American Journal of Otolaryngology最新文献

{"title":"Salivary and tissue CD44 expression in laryngeal cancer","authors":"Maria Rita Bianco ,&nbsp;Federico Occhiuzzi ,&nbsp;Cosimo Galletti ,&nbsp;Mario Lentini ,&nbsp;Lidia Puzzo ,&nbsp;Eugenia Allegra","doi":"10.1016/j.amjoto.2025.104702","DOIUrl":"10.1016/j.amjoto.2025.104702","url":null,"abstract":"<div><div>The most common malignant tumor of head and neck cancer is laryngeal carcinoma, often diagnosed at advanced stages, underscoring the need for reliable diagnostic and prognostic biomarkers. This study investigates the correlation between CD44 expression in tumor tissues and its soluble fraction (CD44sol) in saliva, evaluating their potential as diagnostic and prognostic markers. The study was conducted on 74 patients with laryngeal carcinoma. CD44 expression in tumor tissues was assessed using immunohistochemical techniques, while salivary CD44sol levels were measured using Enzyme Linked ImmunoSorbent Assay (ELISA). A significant statistical correlation was found between CD44 tumor expression and salivary CD44sol levels. Furthermore, CD44 expression was identified as a prognostic biomarker for low-grade tumors, and metastatic lymphadenopathy at diagnosis. Similarly, positive salivary CD44sol levels were identified as predictive factors for low-grade tumors, tumor site, and lymph node metastasis at diagnosis. To the best of our knowledge, this study is the first to demonstrate a significant correlation between salivary levels and tumor tissue expression of CD44 in patients with laryngeal cancer.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104702"},"PeriodicalIF":1.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738088","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":"Controversies in thyroid and parathyroid surgery","authors":"Courtney Brooke Shires ,&nbsp;Aaron Parsons ,&nbsp;Karuna Dewan ,&nbsp;Merry Sebelik","doi":"10.1016/j.amjoto.2025.104703","DOIUrl":"10.1016/j.amjoto.2025.104703","url":null,"abstract":"<div><h3>Background/purpose</h3><div>Clinicians involved in thyroid and parathyroid surgical care can harbor strongly held beliefs meant to achieve the best outcomes, sometimes based on erroneous or outdated evidence. This article will clarify some common practices that can be refuted by critical analysis of the literature.</div></div><div><h3>Methods</h3><div>Observations in clinical practice of the most strongly communicated practice patterns were compared to review of published literature. Those practice patterns most discordant with evidence were included in the list of myths.</div></div><div><h3>Results</h3><div>Eligible clinical practices were organized by source: Surgeon, Anesthesiologist, Endocrinologist, and Institution. Examples of practices that can be disputed by evidence included the avoidance of muscle relaxants during recurrent nerve monitoring, awake fiberoptic airway management during induction for large or retrosternal goiter surgery, avoidance of contrast for CT imaging, and utilization of neural monitor technicians during surgery. Overall, 10 practice patterns that are discordant with published evidence were identified as appropriate for myth-busting.</div></div><div><h3>Discussion</h3><div>All clinicians caring for thyroid and parathyroid surgery patients share a desire for highest quality outcomes, especially since the patient may have many years to live with the consequences of complications. It is understandable that practice patterns can be strongly adhered to even if evidence suggests alternatives. This project identified some of the more controversial or heterogeneously applied practice patterns.</div></div><div><h3>Conclusions</h3><div>Identification of 10 practice patterns that can be altered based on high quality evidence may provide an opportunity for clinicians to reflectively modify what they do, possibly resulting in better, less complex, or more precise clinical care.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104703"},"PeriodicalIF":1.8,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678979","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":"Association between vitamin D deficiency and residual dizziness in idiopathic BPPV: Focus on otolith dysfunction and regression insights","authors":"Xuanchen Zhou ,&nbsp;Tao Lin ,&nbsp;Qiang Zhang ,&nbsp;Changle Li ,&nbsp;Ling Ding","doi":"10.1016/j.amjoto.2025.104704","DOIUrl":"10.1016/j.amjoto.2025.104704","url":null,"abstract":"<div><h3>Background</h3><div>Residual dizziness (RD) following successful canalith repositioning maneuvers (CRMs) in idiopathic benign paroxysmal positional vertigo (BPPV) is multifactorial, with vitamin D (VD) deficiency hypothesized to influence otolith-mediated vestibular pathways.</div></div><div><h3>Objective</h3><div>To determine the impact of VD deficiency severity on RD incidence and vestibular dysfunction, and to evaluate the effects of VD supplementation on vestibular dysfunction.