Journal of Otolaryngology - Head & Neck Surgery最新文献

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Lessons Learned: A Decade of Implementing an Interdisciplinary Airway Training Simulation Module. 经验教训:十年来实施跨学科气道训练模拟模块。
IF 2.2 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-12-17 DOI: 10.1177/19160216251398772
George Gerardis, Jennifer A Silver, Meredith Young, Milène A Azzam, Rachel Fisher, Ilana Bank, Lily H P Nguyen
{"title":"Lessons Learned: A Decade of Implementing an Interdisciplinary Airway Training Simulation Module.","authors":"George Gerardis, Jennifer A Silver, Meredith Young, Milène A Azzam, Rachel Fisher, Ilana Bank, Lily H P Nguyen","doi":"10.1177/19160216251398772","DOIUrl":"10.1177/19160216251398772","url":null,"abstract":"<p><p>ImportanceNontechnical skills are crucial in delivering critical and urgent patient care. Through our simulation module, we gear residents and interprofessional personnel with the knowledge and skills necessary to tackle complex airway emergencies and limit human error.ObjectiveDevelop, implement, adapt, and evaluate a novel interdisciplinary and interprofessional crisis resource management (CRM) simulation module for the management of complex airways.DesignSimulation-Based Quality Improvement Project.SettingMcGill University's Arnold and Blema Steinberg Medical Simulation Center and a variety of hospital environments at the McGill University Health Centre in Montreal, Quebec, Canada.Participants138 residents (otolaryngology, anesthesia, pediatric emergency medicine) and allied healthcare professionals (nurses and respiratory therapists) participated in 20 unique scenarios.Intervention or ExposuresFrom 2012 to 2022, modules occurred from 4 to 6 half days per year, structured as 3 to 4 simulation scenarios, each followed by debriefing sessions.Main Outcome MeasuresParticipants completed self-assessment forms evaluating module satisfaction, CRM skill development, and narrative commentary. Quantitative and qualitative data were obtained and analyzed.ResultsParticipants reported a significant perceived increase (<i>P</i> < .05) in all nontechnical CRM skills. Participants without previous CRM training reached comparable levels in CRM skills to those with such training. Increasing involvement of allied healthcare professionals, formal debriefing focused on role clarity, and increasing complexity of scenarios are identified as key elements for stressing CRM skills and consolidating lessons learned.ConclusionsThis module is among the first of its kind in otolaryngology given its interprofessional, longitudinal, and evolving nature, while providing an opportunity for residents to develop nontechnical skills through simulation. Its interdisciplinary and interprofessional nature is a key element to its success.RelevanceThis module aims to translate into positive results in patient safety and patient outcomes in challenging airway management scenarios. Implementing modules as continued medical education may help maintain proficiency overtime.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251398772"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145774750","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}
引用次数: 0
Preoperative Radiotherapy Does Not Increase the Risk for Early Complications Following Surgery for Oral Cancer: A Study on Data From the Randomized ARTSCAN 2 Trial. 术前放疗不会增加口腔癌术后早期并发症的风险:来自随机ARTSCAN 2试验的数据研究
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-06-14 DOI: 10.1177/19160216251345473
Kristin Carlwig, Maria Gebre-Medhin, Lennart Greiff, Peter Hällman, Per Nilsson, Johan Wennerberg, Björn Zackrisson, Johanna Sjövall
