American Journal of Otolaryngology最新文献

{"title":"Enhanced recovery in unilateral vestibular hypofunction: The synergistic effect of medication and vestibular rehabilitation training","authors":"Hanyue Zhu ,&nbsp;Jianbin Li ,&nbsp;Liheng Li ,&nbsp;Qingyin Zheng ,&nbsp;Jianchu Wei","doi":"10.1016/j.amjoto.2025.104675","DOIUrl":"10.1016/j.amjoto.2025.104675","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the efficacy of medication combined with personalized vestibular rehabilitation training (VRT) versus medication alone in unilateral vestibular hypofunction (UVH) and identify predictors of long-term symptom progression.</div></div><div><h3>Methods</h3><div>Forty-eight UVH patients were randomized into a VRT group (<em>n</em> = 23, medication combined with personalized VRT) and a control group (<em>n</em> = 25, medication alone). Bithermal caloric tests, Dizziness Handicap Inventory (DHI), Vestibular Rehabilitation Benefit Questionnaire (VRBQ), Visual Analog Scale (VAS), Activities-specific Balance Confidence Scale (ABC), and Self-Rating Anxiety Scale (SAS) were assessed at baseline, 2 weeks, and 4 weeks. Symptom progression was tracked over 6 months post-intervention.</div></div><div><h3>Results</h3><div>Both groups improved significantly (<em>P</em> &lt; 0.05), but the VRT group showed faster unilateral weakness (UW) reduction (30.43 % vs. 43.20 % at 4 weeks, <em>P</em> = 0.012) and greater symptom relief (DHI: 6.70 vs. 23.68, <em>P</em> &lt; 0.001). Logistic regression identified abnormal UW (≥ 25 %) as an independent predictor of symptom recurrence (OR = 7.237, 95 % CI:1.43–36.58, <em>P</em> = 0.017), while DHI scores showed no significant association (<em>P</em> = 0.925).</div></div><div><h3>Conclusion</h3><div>Personalized VRT combined with medication accelerates symptom resolution and vestibular recovery compared to medication alone. Persistent abnormal caloric results, even with symptom relief, indicate a need for extended treatment and active lifestyle maintenance to mitigate recurrence.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104675"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144089080","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":"National trends in laryngeal biopsy: Comparison of operative vs. office-based procedures","authors":"Maxwell Scher ,&nbsp;Ashley Bodnar ,&nbsp;Jeremiah C. Tracy ,&nbsp;Lauren Tracy","doi":"10.1016/j.amjoto.2025.104673","DOIUrl":"10.1016/j.amjoto.2025.104673","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze national trends and prevalence of office-based endoscopy with laryngeal biopsy procedures as compared to traditional operative biopsy procedures utilizing direct laryngoscopy with and without microlaryngoscopy.</div></div><div><h3>Methodology</h3><div>The US Medicare Part B claims database was queried for Current Procedural Terminology (CPT) codes 31,576 (flexible laryngoscopy with biopsy), 31,535 (operative direct laryngoscopy with biopsy), and 31,536 (operative direct microlaryngoscopy with biopsy). From 2013 to 2022, the total number of charges billed to the Medicare database in each calendar year was recorded and annual trends were analyzed.</div></div><div><h3>Results</h3><div>The number of office-based flexible laryngoscopy biopsy procedures (CPT code 31576) remained relatively constant over the 10-year period of analysis (range: 551–852<strong>,</strong> trendline slope = −21, R² = 0.51). Office-based flexible laryngoscopy biopsy procedures comprised a small portion of total laryngeal biopsies (range: 3.8 % - 4.8 %). The total number of operative direct laryngoscopy with biopsy, billed by CPT codes 31,535 and 31,536 experienced decline with time (Trendline slope = −310, R² = 0.89; Trendline slope = −254, R² = 0.85 respectively).</div></div><div><h3>Conclusions</h3><div>Office-based laryngeal biopsy procedures comprise a small fraction of laryngeal biopsy procedures overall and prevalence has declined slightly over the last 10 years. This contrasts with prevailing healthcare trends towards less-invasive, office-based procedures. Further research is needed to determine the etiology of the overall decrease in operative direct laryngeal biopsies.