Otology & neurotology open最新文献

{"title":"Evaluating the Accuracy and Completeness of Artificial Intelligence Responses Against Established Otology Guidelines.","authors":"Nicholas A Rossi, Kassandra K Corona, Yuki Yoshiyasu, Dayton L Young, Brian J McKinnon","doi":"10.1097/ONO.0000000000000059","DOIUrl":"10.1097/ONO.0000000000000059","url":null,"abstract":"<p><strong>Background: </strong>The incorporation of artificial intelligence (AI), especially large language models like Generative Pretrained Transformer 4 (GPT-4), into medical practice is a burgeoning field of interest. This research evaluates the applicability of GPT-4 in otology by analyzing its responses to queries based on otologic clinical practice guidelines.</p><p><strong>Methods: </strong>Key guidelines from otology were selected, and corresponding questions were formulated to examine GPT-4's interpretation and response accuracy. Two independent reviewers assessed the AI-generated answers for accuracy and completeness, using a structured Likert scale. A re-evaluation was conducted to evaluate the reproducibility of the results.</p><p><strong>Results: </strong>The analysis showed a high accuracy level (mean score: 4.75 of 5) and completeness (mean score: 2.88 of 3) in GPT-4's responses. The interrater agreement, as indicated by Cohen κ, was substantial. GPT-4 consistently advised on individualized treatment plans and professional consultation, particularly for guidelines with weaker evidence, demonstrating its cautious approach to handling medical information.</p><p><strong>Conclusion: </strong>GPT-4 exhibits promising potential as an auxiliary tool in otology, providing accurate and comprehensive information. However, its role should be viewed as supplementary, with emphasis on continual updates and careful monitoring to align with evolving medical knowledge. Future studies are recommended to further explore the depth of AI application in diverse clinical scenarios and its real-time impact on clinical outcomes.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"4 3","pages":"e059"},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13375056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Outcomes After Cochlear Implantation in a Veteran Versus Nonveteran Population.","authors":"Siddhant H Tripathi, Sarah M Adams, Eric M Wong, Gabrielle Petito, Scott Shapiro, Jedidiah Grisel, Joseph Breen, Reena Dhanda Patil","doi":"10.1097/ONO.0000000000000058","DOIUrl":"https://doi.org/10.1097/ONO.0000000000000058","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate for equivalence in postoperative changes of speech recognition scores in a veteran patient population undergoing cochlear implantation (CI) compared to matched nonveteran patients.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Patients: </strong>A total of 83 veteran patients who underwent CI at a single Veterans Affairs Medical Center (VA cohort) were matched to 83 nonveteran patients from the Health Insurance Portability and Accountability Act-secure, Encrypted, Research, Management and Evaluation Solution database (HERMES cohort) based on age, sex, and baseline Consonant-Nucleus-Consonant (CNC) scores.</p><p><strong>Intervention: </strong>Patients underwent CI.</p><p><strong>Main outcome measures: </strong>Comparison of postoperative CNC and Arizona Biomedical Institute recognition scores.</p><p><strong>Results: </strong>The mean difference and lower confidence interval of CNC scores between matched Veterans Affairs and HERMES cohorts were within a -ΔNI boundary of -15% at the 3-month (mean = 6.15, lower confidence interval = -2.38), 6-month (mean = 7.36, lower confidence interval = -2.21), and 12-month (mean = 4.03, lower confidence interval = -4.88) postoperative time points. The mean difference and lower confidence interval of Arizona Biomedical Institute scores between cohorts were within the -ΔNI boundary of -30% at 3 months (mean = 1, lower confidence interval = -8.71), 6 months (mean = 0.31, lower confidence interval = -12.30), and 12 months (mean = 0.72, lower confidence interval = -10.48).</p><p><strong>Conclusion: </strong>Our veteran population demonstrated improvements in speech recognition scores after CI comparable to a matched nonveteran population. Although veterans face unique factors that affect their hearing, access to medical care, and baseline general health, these findings affirm appropriate veteran candidates should be offered CI.