Laryngoscope Investigative Otolaryngology最新文献

{"title":"HPV Vaccination Knowledge and Decision-Making Among Adults 27 to 45 Years: A Large Online Survey","authors":"Matthew E. Lin,&nbsp;Oluwatobiloba Ayo-Ajibola,&nbsp;Jun Yun,&nbsp;Tyler J. Gallagher,&nbsp;Carlos X. Castellanos,&nbsp;Jonathan D. West,&nbsp;Ian Kim,&nbsp;Sophia Chen,&nbsp;Niels C. Kokot,&nbsp;Tamara N. Chambers","doi":"10.1002/lio2.70182","DOIUrl":"https://doi.org/10.1002/lio2.70182","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Understand knowledge and barriers to human papillomavirus (HPV) vaccination among United States (US) adults, comparing adults in the original age cohort of 18–26 years to those in the expanded 27–45-yearyear-old cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey was administered to US adults recruited through social media. Descriptive statistics characterized the data. Multivariate logistic regression identified factors associated with vaccination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1735 respondents, the majority were in the 27–45 age group (936, 53.94%). The 27–45-year group exhibited more knowledge of HPV's link to head and neck cancer and vaccine protection but expressed less concern about HPV infection (all <i>p</i> &lt; 0.05). Key motivators for the history of vaccination in the 27–45 year cohort included vaccine effectiveness (48.65%) and prior knowledge (42.44%). Self-vaccination rates were comparable across age groups (18–26: 70.62% vs. 27–45: 68.07%, <i>p</i> = 0.256). Older adults were less likely to vaccinate dependents (68.57% vs. 75.00%, <i>p</i> &lt; 0.001) despite higher interest (<i>p</i> &lt; 0.001). Main barriers for unvaccinated 27–45 year old adults included scheduling issues, insurance coverage, and lack of concern for HPV infection (all <i>p</i> &lt; 0.05). Among individuals aged 27 to 45, multivariate logistic regression analysis revealed significantly higher odds of vaccination in those from the Western US (compared to Northeast/Midwest) (OR 3.15, 95% CI: [1.84, 5.39]) and personal history of head and neck cancer (3.01, [1.78–5.09]).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Most respondents understand HPV risks and are vaccinated. Interventions directed towards education about vaccine safety, the hazards of HPV, and improving access may increase vaccination.</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 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70182","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144482039","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":"Compliance of Tonsillitis e-Health Patients: A Prospective Cohort Study","authors":"Oskari Hakanen,&nbsp;Satu Lamminmäki,&nbsp;Paulus Torkki,&nbsp;Morag Tolvi","doi":"10.1002/lio2.70184","DOIUrl":"https://doi.org/10.1002/lio2.70184","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>As canceled appointments and undertreated patients generate substantial expenses in healthcare, this study examines whether tonsillectomy candidates assessed via telemedicine-assisted care paths exhibit elevated appointment cancellation rates compared to those evaluated in-person at an outpatient clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>At Helsinki University Hospital, a tertiary referral clinic, two telehealth-assisted care paths (virtual visits and a digital care pathway) have been available in recent years to remotely assess patients for tonsillectomy. To evaluate whether preoperative telehealth negatively affects tonsillitis patients' compliance to treatment, we compared cancellation rates of these two e-health care paths as primary outcome measures with the outpatient clinic, which was defined as the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The remote care paths showed the highest rates of cancellation. 25.9% of the digital care pathway patients canceled their care path compared to 6.6% of outpatient clinic patients who canceled appointments (<i>p</i> &lt; 0.01). 29.4% of the digital care pathway patients had an additional remote contact with the clinic preoperatively compared to 18.5% of patients assessed at the outpatient clinic (<i>p</i> = 0.002). Patients assessed remotely were more likely to make an unplanned additional contact than patients seen at the outpatient clinic. No significant differences in canceled surgeries were observed between the cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Assessing patients for tonsillectomy via a digital care pathway appears to increase cancellations and additional contacts. Therefore, both digital and in-person assessments should remain available for tonsillectomy candidates to accommodate varying patient needs and offset additional costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70184","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473004","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":"Multilevel Associations of Food Environment and Papillary Thyroid Cancer Outcomes in the United States","authors":"David J. Fei-Zhang,&nbsp;Eric Pan,&nbsp;Jean-Nicolas Gallant,&nbsp;Andrés M. Bur,&nbsp;Ryan H. Belcher","doi":"10.1002/lio2.70186","DOIUrl":"https://doi.org/10.1002/lio2.70186","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To assess the independent associations of poor food environment with differences in papillary thyroid carcinoma (PTC) outcomes using the United States Department of Agriculture (USDA)-validated Food Environment Atlas (FEA).