Journal of Otolaryngology - Head & Neck Surgery最新文献

{"title":"Formal Mentorship in Surgical Training: A Long-Term Prospective Interventional Study.","authors":"Sepideh Mohajeri, Hadi Seikaly, Yaser Alrajhi, Erin D Wright, Hamdy El-Hakim, Han Zhang","doi":"10.1177/19160216241307555","DOIUrl":"10.1177/19160216241307555","url":null,"abstract":"<p><strong>Objective: </strong>Surgical training programs have a high prevalence of trainee stress and burnout. Formal mentorship programs (FMP) have been shown to alleviate these factors and improve quality of life (QOL) in short-term follow-up. This study aims to determine the long-term effects of an FMP on the well-being of a single-center cohort of surgical trainees.</p><p><strong>Methods: </strong>A voluntary FMP was established at a surgical training program comprised 8 resident physicians. To quantitatively measure stress and burnout, the Perceived Stress Survey (PSS) and Maslach Burnout Inventory (MBI) were administered at baseline, 3, 6, 9, 12, 18, and 24 months. The World Health Quality of Life-Bref Questionnaire (WH-QOL) was administered at baseline, 12 and 24 months.</p><p><strong>Results: </strong>Baseline levels of stress and burnout were high among all residents with an average PSS of 18.5 and MBI of 47.6, 50.6, and 16.5 for the emotional, depersonalization, and personal achievement domains respectively. After FMP implementation, PSS was reduced to 7.9 at 12 months (<i>P</i> = .001). These scores were sustained at 24 months (6.8, <i>P</i> = 1). MBI scores improved in emotional exhaustion (14.9, <i>P</i> < .0001), depersonalization (20.1, <i>P</i> < .0001), and personal achievement (40.1, <i>P</i> < .0001) at 12 months. All these benefits were sustained at 24 months. Baseline overall WH-QOL scores reflected low QOL (71.9). These significantly improved at 12 months (37.5, <i>P</i> = .002) with further improvement by 24 months (17.2, <i>P</i> = .03).</p><p><strong>Conclusion: </strong>Long-term follow-up of a previously successful academic surgical FMP showed lasting improvements in stress, burnout, and overall QOL, despite new life challenges.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216241307555"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11696942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation and Translation of the Neck Dissection Impairment Index (NDII) into Spanish.","authors":"Lismelia Vargas, Jake Langlie, Christie McGee, Ruixuan Ma, Olivia Perdigon, Stephen Y Lai, Douglas Chepeha, Francisco J Civantos","doi":"10.1177/19160216251321457","DOIUrl":"10.1177/19160216251321457","url":null,"abstract":"<p><p>ImportanceSelective, modified radical, and radical neck dissections are common surgical procedures that can result in significant musculoskeletal issues of the neck and shoulder. Quality-of-life evaluations after neck dissection must assess and quantify these dysfunctions to allow subsequent comparison of outcomes after different treatments.ObjectiveThere is no validated Spanish-language questionnaire designed to evaluate neck and shoulder dysfunction after cervical lymphadenectomy. We therefore sought to translate a version of the Neck Dissection Impairment Index (NDII) into Spanish.Design, Settings, and ParticipantsA three-phased approach was used. Phase 1: The NDII was translated from English to Spanish using a \"forward and backward\" translational technique following international guidelines. Phase 2: The questionnaire was administered to six patients from our head and neck surgery clinic who were bilingual and fluent in both English and Spanish. Phase 3: The final version was administered prospectively to 34 patients with prior history of neck dissection (ND). These patients were asked to complete the questionnaire a second time 3 to 6 weeks after their first response. Test-retest reliability was calculated with Spearman's correlation. Internal consistency was elicited using Cronbach's alpha.Main Outcome(s) and Measure(s)NDII score at initial administration and follow-up administration 6 weeks later, demographic data.ResultsNDII was successfully translated and validated into Spanish. Cronbach's alpha revealed high internal consistency at both the first time point 0.95 (mean standardized score: 95 (88.1, 97.5), 95% CI: 0.89, 0.97) and at the second time point 0.90 (mean standardized score: 92.5 (80.6, 100.0), 95% CI: 0.81, 0.95). The Spearman's correlation for test-retest reliability of overall score was strong (rho = 0.772, <i>P</i> < 0.001). The intraclass correlation coefficient of the overall score was moderate (ICC = 0.683, <i>P</i> < 0.001).Conclusions and RelevanceNDII is a recognized, previously validated quality-of-life (QOL) tool for the identification of ND-related dysfunction. This validated Spanish version will allow clinicians to adequately assess the neck and shoulder-related QOL for the Spanish-speaking population who are under-represented in head and neck research.