OTO Open最新文献

{"title":"Associations Between Race and Survival Outcomes Among Veterans With Head and Neck Cancer in a Racially Diverse Setting.","authors":"Amanda R Walsh, Jonathan P Giurintano, Jessica H Maxwell, Anuja H Shah, Thomas L Haupt, Andrew E Wadley, Sandeep R Kowkuntla, Andy M Habib, Veranca Shah","doi":"10.1002/oto2.150","DOIUrl":"10.1002/oto2.150","url":null,"abstract":"<p><strong>Objective: </strong>There is limited data on the impact of clinical-demographic factors on survival outcomes among veterans with head and neck squamous cell carcinoma (HNSCC). This study was undertaken to evaluate the impact of race and other factors on overall survival (OS) in a population of veterans with HNSCC treated with curative intent.</p><p><strong>Methods: </strong>Demographic and clinical data were collected on veterans with HNSCC treated with curative intent at our institution between 1999 and 2021. The primary outcome was 3-year OS. Secondary outcomes included treatment delay intervals, including time to treatment initiation (TTI), total package time, and duration of chemoradiation (DCRT).</p><p><strong>Results: </strong>Of 260 veterans with HNSCC, black veterans had significantly lower 3-year OS (49.4%) compared to white veterans (65%, <i>P</i> = .019). Black veterans were also more likely to experience delays in treatment initiation (median TTI 46 vs 41 days; <i>P</i> = .047). Black patients were more likely to receive radiation alone (25.8% [black] vs 8.4% [white]; <i>P</i> < .001) and less likely to receive adjuvant therapy if treated surgically (11.1% [black] vs 22.4% [white]; <i>P</i> = .004), despite any statistically significant difference in stage of their tumor at presentation (Stage I: 21.2% [black] vs 19.6% [white]; <i>P</i> = .372); (Stage IV: 44.4% [black] vs 48.6% [white]; <i>P</i> = .487). Other factors associated with worse 3-year OS included older age (<i>P</i> = .023), lower body mass index (<i>P</i> = .026), neurocognitive disorder/dementia (<i>P</i> = .037), mental health disorders (<i>P</i> = .020), hypopharyngeal primary (<i>P</i> = .001), higher stage disease (<i>P</i> = .002), treatment type (<i>P</i> = .001), need for prophylactic gastrostomy tube (<i>P</i> = .048) or tracheotomy (<i>P</i> = .005), recurrent disease (<i>P</i> = .036), persistent disease (<i>P</i> < .001), distant metastases (<i>P</i> = .002), longer TTI (<i>P</i> = .0362), and longer DCRT (<i>P</i> = .004).</p><p><strong>Discussion: </strong>Black race appears to be an independent predictor of 3-year OS in veterans with HNSCC. Further studies are warranted to determine the factors responsible for disparities in survival.</p><p><strong>Implications for practice: </strong>This study evaluated the ways in which race affects survival for US veterans with head and neck cancer. The authors found that black veterans had an increased risk of death compared to white patients, and also experienced delays when receiving treatment.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e150"},"PeriodicalIF":1.5,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306527","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":"Extramedullary Plasmacytoma of the Maxillary Sinuses in a Patient With Multiple Myeloma.","authors":"Caleb Boehler, Hasan Ozgur, Christopher Le, Samuel Rogers","doi":"10.1002/oto2.144","DOIUrl":"10.1002/oto2.144","url":null,"abstract":"","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e144"},"PeriodicalIF":1.5,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11165674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141306528","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":"Patient Questions Surrounding Posterior Nasal Nerve Ablation for Chronic Rhinitis.","authors":"Daniel Gorelik, Samuel E Razmi, Robert Kenneth Sims, Aatin K Dhanda, Masayoshi Takashima, Ella S Brissett, Nicholas R Rowan, Michael T Yim, Najm Khan, Meha G Fox, Omar G Ahmed","doi":"10.1002/oto2.156","DOIUrl":"10.1002/oto2.156","url":null,"abstract":"<p><strong>Objective: </strong>In-office ablation of the posterior nasal nerve (PNN) has emerged as an effective treatment option for chronic rhinitis patients. This study explored questions patients commonly search online regarding this therapy and the quality of content available.</p><p><strong>Study design: </strong>A retrospective analysis of online search criteria and sources was performed with subsequent analysis of results.</p><p><strong>Setting: </strong>Search and data acquisition was in September of 2023.</p><p><strong>Methods: </strong>Most common search terms related to cryotherapy and radiofrequency neurolysis of the PNN were identified with associated People Also Ask (PAA) questions. Questions were categorized and organized into subtopics and sources evaluated using readability and quality metrics.