</div></div><div><h3>Level of evidence</h3><div>4</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104673"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115290","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":"Early results with hypofractionated gamma knife radiotherapy for treatment of vestibular schwannoma","authors":"Omar Azmeh ,&nbsp;Samuel R. Barber ,&nbsp;Maurice King ,&nbsp;Moisés A. Arriaga","doi":"10.1016/j.amjoto.2025.104674","DOIUrl":"10.1016/j.amjoto.2025.104674","url":null,"abstract":"<div><h3>Objective</h3><div>Vestibular schwannoma (VS) management with stereotactic radiation previously only included stereotactic radiosurgery with Gamma Knife (GKRS) or LINAC-based radiotherapy (LBR). Hypofractionated Gamma Knife radiotherapy (hfGKRS) is a novel protocol potentially producing less toxicity than the alternatives. This study examines early results in tumor control, complications and hearing preservation outcomes in a consecutive series of VS patients treated with hfGKRS.</div></div><div><h3>Study design</h3><div>A retrospective review was conducted for all patients with unilateral VS treated with primary hfGKRS at an academic center between 2017 and 2023.</div></div><div><h3>Setting</h3><div>Tertiary referral center.</div></div><div><h3>Interventions</h3><div>Therapeutic.</div></div><div><h3>Main outcome measures</h3><div>Pre- and post-treatment imaging, notes and audiograms were analyzed. Tumor volumes were tabulated. Audiometric data recorded were pure-tone average (PTA), word recognition score (WRS), and speech reception threshold (SRT). Collected data included tinnitus, imbalance, House-Brackmann score, and facial spasms. Outcomes obtained were compared to literature controls of GKRS and LBR.</div></div><div><h3>Results</h3><div>Twenty-five hfGKRS cases were identified. Mean tumor volume was 1.79 cm³ (range 0.14–9.29cm³). Mean patient follow-up was 28 months (range 6–86 months). Pre-treatment versus post-treatment hearing results were: PTA 62.9 dB versus 68.6 dB, WRS 40 % versus 30.8 % and SRT 33.1 dB versus 34.1 dB. The tumor control was 96 % and hearing was preserved in 80 % of patients with pre-treatment serviceable hearing. hfGKRS complications included tinnitus (12.5 %), dizziness (12.5 %), facial pain (8 %), and facial spasms (4 %).</div></div><div><h3>Conclusion</h3><div>Short term results for VS treated with hfGKRS had high rates of tumor control, favorable hearing results and comparable complication rates to literature reports for GKRS and LBR. Further follow-up is needed to adequately evaluate long-term outcomes of hfGKRS in tumor control, toxicity and hearing results in order to compare this technique with GKRS and LBR. However, these results support further evaluation of hfGKRS as a potential technique to improve outcomes in stereotactic radiation treatment of VS.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104674"},"PeriodicalIF":1.8,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106508","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":"Effect of corticosteroid-based combination therapy on sudden deafness: a retrospective study","authors":"Liang'e Zhi ,&nbsp;Shiyuan Li ,&nbsp;Yajin Feng ,&nbsp;Qian Liu ,&nbsp;Zhendong Jiang ,&nbsp;Cheng Zhong ,&nbsp;Ya He","doi":"10.1016/j.amjoto.2025.104666","DOIUrl":"10.1016/j.amjoto.2025.104666","url":null,"abstract":"<div><h3>Objectives</h3><div>Systemic corticosteroid therapy is widely recommended as the first-line treatment for sudden deafness(SD). However, the factors influencing treatment outcomes remain uncertain, and the efficacy of corticosteroid-based combination therapies is still controversial. Aim of this study is to declare the impact of treatment initiation time, patient age and evaluate the combined therapies including hyperbaric oxygen therapy (HBOT), batroxobin, and acupuncture on treatment outcome.</div></div><div><h3>Methods</h3><div>248 SD patients undergoing corticosteroid-based combination therapy were included and classified into four subtypes. Additionally, 17 patients who received remedial intratympanic corticosteroid (ICT) were analyzed. Improvement of hearing and accompanying symptoms (vertigo/tinnitus) was evaluated to indicate the effectiveness of treatment.