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study assessed patients from 2000 to 2017 for trends in overall and 3-year survival, and the number of tumors at diagnosis with increasing food environment vulnerability/FEA-scores by Cox hazards and logistic regression models stratified by race-ethnicity and age. FEA-scores were based on 282 county-level variables of food security, store-restaurant availability, SNAP/WIC enrollment, pricing, taxes, and producer vicinity while adjusting for traditional social determinant factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 148,296 patients, increased food environment vulnerability was associated with decreased overall survival (HR 1.06, 95% CI 1.04–1.07). These FEA effects were exacerbated among non-White patients (1.08, 1.05–1.11) compared to White patients (1.05, 1.04–1.07). Increased FEA was also associated with increased 3-year mortality (OR 1.05, 95% CI 1.03–1.07). These effects were exacerbated among non-White (1.06, 1.02–1.10) and older patients (1.05, 1.02–1.07). Increased food environment vulnerability was additionally associated with increased odds of having more than one primary tumor (1.02, 95% CI 1.01–1.03). When stratified separately for race and for age, worse food environment was associated with non-White patients (1.03, 1.01–1.06) and patients aged 45 years and older (1.02, 1.01–1.03).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Food environment vulnerability was associated with poorer prognosis after adjusting for traditional social determinant vulnerabilities, with varying magnitude upon stratification of race and age. Given PTC's rise in incidence and severity, the effects of food environment should be considered when informing future investigation and policy.</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 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70186","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473006","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":"Impact of the 2015 American Thyroid Association Guidelines on Treatment of Low-Risk Thyroid Cancer","authors":"Akash S. Halagur,&nbsp;Jeffrey D. Huynh,&nbsp;Uchechukwu C. Megwalu","doi":"10.1002/lio2.70175","DOIUrl":"https://doi.org/10.1002/lio2.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>The 2015 American Thyroid Association (ATA) guidelines recommended lobectomy for management of low-risk differentiated thyroid carcinomas (DTC), aiming to mitigate overtreatment. The primary objective of this study was to assess the impact of the 2015 ATA guidelines on the rates of lobectomy versus total thyroidectomy for the treatment of low-risk DTC, using the Surveillance, Epidemiology, and End Results (SEER) 17 database. Our secondary objectives were to examine the modifying effects of tumor size on the change in the rates of lobectomy between the pre- and post-guideline periods and to identify factors that are associated with the use of lobectomy in the post-guideline period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort analysis of adults diagnosed with low-risk DTC from 2011 to 2020 was conducted using the SEER 17 database. Logistic regression assessed the likelihood of lobectomy and total thyroidectomy before and after guideline implementation, including size-stratified and post-guideline subgroup analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 61,078 patients, lobectomy rates increased from 16% pre-guideline to 25% post-guideline (aOR 1.81, 95% CI 1.74–1.89). Lobectomy increased across both T1 and T2 tumors; post-guideline subgroup analysis indicates T2 tumors were less likely to receive lobectomy than T1 tumors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The use of lobectomy for treatment of low-risk DTC has significantly increased since the publication of the 2015 ATA guidelines. However, total thyroidectomy remains the predominant treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70175","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473005","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":"Micro-CT Analysis of Rodent Temporal Bones: Identifying Optimal Species for Otological Research","authors":"Hannah Daoudi,&nbsp;Evelyne Ferrary,&nbsp;Cerine Moula,&nbsp;Florence Agnely,&nbsp;Amélie Bochot,&nbsp;Catherine Cailleau,&nbsp;Yann Nguyen,&nbsp;Ghizlène Lahlou,&nbsp;Renato Torres","doi":"10.1002/lio2.70190","DOIUrl":"https://doi.org/10.1002/lio2.70190","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Rodents are used in most otological research studies and the choice of the most appropriate animal model may be crucial in studies of ear diseases and in the development of effective treatments. Here, we used micro-CT to compare temporal bone anatomy between four rodent model animals (guinea pigs, gerbils, rats, and mice) and humans, aiming to better characterize the anatomy of the inner and middle ear, and facial nerve to support informed animal model selection in otologic research.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We generated three-dimensional reconstructions and measured the various middle (tympanic membrane, ossicular chain, and facial nerve) and inner (cochlea, vestibular labyrinth) ear structures.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Each structure of the middle or inner ear of each rodent was described and measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This micro-CT analysis of rodents can guide researchers in their choice of the most suitable middle or inner ear models based on the specific anatomic area of interest. Our findings highlight the strengths and limitations of each species, providing essential insight that could enhance the precision and applicability of otological studies.