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251321457"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11898087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the COVID-19 Pandemic on Retirement Among Canadian Otolaryngologists.","authors":"Nick Sahlollbey, Arunima Vijay, Michele M Carr","doi":"10.1177/19160216251321458","DOIUrl":"10.1177/19160216251321458","url":null,"abstract":"<p><p>IntroductionOtolaryngologists were among the physicians with the highest risk of exposure to SARS-CoV-2, and more than half of them reported anxiety and distress during the pandemic. Consequences of this experience on retirement plans among otolaryngologists are unknown. This study aimed to describe the effect of the pandemic on retirement plans among otolaryngologists.MethodsA cross-sectional survey assessed retirement plans of physicians in the Canadian Society of Otolaryngology-Head and Neck Surgery (CSOHNS) between May and June 2023. Participants were recruited through CSOHNS membership lists. Respondents shared demographic information and rated 4 pandemic-related factors and 13 independent factors on a 5-point Likert scale from least important to most important in influencing retirement.ResultsEighty-two members responded, of which 20 (24.4%) were females. All female participants were 65 or younger, whereas 25 (40.3%) males were 65 or older. Half of the participants were in academic practice; 39% reported no change to their anticipated retirement date prior to the pandemic, whereas 25% reported either earlier or later dates. A greater proportion of female otolaryngologists reported earlier dates of retirement than originally planned compared with males (40% vs 19.3%). The factors most commonly rated as \"important\" were the desire for time with loved ones (mean: 3.82, SD: 1.179), the desire to improve their quality of life (mean: 3.65, SD: 1.344), and increased workload (mean: 3.26, SD: 1.210). Significant differences were observed between genders and age groups (≤55 years vs >55 years) regarding increased workload, desire for improved quality of life, personal and loved ones' health concerns, pandemic-related concerns, psychological/emotional issues, and burnout (<i>P</i> < .05).ConclusionsPandemic-related factors play a limited role in retirement decisions made by otolaryngologists. More females reported earlier retirement dates after the pandemic, which may further exacerbate preexisting gender inequalities in the otolaryngology workforce.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251321458"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11915291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Head and Neck Carcinoma - A Retrospective Study on 1115 Head and Neck Carcinoma Patients in Austria.","authors":"Barbara Kofler, Margarethe Hochleitner, Benedikt Hofauer, Wegene Borena, Daniel Dejaco, Volker Schartinger, Michelle Liu, Teresa Steinbichler, Jozsef Dudas, Matthias Santer, Joachim Schmutzhard, Herbert Riechelmann","doi":"10.1177/19160216251318238","DOIUrl":"https://doi.org/10.1177/19160216251318238","url":null,"abstract":"<p><p>ImportanceIn different types of carcinoma, sex has a strong impact on risk factors, diagnosis, treatment, and outcomes. Previous studies have reported that female patients with head and neck carcinoma (HNC) have better survival.ObjectiveThis study aimed to analyze sex differences in tumor regression and survival, as well as host- and disease-related factors.DesignA retrospective cohort study.SettingTertiary Care, University Hospital.Participants1115 patients registered in the Head and Neck Tumor Registry of the Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck were included.Main Outcome MeasuresSeveral host- and disease-related factors were analyzed to determine possible sex differences.ResultsThis study included 1115 patients with HNC, of whom 78.6% (n = 876) were men and 21.4% (n = 239) were women. There were no differences in tumor regression or incident cases per year in our department between male and female patients with HNC. Statistically significant sex differences were found for tumor site (<i>P</i> < .001), Union for International Cancer Control (UICC) stage (<i>P</i> = .04), treatment modality (<i>P</i> = .027), alcohol consumption (<i>P</i> = .005), and alcohol cessation (<i>P</i> < .001).Conclusions and RelevanceThis study revealed significant sex differences in patients with HNC. Female patients with HNC were characterized by a higher percentage of oral carcinoma, lower UICC tumor stage, single treatment modality, and less alcohol consumption than men.