{"title":"Preoperative Radiotherapy Does Not Increase the Risk for Early Complications Following Surgery for Oral Cancer: A Study on Data From the Randomized ARTSCAN 2 Trial.","authors":"Kristin Carlwig, Maria Gebre-Medhin, Lennart Greiff, Peter Hällman, Per Nilsson, Johan Wennerberg, Björn Zackrisson, Johanna Sjövall","doi":"10.1177/19160216251345473","DOIUrl":"10.1177/19160216251345473","url":null,"abstract":"<p><p>ImportanceThe management of complications following oral cavity squamous cell carcinoma (OCSCC) surgery can be challenging. Previous studies show conflicting results on complication risks after preoperative radiotherapy (RT), necessitating a randomized controlled trial (RCT).ObjectiveTo compare early complications during hospitalization for OCSCC surgery between patients receiving preoperative accelerated fractionated RT and those planned for but not yet exposed to RT.DesignA part of the ARTSCAN 2 RCT comparing preoperative accelerated RT with postoperative conventionally fractionated RT for OCSCC.SettingA multicentre trial in 6 tertiary care hospitals in Sweden.ParticipantsUntreated and resectable OCSCC patients of all stages recommended combination treatment by the local multidisciplinary board.InterventionPreoperative accelerated RT was administered twice daily to a total dose of 68 Gy, completed 4 to 6 weeks before surgery.Main Outcome MeasuresComplications during hospitalization included wound infection, neck flap necrosis, chyle leakage, oro/pharyngocutaneous fistula, free flap necrosis, tracheostomy, revision surgery, and medical complications. Length of surgery, perioperative blood loss, and transfusions were also monitored.ResultsTwo hundred and twenty-one patients were eligible for analysis: 103 in the preoperative RT group and 118 not yet exposed to RT. Complication rates were low, with no statistically significant differences between groups. Patients receiving preoperative RT had similar wound infection rates (12/103; 11.7%) to those not exposed (9/118; 7.6%) (<i>P</i> = .31). Among free flap patients, 1/40 (2.5%) in the preoperative RT group and 3/52 (5.8%) in the unirradiated group had free flap necrosis (<i>P</i> = .63). No differences were found in oro/pharyngocutaneous fistula frequency (3/103; 2.9% vs 3/118; 2.5%) (<i>P</i> = 1.00).Conclusion and RelevancePreoperative accelerated RT at 68 Gy, administered 4 to 6 weeks before surgery, does not increase early complications. Although survival rates, morbidities, quality of life, and societal costs need consideration in the ARTSCAN 2 assessment, our findings show that early postoperative complication risks remain unchanged by preoperative RT.Trial RegistrationISRCTN, ISRCTN00608410, Registered 20 March 2008-Retrospectively registered, https://www.isrctn.com/ISRCTN00608410.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251345473"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171260/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293877","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}
引用次数: 0
Prognostic Factors of Pediatric Acute Ethmoidal Rhinosinusitis With Orbital Subperiosteal Abscess: A Retrospective Cohort Study. 儿童急性筛窦性鼻窦炎合并眼眶骨膜下脓肿的预后因素:一项回顾性队列研究。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-07-13 DOI: 10.1177/19160216251349444
Eric Moreddu, Marie-Eva Rossi, Dalia Bellal, Fadi Alshawareb, Richard Nicollas, Jawad Qarbal
{"title":"Prognostic Factors of Pediatric Acute Ethmoidal Rhinosinusitis With Orbital Subperiosteal Abscess: A Retrospective Cohort Study.","authors":"Eric Moreddu, Marie-Eva Rossi, Dalia Bellal, Fadi Alshawareb, Richard Nicollas, Jawad Qarbal","doi":"10.1177/19160216251349444","DOIUrl":"10.1177/19160216251349444","url":null,"abstract":"<p><p>ObjectiveTo identify reliable clinical, biological, and radiological markers predicting the failure of medical treatment in pediatric patients with acute ethmoidal rhinosinusitis (AERS) and subperiosteal abscess, facilitating informed decisions regarding the need for surgical intervention.DesignRetrospective multicenter cohort study.SettingPediatric otorhinolaryngology departments at a tertiary-care center and a public hospital in France, spanning from January 2014 to January 2024.ParticipantsChildren under 18 years diagnosed with Chandler stage III orbital complication of AERS, confirmed by computed tomography (CT).InterventionsInitial treatment with antibiotics, with surgical intervention as required based on clinical