</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 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144473007","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":"Correction to “Obstructive Sleep Apnea in Overweight and Obese Children: Factors Influencing Quality of Life”","authors":"","doi":"10.1002/lio2.70179","DOIUrl":"https://doi.org/10.1002/lio2.70179","url":null,"abstract":"<p>M. Al-Iede, R. Rahal, S. Al-Mashaqbeh, et al., “Obstructive sleep apnea in overweight and obese children: factors influencing quality of life,” <i>Laryngoscope Investig Otolaryngol</i> 10, no. 3 (2025), e70134. doi: https://doi.org/10.1002/lio2.70134.</p><p>The affiliation of the last author, Nihad Almasri, is incorrect and should be replaced with: Department of Rehabilitation Sciences, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.</p><p>The second email address of the corresponding author, Montaha Al-lede, is incorrect. It should be replaced with <span>[email protected]</span>.</p><p>We apologize for these errors.</p>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339520","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":"Subacute Mastoiditis Without Verified Nontuberculous Mycobacteria—Still a Clinical Challenge","authors":"Lara Kakabas,&nbsp;Anna Granath,&nbsp;Kaijsa Edholm,&nbsp;Julia Arebro","doi":"10.1002/lio2.70183","DOIUrl":"https://doi.org/10.1002/lio2.70183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>An indolent form of mastoiditis has gained increased attention lately, challenging clinicians both regarding diagnosis as well as treatment. The etiology behind this assumed infection herein named subacute mastoiditis (SAM) is unknown; however, a link to nontuberculous mycobacteria (NTM) infections has been seen. A survey on pediatric cases with SAM over 20 years was performed to investigate the typical clinical features and to identify optimal treatment strategies for this condition, causing aggressive temporal bone destructions along with intratemporal and intracranial complications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective survey of pediatric patients (0–17 years) hospitalized with SAM during 2003–2023 at Karolinska University Hospital, Sweden, was conducted. Data collection included demographics, diagnostics (radiology, microbiology, histopathology), treatment, and clinical outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixteen cases (median age 7.5 years) with SAM were included. Longstanding otorrhea from ventilation tubes preceded clinical signs of mastoiditis in most cases. CT scan generally revealed cortical temporal bone destructions close to the ear canal and sigmoid sinus. Histopathological examination displayed a high incidence of granulomatous inflammation. Upon microbiological testing, six cases revealed NTM infection. All cases underwent mastoidectomy, and 11 cases received long-term mycobacteria-targeted antibiotics. No deaths occurred, but seven cases had a delayed recovery or relapsing disease, and several cases experienced complications. The long-term outcomes were good. Two cases with <i>Mycobacterium tuberculosis</i> mastoiditis were identified, entailing diagnostic challenges.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Histopathological and microbiological sampling along with CT scan is crucial in diagnosing SAM. We suggest surgical intervention combined with empirical long-term antimycobacterial treatment for optimal recovery and outcome in SAM.</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 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339522","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 of Cochlear-Facial Nerve Dehiscence and Facial Nerve Stimulation for Adult Cochlear Implant Recipients","authors":"Ezer H. Benaim,&nbsp;Michael W. Canfarotta,&nbsp;Margaret E. Richter,&nbsp;Margaret T. Dillon,&nbsp;Nicholas J. Thompson","doi":"10.1002/lio2.70181","DOIUrl":"https://doi.org/10.1002/lio2.70181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To estimate the prevalence of cochlear-facial nerve dehiscence (CFD) in cochlear implant (CI) recipients, measure cochlear-facial nerve partition width (CFPW), and analyze the relationship of CFD and CFPW for the presence or absence of facial nerve stimulation (FNS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective review of 314 ears from 294 adult CI recipients was conducted. Two blinded reviewers measured CFPW and identified cases with CFD from the preoperative or postoperative high-resolution computed tomography (CT) scan. Analyses included the associations of CFPW and CFD with FNS, defined as facial movement elicited by CI stimulation. Audiologic and surgical data were reviewed for electrode characteristics and management of FNS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Reviewers had excellent inter-rater reliability for CFPW measurements (intraclass correlation coefficient = 0.974). CFPWs were significantly smaller in ears with FNS (median: 0.40 mm) compared to those without FNS (median: 0.48 mm; <i>p</i> = 0.003). The prevalence of CFD was 3.2% (<i>n</i> = 10) and 70% of cases with CFD experienced FNS (relative risk [RR] = 14.2, 95% CI: 6.88–25.50, <i>p</i> &lt; 0.001). Cases with CFD demonstrated a higher rate of FNS regardless of electrode type (lateral wall versus precurved).