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Online Attention to Articles Published in Otolaryngology Journals.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-20 DOI: 10.1001/jamaoto.2024.5251
Robert Stephen Hong, Caleb James Fan, Jacob Charles Lucas

Importance: The internet has changed the way that medical information by journals is disseminated, with a shift toward online distribution. Given this, it is important to include alternative metrics that measure online attention when determining the influence of otolaryngology journals.

Objective: To describe a ranking system for otolaryngology journals that reflects the amount of publicity received online and to determine factors associated with these rankings.

Design and setting: In this cross-sectional study, online attention was measured using Altmetric Attention Scores obtained for all 26 112 articles published by the 43 journals classified under the Journal Citation Reports category of otorhinolaryngology from 2018 to 2022. Data were analyzed from January to June 2023.

Main outcomes and measures: Altmetric journal rankings were created from the top 500 articles with the highest Altmetric Attention Scores, using a rank sum weight-based method to assign credit for an article's attention online to its respective journal. The association of article content, study design and type, and social media presence on X (formerly Twitter) with ranking was examined. Comparisons between Altmetric journal rankings and bibliometric rankings (5-year Impact Factor) were also performed.

Results: Of 43 otolaryngology journals, JAMA Otolaryngology-Head & Neck Surgery had the highest Altmetric journal ranking. Most articles in the Altmetric top 500 were nonoperative clinical studies (220 articles [43.5%]) or described the natural history of disease (176 articles [34.9%]) and involved otology/neurotology (158 articles [29.9%]) or rhinology/allergy (134 articles [25.4%]). The COVID-19 pandemic was a common topic (169 articles [33.5%]). The presence of an active X account for the entire 5-year period was associated with a higher Altmetric total rank sum score for journals (η2 = 0.07; 95% CI, 0.02-0.13 [moderate effect size]). There was a moderate statistically significant correlation between Altmetric journal rankings and 5-year Impact Factor rankings (r = 0.5; 95% CI, 0.2-0.7).

Conclusions and relevance: This cross-sectional study demonstrates that metrics based on online attention provide an alternative way to assess the reach and influence of medical journals. Journals seeking to expand their influence online may benefit from a presence on social media.

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引用次数: 0
EORTC Quality-of-Life Questionnaire Responsiveness in Surgical Patients With Head and Neck Cancer.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-20 DOI: 10.1001/jamaoto.2024.5260
Michael P Wu, Samir C Seshadri, Sarah Whittaker, Nadine McCleary, Ravindra Uppaluri, Eleni Rettig, Donald Annino, Laura Goguen, Rosh K V Sethi
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引用次数: 0
Performance of 8 Smoking Metrics for Modeling Survival in Head and Neck Squamous Cell Carcinoma.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-20 DOI: 10.1001/jamaoto.2024.5392
Andrew C L Lam, Katrina Hueniken, Martha Pienkowski, John J W Lee, Mei Dong, Brenda Diergaarde, Andrew F Olshan, Paul Brennan, Shama Virani, Deborah Saunders, Stacey A Santi, Michael S C Conlon, Tim Waterboer, D Neil Hayes, Miranda Pring, Gary J Macfarlane, Pagona Lagiou, Areti Lagiou, Jerry Polesel, Antonio Agudo, Laia Alemany, Wolfgang Ahrens, Claire M Healy, David I Conway, Mari Nygard, Cristina Canova, Anna Hornakova, Lorenzo Richiardi, Ariana Znaor, Rayjean J Hung, Wei Xu, Geoffrey Liu
<p><strong>Importance: </strong>Cigarette smoking is a strong risk factor for mortality in patients diagnosed with head and neck squamous cell carcinoma (HNSCC). However, little evidence supports which smoking metric best models the association between smoking and survival in HNSCC.</p><p><strong>Objective: </strong>To determine which smoking metric best models a linear association between smoking exposure and overall survival (OS) in patients with HNSCC.</p><p><strong>Design, setting, and participants: </strong>A retrospective multicenter cohort study of 6 clinical epidemiological studies was performed. Five were part of the Human Papillomavirus, Oral and Oropharyngeal Cancer Genomic Research (VOYAGER) consortium. Participants included patients 18 years and older with pathologically confirmed HNSCC. Data were collected from January 2002 to December 2019, and data were analyzed between January 2022 to November 2024.</p><p><strong>Main outcomes and measures: </strong>The primary outcome was OS. The performance of 8 smoking metrics, including pack-years, duration, and log cig-years (calculated as log10[cigarettes smoked per day + 1] × number of years smoked) for modeling OS were compared. Metric performance was measured by the strength of association in Cox proportional hazard models, linearity based on P for linear trend, Akaike information criterion (AIC; lower value indicates better model fit), and visual assessment of spline curves. Secondary outcomes included modeling OS in clinicodemographic subgroups and HNSCC anatomic subsites. Exploratory outcomes included cancer-specific survival and noncancer survival.</p><p><strong>Results: </strong>In total, 8875 patients with HNSCC (2114 [24%] female; median [IQR] age, 61 [54-69] years) were included. Of 8 smoking metrics evaluated, smoking duration (adjusted hazard ratio [aHR], 1.11 [95% CI, 1.03-1.19]) and log cig-years (aHR, 1.11 [95% CI, 1.04-1.18]) had the highest aHRs; both had a statistically significant linear association with OS. Log cig-years had the lowest AIC linear value and the most visually linear spline curve when modeling OS. Duration and log cig-years outperformed pack-years for modeling OS regardless of age, smoking status, and cancer stage. Both performed well in lip and oral cavity, laryngeal (only duration was significant), and human papillomavirus-negative oropharyngeal subsites. In an exploratory analysis, duration had the highest aHR (1.15 [95% CI, 1.02-1.29]), and log cig-years had the lowest AIC linear value when modeling noncancer survival.</p><p><strong>Conclusions and relevance: </strong>In this cohort study, smoking duration and log cig-years best modeled a linear relationship with OS for patients with HNSCC. Both metrics maintained robust performance within specific clinicodemographic subgroups and anatomic subsites. Although most HNSCC survival models control for smoking exposure using smoking status or pack-years, duration and log cig-years may be superior metrics to
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引用次数: 0
Perceived Taste Loss From Early Adulthood to Mid to Late Adulthood and Mortality.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-13 DOI: 10.1001/jamaoto.2024.5072
Ruixin Zhu, Ran Wang, Jingjing He, Liwei Zhang, Peng An, Keji Li, Fazheng Ren, Weili Xu, Jie Guo