</div></div><div><h3>Methods</h3><div>A cross-sectional study enrolled 138 idiopathic BPPV patients with different VD level. Participants were stratified by deficiency severity: normal (&gt;20 ng/mL), insufficiency (10–20 ng/mL), and deficiency (&lt;10 ng/mL). RD risk factors (gender, age, times of CRMs, involved semicircular canals) were recorded. Otolith function was assessed via cervical/ocular vestibular-evoked myogenic potentials (cVEMP/oVEMP), and vestibular function via bithermal caloric testing. RD severity was measured using the Dizziness Handicap Inventory (DHI) at 1 week post-CRM. A subgroup (<em>n</em> = 30) with deficiency/insufficiency received 12-week VD3 supplementation (0.25 μg of oral calcitriol twice daily). Binary regression analysis was used to analyze predictors of RD.</div><div><em>Results:</em> A moderate positive correlation emerged between serum VD and DHI scores (<em>r</em> = 0.365, <em>P</em> &lt; 0.001). cVEMP abnormalities were the only otolith parameter associated with RD (χ² = 9.75, <em>P</em> = 0.002). The degree of VD deficiency, cVEMP, and age emerged as significant predictors of RD. There was a significant increase in VD levels before and after treatment (13.29 ± 2.99 vs. 23.24 ± 4.78, P = 0.00) in the treatment group. Both groups showed significant shortening of cVEMP N23 wave latency after three months (<em>P</em> = 0.01 and <em>P</em> = 0.02), but only the treatment group showed significant reduction in oVEMP N10 wave latency (P = 0.01), with DHI scores reduced by 48.2 % (<em>P</em> = 0.008).</div></div><div><h3>Conclusions</h3><div>We confirmed that VD enhances otolith function and neural integrity. CVEMP, age, and VD levels predict RD likelihood. This research is the first to show VD supplementation improves saccule function and transmission pathways.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104704"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696701","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":"Primary external auditory canal cholesteatoma: Clinical characteristics and role of endoscopic ear surgery","authors":"Yuvatiya Plodpai,&nbsp;Pittayapon Pitathawatchai,&nbsp;Pattarawadee Prayuenyong","doi":"10.1016/j.amjoto.2025.104701","DOIUrl":"10.1016/j.amjoto.2025.104701","url":null,"abstract":"<div><h3>Purpose</h3><div>Primary external auditory canal cholesteatomas (PEACCs) are uncommon, and the role of endoscopy in managing the lesion has not yet been clarified. We aimed to investigate the clinical characteristics of PEACC and explore the feasibility of endoscopy for its treatment.</div></div><div><h3>Material and methods</h3><div>A retrospective study in patients who diagnosed with PEACC from January 2012 to January 2024 was conducted. The presenting features, disease extension according to Naim's classification, and treatment option used were assessed. The clinical characteristics were compared between the conservative successful group and the surgical group.</div></div><div><h3>Results</h3><div>A total of 72 patients who completed the treatment protocols were enrolled. Per the classification by Naim et al., PEACC was categorized as stage II, III, and IV in 7, 42, and 23 cases, respectively. Successful nonoperative treatment using the transcanal endoscopic approach was achieved in 46 patients without tympanic perforation (<em>p</em> <em>=</em> <em>0.035</em>), scutum erosion (<em>p</em> <em>&lt;</em> <em>0.001</em>), ossicular involvement (<em>p</em> <em>=</em> <em>0.02</em>), erosion of the vertical segment of the facial canal (<em>p</em> <em>=</em> <em>0.018</em>), or mastoid involvement (<em>p</em> <em>=</em> <em>0.046</em>), with maintenance of dry ear for 2 months (<em>p</em> <em>&lt;</em> <em>0.001</em>). Endoscopy-assisted and exclusive endoscopic surgery were performed in nine and ten patients, respectively. Canal wall-down mastoidectomy with obliteration was performed in seven patients with advanced stage IV disease. Complications were not reported in either group.</div></div><div><h3>Conclusion</h3><div>Endoscopy is useful for PEACC management even in advanced stages. However, the approach varies according to the lesion extent. Successful nonoperative management feasible in patients without tympanic membrane perforation, scutum erosion, facial canal erosion, ossicular or mastoid involvement and in those with ear drainage for &lt;2 months.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104701"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702645","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":"Treatment effects of combined transcranial direct current stimulation and counseling for the treatment of chronic tinnitus","authors":"Zoo Young Lee ,&nbsp;Seung-Ho Shin ,&nbsp;Sung Wan Byun ,&nbsp;Soo Hee Oh ,&nbsp;Ho Yun Lee","doi":"10.1016/j.amjoto.2025.104699","DOIUrl":"10.1016/j.amjoto.2025.104699","url":null,"abstract":"<div><h3>Aims</h3><div>We aimed to evaluate the comparative efficacy of three treatment modalities for chronic tinnitus: TRT-based directive counseling, transcranial direct current stimulation (tDCS), and their combination. Primary endpoints were changes in tinnitus severity and psychological distress; secondary endpoints included treatment response rates and anxiety reduction.