JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Neoadjuvant Therapy for Mucosal Head and Neck Squamous Cell Carcinoma: A Review From the American Head and Neck Society.","authors":"Kevin J Contrera, Sagar Kansara, Neerav Goyal, Leila J Mady, Sidharth V Puram, Geoffrey D Young, Dan P Zandberg, Ravindra Uppaluri, Renatta Ferrarotto, F Christopher Holsinger, Robert L Ferris, Barry L Wenig, Joseph M Curry","doi":"10.1001/jamaoto.2025.0410","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0410","url":null,"abstract":"<p><strong>Importance: </strong>While neoadjuvant chemotherapy for head and neck squamous cell carcinoma dates to the earliest multidisciplinary approaches, the introduction of immune checkpoint inhibitors (ICIs) has renewed enthusiasm and research into its use. Although neoadjuvant therapy has remained mostly investigative through single-institutional clinical trials for mucosal head and neck squamous cell carcinoma, new data have emerged to support its use.</p><p><strong>Observations: </strong>A narrative review was conducted by the American Head and Neck Society to address current literature, evolving research, and gaps in knowledge surrounding neoadjuvant therapy. Neoadjuvant ICIs, most notably agents targeting anti-programmed cell death protein 1 (anti-PD-1), are a promising approach for bolstering antitumor immunity prior to ablating local structures. While neoadjuvant therapy may allow for an individualized approach, biomarkers to guide patient selection are limited. Potential benefits include de-escalation of subsequent treatment, but neoadjuvant therapy for curable disease also carries a small but real risk of progression and compromise of curative options. Measures of response include pathologic, clinical, and radiographic, but there are rapidly expanding capabilities in new diagnostics, such as circulating tumor DNA, with the emerging potential to provide objective quantification of disease burden. Further neoadjuvant strategies include response adaptive therapy, such as treatment selection/bioselection or modification of surgery, adjuvant therapy, or definitive treatment. Neoadjuvant ICI trials are summarized in this review. Optimized trial designs and additional research are needed to standardize surrogate outcomes and compare survival to standard treatment.</p><p><strong>Conclusions and relevance: </strong>Neoadjuvant therapy can be an effective option for precision head and neck oncology bolstered by the advent of anti-PD-1 immunotherapy. However, tools for predicting and assessing treatment response remain limited. Further trials are evaluating adaptive strategies, combinations to increase efficacy, and comparisons to standard approaches.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144000498","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 to Progression to Cancer of Oral Premalignant Disorders.","authors":"Saverio Caini, Oreste Gallo","doi":"10.1001/jamaoto.2025.0404","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0404","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013061","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":"Final Ruling on Provisional Coverage for Medicare Telehealth Services by Audiologists.","authors":"Lori Zitelli, Catherine Palmer","doi":"10.1001/jamaoto.2025.0407","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0407","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983714","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":"Population Attributable Fraction of Incident Dementia Associated With Hearing Loss.","authors":"Emily Ishak, Emily A Burg, James Russell Pike, Pablo Martinez Amezcua, Kening Jiang, Danielle S Powell, Alison R Huang, Jonathan J Suen, Pamela L Lutsey, A Richey Sharrett, Josef Coresh, Nicholas S Reed, Jennifer A Deal, Jason R Smith","doi":"10.1001/jamaoto.2025.0192","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0192","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Hearing loss treatment delays cognitive decline in high-risk older adults. The preventive potential of addressing hearing loss on incident dementia in a community-based population of older adults, and whether it varies by method of hearing loss measurement, is unknown.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To calculate the population attributable fraction of incident dementia associated with hearing loss in older adults and to investigate differences by age, sex, self-reported race, and method of hearing loss measurement.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This prospective cohort study was part of the Atherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS) and had up to 8 years of follow-up (2011-2019). The 4 ARIC field centers in the study included Jackson, Mississippi; Forsyth County, North Carolina; the Minneapolis suburbs, Minnesota; and Washington County, Maryland. Community-dwelling older adults aged 66 to 90 years without dementia at baseline who underwent a hearing assessment at ARIC-NCS visit 6 (2016-2017) were included in the analysis. Data analysis took place between June 2022 and July 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposures: &lt;/strong&gt;Hearing loss measured objectively (audiometric) and subjectively (self-reported).