American Journal of Otolaryngology最新文献

{"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}

{"title":"Minor salivary gland tumors: A retrospective review of cases in a single centre of south Italy","authors":"Ida Barca ,&nbsp;Francesco Ferragina ,&nbsp;Samuel Staglianò ,&nbsp;Giuseppe Tarallo ,&nbsp;Angelo Ruggero Sottile ,&nbsp;Maria Grazia Ioppolo ,&nbsp;Marco Frasca ,&nbsp;Maria Giulia Cristofaro","doi":"10.1016/j.amjoto.2025.104650","DOIUrl":"10.1016/j.amjoto.2025.104650","url":null,"abstract":"<div><h3>Purpose</h3><div>Tumors of the minor salivary glands (TMSGs) are rare with heterogeneous behavior despite their low frequency. This study aimed to investigate their distribution characteristics in a single centre of south Italy during the last 10 years and to compare them with similar studies done elsewhere.</div></div><div><h3>Materials and methods</h3><div>A retrospective study of TMSGs was performed in 110 patients. Data were analyzed using SPSS version 25, Kaplan-Meier analysis was used to find the survival and the outcome hazard ratio was calculated for each variable using Cox regression.</div></div><div><h3>Results</h3><div>110 patients with TMSGs (55 female ad 55 male, median age 61 years) was examined, including 34 benign and 76 malignant lesions. The palate was the most commonly affected site (41.81 %) in both benign and malignant tumors and the most frequent histological type was respectively pleomorphic adenoma and adenoid cystic carcinoma. Overall survival at 5 years was estimated at 92 %, with statistically significant values for histological high risk and pathological TNM (<em>p</em> value 0.048 and 0.032). Recurrence free survival at 5 years is equal to 82 %.</div></div><div><h3>Conclusion</h3><div>TMSGs have good overall survival despite recurrences. The most significant predictors of outcome are pathological stage and histological risk group.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104650"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898699","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":"Acyclovir efficacy for bell's palsy treatment","authors":"Çağlar Günebakan ,&nbsp;Selçuk Kuzu ,&nbsp;Erhan Bozkurt","doi":"10.1016/j.amjoto.2025.104637","DOIUrl":"10.1016/j.amjoto.2025.104637","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to analyze the results regarding prednisolone alone, and the combined use of acyclovir with prednisolone in the treatment modality of Bell's palsy.</div></div><div><h3>Methods</h3><div>In this prospective, randomized clinical study, which was held in a single tertiary hospital, we evaluated 63 patients with Bell's palsy. 30 patients were given prednisolone alone, and we gave 33 patients prednisolone and acyclovir combination. We evaluated facial nerve functions using the House-Brackmann facial nerve staging scale. We completed the follow-up of the patients with the controls performed at 1st, 3rd, 6th, and 12th weeks.</div></div><div><h3>Results</h3><div>We determined improvement according to the House-Brackmann scale as 86.6 % in the acyclovir + prednisolone group and 90 % in the prednisolone group (Table 2), and there was no statistically significant difference between the results got from the treatment groups (<em>p</em> &gt; 0.05). The sequelae were 23.3 % (<em>n</em> = 7) in the acyclovir + prednisolone group and 27.27 % (<em>n</em> = 9) in the prednisolone group, but this difference was not statistically significant (<em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>We observed that the combined use of acyclovir and steroids in Bell's palsy does not have the advantage over using steroids alone.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104637"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144489679","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":"Interrupt a vicious cycle to Cure refractory chronic cough","authors":"Miles Weinberger ,&nbsp;Ran D. Anbar ,&nbsp;Dennis Buettner","doi":"10.1016/j.amjoto.2025.104627","DOIUrl":"10.1016/j.amjoto.2025.104627","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104627"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143892167","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":"Incidence and prognosis of otitis media with effusion in COVID-19 patients a comparative case-control analysis","authors":"Qian Yu ,&nbsp;Yuedong Zhang ,&nbsp;Huina Lu ,&nbsp;Yanli Zhao ,&nbsp;Xin Zhou","doi":"10.1016/j.amjoto.2025.104649","DOIUrl":"10.1016/j.amjoto.2025.104649","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the association between SARS-CoV-2 and secretory otitis media (OME), evaluating the presence of the virus in middle ear fluid (MEF) and its impact on OME incidence and patient outcomes.