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251318238"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Gap Detection Threshold Predicts Late Speech Perception in Cochlear Implant Users.","authors":"Dianzhao Xie, Jianfen Luo, Xiuhua Chao, Ruijie Wang, Zhaomin Fan, Haibo Wang, Lei Xu","doi":"10.1177/19160216251333356","DOIUrl":"https://doi.org/10.1177/19160216251333356","url":null,"abstract":"<p><p>ObjectiveTo study whether the ability to detect frequency changes or temporal gaps at the early phase postactivation can predict speech perception performance at the late phase postactivation in postlingually deafened cochlear implant (CI) users.MethodPsychophysical tests and event-related potential (ERP) tests were conducted at the third-month postactivation (early phase postactivation, T1) and after 1-year postactivation (late phase postactivation, T2) in 27 postlingually deafened CI users. CI hearing thresholds and speech perception performance were measured at T1 and T2. The frequency change detection threshold (FCDT) and gap detection threshold (GDT) were obtained through psychophysical tests. The evoked threshold, amplitude, and latency of auditory change complex response, evoked by frequency change or temporal gap stimuli, were investigated using ERP tests.ResultsCompared with T1, speech perception performance was significantly better at T2, but there was no significant difference in the psychophysical or ERP test results. Speech perception performance at T2 could be predicted by GDT at T1, but not by FCDT or ERP indicators at T1. Receiver-operating characteristic curve analysis suggested that the GDT at T1 may be moderately accurate in discriminating between good and poor speech perception groups at T2.ConclusionCompared to early phase postactivation, CI users' ability to detect frequency changes or temporal gaps did not change significantly at the late phase postactivation, but speech perception performance improved significantly. The early GDT can predict later speech perception performance of CI users.Level of EvidenceIII.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333356"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Location-Grading-Node-Metastasis Staging System in Patients With Head and Neck Soft Tissue Sarcoma.","authors":"Dingfu Du, Shaojun Wu, Zilu Wang, Yuanxiang Guan, Ke Jiang, Bushu Xu, Yao Liang","doi":"10.1177/19160216251333359","DOIUrl":"https://doi.org/10.1177/19160216251333359","url":null,"abstract":"<p><p>ImportanceUnlike other head and neck cancers, head and neck soft tissue sarcoma (HN-STS) is staged similarly to sarcomas in the trunk and extremities. The current American Joint Committee on Cancer (AJCC) staging system has limitations that hinder accurate prognosis prediction for HN-STS.ObjectiveWe aimed to develop a novel location-grading-node-metastasis (LGNM) staging system based on the primary tumor location to more accurately stratify prognosis for HN-STS.DesignA retrospective case series from 1990 to 2021.Setting/ParticipantsThis study included 471 patients diagnosed with HN-STS at Sun Yat-sen University Cancer Center between 1990 and 2021.Main outcome measuresIn the primary analysis, we obtained the overall survival (OS) rate. Secondary measures included area under the receiver operating characteristic curve, Harrell's <i>C</i>, Somers' <i>D</i>, Gönen and Heller's <i>K</i>, O'Quigley's ρ2<i>k</i>, Royston's <i>R</i>², the Bayesian information criterion for concordance, and variation in patient outcomes.ResultsThe eighth edition of AJCC T classification for tumor size inadequately conveys prognosis information. In contrast, the primary tumor location and local invasion are prognostic factors for HN-STS and categorized into 4 stages: L1 (low risk: scalp, face, supraclavicular, ear), L2 (intermediate risk: neck, paravertebral, pharynx, tonsil, eye, orbit), L3 (high risk: cavity, lip, palate, buccal mucosa, salivary gland, maxilla, mandible), and L4 (any location with local invasion). The new LGNM staging system effectively distributed patients into stages I to IV, with statistically-significant survival differences among these stages. Five-year OS rates were 96.9% for stage I, 78.4% for stage II, 37.1% for stage III, and 7.1% for stage IV (<i>P</i> < .001). Additionally, the LGNM staging system demonstrated superior predictive ability and concordance compared with the seventh and eighth editions of AJCC staging systems.Conclusions/RelevanceThe LGNM staging system shows better homogeneity and discriminatory power than the AJCC system, improving risk stratification and prognosis prediction in HN-STS.