American Journal of Otolaryngology最新文献

{"title":"White matter lesions in brain MRI and cardiovascular risk factors in sudden sensorineural hearing loss patients: A comparative study","authors":"Shadman Nemati ,&nbsp;Negar Hosseinpoor ,&nbsp;Mehrgan Khanhakimi ,&nbsp;Sima Fallah Arzpeyma ,&nbsp;Mohammad Ebrahim Ghaffari ,&nbsp;Seyed Hassan Mostafavi ,&nbsp;Pejman Kiani ,&nbsp;Alia Saberi","doi":"10.1016/j.amjoto.2025.104607","DOIUrl":"10.1016/j.amjoto.2025.104607","url":null,"abstract":"<div><h3>Background</h3><div>Sudden Sensorineural Hearing Loss (SSNHL) is an otologic emergency characterized by a rapid decrease in hearing threshold. The etiology of SSNHL is often unclear, with potential links to vascular pathologies. This study investigates the association between white matter lesions (WMLs) observed in brain MRI and cardiovascular risk factors in SSNHL patients.</div></div><div><h3>Methods</h3><div>This case-control study involved 34 SSNHL patients and 34 matched controls, none of them had migraine. Both groups underwent pure tone audiometry and brain MRI. WMLs were assessed using the Fazekas scale. Cardiovascular risk factors, including hypertension, diabetes, dyslipidemia, BMI, and smoking, were documented.</div></div><div><h3>Results</h3><div>While none of the cardiovascular risk factors showed a significant difference between the two groups, the presence of WMLs was significantly higher in the SSNHL group compared to controls (79.4 % vs. 32.4 %; p &lt; 0.001). More specifically, 24 patients (70.6 %) and 10 controls (29.4 %) had periventricular white matter (PVWM) lesions, while 20 patients (58.8 %) and 8 controls (23.5 %) had deep white matter (DWM) lesions. Logistic regression analysis revealed that increased grades of PVWM lesions were associated with a 5.7-fold higher likelihood of moderate or greater hearing loss (p = 0.033). The degree of DWM lesions, according to the Fazekas scale, demonstrated a significant correlation with hearing recovery rate.</div></div><div><h3>Conclusion</h3><div>White matter lesions (WMLs) are significantly associated with sudden sensorineural hearing loss (SSNHL), with higher grades of PVWM lesions increasing the likelihood of severe hearing loss and DWM lesions correlating with hearing recovery. These associations seem to be independent of cardiovascular risk factors.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104607"},"PeriodicalIF":1.8,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619345","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}

{"title":"Elastic scattering spectroscopy for intraoperative oral cancer mucosal margin guidance: Initial results from a 104 patient cohort","authors":"G.P. Krisciunas ,&nbsp;E. Rodriguez-Diaz ,&nbsp;L. Berry ,&nbsp;G. Spokas ,&nbsp;O.M. A'Amar ,&nbsp;M. Couey ,&nbsp;H. Edwards ,&nbsp;J. Gooey ,&nbsp;J. Hanks ,&nbsp;Z. Lu ,&nbsp;D. Lucas ,&nbsp;M. O'Leary ,&nbsp;R. Pistey ,&nbsp;M. Sakharkar ,&nbsp;K. Sayre ,&nbsp;J. Tracy ,&nbsp;G. Zhao ,&nbsp;I.J. Bigio ,&nbsp;G.A. Grillone","doi":"10.1016/j.amjoto.2025.104605","DOIUrl":"10.1016/j.amjoto.2025.104605","url":null,"abstract":"<div><h3>Objective</h3><div>To assess Elastic Scattering Spectroscopy (ESS) classification accuracy of benign vs malignant tissue obtained during intra-operative oral cancer resection.</div></div><div><h3>Methods</h3><div>The study comprised 104 patients with a biopsy positive for oral cancer (<em>N</em> = 85) or dysplasia (<em>N</em> = 19) who were scheduled to undergo surgical excision. ESS measurements were obtained intraoperatively on and immediately adjacent to the lesion within the planned resection margin prior to excision, and on contralateral normal-site control tissue. Two-millimeter biopsies were obtained from tumor and margin tissue. All measurements were evaluated using Leave One Person Out (LOPO) AI-assisted statistical algorithms. Three analyses evaluated ESS diagnostic accuracy: one at the sample level, one at the pooled sample patient level, and one using only diagnostically variable biopsy co-registered margin samples. Statistical analyses included sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and Area Under the Receiver Operating Characteristic Curve (AUC-ROC).</div></div><div><h3>Results</h3><div>Diagnostic accuracy at the sample level yielded sensitivity = 82 %, specificity = 84 %, and AUC = 0.91. Pooling samples within each patient yielded sensitivity = 94 %, specificity = 87 %, and AUC = 0.95. Sample level diagnostic accuracy at the margin yielded sensitivity = 76 %, specificity = 50 %, and AUC = 0.70, but prioritizing sensitivity, yielded a sensitivity = 90 %, specificity = 30 %, with AUC = 0.70.</div></div><div><h3>Conclusion</h3><div>The ESS device demonstrated high sensitivity and appropriate specificity when differentiating benign from malignant tissue. Discriminant ability increased when samples were pooled within patients, informing future protocols for evaluating intraoperative ESS measures. These data are very promising and support the contention that ESS could be a valuable adjunct tool that facilitates comprehensive and efficient assessment of surgical margins.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 3","pages":"Article 104605"},"PeriodicalIF":1.8,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143580335","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}