</div></div><div><h3>Methods</h3><div>A case-control study was conducted with COVID-19 patients (<em>n</em> = 86) and control subjects (<em>n</em> = 20). OME incidence was compared across three time periods. Recovery rates, recurrence rates, catheterization rates, Eustachian Tube Dysfunction Questionnaire-7 (ETDQ-7) scores, as well as audiometry results were analyzed.</div></div><div><h3>Results</h3><div>The detection of SARS-CoV-2 in MEF samples showed a similar duration compared to nasal swabs (28.65 ± 8.99 vs 27.18 ± 7.99 days). There was a significant increase in OME incidence following COVID-19 infection, particularly during the '22-'23 period (<em>P</em> &lt; 0.05). No significant differences were observed in terms of recovery rates, recurrence rates or catheterization rates among groups (<em>P</em> &gt; 0.05). ETDQ-7 scores remained unchanged after treatment intervention (P &gt; 0.05). Statistically significant differences were found for air conduction threshold and air-bone gap measurements (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The presence of SARS-CoV-2 in MEF is associated with an elevated risk of developing OME but has minimal impact on the prognosis of this condition.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104649"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898698","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":"Gelatin versus chitosan as packing materials in endoscopic myringoplasty for chronic suppurative otitis media","authors":"Vanessa Hui En Chen ,&nbsp;Linette Shu Hwei Tan","doi":"10.1016/j.amjoto.2025.104654","DOIUrl":"10.1016/j.amjoto.2025.104654","url":null,"abstract":"<div><h3>Purpose</h3><div>There is a lack of literature studying the impact of various middle ear packing materials on the outcomes of myringoplasty. Absorbable gelatin sponge is commonly used, though it has been reported to induce middle ear fibrosis or adhesions. Chitosan-based sponge has useful properties including hemostasis, anti-adhesion and antimicrobial activity, potentially making it useful for supporting the graft in myringoplasty. This study compares graft success when chitosan and gelatin are used as packing materials for endoscopic myringoplasty.</div></div><div><h3>Methods</h3><div>An audit was performed of all patients who underwent endoscopic myringoplasty for chronic suppurative otitis media under the Otolaryngology department of Ng Teng Fong General Hospital between June 2021 and March 2024. Patients were followed up at least 3 months after surgery. Graft success was defined as the presence of an intact graft without perforation at the end of 3 months.</div></div><div><h3>Results</h3><div>91 patients were analyzed. Gelatin and chitosan were used in 40 and 51 patients respectively. The overall graft success rate of the 91 cases was 79.1 %(<em>n</em> = 72). Tragal perichondrium was most commonly used(46.1 %, <em>n</em> = 42/91), with a success rate of 80.9 %(<em>n</em> = 34/42). The differences in graft success rates among the various graft types and across perforation sizes were not statistically significant.(<em>p</em> = 0.129 and <em>p</em> = 0.399 respectively) There was no significant difference in the success rate between the chitosan group(80.4 %, <em>n</em> = 41/51) and the gelatin group(77.5 %, <em>n</em> = 31/40).(<em>p</em> = 0.736).</div></div><div><h3>Conclusion</h3><div>Chitosan-based packing affords at least equivalent success when compared to gelatin-based packing for endoscopic myringoplasty. It should be considered as a competitive alternative given its other benefits.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104654"},"PeriodicalIF":1.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143898702","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":"Clinical efficacy of sublingual immunotherapy for allergic rhinitis and atopic cough: 5-year real-world surveillance","authors":"Jinming Qiu,&nbsp;Bingquan Jian,&nbsp;Xiaoqian Xin,&nbsp;Guopeng Tang","doi":"10.1016/j.amjoto.2025.104624","DOIUrl":"10.1016/j.amjoto.2025.104624","url":null,"abstract":"<div><h3>Purpose</h3><div>Atopic cough (AC) is a prevalent allergic condition, frequently observed in children with allergic rhinitis (AR) seeking treatment at our clinical department. Hence, the primary objective of this study was to assess the effectiveness and safety of house dust mite (HDM)-sublingual immunotherapy (SLIT) in managing AC, offering a novel therapeutic strategy for its treatment.