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"4 3","pages":"e058"},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11424051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular Schwannoma Management: Patient Perspectives and Health Literacy.","authors":"Julia A Casazza, Kristen L Yancey, Jacob B Hunter","doi":"10.1097/ONO.0000000000000054","DOIUrl":"10.1097/ONO.0000000000000054","url":null,"abstract":"<p><strong>Objective: </strong>To assess medical decision-making, reasons for attrition, and health literacy among vestibular schwannoma (VS) patients last seen in clinic more than 2 years ago.</p><p><strong>Study design: </strong>Survey.</p><p><strong>Setting: </strong>Tertiary skull base center.</p><p><strong>Patients: </strong>Adults with sporadic VS last evaluated more than 2 years ago.</p><p><strong>Methods: </strong>Survey including Brief Health Literacy Screen (BHLS), a validated 3-question measure of health literacy, and open-ended questions on care; retrospective chart review.</p><p><strong>Main outcome measures: </strong>BHLS score, patient reasons for attrition.</p><p><strong>Results: </strong>Of 1011 patients contacted, 205 (20.3%) patients responded and met all criteria for analysis. At initial evaluation, mean patient age was 50.6 ± 12.8 years, roughly half (51.4%) were female, and the majority (80.2%) identified as White. At the time of the survey, 48 (23%) continued to observe their tumor. The remaining 160 (76.9%) patients previously underwent treatment (surgery and/or radiation). Of those treated, 34 (21.3%) underwent intervention elsewhere. Symptoms since the last patient visit did not differ between observed and treated patients. About 94.7% of the cohort displayed high health literacy (BHLS > 9), though rates of inadequate health literacy were higher among observed patients (12.5% versus 3.1% in those treated). The most common reasons for opting not to follow-up included counseling issues, personal decisions, and social/life stressors (including the COVID-19 pandemic).</p><p><strong>Conclusions: </strong>Despite being a highly health-literate cohort, patients cited multiple reasons for attrition. Regardless of whether they were observed or treated, patients described follow-up visits as burdensome and perceived them to be of minimal benefit.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"4 2","pages":"e054"},"PeriodicalIF":1.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Residual Low-frequency Hearing Loss in Children and Type of Ventilation Tube Placed During Myringotomy With Tympanostomy Tube Placement.","authors":"Kristin Drew, Celeste Goh Yergin, Adam Snoap, Victoria Claire James, William Collins, Thomas Schrepfer","doi":"10.1097/ONO.0000000000000053","DOIUrl":"10.1097/ONO.0000000000000053","url":null,"abstract":"<p><strong>Objective: </strong>Assess whether titanium Tytan tympanostomy tubes result in a larger air-bone gap (ABG) at lower frequencies compared to Armstrong and Paparella tubes.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Pediatric otolaryngology department of a 1000-bed academic center.</p><p><strong>Patients: </strong>A cohort of 110 children, aged 4-16 years, who had no sensorineural hearing loss or congenital syndromes and underwent tympanostomy tube placement between August 2018 and February 2021.</p><p><strong>Interventions: </strong>Tympanostomy procedures using Tytan, Armstrong, or Paparella tubes.</p><p><strong>Main outcome measure: </strong>Evaluation of pure tone average (PTA) and ABG at frequencies of 500 and 250 Hz.</p><p><strong>Results: </strong>Tytan tubes enhanced PTA and ABGs across studied frequencies. Nonetheless, post-Tytan tube placement exhibited significantly worse PTA and 500 Hz ABG compared to Armstrong and Paparella tubes (<i>P</i> < 0.05; <i>P</i> < 0.0001). Additionally, 250 Hz ABG post-Tytan was inferior to post-Armstrong (<i>P</i> < 0.0001). Relative risks of persistent ABG ≥ 15 dB with Tytan versus Armstrong tubes were 2.36 (1.62-3.44) at 500 Hz and 1.49 (1.09-1.99) at 250 Hz. Against Paparella tubes, these were 2.11 (1.28-3.72) at 500 Hz and 1.12 (0.81-1.67) at 250 Hz, the latter being not significant.</p><p><strong>Conclusion: </strong>While Tytan tubes optimize PTA, they are linked to enduring ABG ≥ 15 dB at lower frequencies. Notably, they perform less favorably in terms of 500 Hz PTA and ABG compared to both Armstrong and Paparella and demonstrate poorer 250 Hz ABG when juxtaposed with Armstrong tubes.