{"title":"Exploring extended reality as a therapy for patients with facial paralysis: A scoping review","authors":"Shaun Edalati BS,&nbsp;Barak Spector BA,&nbsp;Richa Nathan BA,&nbsp;Vikram Vasan BS,&nbsp;Joshua Rosenberg MD,&nbsp;Mingyang L. Gray MD","doi":"10.1016/j.amjoto.2024.104562","DOIUrl":"10.1016/j.amjoto.2024.104562","url":null,"abstract":"<div><h3>Objectives</h3><div>In this study, we explore the use of extended reality (XR) therapy, which includes augmented (AR), virtual (VR), and mixed reality (MR), in patients experiencing symptoms of facial paralysis.</div></div><div><h3>Data sources</h3><div>Pubmed, Scopus, Embase.</div></div><div><h3>Methods</h3><div>A scoping review across PubMed, Scopus, Embase was performed following PRISMA-ScR systematic review guidelines with the use of Covidence.</div></div><div><h3>Results</h3><div>160 articles were identified and 7 articles, spanning from 2015 to 2023, ultimately met the criteria for this review. The articles reviewed highlight various XR applications and grading systems designed to enhance facial muscle strength, symmetry, and emotional well-being in Bell's palsy patients. Notable programs include FaraPy, FACE2FACE®App, eFace App, Canfeld, RealSense, GY MEDIC, and FaceRehab. These programs exhibit significant potential as effective rehabilitation and assessment tools in facial paralysis patients.</div></div><div><h3>Conclusion</h3><div>The use of extended reality (XR) technologies, along with 3D and 4D imaging, represents a major advancement in the field of facial paralysis therapy. These innovations offer exciting possibilities for enhancing patient care and optimizing outcomes for patients experiencing facial paralysis and muscle deficits. As these technologies start to be integrated into clinical contexts, further research and validation is required to ensure their efficacy and utilization.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104562"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536530","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}

{"title":"How we ask matters: Ensuring accurate responses from AI in patient counseling","authors":"Luigi Angelo Vaira ,&nbsp;Giacomo De Riu ,&nbsp;Carlos Miguel Chiesa-Estomba ,&nbsp;Antonino Maniaci ,&nbsp;Miguel Mayo-Yáñez ,&nbsp;Alberto Maria Saibene ,&nbsp;Jerome R. Lechien","doi":"10.1016/j.amjoto.2024.104557","DOIUrl":"10.1016/j.amjoto.2024.104557","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104557"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823736","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}

