Laryngoscope Investigative Otolaryngology最新文献

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Evaluation of Large Language Models' Concordance With Guidelines on Olfaction
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-22 DOI: 10.1002/lio2.70130
Ariana L. Shaari, Anthony M. Saad, Disha Patil, Jennifer Yanik, Wayne D. Hsueh, Jean Anderson Eloy, Andrey Filimonov
{"title":"Evaluation of Large Language Models' Concordance With Guidelines on Olfaction","authors":"Ariana L. Shaari,&nbsp;Anthony M. Saad,&nbsp;Disha Patil,&nbsp;Jennifer Yanik,&nbsp;Wayne D. Hsueh,&nbsp;Jean Anderson Eloy,&nbsp;Andrey Filimonov","doi":"10.1002/lio2.70130","DOIUrl":"https://doi.org/10.1002/lio2.70130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the concordance of artificial intelligence (AI)-generated information with the 2022 International Consensus Statement on Allergy and Rhinology: Olfaction (ICAR-O).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Forty-two guidelines were extracted from the ICAR-O. Each guideline was converted into a question, which was presented to ChatGPT version 4.o and Google Gemini. Concordance was deemed an agreement between the AI response and the clinical recommendation. Credibility was granted if the AI platform provided a credible resource. Accuracy was graded on a Likert scale (0: entirely inaccurate information, 1: mix of accurate and inaccurate information, 2: entirely accurate information). Statistical analysis was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 84 responses were generated. The mean accuracy of the ChatGPT and Gemini responses was 1.85 and 1.48 out of 2, respectively, indicating that the responses contained a mix of accurate and inaccurate information. ChatGPT responses were significantly more accurate than Gemini responses (<i>p</i> = 0.001). Of the ChatGPT responses, 78.57% (<i>N</i> = 33) were concordant with the ICAR-O guidelines and 100% (<i>N</i> = 42) cited a credible resource. Of the Gemini responses, 66.67% (<i>N</i> = 28) were concordant and 97.62% (<i>N</i> = 41) cited a credible resource. There were no significant differences in concordance (<i>p</i> = 0.22) or credibility (<i>p</i> = 0.31) between the AI platforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ChatGPT provided more accurate information than Gemini on olfaction. However, overall, both platforms did not consistently align with clinical guidelines. AI platforms require further evaluation before clinical implementation or use as educational adjuncts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Disparities in Hearing Aid Use Among Those With Hearing Loss in Rural and Urban Settings 农村和城市听力损失者在助听器使用方面的差异
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-21 DOI: 10.1002/lio2.70125
Paul Johnson, Emmanuel Garcia Morales, Nicholas Reed
{"title":"Disparities in Hearing Aid Use Among Those With Hearing Loss in Rural and Urban Settings","authors":"Paul Johnson,&nbsp;Emmanuel Garcia Morales,&nbsp;Nicholas Reed","doi":"10.1002/lio2.70125","DOIUrl":"https://doi.org/10.1002/lio2.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate potential disparities in hearing aid use among urban and rural populations with hearing loss.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Study Design</h3>\u0000 \u0000 <p>Cross-sectional analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used pooled data from the 2017 and 2018 rounds of the Medicare Current Beneficiary Survey (MCBS). Our analytic sample was restricted to 8107 participants with hearing loss (those who reported little to a lot of trouble hearing) and with a full set of covariates. Multivariate logistic regression models for the probability of hearing aid use were estimated using a participant's place of residence (rural/urban) and household income relative to the Federal Poverty Level (low and middle income ≤ 200% of Federal Poverty Level (FPL); high income &gt; 200% FPL) as main exposures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In models using place of residence as the main exposure, we found no statistically significant difference in hearing aid use between rural and urban populations. In models combining place of residence with income, we found that respondents in the rural high-income group were at the highest odds for hearing aid use (odds ratio (OR): 1.99, 95% confidence interval (CI): 1.52–2.59) when compared to the rural low and middle-income group and, similarly, for the urban high-income (OR: 1.57, 95% CI: 1.26–1.96) and urban low and middle-income groups (OR: 1.31, 95% CI: 1.02–1.69).