Importance: Evidence on the associations of taste function changes from early adulthood to mid to late adulthood with all-cause mortality is limited.

Objective: To investigate the associations between subjective perception of taste loss from early adulthood to mid to late adulthood and all-cause mortality.

Design, setting, and participants: This population-based cohort study used data from the US National Health and Nutrition Examination Survey (2011-2014) and linked mortality information from the National Death Index (NDI) and included adults aged 40 years and older. Data analyses were conducted between May 6, 2024, and July 22, 2024.

Exposures: Subjective decline in taste function and ability to detect basic tastes (ie, salt, sourness, sweetness, or bitterness) since the age of 25 years.

Main outcomes and measures: All-cause mortality was ascertained via linkage to the NDI with follow-up until December 31, 2019.

Results: Among 7340 participants (52.8% female), 662 (weighted, 8.9%) reported subjective perception of taste loss from early adulthood to mid to late adulthood. During a median (IQR) follow-up of 6.67 (5.67-7.83) years, 1011 deaths occurred. Subjective perception of taste loss was associated with a 47% higher risk of mortality (multiadjusted hazard ratio [HR], 1.47; 95% CI, 1.06-2.03). Specifically, self-reported loss in ability to taste salt (multivariable adjusted HR [aHR], 1.65; 95% CI, 1.21-2.26) and sourness (aHR, 1.69; 95% CI, 1.19-2.40) was associated with increased mortality. Self-reported decline in ability to taste bitterness was associated with increased mortality only in female participants (aHR, 1.63; 95% CI, 1.05-2.53), whereas decline in ability to taste sourness was associated with increased mortality only in male participants (aHR, 1.69; 95% CI, 1.03-2.75). Moreover, among all and female participants without perceived smell function loss, those with perceived taste function loss still had increased mortality (all participants: aHR, 1.64; 95% CI, 1.12-2.40; female participants: aHR, 1.71; 95% CI, 1.14-2.56; male participants: aHR, 1.44; 95% CI, 0.80-2.59).

Conclusions and relevance: In this population-based cohort study, subjective perception of taste loss from early adulthood to mid to late adulthood, particularly perception of salt and sourness, was associated with increased all-cause mortality. The mortality risk associated with perceived taste loss could not be mitigated by undeteriorated smell function. These findings suggest that subjective perception of taste loss may serve as a simple and valuable indicator for screening high-risk populations in clinic and public health practice.

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引用次数: 0
Cost-Benefit Analysis of Intraoperative Autofluorescence for Parathyroid Identification.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-13 DOI: 10.1001/jamaoto.2024.5185
Hazel G Serrao-Brown, Alexander J Papachristos, Stanley B Sidhu

Importance: Hypoparathyroidism (hypoPT) is the most common complication post-total thyroidectomy and is associated with increased morbidity and mortality when chronic. Conventionally, the prevention of hypoPT has involved visual inspection of parathyroid glands; however, near-infrared autofluorescence detection systems have been recently used as adjuncts. These systems involve significant outlay and ongoing costs.

