American Journal of Otolaryngology最新文献

{"title":"Comparison of myringoplasty techniques for eardrum perforations","authors":"Chappel Pettit,&nbsp;Shelby Barrera,&nbsp;Boris Kuyeb,&nbsp;Joshua Stanford,&nbsp;Oishika Paul,&nbsp;Jeffrey Carron","doi":"10.1016/j.amjoto.2025.104662","DOIUrl":"10.1016/j.amjoto.2025.104662","url":null,"abstract":"<div><h3>Purpose</h3><div>This retrospective study aims to analyze and compare the surgical outcomes and efficacy of different myringoplasty techniques, specifically focusing on Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft. The objective is to provide insights into the success rates and associated factors for each method in pediatric patients undergoing myringoplasty.</div></div><div><h3>Materials and methods</h3><div>The study included patients under 18 years who underwent myringoplasty between 2014 and 2022. Data was collected on patient demographics, perforation size and location, etiology, age at myringoplasty, technique used, operative time, and postoperative outcomes.</div></div><div><h3>Results</h3><div>Out of 561 myringoplasties, 325 met study criteria with an average age of 7 years. Gelfoam overlay (39 %), Gelfoam-stuffed (51 %), and fat graft (10 %) were the techniques analyzed. Overall, 96.3 % of cases were successful, with no significant differences among the three techniques. Postoperatively, 17.7 % had perforation, 13.8 % had otorrhea, and 2.1 % required additional surgery. Fat grafts associated with significantly longer operative times and were more likely to be done for persistent perforations rather than retained ear tubes.</div></div><div><h3>Conclusion</h3><div>This study demonstrates comparable efficacy among Gelfoam-stuffed graft, Gelfoam overlay graft, and fat graft myringoplasty techniques in pediatric patients. While surgical time differed, there were no clinically significant variations in postoperative outcomes. Despite limitations, these findings suggest that all three techniques are viable options, allowing otolaryngologists flexibility in choosing myringoplasty methods based on patient characteristics and clinical considerations.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104662"},"PeriodicalIF":1.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943425","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 short-term longitudinal study of vocal development in young children with simultaneous bilateral cochlear implants","authors":"Youngmee Lee ,&nbsp;Yesol Jeon","doi":"10.1016/j.amjoto.2025.104648","DOIUrl":"10.1016/j.amjoto.2025.104648","url":null,"abstract":"<div><h3>Objectives/hypothesis</h3><div>Vocal development is crucial for children's speech and language acquisition, allowing them to produce sounds, form words, and construct sentences for verbal communication. This study examined the vocal development trajectory in children who received early simultaneous bilateral cochlear implants (CIs) and compared it to age-matched children with typical hearing (TH).</div></div><div><h3>Study design</h3><div>Case-control study design.</div></div><div><h3>Methods</h3><div>Participants included nine children who received simultaneous bilateral CIs between 7 and 20 months of age and eight age-matched children with TH. Parent-child play interactions were video- and audio-recorded at 6-month intervals. Child vocalizations were categorized into four categories: noncanonical babbling, canonical babbling, words, and sentences. Developmental trajectories and group differences were analyzed over three points: initial visit, 6 months, and 12 months after the initial visit (mean age at the first session: 19.76 months; standard deviation: 4.89; range: 12–28 months).</div></div><div><h3>Results</h3><div>Both groups showed an increase in total vocalizations and advanced forms over 1 year. However, the CI group produced a significantly lower proportion of words and sentences and a higher proportion of noncanonical babbling than the TH group.</div></div><div><h3>Conclusions</h3><div>Although children with early-identified hearing loss and simultaneous bilateral CIs make significant progress in vocal development, their vocal milestones remain delayed compared to those of their peers with TH. These children do not fully catch up in vocal development within 1 to 2 years of bilateral CI use. These findings highlight the need for targeted support and early intervention for children with CIs and their parents.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104648"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943424","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":"Laryngeal mask airway in pediatric tonsillectomy and adenoidectomy: a large cohort analysis","authors":"Travis Peng ,&nbsp;Matthew I. Saleem ,&nbsp;Michelle S. Kars ,&nbsp;Lee P. Smith","doi":"10.1016/j.amjoto.2025.104641","DOIUrl":"10.1016/j.amjoto.2025.104641","url":null,"abstract":"<div><div>Tonsillectomy and/or adenoidectomy are often performed with endotracheal intubation (ETT), however use of laryngeal mask airway (LMA) may offer decreased airway irritation. We investigated the laryngospasm rate and conversion rate of LMA use in a total of 1585 retrospective cases of tonsillectomies and/or adenoidectomies, the largest single center cohort to date. We found a low complication rate of 0.19 % and no significant clinical complications. Our study provides data on the safety and efficacy of LMA use in these surgeries and supports the potential use of LMA in cases without significant blood loss.