Otolaryngology- Head and Neck Surgery最新文献

{"title":"Functional Outcomes of Free Flap Reconstruction After TORS in Early-Stage HPV-Positive Oropharyngeal Cancer.","authors":"Praneet C Kaki, Neel R Sangal, Doreen Lam, Ryan M Carey, Karthik Rajasekaran, Ara Chalian, Robert M Brody, Gregory S Weinstein, Steven B Cannady","doi":"10.1002/ohn.1221","DOIUrl":"10.1002/ohn.1221","url":null,"abstract":"<p><strong>Objective: </strong>In the unique clinical context of a retropharyngeal carotid artery (RPC), free flap reconstruction (FFR) may be used for small pathologic tumor (pT)1-2 human papillomavirus (HPV)+ oropharyngeal squamous cell carcinoma (OPSCC) tumors to provide vessel coverage, providing a unique case-control study model. This study aims to elucidate the impact of FFR on functional outcomes following transoral robotic surgery (TORS).</p><p><strong>Study design: </strong>Retrospective review of electronic medical records between 2010 and 2022.</p><p><strong>Setting: </strong>Single-institution tertiary care center.</p><p><strong>Methods: </strong>Cohorts were defined as FFR (with RPC) and no FFR (nFFR). A 1:2 propensity score match (PSM) was performed. The functional oral intake scale (FOIS) was used to characterize swallowing outcomes. Statistical analysis was performed in R-Studio.</p><p><strong>Results: </strong>Post-PSM, 93 patients met inclusion criteria (59.8 years, 92% white, 88% male). In total, 31 (33%) underwent FFR, 77 (83%) had pT2 tumors, and 87 (93%) underwent adjuvant treatment. The FFR cohort saw increased return to the operating room (FFR 19% vs nFFR 3.3%, P < .001) and mean hospital stay (7.2 ± 2.2 vs 4.9 ± 3.1 days, P = .02). Median preoperative FOIS was similar between groups (FFR: 7.00 [interquartile range (IQR) 6.00-7.00] vs nFFR: 7.0 [7.00-7.00], P = .2) with comparable decline at first follow-up. The nFFR cohort had higher FOIS at 3 and 6 months (5.00 [5.00-6.00] vs 6.00 [5.00-7.00], P = .04). FOIS was similar after 1 year (6.00 [5.00-7.00] vs 6.00 [6.00-7.00], P = .3).</p><p><strong>Conclusion: </strong>FFR achieved comparable functional outcomes to nFFR at 1 year. FFR is a viable reconstructive option for pT1-2 tumors for which TORS that are amenable to surgical resection via TORS despite an anatomic barrier such as RPC.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"40-48"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605974","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":"Comparative Analysis of Information Quality in Pediatric Otorhinolaryngology: Clinicians, Residents, and Large Language Models.","authors":"Eleonora M C Trecca, Vito Carlo Alberto Caponio, Mario Turri-Zanoni, Antonella Miriam di Lullo, Michele Gaffuri, Jérôme R Lechien, Antonino Maniaci, Giuseppe Maruccio, Marella Reale, Irene Claudia Visconti, Virginia Dallari","doi":"10.1002/ohn.1225","DOIUrl":"10.1002/ohn.1225","url":null,"abstract":"<p><strong>Objective: </strong>Pediatric otorhinolaryngology (ORL) addresses complex conditions in children, requiring a tailored approach for patients and families. With artificial intelligence (AI) gaining traction in medical applications, this study evaluates the quality of information provided by large language models (LLMs) in comparison to clinicians, identifying strengths and limitations in the field of pediatric ORL.</p><p><strong>Study design: </strong>Comparative blinded study.</p><p><strong>Setting: </strong>Controlled research environment using LLMs.</p><p><strong>Methods: </strong>Fifty-four items of increasing difficulty, namely 18 theoretical questions, 18 clinical scenarios, and 18 patient questions, were posed to ChatGPT-3.5, -4.0, -4o, Claude-3, Gemini, Perplexity, Copilot, a second-year resident, and an expert in the field of pediatric ORL. The Quality Analysis of Medical Artificial Intelligence (QAMAI) tool was used for blinded evaluation of the quality of medical information by a panel of expert members from the Young Otolaryngologists Group of the Italian Society of ORL and the International Federation of ORL Societies.</p><p><strong>Results: </strong>LLMs performed comparably to specialist in theoretical and standardized clinical scenarios, with Bing Copilot achieving the highest QAMAI scores. However, AI responses lacked transparency in citing reliable sources and were less effective in addressing patient-centered questions. Poor interrater agreement among reviewers highlighted challenges in distinguishing human-generated from AI-generated responses. Rhinology topics received the highest scores, whereas laryngology and patient-centered questions showed lower agreement and performance.