American Journal of Otolaryngology最新文献

{"title":"Management of acute invasive fungal rhinosinusitis in immunocompromised children: a narrative review","authors":"Francesca Galluzzi ,&nbsp;Werner Garavello","doi":"10.1016/j.amjoto.2025.104698","DOIUrl":"10.1016/j.amjoto.2025.104698","url":null,"abstract":"<div><h3>Objective</h3><div>The aim is to review the current evidence for the management of acute invasive fungal rhinosinusitis (AIFR) in immunocompromised children.</div></div><div><h3>Material and methods</h3><div>A systematic search of PubMed, Embase, and Cochrane Library was performed. Data regarding the epidemiology, clinical presentation, diagnostic instruments, and treatments of pediatric AIFR were narratively summarized and critically analyzed.</div></div><div><h3>Results</h3><div>The management of AIFR in immunocompromised children can be very challenging because of the paucity of symptoms and rapidly progressive disease. The following key concepts are crucial to optimize the management: 1) early diagnosis through clinical features (sinonasal, oral, ocular, neurological symptoms and fever) and instrumental exams (nasal endoscopy with biopsy, microbiological tests, CT and MRI); 2) vigorous medical antifungal therapy associated with surgical treatment (endoscopic/open); 3) treat the underlying immunosuppression by improving immunocompetence; 4) close follow-up and prompt intervention in case of recurrence.</div></div><div><h3>Conclusion</h3><div>AIFR in immunocompromised children is a rare but serious condition that requires the use of fast and precise methods that can support clinicians in its management. In this perspective, a multidisciplinary diagnostic and therapeutic approach is essential. However, mortality is still high and further research is needed to improve knowledge in this field.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104698"},"PeriodicalIF":1.7,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preliminary study on classification and treatment of type I variant preauricular fistula","authors":"Liang Liu ,&nbsp;Haigang Zhang ,&nbsp;Xunwu Dou ,&nbsp;Xinghe Zhao ,&nbsp;Mingyue Fan","doi":"10.1016/j.amjoto.2025.104709","DOIUrl":"10.1016/j.amjoto.2025.104709","url":null,"abstract":"<div><h3>Objective</h3><div>To classify and manage Type I Variant Preauricular Fistulas (Type I VPFs) based on clinical manifestations, evaluate the efficacy of individualized surgical approaches, and provide a reference for their treatment.</div></div><div><h3>Methods</h3><div>From January 2016 to December 2023, our department treated 34 cases of Type I VPFs, including 19 males and 15 females, aged 11 months to 12 years (mean age: 5 years and 5 months). Sixteen cases involved the left ear, and 18 involved the right ear, with 4 cases presenting double fistulas. All cases had recurrent infections, and 7 cases had a history of incision and drainage. Based on clinical features, the fistulas were classified into Simple Type I VPFs, Conchal Type I VPFs, Retroauricular Groove Type I VPFs, External Auditory Canal Type I VPFs, and Hybrid Type I VPFs. Surgical management included complete fistula excision with adjacent crus helicis cartilage removal. Auxiliary incisions were made to debride granulation tissue based on its location, and primary flap reconstruction was performed for skin defects.</div></div><div><h3>Results</h3><div>The distribution of cases was as follows: Simple Type I VPFs (20.59 %, 7/34), Conchal Type I VPFs (35.29 %, 12/34), Retroauricular Groove Type I VPFs (29.41 %, 10/34), External Auditory Canal Type I VPFs (11.76 %, 4/34), and Hybrid Type I VPFs (2.94 %, 1/34). Approximately 29.41 % (10/34) of patients required flap reconstruction for defect repair, with these cases exclusively involving the conchal typeI VPFs.</div></div><div><h3>Conclusion</h3><div>Classification of Type I VPFs facilitates tailored surgical planning, achieving optimal functional and cosmetic outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104709"},"PeriodicalIF":1.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison between bougie and balloon dilation of benign esophageal strictures in infants and children","authors":"Yin Zhang ,&nbsp;Xinwei Han ,&nbsp;Yonghua Bi","doi":"10.1016/j.amjoto.2025.104715","DOIUrl":"10.1016/j.amjoto.2025.104715","url":null,"abstract":"<div><h3>Objectives</h3><div>The clinical outcomes regarding esophageal dilation are mainly composed of data collected from adults, who are likely to differ from children. The safety and efficacy of the bougie and balloon dilation were compared in two groups with benign esophageal strictures (BES) in infants and children.