JAMA otolaryngology-- head & neck surgery最新文献

{"title":"Exogenous Estrogen and Head and Neck Cancer-Reply.","authors":"Christian Doll, Elena Hofmann, Saskia Preissner","doi":"10.1001/jamaoto.2024.2159","DOIUrl":"10.1001/jamaoto.2024.2159","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"836-837"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758795","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 Figure 2.","authors":"","doi":"10.1001/jamaoto.2024.2344","DOIUrl":"10.1001/jamaoto.2024.2344","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"838"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258631/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633508","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":"Voice Disorder Prevalence and Vocal Health Characteristics in Adolescents.","authors":"Robert Brinton Fujiki, Susan L Thibeault","doi":"10.1001/jamaoto.2024.2081","DOIUrl":"10.1001/jamaoto.2024.2081","url":null,"abstract":"<p><strong>Importance: </strong>Voice disorders impede communication and detract from quality of life, yet little is known about how voice problems present in adolescents. This study characterized the prevalence of voice problems and vocal health characteristics of adolescents throughout the US.</p><p><strong>Objective: </strong>To determine the prevalence of adolescent voice problems in the US as well as the symptoms, voice use patterns, and risk factors associated with these problems.</p><p><strong>Design, setting, and participants: </strong>This prospectively performed, cross-sectional survey study conducted from March to June 2023 included a probability sample of adolescents (aged 13-17 years) who were located across the US.</p><p><strong>Main outcome and measures: </strong>Adolescents were surveyed concerning voice use, voice symptoms, demographic information, and substance use patterns. The Vocal Fatigue Index (VFI) was also completed. Fisher exact tests, χ2 tests, and logistic regression were used to compare those with and without reported voice problems.</p><p><strong>Results: </strong>Five-hundred and two adolescents participated (51.6% participation rate), including 248 female (49.4%), 7 nonbinary (1.3%), 254 male (50.6%), 4 transfemale (0.7%), and 3 transmale individuals (0.5%) (mean [SD] age, 15.2 [1.3] years). The lifetime prevalence of voice problems was 24.3%, and current prevalence was 7.4%. Voice-related diagnoses included dysphonia associated with acute illness, vocal hyperfunction, benign lesions, and muscle tension. The mean (SD) VFI score was 4.7 (8.09) for part 1, 1.6 (3.2) for part 2, and 2.1 (3.2) for part 3. Adolescents with voice complaints presented with significantly higher VFI scores than those without voice problems (Cohen d for part 1 = 0.78, part 2 = 0.59, and part 3 = 0.79). Voice problems interfered with daily tasks, prevented participation in extracurricular activities, limited the ability to sing, and were associated with school absences. Voice use patterns associated with voice problems included frequent loud voice use, coughing, and/or throat clearing. Risk factors for increased voice problem prevalence included part-time employment in childcare (odds ratio [OR], 6.4; 95% CI, 1.6-26.3), singing (OR, 2.08; 95% CI, 1.3-3.1), performance-related extracurricular activities (ie, musical theater [OR, 2.67; 95% CI, 1.1-6.6 ], karaoke [OR, 3.08; 95% CI, 1.3-6.9]), vaping (OR, 1.99; 95% CI, 1.1-3.5), and/or secondhand smoke exposure (OR, 1.83; 95% CI, 1.2-2.7). Adolescents identifying as transgender were more than 4 times (OR, 4.44; 95% CI, 0.63-31.2) as likely to report voice problems compared with cisgender adolescents.</p><p><strong>Conclusions: </strong>The results of this survey study illuminate the nature of voice problems in adolescents and may guide clinicians in preventing and treating voice disorders in this population. Future work may define the mechanisms through which these factors are associated with the","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"800-810"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758717","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":"Differentiating Superior and Inferior Parathyroid Adenomas-A Novel Ultrasonography-Based Approach.","authors":"Paul M Bunch, Reese W