Laryngoscope Investigative Otolaryngology最新文献

{"title":"Social Media Perspectives on Over-The-Counter Hearing Aids: Sentiment and Thematic Analysis of Twitter (X) Data","authors":"Joel S. Feier,&nbsp;Matthew E. Lin,&nbsp;Matthew Awad,&nbsp;Aman M. Patel,&nbsp;Cindy Vu,&nbsp;John C. Parsons,&nbsp;Margaret Wallhagen,&nbsp;Janet S. Choi","doi":"10.1002/lio2.70242","DOIUrl":"https://doi.org/10.1002/lio2.70242","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess public perspective on over-the-counter (OTC) hearing aids through social media data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twitter (X)'s Application Program Interface was utilized to collect English-language tweets mentioning OTC hearing aids between January 2019 and October 2022. Sentiment analysis was conducted using the Valence Aware Dictionary and Sentiment Reasoner, categorizing tweets as positive, neutral, or negative. Main outcomes and measures were average compound sentiment scores. Joinpoint analysis was used to evaluate changes in sentiment scores over time. Two independent raters categorized account type and tweets into categories determined by thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 8912 tweets were included. The tweets were categorized as Economy, Political, Logistics, Information, and Other based on thematic analysis. Overall mean (SD) compound sentiment score (range: −1 to +1) was weakly positive at 0.15 (0.40). The total number of tweets increased significantly after August 2022, with 331 tweets in Q2 of 2022 and 2110 tweets in Q3 of 2022. There were no significant changes in sentiment scores over the study period. Economy received the highest average compound sentiment score of 0.21 (0.39), followed by Political 0.18 (0.46), Logistics 0.16 (0.41), Other 0.14 (0.39), and lastly Information 0.13 (0.36).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated an increase in public awareness regarding OTC hearing aids in social media; although the sentiment toward them remained unchanged, reflecting mixed opinions on their benefits and challenges. Our findings highlight the need for more transparent and educational information, particularly given the increasing confusion accompanying the growing awareness.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70242","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894214","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}

{"title":"Reconstructing Perioperative Patient Education in Head and Neck Surgery","authors":"Makayla R. Matthews,&nbsp;Victoria I. Fonseca,&nbsp;Hannah L. Eadie Reid,&nbsp;Trevor G. Hackman","doi":"10.1002/lio2.70249","DOIUrl":"https://doi.org/10.1002/lio2.70249","url":null,"abstract":"<p>Patients undergoing extirpative oncologic and/or reconstructive head and neck surgery face complex postoperative milestones required for safe discharge. Through this quality improvement project, we evaluated our current practices in perioperative patient education and its impact on 30-day metrics. In this baseline assessment, 15 patients (mean 66 years; 60% male; 80 white; 73% with 12th grade education or higher; 60% undergoing free flap reconstruction) who underwent extensive head and neck reconstruction at a tertiary care institution between August and December 2024 were surveyed. Most (93%) were satisfied with the timing of the information received but suggested additional visual aids and information about various recovery timelines. Preliminary findings from this ongoing quality improvement project reveal a need for more comprehensive perioperative education, particularly regarding support services and side-effect management. In response, we have introduced procedure-specific educational packets and preoperative phone calls to help patients better understand and navigate the recovery process.</p><p><b>Level of Evidence:</b> 4</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70249","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894215","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}

{"title":"Cochlear Implantation: Electrode Impedance in Users With Triphasic Pulse Pattern","authors":"Alhassan Algazlan,&nbsp;Fida Almuhawas,&nbsp;Sarah Alarifi,&nbsp;Yassin Abdelsamad,&nbsp;Maram Alkahtani,&nbsp;Isra Aljazeeri,&nbsp;Abdulrahman Alsanosi,&nbsp;Abdulrahman Hagr","doi":"10.1002/lio2.70247","DOIUrl":"https://doi.org/10.1002/lio2.70247","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The triphasic pulse pattern (TPP) is one of the successful strategies for managing facial nerve stimulation (FNS) after cochlear implantation (CI). This study evaluates the electrode impedance (EI) changes for patients who were shifted from the biphasic pulse pattern (BPP) to TPP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>This retrospective study was conducted on the patients who experienced FNS post-CI and were managed with a TPP strategy. The fitting parameters with TPP were compared to those with BPP, including electrode impedance, maximum comfortable levels (MCL), threshold levels (THR), and phase duration. .</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 25 implanted ears. The impedances of the electrode contacts significantly decreased when shifted to TPP at the first two apical contacts compared to the BPP (7.0 ± 2.7 vs. 7.8 ± 3.4 kΩ at the first contact and 6.5 ± 2.4 vs. 7.1 ± 2.9 kΩ at the second contact, respectively). The MCL showed a statistically significant increase with TPP compared to the BPP at the first 10 electrode contacts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The TPP of stimulation appears to be a successful strategy for managing FNS. Among the patients with FNS, there is a decrease in the most apical impedance values and an increase in MCL when using TPP. These findings suggest that TPP might be considered a routine and successful pattern for FNS patients. Future studies should investigate the impact of different stimulation patterns on CI outcomes.</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 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70247","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894219","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}