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>There are potential interactions of metro status and income regarding hearing aid use that are more pronounced in rural populations. This might allow policymakers to target interventions for hearing loss to rural and low-income populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70125","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Systemic Hormonal Contraceptive Use and Rhinitis Among Adult Women: An All of Us Database Analysis
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-21 DOI: 10.1002/lio2.70123
Richard G. Chiu, Kamal Eldeirawi, Anthony I. Dick, Sharmilee M. Nyenhuis, Thasarat Sutabutr Vajaranant, Rachel Caskey, Victoria S. Lee
{"title":"Systemic Hormonal Contraceptive Use and Rhinitis Among Adult Women: An All of Us Database Analysis","authors":"Richard G. Chiu,&nbsp;Kamal Eldeirawi,&nbsp;Anthony I. Dick,&nbsp;Sharmilee M. Nyenhuis,&nbsp;Thasarat Sutabutr Vajaranant,&nbsp;Rachel Caskey,&nbsp;Victoria S. Lee","doi":"10.1002/lio2.70123","DOIUrl":"https://doi.org/10.1002/lio2.70123","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The role of sex hormones in the pathogenesis of allergic and inflammatory conditions such as rhinitis has been receiving increased attention, with evidence supporting an inflammation-modulating role of estrogen and progesterone in the nasal mucosa. However, the specific influence of hormonal contraceptives in rhinitis has been sparsely studied. As such, we sought to investigate the association of systemic hormonal contraceptives with both allergic (AR) and nonallergic rhinitis (NAR) using a national data set of adults in the United States.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study was conducted using data from 46,205 female participants aged 20–40 in the <i>All of Us</i> Research Program. Rhinitis diagnoses, systemic hormonal contraceptive use, and covariate data were extracted for all participants. These variables were included in multivariable logistic regression models assessing the association of any systemic hormonal contraceptive use with rhinitis, both AR and NAR. Separate models were conducted to examine the association of progestin-only contraceptives (POCs) and estrogen-containing contraceptives (ECCs) on the odds of rhinitis. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were calculated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Systemic hormonal contraceptives were associated with AR (OR: 1.32; 95% CI: 1.20–1.44) but not NAR (OR: 1.20; 95% CI: 0.90–1.56) after controlling for covariates. When analyzing POCs and ECCs separately, both were associated with AR compared to those not taking any systemic hormonal contraceptives (OR: 1.29; 95% CI: 1.12–1.48 for POC, OR: 1.35; 95% CI: 1.21–1.51 for ECC) but were not significantly associated with NAR (OR: 1.04; 95% CI: 0.66–1.57 for POC, OR: 1.33; 95% CI: 0.95–1.81 for ECC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Systemic hormonal contraceptive use was independently associated with AR, with no significant difference between POCs and ECCs, while not being associated with NAR. Our findings may support a hormonal role in the pathogenesis of AR, but further research is needed to establish causation and understand the underlying mechanisms linking systemic hormonal contraceptive use to AR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70123","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Transposition of temporoparietal fascia flap through lateral orbital window for anterior skull base reconstruction: A cadaveric feasibility study
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-21 DOI: 10.1002/lio2.70067
Jate Lumyongsatien MD, Anuch Durongphan MD, Siri-on Tritrakarn MD, Pongsakorn Tantilipikorn MD, PhD
