American Journal of Otolaryngology最新文献

{"title":"Efficacy and safety of laser ablation and microwave ablation to treat papillary thyroid microcarcinoma: A retrospective study","authors":"Yuqing Huang ,&nbsp;Xinyu Zhao ,&nbsp;Yu Yang ,&nbsp;Lanyan Qiu ,&nbsp;Junfeng Zhao ,&nbsp;Linxue Qian ,&nbsp;Xianquan Shi","doi":"10.1016/j.amjoto.2024.104496","DOIUrl":"10.1016/j.amjoto.2024.104496","url":null,"abstract":"<div><h3>Objective</h3><p>To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC).</p></div><div><h3>Methods</h3><p>This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed.</p></div><div><h3>Results</h3><p>Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, <em>P</em> &lt; 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (<em>P</em> = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (<em>P</em> &gt; 0.05).</p></div><div><h3>Conclusion</h3><p>During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104496"},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021389","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":"Is video interpretation compromising care for the hearing loss population?","authors":"Julianna Mastropierro ,&nbsp;Ritwik Sanyal ,&nbsp;Alyssa Heiser ,&nbsp;Emily Gjini ,&nbsp;Kathryn Noonan","doi":"10.1016/j.amjoto.2024.104499","DOIUrl":"10.1016/j.amjoto.2024.104499","url":null,"abstract":"<div><h3>Objective</h3><p>The convergence of hearing impairment and language barriers presents unique communication challenges to patients and practicing otolaryngologists. Limited data exist comparing interpretation methods for patients with hearing loss. Patients with hearing loss rely on visual cues, lip-reading, written communication, and/or comprehensive interaction techniques, which may encounter limitations by remote services. Herein, we examine patient and otolaryngology provider satisfaction, cost, and encounter efficiency between virtual and in-person interpretation among adults who speak Mandarin and Cantonese.</p></div><div><h3>Methods</h3><p>This study is a prospective, randomized controlled trial in patients with moderate-to-severe bilateral hearing loss, Limited English Proficiency, and a primary language of Mandarin or Cantonese. Fifty-two patients were randomized to either in-person or virtual interpretation conditions. Patient satisfaction was measured using an 8-item Likert scale assessing communication effectiveness, encounter efficiency, and overall quality. Otolaryngology provider satisfaction was measured using a 1-item Likert scale. Encounter time, cost, and communication difficulty were measured and compared using independent sample <em>t</em>-tests.</p></div><div><h3>Results</h3><p>Patient and otolaryngology provider satisfaction scores were significantly higher with in-person interpretation (<em>p</em> &lt; 0.05 for 7 of 8 patient items; physician mean score 4.9, <em>p</em> &lt; 0.001, <em>r</em> = 0.54) compared to virtual interpretation (physician mean 3.8) conditions, while overall quality of the encounter remained the same. There was no significant difference in the length of encounters or in the number of times patients requested interpreter repetition between groups. A difference in average cost existed for in-person interpretation ($14.50) compared to video interpretation ($25) services for an average length appointment.</p></div><div><h3>Conclusion</h3><p>Patients and otolaryngologists reported higher overall satisfaction with in-person compared to virtual interpretation services. In-person interpretation yielded better comprehension in the hearing loss population among Mandarin and Cantonese-speaking patients and demonstrated a cost advantage over virtual interpretation.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104499"},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006720","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 antibiotic resistant infections associated with hirudotherapy","authors":"Philip R. Brauer ,&nbsp;Malaak Saadah ,&nbsp;Michael A. Fritz ,&nbsp;Shannon S. Wu ,&nbsp;Eric D. Lamarre","doi":"10.1016/j.amjoto.2024.104500","DOIUrl":"10.1016/j.amjoto.2024.104500","url":null,"abstract":"<div><h3>Objective</h3><p>Given rising concern regarding antibiotic resistance, our objective was to evaluate antibiotic-resistant infections following leech therapy and to characterize the use of prophylactic antibiotics.</p></div><div><h3>Methods</h3><p>All reports of adverse events involving hirudotherapy (product code “NRN”) were retrieved from the U.S. Food and Drug Administration MAUDE database between 2012 and 2021. Antibiotic resistance was defined by bacterial culture or infection after antibiotic administration.