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The main outcome was incident dementia (standardized algorithmic diagnosis with expert panel review). The population attributable fractions of dementia from both audiometric and self-reported hearing loss were calculated in the same participants, which quantified the maximum proportion of dementia risk in the population that can be attributed to hearing loss.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Among 2946 participants (mean [SD] age, 74.9 [4.6] years; 1751 [59.4] female; 637 Black [21.6%] and 2309 White [78.4%] individuals), 1947 participants (66.1%) had audiometric hearing loss, and 1097 (37.2%) had self-reported hearing loss. The population attributable fraction of dementia from any audiometric hearing loss was 32.0% (95% CI, 11.0%-46.5%). Population attributable fractions were similar by hearing loss severity (mild HL: 16.2% [95% CI, 4.2%-24.2%]; moderate or greater HL: 16.6% [95% CI, 3.9%-24.3%]). Self-reported hearing loss was not associated with an increased risk for dementia, so the population attributable fraction was not quantifiable. Population attributable fractions from audiometric hearing loss were larger among those who were 75 years and older (30.5% [95% CI, -5.8% to 53.1%]), female (30.8% [95% CI, 5.9%-47.1%]), and White (27.8% [95% CI, -6.0% to 49.8%]), relative to those who were younger than 75 years, male, and Black.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This cohort study suggests that treating hearing loss might delay dementia for a large number of older adults. Public health interventions targeting clinically significant audiometric hearing loss might have broad benefits for dementia prevention","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12006913/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024327","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":"Final Ruling on Provisional Coverage for Medicare Telehealth Services by Audiologists-Reply.","authors":"Peter R Dixon, Elizabeth Camposeo, Theodore R McRackan","doi":"10.1001/jamaoto.2025.0397","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0397","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008987","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 40-Year-Old With Nasal Ulceration and Septal Perforation.","authors":"Si Hao Tang, Morgan Blakely, Rijul S Kshirsagar","doi":"10.1001/jamaoto.2025.0399","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0399","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009945","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":"Development, Validation, and Valuation of a Head and Neck Cancer-Specific Health Utility Instrument (HNC-8D): A Head and Neck Cancer International Group Collaborative Study.","authors":"John R de Almeida, Jie Su, Abdullah AlShenaiber, Hesameddin Noroozi, Matthias Buttner, David P Goldstein, Aaron Hansen, Luiz P Kowalski, Lisa Licitra, Hisham Mehanna, Christopher W Noel, Ambica Parmar, Sandro Porceddu, Jolie Ringash, Simon Rogers, Marcos Antonio Dos Santos, Christian Simon, Minh-Tam Truong, Wei Xu","doi":"10.1001/jamaoto.2025.0160","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0160","url":null,"abstract":"<p><strong>Importance: </strong>Generic health utility instruments lack the discriminative ability to differentiate among health states in patients after head and neck cancer treatment.</p><p><strong>Objective: </strong>To develop, validate, and valuate a head and neck cancer-specific health utility measure.</p><p><strong>Design, setting, and participants: </strong>This psychometric study comprised 2 phases to develop and validate a health utility instrument. The first phase, development and validation, occurred from January 2021 to August 2022. An expert panel selected disease-specific quality-of-life instruments as the basis for a new utility instrument. Two datasets (n = 458 and 493) were used to establish dimension structure through exploratory factor analysis, and to select items using Rasch and psychometric criteria and expert opinion. Discriminative validity of the new instrument was tested by comparing scores for different disease severities (patients with and without gastrostomy and tracheostomy tubes). The second phase, valuation, was conducted from January 2023 to January 2024 in a quaternary referral center with healthy participants. Participants completed time-trade-off exercises for 100 sampled health states and were randomized to discovery and validation sets (80:20). Using a repeated measures model, a scoring algorithm to predict utilities of health states within the instrument was created in the discovery set and tested in both sets. Data were analyzed from January 2022 to December 2023.</p><p><strong>Intervention: </strong>Participants performed time-trade-off exercises for various states.</p><p><strong>Main outcomes and measures: </strong>Discriminative validity (first phase) and the mean absolute differences of predicted and observed utilities (second phase).