American Journal of Otolaryngology最新文献

{"title":"Editor letter","authors":"Halime Sümeyra Sevmez","doi":"10.1016/j.amjoto.2025.104724","DOIUrl":"10.1016/j.amjoto.2025.104724","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104724"},"PeriodicalIF":1.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205426","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":"Comment on “Assessment of TISA ‘Transcutaneous Implant Skin Anomalies’ scale for cutaneous complications related to bone conduction hearing implants” by Hernández et al. American Journal of Otolaryngology-Head and Neck Medicine and Surgery 46 (2025) 104554","authors":"C. Hajema , I.J. Kruyt , M.K.S. Hol","doi":"10.1016/j.amjoto.2025.104723","DOIUrl":"10.1016/j.amjoto.2025.104723","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104723"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154726","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 appraisal of “diagnosis and treatment of CSF rhinorrhea with intracranial hypertension”","authors":"Tejaswi Gupta , Jyoti Kumar Verma , Sanjeev Yadav","doi":"10.1016/j.amjoto.2025.104722","DOIUrl":"10.1016/j.amjoto.2025.104722","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104722"},"PeriodicalIF":1.7,"publicationDate":"2025-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079498","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 socioeconomic status on management of pediatric subglottic stenosis and outcomes.","authors":"Courtney B Shires, Roger Bui, Brooke Bocklud, Karuna Dewan","doi":"10.1016/j.amjoto.2025.104718","DOIUrl":"10.1016/j.amjoto.2025.104718","url":null,"abstract":"<p><strong>Objective: </strong>There is currently a paucity of literature detailing the socioeconomic implications on management and outcomes of pediatric subglottic stenosis. Through this study, we sought to ascertain whether disparities of social determinants of health did have a discernible impact on management of subglottic stenosis through endoscopic versus open procedures and whether there would be a difference in outcomes.</p><p><strong>Study design: </strong>The study is a multi- institutional, academic center, retrospective case series.</p><p><strong>Methods: </strong>The study examines pediatric patients under the age of 18 evaluated by Ochsner-affiliated hospitals through May 2012 to May 2022 with the diagnosis of subglottic stenosis, acquired or congenital, through Epic SlicerDicer search engine. Patients were stratified into low and high socioeconomic status (SES), which served as independent variables, using principal component analysis of several social determinants. We recorded sex, age, ethnicity, and completion of college education. Interventions reviewed included endoscopic treatment, open airway surgery, and presence of tracheostomy. Outcome measurements included decannulation, time to decannulation, and death. Chi squared analysis was performed on dichotomous variables and student t-test was performed for continuous variables.</p><p><strong>Results: </strong>The groups were similar in demographics: sex, age, ethnicity, and proportion with college degree. Cotton Meyer grade was significantly higher in low SES compared to high SES (p = 0.04). Patients of low SES were significantly more likely to die (p < 0.001). Low SES patients were more likely to have an acquired rather than a congenital subglottic stenosis as compared to their high SES counterparts (p = 0.02). Low SES patients were also more likely to undergo endoscopic intervention (p = 0.03). There was no statistically significant difference in tracheostomy status or decannulation success between the two groups.</p><p><strong>Conclusion: </strong>There were statistically significant findings between low and high SES groups. Overall, patients of low SES appeared to have greater severity of subglottic stenosis, with greater number of endoscopic interventions, and greater mortality. This study which collected data from an area with marginalized patients with poor health literacy, demonstrates that sociodemographic factors contribute to disparate intervention and outcomes in pediatric patients with subglottic stenosis.</p>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"104718"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803262","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":"Readability of custom chatbot vs. GPT-4 responses to otolaryngology-related patient questions.","authors":"Yossef Alsabawi, Pompeyo R Quesada, David T Rouse","doi":"10.1016/j.amjoto.2025.104717","DOIUrl":"10.1016/j.amjoto.2025.104717","url":null,"abstract":"<p><strong>Background: </strong>Low health literacy among patients hinders comprehension of care instructions and worsens outcomes, yet most otolaryngology patient materials and chatbot responses to medical inquiries exceed the recommended reading level of sixth- to eighth-grade. Whether chatbots can be pre-programmed to provide accurate, plain-language responses has yet to be studied. This study aims to compare response readability of a GPT model customized for plain language with GPT-4 when answering common otolaryngology patient questions.