American Journal of Otolaryngology最新文献

{"title":"Technique and outcomes of endoscopic supraglottic laryngectomy type IIIa using CO2 laser","authors":"Sara Bassani , Erica Zampieri , Gabriele Molteni","doi":"10.1016/j.amjoto.2024.104515","DOIUrl":"10.1016/j.amjoto.2024.104515","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104515"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666780","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":"Unmet educational needs and expectations among tracheostomy recipients","authors":"Tyler J. Gallagher ,&nbsp;Oluwatobiloba Ayo-Ajibola ,&nbsp;Michelle Koh ,&nbsp;Catherine Julien ,&nbsp;Kevin Herrera ,&nbsp;Jonathan D. West ,&nbsp;Niels C. Kokot","doi":"10.1016/j.amjoto.2024.104510","DOIUrl":"10.1016/j.amjoto.2024.104510","url":null,"abstract":"<div><h3>Objective</h3><div>This study seeks to better understand unmet educational needs and treatment expectations in individuals with a tracheostomy.</div></div><div><h3>Study design</h3><div>Retrospective, cross-sectional survey.</div></div><div><h3>Methods</h3><div>A survey was distributed to individuals who received a tracheostomy at a tertiary care center in the last five years as well as in Facebook support groups for tracheostomy and head and neck cancer patients. The survey focused on tracheostomy education, satisfaction with care, and gaps in treatment plan understanding. Primary outcome was rate of tracheostomy peri-operative experience being on-par with expectations.</div></div><div><h3>Results</h3><div>Among 83 respondents, only report of pre-operative speech (<em>p</em> = 0.024) and swallow (<em>p</em> = 0.019) discussions were associated with peri-operative experience being on-par with expectations. Respondents were more likely to report importance of counseling regarding psychological well-being (<em>p</em> &lt; 0.001) and post-operative social integration/interaction (p &lt; 0.001) than they were to report receiving focused counseling about these topics. Qualitative analysis demonstrated the most frequently missing components of understanding of treatment plans included post-operative care and the post-operative experience (<em>n</em> = 19, 40.4 % each). Reasons for treatment not meeting expectations included lack of communication/education (<em>n</em> = 15, 39.5 %) and experience being worse than expected (<em>n</em> = 8, 21.1 %). Individuals frequently wanted more details of the experience of living with a tracheostomy (<em>n</em> = 25, 42.6 %) and details about tracheostomy care (<em>n</em> = 10, 16.4 %).</div></div><div><h3>Conclusion</h3><div>This study demonstrates significant gaps in informational needs for individuals receiving a tracheostomy, emphasizing the importance of guideline-directed tracheostomy counseling. Specifically, more information is needed regarding expected post-surgical experience, tracheostomy care and maintenance, psychosocial wellbeing, and communication support.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104510"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666781","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":"The impact of primary immunodeficiency on the severity of chronic rhinosinusitis","authors":"Kevin Tie ,&nbsp;Mohamed A. Aboueisha ,&nbsp;Madelyn Wang ,&nbsp;David S. Caradonna ,&nbsp;Christopher D. Brook","doi":"10.1016/j.amjoto.2024.104541","DOIUrl":"10.1016/j.amjoto.2024.104541","url":null,"abstract":"<div><h3>Background</h3><div>Primary immunodeficiency has been associated with chronic rhinosinusitis (CRS). However, limited evidence exists on how primary immunodeficiencies affect the severity of CRS.</div></div><div><h3>Objective</h3><div>To assess how primary IgA and/or IgG immunodeficiency affects the severity of CRS.