{"title":"Transposition of temporoparietal fascia flap through lateral orbital window for anterior skull base reconstruction: A cadaveric feasibility study","authors":"Jate Lumyongsatien MD,&nbsp;Anuch Durongphan MD,&nbsp;Siri-on Tritrakarn MD,&nbsp;Pongsakorn Tantilipikorn MD, PhD","doi":"10.1002/lio2.70067","DOIUrl":"https://doi.org/10.1002/lio2.70067","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility of utilizing a temporoparietal fascia flap (TPFF) via the lateral orbital window for anterior skull base reconstruction (ASBR) in cadavers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Four cadavers underwent anatomical dissections on eight sides. The dissection procedure involved exposing the anterior skull base (ASB) using endoscopic endonasal techniques, dissecting the orbit, harvesting the temporalis muscle fascial flap (TPFF), and transposing the TPFF to the ASB through the lateral orbital window. The minimum required length (MRL) of the TPFF to reach the ASB and maximum harvestable length (MHL) of the flap were determined. A computed tomography (CT) scan was used to measure the dimensions of the anterior skull base defects (ASBD) in each cadaver.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The harvested TPFFs successfully reached the intended ASBDs. The average MRL and MHL were 14.00 ± 1.06 and 16.45 ± 1.16 cm, respectively. The resulting ASBDs exhibited an average anterior–posterior distance, width, and area of 2.45 ± 0.42 cm, 2.46 ± 0.46 cm, and 5.17 ± 1.07 cm<sup>2</sup>, respectively. Moreover, utilizing this method, the TPFF consistently reached the posterior wall of the frontal sinus in all cadavers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The TPFF can be effectively utilized to cover the ASBD by passing through the lateral orbital window. The TPFF serves as a viable option for repairing defects in the posterior wall of the frontal sinus.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 4.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70067","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of the Effect of Platelet-Rich Plasma Injection After Recurrent Nerve Injury in Rats
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-19 DOI: 10.1002/lio2.70087
Adem Senturk, Ahmet Tarik Harmantepe, Mevlut Yordanagil, Bilgehan Celik, Ozcan Budak, Songul Doganay, Fatih Turan, Alp Omer Canturk, Recayi Capoglu, Fuldem Mutlu
{"title":"Evaluation of the Effect of Platelet-Rich Plasma Injection After Recurrent Nerve Injury in Rats","authors":"Adem Senturk,&nbsp;Ahmet Tarik Harmantepe,&nbsp;Mevlut Yordanagil,&nbsp;Bilgehan Celik,&nbsp;Ozcan Budak,&nbsp;Songul Doganay,&nbsp;Fatih Turan,&nbsp;Alp Omer Canturk,&nbsp;Recayi Capoglu,&nbsp;Fuldem Mutlu","doi":"10.1002/lio2.70087","DOIUrl":"10.1002/lio2.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Injuries to the recurrent laryngeal nerve (RLN) that may occur during thyroidectomy cause hoarseness, dysphagia, and dyspnea. Even if the injured nerve can be repaired surgically, it heals slowly and not completely. Platelet-rich plasma (PRP) is obtained by centrifuging blood taken from the human body. PRP accelerates the healing of the injured nerve due to the many growth factors it contains. The aim of this study is to investigate the therapeutic effectiveness of PRP and assess surgical repair after RLN injury.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Twenty-eight male Wistar albino rats were used in this study. We divided the rats into four groups, with seven animals in each group. Group 1: RLN was cut and primary repair was performed. Group 2: RLN was cut but not repaired. Group 3: RLN was cut, primary repair was performed, and PRP was injected. Group 4: RLN was cut, and PRP was injected without repair. Laryngoscopy and electromyography (EMG) were conducted before and after the procedure. For histopathological evaluation, parameters such as Schwann cell count, axon damage, and immunohistochemical staining intensity of Ki-67 cell proliferation marker were examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The highest amplitudes in EMG were seen in Group 3 rats at the third- and sixth-week postoperatively (<i>p</i> &lt; 0.05). Regarding histopathological evaluation, Schwann cell count, and Ki-67 immunohistochemical staining were primarily observed in Group 3 rats (<i>p</i> &lt; 0.05). Axonal damage and cytoplasmic vacuolization were minimally detected in Group 3 rats (<i>p</i> &lt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In our experimental rodent model, PRP injection increased the Schwann cell count and cell proliferation rate in the injured RLN area by promoting the healing of nerve axons.