</div></div><div><h3>Methods</h3><div>Forty-one patients with chronic tinnitus lasting 3 months or more of duration were enrolled who were treated at a tertiary hospital between November 2021 and December 2023. Patients were allocated to counseling (<em>n</em> = 11), tDCS (<em>n</em> = 19), or combined therapy (n = 11) based on informed preference. Treatment outcomes were assessed using the Tinnitus Handicap Inventory (THI), Visual Analog Scale (VAS), Beck's Depression Inventory (BDI), and Hospital Anxiety-Depression Scale (HADS). Statistical analysis included Wilcoxon Signed-Rank tests for within-group comparisons and Kruskal-Wallis tests for between-group analyses.</div></div><div><h3>Results</h3><div>Clinically significant improvement (THI reduction ≥7 points) was achieved in 70.7 % of patients overall: 63.6 % in counseling, 73.7 % in tDCS, and 72.7 % in combined therapy groups. Mean THI scores decreased significantly from 54.3 ± 22.8 to 37.7 ± 19.7 (<em>p</em> &lt; 0.01). The combined therapy group showed superior anxiety reduction (HAD-A, <em>p</em> = 0.034) compared to single modalities. Both tDCS and combined therapy demonstrated greater improvements in multiple psychological measures compared to counseling alone.</div></div><div><h3>Conclusion</h3><div>Combined tDCS and counseling therapy shows enhanced efficacy in managing chronic tinnitus, particularly for patients with concurrent anxiety symptoms. This multimodal approach may provide a more comprehensive treatment strategy than single modalities alone. Future randomized controlled trials are needed to confirm these findings and establish optimal treatment protocols.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104699"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144696702","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":"Efficacy of auricular vagus nerve stimulation for globus pharyngeus: A prospective pilot study","authors":"Chao Hang ,&nbsp;Xiangming Meng","doi":"10.1016/j.amjoto.2025.104714","DOIUrl":"10.1016/j.amjoto.2025.104714","url":null,"abstract":"<div><h3>Purpose</h3><div>Globus pharyngeus (persistent “lump in the throat” sensation) is a common, often benign condition with unclear etiology and limited treatment options. This study aimed to evaluate the efficacy of transcutaneous auricular vagus nerve stimulation (taVNS) in reducing globus symptoms in affected patients.</div></div><div><h3>Methods</h3><div>We conducted a prospective single-arm trial at a tertiary care center. Adult patients with GP received taVNS therapy once daily for 30 min over a two-week period. Stimulation was delivered via an electrode placed on the auricular branch of the vagus nerve. Symptom severity was assessed using the Laryngopharyngeal Measure of Perceived Sensation (LUMP) questionnaire. Anxiety and depression were assessed using the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). Pre- and post-treatment scores were compared using paired nonparametric or <em>t</em>-tests, as appropriate. Subgroup analyses were conducted in patients with baseline anxiety or depression, defined as a SAS or SDS score ≥ 50.</div></div><div><h3>Results</h3><div>A total of 35 patients completed the trial (mean age 51.4 ± 10.9 years), of whom 28 (80 %) were female. All patients tolerated the taVNS protocol well, and no serious adverse effects were reported. There was a significant reduction in globus symptom severity following treatment: the median LUMP score decreased from 10 (IQR 7.5–15) at baseline to 5 (IQR 3–9) post-treatment (<em>p</em> &lt; 0.001). Mean anxiety and depression scores also decreased (SAS: 46.0 ± 8.4 to 43.0 ± 7.7, <em>p</em> = 0.002; SDS: 49.5 ± 11.7 to 44.7 ± 9.4, <em>p</em> = 0.005). Subgroup analyses indicated that mood-related improvements were confined to participants with baseline anxiety (−5.6 points; <em>p</em> = 0.008) or depression (−9.3 points; <em>p</em> = 0.001), while no significant changes were observed in those without baseline emotional symptoms.</div></div><div><h3>Conclusion</h3><div>taVNS significantly reduced globus pharyngeus symptoms and improved anxiety and depression scores, especially in patients with baseline emotional distress. These findings support the potential of taVNS as a well-tolerated neuromodulation approach for managing globus and warrant further validation in controlled trials.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104714"},"PeriodicalIF":1.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738297","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":"Analysis of adverse reaction characteristics of four biologics for the treatment of chronic sinusitis with nasal polyps: A descriptive analysis from WHO-VigiAccess","authors":"Xiaobi Fang ,&nbsp;Tingfeng Zhou ,&nbsp;Fan Ye","doi":"10.1016/j.amjoto.2025.104705","DOIUrl":"10.1016/j.amjoto.2025.104705","url":null,"abstract":"<div><h3>Background</h3><div>Chronic rhinosinusitis with nasal polyps (CRSwNP) imposes a significant global disease burden. However, systematic comparisons of adverse drug reaction (ADR) profiles among these agents remain scarce, necessitating large-scale pharmacovigilance evaluation.