JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Sore Throat and Diffuse Laryngeal Swelling in an Adult Male.","authors":"Xueqian Yang, Xiaolin Zhu, Wei Sun","doi":"10.1001/jamaoto.2026.1257","DOIUrl":"10.1001/jamaoto.2026.1257","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"824-825"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156602","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":"Young Male With Multifocal Oral Ulcers.","authors":"Tyler R Selkin, Elizabeth A Bilodeau, Bradley A Shessel","doi":"10.1001/jamaoto.2026.1251","DOIUrl":"10.1001/jamaoto.2026.1251","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"822-823"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156664","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":"Smell and Taste Disturbances Among Glucagon-Like Peptide-1 Receptor Agonist Users.","authors":"Jonathan Zontag, Nir Zontag","doi":"10.1001/jamaoto.2026.1498","DOIUrl":"10.1001/jamaoto.2026.1498","url":null,"abstract":"<p><strong>Importance: </strong>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have gained popularity over the last decade for both glycemic control and weight loss. Although various adverse events have been reported among GLP-1 RA users, little is known regarding their potential impact on smell and taste perception.</p><p><strong>Objective: </strong>To evaluate the association between GLP-1 RAs and smell and taste disturbances.</p><p><strong>Design, setting, and participants: </strong>This large-scale multicenter retrospective cohort study used electronic health records from a large electronic health records database (TriNetX Global Collaborative Network) from December 5, 2017, to April 20, 2026 (date of analysis), with follow-up of up to 2 years after treatment initiation. Patients (aged ≥18 years) diagnosed with type 2 diabetes (T2D) with no record of smell or taste disturbances were divided into 2 groups: the control group comprised patients prescribed T2D medications without GLP-1 RA exposure and the exposure group consisted of patients who received a GLP-1 RA prescription after their first recorded diagnosis of T2D. Propensity score matching was applied to balance demographic, clinical, and socioeconomic differences.</p><p><strong>Exposure: </strong>GLP-1 RA or different antidiabetic medications.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was incident smell and taste disturbances, identified using International Classification of Diseases (ICD) codes, assessed overall and separately during a follow-up period of 3 months to 2 years. Hazard ratios (HRs) and 95% CIs were estimated using Cox regression analyses to evaluate the risk of incident cases.</p><p><strong>Results: </strong>After matching, each cohort included 438 474 patients (GLP-1 RA: mean [SD] age, 57.7 [12.2] years; 240 620 females [54.9%]; control: mean [SD] age, 57.6 [13.4] years; 245 730 females [56.0%]). Patients with documented GLP-1 RA therapy had an increased risk of overall smell and taste disturbances (HR, 1.48; 95% CI, 1.37-1.61) compared with matched control patients. When stratified by outcome, GLP-1 RA use was associated with a higher risk of smell (HR, 1.81; 95% CI, 1.58-2.07) and taste (HR, 1.52; 95% CI, 1.35-1.71) disturbances. These findings were consistent throughout the follow-up period.</p><p><strong>Conclusions and relevance: </strong>This study suggests that GLP-1 RA therapy is associated with a higher risk of smell and taste disturbance, highlighting the need for closer monitoring and greater public health awareness. Future research is required to validate these findings and to further explore the mechanisms underlying this association.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"758-765"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317135","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":"Palate Repair Timing Under Age 15 Months and Early Speech Outcomes.","authors":"Katelyn Kotlarek, Kazlin Mason, Amy Davies, Yvonne Wren","doi":"10.1001/jamaoto.2026.1404","DOIUrl":"10.1001/jamaoto.2026.1404","url":null,"abstract":"<p><strong>Importance: </strong>Early primary palatoplasty is recommended to optimize speech outcomes, but it is unclear whether small variations in timing within the first 15 months affect the development of passive cleft speech characteristics (CSCs), which can persist despite early repair and impact early speech development.</p><p><strong>Objective: </strong>To examine whether differences in timing of primary palatoplasty before age 15 months are associated with development of passive CSCs at age 18 to 24 months and at age 36 months.