</p>","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"4 2","pages":"e053"},"PeriodicalIF":1.3,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13585301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148992760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Dehydration and the Prognosis of Sudden Sensorineural Hearing Loss","authors":"Yasunori Abe, Masahiro Okada, Keiko Tanaka, Kensuke Toyama, Yoshito Miyamoto, Naohito Hato","doi":"10.1097/ono.0000000000000041","DOIUrl":"https://doi.org/10.1097/ono.0000000000000041","url":null,"abstract":"Background: There is an urgent need to identify undetermined risk factors for sudden sensorineural hearing loss (SSNHL) for the development of effective treatment strategies. SSNHL is likely associated with vascular insufficiency; however, no study has evaluated the relationship between dehydration and SSNHL. Objective: This study aimed to investigate the role of dehydration in the development and prognosis of sudden sensorineural hearing loss. Study Design: Retrospective case-control study. Setting: Secondary referral hospital. Patients and Interventions: This was a comparative study that compared dehydration parameters between healthy subjects without SSNHL (n = 94) and patients with SSNHL (n = 94). The study also evaluated the effect of dehydrated conditions on the prognosis of SSNHL. Main Outcome Measures: We compared dehydration parameters, such as the blood urea nitrogen-to-creatinine ratio (BUN/Cre) and plasma osmolality (Posm), between matched healthy subjects without SSNHL and patients with SSNHL. To evaluate the effect of dehydrated conditions on the SSNHL prognosis, the SSNHL patients were divided into 2 groups based on the cutoff value obtained from the receiver operating characteristic analysis: hydrated (n = 50; BUN/Cre <21.4) and dehydrated (n = 44; BUN/Cre ≥21.4) groups. Subsequently, the severity and prognosis of SSNHL were analyzed. Results: The dehydration parameters, BUN/Cre and Posm, were significantly higher in patients with SSNHL than in healthy subjects. The initial hearing levels and SSNHL grades were worse in the dehydrated group than in the hydrated group. Moreover, a dehydrated condition (BUN/Cre ≥21.4) was associated with a poor SSNHL prognosis in all models of the multiple logistic regression analysis. Conclusions: The dehydration parameters of BUN/Cre and Posm were higher in patients with SSNHL than in healthy subjects. Additionally, a dehydrated condition (BUN/Cre ≥21.4) was an independent prognostic factor for SSNHL. Level of evidence: Level 4.","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136360532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Sarcoidosis of the Temporal Bone a Clinical Pathologic Correlation","authors":"Keelin Fallon, Ali Akalin, Peggy Wu, Aaron K. Remenschneider","doi":"10.1097/ono.0000000000000039","DOIUrl":"https://doi.org/10.1097/ono.0000000000000039","url":null,"abstract":"Objective: This report describes a case of sarcoidosis that presented as a lytic bone lesion in the squamous part of the temporal bone. Patients: A 64-year-old woman presented with right-sided aural fullness, pulsatile tinnitus, and intermittent otalgia. Interventions: CT and MRI were performed without contrast and suggested an osseodestructive, lytic bone lesion. An excisional biopsy was performed, showing granulomatous infiltration suggestive of osseous sarcoidosis. Main Outcome Measures: Removal of mass and resolution of symptoms. Results: Initial findings from patient imaging suggested a lytic bone lesion. An excisional biopsy was required for diagnosis and was performed with little patient morbidity. Biopsy findings showed granulomatous infiltration suggestive of osseous sarcoidosis. Osseous involvement of sarcoidosis is a rare manifestation and typically occurs secondary to other disease manifestations. After the removal of the mass and a short unrelated course of steroids, the patient’s symptoms resolved. Conclusions: Sarcoidosis should be added to the differential diagnosis of lytic bone lesions in the temporal bone.","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135255372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vestibular Schwannoma: Long-term Outcome of the Vestibular Function After Stereotactic Radiosurgery","authors":"Lukas Anschuetz, Ekin Ermiş, Isabel Gebhart, Odile Stalder, Andreas Raabe, Georgios Mantokoudis, Marco Caversaccio, Evelyne Hermann, Franca Wagner, Dominique Vibert","doi":"10.1097/ono.0000000000000038","DOIUrl":"https://doi.org/10.1097/ono.0000000000000038","url":null,"abstract":"Objective: Evaluation at long term of the impact of the stereotactic surgery (SRS) on the vestibular function in vestibular schwannoma (VS) patients. Study design and setting: Retrospective study in a tertiary referral center. Patients: Fifty-one VS patients were included (34 females;17 males), aged from 41 to 78 years treated exclusively with SRS. Intervention: Vestibular function was assessed before SRS and with median time interval of 14 (FU1) and 25 (FU2) months after treatment. Vestibular evaluation included: history, clinical vestibular examination, videonystagmography, head impulse test (v-HIT) and cervical vestibular evoked myogenic potentials (c-VEMPS). Results: Before SRS, caloric testing (Caloric) was impaired in 77%; after treatment, in 92% (FU1) and 77% (FU2). Lateral HIT was decreased in 22% before SRS, in 39% at FU1 and FU2. C-VEMPS were absent in 50% before SRS, in 76% at FU1 and, FU2. Before SRS, no statistically significant association was found between asymptomatic and symptomatic patients with respect to the results of Caloric, v-HIT and c-VEMPS. This lack of association was also seen after SRS, at FU1 and FU2. Conclusion: Our study showed that the impairment of the vestibular function might be attributed to the VS itself as well as to the radiation of the inner ear during SRS. The lateral SSC at low frequencies and the saccular function seem to be more involved with the time.","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135255223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinning Through History: Evolution of the Concept of Vestibular Migraine","authors":"Yoon-Hee Cha","doi":"10.1097/ono.0000000000000040","DOIUrl":"https://doi.org/10.1097/ono.0000000000000040","url":null,"abstract":"Vestibular migraine represents a growing public health problem, imposing enormous societal burdens in the form of patient suffering, loss of productivity, and direct healthcare costs. This raises the question of how we developed our ideas about vestibular migraine and how these ideas shape how we treat it. This review walks through the history of how our conceptualization of migraine and vestibular symptoms evolved, starting with clinical observations in ancient times, inclusion under the umbrella of Meniere’s disease, and then separation from Meniere’s disease with its own identity. Tradition, clinical observations, and diagnostic criteria developed by professional societies have played prominent roles in building our current concept of vestibular migraine. A review of the ideas that have shaped our current conception of vestibular migraine may help us to see which ones have stood the test of time and which ones should continue to evolve. As in other disciplines, we study history in medicine to be inspired, warned, and sometimes, to be freed.","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"114 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135255300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Cochlear Implantation in Age Subgroups of Veterans Over 50 Years Old","authors":"Gabrielle T. Petito, Siddhant H. Tripathi, Reena Dhanda Patil","doi":"10.1097/ono.0000000000000037","DOIUrl":"https://doi.org/10.1097/ono.0000000000000037","url":null,"abstract":"This study aimed to determine whether there was a difference in postoperative Arizona Biomedical (AzBio) speech recognition scores in 2 differently aged subgroups of veterans 50 years and older after cochlear implantation (CI). Retrospective chart review. Tertiary referral center. Seventy-one patients aged 50 to 74 years (younger cohort) were compared with 56 patients aged 75 years and older (older cohort) at the time of CI. Patients underwent therapeutic CI. Comparison of AzBio speech recognition test scores in a quiet environment between the 2 differently aged cohorts of veterans 50 years and older. Despite no significant differences in preoperative AzBio score between the younger (mean 22.2%) and older cohorts (mean, 17.3%; P > 0.05), when examining the 6- and 12-month postoperative time points, the older cohort had significantly lower mean AzBio scores (50%, 55.8%; P < 0.05) than the younger cohort (69.8%, 71.9%; P < 0.05). All patients aged >50 years experienced significant improvement in speech recognition scores following CI, although the cohort of ages 50 to 74 years scored significantly higher in later follow-up visits. These findings suggest that CI should be offered to appropriate candidates, regardless of age, although earlier intervention may be more advantageous.","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135088125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Labyrinthitis With Negative MRI As a Precursor to Rapidly Developing Primary CNS Lymphoma of the Cerebellopontine Angle: Erratum","authors":"","doi":"10.1097/ono.0000000000000032","DOIUrl":"https://doi.org/10.1097/ono.0000000000000032","url":null,"abstract":"","PeriodicalId":74382,"journal":{"name":"Otology & neurotology open","volume":"222 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135185449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}