</div></div><div><h3>Results</h3><div>Early-stage treatment (≤7 days) and younger patients (&lt;18 years) were associated with better outcomes(<em>P</em> &lt; 0.05). For combined therapies, batroxobin and acupuncture showed no significant effect on treatment outcomes(<em>P</em> &gt; 0.05). In contrast, patients receiving HBOT exhibited worse hearing improvement in total deafness and low-frequency descending subtypes(<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Early-stage treatment should be emphasized for patients with SD, particularly in young patients. Combined therapies, especially HBOT, cannot improve prognosis. Remedial ICT can further improved outcomes in SD patients with total deafness subtype who responded poorly to systemic corticosteroid therapy.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 5","pages":"Article 104666"},"PeriodicalIF":1.8,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144106507","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":"Developing a smart system for binary classification of disordered voices using machine learning","authors":"Yat Chun Au,&nbsp;Manwa L. Ng","doi":"10.1016/j.amjoto.2025.104672","DOIUrl":"10.1016/j.amjoto.2025.104672","url":null,"abstract":"<div><h3>Objectives</h3><div>Voice disorder is characterized by disruptions in voice quality caused by issues in vocal fold vibration during phonation. The study explored the application of machine learning, based on the Random Forest (RF) and Decision Tree (DT) models, in the classification of normophonic and disordered voices using acoustic features. The RF and DT classifiers were compared, and the diagnostic utility of individual acoustic parameters was evaluated across multilingual databases, with an emphasis on Cantonese voice samples.</div></div><div><h3>Methods</h3><div>Sustained vowel /a/ recordings were extracted from the Saarbruecken Voice Database, the Perceptual Voice Qualities Database, and a local Cantonese clinical repository. A total of 1986 samples were used for training and testing. Twenty-nine acoustic features were extracted using Parselmouth, a Python interface to Praat. RF and DT models were trained on overseas data and validated on local Cantonese recordings. The RF and DT models were compared based on classification accuracy, sensitivity, specificity, and F1-score. Feature importance was assessed using Mean Decrease in Impurity (MDI) and Mean Decrease in Accuracy (MDA). Receiver Operating Characteristic (ROC) analysis was performed to evaluate the discriminative ability of each acoustic parameter by sex and dataset origin.</div></div><div><h3>Results</h3><div>The RF model outperformed the DT model, with RF achieving an accuracy of 89 %, precision of 79 %, and F1 score of 77 %, compared to 78 % accuracy and 61 % F1 score associated with DT. RF demonstrated superior true positive and negative rates, and lower false negative rates, making it more suitable for clinical applications. Acoustic feature analysis identified age, CSID, and shimmer and jitter measures as key contributors to classification performance. ROC analyses revealed that CSID and stdevF0Hz were reliable discriminators for male voices, while CSID, localabsoluteJitter, apq11Shimmer, and localdbShimmer demonstrated strong classification performance in female voices across all datasets. However, threshold variability between local and overseas datasets highlights the need for population-specific calibration.</div></div><div><h3>Conclusion</h3><div>This study underscores the potential of machine learning, particularly the RF algorithm, in enhancing the accuracy of voice disorder diagnosis by automating acoustic feature analysis. The integration of such models into clinical practice could offer more reliable, non-invasive methods for early detection and management of voice disorders, thus improving patient outcomes. Future research should focus on expanding dataset diversity and further validation to enhance the generalizability and clinical applicability of these findings.