</p><p><strong>Design, setting, and participants: </strong>This is a longitudinal cohort study including data from the Cleft Collective, a cohort of children with clefting in the UK recruited from all UK regional cleft centers. Recruitment and data collection began in 2013 and is ongoing. Analysis reported in this study took place on August 14, 2024. Participants were children with cleft palate with or without a cleft lip who had palatoplasty before 15 months and completed speech assessments at 18 to 24 months and/or at 36 months.</p><p><strong>Exposures: </strong>Palatoplasty before age 15 months.</p><p><strong>Main outcomes and measures: </strong>Presence of passive CSCs at 18 to 24 months and at 36 months.</p><p><strong>Results: </strong>Speech assessment data were available for 157 children at 18 to 24 months (mean [SD] age at primary palatoplasty, 9.6 [2.3] months; 75 male [47.8%]), of whom 53.5% had cleft palate only, and 174 children at 36 months (mean [SD] age at primary palatoplasty, 9.7 [2.2] months; 90 male [51.7%]), of whom 47.7% had cleft palate only. Palatoplasty technique was available for 105 children at 18 to 24 months and 117 children at 36 months; 94% received an intravelar veloplasty across both samples. Passive CSCs occurred in 18.5% of children aged 18 to 24 months and 16.7% of children aged 36 months. No association was seen at 18 to 24 months; at 36 months, each additional month at repair was associated with increased odds of passive CSCs (odds ratio, 1.24; 95% CI, 1.00-1.54).</p><p><strong>Conclusions and relevance: </strong>Results of this study suggest that even before age 15 months, later palatoplasty may be associated with modest increases in the likelihood of passive CSCs at age 36 months, highlighting the potential role of small delays in early speech and velopharyngeal function.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"753-757"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13261513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217919","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":"Artificial Intelligence-Based Risk Prediction Models for Complications After Tongue Cancer Surgery.","authors":"Dany Y Matar, Anthony Y Matar, Anahita Nimbalkar, Charbel G Saad, John J Lee, William Huang, Thomas Ren, Samuel Knoedler, Iman Ghanad, Dennis P Orgill, Gabriel Hundeshagen, Adriana C Panayi","doi":"10.1001/jamaoto.2026.1453","DOIUrl":"10.1001/jamaoto.2026.1453","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Glossectomy and reconstruction for tongue tumors carries substantial risk of postoperative morbidity, yet current tools offer limited individualized risk stratification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To develop and validate machine learning (ML) models to predict major 30-day postoperative complications after glossectomy and to compare performance with the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) risk calculator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This retrospective cohort study used 2008-2024 data from the ACS-NSQIP database, comprising more than 700 hospitals predominantly in the US. Thirty-one preoperatively available variables were used to train a logistic regression model and 5 ML models (neural network, support vector classifier, LightGBM, XGBoost, and stacked generalization). Among adult patients with tongue cancer, data for 2008 to 2023 were split 85:15 into training and validation sets, while data for 2024 were used as a test set.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Exposure: &lt;/strong&gt;Glossectomy of malignant tongue tumors.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;Six 30-day outcomes: surgical site infection, bleeding requiring transfusion, pneumonia, unplanned reoperation, any complication, and serious complications. Model prediction performance was primarily assessed on the test set using risk stratification (lift). Discrimination (area under the receiver operating characteristic and area under the precision-recall curve) and calibration (Brier score) were compared with the ACS-NSQIP risk calculator.