Randle","doi":"10.1001/jamaoto.2024.1659","DOIUrl":"10.1001/jamaoto.2024.1659","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"763-764"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633507","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":"Intraoperative Pathology Consultation in Patients With p16-Positive Unknown Primary Squamous Cell Carcinoma.","authors":"Daniel R Awad, Anisha Konanur, Robert L Ferris, Seungwon Kim, Umamaheswar Duvvuri, Simion I Chiosea","doi":"10.1001/jamaoto.2024.2011","DOIUrl":"10.1001/jamaoto.2024.2011","url":null,"abstract":"<p><strong>Importance: </strong>Current guidelines recommend intraoperative frozen section(s) during diagnostic surgery for squamous cell carcinoma for unknown primary tumors (SCCUP).</p><p><strong>Objective: </strong>To determine the utility of intraoperative pathology consultation during transoral robotic surgery (TORS) in localizing primary tumors and influencing need for adjuvant therapy.</p><p><strong>Design, setting, and participants: </strong>A retrospective case series including 47 adult patients with human papillomavirus (HPV)-associated SCCUP who underwent TORS/oropharyngectomy between January 2016 and February 2023 was carried out at a single tertiary care hospital. The analysis took place on May 13, 2024.</p><p><strong>Exposures: </strong>Nodal stage, tonsillectomy history, extranodal extension (ENE).</p><p><strong>Main outcomes and measures: </strong>Intraoperative pathology consultation and final pathology results were compared with surgical outcomes, including margin revision, need for second procedure and/or radiation with or without chemotherapy.</p><p><strong>Results: </strong>This study included 47 adult patients. Mean (range) age was 61 (41-79) years; patients were mostly men (37 [79%]). Overall, primary tumors were identified in 37 patients (79%), including all cases with positive nodes involving more than 1 neck level. Patients whose primary tumor was not found tended to have tobacco use history (8/10 vs 13/37 [35%]; difference, 45%; 95% CI, 16%-74%) and absence of ENE (8/10 vs 15/37 [41%]; difference, 39%; 95% CI, 10%-68%). Primary tumor was identified intraoperatively in 18 of 37 patients (49%). SCCs identified intraoperatively were significantly larger than SCCs found on permanent sections only: mean (SE), 1.2 (0.13) cm vs 0.5 (0.1) cm (difference, 0.7 cm; 95% CI, 0.53-1.94). The sensitivity, specificity, positive predictive value, and negative predictive value of intraoperative consultation was 49% (95% CI, 33%-64%), 100% (95% CI, 100%-100%), 100%, and 34% (95% CI, 19%-53%), respectively. Margins were revised in 11 of 18 patients (61%) whose primary tumor was identified intraoperatively (during original procedure) and in 3 of 19 patients (16%) whose primary tumor was identified on permanent pathologic findings only (during a second procedure) (11/18 [61%] vs 3/19 [16%]; difference, 45%; 95% CI, 17%-73%). However, there was no significant difference in the use of adjuvant radiotherapy with or without chemotherapy or need for a second procedure based on intraoperative primary tumor localization.</p><p><strong>Conclusion and relevance: </strong>In this case series study, the sensitivity and negative predictive value of intraoperative pathology consultation among 47 patients was less than 50%. Given the lack of influence on the need for radiotherapy with or without chemotherapy or second procedure, the practical utility of routine intraoperative frozen section requires further scrutiny.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"792-799"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11258632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633509","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":"Langerhans Cell Histiocytosis of the Nasal Mucosa.","authors":"Ajay Narayanan, Flavia Rosado, Andrew Vaughn, Matthew Ryan","doi":"10.1001/jamaoto.2024.1908","DOIUrl":"10.1001/jamaoto.2024.1908","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"831-832"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633510","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":"Concerns Regarding Hearing Loss and Cognitive Outcomes.","authors":"Hujun Wang, Yongzhen Li, Congxiao