{"title":"Hearing following total ossicular chain reconstruction prosthesis with and without footplate shoe prosthesis","authors":"Zainab Balogun ,&nbsp;Sophia Dang ,&nbsp;Rahilla Tarfa ,&nbsp;Nadine Haykal ,&nbsp;Amber Shaffer ,&nbsp;Jennifer McCoy ,&nbsp;David Chi","doi":"10.1016/j.amjoto.2024.104561","DOIUrl":"10.1016/j.amjoto.2024.104561","url":null,"abstract":"<div><h3>Purpose</h3><div>To examine the audiometric outcomes of a footplate shoe (FPS) in total ossicular chain reconstruction prostheses (TORP) compared to TORP without shoe.</div></div><div><h3>Materials and methods</h3><div>Retrospective cohort study of patients who underwent TORP from 2010 to 2021 at a tertiary children's hospital. Patients without audiograms or unknown FPS status were excluded. Demographics, TORP indication, pure tone average (PTA) thresholds, and TORP revisions/replacements were recorded. Characteristics of patients with and without FPS were compared using exact logistic regression, <em>t</em>-test, Wilcoxon rank-sum, and log-rank tests.</div></div><div><h3>Results</h3><div>Of 76 patients, 27 (36 %) were female, and median age was 9.9 years (range 2.5–22.0 years). FPS was present in 12 (16 %) cases. Mean pre-operative PTA was 49.4 dB (SD: 15.1 dB) (no FPS) and 47.1 dB (SD: 9.3 dB) (with FPS) (<em>P</em> = 0.62). The first post-operative median PTA (median 3 months following surgery) was 36.3 dB (range 13.8–101.3 dB) (no FPS) and 31.6 dB (range 16.9–56.3 dB) in FPS group (<em>P</em> = 0.24). At the second post-operative visit (median 30.5 months following first audiogram), PTA <u>increased</u> to 45.6 dB (SD: 18.1 dB) (no FPS) compared to the first postoperative visit (<em>P</em> = 0.001). However, PTA was stable in the FPS group at the second postoperative visit (mean 35.6 dB, SD: 22.0 dB) compared to the first postoperative visit (<em>P</em> = 0.50).</div></div><div><h3>Conclusions</h3><div>Surgical intervention, regardless of FPS status, demonstrates significant improvement in audiometric outcomes at the first post-operative visit. At the second post-operative, there were no differences in audiometric outcomes among the FPS group, while the no FPS group had worse audiometric outcomes.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104561"},"PeriodicalIF":1.8,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536559","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}

{"title":"Incidence and characteristics of sudden sensorineural hearing loss during pregnancy and the postpartum period: A nationwide population-based study using customized cohort data","authors":"Taeung Eom ,&nbsp;Byungjun Jeong ,&nbsp;Seok-Hyun Kim ,&nbsp;Dong-Jo Kim ,&nbsp;Il-Woo Lee ,&nbsp;Hyun Min Lee ,&nbsp;Hwi Gon Kim","doi":"10.1016/j.amjoto.2025.104600","DOIUrl":"10.1016/j.amjoto.2025.104600","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to investigate the incidence and characteristics of sudden sensorineural hearing loss (SSNHL) in pregnant and non-pregnant women using the Korean National Health Insurance Service customized cohort data.</div></div><div><h3>Materials and methods</h3><div>We defined the delivery group as women aged 15–49 years with International Classification of Diseases 10th Revision codes O80-O84 indicating delivery between January 2013 and December 2019. The control group was selected from individuals in the same age range without a history of delivery during the same period. SSNHL was defined as having an H91.2 diagnostic code and having undergone audiometry at least once. The incidence and characteristics of SSNHL were compared between the two groups from 2015 to 2018.</div></div><div><h3>Results</h3><div>The incidence of SSNHL per 1000 individuals was lower in the delivery group (1.08–1.17) compared to the control group (1.52–1.80) each year. In the delivery group, SSNHL occurred most frequently in the 30–34 age group during the third trimester of pregnancy and the postpartum period. The proportion of patients with SSNHL with comorbidities such as hypertension, diabetes, and dyslipidemia was higher in the delivery group than in the control group.</div></div><div><h3>Conclusions</h3><div>Using the longest follow-up period and the largest population in South Korea, we found that pregnancy and childbirth did not increase the risk of SSNHL, which is consistent with the results of previous population-based studies. Our findings provide insights into the etiology of SSNHL and highlight the need for further research to better understand the underlying mechanisms and risk factors associated with SSNHL.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104600"},"PeriodicalIF":1.8,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027756","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}