</p><p><strong>Results: </strong>A total of 255 unique PAA questions and 175 unique websites were identified. The most common subtopics were related to facts about chronic rhinitis (26.7%) and rhinitis treatment options (25.1%). Nearly a quarter (24.3%) of websites were from commercial sources. Quality metrics indicate difficult-to-read and low-quality materials.</p><p><strong>Conclusion: </strong>Existing online resources need improvement to provide patients material that is easier to read. Physicians counseling patients should be aware of these areas for adequate shared decision making.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e156"},"PeriodicalIF":1.5,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284409","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":"Hearing Loss: Self-Reported Onset and Etiology Among Older Adults in the United States.","authors":"Tyler J Gallagher, Ziphron Russel, Janet S Choi","doi":"10.1002/oto2.146","DOIUrl":"10.1002/oto2.146","url":null,"abstract":"<p><p>This study investigated self-reported age of onset and etiology of hearing loss among older adults in the United States. Study cohort included older adult (≥70 years) survey respondents from the 2017 to 2020 National Health and Nutrition Examination Survey (n = 797). Overall, 51.1% [95% confidence interval [CI]: 46.1-56.1] of older adults self-reported hearing loss. Among older adults who reported hearing loss, the most reported age of onset was age 70 or older (41.7% [95% CI: 38.1%-45.3%]), followed by sequentially younger age brackets including ages 60 to 69 years (27.3% [95% CI: 23.6%-31.3%]) and ages 40 to 59 years (15.7% [95% CI: 12.9%-19.0%]). The most common etiology of hearing loss was aging (66.3% [95% CI: 60.8%-71.4%]) followed by loud long-term noise (30.3% [95% CI: 26.2%-34.9%]) and loud brief noise (13.8% [95% CI: 10.3%-18.4%]). Our study describes the most common age of onset and etiologies of hearing loss among a representative sample of United States older adults.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e146"},"PeriodicalIF":1.5,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284407","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":"Intraoperative Ultrasound for the Management of Oral Tongue Cancer: a Systematic Review and Meta-Analysis.","authors":"Ryland N Spence, Vivienne H Au, Yan Zhao, Allen L Feng, Amy F Juliano, Deborah Goss, Mark A Varvares","doi":"10.1002/oto2.147","DOIUrl":"10.1002/oto2.147","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate for correlation between intraoperative ultrasound (IOUS)-measured tumor thickness (TT) (uTT) and histopathological TT (hTT), and to compare IOUS-assisted resection with conventional resection in patients with oral tongue cancers.</p><p><strong>Data sources: </strong>Ovid MEDLINE (1946-2023), Embase.com (1947-2023), and Web of Science (All Databases 1900-2023).</p><p><strong>Review methods: </strong>Inclusion criteria were the use of IOUS for the management of oral tongue cancer. Studies that did not report quantitative data were excluded. Additionally, studies that were not contributory to meta-analysis, or a narrative analysis of pooled results were excluded. Selection was carried out by 2 reviewers. A total of 2417 studies were initially identified, with 12 ultimately being included in this review, and 7 included in the meta-analysis. Data were extracted by 2 investigators and were pooled using a random-effects model.</p><p><strong>Results: </strong>Our meta-analysis reveals a pooled correlation coefficient of 0.92 (95% confidence interval: 0.80-0.96) for studies comparing uTT to hTT. Studies comparing IOUS-assisted resection to conventional resection found IOUS-assisted resection yielded wider nearest margins in all studies reporting this outcome.</p><p><strong>Conclusion: </strong>IOUS reliably measures TT, similarly to that of histopathology measurement. IOUS-assisted resection, which allows the surgeon to view the deep extent of tumor invasion, may increase closest radial margin distance compared to conventional resection. IOUS-assisted resection may represent a more reliable approach to achieving clear margins than conventional resection.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e147"},"PeriodicalIF":1.5,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11154832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141284408","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 Procedural Management of Meniere's Disease: Analysis of a National Insurance Claims Database.","authors":"Nihar Rama, Samuel Auger, Terence E Imbery","doi":"10.1002/oto2.152","DOIUrl":"10.1002/oto2.152","url":null,"abstract":"<p><strong>Objective: </strong>This study used a national insurance claims database to analyze trends in procedural management of Meniere's disease.</p><p><strong>Study design: </strong>Retrospective cohort analysis.</p><p><strong>Setting: </strong>Database study using United States inpatient and outpatient insurance claims submitted from January 2003 to December 2021.