</div></div><div><h3>Methods</h3><div>Utilizing the WHO VigiAccess database, we analyzed 402,778 ADR reports for four biologics—omalizumab, dupilumab, mepolizumab, and tezepelumab. Descriptive statistics and disproportionality analyses (reporting odds ratio [ROR], proportional reporting ratio [PRR]) were performed to identify safety signals across 27 system organ classes (SOCs). Severity stratification included fatal, hospitalization-requiring, and major adverse events.</div></div><div><h3>Results</h3><div>Females accounted for 56.08 %–65.80 % of reports, with geographic disparities (Americas: 70.91 %–91.98 %). Temporal trends revealed surging reports for newer agents (dupilumab: 26.62 % in 2024) versus declining rates for older therapies (omalizumab: 44.71 % pre-2019). Distinct SOC patterns emerged: dupilumab dominated cutaneous (24.40 %) and ocular ADRs (ROR = 6.51), while omalizumab showed elevated pregnancy-related risks (ROR = 12.15). Mepolizumab exhibited a 4.6-fold higher severe event incidence (1.81 %) versus dupilumab (0.39 %). Tezepelumab demonstrated unique musculoskeletal ADRs (10.02 %) and cardiac risks (ROR = 3.21).</div></div><div><h3>Conclusions</h3><div>This study delineates agent-specific ADR profiles tied to mechanistic targets, advocating for tailored monitoring strategies. Findings underscore the imperative for risk-stratified biologic selection in CRSwNP management, supported by ongoing pharmacovigilance and mechanistic investigations.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104705"},"PeriodicalIF":1.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144750762","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":"Outcomes after radiofrequency neurolysis of the posterior nasal nerve for treating Chinese adults with moderate to severe allergic rhinitis","authors":"Jibin Huang,&nbsp;Ming Xu,&nbsp;Jiayan Wang,&nbsp;Di Wu","doi":"10.1016/j.amjoto.2025.104708","DOIUrl":"10.1016/j.amjoto.2025.104708","url":null,"abstract":"<div><h3>Background</h3><div>Temperature-controlled radiofrequency ablation (TCRA) represents a minimally invasive alternative to surgical posterior nasal neurectomy for the management of allergic rhinitis (AR). However, to date, the impact of this minimally invasive operation on Chinese adult individuals suffering from AR remains unclear.</div></div><div><h3>Objectives</h3><div>To assess the safety and efficacy of TCRA for the treatment of perennial moderate and severe AR in Chinese adults.</div></div><div><h3>Methods</h3><div>This retrospective case-control study included 48 consecutive patients assigned to two groups: one received TCRA and the other received posterior nasal neurectomy (PNN). Follow-up assessments were conducted at 11–13 months post-surgery. The reflective total nasal symptom score (rTNSS), total non-nasal symptom score (rTNNSS), total rhinitis medication score (TRMS), and total nasal resistance were measured both preoperatively and postoperatively.</div></div><div><h3>Results</h3><div>At the tertiary endpoint, the TCRA group demonstrated an 73.1 % improvement in rTNSS compared to baseline, while the PNN group showed a 74.0 % improvement. However, the mean change in rTNNSS at the tertiary endpoint was 72.7 % for the TCRA group and 73.1 % for the PNN group. The mean change in TRMS from baseline to the tertiary endpoint was 68.8 % for the TCRA group and 70.9 % for the PNN group. TCRA yielded a striking 62.5 % reduction in total nasal resistance. Notably, a positive linear correlation was observed between the subjective and objective assessments of nasal resistance at baseline, the secondary and the tertiary endpoints.</div></div><div><h3>Conclusion</h3><div>The findings suggest that the minimally invasive TCRA technique, as a safe and effective surgical procedure, can provide a novel and superior alternative to PNN for Chinese adults with AR.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104708"},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144702647","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":"Correspondence: Use of ChatGPT for patient education involving HPV-associated oropharyngeal cancer","authors":"Hinpetch Daungsupawong ,&nbsp;Viroj Wiwanitkit","doi":"10.1016/j.amjoto.2025.104697","DOIUrl":"10.1016/j.amjoto.2025.104697","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104697"},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656552","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":"Annotating risk stratification of thyroid nodules: Assessing the suitability of ChatGPT for text-based analysis in thyroidology","authors":"Ilker Sengul ,&nbsp;Demet Sengul","doi":"10.1016/j.amjoto.2025.104696","DOIUrl":"10.1016/j.amjoto.2025.104696","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104696"},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656553","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}