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11922806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143671392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Clinical Outcome of Image-Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-18 DOI: 10.1002/lio2.70106
Kangchen Lyu, Baoying Tan, Ziling Su, Jianwei Xuan
{"title":"The Clinical Outcome of Image-Guided System in Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis","authors":"Kangchen Lyu,&nbsp;Baoying Tan,&nbsp;Ziling Su,&nbsp;Jianwei Xuan","doi":"10.1002/lio2.70106","DOIUrl":"https://doi.org/10.1002/lio2.70106","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Although image-guided system (IGS) is considered useful in endoscopic sinus surgery (ESS), its impact on clinical outcomes needs further evaluation. This study aimed to compare clinical outcomes in patients with chronic rhinosinusitis (CRS) undergoing ESS with or without IGS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Sources</h3>\u0000 \u0000 <p>Two independent reviewers searched PubMed, EMBASE, Cochrane, CNKI, WanFang, and VIP to identify comparative clinical studies on clinical outcomes of ESS with or without IGS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The primary outcome were total complications. Secondary outcomes were recurrence, revision surgery, blood loss, surgical time, and patient-reported outcomes. A meta-analysis was performed to calculate odds ratios (OR) and weighted mean difference (WMD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 16 studies were included with a total sample size of 3014 patients. Compared with non-IGS, total complications were less common in IGS group (OR = 0.52, 95% CI, 0.37 to 0.74, <i>p</i> &lt; 0.01), and recurrence rate and revision surgery rate in IGS group was also lower (recurrence rate: OR = 0.31, 95% CI, 0.18 to 0.52, <i>p</i> &lt; 0.001; revision surgery rate: OR = 0.59, 95% CI, 0.36 to 0.98, <i>p</i> = 0.04). What is more, IGS could reduce intraoperative blood loss (WMD = −10.74 mL; 95% CI, −20.92 to −0.57; <i>p</i> = 0.04) and surgical time (WMD = −6.25 min; 95% CI, −9.59 to −2.90, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Compared with non-IGS, IGS-assisted ESS was associated with a lower risk of total complications, recurrence, and revision surgery, and with a reduction of intraoperative blood loss and surgical time. These findings support the clinical use of IGS as an adjunct in ESS for CRS patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70106","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Neck Dissection and Survival Among Head and Neck Cancer Patients Undergoing Adjuvant Immunotherapy 颈部切除术与接受辅助免疫疗法的头颈癌患者的生存率
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-18 DOI: 10.1002/lio2.70120
Aman M. Patel, Afash Haleem, Paul T. Cowan, Dylan F. Roden
{"title":"Neck Dissection and Survival Among Head and Neck Cancer Patients Undergoing Adjuvant Immunotherapy","authors":"Aman M. Patel,&nbsp;Afash Haleem,&nbsp;Paul T. Cowan,&nbsp;Dylan F. Roden","doi":"10.1002/lio2.70120","DOIUrl":"https://doi.org/10.1002/lio2.70120","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Some studies suggest that neck dissection (ND) should be avoided in candidates for immunotherapy because lymph nodes are primary sites for immunotherapy activation. Our study investigates ND utilization and associated differences in overall survival (OS) among patients with head and neck cancer (HNC) undergoing adjuvant immunotherapy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 2013–2018 National Cancer Database was retrospectively