OTO Open最新文献

{"title":"Postnasal Drip and Nasal Endoscopy: Localization and Association With Clinical Features.","authors":"Jenilkumar H Patel, Nicholas Mankowski, Robbie A Beyl, Manal S Malik, Andrew Parker, Edward D McCoul","doi":"10.1002/oto2.70094","DOIUrl":"https://doi.org/10.1002/oto2.70094","url":null,"abstract":"<p><strong>Objective: </strong>Postnasal drip (PND) is a common symptom that is difficult to verify with a traditional examination. Nasal endoscopy has the potential to improve the diagnostic process by confirming the presence and location of mucus. This study sought to describe the association of specific features of PND on nasal endoscopy with other clinical features.</p><p><strong>Study design: </strong>Cross-sectional with prospective data collection.</p><p><strong>Setting: </strong>Outpatient rhinology practice.</p><p><strong>Methods: </strong>Data were prospectively collected on adult (≥18 years of age) patients with PND who underwent nasal endoscopy over a 6-month period. Variables of interest included reflux-related symptoms, nasal congestion, hyposmia, rhinorrhea, pruritic symptoms, inferior turbinate (IT) hypertrophy, 22-item sinonasal outcome test (SNOT-22) scores, and diagnoses of allergic rhinitis (AR), chronic rhinosinusitis (CRS), and reflux disease. Presence of mucus was designated at the nasal cavity (NC) floor, posterior IT, middle meatus (MM), and sphenoethmoidal recess (SER), and consistency of thick or thin was assigned during nasal endoscopy.</p><p><strong>Results: </strong>Of 118 patients, 112 (94.9%) had identifiable mucus on nasal endoscopy. MM/SER mucus was associated with SNOT-22 score ≥ 50, diagnosis of CRS, and absence of IT hypertrophy or diagnosis of AR. NC and IT mucus was associated with nasal congestion, rhinorrhea, pruritic symptoms, IT hypertrophy, AR, and absence of CRS. Thick NC/IT mucus was associated with reflux symptoms.</p><p><strong>Conclusion: </strong>Great majority of patients who report PND have posterior nasal drainage of abnormal mucus that can be directly observed with nasal endoscopy. Clinicians should be encouraged to utilize nasal endoscopy when available to evaluate patients with PND.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70094"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in Dysphagia Care Among Head and Neck Cancer Patients: A Retrospective Cohort Study.","authors":"Daniel Karasik, Gillian Michaelson, Claudia I Cabrera, Alexis Nahra, Nina W Zhao","doi":"10.1002/oto2.70090","DOIUrl":"https://doi.org/10.1002/oto2.70090","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence of dysphagia among head and neck cancer (HNC) patients and assess disparities in utilization of speech-language pathology (SLP) services across different demographic groups.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Analysis of data from the TriNetX global health network, comprising over 125 million deidentified electronic health records worldwide.</p><p><strong>Methods: </strong>HNC patients diagnosed with oral, oropharyngeal, laryngeal, or nasopharyngeal cancer with and without dysphagia between January 1, 2004 and October 30, 2024 were identified. Patients were divided into two cohorts for comparison: those who received SLP services after dysphagia diagnosis and those who did not. The association of demographic characteristics (sex, ethnicity, and race) with SLP services were analyzed.</p><p><strong>Results: </strong>Of 269,629 HNC patients, 28.8% (n = 77,562) were diagnosed with dysphagia. Significant disparities were found: female and non-White patients were less likely to be diagnosed with dysphagia. Once diagnosed, female, Hispanic/Latino, and non-White patients were also significantly less likely to receive SLP services compared to female, Hispanic/Latino, and non-White patients. Overall, only 38.8% of patients with dysphagia received SLP services.</p><p><strong>Conclusion: </strong>This study highlights significant sex, ethnic, and racial disparities in dysphagia diagnosis and SLP service utilization among HNC patients. Furthermore, SLP services are underutilized. There is a need for targeted interventions to increase dysphagia prevention and surveillance and ensure equitable access to dysphagia care, improving outcomes for all HNC survivors.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70090"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Private Equity Owned Otolaryngology Practice Clinician Distribution.","authors":"Shravan Asthana, Daron Excel, Hemali Shah, Abhinav Talwar, Stephanie Smith","doi":"10.1002/oto2.70112","DOIUrl":"https://doi.org/10.1002/oto2.70112","url":null,"abstract":"<p><strong>Objective: </strong>Investigate how private equity (PE) acquisitions shape the otolaryngology workforce.