</div></div><div><h3>Materials and methods</h3><div>This retrospective study enrolled 103 children diagnosed with AR and AC. Among them, 55 children underwent a 3-year course of SLIT (SLIT group), while 48 children received only symptomatic drug therapy (control group). Treatment initiation for both groups was in 2019, with annual on-site follow-up visits conducted until 2024 to evaluate treatment efficacy and safety. The comparison of efficacy evaluation indicators between the SLIT group and the control group encompassed the total nasal symptoms score (TNSS), daytime cough symptom score (daytime CSS), nighttime cough symptom score (nighttime CSS), cough evaluation test (CET) score, the total medication score (TMS), and visual analogue scale (VAS) score. Furthermore, the long-term efficacy of a 3-year SLIT treatment was evaluated. Safety was assessed based on adverse events (AEs).</div></div><div><h3>Results</h3><div>All efficacy indicators exhibited no significant differences at baseline (all <em>p</em> &gt; 0.05). The TNSS in the SLIT group demonstrated a significant reduction compared to baseline across the study period (2019–2024) (all <em>p</em> &lt; 0.001). In contrast, the decrease in TNSS in the control group was less pronounced than in the SLIT group, with a noticeable rebound in 2024. Regarding AC assessment, the daytime/nighttime CSS in the SLIT group remained consistently lower both during the SLIT treatment phase and post-SLIT discontinuation, while the control group displayed a rebounding trend, albeit without statistical significance (<em>p</em> &gt; 0.05). Furthermore, CET score in the SLIT group remained consistently low from the initiation of SLIT treatment until 2024, whereas the control group experienced a significant rebound (<em>p</em> &lt; 0.001), indicating deteriorating cough symptoms. In the comprehensive evaluation of treatment efficacy, a significant decrease in TMS and VAS score was observed in the SLIT group throughout the study duration (all <em>p</em> &lt; 0.001), whereas the control group exhibited varying degrees of rebound in TMS and VAS score in 2023 and 2024.</div></div><div><h3>Conclusion</h3><div>Compared to treatment with symptomatic medication alone, a 3-year course of HDM-SLIT exhibited superior efficacy in managing AC, both during the treatment period and following treatment discontinuation.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104624"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887384","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":"Postnasal drip syndrome: A new definition and successful oral gargling treatment","authors":"Yeon-Hee Joo ,&nbsp;Hyun Jung Kim ,&nbsp;Yung-Jin Jeon ,&nbsp;Sang-Wook Kim","doi":"10.1016/j.amjoto.2025.104617","DOIUrl":"10.1016/j.amjoto.2025.104617","url":null,"abstract":"<div><h3>Introduction</h3><div>Many patients visit the rhinology clinic with complaints of postnasal drip (PND), a condition initially termed postnasal drip syndrome (PNDS) but today is known as upper airway cough syndrome (UACS). However, some patients complain only of discomfort caused by PND without cough and exhibit no definite endoscopic evidence of nasal secretions or PND. We investigated the correlation between endoscopic findings and symptoms and evaluate the effectiveness of oral gargling for PND patients without cough.</div></div><div><h3>Materials and methods</h3><div>We retrospectively reviewed the medical records of PND patients who underwent oral gargling. Patients with PND as their only nasal symptom were included. Oral gargling was prescribed for all patients. Objective endoscopic examinations were also conducted. Discomfort caused by PND was assessed using questionnaires, specifically the Sino-Nasal Outcome Test22 (SNOT-22) score and the scores on the post-nasal drip symptom sheet (PNDSS).</div></div><div><h3>Results</h3><div>Oral gargling with normal saline for 12 weeks led to significant improvements in PNDS patients. The mean SNOT-22 score and the PNDSS score decreased significantly. However, no correlation was found between the endoscopic findings and either the SNOT-22 or PNDSS score. No severe complications were reported.</div></div><div><h3>Conclusions</h3><div>Oral gargling may be a safe and potentially effective treatment for PNDS. It could help dilute and remove mucus from the nasopharynx and oropharynx. We propose a new definition for PNDS: a sensation of PND without cough in the absence of any sinonasal disease, irrespective of endoscopic findings.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104617"},"PeriodicalIF":1.8,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912558","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}