American Journal of Otolaryngology最新文献

{"title":"Inpatient outcomes after tracheostomy for pediatric tracheal stenosis: An analysis of the Kids' Inpatient Database.","authors":"Saharsh Talwar, Emily Kwon, Wayne D Hsueh, Rachel Kaye","doi":"10.1016/j.amjoto.2026.104855","DOIUrl":"https://doi.org/10.1016/j.amjoto.2026.104855","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate inpatient outcomes associated with tracheostomy in pediatric patients diagnosed with tracheal stenosis using a large, multi-year administrative sample.</p><p><strong>Setting: </strong>Pediatric hospital discharges from the Kids' Inpatient Database (KID), 2003-2019.</p><p><strong>Methods: </strong>Patients aged ≤20 years with a diagnosis of tracheal stenosis who underwent tracheostomy were identified using validated ICD-9/10 codes. Primary outcomes included length of stay (LOS), total hospital charges, and in-hospital mortality. Descriptive statistics were stratified by age group and insurance status. Multivariable linear regression was used for log-transformed LOS and charges; logistic regression assessed predictors of mortality.</p><p><strong>Results: </strong>A total of 1480 patients were included; 57.9% were male and 77.4% were infants. Median LOS was 51 days (IQR: 24-101), and median inflation-adjusted charges were $389,221 (IQR: $170,641-$805,264, 2019 USD). In-hospital mortality was 6.6%. Infants had the longest total hospital LOS and highest charges. Medicaid patients had significantly longer LOS (p = 0.011). On multivariable analysis, longer LOS was associated with infant age, female sex, and psychiatric or pulmonary comorbidities. Higher charges were associated with infants, adults, and patients with psychiatric or pulmonary conditions. Pulmonary circulatory disease was associated with increased odds of in-hospital mortality; no demographic or hospital-level variables were significant predictors.</p><p><strong>Conclusion: </strong>Children with tracheal stenosis undergoing tracheostomy experience prolonged hospitalizations and substantial inpatient charges. Infants and those with psychiatric or cardiopulmonary comorbidities are particularly vulnerable. These findings highlight the need for targeted care pathways to improve outcomes for this population.</p>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"104855"},"PeriodicalIF":1.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147855658","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":"Toward non-living training models: A trainee-preferred and sustainable 3D-printed model in microvascular anastomosis.","authors":"Junqiang Bai, Weiyu Wang, Xinmiao Wang, Shutian Guo, Xiaomeng Guo, Zhengjun Shang, Erhui Jiang, Zhe Shao","doi":"10.1016/j.amjoto.2026.104854","DOIUrl":"https://doi.org/10.1016/j.amjoto.2026.104854","url":null,"abstract":"<p><strong>Objective: </strong>Various non-living models have been developed and showed their different characteristics for microvascular anastomosis training, but each has limitations. The aim of this study was to evaluate the training efficiency and the practicality of a novel 3D-printed model designed to address these shortcomings.</p><p><strong>Methods: </strong>Sixty postgraduate students from the School of Stomatology were randomly assigned to either the 3D-printed model group or the chicken wing group to perform end-to-end anastomosis. After training, participants performed end-to-end anastomosis on the caudal artery of live rats to assess the training effect. Procedures were recorded and evaluated by two blinded experts using the validated Objective Structured Assessment of Technical Skills (OSATS) scoring system. A post-training questionnaire was also administered to gather participants' feedback on the models.</p><p><strong>Results: </strong>Compared with pre-training, OSATS scores improved significantly in both the chicken wing group (from 9.083 ± 0.736 to 22.330 ± 1.252, P < 0.000) and the 3D-printed model group (from 8.750 ± 0.880 to 23.080 ± 1.158, P < 0.000). However, the magnitude of improvement did not differ significantly between the two groups (mean difference in change: 1.083 ± 0.970, P = 0.290). In addition, the post-training questionnaire revealed that participants were more likely to recommend the 3D-printed model for microvascular anastomosis training (P = 0.013).</p><p><strong>Conclusions: </strong>The 3D-printed model demonstrated a similar training effect to the chicken wing model for microvascular anastomosis. It can be considered a viable alternative to the chicken wing model in microvascular anastomosis training.</p>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 4","pages":"104854"},"PeriodicalIF":1.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147832298","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":"Diagnostic utility of tubomanometry for patulous eustachian tube: A comparative study","authors":"Xiaoling Shi ,&nbsp;Ren Zhou ,&nbsp;Yanbo Yin ,&nbsp;Yunfeng Wang","doi":"10.1016/j.amjoto.2026.104846","DOIUrl":"10.1016/j.amjoto.2026.104846","url":null,"abstract":"<div><h3>Purpose</h3><div>The current diagnosis of patulous Eustachian tube (PET) has limitations and cannot accurately assess its functional status. This study aims to validate tubomanometry (TMM) as an objective diagnostic tool for PET by analyzing pressure-specific R-values.