Otolaryngology- Head and Neck Surgery最新文献

{"title":"Phenotyping and Endotyping Pediatric Chronic Rhinosinusitis.","authors":"Ella Morgan, Michael J Cunningham, Eelam A Adil","doi":"10.1002/ohn.1231","DOIUrl":"10.1002/ohn.1231","url":null,"abstract":"<p><strong>Objective: </strong>To differentiate pediatric chronic rhinosinusitis (CRS) into clinically relevant primary and secondary phenotypes based on clinical, radiographic, and laboratory findings.</p><p><strong>Study design: </strong>Retrospective chart review of patients with CRS who underwent endoscopic sinus surgery over a 5-year period.</p><p><strong>Setting: </strong>Tertiary referral children's hospital.</p><p><strong>Methods: </strong>Relevant medical and surgical history inclusive of disease onset, clinical and radiographic findings, laboratory data, and operative culture results was recorded. Data analysis resulted, where appropriate, in phenotype and endotype characterization.</p><p><strong>Results: </strong>In total, 94 patients, aged 6.8 to 22.0 years, with a mean age of 15.4 years, satisfied the inclusion criteria. Eosinophilic CRS was the most common primary phenotype (n = 19, 20.2%), and this group was the most likely to have recurrent disease requiring revision surgery. Additional primary phenotypes identified included allergic fungal rhinosinsusitis (n = 10, 10.6%) and central compartment atopic disease (n = 2, 2.1%). CRS associated with cystic fibrosis was the most common secondary CRS category (n = 13, 13.8%). Based on available data, over one-third of patients (n = 36, 38.2%) could not be categorized into a specific phenotype based on current clinical and radiologic criteria.</p><p><strong>Conclusion: </strong>A phenotype and endotype-based classification system for CRS is evolving for the adult population. This study highlights that such a classification system is possible in the pediatric and adolescent age group, facilitating targeted biologic therapies at the underlying inflammatory mechanism. Further investigation is clearly required given an etiologic source of paranasal sinus inflammation could not be identified in approximately one-third of patients.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"243-250"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662736","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":"Application of an AI-Based Model for Non-Invasive Sonographic Assessment for Injection Laryngoplasty.","authors":"Wen-Hsuan Tseng, Ming-Sui Lee, Shung-Cyuan Hong, Tzu-Yu Hsiao, Tsung-Lin Yang","doi":"10.1002/ohn.1215","DOIUrl":"10.1002/ohn.1215","url":null,"abstract":"<p><strong>Objective: </strong>Hyaluronic acid (HA) can be degraded over time. However, the persistence of the effects after injection laryngoplasty (IL) for unilateral vocal fold paralysis (UVFP) has been observed. The relation between HA residue and clinical voice outcomes is undetermined. We aimed to develop a non-invasive method with clinical applicability for objective evaluation of the temporal change in HA volume using artificial intelligence-based ultrasonographic assessment. Furthermore, the volume outcome and its relation to voice outcomes were investigated.</p><p><strong>Study design: </strong>A prospective cohort study.</p><p><strong>Setting: </strong>A voice clinic at a tertiary medical center.</p><p><strong>Methods: </strong>Adult patients who underwent HA IL for UVFP were recruited. The Voice Handicap Index-10 questionnaire, the grade, roughness, breathiness, asthenia, strain scale, and the normalized glottal gap were evaluated before IL. Patients received ultrasonography for the identification of HA and estimation of volume based on Temporal Convolutional Segmentation Network, and also voice outcome assessments at 2 weeks, and 2 and 6 months after IL.</p><p><strong>Results: </strong>Contours of HA were well-described, and volumes were estimated accordingly. Clinical voice outcomes were significantly improved postoperatively and remained stationary. Contrarily, residual HA volume decreased significantly across time points (1.21 ± 0.53 at 2 weeks, 0.63 ± 0.35 at 2 months, P < .001; 0.32 ± 0.25 at 6 months, P < .001). Simple linear regression showed no significant relationship between the remaining volume at 2 months and patient age or duration of symptoms (P = .67).</p><p><strong>Conclusion: </strong>Volume change of injected HA over time was estimated non-invasively. The prolonged voice improvement, longer than HA longevity, was demonstrated objectively. The knowledge on HA longevity and duration of benefit provides perspectives beneficial to counseling patients and future treatment planning.