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104641"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916553","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":"Olfactory and gustatory impairment in systemic cardiac amyloidosis: a prospective case-control study","authors":"Clémentine Hyvrard ,&nbsp;Maxime Fieux ,&nbsp;Thibaud Damy ,&nbsp;Marina Dockes ,&nbsp;Marion Renaud ,&nbsp;Julien Lucas ,&nbsp;Axelle Coban ,&nbsp;Margaux Petitjean ,&nbsp;Nisrine Khemies ,&nbsp;Florence Canouï-Poitrine ,&nbsp;Imene Nouri ,&nbsp;Mounira Kharoubi ,&nbsp;André Coste ,&nbsp;Emilie Bequignon ,&nbsp;Sophie Bartier","doi":"10.1016/j.amjoto.2025.104665","DOIUrl":"10.1016/j.amjoto.2025.104665","url":null,"abstract":"<div><h3>Purpose</h3><div>Amyloidosis is a multi-systemic disease with a poor prognosis. We hypothesized that amyloid proteins could deposit along the olfactory and gustatory systems and cause olfactory and gustatory impairment. The objective was to assess the prevalence of olfactory and gustatory disorders in a population of patients diagnosed with cardiac amyloidosis (CA).</div></div><div><h3>Methods</h3><div>CA patients from three amyloid subtypes (hereditary or wild-type transthyretin (ATTRv and ATTRwt) and light chain (AL)) and a control group of patients with chronic non-amyloidotic heart failure were enrolled prospectively in this case-control study. Nasal endoscopy, olfactory and gustatory questionnaires, “shortened Sniffin’ Sticks” test (sSST) and Taste Band Strips test were performed.</div></div><div><h3>Results</h3><div>Thirty-eight CA patients (mean age of 80.8 +/− 8.6 years; 65.8 % males) and 13 control patients (mean age of 63.2 +/− 16.4 years; 53.8 % males) were included. The mean total score on the sSST for CA patients was significantly lower than that of the control group (15.4±6.2 vs 20.3 +/− 5.3, respectively, <em>p</em> = 0.02). Five out of 38 (13.1 %) CA patients were complaining of dysosmia compared to 3/13 (23.1 %) patients in the control group. Taste impairment was noted in 24/37 (64.9 %) CA patients vs 6/12 (50 %) patients in the control group (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study comparing olfactory function of CA patients to chronic non-amyloidotic heart failure patients found that CA patients had significantly more olfactory impairments. Olfactory impairments could therefore be a new “red flag” that may help in early diagnosis and treatment of CA.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104665"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898701","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":"Refining necrotising otitis externa management: A follow-up study on a departmental algorithm and the role of nuclear medicine imaging","authors":"A.H. Haleem ,&nbsp;S. Shahidi ,&nbsp;J.M. Hilton ,&nbsp;M. Pringle ,&nbsp;T.C. Biggs ,&nbsp;J. Buckland","doi":"10.1016/j.amjoto.2025.104659","DOIUrl":"10.1016/j.amjoto.2025.104659","url":null,"abstract":"<div><h3>Objective</h3><div>This study evaluates the effectiveness of a departmental diagnostic and treatment algorithm for necrotising otitis externa (NOE), with a particular focus on the role of nuclear medicine imaging in improving diagnostic accuracy and patient outcomes.</div></div><div><h3>Methods</h3><div>A retrospective cohort analysis was conducted on patients admitted with suspected NOE to a major UK general hospital over a two-year period. Clinical presentation, imaging modalities, and treatment outcomes were reviewed to assess the algorithm's impact, with a focus on the diagnostic yield of CT, Technetium scans, and MRI, as well as treatment success rates and recurrence.</div></div><div><h3>Results</h3><div>Among 33 patients (mean age: 77 years), 28 were diagnosed with necrotising otitis externa (NOE). Diabetes was present in 41 %, and <em>Pseudomonas aeruginosa</em> was identified in 70 % of cases.</div><div>CT confirmed NOE in 21 patients (64 %), including two with skull base erosion. Among 12 patients with negative CT findings, 9 underwent Technetium bone scintigraphy, with 5 (56 %) yielding positive results. Two patients underwent MRI, confirming NOE in one case. One patient was diagnosed clinically. Overall, 6 of 12 patients (50 %) with negative CT results were ultimately diagnosed with NOE following further imaging.</div><div>All 28 diagnosed patients received prolonged intravenous or oral antibiotic therapy based on microbiological sensitivity. Of these, 24 had follow-up (mean: 5.6 weeks), with clinical resolution observed in 20 patients (83 %). Additional imaging was performed in 13 cases, including MRI (<em>n</em> = 4), CT (<em>n</em> = 5), Gallium scan (<em>n</em> = 1), PET-CT (n = 1), and combined CT/MRI (<em>n</em> = 2), primarily for persistent symptoms. Four patients were diagnosed with alternative conditions, including canal cholesteatoma and squamous cell carcinoma.