reviewed for patients with HNC undergoing surgery with curative intent, and adjuvant immunotherapy. Multivariable binary logistic and Cox regression models adjusted for patient demographics, clinicopathologic features, and treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 1335 patients satisfying inclusion criteria, 679 (50.9%) patients underwent ND: 94 (13.8%) had pN0, 109 (16.1%) had pN1, 411 (60.5%) had pN2, 60 (8.8%) had pN3, and 5 (0.7%) had pNx classification. On multivariable binary logistic regression, academic treatment facility, cT4, and cN1–3 classification were associated with higher odds of undergoing ND (<i>p</i> &lt; 0.05); salivary, sinonasal, oropharyngeal, hypopharyngeal, and laryngeal primary sites were associated with decreased odds (<i>p</i> &lt; 0.05). Compared with those undergoing neck observation, patients undergoing ND had worse OS (49.4% vs. 61.5%, <i>p</i> &lt; 0.001) on Kaplan–Meier but not multivariable Cox (adjusted hazard ratio [aHR] 1.00, 95% confidence interval [CI] 0.82–1.24, <i>p</i> = 0.968) regression. Compared with adjuvant immunotherapy alone, the addition of radiotherapy (aHR 0.64, 95% CI 0.44–0.93) and chemoradiotherapy (aHR 0.56, 95% CI 0.37–0.86) were associated with higher OS (<i>p</i> &lt; 0.025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ND was utilized in approximately 51% of patients with HNC undergoing adjuvant immunotherapy. ND was not associated with worse OS, possibly related to the high rate of pN1–3 classification.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>4</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Recommendation for Standardized Exam for Nasal Obstruction
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-07 DOI: 10.1002/lio2.70117
Jordan Kai Simmons, Wasiq Nadeem, Matthew K. Lee, Henry H. Chen
{"title":"Recommendation for Standardized Exam for Nasal Obstruction","authors":"Jordan Kai Simmons,&nbsp;Wasiq Nadeem,&nbsp;Matthew K. Lee,&nbsp;Henry H. Chen","doi":"10.1002/lio2.70117","DOIUrl":"https://doi.org/10.1002/lio2.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Nasal septal deviation, inferior turbinate hypertrophy, and nasal valve compromise are among the most common etiologies of NAO seen by facial plastic surgeons and otolaryngologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While both validated and non-validated scales and grading systems exist, they are inconsistently used. Further, anecdotally useful tools such as the Cottle maneuver have been adapted for purposes outside of patient care, such as billing. Although these NAO assessment systems have great utility in the diagnosis of nasal pathology, in isolation, they are not robust enough to influence surgical decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In this study, we summarize the existing literature surrounding the nasal exam in cases of obstruction and offer a standardized nasal exam protocol based on grading systems and physical exam maneuvers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>N/A.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70117","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Enhancing Mucus Flow and Clearance by Grafting Zwitterionic Hydrogel Films to Luminal Surfaces
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-07 DOI: 10.1002/lio2.70118
Ryan Horne, Caleb Escudero, Morgan Ellerman, C. Allan Guymon, Marlan Hansen
{"title":"Enhancing Mucus Flow and Clearance by Grafting Zwitterionic Hydrogel Films to Luminal Surfaces","authors":"Ryan Horne,&nbsp;Caleb Escudero,&nbsp;Morgan Ellerman,&nbsp;C. Allan Guymon,&nbsp;Marlan Hansen","doi":"10.1002/lio2.70118","DOIUrl":"https://doi.org/10.1002/lio2.70118","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To determine the effects of zwitterionic hydrogel films on mucus contact angles, flow, and stasis with respect to medical polymer surfaces, both flat and tubular.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A zwitterionic hydrogel thin film was photografted onto medical rubber surfaces and compared against non-zwitterionic hydrogel thin films and untreated surfaces to determine its impact on mucus contact angles, mucus flow on sheets and tubes, and mucus plugging.