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving 95 ears from 64 patients which were stratified into three groups: Definite PET (<em>n</em> = 26), Possible PET (<em>n</em> = 41), and Controls (<em>n</em> = 28). Diagnostic performance was evaluated by receiver operator characteristic (ROC) curve analysis to determine optimal R-value thresholds.</div></div><div><h3>Results</h3><div>The Definite PET group exhibited significantly lower R-values compared to the Possible PET and Control groups at all pressure levels (30 mbar: 0.27 ± 0.39 <em>vs</em> 0.40 ± 0.34 <em>vs</em> 0.99 ± 0.49, <em>p</em> &lt; 0.001; 40 mbar: 0.39 ± 0.55 <em>vs</em> 0.54 ± 0.44 <em>vs</em> 0.75 ± 0.31, <em>p</em> = 0.001; 50 mbar: 0.32 ± 0.33 <em>vs</em> 0.41 ± 0.33 <em>vs</em> 0.70 ± 0.32, <em>p</em> &lt; 0.001). The optimal diagnostic threshold was achieved at 30 mbar (R-value cutoff: 0.585; sensitivity: 75%, specificity: 77%, area under curve [AUC]: 0.802). Asymptomatic contralateral ears in unilateral PET cases exhibited R-values that were similar to healthy controls (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>TMM is a robust diagnostic tool for PET, with optimal clinical utility at 30 mbar. Pressure-specific R-value thresholds can differentiate the severity of PET and validate the status of asymptomatic ears in unilateral cases.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104846"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759875","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":"Postoperative recurrent laryngeal nerve paralysis in thyroid carcinoma surgery","authors":"Takemasa Terao,&nbsp;Ryota Kiwaki,&nbsp;Yorihisa Orita","doi":"10.1016/j.amjoto.2026.104849","DOIUrl":"10.1016/j.amjoto.2026.104849","url":null,"abstract":"<div><h3>Objective</h3><div>Recurrent laryngeal nerve (RLN) paralysis is a significant complication of thyroid surgery. Even with meticulous nerve preservation, postoperative RLN paralysis can still occur. We investigate risk factors for postoperative RLN paralysis among the patients with thyroid carcinoma.</div></div><div><h3>Methods</h3><div>Between 2017 and 2023, 216 patients underwent surgery for thyroid carcinoma at Kumamoto University Hospital. Among these, 26 patients displayed preoperative vocal cord paralysis. Records for the remaining 190 patients were reviewed retrospectively to identify risk factors for postoperative RLN paralysis.</div></div><div><h3>Results</h3><div>Among the 190 cases, 16 required RLN resection during surgery due to tumor invasion. Out of the remaining 174 patients who preserved RLN, 29 suffered temporary and 7 permanent postoperative RLN paralysis. Tracheal invasion was identified as a significant risk factor for the need to resect RLN during surgery, even in the absence of preoperative RLN paralysis (OR 7.0, <em>P</em> = 0.038). For patients suffering postoperative RLN paralysis even though preserving RLN during surgery, RLN shaving (OR 42.8, <em>P</em> &lt; 0.001) and blood loss (OR 1.51 per 100 mL increase, <em>p</em> = 0.024) were identified as an independent factor. Excluding RLN shaving cases, blood loss was an independent factor.</div></div><div><h3>Conclusion</h3><div>Patients with suspected tracheal invasion preoperatively are at high risk of requiring intraoperative RLN resection. Among the patients with thyroid carcinoma who preserved RLN during surgery, the cases in which nerve preservation was achieved by shaving technique and those with greater intraoperative bleeding had a higher risk of postoperative RLN paralysis.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104849"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759853","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":"Hyperbaric oxygen combined with postauricular and intratympanic steroid injections in diabetic patients with severe or profound refractory sudden sensorineural hearing loss","authors":"Huimei Li,&nbsp;Chenyang Zhao,&nbsp;Weihong Zhang,&nbsp;Yin Fu","doi":"10.1016/j.amjoto.2026.104838","DOIUrl":"10.1016/j.amjoto.2026.104838","url":null,"abstract":"<div><h3>Background</h3><div>Patients with type 2 diabetes mellitus (T2DM) and severe or profound refractory sudden sensorineural hearing loss (RSSNHL) urgently require more effective salvage therapies.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the efficacy of a triple salvage therapy—combining hyperbaric oxygen (HBO), intratympanic steroids (ITS), and postauricular steroid injections (PSI)—for severe or profound RSSNHL in diabetic patients.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 117 patients with unilateral severe or profound RSSNHL and concurrent T2DM between January 2020 and December 2024. All patients underwent salvage therapy with PSI and ITS, either with (<em>n</em> = 60) or without (<em>n</em> = 57) HBO. The primary efficacy endpoint was the change in hearing level, while secondary endpoints included changes in glycemic control, tinnitus and vertigo symptoms, anxiety and depression scores, and sleep quality.