Objective: To evaluate the cost-effectiveness of autofluorescence for hypoPT prevention and to determine the chronic hypoPT rate at which this technology would become economically feasible.

Design, setting, and participants: In this cost-benefit analysis, a decision tree economic model was developed to compare thyroidectomies performed with autofluorescence to visual inspection only. All costs associated with conventional surgery, autofluorescence, and the costs of managing hypoPT were captured. Morbidity was defined in terms of disutility, quantified as quality-adjusted life-years, determined over a lifetime time horizon. The model was used to calculate the incremental cost-effectiveness ratio for autofluorescence-guided surgery and to identify determinants that influenced this ratio, and hence the economic feasibility of the use of autofluorescence. This study was based on the health care setting in Australia, in which more than 3500 thyroidectomies are performed annually. A probe-based autofluorescence detection system was used for analysis based on its availability in Australia. All costs were quantified in Australian dollars (A$) and were adjusted for 2024. The study data spanned from June 2022 to May 2023, and the data were analyzed in June 2023.

Results: The economic model analysis indicated that autofluorescence involved an additional cost of A $1024 (US $639) per surgery, offset by an increase in quality-adjusted life-years of 0.0080, resulting in an incremental cost-effectiveness ratio of A $128 234 (US $80 060). In Australia, it is generally assumed that interventions with a ratio of up to A $70 000 (US $43 703) may be considered cost-effective. Cost-effectiveness was most sensitive to a change in the overall hypoPT rate, chronic hypoPT rate, and the efficacy of autofluorescence. Autofluorescence-guided surgery achieved the cost-effectiveness threshold at a chronic hypoPT rate of greater than or equal to 5%.

Conclusions and relevance: Although the use of autofluorescence involves significant costs, its economic feasibility for the prevention of postsurgical hypoPT is determined by the underlying chronic and overall hypoPT rate, as well as the efficacy of autofluorescence for the reduction of hypoPT. The findings of this cost-benefit analysis are relevant in determining the prioritization and allocation of finite health care resources.