</p><p><strong>Subjects and methods: </strong>The Merative MarketScan Commercial and Medicare Claims Databases were queried for adults (≥18 years) with a diagnosis of Meniere's Disease according to <i>International Classification of Diseases</i> codes. Patients receiving procedures per <i>Current Procedural Terminology</i> codes for endolymphatic sac surgery, vestibular nerve section, labyrinthectomy, and intratympanic dexamethasone or gentamicin were identified. Temporal trends were analyzed by calculating annual percent change (APC) in the proportion of patients receiving procedures using Joinpoint regression.</p><p><strong>Results: </strong>A total of 16,523 unique patients with MD receiving procedural management were identified. From 2003 to 2021, the proportion of patients managed with intratympanic dexamethasone increased (APC 1.76 [95% CI 1.53-1.98], <i>P</i> < .001). The proportion of patients receiving intratympanic gentamicin increased from 2003 to 2015 (APC 4.43 [95% CI 1.29-7.66], <i>P</i> = .008) but decreased from 2015 to 2021 (APC -10.87 [95% CI -18.31 to -2.76], <i>P</i> = .013). The proportion of patients receiving endolymphatic sac surgery (APC: -10.20 [95% CI -11.19 to -9.20], <i>P</i> < .001) and labyrinthectomy (APC: -6.29 [95% CI -8.12 to -4.42], <i>P</i> < .001) decreased from 2003 to 2021.</p><p><strong>Conclusion: </strong>From 2003 to 2021, there has been an increase in the use of intratympanic dexamethasone and a decrease in the use of intratympanic gentamicin, endolymphatic sac surgery, and labyrinthectomy for procedural management of Meniere's Disease.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e152"},"PeriodicalIF":1.5,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11145946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141236274","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":"Prevalence of and Barriers to Health Disparities Education Among Otolaryngology Residency Curricula.","authors":"Isabel Snee, Amir Hakimi, Sonya Malekzadeh","doi":"10.1002/oto2.148","DOIUrl":"10.1002/oto2.148","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of health disparities curricula in otolaryngology residency programs and identify implementation barriers.</p><p><strong>Study design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>National otolaryngology residency programs.</p><p><strong>Methods: </strong>A survey based on published literature discussing the incorporation of health disparities curricula, educational design, quality, barriers to implementation, and patient demographics was sent to US otolaryngology residency program directors (PDs). Otolaryngology programs excluded from consideration included those of osteopathic recognition, programs outside of the United States, and military programs. In excluding osteopathic, international, and military-based residency programs from our survey, we aimed to maintain sample homogeneity and focus our analysis on allopathic programs due to potential variations in demographic compositions and practice settings. This decision was made to ensure a more targeted examination of health disparities within a specific context, aligning with our research objectives and resource constraints. Anonymous survey results were collected and analyzed to determine the prevalence of health disparities curricula as well as their effectiveness and standardization across residency programs.</p><p><strong>Results: </strong>A total of 24 PDs (response rate, 23%) responded to the survey. Half of the PDs reported having a health disparities curriculum, among whom only 25% felt the quality of their curriculum was very good or excellent. All institutions with an explicit health disparities educational program reported having developed their own curriculum, 75% of which changed annually. However, 92% of these programs reported not measuring outcomes to assess their curriculum's utility. The most reported barriers to curriculum development for all programs included insufficient time (63%), limited teaching ability specific to health disparities education (54%), and faculty disinterest in teaching (33%).</p><p><strong>Conclusion: </strong>Very few of the surveyed otolaryngology residency programs have implemented a health disparities curriculum. A comprehensive and standardized health disparities curriculum would be beneficial to ensure that residents can confidently develop competency in health disparities, aligning with the Clinical Learning Environment Review mandate and Accreditation Council for Graduate Medical Education expectations.