Otolaryngology- Head and Neck Surgery最新文献

{"title":"Evaluating the Impact of Gender and Race on Otolaryngology Resident Experiences Across the United States.","authors":"Shweta Lodha, Nathan Luzum, Claire Washabaugh, Ariana Allen, Sandra Stinnett, Charles Woodard, Sharon Fekrat","doi":"10.1002/ohn.966","DOIUrl":"10.1002/ohn.966","url":null,"abstract":"<p><strong>Objective: </strong>Otolaryngology residents often encounter work-related stress and challenges during training. Sociodemographic factors influence experiences during residency; however, the impact of race and gender on otolaryngology trainee well-being during residency remains understudied.</p><p><strong>Study design: </strong>Online survey.</p><p><strong>Setting: </strong>US residency programs.</p><p><strong>Methods: </strong>An anonymous online survey consisting of 59 multiple-choice questions was sent to 104 directors of Accreditation Council for Graduate Medical Education otolaryngology residency programs to distribute to residents. Respondents were queried regarding demographics and experiences with bias. Residents self-identified gender and race. Black, Hispanic/Latinx, Middle Eastern/North African, and multiracial residents were categorized as underrepresented minorities (URM).</p><p><strong>Results: </strong>Sixty-one US otolaryngology residents responded to the survey, the majority of whom were women (60.7%) and white (62%). Many residents endorsed a belief that receipt of research and training opportunities was negatively impacted by bias due to race (29.5%) or gender (45.9%). More women (27%) than men (13%) reported maximal burnout, and fewer men (17.4%) than women (40.5%) expressed low confidence in ability to independently care for patients. More male (47.8%) and white (31.6%) residents strongly agreed they were thriving. 94.6% of women and 33.3% of URM residents reported being mistaken for a nonphysician, compared to 0% of white male respondents.</p><p><strong>Conclusion: </strong>Otolaryngology residents perceived differential treatment based on race and gender, with women and URM residents experiencing greater exclusion and bias, as well as increased misidentification and decreased ability to thrive. Future work includes increasing sample size for generalizability and developing interventions that uphold equity in residency training environments.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"144-151"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracheostomy Exchange in the Setting of Do-Not-Intubate Order.","authors":"Zoë Fullerton, Monica Bodd, Susan McCammon, Brian Nuyen","doi":"10.1002/ohn.979","DOIUrl":"10.1002/ohn.979","url":null,"abstract":"","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"366-368"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Metformin on Cisplatin-Induced Ototoxicity in Diabetic Patients.","authors":"Marc-Elie Nader, Jonathan Choi, Mike Hernandez, Katherine Hutcheson, Taylor Myers, Shirin Jivani, Rajarshi Pratihar, Katharine Fernandez, Jack Phan, Chelsea You, Paul W Gidley","doi":"10.1002/ohn.1032","DOIUrl":"10.1002/ohn.1032","url":null,"abstract":"<p><strong>Objective: </strong>Ototoxicity is an important side effect of cisplatin. Recent animal and in vitro studies suggest metformin may protect hearing, though human studies are lacking. We report the first retrospective clinical study exploring the effects of metformin on cisplatin-induced ototoxicity.</p><p><strong>Study design: </strong>Retrospective case-control.</p><p><strong>Setting: </strong>Tertiary-care center.</p><p><strong>Methods: </strong>We reviewed all diabetic patients treated with cisplatin who were enrolled in an auditory monitoring program between January 1, 2000 and December 31, 2018. Patients were grouped according to their use of metformin at the time of chemotherapy. Demographics, oncologic diagnosis and treatment, and prior noise exposure were recorded. Audiometric thresholds were compared before and after chemotherapy. The primary outcome measure was a change in hearing as defined by the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE). Secondary measures of ototoxicity included changes in hearing using the American Speech-Language-Hearing Association (ASHA) and TUNE criteria.