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引用次数: 0
Postnasal Drip.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-13 DOI: 10.1001/jamaoto.2024.5136
Jerlon Chiu, Nicholas R Rowan
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引用次数: 0
Reduction of Bleeding From Pterygopalatal Injection: A Systematic Review and Meta-Analysis.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-13 DOI: 10.1001/jamaoto.2024.5047
Sung Ryul Shim, Jieun Shin, Cheol Mog Hwang, Yong Kyun Kim, Jong Bum Park, Jong-Yeup Kim
<p><strong>Importance: </strong>Endoscopic sinus surgery (ESS) is a minimally invasive surgical method that is widely used in the treatment of various sinonasal conditions, including chronic sinusitis, nasal polyps, and fungal sinusitis. However, intraoperative bleeding remains a significant challenge.</p><p><strong>Objective: </strong>To evaluate the effects of pterygopalatal injections with lidocaine and adrenaline during sinus surgery.</p><p><strong>Data sources: </strong>PubMed/MEDLINE, the Cochrane Library, and EMBASE were systematically searched from database inception through July 31, 2024. Two authors also manually and independently searched all relevant studies.</p><p><strong>Study selection: </strong>Randomized clinical trials with (1) patients diagnosed with sinusitis; (2) interventions that included pterygopalatal injections with lidocaine and adrenaline; (3) comparisons that were specified as normal saline or no injection; and (4) outcomes that used subjective scores (Boezaart surgical field grading [BSFG]) and objective markers (amount of bleeding, duration of surgery, and mean arterial pressure [MAP]).</p><p><strong>Data extraction and synthesis: </strong>Data extraction was completed independently by 2 extractors and cross-checked for research integrity. The pairwise meta-analysis was performed to compare the treatment group with control used in ESS. Hedges g standardized mean differences (SMDs) and mean differences (MDs) were used for improvement in all outcomes.</p><p><strong>Main outcomes and measures: </strong>Efficacy outcomes included subjective scores, such as BSFG, as well as objective markers measuring amount of bleeding, duration of surgery, and MAP.</p><p><strong>Results: </strong>A comprehensive literature search identified 322 patients from 7 studies. The studies were conducted in Australia, Canada, Egypt, India, and Iran. The mean age range was 30 to 48.8 years, and 36.7% to 66.7% of the study populations were male. In most studies, the observation time of BSFG was measured at 15-minute intervals and measured from a minimum of 15 minutes to a maximum of 150 minutes. The pooled SMD for BSFG between treatments vs the control group was -1.01 (95% CI, -1.72 to -0.30), indicating that pterygopalatal injection with lidocaine and adrenaline was associated with improvement in the surgical field condition. The pooled MD for MAP between treatments vs the control group was -0.49 mm Hg (95% CI, -0.91 to -0.07), indicating that pterygopalatal injection was associated with significantly reduced MAP. The pooled MD for amount of bleeding between treatments vs the control group was -9.47 mL (95% CI, -29.05 to 10.11), and the pooled MD for duration of surgery between treatments vs the control group was -4.28 minutes (95% CI, -12.85 to 4.29), indicating that that this technique was not significantly associated with amount of bleeding or duration of surgery.</p><p><strong>Conclusions and relevance: </strong>The findings of this systemat
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引用次数: 0
Concerns Regarding Mouth Closure and Airflow in Obstructive Sleep Apnea.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.5073
Yu-Ting Lin, Chi-Yu Liao, Chia-Hao Hsu
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引用次数: 0
Manual Therapy for Fibrosis-Related Late Effect Dysphagia in Head and Neck Cancer Survivors: The MANTLE Nonrandomized Clinical Trial.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.5157
Holly McMillan, Carla L Warneke, Sheila Buoy, Christine Porsche, Kiara Savage, Stephen Y Lai, Clifton D Fuller, Katherine A Hutcheson
<p><strong>Importance: </strong>Late radiation-associated dysphagia (RAD) after head and neck cancer (HNC) treatment is challenging and commonly treatment refractory, with fibrosis stiffening connective tissues and compressing peripheral nerve tracts, contributing to diminished strength and possibly denervation of swallowing muscles. Manual therapy (MT), while common for cancer-related pain and other indications, remains largely unstudied for fibrosis-related late RAD.</p><p><strong>Objective: </strong>To determine the feasibility and safety of MT, estimate effect size and durability of MT for associated improvements in cervical range of motion (CROM), and examine functional outcomes after MT in survivors of HNC with fibrosis-related late RAD.</p><p><strong>Design, setting, and participants: </strong>This nonrandomized clinical trial, Manual Therapy for Fibrosis-Related Late Effect (MANTLE) Dysphagia in Head and Neck Cancer Survivors, is a prospective, single-institution, pilot, single-arm supportive care trial conducted at a National Comprehensive Cancer Network-designated academic comprehensive cancer center. Participants were adult survivors of HNC who were disease free at 2 or more years after curative-intent radiotherapy with grade 2 or higher fibrosis (per Common Terminology Criteria for Adverse Events version 4.0) and grade 2 or higher dysphagia (per video fluoroscopy Dynamic Imaging Grade of Swallowing Toxicity [DIGEST]). Data were collected June 2018 to July 2021 and analyzed November 2022 to November 2024.</p><p><strong>Intervention: </strong>MANTLE included 10 hourly MT sessions by lymphedema-certified speech-language pathologists over 6 weeks with a home exercise program. During the subsequent 6-week washout period, participants implemented only the home exercise program, without clinician MT.</p><p><strong>Outcomes and measures: </strong>Primary end points were feasibility (per therapy completion rate, with a 75% target) and safety. Secondary end points included functional outcomes per CROM, dysphagia severity (per DIGEST), maximum interincisal opening (MIO), and validated participant-reported outcomes (PROs).</p><p><strong>Results: </strong>Among 24 survivors of HNC (20 male [83.3%]; median [range] age, 68 [53-80] years), there was a median (range) of 8.9 (2.4-30.2) years after curative-intent radiotherapy. A total of 22 participants (91.7%) completed the 10 prescribed therapy sessions, and 1 participant experienced a severe adverse event. Secondary end points improved among participants who completed the therapy: MIO (r = 0.76; 95% CI, 0.66 to 0.94) and all 6 planes of CROM (eg, cervical extension: r = 0.86; 95% CI, 0.83 to 0.93) improved, with large effect sizes from baseline to after MT. Large to moderate effect sizes were achieved in symptom measures per PROs (eg, lymphedema-fibrosis symptom severity after MT: r = 0.74; 95% CI, 0.63 to 0.99). However, effect sizes were small to moderate or null in uncompensated swallowing outcom
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引用次数: 0
Back to the Workforce-An Important Marker of Survivorship.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.5016
Mark Varvares, Regan Bergmark, Nosayaba Nosa Osazuwa-Peters
{"title":"Back to the Workforce-An Important Marker of Survivorship.","authors":"Mark Varvares, Regan Bergmark, Nosayaba Nosa Osazuwa-Peters","doi":"10.1001/jamaoto.2024.5016","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.5016","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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JAMA otolaryngology-- head & neck surgery
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