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e148"},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200306","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":"Letter Regarding \"Improvement in Nasal Symptoms of Chronic Rhinitis after Cryoablation of the Posterior Nasal Nerve\": Toward a Unified Airway Approach.","authors":"Diego M Conti, Eduardo J Correa","doi":"10.1002/oto2.153","DOIUrl":"10.1002/oto2.153","url":null,"abstract":"","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e153"},"PeriodicalIF":1.8,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11143484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141200148","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 Diagnosis of Granulomatosis With Polyangiitis When Serology and Biopsies are Negative.","authors":"Charles Teames, Julie Highland, Daniel Cox, Mark Elstad, Curry Koening, Marshall Smith","doi":"10.1002/oto2.138","DOIUrl":"10.1002/oto2.138","url":null,"abstract":"<p><strong>Objective: </strong>Granulomatosis with polyangiitis (GPA) is a potentially fatal condition which often manifests in the head and neck. Currently, diagnosis relies on antineutrophil cytoplasmic autoantibody (c-ANCA) serology and mucosal or renal biopsy. However, a significant proportion of patients with GPA limited to the head and neck are seronegative and biopsy negative. This study evaluates the role of clinical diagnosis of GPA in the absence of positive laboratory findings.</p><p><strong>Study design: </strong>Case series with chart review.</p><p><strong>Setting: </strong>Academic Tertiary Medical Center.</p><p><strong>Methods: </strong>This was a retrospective review of 143 patients treated in an outpatient otolaryngology clinic at a tertiary care hospital for known or suspected GPA from 1998 to 2021. Presenting symptoms, C-ANCA status at initial presentation, biopsy results, long-term serology results, and time to initiation of treatment were analyzed.</p><p><strong>Results: </strong>Twenty-six of 143 (18.2%) patients were seronegative; only 3 of these patients (12%) had positive biopsies. Seventeen (73.9%) of these patients presented with nasal and sinus disease and 12 (52.2%) presented with airway involvement. Only 4 (17.4%) patients had renal involvement. Delay in treatment of patients with negative laboratory workup ranged from 0 months to 11 years. All patients who were seronegative and/or biopsy negative at presentation responded clinically to immunosuppressive therapy.</p><p><strong>Conclusion: </strong>GPA cases are often limited to the upper respiratory tract, making diagnosis difficult, particularly in seronegative patients. These results suggest that, when GPA is suspected, despite negative serology, the diagnosis of GPA should be made on clinical grounds, and empiric therapy encouraged to prevent delay in treatment.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e138"},"PeriodicalIF":1.5,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944792","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":"Identifying Practice Gaps Among Otolaryngology Providers for the Treatment of Chronic Cough.","authors":"Natalie L Demirjian, Austin Lever, Helena Yip","doi":"10.1002/oto2.143","DOIUrl":"10.1002/oto2.143","url":null,"abstract":"<p><strong>Objective: </strong>Increasing evidence over the last decade suggests that many cases of unexplained chronic cough (UCC) have a neurogenic etiology, with laryngeal hypersensitivity (LH) being identified as a key mechanism. Official guidelines since 2015 have adopted use of neuromodulators and adjuvant speech therapy as a result, but historically implementation of guidelines is slow. Our survey aimed to investigate gaps in diagnosis and management practices of otolaryngology providers in caring for patients with UCC.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Survey.</p><p><strong>Methods: </strong>12-item survey was distributed to 110 otolaryngology practitioners experienced in diagnosis and treatment of chronic cough at a regional otolaryngology continuing education conference. Statistical analysis included Kendall's Tau Rank Correlation to measure the ordinal association between responses to questions, and Fisher's exact test to determine if there were associations between responses and years of career experience.</p><p><strong>Results: </strong>Forty eligible respondents underwent subsequent analysis. There was no association between frequency of identifying LH as a primary etiology and use of neuromodulators (<i>τ</i> = 0.23, <i>P</i> = .10). However, there was a significant correlation between LH and referrals to speech therapy (<i>τ</i> = 0.27, <i>P</i> = .05). Fisher's exact test did not reveal any significant differences among any responses based on practitioner experience.</p><p><strong>Conclusion: </strong>Our results indicate a possible disparity in treatment of UCC with neuromodulators and the utilization of speech therapy despite guideline recommendations advocating for neuromodulators with adjuvant speech therapy. Further research with larger sample sizes and more specific inquiries is necessary to elucidate this association and control for any regional differences.</p>","PeriodicalId":19697,"journal":{"name":"OTO Open","volume":"8 2","pages":"e143"},"PeriodicalIF":1.5,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11094514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140944791","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}