</p><p><strong>Results: </strong>Seventy-two diabetic patients met the inclusion criteria. Forty-six patients had taken metformin while on chemotherapy and 26 had not. The proportion of hearing loss as defined by both, CTCAE and ASHA criteria, was more than double in the metformin group relative to the nonmetformin group (CTCAE: 54.4% vs 19.2%, P = .004; ASHA: 62.2% vs 28.0%, P = .003). None of the potential covariates believed to be confounders were significantly associated with the outcome of multivariable analysis.</p><p><strong>Conclusion: </strong>Contrary to expectations from preclinical data, metformin did not reduce the incidence of hearing loss in patients receiving cisplatin and may, in fact, be associated with an increased risk.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"243-253"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic Differences in Emergency Room Epistaxis Treatment Patterns and Outcomes.","authors":"Kevin Herrera, Marcela Moran Mojica, Karla Marlene Sintigo, Kevin Hur","doi":"10.1002/ohn.940","DOIUrl":"10.1002/ohn.940","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the association between demographic characteristics and emergency department (ED) epistaxis management and outcomes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>TriNetX US collaborative database.</p><p><strong>Methods: </strong>Adults presenting to the ED for epistaxis were retrospectively followed for 7 days. Spanish-speaking patients were propensity score matched to English-speaking patients by demographics and medical history. Outcomes included use of nasal decongestant, nasal packing or cautery, diagnostic nasal endoscopy, endoscopic control of hemorrhage, hospital admission, and mortality. The analysis was also performed with stratification by race and ethnicity.</p><p><strong>Results: </strong>Spanish-speaking patients were less likely to receive nasal packing or cautery [odds ratio, OR: 0.78; 95% confidence interval, CI: (0.68; 0.90)] or diagnostic nasal endoscopy [OR: 0.72; 95% CI: (0.52; 0.98)] compared to English-speaking patients. Black patients were more likely to receive treatment with a nasal decongestant spray [OR: 1.31; 95% CI: (1.27, 1.36)], but less likely to receive any other treatment compared to White patients. Asian patients were less likely to undergo nasal packing or cautery [OR: 0.90; 95% CI: (0.82; 0.99)], but had more ED visits [(1.37; 1.32) P < .01] compared to White patients. Hispanic patients were less likely to be admitted [OR: 0.93; 95% CI: (0.87; 0.98)], and averaged fewer ED visits [(1.27; 1.30) P = <.0001] compared to non-Hispanic patients.</p><p><strong>Conclusion: </strong>While demographic trends in ED epistaxis management are nuanced, our results suggest that Spanish-speaking, Black, Asian, and Hispanic patients are less likely to receive diagnostic and epistaxis control procedures. Additional research is needed to determine the etiology of these differences.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"110-117"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11697530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141907331","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":"A Systematic Review and Meta-Analysis of Management Options for Empty Nose Syndrome: A Proposed Management Algorithm.","authors":"Salman Hussain, Jafar Hayat, Hamad Almhanedi, Mohammad Alherz, Mahmoud Ebrahim, Ali Lari, Andrew Thamboo","doi":"10.1002/ohn.929","DOIUrl":"10.1002/ohn.929","url":null,"abstract":"<p><strong>Objective: </strong>Empty nose syndrome (ENS) is an acquired condition characterized by paradoxical nasal obstruction and sensation of nasal dryness often accompanied by psychological disorders such as depression or anxiety, typically occurring after the loss of inferior turbinate tissue or volume in the setting of prior sinonasal surgery. This review aims to identify and evaluate the reported management options.</p><p><strong>Data sources: </strong>PubMed, Scopus, and Web of Science.</p><p><strong>Review methods: </strong>The terms \"empty nose syndrome\" OR \"atrophic rhinitis\" were used in a systematic search of original articles since the year 1990, yielding 1432 individual studies. These were screened on the Covidence platform for inclusion if any intervention was reported for the treatment of ENS. A pooled analysis of standardized mean differences (SMDs) combined with a random effects model was employed to report outcomes in Empty Nose 6-Item Questionnaire (ENS6Q), Sino-Nasal Outcome Test (SNOT), anxiety, and depression scores.