</div></div><div><h3>Results</h3><div>Compared to the No-HBO group, the HBO group achieved superior post-salvage efficacy, with significantly higher cure rates, clinical effectiveness rates, and hearing threshold gain (<em>P</em> &lt; 0.05), while maintaining a comparable safety profile (<em>P</em> &gt; 0.05). Salvage therapy improved glycemic control, neurotological symptoms, sleep, and psychological status in both groups, with greater benefits observed in the HBO group (<em>P</em> &lt; 0.05). Shorter intervals from symptom onset to salvage therapy and shorter T2DM duration were associated with significantly greater hearing improvement (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>This triple salvage therapy effectively treats severe or profound RSSNHL in diabetic patients, improving auditory outcomes, glycemic control, and comorbid symptoms without increasing the incidence of adverse events.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104838"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759912","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":"“Critical methodological considerations in the study of combined tDCS and counseling for chronic tinnitus”","authors":"Ho Yun Lee","doi":"10.1016/j.amjoto.2025.104785","DOIUrl":"10.1016/j.amjoto.2025.104785","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104785"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803290","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":"Self-perception of balance function in adults following cochlear implant surgery: A cross-sectional study","authors":"Rania Alkahtani ,&nbsp;Abeer Alotaibi ,&nbsp;Arwa Alhussain ,&nbsp;Layan Algharbi ,&nbsp;Reenad Al-hlail ,&nbsp;Reem Elbeltagy ,&nbsp;Hadeel Alsaleh ,&nbsp;Sahar Asqool","doi":"10.1016/j.amjoto.2026.104843","DOIUrl":"10.1016/j.amjoto.2026.104843","url":null,"abstract":"<div><h3>Objective</h3><div>To assess self-perceived balance function in adults after cochlear implantation and explore factors associated with postoperative vertigo.</div></div><div><h3>Methods</h3><div>A cross-sectional questionnaire-based study was conducted among adult cochlear implant recipients (≥18 years). Collected data included demographics, hearing history, vestibular symptoms before and after implantation, and satisfaction with hearing outcomes. Chi-square analysis was used to examine associations between vertigo and clinical variables.</div></div><div><h3>Results</h3><div>A total of 50 adult participants were included. Perception of vertigo was reported by 38% prior to implantation and 48% post-implantation. Among those with post-implant symptoms, 58.3% experienced vertigo daily, and 54.2% rated their symptoms as moderate in severity. The majority of symptoms developed within one month post-surgery. Male sex was significantly associated with a higher incidence of post-implant vertigo (<em>p</em> = 0.049), while no significant associations were observed with other factors.</div></div><div><h3>Conclusion</h3><div>Nearly half of adult cochlear implant recipients reported postoperative vertigo, with many describing symptoms of moderate severity that interfered with daily activities. These findings underscore the importance of incorporating systematic pre- and post-operative vestibular assessment and follow-up into standard cochlear implant care.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104843"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803288","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":"Epidemiological characteristics and surgical management of external auditory canal foreign bodies: A 16-year single center retrospective study","authors":"Seok Hyun Kim ,&nbsp;Dae Sup Lee ,&nbsp;Sung Won Choi ,&nbsp;Se Joon Oh ,&nbsp;Il Woo Lee ,&nbsp;Hyun Min Lee","doi":"10.1016/j.amjoto.2025.104774","DOIUrl":"10.1016/j.amjoto.2025.104774","url":null,"abstract":"<div><h3>Objective</h3><div>External auditory canal foreign bodies (EAC-FBs) are common otologic emergencies across all age groups. While many cases are managed outpatient, some require surgery with risk of complications. This study analyzed epidemiological characteristics and risk factors for surgical management of EAC-FBs over a 16-year period at a single center.</div></div><div><h3>Methods</h3><div>We retrospectively reviewed 411 EAC-FB cases from November 2008 to June 2024. Data on demographics, FB type, removal methods, surgical need, and complications were collected. Foreign bodies were categorized into eight types and analyzed by age group, season, and treatment outcome.</div></div><div><h3>Results</h3><div>The mean age was 27.78 ± 22.63 years; adults comprised 48.8 % of patients. The peak incidence occurred in summer (29.7 %). Surgical intervention was required in 10.2 % of cases, with higher rates in preschoolers (27.5 %) and patients with prior hospital visits (31.6 %). The most common FBs were insects (27.3 %) and ear-related medical supplies (25.1 %), with age-specific patterns. Toys were predominant in preschoolers (47.1 %), while adults more often had insects or medical items. The overall complication rate was 1.9 %, increasing to 19.0 % in surgical cases.