</div></div><div><h3>Methods</h3><div>The medical records of the BES patients, who received esophageal dilation between 2013 and 2024, were reviewed retrospectively. Bougie dilators were used in 19 patients (Group A) and balloon dilators in 18 patients (Group B). The etiology of strictures, degree and location of strictures, dilation methods, complications and dilation outcomes of bougie and balloon dilations were evaluated and compared.</div></div><div><h3>Results</h3><div>Thirty-seven patients [21 males and 16 females with a mean age of 6.2 years (range, 0.1–17)] underwent 124 esophageal dilations. The stricture etiologies included corrosive strictures (40.5 %), anastomotic strictures (40.5 %), and others in 18.9 %. Dysphagia relief was observed in all patients after the dilation, except for one session of dilation in each of the two groups. The technical success rate was 99.2 % in group A and 98.9 % in group B, respectively. The mean diameter of strictures increased significantly after dilation (<em>P</em> &lt; 0.0001). Thirty patients (81.1 %) had clinical symptoms regress after repeated dilations, and dysphagia was relieved in the remaining 6 patients during the follow-up period. There was no procedure-related mortality or major complications, including esophageal ruptures or massive bleeding. Mild bleeding was the most common complication.</div></div><div><h3>Conclusion</h3><div>Bougies and balloon catheters are safe, effective and well tolerated in both groups with BES in infants and children. More future randomized prospective studies will be needed to validate the results.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104715"},"PeriodicalIF":1.7,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in postoperative complications following pediatric tonsillectomy & adenoidectomy: A 10-year analysis","authors":"Ogechukwu S. Anwaegbu ,&nbsp;Delaney E.S. Clark ,&nbsp;Samsudeen O. Iyamah ,&nbsp;Chikobi Ezenwukwa ,&nbsp;Ugonne L. Etufugh ,&nbsp;Brian J. McKinnon","doi":"10.1016/j.amjoto.2025.104712","DOIUrl":"10.1016/j.amjoto.2025.104712","url":null,"abstract":"<div><h3>Objective</h3><div>Assess the rates of post-operative complications following tonsillectomy with/without adenoidectomy over a 10-year span, comparing young children and adolescents, while examining the influence of comorbidities, social determinants of health, and potential racial, and gender differences.</div></div><div><h3>Methods</h3><div>A retrospective cohort study using TriNetX database with de-identified electronic medical records from 57 healthcare organizations for ages 0–17 who had tonsillectomy with/without adenoidectomy from January 2014 to December 2023. Risk analysis and incidence proportion over a 10-year period for 5 outcomes occurring within 30 days, stratified by gender, race, and ethnicity. Then further subdivided into two groups: Early Childhood (0–9 years) and Adolescence (10–17 years). Statistical analysis included risk ratios (RR), and 95 confidence intervals (CI), with statistical significance set at <em>p</em> ≤ 0.05.</div></div><div><h3>Results</h3><div>Before propensity score matching, 197,885 pediatric patients were identified. Most common complications occurring within 30 days were pain (3.1 %), post-operative hemorrhage (2.3 %) with 1.3 % requiring re-operation for control, dehydration (2.1 %), infection (0.26 %), and acute respiratory complications (0.21 %). Before propensity score matching, Early Childhood cohort (0–9 years: <em>n</em> = 71,024) and Adolescence cohort (10–17 years: <em>n</em> = 126,861). After propensity matching, <em>n</em> = 56,036 for both groups. Early Childhood cohort had higher rates for potential health hazards related to socioeconomic and psychosocial circumstances (<em>p</em> = 0.013) and environmental tobacco smoke exposure-related risks (<em>p</em> = 0.016) than Adolescence cohort. No significant differences in complication risks were observed between the two pediatric age groups.