</p><p><strong>Results: </strong>A total of 35 articles were included, comprising 957 individual ENS patients. Surgical interventions mostly in the form of meatus augmentation implants accounted for 26 out of the 36 articles. The remaining ten articles included medical and psychological management options. SMD in SNOT, ENS6Q, anxiety, and depression scores were reported and demonstrated statistically significant improvements in follow-up periods of up to 1 year. All articles reported favorable outcomes following their chosen interventions.</p><p><strong>Conclusion: </strong>There is a paucity of evidence on the management of ENS and an absence of randomized controlled trials. Surgical intervention appears to be the current mainstay of treatment, but there is a potential role for psychological and medical management.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1-12"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indications, Surgical Strategies And Hearing Outcomes of Revision Stapes Surgery for Otosclerosis: A Systematic Review and Meta-analysis on 2602 Patients.","authors":"Michele Tomasoni, Daniele Borsetto, Pietro Canzi, Alperen Vural, Gabriele Testa, Cesare Piazza, Lorenzo Pinelli, Luca Oscar Redaelli de Zinis","doi":"10.1002/ohn.974","DOIUrl":"10.1002/ohn.974","url":null,"abstract":"<p><strong>Objective: </strong>To summarize current knowledge on the indications, surgical strategies, and auditory outcomes of revision stapes surgery (RSS) for otosclerosis.</p><p><strong>Data sources: </strong>The search was conducted in PubMed, Scopus, and Web of Science online databases, including papers published since 2000.</p><p><strong>Review methods: </strong>The study was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. We considered original series describing RSS for otosclerosis, reporting postoperative hearing outcomes according to the American Academy of Otolaryngology-Head and Neck Surgery guidelines for conductive hearing loss (CHL) for at least 30 consecutive cases. The quality of included studies was assessed with the Joanna Briggs Institute checklist. Pooled proportion and odds ratio (OR) meta-analysis were conducted using random effect models.</p><p><strong>Results: </strong>Nineteen studies were included, for a total of 2602 patients (2735 ears) and 2359 postoperative hearing results. RSS was mostly performed for recurrent CHL with air-bone gap (ABG)>20 dB. Multiple concomitant causes were often present, with prosthesis placement defect and incus necrosis as the most common causes. The pooled proportion of postoperative ABG<10 dB and ABG<20 dB was 57.2% (95% confidence interval [CI]: 52.8%-61.4%) and 79% (95% CI: 76.0%-81.8%), respectively. Dead ears were 1.2% (95% CI: 0.7%-2.1%). Compared to primary surgery, RSS had a significantly lower rate of ABG<10 dB (OR = 0.36, 95% CI: 0.24%-0.54%; P < .001). Both revision incudostapedotomy with/without incus reconstruction and malleovestibulopexy are viable options with nonsignificant differences in ABG closure rates (P = .182).</p><p><strong>Conclusion: </strong>RSS is challenging and requires the surgeon to carefully evaluate all potential causes of previous failure and tailor the intervention according to intraoperative findings. In most cases, ABG closure within 20 dB can be achieved with a relatively low risk of dead ears.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"50-62"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142292859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dizziness and Imbalance Across the Lifespan: Findings of a Pediatric and Adult Vestibular Clinic.","authors":"Alana L Ferreira, Alanna M Windsor, Tiffany P Hwa, Stephanie Y Wang, Erin W Field, Michael J Ruckenstein, Robert C O'Reilly","doi":"10.1002/ohn.962","DOIUrl":"10.1002/ohn.962","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate diagnostic trends in pediatric and adult patients presenting for multidisciplinary subspecialty evaluation of dizziness and imbalance across the lifespan.