</p><p><strong>Study design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Private outpatient clinics.</p><p><strong>Methods: </strong>A comprehensive market database, Pitchbook (Seattle, WA), was queried utilizing keywords for outpatient otolaryngology practices acquired by PE firms from 2010 to 2023. Acquisitions were manually verified using practice websites. An open-source website archive service, WayBack Machine, was utilized to track workforce history of practicing otolaryngologist physicians, audiologists (AuDs), and advanced practice providers (APPs) at these outpatient practices and then subjected to linear regression and Pearson correlation test analysis.</p><p><strong>Results: </strong>In total, 25 otolaryngology practices were determined to have been acquired by PE, all between 2018 and 2023. Acquisitions predominantly occurred in 2020 (n = 8, 32%) and 2023 (n = 7, 28%) and were mostly in the South Atlantic (n = 10, 40%) or Midwest (n = 8, 32%) regions. From 2018 to 2023, total practice locations increased by 32.0% (n = 194 to n = 256), and the total clinician pool increased by 17.9% (n = 901 to n = 1007). Although physicians (n = 500 to n = 517, <i>r</i> = 0.59, <i>P</i> = .213) and AuDs (n = 229 to n = 242, <i>r</i> = 0.34, <i>P</i> = .507) increased nonlinearly, the increase in APPs was strongly linear (n = 172 to n = 248, <i>r</i> = 0.95, <i>P</i> = .003). As a proportion of the total clinician pool, there was a relative decrease in physicians (55.5%-51.3%) and AuDs (25.4%-24.0%), offset by a relative increase in APPs (19.1%-24.6%).</p><p><strong>Conclusion: </strong>Our findings indicate a disproportionate increase in APPs relative to physicians and AuDs, although without a comparison group we are unable to draw conclusions in relation to changes in the non-PE workforce as a whole.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70112"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Augmented Reality Navigation in Craniomaxillofacial/Head and Neck Surgery.","authors":"E Brandon Strong, Anuj Patel, Alexander P Marston, Cameron Sadegh, Jeffrey Potts, Darin Johnston, David Ahn, Shae Bryant, Michael Li, Osama Raslan, Steven A Lucero, Marc J Fischer, Marike Zwienenberg, Neha Sharma, Florian Thieringer, Christian El Amm, Kiarash Shahlaie, Marc Metzger, E Bradley Strong","doi":"10.1002/oto2.70108","DOIUrl":"https://doi.org/10.1002/oto2.70108","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to (1) develop an augmented reality (AR) navigation platform for craniomaxillofacial (CMF) and head and neck surgery; (2) apply it to a range of surgical cases; and (3) evaluate the advantages, disadvantages, and clinical opportunities for AR navigation.</p><p><strong>Study design: </strong>A multi-center retrospective case series.</p><p><strong>Setting: </strong>Four tertiary care academic centers.</p><p><strong>Methods: </strong>A novel AR navigation platform was collaboratively developed with Xironetic and deployed intraoperatively using only a head-mounted display (Microsoft HoloLens 2). Virtual surgical plans were generated from computed tomography/magnetic resonance imaging data and uploaded onto the AR platform. A reference array was mounted to the patient, and the virtual plan was registered to the patient intraoperatively. A retrospective review of all AR-navigated CMF cases since September 2023 was performed.</p><p><strong>Results: </strong>Thirty-three cases were reviewed and classified as either trauma, orthognathic, tumor, or craniofacial. The AR platform had several advantages over traditional navigation including real-time 3D visualization of the surgical plan, identification of critical structures, and real-time tracking. Furthermore, this case series presents the first-known examples of (1) AR instrument tracking for midface osteotomies, (2) AR tracking of the zygomaticomaxillary complex during fracture reduction, (3) mandibular tracking in orthognathic surgery, (4) AR fibula cutting guides for mandibular reconstruction, and (5) integration of real-time infrared visualization in an AR headset for vasculature identification.</p><p><strong>Conclusion: </strong>While still a developing technology, AR navigation provides several advantages over traditional navigation for CMF and head and neck surgery, including heads up, interactive 3D visualization of the surgical plan, identification of critical anatomy, and real-time tracking.