Wang","doi":"10.1001/jamaoto.2024.2174","DOIUrl":"10.1001/jamaoto.2024.2174","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"837"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758789","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":"Congenital Cutaneous Sinus at the Sternoclavicular Joint.","authors":"Xue-Qin Huang, Jian-Long Zheng, Yi-Ming Fan","doi":"10.1001/jamaoto.2024.2156","DOIUrl":"10.1001/jamaoto.2024.2156","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"829-830"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758791","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":"Long-Term Outcomes of Self-Fit vs Audiologist-Fit Hearing Aids.","authors":"Karina C De Sousa, Vinaya Manchaiah, David R Moore, Marien A Graham, De Wet Swanepoel","doi":"10.1001/jamaoto.2024.1825","DOIUrl":"10.1001/jamaoto.2024.1825","url":null,"abstract":"<p><strong>Importance: </strong>With rising interest in over-the-counter (OTC) hearing aids as an alternative to traditional audiologist-fit devices, understanding their long-term efficacy is crucial. However, given the novelty of the US Food and Drug Administration category of OTC hearing aids, minimal evidence currently supports their long-term efficacy.</p><p><strong>Objective: </strong>To compare the long-term self-reported outcomes at 8 months of self-fit OTC hearing aids to the same hearing aids fit by audiologists.</p><p><strong>Design, setting, and participants: </strong>Building on a previous randomized clinical trial, this follow-up comparative effectiveness research study reassessed a number of the original participants that were not lost to follow-up. Participants were initially divided into those with self-fit OTC hearing aids and those with audiologist-fit devices. Approximately 8 months after fitting, participants completed self-reported questionnaires. Missing data were addressed through multiple imputation. The original noninferiority trial was conducted at the University of Pretoria in South Africa from April 2022 to August 2022. The current analysis took place between July 7, 2023, to November 20, 2023.</p><p><strong>Interventions: </strong>In the original trial, participants in the self-fit device group received a pair of OTC hearing aids and independently fit them with remote support as needed. The audiologist-fit device group received the same hearing aids fit by a certified audiologist using best practices.</p><p><strong>Main outcomes and measures: </strong>The main outcomes were self-reported hearing aid benefit, measured using the Abbreviated Profile of Hearing Aid Benefit (APHAB) and the International Outcome Inventory for Hearing Aids (IOI-HA).</p><p><strong>Results: </strong>Of 64 participants in the trial, 44 participants were included in the extension study (21 [47.7%] in the audiologist-fit group; 23 [52.3%] in the self-fit group). The mean (SD) age of these participants was 63.0 (13.2) years, and 21 (47.7%) were male. At the long-term follow-up, self-fit and audiologist-fit groups showed no significant differences in the APHAB global score (mean difference, 0.02 [95% CI, -7.1 to 7.1]; Cohen d, 0.01 [95% CI, -0.5 to 0.5]) or the IOI-HA total score (mean difference, 1.5 [95% CI, -1.4 to 4.4]; Cohen d, 0.3 [95% CI, -0.2 to 0.8]). From 6 weeks to 8 months, no clinically meaningful group-time interaction was found between groups for the APHAB global score (Cohen d, 0.1 [95% CI, -0.2 to 0.3]), but a significant interaction for the IOI-HA total score was found (Cohen d, -0.6 [95% CI, -0.8 to -0.3]), with the self-fit group generally performing better.</p><p><strong>Conclusion: </strong>This comparative effectiveness research study demonstrated that self-fit OTC hearing aids can offer comparable long-term benefits to audiologist-fit hearing aids for individuals with mild to moderate hearing loss.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"765-771"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11240231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579712","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":"Exogenous Estrogen and Head and Neck Cancer.","authors":"Tsai-Ni Yang, Chien Shih, Yung-Shuo Kao","doi":"10.1001/jamaoto.2024.2158","DOIUrl":"10.1001/jamaoto.2024.2158","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"836"},"PeriodicalIF":6.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141758794","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}