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333359"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perineural Invasion Unveiled: Deciphering the Prognostic Impact of Diameter and Quantity Subcategories in Oral Cancer.","authors":"Hui-Wen Cheng, Li-Han Lin, Hung-Pin Lin, Chung-Ji Liu","doi":"10.1177/19160216251316219","DOIUrl":"10.1177/19160216251316219","url":null,"abstract":"<p><strong>Importance: </strong>Perineural invasion (PNI) is an established prognostic factor in oral squamous cell carcinoma (OSCC), but the impact of its subcategories on survival is not fully understood. This study quantifies the number and diameter of PNI foci to assess their prognostic relevance in OSCC.</p><p><strong>Objective: </strong>To evaluate the prognostic significance of PNI subcategories, specifically the number and diameter of PNI foci, as predictors of overall survival (OS) and disease-free survival (DFS) in OSCC patients.</p><p><strong>Design: </strong>Retrospective cohort study, adhering to STROBE guidelines.</p><p><strong>Setting: </strong>Single-center study at MacKay Memorial Hospital, Taiwan, including patients diagnosed with OSCC from 2005 to 2018.</p><p><strong>Participants: </strong>Nine hundred twenty-six patients with biopsy-proven OSCC, excluding those with perioperative mortality or incomplete follow-up.</p><p><strong>Exposure: </strong>Histological evaluation of PNI, including quantifying the number and diameter of invaded nerves, along with clinicopathological features such as tumor stage and lymphovascular invasion (LVI).</p><p><strong>Main outcome measures: </strong>OS and DFS, assessed via Cox proportional hazards models, Kaplan-Meier survival analysis, and receiver operating characteristic curve analysis for PNI foci subcategories.</p><p><strong>Results: </strong>PNI was present in 138 (14.9%) patients and was significantly associated with adverse histologic features, advanced tumor stage, nodal involvement, metastasis, and LVI. Multivariate analysis revealed that both the number of PNI foci greater than 4 and nerve diameters exceeding 0.21 mm were significantly associated with poorer OS and DFS (<i>P</i> < .05). After adjusting for clinical variables, PNI remained an independent predictor of worse OS [hazard ratio (HR): 1.37] and DFS (HR: 1.46).</p><p><strong>Conclusions and relevance: </strong>PNI is a significant independent prognostic factor in OSCC. Patients with more than 4 PNI foci or nerve involvement greater than 0.21 mm in diameter experienced significantly worse survival outcomes. These findings suggest that detailed assessment of PNI subcategories should be incorporated into OSCC management, guiding treatment decisions and potentially informing the need for adjuvant therapies.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251316219"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of Otolaryngologists on Single-Entry Models for Managing Wait Times in Community-Based Health Care in Ontario: A Qualitative Study.","authors":"Justin Shapiro, Jonah Perlmutter, Charlotte Axelrod, Saruchi Bandargal, Gabie Pundaky, Ben B Levy, Veronica Grad, John de Almeida, Joel Davies, Brian Rotenberg, Antoine Eskander, Janet Chung, David R Urbach, Yvonne Chan","doi":"10.1177/19160216251336682","DOIUrl":"10.1177/19160216251336682","url":null,"abstract":"<p><p>ImportanceLong wait times for medical care have been exacerbated following the pandemic in many health systems. Single-entry models (SEMs) have been proposed as a strategy to manage growing surgical backlogs and increase timeliness and quality of care by creating a single queue and centralizing the referral triage process.ObjectiveThe primary objective was to evaluate the perceptions of SEMs among community otolaryngologists for managing surgical backlogs. The secondary objectives were to better understand their experiences with the current system and to investigate their recommendations for implementing an SEM.DesignInterpretive Description.SettingOntario, Canada.ParticipantsNine community-based otolaryngologists.Intervention/ExposuresNot available.MethodsVirtual semi-structured interviews were conducted with study participants. Data were independently analyzed using inductive and deductive methods by multiple team members. Results were triangulated, and a final coding framework was developed collaboratively from which themes were identified.Main Outcome MeasuresPerceptions of SEMs as well as recommendations for design and implementation.ResultsThree thematic domains and 9 subdomains were identified from our interview data: (1) factors affecting the utility of SEMs; (2) opinions and buy-in of physicians; and (3) opportunities to improve equity.Conclusions and RelevanceWe identified a number of factors that should be considered in supporting community-based otolaryngologists to adopt SEMs as a strategy for ensuring timely and equitable access to care. Clinical leaders and specialty organizations play a pivotal role for such changes to succeed. Implementing SEMs may be an important step toward increasing equity, quality, efficiency, and cost-effectiveness in otolaryngology.