</div></div><div><h3>Conclusion</h3><div>Rates of dehydration and acute respiratory distress have declined, while post-operative hemorrhage, and pain have been increasing, and observable racial differences continue to persist within these complications.</div><div><strong>Level of Evidence:</strong> III</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104712"},"PeriodicalIF":1.7,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 and socio-economic crisis on primary hyperparathyroidism patients in Lebanon: A trend to operate more acute and advanced-stage cases","authors":"Bassam Abboud ,&nbsp;Christopher Abboud","doi":"10.1016/j.amjoto.2025.104713","DOIUrl":"10.1016/j.amjoto.2025.104713","url":null,"abstract":"<div><h3>Backgrounds</h3><div>Evaluate contribution of COVID-19 pandemic, the socio-economic crisis, and explosion of Beirut port to a concerning trend of operating on more advanced-stage in primary hyperparathyroism (PHPT).</div></div><div><h3>Methods</h3><div>We included all patients operated for PHPT between 1997 and 2024. Two groups were established: Group 1 between 1997 and 2018, and Group 2 after 2018.</div></div><div><h3>Results</h3><div>Asymptomatic PHPT was statistically significantly more frequent in group 1. The rates of systemic manifestations were comparable but with a more advanced stage for some system in group 2. The rates of acute pancreatitis and acute hypercalcemia were significantly higher in group 2. The rate of parathyroid carcinoma was significantly higher in group 1. The hospital stay was statistically significantly longer in the group 2.</div></div><div><h3>Conclusion</h3><div>COVID-19 pandemic and economic crisis has affected early intervention and comprehensive treatment for PHPT patients, resulting in a concerning rise in late-stage and acute cases requiring surgical intervention.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104713"},"PeriodicalIF":1.8,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth utilization and perceptions among deaf or hard of hearing adults: A cross-sectional analysis of the HINTS6 national dataset","authors":"Andrew W. Liu ,&nbsp;Sara J. Yi ,&nbsp;Divya A. Chari","doi":"10.1016/j.amjoto.2025.104716","DOIUrl":"10.1016/j.amjoto.2025.104716","url":null,"abstract":"<div><h3>Objective</h3><div>Telehealth has emerged as a vital medium for healthcare delivery and has been integrated increasingly in clinic and hospital settings in the post-COVID-19 era. However, accessibility of telehealth for individuals who are deaf or hard of hearing (DHH) remains underexplored. As effective communication is critical to high-quality healthcare, a deeper understanding of how DHH individuals interact with telehealth and identifying specific barriers they face can inform targeted interventions to improve care.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional analysis of the 2022 Health Information National Trends Survey (HINTS 6), a nationally representative dataset. Respondents were stratified by self-identified DHH status. Demographic, internet access, health behavior, and telehealth perception variables were compared between DHH and normal hearing individuals. Statistical analyses were performed using chi-square tests and <em>t</em>-tests.</div></div><div><h3>Results</h3><div>Among 5694 respondents, 521 identified as DHH. Chi-square testing found that DHH patients reported poorer general health (<em>p</em> &lt; 0.01), lower internet use (p &lt; 0.01), and less engagement with online health resources (p &lt; 0.01), with similar rates of telehealth being offered and utilized. However, DHH individuals were less likely to perceive telehealth as convenient (<em>p</em> = 0.04) and more likely to cite difficulty using the platform (<em>p</em> = 0.01). They were also more likely to value the inclusion of others in their telehealth visits (<em>p</em> &lt; 0.01) and report technical issues (p &lt; 0.01).</div></div><div><h3>Conclusions</h3><div>While DHH individuals use telehealth at similar rates to the general population, they face significant barriers related to convenience, usability, and communication. Enhancing platform accessibility and expanding support for these patients can help reduce difficulties and further promote equity in telehealth.