</p><p><strong>Conclusion: </strong>LLMs show promise as supportive resources in pediatric ORL, particularly in theoretical learning and standardized cases. However, significant limitations remain, including source transparency and contextual communication in patient interactions. Human oversight is essential to mitigate risks. Future developments should focus on refining AI capabilities for evidence-based and empathetic communication to support both clinicians and families.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"228-236"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658095","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":"Estimation of Minimal Clinically Important Difference for Tinnitus Handicap Inventory and Tinnitus Functional Index.","authors":"Milena Engelke, Laura Basso, Berthold Langguth, Florian Zeman, Winfried Schlee, Stefan Schoisswohl, Rilana Cima, Dimitris Kikidis, Jose Antonio Lopez-Escamez, Petra Brüggemann, Birgit Mazurek, Jorge Piano Simões","doi":"10.1002/ohn.1217","DOIUrl":"10.1002/ohn.1217","url":null,"abstract":"<p><strong>Objective: </strong>The minimal clinically important difference (MCID) represents the smallest change in treatment outcome deemed clinically meaningful. This study estimates the MCID for 2 widely used tinnitus measures: the Tinnitus Handicap Inventory (THI) and the Tinnitus Functional Index (TFI), using anchor-based approaches while accounting for baseline severity and time interval.</p><p><strong>Study design: </strong>A multi-center randomized clinical trial.</p><p><strong>Setting: </strong>European tinnitus centers.</p><p><strong>Methods: </strong>Anchor-based approaches, including the effect size, receiver-operating characteristics, and ΔTHI/TFI methods, were employed to determine the MCID. The \"minimally improved\" category of the Clinical Global Impression Scale-Improvement (CGI-I) served as the anchor. The standard error of measurement was used to assess random variation.</p><p><strong>Results: </strong>For the THI, MCID estimates ranged from 7.8 to 12, with a point estimate of 11 after 12 weeks of treatment (N = 364). For the TFI, MCID estimates ranged from 7.3 to 9.4, with a point estimate of 9 points after 12 weeks (N = 359). Both measures indicated that higher baseline severity and longer time intervals required greater score reduction for clinical relevance.</p><p><strong>Conclusion: </strong>This study highlights the context-specific nature of MCID values for tinnitus measures and emphasizes the need for consensus on optimal anchor-based approaches to improve comparability.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"69-79"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662729","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":"Can Manual Therapy Alter Muscle Stiffness in Patients With Spinal Accessory Nerve Injury?","authors":"Ferhat Simsek, Baha Naci, Meltem Bozaci Kilicoglu, Zeynep Alkan, Osman Melih Topcuoglu, Aysegul Gormez, Gunter Hafiz, Ali Fethi Okyar","doi":"10.1002/ohn.1236","DOIUrl":"10.1002/ohn.1236","url":null,"abstract":"<p><strong>Objective: </strong>Shoulder and neck dysfunctions resulting from spinal accessory nerve injury impair quality of life. This study aims to investigate the effects of manual therapy in combination with standard physiotherapy on the mechanical properties of muscle, neck and shoulder function, pain, and quality of life in head and neck cancer patients.</p><p><strong>Study design: </strong>Prospective, randomized, controlled, double-blind clinical trial.</p><p><strong>Setting: </strong>Department of Otorhinolaryngology Head and Neck Surgery of a university hospital.</p><p><strong>Methods: </strong>A total of 26 participants were randomized into two groups. The control group (n = 11) received standard physiotherapy including therapeutic exercises, scar tissue massage, and education. The intervention group (n = 10) received manual therapy consisting of soft tissue, myofascial release, and mobilization techniques in combination with standard physiotherapy. Outcome measures were mechanical properties of muscle, neck and shoulder active range of motion, shoulder pain and disability, and quality of life.</p><p><strong>Results: </strong>Upper trapezius and sternocleidomastoid muscle stiffness increased significantly in the control group (P < .01), whereas a significant reduction was observed in the intervention group compared to the control group (P = .001). A reduction in muscle thickness was observed bilaterally in both groups (P < .01). Moreover, all participants showed improvements in neck and shoulder active range of motion, shoulder pain, and quality of life (P < .01).</p><p><strong>Conclusion: </strong>Manual therapy in addition to standard physiotherapy was more effective in improving neck and shoulder function, quality of life, and reducing muscle stiffness compared to standard physiotherapy alone. Therefore, clinicians should consider incorporating manual therapy into their treatment protocols to optimize patient outcomes.