</p></div><div><h3>Results</h3><p>Nineteen cases of antibiotic resistance involving hirudotherapy were identified. Only three cases of antibiotic resistance were discovered on routine testing and the remaining 16 cases were associated with patient injury. Positive blood cultures or fever were present in 26.3 % (<em>n</em> = 5) of cases. Cultures of the infection grew Aeromonas hydrophilia (<em>n</em> = 13; 68.4 %), <em>Vibrio vulnificus</em> (<em>n</em> = 3; 15.8 %), <em>Pseudomonas aeruginosa</em> (<em>n</em> = 2; 10.5 %), and <em>Proteus vulgaris</em> (<em>n</em> = 1; 5.3 %). There were nine (47.4 %) multi-drug resistant infections. Infection was most commonly resistant to fluoroquinolones (<em>n</em> = 9; 47.4 %), trimethoprim-sulfamethoxazole (n = 9; 47.4 %) and ertapenem (<em>n</em> = 4; 21.1 %).</p></div><div><h3>Conclusion</h3><p>Antibiotic-resistant infections involving hirudotherapy are frequently resistant to multiple drugs, including fluoroquinolones and trimethoprim-sulfamethoxazole. Resistance to ertapenem, a drug of last resort, was also documented. The findings presented in this study support growing literature that the trend in multi-drug resistance is more severe than previously reported.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104500"},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087878","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 influence of tinnitus frequency on patients experiencing subjective tinnitus and the efficacy and prognosis of acoustic therapy","authors":"Juan Li,&nbsp;Yu Zhang,&nbsp;Yuqin Chen,&nbsp;Songli Xi,&nbsp;Song Shi,&nbsp;Cong Li,&nbsp;Tiantian Su","doi":"10.1016/j.amjoto.2024.104498","DOIUrl":"10.1016/j.amjoto.2024.104498","url":null,"abstract":"<div><h3>Objective</h3><p>This study examines the therapeutic impact and prognosis of acoustic therapy in patients with chronic subjective tinnitus across different tinnitus frequencies.</p></div><div><h3>Methods</h3><p>A total of 135 patients with subjective tinnitus were selected and categorized based on their primary tone frequency into three groups: high frequency (43 patients, 4–8 kHz), mid frequency (40 patients, 1–3 kHz), and low frequency (42 patients, &lt; 1 kHz). All patients received acoustic therapy customized to their specific frequency and loudness levels, along with tinnitus cognitive behavioral therapy. Changes in tinnitus loudness and efficacy rates before and after treatment in the different groups, as well as before and after tinnitus cognitive behavioral therapy were evaluated and assessed.</p></div><div><h3>Results</h3><p>The low frequency group showed a statistical improvement in tinnitus loudness compared to the mid and high frequency groups (<em>P</em> &lt; 0.05). The efficacy rate was 93.55 % in the low frequency group, 82.88 % in the mid frequency group, and 58.82 % in the high frequency group. The efficacy rate in the low frequency group was significantly higher than in the high frequency group, but there was no statistical difference when compared to the mid frequency group.</p></div><div><h3>Conclusion</h3><p>The frequency of tinnitus in patients with chronic subjective tinnitus might be a key factor affecting treatment effectiveness and could account for the differences in treatment outcomes among patients.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104498"},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040271","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":"Individualized sublingual immunotherapy with dynamic maintenance dose ascending for house dust mite-induced allergic rhinitis","authors":"Juan Wang ,&nbsp;Ling Cai ,&nbsp;Caiqin Huang ,&nbsp;Jing Pei,&nbsp;Xinyi Shi,&nbsp;Yuejin Tao","doi":"10.1016/j.amjoto.2024.104476","DOIUrl":"10.1016/j.amjoto.2024.104476","url":null,"abstract":"<div><h3>Background</h3><p>Precision dosing in sublingual immunotherapy (SLIT) has become a hotspot gradually, yet no standardized dose adjustment pattern for house dust mite (HDM)-SLIT. This study aims to investigate the clinical feasibility of the dynamic maintenance dose ascending regimen for individualized SLIT.