{"title":"A Surgeon's Field Guide to Value-Based Specialty Care","authors":"Willard C. Harrill,&nbsp;Frank G. Opelka,&nbsp;Mary L. Witkowski,&nbsp;David E. Melon,&nbsp;Jacob S. Riegler,&nbsp;Sally Engelman,&nbsp;Charles R. Woodard,&nbsp;Scott M. Goldstein,&nbsp;David C. Johnson","doi":"10.1002/lio2.70239","DOIUrl":"https://doi.org/10.1002/lio2.70239","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide a comprehensive state-of-the-art review from the perspective of the surgeon and the surgical specialty academies of the conceptual shift from a volume-driven fee-for-service payment model to one of value-based accountable care payment. This field guide attempts to clarify drivers of surgical value-based performance and outline a comprehensive strategy to successfully engage this healthcare reform paradigm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Data Source</h3>\u0000 \u0000 <p>Pubmed/MEDLINE/Google search.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Review Methods</h3>\u0000 \u0000 <p>Pubmed/MEDLINE/Google search was performed during June 1, 2024–May 17, 2025 for value-based initiatives, administrative, and government agency publications, Centers for Medicare and Medicaid Services, and Center for Medicare and Medicaid Innovation value-based care policy, directives, and programs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The transition from volume-based to value-based payment models necessitates rethinking how surgeons define, quantify, and engage the care they deliver. The social contract between the surgeon and patient is poorly aligned within the current fragmented fee-for-service payment model. Relative value units continue to function as a poor benchmark measure of the physician-patient relationship, which is foundational to achieving consistent patient engagement and favorable clinical outcomes. To facilitate this value-based realignment within surgical care, we introduce a novel three-dimensional framework for patient experience management (EM³) focusing on three core elements driving value-based surgical care: clinical outcomes, patient engagement, and episode-of-care spend. EM³ is proposed as a strategic roadmap to operationalize episode-of-care transparency within the traditional value equation: Value = Outcomes/Cost. EM³ lays out a comprehensive pathway to facilitate improvements in surgical value-chain competency, team-based care leadership, and longitudinal care management skills. These represent the essential core components for competitiveness within a new era of performance metrics relevant to alternative payment arrangements within bundle payments and value-based referrals. At the academy and peer-review leadership level, each surgical specialty will need to invest in developing clinically valid next generation assessment measures and care plans encompassing EM³ dimensional elements to remain both relevant and competitive in a new era of evolving accountable care models.</p>\u0000 ","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70239","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894217","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}

{"title":"Characteristics of Cannabis Use Among Head and Neck Cancer Survivors","authors":"Talia A. Wenger,&nbsp;Tyler J. Gallagher,&nbsp;Niels C. Kokot","doi":"10.1002/lio2.70244","DOIUrl":"https://doi.org/10.1002/lio2.70244","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Understand the characteristics of cannabis use, including frequency, mode, and purpose, among head and neck cancer (HNC) survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was distributed using ResearchMatch and online support groups for survivors of HNC. Respondents answered questions regarding demographics, cancer history, cannabis use, and knowledge of cannabis and completed a Short Form-12 Questionnaire. Multivariate logistic regression and descriptive statistics were utilized for analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of 92 respondents, 75% were current or former cannabis users and 25% were never users. Cannabis users were less likely to have above-median household income (OR 0.115, 95% CI 0.0139–0.662) and live outside of the United States (OR 0.0697, 95% CI 0.0026–0.7404) than current or former users. 36.2% and 27.5% of cannabis users reported occasional (1–5 days/month) and daily use, respectively. The most common mode of use was in edible products (46.4%). The most common reasons for use were to treat pain (79.4%), improve sleep (76.5%), cope with stress (64.7%), and recreation (63.6%). 19.2% of respondents reported receiving information regarding cannabis use in relation to cancer. Of those who had received information, the most common sources were a physician treating cancer (38.1%), friends (33.3%), and cancer support groups (33.3%). 45.6% of respondents reported significant or very high interest in receiving information about cannabis use in relation to cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cannabis use for treatment of cancer-associated symptoms and recreation is common among HNC survivors. Many survivors are interested in information regarding cannabis use, but few have received information from a reputable source.</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 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70244","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894220","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}