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Data from 8266 adults (median [IQR] age, 63 [54-71] years; 4895 [59.2%] male) undergoing tongue resection for cancer were used to develop PRO-TONGUE (Postresection and Reconstruction Outcome Prediction Tool for Tongue Cancer Surgery), a publicly available, outcome-specific risk prediction tool that provides individualized, interpretable risk estimates to support preoperative planning. Procedures included partial glossectomy among 6132 patients (74.2%), composite/extended glossectomy among 784 (9.5%), total glossectomy among 341 (4.1%), and minor excisions among 1274 (15.4%). Unplanned reoperation occurred among 708 patients (8.6%), surgical site infection among 510 (6.2%), bleeding requiring transfusion among 546 (6.6%), pneumonia among 262 (3.2%), serious complications among 1197 (14.5%), and any complications among 1428 (17.3%). Outcome-specific model selection based on risk stratification of the test set identified XGBoost as optimal for bleeding, serious complications, and any complications, and LightGBM for reoperation, surgical site infection, and pneumonia. ML and logistic regression models demonstrated discriminative performance of the test set comparable to the ACS-NSQIP risk calculator across outcomes. Prediction of bleeding requiring transfusion, which was not available in the ACS-NSQIP risk calculator, sh","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"797-809"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271469","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":"Pembrolizumab Plus Quad-Shot Radiotherapy for Recurrent, Unresectable, or Metastatic Head and Neck Cancer: A Nonrandomized Clinical Trial.","authors":"Ryan T Hughes, Sydney Smith, Thomas W Lycan, Paul M Bunch, Ralph B D'Agostino, Bart A Frizzell, Rebecca D Kinney, Shafaq Rashid, Pierre Triozzi, Wei Zhang, Cristina M Furdui, Mercedes Porosnicu","doi":"10.1001/jamaoto.2026.1527","DOIUrl":"10.1001/jamaoto.2026.1527","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Importance: &lt;/strong&gt;Immune checkpoint inhibitor (ICI) monotherapy for patients with recurrent, unresectable, or metastatic (RUM) head and neck squamous cell carcinoma (HNSCC) is associated with poor outcomes. Low-dose, hypofractionated, quad-shot radiotherapy (QSRT) may enhance the efficacy of ICIs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate the efficacy and toxic effects of ICIs in combination with QSRT for patients with RUM HNSCC that is amenable to QSRT.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design, setting, and participants: &lt;/strong&gt;This single-arm, phase 2, nonrandomized clinical trial was conducted at a single, academic, National Cancer Institute-designated Comprehensive Cancer Center and included patients with RUM HNSCC who were going to receive treatment with pembrolizumab monotherapy and had a targetable site in the head and neck that was amenable to QSRT (based on location, prior radiotherapy dose, and tolerance). Patients were enrolled and treated between February 2021 and May 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Interventions: &lt;/strong&gt;Pembrolizumab (200 mg/m2) was administered every 3 weeks until disease progression, intolerance, or a maximum duration of 2 years. QSRT comprised 14.8 Gy in four 3.7-Gy fractions that were delivered twice daily on consecutive days. QSRT courses were delivered cyclically between pembrolizumab cycles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcomes and measures: &lt;/strong&gt;The primary outcome was overall response rate per Response Evaluation Criteria in Solid Tumors, version 1.1, in patients with at least 1 response assessment. Secondary outcomes were progression-free survival (PFS), overall survival (OS), and clinician-rated (Common Terminology Criteria for Adverse Events, version 5.0) and patient-reported (patient-reported outcomes version of the Common Terminology Criteria for Adverse Events, version 1.0) adverse effects (AEs).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Of the 29 individuals who were screened, 21 enrolled, and 15 patients (median [range] age, 61 [33-86] years) were eligible for response analysis: 5 women (33.3%), 10 men (66.7%), 9 individuals with oropharyngeal/oral cavity primary tumors, and 14 current/former smokers (93.3%). Fourteen patients had received prior systemic therapy, and 11 had received prior RT. Among evaluable patients, the overall response rate was 47% (95% CI, 21%-73%). Median PFS and OS among the treated patients (n = 20) were 9.2 months (95% CI, 3-17) and 14.9 months (95% CI, 5 to not estimable), respectively. For the 15 patients who were evaluable for the primary end point, median PFS was 11.5 months (95% CI, 5.1 to not estimable), and median OS was 15.3 months (95% CI, 6.3 to not estimable). Grade 3 and 4 AEs occurred for 6 and 2 patients, respectively. Patient-reported AEs did not substantially change over time.