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>CFD is a risk factor of FNS in CI recipients. Preoperative high-resolution CT can identify patients with CFD that are at high risk for FNS; however, use of a precurved electrode array may not reduce the risk for FNS in this population. Investigation is needed of interventions to mitigate FNS risk in patients with CFD.</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 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70181","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308717","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":"Economic Study of a Pediatric Tracheostomy Remote Home Monitoring Program (PTRHMP) Compared to Prolonged Hospitalization for Children With Tracheostomy","authors":"Adele K. Evans","doi":"10.1002/lio2.70167","DOIUrl":"https://doi.org/10.1002/lio2.70167","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background/Context</h3>\u0000 \u0000 <p>Home health nursing is considered critical to transition to at-home care after pediatric tracheostomy. This diminishing resource contributes a barrier to at-home care. Telemedicine (Bluetooth wireless technology for monitoring vital signs, Wi-Fi data transfer to a centralized monitoring center for alarm response) could add support for families during this transition. This manuscript compares a retrospective evaluation of observed hospital costs to modeled estimates for a Pediatric Tracheostomy Remote Home Monitoring Program (PTRHMP): equipment alarm monitoring, call-to-home confirmation, and a centralized database of critical information for Emergency Medical Services (EMS) dispatch.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Methods</h3>\u0000 \u0000 <p>(1) Cost of Care Cohort analysis of in-patient cost of care for pediatric tracheostomy patients using retrospective chart review. (2) Modeled cost estimates using a financial proforma developed by experts in the field. (3) Comparative Analysis of Cost of Care Cohort versus PTRHMP proforma. (4) Potentially avoidable Adverse Event analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Thirty-three candidates met inclusion criteria for the Cost of Care Cohort Analysis. Average LOS was 31.6 days longer than target LOS, was influenced by average number of caregivers (<i>p</i> &lt; 0.0001) and by age at tracheostomy placement (<i>p</i> = 0.038; 1), and averaged ($17,000/day billed, $3000/day payments received) 10 times the cost estimated for the PTRHMP proforma ($285 per patient-day).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The widespread adoption of a Pediatric Tracheostomy Remote Home Monitoring Program (PTRHMP) appears to be technologically and financially tenable at one tenth the cost of in-patient care. Patients under the age of 2 at tracheostomy placement may represent a separate subgroup for analysis. An implementation study is required to determine the level of safety compared to currently available conditions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>2—Cohort Study.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70167","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144308718","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":"Machine Learning-Based Mobile Application for Predicting Posterior Canal Benign Paroxysmal Positional Vertigo","authors":"Emre Soylemez,&nbsp;Sait Demir,&nbsp;Kasım Ozacar","doi":"10.1002/lio2.70177","DOIUrl":"https://doi.org/10.1002/lio2.70177","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the predictability of the Posterior Canal Being Paroxysmal Positional Vertigo (PC-BPPV) using vertigo/dizziness features and medical history in machine learning. Secondly, this study aimed to develop a mobile application using the model that predicts PC-BPPV with the highest accuracy rate.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively analyzed the medical records of patients who presented to the Audiology and Balance Clinic with complaints of dizziness or vertigo between 04/01/2021 and 09/16/2023. Patients' diagnoses, demographic information, medical history, and dizziness/vertigo characteristics were used in 8 different machine learning models. A mobile application was developed with the model with the highest accuracy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included data from 280 patients. Age, symptom onset time, duration of symptoms, dizziness type, triggering factors, and auditory symptom status were the distinguishing factors for PC-BPPV. Using these features, the Random Forest algorithm predicted PC-BPPV with 96.43% accuracy. The accuracy rates of other algorithms were between 89.28% and 94.64%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dizziness/vertigo characteristics and medical history can be effectively utilized in machine learning to predict BPPV with high accuracy. The mobile application developed using this algorithm underscores the potential of artificial intelligence platforms to contribute to vestibular science in the telemedicine field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Level of Evidence</h3>\u0000 \u0000 <p>Level 2.</p>\u0000 </section>\u0000 </div>","PeriodicalId":48529,"journal":{"name":"Laryngoscope Investigative Otolaryngology","volume":"10 3","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/lio2.70177","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144281627","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}