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70108"},"PeriodicalIF":1.8,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11986686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Digital Inequities on Oropharyngeal Cancer Disparities in the United States.","authors":"David J Fei-Zhang, Achilles A Kanaris, Camaren M Cuenca, Sydney A Fleishman, Jill N D'Souza, Anthony M Sheyn, Daniel C Chelius, Jeffrey C Rastatter","doi":"10.1002/oto2.70113","DOIUrl":"https://doi.org/10.1002/oto2.70113","url":null,"abstract":"<p><strong>Objective: </strong>To assess associations of digital inequity with oropharyngeal cancer (OPC) prognostic and care outcomes in the United States while adjusting for traditional social determinants/drivers of health (SDoH).</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>United States.</p><p><strong>Methods: </strong>In total, 70,604 patients from 2008 to 2017 were assessed for regression trends in long-term follow-up period, survival, prognosis, and treatment across increasing overall digital inequity, as measured by the Digital Inequity Index (DII). DII is based on 17 census-tract level variables derived from the American Community Survey and Federal Communications Commission. Variables were categorized as infrastructure-access (ie, digital-related variables) or sociodemographic (ie, education, income, and disability status) and weighted-averaged into a composite score.</p><p><strong>Results: </strong>With increasing DII, decreases in length of follow-up (10.22%, 32.9-29.5 months; <i>P</i> < .001) and survival (8.93%, 19-17.3 months; <i>P</i> < .001) were observed. Affordability of internet access displayed the largest influence, followed by device access and internet-service availability. Compared to OPC patients with low digital inequity, high digital inequity was associated with increased odds of diagnosing more than one malignant tumor (odds ratio [OR] 1.01, 95% CI 1.01-1.03; <i>P</i> = .012) and advanced staging (OR 1.01, 95% CI 1.00-1.02; <i>P</i> = .034), while having decreased odds of receiving indicated chemotherapy (OR 0.98, 95% CI 0.97-0.99; <i>P</i> < .001), radiation therapy (OR 0.98, 95% CI 0.97-0.99; <i>P</i> < .001), or primary surgery (OR 0.98, 95% CI 0.97-0.99; <i>P</i> < .001).</p><p><strong>Conclusion: </strong>Digital inequities contribute to detrimental trends in OPC patient care and prognosis in the United States. These findings can inform strategic discourse targeted against the most pertinent disparities in the modern-day environment.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70113"},"PeriodicalIF":1.8,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980432/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental Health Disorders and Pain in Patients Undergoing Head and Neck Free Flap Surgery.","authors":"Kelly L Vittetoe, Marina Aweeda, Lily Gao, Christopher Naranjo, Liping Du, Xiaoke Feng, Wenda Ye, Alexander J Langerman, Kyle Mannion, James L Netterville, Eben L Rosenthal, Robert J Sinard, Michael C Topf, Sarah L Rohde, Alexander H Gelbard, Melanie D Hicks","doi":"10.1002/oto2.70105","DOIUrl":"10.1002/oto2.70105","url":null,"abstract":"<p><strong>Objective: </strong>Determine relationships between pain and mental health disorders (MHDs) in patients undergoing microvascular free flap reconstruction for head and neck cancer (HNC).</p><p><strong>Study design: </strong>Retrospective cohort.</p><p><strong>Setting: </strong>Tertiary Care Institution in the Southeastern United States.</p><p><strong>Methods: </strong>Clinical data were manually abstracted from digital health records to obtain demographic, MHD, clinical outcomes, and pain data for HNC patients who underwent free flap reconstruction from 2017 to 2023. Univariate and multivariable regression analyses were performed to delineate relationships between MHDs and postoperative pain.</p><p><strong>Results: </strong>The study cohort comprised 283 patients. Ninety-four patients (33%) had preoperative MHDs, which were more common in women (42% vs 30%, <i>P</i> = .04) and in patients with chronic pain (53% vs 32%, <i>P</i> < .01). Preoperative opioid use (<i>P</i> = .03) and preoperative MHD (<i>P</i> = .03) were predictive of higher postoperative day (POD) 5 pain score. Thirty-three patients (11.7%) were diagnosed with a new MHD postoperatively, and 58 patients (20.5%) were started on a new long-term psychiatric medication postoperatively. POD1 pain score was predictive of the need for a new psychiatric medication postoperatively (odds ratio [OR] = 1.27, 95% CI: 1.05-1.56, <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Postoperative pain and MHDs are independently predictive of one another in patients with HNC undergoing microvascular free flap reconstruction. Higher POD5 pain is predicted by the presence of preoperative MHD, and the need for a new psychiatric medication postoperatively is predicted by higher POD1 pain. HNC surgeons should align themselves with psychiatrists, social workers, and other allied fields to meet the complex mental health needs of their patients both preoperatively and postoperatively.