evaluation.Main Outcome MeasuresFactors associated with the need for surgical intervention, including demographic data, clinical examination, C-reactive protein (CRP) levels, leukocyte count, and CT evaluation.ResultsOut of 65 patients, 31 (48%) underwent surgery and 34 (52%) were treated with antibiotics alone. In multivariate analysis adjusted for age, the significant factors associated with surgical intervention included complete eyelid closure (odds ratio (OR) = 7.6; <i>P</i> < .001), ophthalmoplegia (OR = 14.2; <i>P</i> < .001), clinical exophthalmos (OR = 25.0; <i>P</i> < .001), CRP level >60 mg/L (OR = 6.9; <i>P</i> = .006), leukocyte count >15,600 g/L (OR = 7.7; <i>P</i> = .002), radiological exophthalmos (OR = 6.1; <i>P</i> = .001), retro-septal cellulitis (OR = 3.5; <i>P</i> = .02), posterior ethmoid opacification (OR = 6.1; <i>P</i> = .03), and abscess width >4 mm (OR = 8.2; <i>P</i> = .01).Conclusions and RelevanceMany patients can be managed medically. However, complete eyelid closure should prompt a CT scan. Exophthalmos, retro-septal cellulitis, or an abscess wider than 4 mm is an indication for surgical drainage. Ophthalmoplegia should be interpreted in context. CRP level >60 mg/L, a leukocyte count >15,600 g/L, and posterior ethmoid opacification should lead to close monitoring. These findings can aid in developing a clinico-bio-radiological score to guide treatment decisions, potentially improving patient outcomes by standardizing care protocols.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251349444"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12256756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144618555","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}
引用次数: 0
The Critical Role of Otolaryngologists in Managing Lassa Fever Sequelae: A Call for Action. 耳鼻喉科医生在管理拉沙热后遗症中的关键作用:呼吁采取行动。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-03-13 DOI: 10.1177/19160216251326559
Sulymon A Saka
{"title":"The Critical Role of Otolaryngologists in Managing Lassa Fever Sequelae: A Call for Action.","authors":"Sulymon A Saka","doi":"10.1177/19160216251326559","DOIUrl":"10.1177/19160216251326559","url":null,"abstract":"","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251326559"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625164","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}
引用次数: 0
The Multidimensional Approach to Assessing Factors Influencing Type I Tympanoplasty Outcomes in Chronic Otitis Media. 影响慢性中耳炎I型鼓室成形术疗效因素的多维分析。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 DOI: 10.1177/19160216241307623
Arnavaz Hajizadeh Barfejani
{"title":"The Multidimensional Approach to Assessing Factors Influencing Type I Tympanoplasty Outcomes in Chronic Otitis Media.","authors":"Arnavaz Hajizadeh Barfejani","doi":"10.1177/19160216241307623","DOIUrl":"10.1177/19160216241307623","url":null,"abstract":"","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216241307623"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11807276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374367","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}
引用次数: 0
Mentorship in Otolaryngology Head and Neck Surgery: A Scoping Review. 耳鼻喉头颈外科的指导:范围审查。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 DOI: 10.1177/19160216241307548
Norbert Banyi, Dianne Valenzuela, M Elise Graham, Amanda C Hu
{"title":"Mentorship in Otolaryngology Head and Neck Surgery: A Scoping Review.","authors":"Norbert Banyi, Dianne Valenzuela, M Elise Graham, Amanda C Hu","doi":"10.1177/19160216241307548","DOIUrl":"10.1177/19160216241307548","url":null,"abstract":"<p><strong>Importance: </strong>Mentorship is increasingly recognized as a critical part of training across the spectrum of trainees. While explored more in-depth in the literature of other medical specialties, mentorship remains a nascent topic in the Otolaryngology Head and Neck Surgery (OHNS) literature.</p><p><strong>Objective: </strong>The objective of this study was to assess the current literature on mentorship in OHNS.