</p></div><div><h3>Methods</h3><p>A total of 258 allergic rhinitis (AR) patients treated with HDM-SLIT were included in this retrospective study. Patients were divided into the regular dose (RD) group (<em>n</em> = 101) and the high dose (HD) group (<em>n</em> = 157) according to different maintenance dosages of SLIT. In the RD group, patients received the fixed dose recommended by the manufacturer. In the HD group, patients received a maximum tolerance dose determined by dynamic dose ascending. The clinical efficacy was evaluated by combined symptom and medication score (CSMS) and visual analogue scale score (VAS) at the baseline, 0.5-year, 1-year, and 2-year. The safety was evaluated by adverse events (AEs).</p></div><div><h3>Results</h3><p>Significant reductions of CSMS and VAS at 0.5-year, 1-year, and 2-year were observed in both the RD group and the HD group compared to the baseline (<em>P</em> &lt; 0.05). In addition, greater improvements in these clinical parameters from 0.5- to 2-year were found in the HD group compared to the RD group (<em>P</em> &lt; 0.05). For subgroup analysis in the HD group, no significant differences in CSMS and VAS were observed among subgroups of patients &lt;14 years old and patients ≥14 years old (<em>P</em> &gt; 0.05). No serious AEs in the two groups and no significant differences were observed between the AE incidence rate of the RD group and HD group during the incremental and maintenance phases.</p></div><div><h3>Conclusions</h3><p>The 2-year HDM-SLIT with dynamic maintenance dose ascending regimen offers an “optimal” treatment for AR patients while maintaining safety. This study introduced a pattern for individualized dose adjustment in clinical practice, offering potential benefits for AR patients.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104476"},"PeriodicalIF":1.8,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142008130","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 blood transfusion and outcomes of free flap head and neck cancer surgery","authors":"Kenzo M. Cotton ,&nbsp;Andrew R. Mangan ,&nbsp;James R. Gardner ,&nbsp;Aryan Shay ,&nbsp;Deanne King ,&nbsp;Emre A. Vural ,&nbsp;Mauricio Moreno-Vera ,&nbsp;Geoffrey Muller ,&nbsp;Jumin Sunde","doi":"10.1016/j.amjoto.2024.104497","DOIUrl":"10.1016/j.amjoto.2024.104497","url":null,"abstract":"<div><h3>Objective</h3><p>Investigate the impact of patient risk factors and blood transfusions in Head and Neck free flap surgeries.</p></div><div><h3>Study design</h3><p>Retrospective chart review.</p></div><div><h3>Setting</h3><p>Single tertiary referral center.</p></div><div><h3>Methods</h3><p>400 patients were included undergoing free flap reconstruction from 2014 to 2020. The primary outcome measures were red blood cell transfusion and volume transfused. Race, sex, flap location and tissue type, pathology, dependent functional status, length of stay, and cancer recurrence were evaluated for association with red blood cell transfusion intraoperatively and/or postoperatively. Transfusions were indicated on patients with Hemoglobin &lt;7–8 and/or symptomatic anemia. ANOVA and Chi² statistical analysis were performed. The significance was set at <em>p</em> ≤0.05.</p></div><div><h3>Results</h3><p>Of the 400 patients included, 58 required red blood cell transfusion. Of these 67.8 % were males, racial demographics included 9.00 % African American, 1.30 % Asian, 1.00 % Hispanic/Latino, 87.8 % White, 1.00 % other. African American patients received a higher volume of transfused red blood cells versus white patients (855.00 mL vs. 437.07 mL, <em>p</em> = 0.005). Length of stay was significantly associated with red blood cell transfusion (5.95 days vs. 7.22 days, <em>p</em> ≤0.001). Dependent functional status and need for red blood cell transfusion were associated (<em>p</em> = 0.002). Type of free flap was associated with need for red blood cell transfusion (<em>p</em> ≤0.001) with anterolateral thigh flaps being the most common resulting in transfusion (34/58).</p></div><div><h3>Conclusion</h3><p>Red blood cell transfusion was significantly associated with race, dependent functional status and length of stay. Certain free flaps have a higher risk of blood transfusion.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104497"},"PeriodicalIF":1.8,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141992855","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 lightweight intelligent laryngeal cancer detection system for rural areas","authors":"Yi-Fan Kang ,&nbsp;Lie Yang ,&nbsp;Kai Xu ,&nbsp;Bin-Bin Hu ,&nbsp;Lan-Jun Cai ,&nbsp;Yin-Hao Liu ,&nbsp;Xiang Lu","doi":"10.1016/j.amjoto.2024.104474","DOIUrl":"10.1016/j.amjoto.2024.104474","url":null,"abstract":"<div><h3>Objective</h3><p>Early diagnosis of laryngeal cancer (LC) is crucial, particularly in rural areas. Despite existing studies on deep learning models for LC identification, challenges remain in selecting suitable models for rural areas with shortages of laryngologists and limited computer resources. We present the intelligent laryngeal cancer detection system (ILCDS), a deep learning-based solution tailored for effective LC screening in resource-constrained rural areas.