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104672"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071765","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 prognostic value of systemic immune-inflammation index and lymphocyte-to-monocyte ratio in cases with profound sudden sensorineural hearing loss","authors":"Kun Zhao,&nbsp;Hongfeng Ma","doi":"10.1016/j.amjoto.2025.104671","DOIUrl":"10.1016/j.amjoto.2025.104671","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the prognostic value of SII and LMR in predicting hearing recovery outcomes in profound SSHL cases.</div></div><div><h3>Methods</h3><div>The relationships between inflammatory markers and hearing outcomes were assessed using univariate and multivariate logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive accuracy of SII and LMR for recovery outcomes.</div></div><div><h3>Results</h3><div>The study revealed that SII and LMR were linked to hearing recovery in profound SSHL. Cases in the complete recovery group had significantly lower SII (806.57 ± 217.26) and higher LMR (2.14 ± 0.94) compared to those in the partial and no recovery groups (<em>P</em> &lt; 0.001 for both). Multivariate logistic regression identified Tbil, SII, and LMR as independent predictors of recovery outcomes. Higher SII and lower LMR were significantly associated with poor recovery, while lower SII and higher LMR predicted better recovery. ROC curve analysis showed that SII and LMR had moderate predictive power for partial recovery (AUC: 0.668 for SII, 0.696 for LMR) and excellent predictive power for no recovery (AUC: 0.804 for SII, 0.819 for LMR). The combination of SII and LMR further enhanced predictive accuracy (AUC: 0.879 for no recovery).</div></div><div><h3>Conclusion</h3><div>SII and LMR are valuable biomarkers for predicting recovery outcomes in cases with profound SSHL. Elevated SII and reduced LMR are associated with poor recovery, while lower SII and higher LMR suggest a favorable prognosis. The combined use of these markers improves the accuracy of prognosis prediction and could guide clinical management in SSHL cases.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104671"},"PeriodicalIF":1.8,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143943314","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 Characteristics, Concomitant Malformations and Hearing Status in Congenital Microtia - A Retrospective Analysis of 635 Cases","authors":"Weiliang Zhao ,&nbsp;Sijun Zhao ,&nbsp;Min Wang ,&nbsp;Zhong Xie ,&nbsp;Lihua Xie ,&nbsp;Min Huang ,&nbsp;Xiangyue Peng ,&nbsp;Guanghui Zhu","doi":"10.1016/j.amjoto.2025.104668","DOIUrl":"10.1016/j.amjoto.2025.104668","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to investigate the clinical characteristics of congenital microtia, providing valuable insights for its diagnosis and treatment.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on the medical records of 635 patients with congenital microtia admitted to our hospital between July 2017 and July 2021. Patients were categorized based on the presence of concomitant malformations, including craniofacial, cutaneous, and limb skeletal deformities. Mastoid CT scans were used to assess the prevalence of inner ear malformations and middle ear inflammation. Additionally, pure-tone audiometry and auditory brainstem response (ABR) tests were performed to compare the median hearing thresholds across various frequencies, including air conduction, bone conduction, and ABR.</div></div><div><h3>Results</h3><div>Of the 635 patients, 111 (17.5 %) exhibited concomitant anomalies. The most common associated anomaly was craniofacial deformities, found in 39.6 % (44 out of 111) of cases. A statistically significant correlation was observed between the severity of auricular deformity and the presence of concurrent craniofacial anomalies (<em>P</em> &lt; 0.05), but no significant correlation was found with other associated anomalies. Furthermore, a significant association was observed between deformities of the external auditory canal and middle ear inflammation (<em>P</em> &lt; 0.05), while no significant link was found between external auditory canal deformities and inner ear malformations. The severity of auricular deformity was significantly correlated with medium to low-frequency air conduction pure-tone hearing thresholds in the 0.25–2 kHz range (<em>P</em> &lt; 0.05), while no significant correlation was identified with high-frequency air conduction thresholds above 2 kHz. Finally, no significant