</div></div><div><h3>Methods</h3><div>Adult patients at the Beth Israel Deaconess Medical Center in Boston with IgA and/or IgG deficiency (group A) or normal IgA and IgG (group B) were queried between January 1, 2016 and December 31, 2022. Other immunodeficiencies were excluded. The groups were analyzed for prevalence of CRS based on ICD-10 codes. The groups were matched based on demographics and comorbidities. Patients with CRS were analyzed for ≥3 acute rhinosinusitis (ARS) episodes, mean lifetime ARS episodes, and mean ARS episodes per year (all with or without antibiotic treatment). Additional analyses included need for functional endoscopic sinus surgery (FESS) and mean lifetime FESS procedures based on CPT codes. A logistic regression analysis was then performed over the same parameters.</div></div><div><h3>Results</h3><div>A total of 346 patients had IgA and/or IgG deficiency (group A), and 11,438 patients had normal IgA and IgG (group B). CRS prevalence was higher in group A than group B (12 % vs. 5 %; <em>p</em> &lt; 0.001). Group A had more patients with ≥3 ARS episodes, higher mean lifetime ARS episodes, and ARS episodes per year, though none of these findings were statistically significant. There was no difference in need for FESS or mean lifetime FESS procedures.</div></div><div><h3>Conclusion</h3><div>CRS prevalence is higher in patients with IgA and/or IgG deficiency, but IgA and/or IgG immunodeficiency does not predispose patients to ARS episodes or predict need for FESS.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104541"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794283","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":"Rare case of cochlear implant damaged by nearby use of monopolar electrosurgery","authors":"Evan J. Patel ,&nbsp;Colleen Polite ,&nbsp;Jeffrey D. Sharon","doi":"10.1016/j.amjoto.2024.104588","DOIUrl":"10.1016/j.amjoto.2024.104588","url":null,"abstract":"<div><h3>Objectives</h3><div>To present a rare case of a cochlear implant (CI) damaged by nearby use of monopolar electrosurgery.</div></div><div><h3>Patient</h3><div>A 38-year-old man with a right-sided CI reported that his implant had stopped producing sound immediately after his meningioma resection.</div></div><div><h3>Interventions</h3><div>Right pterional craniotomy with use of monopolar electrosurgery.</div></div><div><h3>Main outcome measures</h3><div>Cochlear implant device performance, post-operative word recognition score (WRS).</div></div><div><h3>Results</h3><div>Formal evaluation revealed a defective cochlear implant. During revision surgery no gross defect was noted to the device suggesting that malfunction was due to electrical damage from nearby electrosurgery. The patient's hearing on the right subjectively returned to baseline after replacement of the CI and his WRS dropped to 46 % from 60 % prior to his craniotomy.</div></div><div><h3>Conclusions</h3><div>Monopolar electrosurgery in the immediate proximity to a CI can result in device malfunction.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104588"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891228","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":"Assessing adult sinusitis guidelines: A comparative analysis of AAO-HNS and AI Chatbots","authors":"Shaun Edalati,&nbsp;Shiven Sharma,&nbsp;Rahul Guda,&nbsp;Vikram Vasan,&nbsp;Shahed Mohamed,&nbsp;Sunder Gidumal,&nbsp;Satish Govindaraj,&nbsp;Alfred Marc Iloreta","doi":"10.1016/j.amjoto.2024.104563","DOIUrl":"10.1016/j.amjoto.2024.104563","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the guidelines offered by the American Academy of Otolaryngology—Head and Neck Surgery Foundation (AAO-HNS) on adult sinusitis to chatbots.</div></div><div><h3>Methods</h3><div>ChatGPT-3.5, ChatGPT-4.0, Bard, and Llama 2 represent openly accessible large language model-based chatbots. Accuracy, over-conclusiveness, supplemental, and incompleteness of chatbot responses were compared to the AAO-HNS Adult sinusitis clinical guidelines.