</p></div><div><h3>Methods</h3><p>We compiled a dataset comprised of 2023 laryngoscopic images and applied data augmentation techniques for dataset expansion. Subsequently, we utilized eight deep learning models—AlexNet, VGG, ResNet, DenseNet, MobileNet, ShuffleNet, Vision Transformer, and Swin Transformer—for LC identification. A comprehensive evaluation of their performances and efficiencies was conducted, and the most suitable model was selected to assemble the ILCDS.</p></div><div><h3>Results</h3><p>Regarding performance, all models attained an average accuracy exceeding 90 % on the test set. Particularly noteworthy are VGG, DenseNet, and MobileNet, which exceeded an accuracy of 95 %, with scores of 95.32 %, 95.75 %, and 95.99 %, respectively. Regarding efficiency, MobileNet excels owing to its compact size and fast inference speed, making it an ideal model for integration into ILCDS.</p></div><div><h3>Conclusion</h3><p>The ILCDS demonstrated promising accuracy in LC detection while maintaining modest computational resource requirements, indicating its potential to enhance LC screening accuracy and alleviate the workload on otolaryngologists in rural areas.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104474"},"PeriodicalIF":1.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141964555","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 and safety of SENS-401 in sudden sensorineural hearing loss: The AUDIBLE-S randomized placebo-controlled phase IIb trial","authors":"Itzhak Braverman ,&nbsp;Maya Elziere ,&nbsp;Zoran Komazec ,&nbsp;Mauricio Cohen-Vaizer ,&nbsp;Mahmut Tayyar Kalcioglu ,&nbsp;Viktor Chrobok ,&nbsp;Igor Kazmer ,&nbsp;Ohad Hilly ,&nbsp;Marie Jose Esteve-Fraysse ,&nbsp;Ilana Doweck ,&nbsp;Anne-Lise Glotin ,&nbsp;Serge Fitoussi ,&nbsp;Judith Laredo ,&nbsp;Geraldine Honnet","doi":"10.1016/j.amjoto.2024.104480","DOIUrl":"10.1016/j.amjoto.2024.104480","url":null,"abstract":"<div><h3>Purpose</h3><p>Safety and efficacy of SENS-401, a serotonin type 3 (5-HT₃) receptor antagonist and calcineurin inhibitor, in patients with acute sudden sensorineural hearing loss (SSNHL).</p></div><div><h3>Methods</h3><p>Multicentre randomized, double blind, placebo-controlled trial enrolled adult subjects with sudden sensorineural hearing loss (SSNHL) or unilateral/bilateral acute acoustic trauma leading to SSNHL within 96 h of disease onset. Subjects were randomly assigned to one of the three oral dose groups: 29 mg, 43.5 mg or placebo given twice daily for 28 days. The primary endpoint was the change from baseline in Pure Tone Average (PTA) in the affected ear to the end of treatment visit (day 28). Subjects were further followed up 8 weeks after the end of the treatment period (day 84).</p></div><div><h3>Results</h3><p>A total of 115 subjects were randomized. SENS-401 was well tolerated. Although the primary efficacy endpoint was not met at day 28, post-hoc analyses revealed clinically significant and meaningful efficacy outcomes with SENS-401 when compared to placebo in a substantial group of participants diagnosed with idiopathic SSNHL and who had received corticosteroid treatment. Notable improvements were observed in the PTA change from baseline, the complete hearing recovery rate, and the Word Recognition Score (WRS), particularly at day 84. The responder rate consistently favored treated subjects over those who received the placebo.</p></div><div><h3>Conclusion</h3><p>While the primary endpoint was not achieved at the end of the treatment period, the study revealed consistently positive efficacy results of clinical relevance in patients with idiopathic SSNHL who received SENS-401, particularly in the 8-weeks follow-up phase after the completion of the treatment.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104480"},"PeriodicalIF":1.