</p><p><strong>Design: </strong>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines was used and the methodology was registered on Open Science Framework (https://doi.org/10.17605/OSF.IO/X5FQ7). The Medline, EMBASE, and Web of Science databases were searched. Two authors independently selected studies, with the senior author resolving discrepancies. Study quality was assessed using the Oxford Centre for Evidence-Based Medicine levels of evidence.</p><p><strong>Setting and participants: </strong>English language studies employing any methodology that involved mentorship of medical trainees and staff in OHNS were included from the inception of the database up to September 20, 2023.</p><p><strong>Intervention or exposures: </strong>Any form of mentorship.</p><p><strong>Main outcome measure: </strong>The primary outcome was the benefits of mentorship afforded to the mentee.</p><p><strong>Results: </strong>From 415 unique articles identified, 45 studies were included. The median publication year was 2020 (IQR 6.5, range 1999-2023). The major themes of benefits from mentorship include improving residency uptake (n = 22), clinical competency and professionalism (n = 20), diversity and equity (n = 19), research productivity (n = 17), career planning and advancement (n = 17), and quality of life (n = 11). Other common themes included active mentorship (n = 29), near-peer mentorship (n = 13), and utilizing digital tools for mentorship (n = 6).</p><p><strong>Conclusion and relevance: </strong>Mentorship in OHNS has seen a sharp increase in publications in recent years. There are numerous benefits to mentorship including improving residency uptake, diversity initiatives, clinical competency and professionalism, research productivity, career planning and advancement, as well as quality of life.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216241307548"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11694310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142915100","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}
引用次数: 0
Pooled Analysis of 2 Randomized Clinical Trials to Evaluate the Efficacy and Safety of Clotrimazole 1% Otic Solution for the Treatment of Otomycosis in Adults. 2项随机临床试验的汇总分析,评价1%克曲霉唑耳液治疗成人耳霉菌病的疗效和安全性。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-04-15 DOI: 10.1177/19160216251330629
Ansley J F, Bernal-Sprekelsen M, Butehorn H F, Todorov S, Tzvetkov V, Douglis F, Georgiev K, Moreira da Silva F
{"title":"Pooled Analysis of 2 Randomized Clinical Trials to Evaluate the Efficacy and Safety of Clotrimazole 1% Otic Solution for the Treatment of Otomycosis in Adults.","authors":"Ansley J F, Bernal-Sprekelsen M, Butehorn H F, Todorov S, Tzvetkov V, Douglis F, Georgiev K, Moreira da Silva F","doi":"10.1177/19160216251330629","DOIUrl":"https://doi.org/10.1177/19160216251330629","url":null,"abstract":"<p><p>ImportanceThere is no antifungal otic drug for the treatment of otomycosis approved in the United States. Some current clotrimazole formulations in the market are used off-label.ObjectiveTo evaluate the efficacy and safety of clotrimazole 1% otic solution compared to placebo in treating otomycosis in adults.DesignTwo independent twin multicenter, randomized (2:1), double-blind, controlled clinical trials with identical designs were conducted from February 2020 to October 2021.SettingFifty-three sites located in the United States, Mexico, and Europe.ParticipantsAdults with uncomplicated otomycosis presented with symptoms, debris, and drainage clinically consistent with fungal infection.InterventionPatients received clotrimazole or placebo twice daily for 14 days and were evaluated on visit 1 (day 1), visit 2 (day 8-10), visit 3 (day 15), and follow-up visit 4 (day 24-26).Main Outcome MeasuresAt each visit, pruritus, otalgia, otorrhea, and ear fullness were assessed. Ear exudate was taken for a mycological and microbiological evaluation at baseline and, if present, at subsequent visits. The primary endpoint was a therapeutic cure (mycological and clinical) at visit 4 in