</div></div><div><h3>Results</h3><div>12 guidelines consisting of 30 questions from the AAO-HNS were compared to 4 different chatbots. Adherence to AAO-HNS guidelines varied, with Llama 2 providing 80 % accurate responses, BARD 83.3 %, ChatGPT-4.0 80 %, and ChatGPT-3.5 73.3 %. Over-conclusive responses were minimal, with only one instance each from Llama 2 and ChatGPT-4.0. However, rates of incomplete responses varied, with Llama 2 exhibiting the highest at 40 %, followed by ChatGPT-4.0 at 33.3 %, BARD at 23.3 %, and ChatGPT-3.5 at 36.7 %. Fisher's Exact Test analysis revealed significant deviations from the guideline standard, with less accuracy (<em>p</em> = 0.012 for Llama 2, <em>p</em> = 0.026 for BARD, p = 0.012 for ChatGPT-4.0, <em>p</em> = 0.002 for ChatGPT-3.5), inclusion of supplemental data (<em>p</em> &lt; 0.001 for all), and less completeness (<em>p</em> &lt; 0.01 for all) across all chatbots, indicating potential areas for enhancement in their performance.</div></div><div><h3>Conclusion</h3><div>Although AI chatbots like Llama 2, Bard, and ChatGPT exhibit potential in sharing health-related information, their present performance in responding to clinical concerns concerning adult rhinosinusitis is not up to par with recognized clinical criteria. Future revisions should focus on addressing these shortcomings and placing an emphasis on accuracy, completeness, and conformity with evidence-based practices.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104563"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143062985","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":"Gargantuan carcinoma ex-pleomorphic adenoma of the submandibular gland: Case report and review of literature","authors":"Milena Fabry ,&nbsp;Jamie Shehan ,&nbsp;Jacob Markovicz ,&nbsp;Mohamedkazim Alwani MD ,&nbsp;Sameep Kadakia","doi":"10.1016/j.amjoto.2024.104539","DOIUrl":"10.1016/j.amjoto.2024.104539","url":null,"abstract":"<div><h3>Introduction</h3><div>Pleomorphic adenoma is the most common neoplasm of the major salivary glands, and can undergo malignant transformation to carcinoma ex-pleomorphic adenoma (CXPA) in untreated patients.</div></div><div><h3>Case presentation</h3><div>Our case describes a 56-year-old male with a 15-year history of slowly growing expansive right-sided neck. He underwent excision of the neck mass, neck dissection, and pectoralis flap reconstruction. Final pathology revealed a 22 cm CXPA with myoepithelial and salivary duct carcinoma components. The patient was recommended radiation therapy to receive 66 Gy in 33 fractions.</div></div><div><h3>Discussion</h3><div>CXPA is rare, typically aggressive, and carries a poor prognosis. This case is unique given the location of the tumor arising from the submandibular gland and delayed presentation leading to its massive size. Surgical planning for a lesion of this nature is complex due to structures in the vicinity and additional needs for reconstruction. Another important consideration highlighted by this case includes the need to assess patient reliability and provide resources to reduce the odds of being lost to follow up and enhance patient care.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104539"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790936","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":"Non-invasive screening for laryngeal cancer using the oral cavity as a proxy for differentiation of laryngeal cancer versus leukoplakia: A novel application of ESS technology and artificial intelligence supported statistical modeling","authors":"M. Sakharkar ,&nbsp;G. Spokas ,&nbsp;L. Berry ,&nbsp;K. Daniels ,&nbsp;P. Nithagon ,&nbsp;E. Rodriguez-Diaz ,&nbsp;L. Tracy ,&nbsp;J.P. Noordzij ,&nbsp;I. Bigio ,&nbsp;G. Grillone ,&nbsp;G.P. Krisciunas","doi":"10.1016/j.amjoto.2024.104581","DOIUrl":"10.1016/j.amjoto.2024.104581","url":null,"abstract":"<div><h3>Objective</h3><div>This preliminary study tested whether non-invasive, remote Elastic Scattering Spectroscopy (ESS) measurements obtained in the oral cavity can be used as a proxy to accurately differentiate between patients with laryngeal cancer versus laryngeal leukoplakia.</div></div><div><h3>Methods</h3><div>20 patients with laryngeal lesions [cancer (<em>n</em> = 10),leukoplakia (n = 10)] were clinically assessed and categorized by otolaryngologists per standard clinical practice. Patient demographics of age, race, sex, and smoking history were collected. A machine-learning artificial intelligence (AI) algorithm was applied to classify patients using ESS spectra of patients with benign laryngeal leukoplakia or laryngeal cancer. Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), F1, and area-under-the-curve (AUC) were calculated. Additional algorithms stratified spectral data by sub-anatomical site and smoking status to explore diagnostic capability.</div></div><div><h3>Results</h3><div>Overall, the algorithm had a sensitivity = 74 %, specificity = 40 %, PPV = 51 %, NPV = 64 %, F1 = 0.61 and AUC = 0.65. When stratifying by former and active smokers, algorithm sensitivities increased to 85 % and 77 %. Analysis by sub-anatomic location yielded an AUC = 0.77 for lateral tongue, and when stratified by (former/current) smoking status, demonstrated AUC = 0.94 and 0.83, sensitivities = 98 % and 76 %, and specificities = 85 % and 86 %. Algorithm output from the mucosal lip yielded sensitivity = 89 %, specificity = 88 %, PPV = 83 %, and NPV = 92 % in former smokers.</div></div><div><h3>Conclusion</h3><div>This pilot study demonstrated ESS technology coupled with AI-assisted statistical modeling, could differentiate between patients with laryngeal leukoplakia versus cancer with good precision, especially with smoking status and anatomic subclassification. If ESS can be utilized in the oral cavity as a non-invasive screening tool for laryngeal cancer, it would greatly facilitate early detection in specialized/non-specialized clinics, and under-resourced regions.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104581"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913727","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":"Predictive factors for drainage in pediatric cervical lymphadenitis: A study of clinical indicators and recovery outcomes","authors":"Hatice Merve Savran ,&nbsp;Fatih Savran ,&nbsp;Naciye Gönül Tanır","doi":"10.1016/j.amjoto.2024.104586","DOIUrl":"10.1016/j.amjoto.2024.104586","url":null,"abstract":"<div><h3>Background</h3><div>The purpose of this study was to investigate the predictive factors for drainage in patients hospitalized with cervical lymphadenitis in the Pediatrics Infectious Diseases Department and to differentiate the recovery time between patients who received antibiotic treatment only and those who received drainage for their lymphadenitis.</div></div><div><h3>Materials and methods</h3><div>We retrospectively analyzed 169 patients selected for this study, aged 1 month to 18 years, who were followed up with a diagnosis of cervical lymphadenitis between January 2011 and December 2019. Clinical features such as sex, age, physical examination findings, laboratory findings, imaging findings, and antibiotic treatments were retrospectively reviewed. Patients with lymphadenopathy larger than 2.5 cm, whose initial complaints lasted &lt;28 days, and whose clinical and follow-up data were complete were included in the study.</div></div><div><h3>Results</h3><div>Of the 169 patients in our study, 137 recovered without drainage and 32 with drainage. In these patients, findings such as an erythrocyte sedimentation rate &gt;53.5 mm/h, platelet count &gt;436,000/mm³, unilaterality, outpatient antibiotic use, and the lymph node ratio of short axis to long axis &gt;0.5 were found to be predictive factors for lymph node drainage.</div></div><div><h3>Conclusions</h3><div>Evaluation of patients with cervical lymphadenitis with physical examination, laboratory and imaging findings, and consideration of the factors predicting drainage with fine needle aspiration as soon as possible will shorten the length of hospital stay.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104586"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926280","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":"Outcomes with transcutaneous bone conduction implants in patients with mixed hearing loss","authors":"Ghazal S. Daher,&nbsp;Emily S. Thompson,&nbsp;Meredith Thomason,&nbsp;George B. Sankar,&nbsp;Cynthia A. Hogan,&nbsp;Matthew L. Carlson","doi":"10.1016/j.amjoto.2024.104513","DOIUrl":"10.1016/j.amjoto.2024.104513","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate audiological outcomes of transcutaneous devices among individuals with mixed hearing loss (MHL) who underwent implantation with the Cochlear™ Osia® and Med-El Bonebridge™ devices.