correlation was found between bone conduction pure-tone hearing thresholds, ABR, and the severity of auricular deformity (<em>P</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>This study provides a comprehensive analysis of the clinical characteristics of congenital microtia. It reveals a clear correlation between increased severity of auricular deformity and a higher likelihood of associated craniofacial anomalies. Additionally, higher thresholds for medium to low-frequency air conduction hearing were linked to more severe auricular deformities. Furthermore, individuals with narrower external auditory canals had a higher prevalence of middle ear inflammation.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104668"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069592","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":"Comprehensive analysis of smoking as a risk factor and its prognostic implications in patients with deep neck infections","authors":"Yu-Ching Tseng ,&nbsp;Chia-Ying Ho ,&nbsp;Yu-Chien Wang ,&nbsp;Shy-Chyi Chin ,&nbsp;Shih-Lung Chen","doi":"10.1016/j.amjoto.2025.104669","DOIUrl":"10.1016/j.amjoto.2025.104669","url":null,"abstract":"<div><h3>Background</h3><div>Deep neck infection (DNI) is a potentially life-threatening bacterial infection that affects the anatomical spaces within the neck, with upper airway infections being among the most common etiological factors. Smoking has well-documented local and systemic effects on the respiratory tract, immune system, as well as on the skin and soft tissues. However, the relationship between smoking and the development of DNI remains inadequately addressed in the existing literature. The objective of this study is to investigate the potential association between smoking and the occurrence of DNI.</div></div><div><h3>Methods</h3><div>A total of 332 patients diagnosed with DNI were enrolled in this study. Of these, 81 patients were identified as smokers, while 251 were non-smokers. A comprehensive analysis of relevant clinical data was conducted to assess the potential association between smoking status and clinical outcomes in this cohort.</div></div><div><h3>Results</h3><div>In the univariate analysis, age ≥ 60 years (OR = 3.5161, 95 % CI: 1.0481–11.792, <em>p</em> = 0.0293), elevated C-reactive protein (CRP) levels ≥300 mg/L (OR = 3.9375, 95 % CI: 1.1958–12.965, <em>p</em> = 0.0263), and the involvement of multiple anatomical spaces (≥ 3) (OR = 5.8776, 95 % CI: 1.9446–17.764, <em>p</em> = 0.0012) were identified as statistically significant risk factors for prolonged hospitalization (&gt;14 days) in patients with DNI who were smokers. Upon conducting multivariate analysis, it was found that the involvement of multiple spaces (≥ 3) (OR = 3.7383, 95 % CI: 1.1332–12.331, <em>p</em> = 0.0304) emerged as an independent and significant predictor of prolonged hospitalization in this cohort of smokers. However, no statistically significant differences were observed between the groups in terms of the extent of space involvement, the spectrum of pathogens, or the incidence of complications.</div></div><div><h3>Conclusions</h3><div>This study explored the potential association between smoking and the development of DNI. The findings demonstrated that advanced age, elevated CRP levels, and the involvement of multiple deep neck spaces were significant risk factors for prolonged hospitalization. Multivariate analysis further identified the involvement of three or more deep neck spaces as an independent predictor of extended hospital stay among smokers. Collectively, these results suggest that smokers with DNI exhibit a worse clinical prognosis, which may be attributed to smoking-induced impairments in immune function and upper respiratory tract integrity.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104669"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143917423","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":"Evaluating advanced AI reasoning models: ChatGPT-4.0 and DeepSeek-R1 diagnostic performance in otolaryngology: a comparative analysis","authors":"Soumil Prasad,&nbsp;Jake Langlie,&nbsp;Luke Pasick,&nbsp;Ryan Chen,&nbsp;Elizabeth Franzmann","doi":"10.1016/j.amjoto.2025.104667","DOIUrl":"10.1016/j.amjoto.2025.104667","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to evaluate the diagnostic accuracy, comprehensiveness, and clinical relevance of two advanced artificial intelligence (AI) models, OpenAI's ChatGPT-4.0 and DeepSeek-R1, in the field of otolaryngology.