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Single pediatric and single adult academic tertiary care hospital.</p><p><strong>Methods: </strong>Retrospective review of electronic health record for patients presenting to an adult or pediatric multidisciplinary vestibular clinic from 2017 to 2020, including clinical data, physical therapy evaluation, and audiovestibular testing.</p><p><strong>Results: </strong>A total of 1934 patients aged 1 to 95 were evaluated. Most patients were female (n = 1188, 61%); the largest cohort was in the fifth decade of life (n = 321, 17%). Seventy-six percent of patients (n = 1470) were assigned a pathologic diagnosis. Central causes of dizziness were most common in children and young adults, comprising 38% to 54% of all diagnoses in ages 1 to 30. The proportion of peripheral vestibular disorders increased with age, peaking at 32% in ages 61 to 70. Vestibular migraine was the most common pathologic diagnosis in ages 6 to 20 (n = 110, 39%) and 31 and 50 (n = 69, 17%) regardless of gender, but was more prevalent in females (21% vs 14%; P < .0001). The prevalence of benign paroxysmal positional vertigo (BPPV) increased throughout the lifespan, peaking at age 71 to 80. Meniere's disease (MD) did not occur within the first decade of life, but increased thereafter, peaking at ages 51 to 60.</p><p><strong>Conclusion: </strong>Multidisciplinary vestibular evaluation resulted in a diagnosis for the majority of patients. Vestibular diagnoses vary across the lifespan however among most age groups, central disorders, including migraine disorders, outnumber peripheral vestibulopathies. The prevalence of peripheral vestibular disorders such as BPPV and MD increased with age.</p><p><strong>Level of evidence: </strong>Level IV.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"254-261"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes from a Multidisciplinary Otolaryngology and Rheumatology Clinic for the Management of Chronic Sialadenitis.","authors":"Anna G Holley, Sara M Stern, Albert H Park","doi":"10.1002/ohn.960","DOIUrl":"10.1002/ohn.960","url":null,"abstract":"<p><strong>Objective: </strong>Determine the outcomes in children with recurrent sialadenitis after establishment of a multidisciplinary pediatric otolaryngology and rheumatology clinic.</p><p><strong>Study design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Single-center tertiary medical center.</p><p><strong>Methods: </strong>We reviewed all children presenting to a multidisciplinary pediatric otolaryngology/rheumatology clinic with recurrent parotitis between December 2019 and April 2023.</p><p><strong>Results: </strong>Thirty-three children presented with recurrent parotitis to a multidisciplinary clinic. Seventy-seven percent of those with childhood Sjögren's disease (cSjD) had xerophthalmia, and 67% had xerostomia. The cSjD group was more likely to have both abnormal parotid and submandibular findings when compared to the non-cSjD group (P < .001). Sixteen percent of the cSjD group had a positive SSA/SSB autoantibody and 47% were antinuclear antibody positive. Fifty percent of the cSjD cohort had a focus score of ≥1 from a minor salivary gland biopsy. There were no significant differences from sialendoscopy outcome between the 2 groups. Seventy percent with juvenile recurrent parotitis showed partial response (PR) or complete response (CR) to sialendoscopy. In the cSjD cohort 3 (27%) reported a CR and 5 (45%) reported a PR. In the non csSjD cohort 5 (42%) reported a CR and 3 (25%) reported a PR. Ten of the 12 cSjD patients on hydroxychloroquine have shown symptom improvement.</p><p><strong>Conclusion: </strong>The establishment of a multidisciplinary otolaryngology and rheumatology clinic can provide a more comprehensive evaluation and treatment of the child with recurrent or persistent parotitis than from a regular ENT clinic.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"137-143"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical Anesthesia in Cutaneous Head and Neck Surgery: A Randomized Controlled Trial.","authors":"Rory O'Neill, Adrinda Affendi, Nathaniel McHugh, Liam Skinner","doi":"10.1002/ohn.1039","DOIUrl":"10.1002/ohn.1039","url":null,"abstract":"<p><strong>Objective: </strong>Cutaneous head and neck surgery can safely and effectively be performed using local anesthetic (LA). However, optimizing pain management during LA administration is paramount for patient comfort and procedural efficacy. The primary objective of this study was to investigate the comparative effectiveness of EMLA cream and ethyl chloride (EC) spray in mitigating pain associated with LA administration in cutaneous head and neck surgery.