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Zwitterionic and conventional hydrogel films significantly reduce the mucus contact angles and the tilt required to initiate mucus flow on sheets and in tubular systems. Preliminary experiments show that these films may also shorten the time required for a mucus-plugged tube to unplug when exposed to saline.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Zwitterionic and conventional hydrogel films on typical medical surfaces reduce resistance to mucus flow, increase mucus discharge, and may facilitate faster unplugging of dried mucus. These effects are the most pronounced on tubes of larger inner diameter (greater than 2.6 mm) and tend to dissipate for tubes of smaller diameter. These results may help guide future improvements to medical tubes intended to discharge mucus and ventilate, resulting in fewer complications for patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 2, randomized individual trial.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70118","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mutations in Anaplastic Thyroid Carcinoma: An Analysis of the Japanese National Genomic Database
IF 1.6 4区 医学
Laryngoscope Investigative Otolaryngology Pub Date : 2025-03-07 DOI: 10.1002/lio2.70110
Hiromi Nagano, Hayato Matsumoto, Yumi Ando, Masatoyo Nakajo, Masaru Yamashita
{"title":"Mutations in Anaplastic Thyroid Carcinoma: An Analysis of the Japanese National Genomic Database","authors":"Hiromi Nagano,&nbsp;Hayato Matsumoto,&nbsp;Yumi Ando,&nbsp;Masatoyo Nakajo,&nbsp;Masaru Yamashita","doi":"10.1002/lio2.70110","DOIUrl":"https://doi.org/10.1002/lio2.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The purpose of this study is to investigate the genetic mutational status of anaplastic thyroid carcinoma (ATC) and its prognostic implications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data were analyzed for 129 consecutive patients with ATC registered at the Japan National Cancer Center, Center for Cancer Genomics and Advanced Therapeutics (C-CAT) between June 2019 and June 2024. Genetic alterations were determined by FoundationOne CDx or Liquid CDx next-generation sequencing. The survival of patients was determined by the log-rank test and a Cox proportional hazards model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The top 30 mutations in ATC were <i>TERT</i> (98/129), <i>TP53</i> (88/129), <i>BRAF</i> (72/129), <i>CDKN2A</i> (39/129), <i>CDKN2B</i> (29/129), <i>LTK</i> (26/129), <i>NRAS</i> (25/129), <i>KMT2D</i> (24/129), <i>PIK3CA</i> (26/129), <i>NOTCH3</i> (27/129), <i>NF2</i> (19/129), <i>MTAP</i> (17/129), <i>TET2</i> (16/129), <i>STK11</i> (15/129), <i>ATM</i> (14/129), <i>FANCA</i> (14/129), <i>NF1</i> (13/129), <i>DNMT3A</i> (13/129), <i>KIT</i> (13/129), <i>NOTCH1</i> (13/129), <i>EP300</i> (12/129), <i>BRCA2</i> (11/129), <i>CARD11</i> (11/129), <i>KEL</i> (11/129), <i>MSH3</i> (11/129), <i>PTEN</i> (11/129), <i>RICTOR</i> (11/129), <i>TSC1</i> (11/129), <i>ROS1</i> (10/129), and <i>KMT2A</i> (10/129) with 13.7 ± 0.5 (mean ± SEM) mutations/individual. Mutations in <i>BRAF</i> (<i>p</i> = 0.003), <i>PIK3CA</i> (<i>p</i> = 0.014), and <i>BRCA2</i> (<i>p</i> = 0.036) were associated with a significantly better prognosis, whereas mutations in <i>STK11</i> (<i>p</i> = 0.024) was associated with a significantly worse prognosis, as determined by log-rank tests. The hazard ratios for cases with these mutations were 0.248 (95% CI, 0.0973–0.633, <i>p</i> = 3.5 × 10<sup>−3</sup>) for <i>PIK3CA</i>, 2.410 (1.054–5.515, <i>p</i> = 0.037) for <i>STK11</i>, and 0.157 (0.0376–0.659, <i>p</i> = 0.011) for <i>BRCA2</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In ATC, <i>PIK3CA</i>, and <i>BRCA2</i> mutations were associated with a better prognosis, and <i>STK11</i> mutation was associated with a poorer prognosis in this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 2","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70110","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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