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"115-125"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693052","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 Novel Natural Language Processing Model for Triaging Head and Neck Patient Appointments.","authors":"Stefanie Seo, Andy S Ding, Syed Ameen Ahmad, Kevin Z Xin, Max L Jiam, Vincent Xin, Leila J Mady, Christine G Gourin, Wojciech K Mydlarz, Nyall R London, Wayne Koch, Carole Fakhry, Nicole T Jiam","doi":"10.1002/ohn.1244","DOIUrl":"10.1002/ohn.1244","url":null,"abstract":"<p><strong>Objective: </strong>Inaccurate patient triage contributes to suboptimal clinical capacity management and delays in patient care, which in cancer patients may significantly increase morbidity and mortality. We developed a natural language processing (NLP) model as an adjunctive tool for head and neck (H&N) patient triage workflows. This study assesses the model's ability to categorize and triage patient appointments based on available documentation.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>An academic institution.</p><p><strong>Methods: </strong>A total of 83 new patients seeing an H&N surgeon from January to April 2024 with at least 1 referral record (clinic note, imaging, or pathology report) available were included in this study. Referral clinic, imaging, and pathology reports were entered into the NLP model to predict pathology type (non-endocrine H&N neoplasm, thyroid, parathyroid, and benign lesions), malignancy risk, and appointment urgency. The gold standard was the final diagnosis from pathology reports or surgeons' clinic notes.</p><p><strong>Results: </strong>The NLP model achieved an accuracy of 81.9% for pathology type and 86.8% for urgency level. Sensitivity was high for non-endocrine H&N neoplasms (88.9%), thyroid pathology (88.9%), and parathyroid pathology (100%), although lower for benign lesions (67.9%). Specificity was 86.8% for non-endocrine H&N neoplasms, 91.9% for thyroid pathology, 97.6% for parathyroid pathology, and 96.4% for benign lesions. Prediction of appointment urgency achieved a Matthews correlation coefficient of 0.698, reflecting strong predictive performance.</p><p><strong>Conclusion: </strong>This novel NLP model demonstrated robust performance characteristics for predicting H&N diagnoses based on referring documents and excelled at identifying patients requiring urgent care based on malignancy risk. This tool may help H&N practice coordinators screen referrals, potentially optimizing patient care.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"126-133"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022702","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":"Comparison of Socioeconomic Factors Influencing Delay and Underuse of Cochlear Implants.","authors":"Maryann Zhao, Victoria Huang, Michelle H Zhang, Jack Y Ghannam, Mary M Morcos, Jennifer J Shin, Alicia M Quesnel, Carleton E Corrales, James G Naples","doi":"10.1002/ohn.1250","DOIUrl":"10.1002/ohn.1250","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare socioeconomic factors associated with underuse and prolonged time to cochlear implant (CI) surgery for qualifying candidates.</p><p><strong>Study design: </strong>Retrospective cohort study of adult patients who were CI candidates from January 1, 2018, to December 31, 2022.</p><p><strong>Setting: </strong>Three tertiary academic centers.</p><p><strong>Methods: </strong>Demographic factors (age, sex, race, zip code, insurance status, preferred language, and marital status) and speech recognition scores in quiet and distance to CI center were collected. Household income quintiles were determined based on zip code matching to US Census data. Main outcomes were decision to pursue CI surgery and time elapsed from initial candidacy to surgery.</p><p><strong>Results: </strong>A total of 382 patients were evaluated for CI candidacy and included in the analysis (191 [50%] women; median age, 70 years; interquartile range [IQR] 58-78). Of these, 306 (80%) underwent cochlear implantation. Multivariable analyses revealed that, among those who qualified, patients with non-English-speaking status (odds ratio [OR] 0.31 [95% CI: 0.13-0.71]), older age (OR 0.97 [95% CI: 0.94-0.99]), male sex (OR 0.40 [95% CI: 0.23-0.72]), and higher speech recognition scores (21%-40%: OR 0.33 [95% CI: 0.15-0.70]; >41%: OR 0.24 [95% CI: 0.076-0.74]) were less likely to receive surgery. Among those who underwent surgery, only non-English-speaking patients experienced significantly longer time to surgery relative to English-speaking patients (hazard ratio [HR] 0.64 [95% CI: 0.43-0.97]).</p><p><strong>Conclusion: </strong>Language is a potential enduring factor impacting both pursuit of and time to CI surgery. Future work should consider target strategies to account for these factors as a way to improve CI access.