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104716"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence synthesis of tinnitus treatment methods: An umbrella review","authors":"Jiawen Xian ,&nbsp;Shipeng Zhang ,&nbsp;Xinyue Xiao ,&nbsp;Jiaqing Yuan ,&nbsp;Yilan Zhao ,&nbsp;Jinyi Li ,&nbsp;Yunyue Zhang ,&nbsp;Qinwei Henry Fu ,&nbsp;Yujie Zhang ,&nbsp;Qinxiu Zhang","doi":"10.1016/j.amjoto.2025.104707","DOIUrl":"10.1016/j.amjoto.2025.104707","url":null,"abstract":"<div><h3>Objective</h3><div>We collated and evaluated evidence from meta-analyses and systematic reviews on tinnitus treatment to establish a reference for clinical decision-making in tinnitus management.</div></div><div><h3>Methods</h3><div>Major medical databases such as CNKI, PubMed, Embase, Web of Science and the Cochrane Library were searched. Literature on systematic review/meta-analysis of evidence of tinnitus treatment was collected without reference language restrictions. The methodological quality, reporting quality, and evidence quality of the included studies were assessed using the Assessing the Methodological Quality of Systematic Reviews 2 (AMSTAR-2), the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist, and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool, respectively.</div></div><div><h3>Results</h3><div>In the end, a total of 48 out of 2642 screened publications met the eligibility criteria. The primary treatment modalities included tinnitus counseling, cognitive behavioral therapy, auditory therapy, tinnitus retraining therapy and pharmacotherapy. We analyzed seven treatment approaches, among which three demonstrated definitive efficacy while four showed probable efficacy.</div></div><div><h3>Conclusion</h3><div>The primary objective of this systematic review was to synthesize and critically evaluate evidence-based data on tinnitus treatment derived from multiple meta-analyses and systematic reviews, while also assessing methodological quality, reporting quality, and evidence quality of the included studies. Our study consolidated the most recent evidence-based findings on various tinnitus treatments to guide clinical decision-making in tinnitus management.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104707"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the multi-disciplinary approach utilizing cognitive behavioral therapy and sound therapy to standard audiological treatment in chronic tinnitus patients: Impact on severity reduction and quality of life improvement","authors":"Qi Kang ,&nbsp;Lingfeng Xiong ,&nbsp;Zhu Shi ,&nbsp;Yimei Li ,&nbsp;Tongkai Xing ,&nbsp;Lize Yang","doi":"10.1016/j.amjoto.2025.104700","DOIUrl":"10.1016/j.amjoto.2025.104700","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the impact of a multi-disciplinary approach utilizing Cognitive Behavioral Therapy (CBT) and Sound Therapy (ST) in chronic tinnitus patients.</div></div><div><h3>Methods</h3><div>The clinical data of 111 adult patients with chronic tinnitus were retrospectively analyzed. Patients were divided into the CBT + ST Group (CBT + ST, <em>n</em> = 55) and the Standard Group (standard therapy, <em>n</em> = 56). Baseline demographic characteristics, severity of tinnitus symptoms, audiometric measures, quality of life scores, treatment efficacy, and anxiety and depression scores were evaluated.</div></div><div><h3>Results</h3><div>Comparing with control, the CBT + ST group significantly reduced tinnitus severity scores, including Tinnitus Handicap Inventory, Tinnitus Functional Index, and Tinnitus Visual Analog Scale. Audiological measures revealed improved hearing thresholds and speech recognition in the CBT + ST group. CBT + ST also improved quality of life, with significant higher percentages of complete and partial treatment responses and lower anxiety and depression scores.</div></div><div><h3>Conclusion</h3><div>Multi-disciplinary approach utilizing CBT + ST effectively reduces tinnitus severity, improves quality of life, and enhances treatment efficacy.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104700"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of patient-centered care (PCC)-based personalized interventions on postoperative pain management and recovery in children undergoing adenotonsillectomy: A retrospective study","authors":"Xinyue Qi ,&nbsp;Yan Li ,&nbsp;Meng Zhang ,&nbsp;Yan Liu","doi":"10.1016/j.amjoto.2025.104706","DOIUrl":"10.1016/j.amjoto.2025.104706","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the impact of patient-centered care (PCC)-based personalized interventions on postoperative pain management and recovery outcomes in children undergoing adenotonsillectomy.