</p><p><strong>Methods: </strong>A custom GPT was created and provided thirty-three questions from Polat et al. (Int J Pediatr Otorhinolaryngol., 2024), and their GPT-4 answers were reused with permission. Questions were grouped by theme. Readability was calculated with Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease (FRE) via online calculator. A board-certified, practicing otolaryngologist assessed content similarity and accuracy. The primary outcome was readability, measured by FKGL (0-18; equivalent to United States grade level) and FRE (0-100; higher scores indicate greater readability).</p><p><strong>Results: </strong>The custom GPT reduced FKGL by an average of 4.2 grade levels (95 % confidence interval [CI]: 3.2, 5.1; p < 0.001) and increased FRE by an average of 17.3 points (95 % CI: 12.5, 21.7; p < 0.001). Improvements remained significant in three of four theme subgroups (p < 0.05). Readability was consistent across question types, and variances were equal between models. Expert review confirmed overall accuracy and content similarity.</p><p><strong>Conclusion: </strong>Preprogramming a custom GPT to generate plain-language instructions yields outputs that meet Centers for Medicare & Medicaid Services readability targets without significantly compromising content quality. Tailored chatbots could enhance patient communication in otolaryngology clinics and other medical settings.</p>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"104717"},"PeriodicalIF":1.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811554","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":"Commentary","authors":"Cheng Zhong","doi":"10.1016/j.amjoto.2025.104720","DOIUrl":"10.1016/j.amjoto.2025.104720","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104720"},"PeriodicalIF":1.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842250","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 data presented in Zhi et al. do not support the conclusion that HBOT leads to worse hearing improvement in sudden hearing loss","authors":"Kiran Ganga ,&nbsp;Christopher Niemczak ,&nbsp;Jay Buckey","doi":"10.1016/j.amjoto.2025.104719","DOIUrl":"10.1016/j.amjoto.2025.104719","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104719"},"PeriodicalIF":1.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828924","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":"A comparison of quality and readability of Artificial Intelligence chatbots in triage for head and neck cancer","authors":"Taylor Kring ,&nbsp;Soumil Prasad ,&nbsp;Supriya Dadi ,&nbsp;Eric Sokhn ,&nbsp;Elizabeth Franzmann","doi":"10.1016/j.amjoto.2025.104710","DOIUrl":"10.1016/j.amjoto.2025.104710","url":null,"abstract":"<div><h3>Objective</h3><div>Head and neck cancers (HNCs) are a significant global health concern, contributing to substantial morbidity and mortality. AI-powered chatbots such as ChatGPT, Google Gemini, Microsoft Copilot, and Open Evidence are increasingly used by patients seeking health information. While these tools provide immediate access to medical content, concerns remain regarding their reliability, readability, and potential impact on patient outcomes.</div></div><div><h3>Methods</h3><div>Responses to 25 patient-like HNC symptom queries were assessed using four leading AI platforms: ChatGPT, Google Gemini, Microsoft Copilot, and Open Evidence. Responses were evaluated using modified DISCERN criteria for quality and SMOG scoring for readability, with ANOVA and post hoc analysis conducted afterward.</div></div><div><h3>Results</h3><div>Microsoft Copilot achieved the highest mean DISCERN score of 41.40 (95 % CI: 40.31 to 42.49) and the lowest mean SMOG reading levels of 12.56 (95 % CI: 11.82 to 13.31), outperforming ChatGPT, Google Gemini, and Open Evidence in overall quality and accessibility (p &lt; .001). Open Evidence scored lowest in both quality averaging 30.52 (95 % CI: 27.52 to 33.52) and readability of 17.49 (95 % CI: 16.66 to 18.31), reflecting a graduate reading level.</div></div><div><h3>Conclusion</h3><div>Significant variability exists in the readability and quality of AI-generated responses to HNC-related queries, highlighting the need for platform-specific validation and oversight to ensure accurate, patient-centered communication.</div></div><div><h3>Level of evidence</h3><div>Our study is a cross-sectional analysis that evaluates chatbot responses using established grading tools. This aligns best with level 4 evidence.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104710"},"PeriodicalIF":1.7,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144771631","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":"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}