</div></div><div><h3>Conclusion</h3><div>EAC-FBs display age-dependent patterns in FB type and treatment outcome. Preschool children and patients with prior visits are at higher surgical risk. Although overall complication rates are low, those requiring surgery have substantially elevated risk. Careful initial evaluation and early referral are essential, along with age-specific management and prevention strategies.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104774"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803285","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":"Prognostic risk factors in patients with jaw osteoradionecrosis: A retrospective cohort study at a tertiary teaching hospital","authors":"Chen-xi Li ,&nbsp;Zhong-cheng Gong ,&nbsp;Sakendeke Jumatai ,&nbsp;Chang Fang ,&nbsp;Parekejiang Pataer ,&nbsp;Hua-rong Zhao","doi":"10.1016/j.amjoto.2026.104845","DOIUrl":"10.1016/j.amjoto.2026.104845","url":null,"abstract":"<div><h3>Background/Objective</h3><div>Osteoradionecrosis of the jaws (ORNJ) is a severe complication of radiotherapy for head and neck cancer, with limited data on prognostic factors. This study aimed to identify risk factors associated with wound healing prognosis in ORNJ patients.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted following STROBE guidelines, including 106 ORNJ patients treated at a tertiary hospital between 2005 and 2020. Patients were divided into normal wound healing (NH, within 7–10 days postoperatively) and delayed wound healing (DH, ≥11 days postoperatively) groups. Univariate analysis, multivariate Logistic regression, and Cox proportional hazards models were used to identify prognostic factors.</div></div><div><h3>Results</h3><div>The median follow-up was 38.6 months. Univariate analysis showed DH patients had significantly higher baseline PIV (median: 490.1 vs 437.8) and SII (median: 775.6 vs 732.2) than NH patients (all <em>p</em> &lt; 0.001). Multivariate logistic regression showed that diabetes mellitus (OR = 9.687, <em>p</em> = 0.010), Charlson comorbidity index (CCI, OR = 10.004, <em>p</em> &lt; 0.001), primary tumor site (OR = 10.384, <em>p</em> = 0.006), T stage (OR = 27.340, <em>p</em> &lt; 0.001), ORNJ grade at diagnosis (OR = 4.367, p &lt; 0.001), pan-immune-inflammatory value (PIV, OR = 1.043, p &lt; 0.001), and systemic immune-inflammatory index (SII, OR = 1.023, <em>p</em> &lt; 0.001) were independent risk factors for delayed healing. Kaplan-Meier curves showed that patients in the highest PIV tertile had significantly longer time-to-healing (median: 31.5 vs 18.3 days, Log-rank p &lt; 0.001).</div></div><div><h3>Conclusions</h3><div>PIV and SII, along with clinical factors (diabetes mellitus, CCI, T stage, ORNJ grade), are independent prognostic factors for wound healing in ORNJ patients. These findings may help clinicians optimize treatment strategies and predict outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104845"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147803286","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":"Tinnitus severity and dizziness: The role of psychological distress in a population-based study","authors":"Hyunji Kim ,&nbsp;Kyoungwoo Kim","doi":"10.1016/j.amjoto.2026.104842","DOIUrl":"10.1016/j.amjoto.2026.104842","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between tinnitus severity and dizziness in a nationally representative sample of adults aged ≥40 years and to evaluate the contribution of psychological distress (anxiety and perceived stress).</div></div><div><h3>Methods</h3><div>We analyzed data from 7634 participants in the Korea National Health and Nutrition Examination Survey (2022−2023). Dizziness was defined as self-reported symptoms within the past 12 months. Tinnitus severity was categorized as mild, moderate, or severe compared with no tinnitus. Survey-weighted logistic regression models estimated odds ratios (ORs) and 95% confidence intervals (CIs) with sequential adjustment for sociodemographic factors, health behaviors, comorbidities, and psychological variables.</div></div><div><h3>Results</h3><div>Among adults aged 40 years and older, the weighted proportions of participants reporting dizziness and tinnitus symptoms were 33.7% and 10.2%, respectively. Tinnitus severity showed a graded association with dizziness (p for trend = 0.003 in Model 4). Compared with the no‑tinnitus group, moderate and severe tinnitus were associated with higher odds of dizziness after full adjustment (OR 1.71, 95% CI 1.33–2.20; OR 2.43, 95% CI 1.75–3.39). Anxiety severity and perceived stress were independently associated with dizziness, and adjustment for these factors attenuated the tinnitus–dizziness association by approximately 9% and 19% for moderate and severe tinnitus.</div></div><div><h3>Conclusions</h3><div>Tinnitus severity was independently associated with dizziness in a graded manner. Psychological distress was also associated with dizziness and partially attenuated this relationship, supporting a clinical approach that integrates auditory and psychological factors in the assessment of dizziness.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 3","pages":"Article 104842"},"PeriodicalIF":1.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759948","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}