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70105"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973587/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Sexual Orientation and Gender Identity on the Otolaryngology Residency Experience.","authors":"Walter M Jongbloed, Hillary A Newsome, Lawrence Kashat, Kourosh Parham, Erynne A Faucett, Chia-Ling Kuo, Kelin Zhong, Katherine R Kavanagh","doi":"10.1002/oto2.70095","DOIUrl":"10.1002/oto2.70095","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the influence of sexual orientation and gender on residents' experiences in US Otolaryngology residency programs. This study assesses the prevalence of bullying, sexual harassment, discrimination, homophobic remarks and evaluates the workplace environment, well-being, and impact of LGBTQ+ residents/faculty on rank list.</p><p><strong>Study design: </strong>A 26-question REDCap survey was distributed to all US Otolaryngology residencies.</p><p><strong>Methods: </strong>The survey was distributed to program directors over three months. Responses were compared between groups (sexual orientation and gender) using Fisher's exact test (5% significance level).</p><p><strong>Results: </strong>The response rate was 5.9% (104 responses), 15.5% identified as LGBTQ+. LGBTQ+ residents felt less comfortable disclosing relationships to attendings than heterosexuals (68.8% versus 85.3%, <i>P</i> = .005). LGBTQ+ and female respondents perceived a worse residency environment (<i>P</i> < .05). LGBTQ+ residents were less satisfied with their decision to pursue Otolaryngology (75% vs 95.4%, <i>P</i> = .044) and more likely to consider leaving their program (25% vs 6.9%; <i>P</i> = .047). An LGBTQ+ faculty member or resident positively impacted rank lists for LGBTQ+ residents (43.8% vs 12.6%, <i>P</i> = .007; 50% vs 16.1% <i>P</i> = .005). Women reported more discrimination and sexual harassment than men (78.4% vs 14.8%; <i>P</i> < .001; 31.9% vs 11.1%; <i>P</i> = .014, respectively).</p><p><strong>Conclusion: </strong>LGBTQ+ and female respondents perceive a worse residency environment. LGBTQ+ residents are less comfortable disclosing relationships to attendings, less satisfied with their decision to pursue Otolaryngology, more likely to consider leaving programs, and desire representation. Women are at increased risk of sexual harassment and discrimination.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70095"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Multimodal Analgesic Use After Otolaryngologic Surgery-A Single-Institution Experience of 9000 Patients.","authors":"Karolina A Plonowska-Hirschfeld, Jasmeet Saroya, Jose Herrera, Jolie L Chang, Andrew N Goldberg, Rahul Seth, Megan L Durr","doi":"10.1002/oto2.70106","DOIUrl":"10.1002/oto2.70106","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to assess a quality improvement intervention to decrease opiate prescriptions at discharge and improve patient access to multimodal analgesics (MMA) after otolaryngologic surgery.</p><p><strong>Study design: </strong>Longitudinal quality improvement initiative with retrospective prescription trend review and prospective patient questionnaire collection.</p><p><strong>Setting: </strong>An academic medical center.</p><p><strong>Methods: </strong>Opioid, acetaminophen, and non-steroidal anti-inflammatory drug (NSAID) discharge prescriptions after otolaryngologic procedures were reviewed. Two annual department-wide workshops were carried out to review the literature on published MMA protocols and develop standardized post-operative pain medication instructions to reduce opioid use. Concurrently, a patient survey was distributed to evaluate discharge pain medication use and satisfaction with pain control.</p><p><strong>Results: </strong>Discharge pain medications were reviewed for 9064 procedures between January 2021 and May 2024. After the interventions above, the percentage of patients receiving opioids at discharge decreased from 61.4% to 46.8% (<i>P</i> < .00001). Concurrently, acetaminophen and NSAID discharge prescriptions increased from 24.3% and 10.2% to 67.4% and 46.1%, respectively (both <i>P</i> < .00001). Among 100 patients surveyed, satisfaction with post-operative pain control was high before and after the implementation of standardized discharge instructions, even though fewer post-intervention patients received opioids at discharge (49.1% compared to 76.6% pre-intervention, <i>P</i> = .007). Notably, 27% of patients prescribed opioids reported not taking them and 23% reported saving unused opioids for future use.