{"title":"The Impact of Tracheostomy Indication on Patient Outcomes and Hospital Course","authors":"Ryan C. Higgins,&nbsp;Kaeli Samson,&nbsp;Duncan Works,&nbsp;Jayme R. Dowdall","doi":"10.1002/lio2.70210","DOIUrl":"https://doi.org/10.1002/lio2.70210","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The purpose of this study is to better understand the prognostic implications for a patient's hospital course, chances for ventilator liberation and decannulation, functional status, and mortality based on the indication for tracheostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was performed at a single tertiary-care institution for 106 adult patients who underwent a tracheostomy from January 2022 to March 2023 and were followed for 6 months post-tracheostomy placement. Demographics, clinical intervals, and clinical outcomes were compared based on the indication for tracheostomy: Airway Obstruction or Ventilator-Dependent Respiratory Failure (VDRF).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the study group, 29 patients received a tracheostomy for airway obstruction, and 77 patients received a tracheostomy for VDRF. The VDRF group had more than three times longer hospital stays, more than three times the duration from first intubation to tracheostomy placement, six times the duration of mechanical ventilation post-tracheostomy, and increased rates of hospital mortality (23.4% vs. 3.4%) and mortality at 6 months post-tracheostomy placement (42.4% vs. 10.5%) compared to the Airway Obstruction group (<i>p</i>'s &lt; 0.05). The VDRF group was less likely to be discharged home (6.5% vs. 44.8%). At discharge, the majority of patients were liberated from mechanical ventilation (82.8%) and speaking (77.0%). Most surviving patients were not decannulated during their admission (65.5%). There were no significant differences in diet or time interval to decannulation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our analysis suggests that consideration of clinical indicators pertaining to tracheostomy placement may facilitate improved conversations with patients, families, and healthcare teams regarding the nuances of the functional and logistical course after receiving a tracheostomy.</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 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70210","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144894218","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}

{"title":"Prevalence, Associations, and Outcomes of Suprastomal Collapse After Pediatric Tracheostomy","authors":"Ashley Young,&nbsp;Alexander Szymczak,&nbsp;Taher Valika,&nbsp;Saied Ghadersohi,&nbsp;Inbal Hazkani","doi":"10.1002/lio2.70245","DOIUrl":"https://doi.org/10.1002/lio2.70245","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Suprastomal collapse is an understudied sequela of pediatric tracheostomy that may hinder decannulation. This study aims to investigate the prevalence and associated risk factors of suprastomal collapse following pediatric tracheostomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study of children who underwent tracheostomy at a tertiary-care children's hospital between 1/2012 and 12/2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 255 children underwent tracheostomy, with 146 (57.3%) developing suprastomal collapse 10.7 ± 12.6 months after the tracheostomy. Patients younger than 6 months at the time of tracheostomy were twice as likely to develop suprastomal collapse (OR = 2.07, <i>p</i> = 0.0059). Direct laryngoscopy and bronchoscopy findings associated with increased odds of collapse included tracheobronchomalacia (OR = 1.72, <i>p</i> = 0.029), subglottic stenosis (OR = 2.96, <i>p</i> = 0.000028), and glottic or subglottic edema (OR = 2.4, <i>p</i> = 0.0012). The presence of peristomal granulation tissue and the surgical removal of this tissue were not significantly associated with the development of suprastomal collapse. On log-rank analysis, the median time to develop collapse was significantly longer in patients who underwent granulation tissue removal compared to those who did not (8.2 vs. 4.8 months, <i>p</i> = 0.003). Patients with suprastomal collapse were significantly more likely to require upper airway surgery (OR 2.1, 95% CI 1.16–3.83, <i>p</i> = 0.0125) or laryngotracheal reconstruction (OR 3.4, 95% CI 1.41–9.64, <i>p</i> = 0.006) than those without collapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Suprastomal collapse occurred in 60% of our cohort and was associated with the need for airway reconstruction. Contributing factors included age at tracheostomy, tracheobronchomalacia, subglottic stenosis, and glottic and subglottic edema. Despite concerns about weakening tracheal cartilage, granulation tissue removal was not associated with the development of collapse.</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 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70245","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881123","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}