</p><p><strong>Study design: </strong>Randomized controlled trial.</p><p><strong>Setting: </strong>University-affiliated tertiary head and neck oncology center.</p><p><strong>Methods: </strong>Sample size calculation was performed followed by computer randomization into the following groups: EMLA, EMLA placebo (aqueous cream), EC, and a control group (no topical agent). Demographics, pain, and procedural experience scores were recorded perioperatively. Statistical analysis was performed to analyse differences between groups utilizing the Mann-Whitney U test, Kruskall-Wallis test, Chi-square test, and Spearman's Rho.</p><p><strong>Results: </strong>121 cutaneous lesions with a median patient age of 76 were analyzed. There were no statistically significant differences in pain scores (median [IQR]) between patients receiving EMLA (4 [3.75]), EMLA placebo (4.8 [3.6]), EC (5.8 [2.8]), and no treatment (5 [4.1], P = .19). Procedural experience scores were clinically similar (P = .02). Risk factors associated with elevated nociceptive sensitivity were surgical site (scalp, P = .01), malignant lesions (P < .01) and lesion surface area (rs = 0.22, P = .01).</p><p><strong>Conclusion: </strong>EMLA and EC did not mitigate LA-associated pain in patients undergoing cutaneous head and neck surgery and as such practitioners should reconsider their use of these in this regard. Patients' operative experience remains excellent regardless of topical anesthetic use.</p><p><strong>Level of evidence: </strong>Ib.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"184-191"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Psychological Distress Among Thyroid Cancer Patients.","authors":"Matthew E Lin, Eric X Wei, Andrey Finegersh, Lisa A Orloff, Julia E Noel, Michelle M Chen","doi":"10.1002/ohn.1051","DOIUrl":"10.1002/ohn.1051","url":null,"abstract":"<p><strong>Objective: </strong>To assess the prevalence of psychological distress (PD) among thyroid cancer patients (TCPs) and identify clinical, demographic, and socioeconomic factors associated with PD.</p><p><strong>Study design: </strong>Retrospective population-based cohort study.</p><p><strong>Setting: </strong>2016 to 2018 National Health Interview Survey.</p><p><strong>Methods: </strong>Adults with cancer were included. The primary outcome measure was moderate-to-severe psychological distress (MSPD), defined as a respondent score ≥5 on the validated K6 Psychological Distress Scale. χ² tests were used to assess differences in MSPD by cancer type. Weighted multivariable logistic regression was used to elucidate factors associated with MSPD among TCPs.</p><p><strong>Results: </strong>The majority of TCPs (n = 684,674) were white (75.4%), female (78.5%), and on average 55.65 years old (SD = 13.2). 28.4% reported MSPD. On weighted analysis, TCPs were more likely to have MSPD than prostate (14.9%, P < .001), bladder (16.4%, P = .011), and nonmelanoma skin cancer (16.3%, P < .001) patients but less likely than pancreatic cancer (30.0%, P = .030) patients. TCPs who were older when surveyed (odds ratio [OR], 0.93; 95% confidence interval [CI, 0.88-0.98), previously drank alcohol (OR, 0.23; 95% CI, 0.06-0.91), and saw a general physician (GP) in the past year (OR, 0.14; 95% CI, 0.03-0.56) were less likely to have MSPD. Female sex (OR, 8.12; 95% CI, 1.61-40.89), increased number of medical comorbidities (OR, 1.46; 95% CI, 1.00-2.14), and functional limitations (OR, 4.55; 95% CI, 1.33-15.74) were associated with increased likelihood of MSPD.</p><p><strong>Conclusion: </strong>Nearly 30% of TCPs have MSPD, especially younger patients who do not regularly see GPs. Future work to identify the most at-risk patients is needed to improve prevention and develop meaningful psychosocial interventions.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"74-81"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}