</p><p><strong>Conclusion: </strong>Implementation of standardized post-operative pain medication instructions at discharge after otolaryngologic procedures led to a substantial decrease in opioids prescribed while maintaining patient satisfaction with post-operative pain management. A significant proportion of patients reported saving unused opioids for future use despite standardized safe disposal instructions.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70106"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Misjudgments of Hearing Loss and Its Implications for Over-the-Counter Hearing Aids.","authors":"Ayelet Hamburger, Russell Whitehead, Elias Michaelides","doi":"10.1002/oto2.70101","DOIUrl":"10.1002/oto2.70101","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated whether patients' perception of their hearing loss accurately reflects their measured hearing thresholds on their audiogram, specifically relating to a mild to moderate hearing loss, which is the determining candidacy for over-the-counter (OTC) hearing aids.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Audiology clinic at a tertiary care center.</p><p><strong>Methods: </strong>This retrospective chart review included 232 ears from 116 patients older than 18 years seen for audiograms at our audiology clinic between 2022 and 2023. Data points were taken using the pure tone average (PTA) thresholds at 500 to 2000 Hz and the PTA thresholds at 2000 to 4000 Hz, as hearing sensitivity at these frequencies is most widely associated with speech comprehension and serves as a reliable measure of hearing.</p><p><strong>Results: </strong>Overall, when using the 2000- to 4000-Hz PTA as an indicator of the degree of hearing loss, only 52% of patients correctly quantified their level of hearing. When using the 500- to 2000-Hz PTA, 61% of patients correctly quantified their degree of hearing loss.</p><p><strong>Conclusion: </strong>This study suggested that individuals are frequently unable to assess their degree of hearing loss with sufficient accuracy to choose the most appropriate care. To ensure that consumers are making informed decisions about the use of OTC hearing aids, the Food and Drug Administration should consider offering additional guidance that directs patients to first seek out a more standardized measure of hearing provided by a hearing health professional. This additional direction can enhance the quality of care of OTC hearing aid consumers.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70101"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ototoxicity Monitoring: The Evolution of a Protocol for Head and Neck Cancer Patients.","authors":"Jena Patel, Jacob Beiriger, Kalena Liu, Zach Urdang, Julia Croce, Molly Wolfson, Jacob Hulswit, Olivia Giglio, Jacob B Hunter, Irina Middleton","doi":"10.1002/oto2.70070","DOIUrl":"10.1002/oto2.70070","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated an ototoxicity monitoring program (OMP) for improving audiologic follow-up in head and neck cancer (HNC) patients.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Methods: </strong>Two hundred and forty patients were recommended for chemotherapy between January 2017 and June 2022. An OMP was implemented in March 2021; every patient received an audiology referral and was contacted to schedule a pretreatment audiogram. Patients were divided into pre-OMP and post-OMP cohorts. Main outcome measures included rates of pretreatment audiograms, posttreatment audiograms, posttreatment otologic symptoms, and hearing aid utilization.</p><p><strong>Results: </strong>There were 131 patients evaluated pre-OMP and 109 evaluated post-OMP. The mean age for all patients was 62.8 ± 11.9 years; 76.3% were male. After the implementation of the OMP, a significantly higher proportion of patients received a pretreatment audiogram (66.1% vs 34.4%, <i>P</i> < .001), with enrolled patients being 3.8 times more likely to obtain 1 (95% confidence interval: 2.2-6.6), <i>P</i> < .001). There was a significant increase in reported otologic symptoms after implementing the program (18% vs 36%, <i>P</i> = .002). However, the rate of hearing aid utilization decreased after OMP implementation (pre-OMP: 33% vs post-OMP: 13%, <i>P</i> = .02).</p><p><strong>Conclusion: </strong>Implementation of an OMP significantly improved the proportion of HNC patients that underwent pretreatment audiograms prior to systemic therapy; however, audiologic follow-up remained largely unchanged in the posttreatment period.</p><p><strong>Level of evidence: </strong>Level 4.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"9 2","pages":"e70070"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11973582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803812","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}