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251336682"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078121","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychological Distress in Patients with Long-lasting COVID-19 Olfactory Dysfunction.","authors":"Manon Louvrier, Sven Saussez, Jerome R Lechien","doi":"10.1177/19160216251328960","DOIUrl":"https://doi.org/10.1177/19160216251328960","url":null,"abstract":"<p><p>ObjectiveThe aim of this study was to investigate the psychological distress associated with long-lasting COVID-19 olfactory dysfunction (OD).MethodsPatients with an OD lasting for more than 6 months were consecutively recruited from the Dour Medical Center (Belgium) from August 2023 to January 2024. The olfaction was investigated with the Olfactory Disorder Questionnaires (ODQ) and the threshold, identification, and discrimination (TDI) testing. General Anxiety Disorder (GAD-7) and Patient Health Questionnaire (PHQ-9) were used to investigate the psychological distress of patients. The olfactory and psychological outcomes of patients were compared with a group of individuals without OD.ResultsA total of 220 patients and 102 asymptomatic individuals completed the evaluations. The mean duration of OD was 31.1 ± 25.1 months. The mean GAD-7 and PHQ-9 scores were significantly higher in OD patients than in asymptomatic individuals (<i>P</i> < 0.008). The OD patient prevalence of mild-to-severe depression (51.2% vs. 44.1%) and mild-to-severe anxiety (39.5% vs. 32.4%) disorders was significantly higher than asymptomatic individuals. Severe anxiety was associated with the presence of anosmia. GAD-7 and PHQ-9 scores were higher in females than in males. The severity of depression (PHQ-9) and anxiety (GAD-7) was significantly associated with the severity of OD (ODQ) and nasal symptoms (SNOT-22).ConclusionThe presence of a long-lasting OD in patients consulting in otolaryngology is associated with psychological distress. While the causality relationship remains unclear, depression and anxiety symptoms must be investigated in this subgroup of patients with long COVID-19.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251328960"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143997395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Intraoperative Interventions on Hypocalcemia Post-Total Thyroidectomy: A Meta-Analysis.","authors":"Hao-Wei Hsu, Sheng-Hsin Huang, Shao Huai Lee, Shih-Tsang Lin, Mingchih Chen, Ru-Yung Yang, Shyh-Dye Lee, Jeng-Wen Chen","doi":"10.1177/19160216251333355","DOIUrl":"https://doi.org/10.1177/19160216251333355","url":null,"abstract":"<p><p>ImportancePostoperative hypocalcemia following total thyroidectomy (TT) can significantly affect patients' quality of life. However, the most effective intraoperative interventions to mitigate this risk remain uncertain.ObjectiveTo assess the efficacy of parathyroid gland autotransplantation (PTA), near-infrared autofluorescence (NIRAF), and indocyanine green angiography (ICGA) in reducing postoperative hypocalcemia risk after TT.DesignMeta-analysis.SettingThis meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, utilizing data from PubMed, Embase, and the Cochrane Library, with searches conducted through February 2024.ParticipantsPatients undergoing TT with or without intraoperative interventions of PTA, NIRAF, ICGA, or a combined approach.InterventionsPTA, NIRAF, ICGA, or a combination of these methods.Main Outcome MeasuresIncidence of postoperative transient and permanent hypocalcemia.ResultsFrom 582 identified records, 32 studies, including 13,299 TT patients (6386 with benign and 6913 with malignant conditions), met the inclusion criteria. PTA was associated with a higher incidence of transient postoperative hypocalcemia (OR = 1.98; 95% CI: 1.42-2.77; <i>I</i>² = 84%). Conversely, NIRAF (OR = 0.45; 95% CI: 0.35-0.57; <i>I</i>² = 0%) and ICGA (OR = 0.22; 95% CI: 0.07-0.69; <i>I</i>² = 0%) showed reduced incidences of transient hypocalcemia. The combined NIRAF and ICGA approach, evaluated in 2 studies, yielded inconclusive results (OR = 0.62; 95% CI: 0.28-1.37).Conclusions and RelevanceIntraoperative use of NIRAF and ICGA significantly decreased the incidence of transient hypocalcemia following TT, whereas PTA did not demonstrate similar efficacy. Minimal effects on permanent hypocalcemia were observed across interventions. Further research is necessary to clarify the effectiveness of the combined NIRAF and ICGA approach.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333355"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}