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"218-227"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008596","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":"Longitudinal Assessment of Music Enjoyment in Hearing Aid Users Based on Music Listening Preferences.","authors":"Isaac L Alter, Alexander Chern, Michael W Denham, Alexis Leiderman, Jessica Galatioto, Jennifer Jones, Amanda J Ucci, Dean Mancuso, Anil K Lalwani","doi":"10.1002/ohn.1242","DOIUrl":"10.1002/ohn.1242","url":null,"abstract":"<p><strong>Objective: </strong>Hearing loss is associated with deterioration of music enjoyment that can be mitigated with hearing aids (HAs). In this study, we assess HA users' music enjoyment and listening habits over time.</p><p><strong>Study design: </strong>Longitudinal.</p><p><strong>Setting: </strong>Tertiary academic medical center and community.</p><p><strong>Methods: </strong>Adult HA users reported music listening habits and music enjoyment using 10-point Likert scales and underwent a melody discernment listening task, once in 2020 and again in 2023. Paired t-tests were used to compare individuals' responses across time points, and unpaired t-tests were performed to juxtapose participants who preferred music sound quality with HAs (\"prefer HA\") versus without (\"prefer unaided\").</p><p><strong>Results: </strong>Forty-three HA users participated, with an average (SD) of 24.3 (18.3) years of HA use as of 2023. Despite an increase in pure tone average from 2020 to 2023 (47.2-52.6, P < .001), there was no significant change in time spent listening to music, overall music enjoyment, or melody discernment ability. In 2023, the \"prefer unaided\" group reported worse music enjoyment with HAs (5.7 vs 7.5, P = .022) and higher music enjoyment before their HL diagnosis (9.7 vs 7.6, P = .007); they also spent less time listening to music (4.0 vs 5.4, P = .038). Similar differences were also observed in 2020.</p><p><strong>Conclusion: </strong>In individual HA users, worsening hearing over time may not translate to changes in music enjoyment or listening habits. However, HA users with higher levels of music enjoyment before HL diagnosis are more dissatisfied with aided music listening and spend less time listening to music.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"80-87"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730654","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":"Impact of Margins on Outcomes in HPV-Related Oropharyngeal Squamous Cell Carcinoma Treated With Surgery Only.","authors":"Omar A Karadaghy, Michael P Wu, Nathan Farrokhian, Maria Armache, Nadia L Samaha, Rohith Bhethanabotla, Danielle M Gillard, Swapnil V Shah, Abigail E Reid, Carole Fakhry, William R Ryan, Jeremy Richmon, Andrew J Holcomb","doi":"10.1002/ohn.1213","DOIUrl":"10.1002/ohn.1213","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the prognostic impact of surgical margin status in HPV-related oropharyngeal squamous cell carcinoma (OPSCCa) and examine the potential for revising surgical margin standards in HPV+ OPSCCa.</p><p><strong>Study design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>This study was conducted across 4 tertiary oncology centers.</p><p><strong>Methods: </strong>Charts of patients treated from 2010 to 2022 for HPV+ OPSCCa were reviewed. Eligible patients underwent surgery without adjuvant treatment for nonrecurrent, nonmetastatic HPV+ OPSCCa. Demographic, oncologic, treatment, and outcome data were collected. Patients with prior head and neck radiation or adjuvant therapy were excluded. Local control, locoregional recurrence (LRR), disease-free survival (DFS), and overall survival (OS) were compared based on surgical margins using the Kaplan-Meier method.</p><p><strong>Results: </strong>Among 194 qualified cases, with a median follow-up of 41.63 months, most cases were pT1 (64.43%) or pT2 (34.54%). Recurrence occurred in 8.76% of patients, with most salvaged successfully. Analysis on univariable and multivariable modeling determined that margins less than 1 mm were considered close, and those ≥1 mm were considered clear. On multivariable modeling, surgical margins of <1 mm were associated with a hazard ratio of 3.69 (95% confidence interval [CI] 1.47-9.30) for LRR and 2.95 (95% CI 1.41-6.16) for DFS when compared to cases where margins were clear by 1 mm or greater.</p><p><strong>Conclusion: </strong>In this multi-institutional cohort of early-stage HPV+ OPSCCa treated surgically without adjuvant therapy, margins <1 mm were associated with worse LRR and DFS. This suggests that traditional definitions of close margins in HPV-negative disease may not apply to HPV+ OPSCCa, warranting a revised definition for surgical margin standards.