{"title":"Efficacy analysis of intratympanic injection of dexamethasone at different concentrations for the treatment of unilateral idiopathic sudden sensorineural hearing loss","authors":"Shi-yi Wang ,&nbsp;Wen-ting Fu ,&nbsp;Meng Yu ,&nbsp;Aidong Sun ,&nbsp;Jingwu Sun ,&nbsp;Guang Li","doi":"10.1016/j.amjoto.2025.104603","DOIUrl":"10.1016/j.amjoto.2025.104603","url":null,"abstract":"<div><h3>Objective</h3><div>Our study tried to evaluate and compare the therapeutic efficacy of intratympanic injection of dexamethasone (DEX) at different concentrations for the treatment of idiopathic sudden sensorineural hearing loss (ISSNHL).</div></div><div><h3>Methods</h3><div>A prospective randomized controlled study was conducted on 203 patients with unilateral ISSNHL. Patients were divided into four groups: the control group (n = 47, systemic treatment only), the high-concentration group (n = 51, intratympanic injection of DEX 20 mg/ml), the medium-concentration group (n = 55, 10 mg/ml), and the low-concentration group (n = 50, 5 mg/ml). Pure tone audiometry (PTA) thresholds were measured before treatment and on the 10th day post-treatment, with a follow-up period of 2 months. Hearing gains and efficacy rates were compared among the groups.</div></div><div><h3>Results</h3><div>Significant differences were observed in PTA thresholds before and after treatment in all four groups (<em>P</em> &lt; 0.05), indicating that both systemic therapy and intratympanic injection were effective. The overall efficacy rate and hearing gain were higher in the intratympanic injection groups compared to the control group, but the differences were not statistically significant. Specifically, the control group achieved an efficacy rate of 57.4 % with a hearing gain of 11.25 ± 10.00 dB HL. The intratympanic injection groups showed an overall efficacy rate of 67.3 % and a hearing gain of 12.50 ± 10.94 dB HL, with subgroup results as follows: low-concentration group (62.0 %, 12.50 ± 11.56 dB HL), medium-concentration group (69.1 %, 11.25 ± 13.75 dB HL), and high-concentration group (70.6 %, 12.50 ± 8.75 dB HL). Among patients with severe or profound hearing loss, the high-concentration group exhibited significantly greater hearing gains compared to the control group, while no significant differences were observed in efficacy rates.</div></div><div><h3>Conclusion</h3><div>Combined intratympanic injection of DEX with systemic treatment for SSNHL provides higher hearing gains and efficacy rates compared to systemic treatment alone, though the differences were not statistically significant. In patients with severe or profound hearing loss, intratympanic injection of high-concentration DEX resulted in significantly greater hearing improvement, suggesting a potential therapeutic advantage in this subgroup.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104603"},"PeriodicalIF":1.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143035719","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}

{"title":"Response to letter to the editor: Making a racket in America's fastest growing sport: Evaluation of noise exposure in pickleball","authors":"Lawrance Lee,&nbsp;Nauman F. Manzoor","doi":"10.1016/j.amjoto.2025.104602","DOIUrl":"10.1016/j.amjoto.2025.104602","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104602"},"PeriodicalIF":1.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027717","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}

{"title":"Letter to the editor: Making a racket in America's fastest growing sport: Evaluation of noise exposure in pickleball","authors":"Kathleen Romito ,&nbsp;Daniel Fink","doi":"10.1016/j.amjoto.2025.104601","DOIUrl":"10.1016/j.amjoto.2025.104601","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104601"},"PeriodicalIF":1.8,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143027760","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}

{"title":"Increase in serum parathyroid hormone level intraoperatively after parathyroidectomy for primary hyperparathyroidism","authors":"Bassam Abboud ,&nbsp;Christopher Abboud","doi":"10.1016/j.amjoto.2025.104598","DOIUrl":"10.1016/j.amjoto.2025.104598","url":null,"abstract":"<div><h3>Background</h3><div>To evaluate the significance of increased of intraoperative parathyroid hormone(IOPTH) 10 min after parathyroidectomy in primary hyperparathyroidism.</div></div><div><h3>Methods</h3><div>All patients underwent parathyroidectomy were retrospectively included. Following the results of IOPTH, three groups were defined: Group 1: increased of IOPTH, Group 2: &lt;50 % decreased of IOPTH, and Group 3: &gt;50 % decreased of IOPTH.</div></div><div><h3>Results</h3><div>Unilateral approach was performed and shifted to bilateral neck exploration(BNE) when indicated. There were single adenoma, double adenomas, and hyperplasia in 84 %, 5 %, and 11 % of cases respectively. We noted that 100 %, 80 %, and 4 % of patients had a polyglandular diseases in Groups 1, 2, and 3 respectively. Double adenoma and hyperplasia were present in 55 %, and 45 %, 22 %, and 58 %, 1 %, and 3 % in Groups 1, 2, and 3 respectively. Female patients represented 55 %, 71 %, and 81 % of patients in Groups 1, 2, and 3 respectively. Cure rate was 99 %.</div></div><div><h3>Conclusions</h3><div>Patients with increased of IOPTH level 10 min after parathyroidectomy had a polyglandular diseases in 100 % of cases and needed BNE.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 2","pages":"Article 104598"},"PeriodicalIF":1.8,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998355","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}