the randomized population with positive fungal culture at baseline [mycological intent-to-treat (MITT)].ResultsThree hundred ninety-three patients received study medication (261 clotrimazole and 132 placebo). Efficacy data from the 228 patients (157 clotrimazole and 71 placebo) included in the MITT were analyzed. The clotrimazole group achieved a higher proportion for the primary endpoint than those with the placebo group (68.2% vs 25.4%; <i>P</i> < .0001), with a 42.8 difference in response rate (95% confidence interval: 30.3, 55.3). The treatment was safe and well tolerated, with 2.7% of related adverse events in the clotrimazole versus 1.5% in the placebo group.ConclusionsClotrimazole 1% otic solution has demonstrated its superiority over the placebo in each study and the pooled analysis. These are the results of the first international, multicenter clinical trials in which clotrimazole 1% otic solution demonstrates efficacy for the treatment of otomycosis.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251330629"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023634","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}
引用次数: 0
Oncocytes in Thyroid Aspirates-Implications of Clinical Parameters and Cytologic Diagnosis. 甲状腺抽吸中的肿瘤细胞-临床参数和细胞学诊断的意义。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-05-15 DOI: 10.1177/19160216251333358
Joanna K M Ng, Joshua J X Li, Matrix M H Fung, Philip P C Ip, Karen K W Yuen, Philippe Vielh
{"title":"Oncocytes in Thyroid Aspirates-Implications of Clinical Parameters and Cytologic Diagnosis.","authors":"Joanna K M Ng, Joshua J X Li, Matrix M H Fung, Philip P C Ip, Karen K W Yuen, Philippe Vielh","doi":"10.1177/19160216251333358","DOIUrl":"10.1177/19160216251333358","url":null,"abstract":"<p><p>ImportanceThe clinical significance of oncocytes in thyroid aspirate is uncertain, leading to inconsistent and possible over-treatment.ObjectiveTo determine the predictive significance of clinico-radiological parameters and cytologic diagnosis on the risks of malignancy (ROM) and neoplasia.DesignData of thyroid aspirates with the presence of oncocytes were reviewed for outcomes and clinical-radiological-pathological parameters.SettingThree regional institutes performing thyroid surgery and investigations.ParticipantsFrom a population base of 1.3 million across a 9-year period, totaling 371 aspirates with oncocytes with an 85.0-month average follow-up.InterventionFine-needle aspiration of thyroid.ResultsOn clinical follow-up, the ROM for Bethesda categories C1-C6 was 15.4%/2.7%/9.2%/6.9%/37.5%/100%, while the risk of neoplasm (considering thyroidectomy follow-up) was 45.5%/23.8%/56.3%/61.9%/50%/100%, including 52 oncocytic follicular lesions (4 carcinomas and 48 adenomas) and 26 other carcinomas/malignancies. C5+ diagnoses were associated with malignancy (<i>P</i> = .003), and C3+ was associated with neoplasm on thyroidectomy (<i>P</i> = .006). Malignant/neoplastic outcomes did not correlate with sex or age (<i>P</i> > .05). High free triiodothyronine/free thyroxine levels were associated with a benign clinical outcome (<i>P</i> = .001). Cystic change on ultrasound was associated with a lower malignancy (<i>P</i> = .012) and neoplasm risk (<i>P</i> = .041). Lesion size, echogenicity, vascularity, multinodularity, lymphadenopathy, and solid areas on ultrasound were not significant in predicting malignancy or neoplasm (<i>P</i> > .05).ConclusionThe presence of oncocytes in thyroid aspirates does not increase malignancy risk. Most malignant oncocytic thyroid aspirates are not attributable to oncocytic carcinomas but papillary thyroid carcinomas. Ultrasound and thyroid function tests are helpful in the risk assessment of these cases.RelevanceFor treatment or follow-up decisions in patients with oncocytes in thyroid aspirates.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333358"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078835","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}
引用次数: 0