{"title":"Clinical Utility of Contemporary Digital Infusion Submandibular Sialography","authors":"Evgeniya Molotkova,&nbsp;Piper Wenzel,&nbsp;Jeff Sylte,&nbsp;Sean Fain,&nbsp;Joan Maley,&nbsp;Ryan Thorpe,&nbsp;Henry Hoffman","doi":"10.1002/lio2.70248","DOIUrl":"https://doi.org/10.1002/lio2.70248","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Contemporary sialography couples mechanical ductal dilation with hydrodilation and utilizes iodinated contrast with antimicrobial properties to generate diagnostic data. This procedure has been reported to have therapeutic value that has not been investigated in a large contemporary series. This study examines the therapeutic value of diagnostic digital infusion submandibular sialography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective chart review of a consecutive series of submandibular sialograms from April 2008 to November 2024, focusing on symptomatic response to sialography.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Review identified 135 submandibular sialograms with follow-up addressing post-study symptom assessment available in 67. Indications for sialography in this group included pain (6/67), swelling (23/67), or both (38/67). Symptomatic improvement following sialography was reported in 67% of cases (45/67). Those reporting initial complete relief of symptoms rarely (15%) required additional treatment during the follow-up period (<i>p</i> = 0.019). The radiographic diagnosis of a distal stricture was associated with a higher rate of symptom improvement (78%) when compared to those without a distal stricture (57%) (<i>p</i> = 0.049). Among patients in this cohort, the median effective radiation dose (1.94 mSv) for the CT imaging preceding sialography (<i>N</i> = 39) was significantly greater than that calculated radiation dose (0.14 mSv) for one-gland sialography (<i>N</i> = 42) (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Diagnostic submandibular sialography is often therapeutic and is performed with limited radiation exposure. Prospective study is ongoing to provide more detailed evaluation of the therapeutic impact of this procedure.</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 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70248","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144881124","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}

{"title":"A Geospatial Analysis of the Sleep Surgeon Workforce in the United States","authors":"Jasmeet Saroya,&nbsp;Amritpal Singh,&nbsp;Jolie L. Chang,&nbsp;Megan L. Durr","doi":"10.1002/lio2.70161","DOIUrl":"https://doi.org/10.1002/lio2.70161","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigates the geographic disparities in the distribution of sleep surgeons in the United States, focusing on the influence of regional sociodemographic characteristics on the proximity of specialized care for obstructive sleep apnea (OSA) surgery.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is a cross-sectional observational geospatial analysis of sleep surgeons practicing in the United States. We correlated geographic coordinates of sleep surgeons with sociodemographic data from the 2020 U.S. Census Bureau and the 2021 American Community Surveys. Multivariate Poisson regression analyses were used to examine predictors of sleep surgeon density and presence across ZIP Code Tabulation Areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Analysis included 205 sleep surgeons. The density of sleep surgeons was higher in urban and coastal areas. Sleep surgeons were also more likely to practice in locations with higher percentages of non-citizen (AOR = 1.067, <i>p</i> &lt; 0.001) and non-White populations (AOR = 1.017, <i>p</i> &lt; 0.001). Sleep surgeons were less likely to practice in areas with greater proportions of uninsured patients (AOR = 0.926, <i>p</i> &lt; 0.001) and elderly patients (AOR = 0.964, <i>p</i> = 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Significant geographic and demographic disparities exist in the distribution of sleep surgeons, particularly marked by a scarcity of sleep surgeons in rural areas and fewer sleep surgeons in areas with larger elderly and uninsured populations. These disparities highlight the need for targeted interventions to enhance access to specialized OSA care, especially in underserved areas. Effective strategies to address these inequalities are crucial for equitable healthcare delivery and improving health outcomes for OSA patients across the U.S.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>III.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70161","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869527","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}

{"title":"Classification in Virtual Temporal Bone Surgical Education: A First Step Towards Automated Virtual Education With Use of Machine Learning","authors":"Arjun Maini,&nbsp;Justyn Pisa,&nbsp;Mina Davari,&nbsp;Bert Unger,&nbsp;Jordan Hochman","doi":"10.1002/lio2.70188","DOIUrl":"https://doi.org/10.1002/lio2.70188","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Simulation-based surgical training is now standard in residency education - aided by tools such as printed, virtual, and augmented reality environments. Autonomous education with use of machine learning is an emerging necessity owing to resident work-hour limitations and staff availability. An essential first step to providing automated feedback during simulated surgery is the development of a tool to classify surgical technique. Distinctive hand motion and drilling patterns can be used in the assessment of trainee proficiency during complex temporal bone surgery (TBS).</p>\u0000 \u0000 <p>This article reviews the development of a software classifier model for automated assessment of surgical performance based on recorded drill trajectory and hand motion tracking during 3D-printed TBS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>REB-approved prospective experimental study, in which a classifier was developed to provide automatic assessment of surgical performance based on drill trajectory and hand motion tracking. Four expert (two otologic surgeons and two PGY5 surgery residents) and four novice (PGY1-3 surgery residents) participants dissected 3D-printed temporal bone models. Individual hand and drill motion data were collected and analyzed for similarities and variations between participants to develop a model to predict the level of expertise (expert or novice), using a supervised classification approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The automated stroke detection algorithm found 80.2%, 82.7%, and 84.8% precision in stroke detection and classification during cortical mastoidectomy (CM), thinning procedures (TP) and facial recess exposure (FRE), respectively. The classifier was able to predict the level of expertise with an accuracy of 92.8% and a sensitivity of 87.5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>A temporal bone classifier can be developed with a high degree of accuracy as an initial stage towards an autonomous training paradigm.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>IV.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 4","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70188","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144869590","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}