</div></div><div><h3>Methods</h3><div>Adults with MHL in at least one ear, including a best bone conduction (BBC) threshold of 30 dB HL or poorer, and air-bone gaps of 15 dB HL or more at one or more frequencies were implanted with the Cochlear™ Osia® or Med-El Bonebridge™ devices for MHL. Four-frequency pure tone average (PTA) was calculated for aided thresholds and compared to preoperative PTAs for BBC thresholds.</div></div><div><h3>Results</h3><div>Among the study participants, 11 were implanted with Osia, and 11 were implanted with Bonebridge. In the Osia group, the BBC PTA averaged 23.6 dB, which was not significantly different from the aided PTA of 27.0 dB (<em>P</em> = 0.2). In the Bonebridge group, the BBC PTA averaged 23.3 dB while the aided PTA was significantly poorer at 32.9 dB (<em>P</em> = 0.03). In both groups, aided sound field thresholds were worse than BBC thresholds overall except for a 7 dB improvement at 2000 Hz in the Osia group (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>We highlight important limitations of current transcutaneous bone conduction systems for rehabilitation of MHL. Sound field outcomes for Osia and Bonebridge devices are limited by the BBC thresholds of either ear; these devices do not provide significant gain or “overclosure” beyond BBC thresholds. While both groups generally experienced declines in aided thresholds compared to best conduction thresholds, the Osia implant exhibited an exception of a 7 dB improvement at 2000 Hz.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104513"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685893","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":"Sudden sensorineural hearing loss in diabetes mellitus patients receiving intra-tympanic steroid injections","authors":"Shih-Lung Chen ,&nbsp;Chia-Ying Ho ,&nbsp;Shy-Chyi Chin ,&nbsp;Kai-Chieh Chan ,&nbsp;Yu-Chien Wang","doi":"10.1016/j.amjoto.2024.104576","DOIUrl":"10.1016/j.amjoto.2024.104576","url":null,"abstract":"<div><h3>Background</h3><div>Sudden sensorineural hearing loss is an acute hearing disorder typically managed using steroids. However, prognostic factors of diabetes mellitus (DM) patients undergoing intra-tympanic steroid injections (ITSIs) are unclear. We explored the prognostic factors for ITSI in DM patients with unilateral SSNHL.</div></div><div><h3>Methods</h3><div>This retrospective study enrolled 89 DM patients with unilateral SSNHL from July 2016 to June 2022. All patients received ITSIs, and their clinical and audiological data were analyzed.</div></div><div><h3>Results</h3><div>The patients' mean age was 49.31 ± 16.26 years. After ITSI, the mean hearing level gain was 14.91 ± 20.28 dB, the mean speech reception threshold (SRT) gain was 15.78 ± 32.16 dB, and the mean speech discrimination score (SDS) gain was 16.94 ± 35.06 %. Based on Siegel's criteria, 8 patients (8.98 %) had complete recovery, 14 (15.73 %) had partial recovery, 16 (17.98 %) had slight recovery, and 51 (57.31 %) had no improvement. Older age (odds ratio [OR] = 0.970, 95 % confidence interval [CI]: 0.941–0.999, <em>p</em> = 0.043) and profound hearing loss on pure-tone audiometry (PTA; OR = 0.058, 95 % CI: 0.007–0.462, <em>p</em> &lt; 0.001) were adverse prognostic factors in univariate analyses. Older age (OR = 0.963, 95 % CI: 0.932–0.994, <em>p</em> = 0.023) and profound hearing loss (OR = 0.048, 95 % CI: 0.005–0.395, <em>p</em> = 0.004) were independent negative prognostic factors in a multivariate analysis.</div></div><div><h3>Conclusions</h3><div>ITSI is effective and avoids side effects of high-dose steroids in patients with SSNHL and DM. Among 89 DM SSNHL patients who underwent ITSI, older age and profound hearing loss were negative prognostic factors. Prompt and active management is necessary for DM patients with these risk factors.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104576"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891236","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}