</div><div>Overall, the cure rate within the cohort was 83 %, with no NOE recurrences or NOE-related mortality recorded during the follow-up period.</div></div><div><h3>Conclusion</h3><div>This study validates the efficacy of the department's updated NOE diagnostic and treatment algorithm, reinforcing the utility of technetium bone scans in cases where CT results are inconclusive. Findings highlight the importance of combining advanced imaging with clinical assessment for optimal NOE management, ensuring high-resolution rates and preventing unnecessary interventions.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104659"},"PeriodicalIF":1.8,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917422","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":"Lymph node ratio as an independent prognostic factor in cN0 floor of mouth squamous cell carcinoma: A single-institution retrospective cohort analysis","authors":"Duy Quoc Ngo ,&nbsp;Thang Manh Hoang ,&nbsp;Trong Van Nguyen ,&nbsp;Quy Xuan Ngo","doi":"10.1016/j.amjoto.2025.104644","DOIUrl":"10.1016/j.amjoto.2025.104644","url":null,"abstract":"<div><h3>Background</h3><div>To analyze the influence of lymph node ratio (LNR) in survival of clinically node-negative (cN0) patients with floor of mouth squamous cell carcinoma (FMSCC).</div></div><div><h3>Materials and methods</h3><div>Clinicopathologic data from 48 patients with cN0 FMSCC who underwent curative surgery and selective neck dissection from 2015 to 2020 was retrospectively assessed. The impact of LNR and other variables on overall survival (OS) and disease-free survival (DFS) was analyzed in univariate and multivariate analyses.</div></div><div><h3>Results</h3><div>Occult nodal metastases were identified in 11 patients (22.9 %). The mean lymph node yield was 13.94 ± 7.11 nodes. ROC curve analysis identified an optimal LNR threshold of 0.034, with an area under the curve of 0.691 (<em>p</em> = 0.03). In the multivariate analysis, LNR was an independent prognostic factor for both OS (HR 9.018, 95 % CI 3.214–25.306, <em>p</em> &lt; 0.001) and DFS (OR 12.889, 95 % CI 2.426–68.473, <em>p</em> = 0.002). Patients with LNR &gt;0.034 demonstrated significantly inferior 5-year OS rates (26.7 % versus 89.1 %).</div></div><div><h3>Conclusions</h3><div>The LNR is an independent prognostic factor in cN0 FMSCC patients. An LNR threshold of 0.034 effectively stratifies risk and may guide adjuvant therapy decisions.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104644"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143902244","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":"Effectiveness of 3D animation tools in patient education on cochlear implantation","authors":"Nienke C. Homans BsC,&nbsp;Jantien L. Vroegop,&nbsp;Robert J. Pauw,&nbsp;Hylke F.E. van der Toom","doi":"10.1016/j.amjoto.2025.104653","DOIUrl":"10.1016/j.amjoto.2025.104653","url":null,"abstract":"<div><h3>Purpose</h3><div>Video animations have emerged as effective tools for patient education across various medical fields. Although evidence is mixed, animations show promise in enhancing comprehension, especially in fields like audiology, where verbal communication can be challenging, and the benefits may be even higher. This study explores whether 3D video animations improve patient education during the cochlear implantation (CI) selection process.</div></div><div><h3>Materials and methods</h3><div>A prospective cohort study was conducted at the Cochlear Implant Center, Erasmus University Medical Center, Rotterdam. Forty-six adult patients were included in the study and divided into two groups: one receiving the standard CI selection process and the other receiving the same process with additional 3D video animations. Participants completed a questionnaire assessing their knowledge, self-assessment of their knowledge, and satisfaction. The group with animations also answered additional questions about their experience with the animations.</div></div><div><h3>Results</h3><div>The group receiving the videos reported significantly higher self-assessment knowledge scores, particularly regarding rehabilitation. However, there were no significant differences in objective knowledge scores between the two groups. Satisfaction with the videos was high, with most participants sharing them with family and friends.</div></div><div><h3>Conclusion</h3><div>3D video animations enhanced patients' self-perceived knowledge, particularly regarding rehabilitation, but did not significantly improve actual knowledge scores. The findings suggest that video animations are a promising tool for patient education in the CI selection process and warrant further investigation with larger sample sizes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104653"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143911550","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":"Cost evaluation in head and neck cancer clinical trials: implications for high-value care","authors":"Rachel G. Collins ,&nbsp;Ina A. Lee ,&nbsp;Daniel R.S. Habib ,&nbsp;Desmond C. Garner ,&nbsp;Douglas B. Johnson ,&nbsp;Priyesh N. Patel ,&nbsp;Michael C. Topf","doi":"10.1016/j.amjoto.2025.104655","DOIUrl":"10.1016/j.amjoto.2025.104655","url":null,"abstract":"<div><h3>Background</h3><div>Clinical trials are crucial in advancing novel therapeutic interventions for head and neck cancer. Given the increased cost of modern healthcare, cost considerations in clinical trials are important yet remain limited.