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142011212","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":"Perioperative opioids in high-risk children undergoing tonsillectomy – A single institution experience","authors":"Asher C. Park ,&nbsp;Kathleen Billings ,&nbsp;John Maddalozzo ,&nbsp;Richard Dsida ,&nbsp;Hubert A. Benzon ,&nbsp;Jennifer Lavin ,&nbsp;Inbal Hazkani","doi":"10.1016/j.amjoto.2024.104453","DOIUrl":"10.1016/j.amjoto.2024.104453","url":null,"abstract":"<div><h3>Background</h3><p>Patients undergoing tonsillectomy/ adenotonsillectomy (T/AT) can experience substantial postoperative pain. The aims of this study are to assess perioperative pain management in high-risk children (children with severe obstructive sleep apnea and other complex medical comorbidities or age younger than 2 years) undergoing T/AT, and the impact on oxygen levels and pain during extended Post-Anesthesia Care Unit (PACU) admission.</p></div><div><h3>Methods</h3><p>A retrospective case series study at a tertiary care children's hospital.</p></div><div><h3>Results</h3><p>There were 278 children enrolled in the study. The Apnea-Hypopnea index and mean oxygen nadir on preoperative polysomnography were 31.3 ± 25.76/h and 79.5 ± 9.5 % respectively. Overall, 246 (89 %) patients received intraoperative opioids alone (<em>n</em> = 35, 13 %) or in combination with non-opioid analgesia (<em>n</em> = 209, 75 %). While the median dose of opioid-free medications (acetaminophen, ibuprofen) ranged from 93 to 100 % of standard maximal dosing by weight and age, the median dose of opioids was significantly lower and ranged from 54 to 63 % of standard maximal dosing by weight and age, with 43 % of the patients receiving less than half the recommended maximum dose. Oxygen desaturation was charted in 21 patients (8 %) during their PACU admission. Patients who received opioid-free analgesia were as likely to develop oxygen desaturations (<em>n</em> = 17 (81 %) vs. <em>n</em> = 228 (89.4 %), <em>p</em> = 0.27) and to receive rescue pain medication during their PACU stay as patients who received opioids intraoperatively (<em>n</em> = 18 (56 %) vs. <em>n</em> = 167 (68 %), <em>p</em> = 0.23).</p></div><div><h3>Conclusions</h3><p>Intraoperative pain management varies across high-risk pediatric tonsillectomies. Opioid-free analgesia was not associated with an increased need for pain medications during PACU admission, or with a decreased likelihood of oxygen desaturations compared to intra-operative opioid analgesia use.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104453"},"PeriodicalIF":1.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991235","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 association between amblyopia and the risks of hearing loss: A propensity matched analysis","authors":"Hejin Jeong ,&nbsp;Chelsea Cleveland ,&nbsp;Todd Otteson","doi":"10.1016/j.amjoto.2024.104495","DOIUrl":"10.1016/j.amjoto.2024.104495","url":null,"abstract":"<div><h3>Introduction</h3><p>Amblyopia occurs due to an imbalance in the visual input between the eyes. This can induce structural changes in the central nervous system and, if left untreated, eventually lead to permanent blindness in the affected eye. As these changes may also impact the auditory system, which closely interacts with the visual system, this study aimed to investigate the risk of hearing loss in patients with amblyopia.</p></div><div><h3>Materials and methods</h3><p>This study was a retrospective review of the electronic medical records contained in a United States national database of medical records. Patients younger than 18 years old with and without amblyopia were matched and compared to evaluate the relative risk (RR) of having a hearing loss. Stratified analyses were further performed to explore whether the disease laterality and the amblyopia subtype influenced the risks.</p></div><div><h3>Results</h3><p>Compared to the controls, patients with amblyopia had a higher overall risk of having hearing loss (RR: 1.09, CI: 1.03–1.14), specifically sensorineural hearing loss (SNHL) (RR: 1.24, CI: 1.08–1.42). The stratified analysis further revealed that SNHL was associated with refractive amblyopia (RR: 1.84, CI: 1.50–2.26), but not strabismic amblyopia (RR: 1.23, CI: 1.10–1.38). The laterality of amblyopia did not influence the risk of hearing loss.</p></div><div><h3>Conclusions</h3><p>Children with amblyopia have a higher rate of SNHL than children without amblyopia. As vision and hearing are essential in the proper cognitive development, language acquisition, and social and emotional well-being of children, patients with amblyopia may benefit from more frequent audiologic screening.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"45 6","pages":"Article 104495"},"PeriodicalIF":1.8,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0196070924002813/pdfft?md5=0b2cb934e5695fc29201c38f92d0ffc4&pid=1-s2.0-S0196070924002813-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}