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions and relevance: &lt;/strong&gt;This nonrandomized trial demonstrated the feasibility of pembrolizumab plus QSRT for patients with RUM HNSCC and provides preliminary evidence of a potential ben","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"768-775"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13280763/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148271553","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 Unusual Tongue Mass.","authors":"Alyssa Y Li, Hagen Klieb, Christopher M K L Yao","doi":"10.1001/jamaoto.2026.1394","DOIUrl":"10.1001/jamaoto.2026.1394","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"826-827"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217907","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 Pulsatile Peritonsillar Mass.","authors":"Jou-Erh Yang, Yu-Hsi Liu","doi":"10.1001/jamaoto.2026.1398","DOIUrl":"10.1001/jamaoto.2026.1398","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"828-829"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217916","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":"Weight Loss at a Cost-Sense and Sensibility.","authors":"Charles A Riley, Edward D McCoul","doi":"10.1001/jamaoto.2026.1704","DOIUrl":"10.1001/jamaoto.2026.1704","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"766-767"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317118","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":"International Trends in Head and Neck Cancer Mortality.","authors":"Tsukasa Higashionna, Tatsuaki Takeda, Mariko Fujii, Nanami Sako, Keith Belangoy, Quynh Thi Vu, Ko Harada, Yoshito Nishimura, Hideharu Hagiya, Hirofumi Hamano, Michio Yamamoto, Yoshito Zamami, Toshihiro Koyama","doi":"10.1001/jamaoto.2026.1593","DOIUrl":"10.1001/jamaoto.2026.1593","url":null,"abstract":"<p><strong>Importance: </strong>Head and neck cancer (HNC) accounts for nearly 1 million new cases and approximately half a million deaths annually worldwide, representing a substantial global health burden. Despite an overall decline in mortality in many regions, patterns vary across anatomical subsites and countries.</p><p><strong>Objective: </strong>To evaluate international and national mortality trends in HNC and its major anatomical subsites from 2001 to 2023.</p><p><strong>Design, setting, and participants: </strong>This observational epidemiologic study analyzed population-based mortality data from the World Health Organization (WHO) Mortality Database for 73 countries between 2001 and 2023. Data collection was conducted in May 2025, and the data were analyzed between May and October 2025. Eligible countries had medium- to high-quality vital registration data. Age-standardized mortality rates (ASRs) were calculated using the new WHO World Standard Population. Country-specific trends from 2010 to 2023 were assessed using joinpoint regression among countries with at least 7 years of available data.</p><p><strong>Main outcomes and measures: </strong>ASRs and average annual percentage change in HNC mortality overall and by anatomical subsite using population-based analysis.</p><p><strong>Results: </strong>From 2001 to 2023, 2 000 066 HNC-related deaths (450 657 females; 1 549 409 males) were recorded. Internationally, ASRs decreased by 38.9%, with greater reductions among male individuals than among female individuals. Substantial divergence was observed across subsites: laryngeal cancer mortality decreased markedly (-50.1%), whereas increasing trends in oropharyngeal cancer mortality were observed in many countries in recent years, particularly in high-income countries such as the UK (average annual percentage change, 4.30%) and the US (average annual percentage change, 3.26%).</p><p><strong>Conclusions and relevance: </strong>Results of this study suggest that, although overall HNC-related ASRs have declined internationally, marked variation across subsites and countries persists. The contrasting trends between laryngeal and oropharyngeal cancers underscore the need for subtype-specific prevention strategies and continued global surveillance.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"810-815"},"PeriodicalIF":7.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13306487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148317075","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}