</div></div><div><h3>Methods</h3><div>A search of <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identified all head and neck cancer studies including cost in the trial description or as a study outcome. Data collected included study type, duration, completion status, enrollment, funding type, cost outcomes, and cost-effectiveness analyses.</div></div><div><h3>Results</h3><div>Among 2290 head and neck cancer-focused clinical trials, only 76 (3.3 %) mentioned cost in any capacity. Among the trials mentioning cost, 53 (70 %) included cost outcomes and 26 (34 %) included cost effectiveness analyses. Cost was reported as a primary outcome in 5 (0.2 %) clinical trials, a secondary outcome in 32 (1.4 %) trials, and an exploratory outcome in 16 (0.7 %) trials. Most trials (87 %) were interventional, and the most common primary interventions were procedures (25 %) or drugs (14 %). The mean enrollment was 206 participants, and mean duration of the trials was 50 months (SD 47). 73 (96 %) studies have not yet reported results.</div></div><div><h3>Conclusion</h3><div>The inclusion of cost in head and neck cancer clinical trials is limited, with &lt;3 % of trials including cost endpoints and &lt; 2 % including cost-effectiveness analyses. The paucity of available study results hinders the assessment of the ultimate impact on patients, insurance companies, and healthcare systems. Given the rising cost pressures in modern healthcare systems, the low prevalence of cost endpoints and cost-effectiveness analyses underscores the need for increased awareness and investment in this domain.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104655"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143916552","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 on “Comparison of glucocorticoids combined with antiviral drugs versus glucocorticoids alone in the management of Bell's Palsy: A systematic review and meta-analysis of randomized clinical trials”","authors":"Nosaibah Razaqi ,&nbsp;Rachana Mehta ,&nbsp;Shubham Kumar ,&nbsp;Ranjana Sah","doi":"10.1016/j.amjoto.2025.104629","DOIUrl":"10.1016/j.amjoto.2025.104629","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104629"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895334","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":"Acetazolamide use in postoperative CSF leak prevention: A literature review","authors":"Evan A. Patel ,&nbsp;Anthony M. Saad ,&nbsp;Peter Filip ,&nbsp;Andrey Filimonov","doi":"10.1016/j.amjoto.2025.104656","DOIUrl":"10.1016/j.amjoto.2025.104656","url":null,"abstract":"<div><h3>Background</h3><div>Acetazolamide, a carbonic anhydrase inhibitor and commonly utilized diuretic, has been found to decrease cerebrospinal fluid (CSF) production, leading to its use in the prevention of postoperative CSF leaks. Despite its widespread use, the efficacy and optimal protocols for acetazolamide in this context remain poorly defined. This systematic review aims to elucidate the role of acetazolamide in preventing postoperative and traumatic CSF leaks.</div></div><div><h3>Methods</h3><div>A systematic review was performed in Covidence adhering to PRISMA Guidelines. A search of PubMed, SCOPUS, and CINAHL for literature published through July 2023 identified 215 unique publications related to acetazolamide use in preventing postoperative CSF leaks. Full texts were independently screened by two authors, with discrepancies resolved by third reviewer. 15 publications were selected and categorized into themes including postoperative CSF leak prevention, trauma management, dosage optimization, and adverse effects.</div></div><div><h3>Results</h3><div>Of the fifteen articles, twelve focused on the role of acetazolamide in preventing postoperative CSF leaks, highlighting its effectiveness in reducing leak rates following neurosurgical and otolaryngological procedures. Themes discussed in the remaining six articles included acetazolamide's role in managing intracranial hypertension in trauma patients, optimal dosing strategies, and the spectrum of side effects ranging from mild to severe.</div></div><div><h3>Conclusion</h3><div>Acetazolamide shows promise in the prevention of postoperative CSF leaks and in certain trauma contexts. However, further studies should establish standardized protocols and optimize dosing regimens. Future research should also focus on long-term outcomes and the management of adverse effects to fully elucidate the benefits and limitations of acetazolamide in these clinical settings.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104656"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887383","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}