days of surgery), (4) timely computed tomography (CT) simulation (within 7 days after the radiation oncology appointment), and (5) timely radiation planning (CT simulation to PORT start within 14 days). Causal mediation analysis was performed to determine the effect of the PORT-related care steps, individually and as a group, on timely PORT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of 145 included patients, 51 (35.2%) were female and 94 (64.8%) were male; 30 (20.7%) were Black and 115 (79.3%) were White; and the median (IQR) age was 63.0 (54.0-69.0) years. A total of 67 patients were randomized to NDURE and 78 to UC. NDURE improved preoperative radiation oncology consultation (odds ratio [OR], 4.9; 95% CI, 2.3-10.3), preoperative dental evaluation and extractions (OR, 27.6; 95% CI, 3.6-213.0), timely postoperative radiation oncology evaluation (OR, 5.0; 95% CI, 2.4-10.7), and timely radiation planning (OR, 2.1; 95% CI, 1.1-4.2). Timely postoperative radiation oncology evaluation mediated 24% (95% CI, 8-65) and completion of more than half of the PORT-related care steps mediated 53% (95% CI, 28-95) of the effect of NDURE on improving timely PORT relative to UC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;In this secondary analysis of a randomized clinical trial, NDURE improved timely PORT relative to UC primarily by enhancing early postoperative evaluation by radiation oncology and completion of a greater number of PORT-related care steps. PORT-related care steps, including preoperative evaluation by radiation oncology, preoperative dental evaluation, timely postoperative radiation oncology evaluati","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"876-884"},"PeriodicalIF":7.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13397119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561852","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}