Awake Versus Asleep Intubation for Mediastinal Goiters: A Systematic Review and Meta-Analysis. 清醒与睡眠插管治疗纵隔甲状腺肿:系统回顾和荟萃分析。
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-05-30 DOI: 10.1177/19160216251333352
Lindsay E Booth, Norbert Banyi, Peter Rose, Shamir Karmali, Biljana Jonoska Stojkova, Donald W Anderson, Oleksandr Butskiy
{"title":"Awake Versus Asleep Intubation for Mediastinal Goiters: A Systematic Review and Meta-Analysis.","authors":"Lindsay E Booth, Norbert Banyi, Peter Rose, Shamir Karmali, Biljana Jonoska Stojkova, Donald W Anderson, Oleksandr Butskiy","doi":"10.1177/19160216251333352","DOIUrl":"10.1177/19160216251333352","url":null,"abstract":"<p><p>ImportanceMediastinal goiters can complicate anesthetic management, and although awake bronchoscopic intubation is the gold standard, it is resource-intensive and may be unpleasant for patients. In many centers across North America, patients undergoing thyroidectomy for mediastinal goiters are routinely intubated awake.ObjectiveThis study aimed to evaluate the outcomes of intubation in patients selected for awake versus asleep intubation for thyroidectomy of mediastinal goiters.DesignPRISMA 2020 Checklist for systematic reviews was followed. A search was performed in the Medline, Embase, Web of Science, CINAHL, Scopus, and Cochrane databases. Two independent reviewers performed abstract and full-text review. Data were extracted in duplicate. Study quality was assessed using the JBI Critical Appraisal tool. To account for heterogeneity, a 3-level random-effects model was constructed using the Der Simonian and Laird method with an arcsine transformation.Setting and ParticipantsPatients undergoing thyroidectomy for benign mediastinal goiters.Intervention and ExposuresAwake or asleep intubation.Main Outcome(s) and Measure(s)Rate of failed intubations in asleep intubation and proportion of uncomplicated intubations in asleep and awake populations.ResultsTwelve of 490 identified studies, involving 1002 patients, were included. Three cases of failed intubations were found in the asleep intubation group, with an overall incidence of failed intubation of 0.3%. Meta-analysis demonstrated an overall uncomplicated intubation rate of 91% (95% CI 77%-98%, n = 1002). Subgroup analyses showed a 96% success rate (95% CI 73%-100%, n = 60) for awake intubations and 88% (95% CI 69%-98%, n = 942) for asleep intubations. Further refined analyses showed uncomplicated intubation rates of 98% (95% CI 93%-100%, n = 469) for asleep, and 92% (95% CI 78%-99%, n = 48) for awake groups.Conclusions and RelevanceThe risk of failed intubation in patients with mediastinal goiters remains low, and awake intubation may require more attempts than asleep intubation. Further research with standardized definitions of intubation difficulty is needed.</p>","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251333352"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12125518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187239","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}
引用次数: 0
Prevalence of a History of Dysphagia Among Pediatric Patients With Avoidant/Restrictive Food Intake Disorder. 儿童回避/限制性食物摄入障碍患者中有吞咽困难病史的患病率
IF 2.6 3区 医学
Journal of Otolaryngology - Head & Neck Surgery Pub Date : 2025-01-01 Epub Date: 2025-06-05 DOI: 10.1177/19160216251338250
Evana Francis, Margaret Lundberg, Sandeep Yerraguntla, Jamie Klein, Barbara McElhanon, William G Sharp, Nikhila Raol
{"title":"Prevalence of a History of Dysphagia Among Pediatric Patients With Avoidant/Restrictive Food Intake Disorder.","authors":"Evana Francis, Margaret Lundberg, Sandeep Yerraguntla, Jamie Klein, Barbara McElhanon, William G Sharp, Nikhila Raol","doi":"10.1177/19160216251338250","DOIUrl":"10.1177/19160216251338250","url":null,"abstract":"","PeriodicalId":16615,"journal":{"name":"Journal of Otolaryngology - Head & Neck Surgery","volume":"54 ","pages":"19160216251338250"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225758","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}
引用次数: 0
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