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"106-114"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143658115","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":"Associations With Changes in Disease-Specific Quality of Life Following Stereotactic Radiosurgery for Sporadic Vestibular Schwannoma.","authors":"Eric E Babajanian, Ghazal S Daher, James R Dornhoffer, Karl R Khandalavala, John P Marinelli, Christine M Lohse, Michael J Link, Matthew L Carlson","doi":"10.1002/ohn.1243","DOIUrl":"10.1002/ohn.1243","url":null,"abstract":"<p><strong>Objective: </strong>To examine associations with changes in quality-of-life (QOL) outcomes following treatment of vestibular schwannoma (VS) using stereotactic radiosurgery (SRS).</p><p><strong>Study design: </strong>Prospective longitudinal study.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Methods: </strong>Patients who were treated for sporadic VS using SRS from 2015 to 2022 were included. QOL outcomes were measured using the disease-specific Penn Acoustic Neuroma QOL (PANQOL) scale.</p><p><strong>Results: </strong>Seventy-nine patients with pre-SRS and at least one post-SRS PANQOL assessments were available for analysis. The mean change in total PANQOL scores was -2 (SD 13) on a 100-point scale. The mean duration between assessments was 4.6 years (SD 2.0). Age at SRS, sex, and SRS treatment doses were not significantly associated with changes in total PANQOL scores. Total PANQOL scores improved a mean of 4 points for patients with tumors confined to the internal auditory canal but declined a mean of 5 points for patients with tumors extending into the cerebellopontine angle (P = .01); however, these changes did not exceed the minimum clinically significant threshold of 11 points. The correlation coefficient between treated tumor volume at SRS and change in total PANQOL scores was -0.30 (P = .007). Changes in PANQOL total (P = .5) and hearing domain (P = .3) scores for patients who maintained serviceable hearing or progressed to nonserviceable hearing did not significantly differ.</p><p><strong>Conclusion: </strong>Tumor extent and treated volume at SRS had a statistically significant but likely not clinically important impact on total PANQOL scores. Progression to nonserviceable hearing did not have a significant impact on PANQOL total or hearing domain scores.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"201-207"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780923","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":"Association of Circulating Cell-Free Mitochondrial DNA With Sudden Sensorineural Hearing Loss.","authors":"Chao-Hui Yang, Ming-Yu Yang, Wei-Che Lin, Chung-Feng Hwang, Yu-Tsai Lin, Ching-Nung Wu, I-Ya Chen, Ming-Hsien Tsai","doi":"10.1002/ohn.1238","DOIUrl":"10.1002/ohn.1238","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association of circulating cell-free mitochondrial DNA (ccf-mtDNA) levels with the severity and treatment outcomes of sudden sensorineural hearing loss (SSNHL).</p><p><strong>Study design: </strong>Observational prospective study.</p><p><strong>Setting: </strong>Tertiary academic medical center.</p><p><strong>Methods: </strong>Plasma samples were collected from patients diagnosed with SSNHL in the morning before steroid treatment, as well as from healthy controls. A quantitative polymerase chain reaction was used to measure ccf-mtDNA levels, expressed as log copy numbers per milliliter. Treatment outcomes were evaluated using hearing gain, percentage of recovery, and Siegel's criteria.</p><p><strong>Results: </strong>The study included 80 subjects, including 50 patients and 30 healthy controls. The mean (SD) plasma ccf-mtDNA level was 8.1 (0.35), which was significantly higher than 7.78 (0.65) controls (95% CI: 0.097-0.542). Patients with good recovery exhibited significantly higher pretreatment ccf-mtDNA levels compared to those with poor recovery (mean [SD] score: 8.29 [0.34] vs 8.02 [0.33]; 95% CI: 0.04-0.48). Ccf-mtDNA levels were positively associated with hearing gain (r = 0.486, 95% CI: 0.227-0.663) and percentage of recovery (r = 0.361, 95% CI: 0.103-0.574). Multivariate analyses revealed that less than 7 days from onset of hearing loss to treatment (odds ratio [OR]: 7.389, 95% CI: 1.324-41.239) and higher ccf-mtDNA levels (OR: 24.634, 95% CI: 1.878-323.163) were independent predictors for good recovery.</p><p><strong>Conclusion: </strong>Plasma ccf-mtDNA levels were elevated in patients with SSNHL and were significantly associated with better treatment outcomes following steroid therapy. These findings suggest that ccf-mtDNA levels may serve as a predictive biomarker for SSNHL treatment outcomes, paving the way for personalized therapeutic strategies.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"193-200"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693051","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}