</div></div><div><h3>Methods</h3><div>A single-center retrospective cohort study was conducted at a tertiary hospital from January 2023 to March 2025, involving 216 children aged 3–12 years. Participants were divided into a PCC intervention group (<em>n</em> = 108) and a routine care group (n = 108). The PCC protocol included individualized pain education, non-pharmacological interventions (cold therapy, distraction techniques), and family-involved decision-making. Data on pain scores (FLACC/FACES scales), analgesic use, hospitalization duration, and complications within 48 h postoperatively were extracted from electronic medical records. Group differences were analyzed using repeated-measures ANOVA, multivariate regression, and subgroup analyses.</div></div><div><h3>Results</h3><div>The PCC group demonstrated significantly lower pain scores at 6 h, 24 h, and 48 h compared to controls (all <em>P</em> &lt; 0.001). Daily acetaminophen and ibuprofen doses were reduced by 19.2 % and 55 %, respectively (both <em>P</em> &lt; 0.001). Median pain relief time was 2.6 h shorter in the PCC group (3.2 h vs. 5.8 h, <em>P</em> &lt; 0.001). Hospitalization duration decreased by 5.5 h (18.5 h vs. 24.0 h, <em>P</em> &lt; 0.001), and overall complication risk was reduced (OR = 0.31, P &lt; 0.001). Subgroup analysis revealed greater benefits in children aged 3–6 years, with a 28.6 % shorter hospitalization (<em>P</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>PCC-based personalized interventions effectively alleviate postoperative pain, reduce analgesic dependence, and accelerate recovery, particularly in younger children. This model provides an evidence-based framework for optimizing pain management in pediatric ambulatory surgery.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104706"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ChatGPT as a decision-support tool for better self-monitoring of hearing","authors":"Małgorzata Pastucha ,&nbsp;Anna Ratuszniak ,&nbsp;Małgorzata Ganc ,&nbsp;Edyta Piłka ,&nbsp;Iryna Drohobycka ,&nbsp;Henryk Skarżyński ,&nbsp;W. Wiktor Jedrzejczak","doi":"10.1016/j.amjoto.2025.104711","DOIUrl":"10.1016/j.amjoto.2025.104711","url":null,"abstract":"<div><h3>Background</h3><div>The rapid development of large language model chatbots, such as ChatGPT, has created new possibilities for healthcare support. This study investigates the feasibility of integrating self-monitoring of hearing (via a mobile app) with ChatGPT's decision-making capabilities to assess whether specialist consultation is required. In particular, the study evaluated how ChatGPT's accuracy to make a recommendation changed over periods of up to 12 months.</div></div><div><h3>Methods</h3><div>ChatGPT-4o was tested on a dataset of 1000 simulated cases, each containing monthly hearing threshold measurements over periods of up to 12 months. Its recommendations were compared to the opinions of 5 experts using percent agreement and Cohen's Kappa. A multiple-response strategy, selecting the most frequent recommendation from 5 trials, was also analyzed.</div></div><div><h3>Results</h3><div>ChatGPT aligned strongly with the experts' judgments, with agreement scores ranging from 0.80 to 0.84. Accuracy scores improved to 0.87 when the multiple-query strategy was employed. In those cases where all 5 experts unanimously agreed, ChatGPT achieved a near-perfect agreement score of 0.99. It adapted its decision-making criteria with extended observation periods, seemingly accounting for potential random fluctuations in hearing thresholds.</div></div><div><h3>Conclusions</h3><div>ChatGPT has significant potential as a decision-support tool for monitoring hearing, able to match expert recommendations and adapting effectively to time-series data. Existing hearing self-testing apps lack capabilities for tracking and evaluating changes over time; integrating ChatGPT could fill this gap. While not without its limitations, ChatGPT offers a promising complement to self-monitoring. It can enhance decision-making processes and potentially encourage patients to seek clinical expertise when needed.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104711"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}