</div></div><div><h3>Methods</h3><div>Five common otolaryngology procedures—adenotonsillectomy, tympanoplasty, endoscopic sinus surgery, parotidectomy, and total laryngectomy—were analyzed through standardized queries posed to both AI models<strong>.</strong> Because the prompts replicate questions that patients typically search online, our evaluation focuses on patient-facing informational adequacy. Responses were independently evaluated by two study members for accuracy, clinical relevance, and comprehensiveness, with discrepancies resolved through consensus. The analysis included comparison with clinical guidelines.</div></div><div><h3>Results</h3><div>ChatGPT-4.0 generally provided detailed procedural insights, effectively covering indications, methodologies, risks, and recovery processes. However, it occasionally suggested excessive diagnostic imaging and omitted subtle yet significant surgical nuances. DeepSeek-R1 delivered concise, structured responses clearly categorizing indications, treatment alternatives, and procedural risks. Nonetheless, it frequently lacked detailed elaboration, omitting important surgical techniques and minor complications. For instance, DeepSeek-R1 omitted specifics such as hemostatic techniques in adenotonsillectomy and graft stabilization details in tympanoplasty. Neither model adequately addressed critical elements like comprehensive staging, detailed surgical planning, and long-term recovery nuances, especially for complex procedures such as total laryngectomy.</div></div><div><h3>Conclusions</h3><div>Both ChatGPT-4.0 and DeepSeek-R1 demonstrated significant diagnostic potential but revealed limitations in precision, comprehensiveness, and nuanced clinical reasoning. Their clinical utility remains restricted, highlighting a continued need for AI refinement to enhance patient-specific decision-making capabilities in otolaryngology.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104667"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143937362","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":"Impact of intraoperative NBI on complete resections and recurrence in oral and oropharyngeal cancer","authors":"Francesca Boscolo Nata ,&nbsp;Rossana Bussani ,&nbsp;Egidio Sia ,&nbsp;Fabiola Giudici ,&nbsp;Paolo Boscolo-Rizzo ,&nbsp;Giancarlo Tirelli","doi":"10.1016/j.amjoto.2025.104630","DOIUrl":"10.1016/j.amjoto.2025.104630","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study was to assess the number of complete resections and recurrence rates in oral and oropharyngeal squamous cell carcinoma treated with intraoperative narrow-band-imaging.</div></div><div><h3>Materials and methods</h3><div>In this observational study, superficial resection margins of oral and oropharyngeal squamous cell carcinoma were intraoperatively defined using narrow-band-imaging. The number of complete resections was assessed. Patients were followed up for at least 5 years: disease free survival and the cumulative incidence of local recurrence were recorded.</div></div><div><h3>Results</h3><div>93 squamous cell carcinoma were considered. Surgical resection was complete in 84.9 % of cases. The 5-years disease free survival was 76.2 % (95%CI: 67.1 %–84.4 %). Cumulative incidence of local recurrence was 9.7 % (95%CI: 4.7 %–16.7 %), lower compared to previous literature: it was higher in patients over 68 years (14.3 %, 95%CI: 6.2 %–25.6 % vs 4.5 %, 95%CI: 0.8 %–13.8 %) although without statistically significance.</div></div><div><h3>Conclusions</h3><div>In oral and oropharyngeal squamous cell carcinoma surgery, narrow-band imaging is a valuable tool for accurately identifying the true superficial extent of the tumor, facilitating complete resection and potentially reducing local recurrence.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 4","pages":"Article 104630"},"PeriodicalIF":1.8,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143912559","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}