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"144-153"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674429","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 Clinical Efficacy and Safety of Endoscopic Vidian-Branch Neurectomy in Intractable Allergic Rhinitis.","authors":"Shaobing Xie, Fengjun Wang, Hua Zhang, Zhihai Xie, Junyi Zhang, Weihong Jiang","doi":"10.1002/ohn.1258","DOIUrl":"10.1002/ohn.1258","url":null,"abstract":"<p><strong>Objective: </strong>Intractable allergic rhinitis (iAR) remains a clinical challenge. This study aims to evaluate the efficacy and safety of endoscopic selective vidian branch neurectomy for iAR.</p><p><strong>Study design: </strong>A prospective clinical study.</p><p><strong>Setting: </strong>A tertiary referral center.</p><p><strong>Methods: </strong>A total of 205 iAR patients were initially recruited and divided into 3 groups: endoscopic vidian-branch neurectomy (EVBN), endoscopic vidian neurectomy (EVN), and conservative treatment (control). All patients were followed up for more than 2 years, and the efficacy and postoperative complications were compared.</p><p><strong>Results: </strong>After 2-year follow-up, a total of 195 patients were included, with 59 patients in EVBN group, 71 in EVN group, and 64 in control group. Post-treatment assessments at 6 months, 1 year, and 2 years revealed significant reductions in the total Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores and each domain in both EVBN and EVN groups compared to their baseline levels. However, no significant changes were observed in control group. Furthermore, the improvements in RQLQ 2 years post-treatment were higher in EVBN and EVN groups compared to control group. In EVBN group, only 3 (5.1%) patients reported mild eye dryness during the first month postoperation. However, in the EVN group, 15 (21.1%) patients experienced eye dryness, with 6 (8.5%) cases persisting for more than 1 year and remaining unresolved by the end of the 2-year follow-up.</p><p><strong>Conclusion: </strong>Both EVBN and EVN were effective in iAR patients. However, EVBN appears to be a safer option, associated with fewer postoperative complications.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"268-277"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035076","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":"A National Study of Emotional Intelligence Among Otolaryngology Residents and Fellows Using the TEIQue-Short Form.","authors":"Juliana Bonilla-Velez, Caleb M Allred, Peter M Vila, Zainab Farzal, Jake J Lee, Kristy Truong, Xing Wang, Carla V Valenzuela","doi":"10.1002/ohn.1260","DOIUrl":"10.1002/ohn.1260","url":null,"abstract":"<p><strong>Objective: </strong>Little is known about emotional intelligence (EI) among otolaryngology trainees and its assessment during training. We aim to assess EI levels and identify demographic and training-related factors associated with higher EI.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Survey of otolaryngology trainees.</p><p><strong>Methods: </strong>Residents and fellows completed a national single-response survey from the Governing Council of the Section for Residents and Fellows-in-Training (November 7 to December 31, 2018). The Trait Emotional Intelligence Questionnaire-Short Form provided a global EI score and subscores for well-being, self-control, emotionality, and sociability. Associations between sociodemographic and training factors with higher scores were assessed.</p><p><strong>Results: </strong>The global EI score was high (5.2 ± 0.6). Fellows had higher global EI scores than residents (5.5 vs 5.23; P = .028). Fellows (6.33 vs 5.83; P = .024), trainees older than 35 years (6.17 vs 5.83; P = .021), and those in humanitarian efforts (P = .012) had higher well-being scores. Trainees older than 35 years had higher self-control scores (5.67 vs 5.17; P = .009). Fellows (5.88 vs 5.50; P = .002) and female trainees (5.62 vs 5.38; P = .001) had higher emotionality scores. Trainees with ≥4 publications had higher sociability scores (5.0 vs 4.83; P = .001).</p><p><strong>Conclusion: </strong>Global EI scores were high in this national sample of otolaryngology trainees. Seniority, age, female gender, research experience, and humanitarian involvement were associated with higher scores in specific dimensions. Future studies should evaluate how training experiences or structured educational programs can enhance the development of EI.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"88-95"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036290","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":"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":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12825393/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}