</p><p><strong>Results: </strong>The European Organization for Research and Treatment of Cancer's Quality of Life Questionnaire-Core 30 and its Head and Neck module 43 were selected by the expert panel and used as the basis instruments. Exploratory factor analysis established 8 dimensions, with 1 item selected per dimension. Of the 488 respondents, 84 with gastrostomy and/or tracheostomy tubes reported lower scores for 7 of the 8 items. In the second phase, 2497 valuations were performed by 250 healthy participants (mean [SD] age, 42.4 [16.5] years; 166 [66%] females). The scoring algorithm produced mean absolute differences between predicted and observed utilities of 0.041 (95% CI, 0.034-0.047) and 0.082 (95% CI, 0.065-0.100) in the discovery and validation sets, respectively.</p><p><strong>Conclusions and relevance: </strong>This psychometric study developed a new head and neck cancer-specific utility measure, the HNC-8D (Head and Neck Cancer-8 Dimensions). The instrument demonstrated predictive accuracy for measuring health utility and can be used to differentiate health utility states following head and neck cancer treatment.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986829/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981113","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":"Olfactory Impairment and Mortality-The Crossroads of Neurodegeneration, Frailty, and Aging.","authors":"Nicholas R Rowan","doi":"10.1001/jamaoto.2025.0161","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0161","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063851","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":"Reflections on Electronic Health for Head and Neck Cancer-Insights Into Patient-Centered Palliative Care.","authors":"Xinyu Liu, Ying Zhang, Fusen Peng","doi":"10.1001/jamaoto.2025.0190","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0190","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988440","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 Deficits and Mortality in Older Adults.","authors":"Robert Ruane, Oliver Lampert, Maria Larsson, Davide Liborio Vetrano, Erika J Laukka, Ingrid Ekström","doi":"10.1001/jamaoto.2025.0174","DOIUrl":"https://doi.org/10.1001/jamaoto.2025.0174","url":null,"abstract":"<p><strong>Importance: </strong>Olfactory deficits are associated with higher mortality in older adults, but the mechanisms remain unclear. Further understanding this relationship could inform interventions to improve survival and quality of life for those with olfactory deficits.</p><p><strong>Objective: </strong>To investigate the association of olfactory deficits with all-cause and cause-specific mortality and to explore potential mediating factors.</p><p><strong>Design, setting, and participants: </strong>The Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), is an ongoing population-based, longitudinal cohort study with baseline between 2001 and 2004. Eligible participants were residents of Kungsholmen, Stockholm, Sweden, and aged between 60 and 99 years from March 21, 2001, to August 30, 2004. Twelve-year follow-up was completed in February 2013. Data analysis took place between February 2024 and July 2024.</p><p><strong>Main outcomes and measures: </strong>Olfactory ability was tested with the 16-item Sniffin' Sticks Odor Identification task. Mortality was determined through the Swedish National Cause of Death Register. Cox proportional hazards models examined the associations between olfaction and mortality over 6 years and 12 years. Competing hazard risks regression analyses assessed the olfactory-mortality association for specific death causes. Generalized structural equation models investigated mediators, including incident dementia, baseline chronic diseases, frailty, and malnutrition. The tested hypotheses were formulated after data collection.</p><p><strong>Results: </strong>Among 2524 participants (baseline mean [SD] age, 71.9 [10.0] years; 1545 [61.2%] female), 445 (17.6%) had died at 6 and 969 (38.4%) at 12 years of follow-up. Each additional incorrect answer on the odor identification test was associated with a 6% increased all-cause mortality risk at 6 years (hazard ratio [HR], 1.06 [95% CI, 1.03-1.08]) and 5% increased risk at 12 years (HR, 1.05 [95% CI, 1.03-1.08]) in multiadjusted models. In cause-specific models, the olfaction-mortality association had the greatest risk in relation to neurodegenerative death causes. Meaningful mediators for death at 6 years included dementia (23% of total association), frailty (11% of total association), and malnutrition (5% of total association). At 12 years, frailty remained a mediator (9% of total association).</p><p><strong>Conclusions and relevance: </strong>The results of this cohort study underscore the importance of olfactory function as a mortality risk marker in older adults and highlight the evolving influence of neurodegeneration and frailty on this relationship. Further research is needed to assess the clinical utility of olfactory assessments in identifying individuals at risk of adverse health outcomes.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015727","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}