首页 > 最新文献

JAMA otolaryngology-- head & neck surgery最新文献

英文 中文
Residential Differences and Depression Among Older Adults With Dual Sensory Loss. 老年双重感觉丧失患者的居住差异与抑郁。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-02 DOI: 10.1001/jamaoto.2024.4488
Ethan B Wang, Emmanuel E Garcia Morales, Alden L Gross, Frank R Lin, Nicholas S Reed, Jennifer A Deal

Importance: Investigating rural-urban and regional differences in the association between dual sensory loss (concurrent hearing and vision loss) and depression may highlight gaps in sensory loss research and health care services, and by socioeconomic status. Whether urbanicity and region may modify associations between sensory loss and depression is unknown.

Objective: To describe the rural-urban and regional differences in the association of dual sensory loss with depression among older adults.

Design, setting, and participants: This cross-sectional study used data from wave 1 (April 2017-December 2019) of the population-based Longitudinal Aging Study in India (LASI). Participants were recruited from 35 states and union territories in India. LASI incorporated a multistage stratified area probability cluster sampling design to recruit participants 45 years and older and their spouses; 31 447 eligible participants 60 years of age or older were interviewed. Data analyses were conducted from May 17, 2022, to November 11, 2023.

Exposures: Sensory loss (no sensory loss, hearing loss only, vision loss only, and dual sensory loss) was determined by respondents' self-reported perceived difficulty regarding hearing and vision function.

Main outcomes and measures: The Composite International Diagnostic Interview (CIDI-SF) scale was used to identify major episodic depression. Logistic regression was used to estimate the odds ratios (ORs) and 95% CIs of depression comparing participants with vs without sensory loss, adjusting for demographic and clinical covariates. Rural-urban and regional differences were assessed by including interaction terms between these variables and sensory loss.

Results: The study analysis included 27 927 participants (mean [SD] age, 68.0 [7.2] years; 14 477 [51%] females and 13 450 [49%] males). The fully adjusted models showed that the odds of depression with dual sensory loss (vs no loss) was higher in urban (OR, 3.16; 95% CI, 2.00-4.99) vs rural (OR, 1.73; 95% CI, 1.31-2.29) residents and among residents in the West (OR, 5.10; 95% CI, 1.74-14.97) vs North (OR, 1.38; 95% CI, 0.81-2.35) regions.

Conclusions and relevance: These findings indicate that sensory loss is associated with depression in older adults, with differences by urbanicity and region. Adults with sensory loss across multiple systems may be an important group to target for intervention.

重要性:调查双重感觉丧失(同时听力和视力丧失)与抑郁症之间关联的城乡和地区差异,可能会突出感觉丧失研究和卫生保健服务以及社会经济地位方面的差距。城市化和地域是否会改变感觉丧失和抑郁之间的联系尚不清楚。目的:探讨老年人双重感觉丧失与抑郁之间的城乡和地区差异。设计、环境和参与者:本横断面研究使用了印度基于人口的纵向老龄化研究(LASI)第一波(2017年4月- 2019年12月)的数据。参与者来自印度的35个邦和联邦属地。LASI采用多阶段分层区域概率整群抽样设计,招募45岁及以上的参与者及其配偶;31 对447名年龄在60岁及以上的合格参与者进行了访谈。数据分析时间为2022年5月17日至2023年11月11日。暴露:感觉丧失(无感觉丧失、仅听力丧失、仅视力丧失和双感觉丧失)由受访者自我报告的听力和视觉功能感知困难来确定。主要结果和测量方法:采用综合国际诊断访谈(CIDI-SF)量表来识别重度发作性抑郁症。采用Logistic回归来估计有感觉丧失与无感觉丧失的受试者抑郁的比值比(ORs)和95% ci,并对人口统计学和临床协变量进行调整。通过纳入这些变量和感觉丧失之间的相互作用项来评估城乡和区域差异。结果:研究分析纳入27名 927名参与者(平均[SD]年龄68.0[7.2]岁;14 477[51%]女性和13 450[49%]男性)。完全调整后的模型显示,在城市中,抑郁症合并双重感觉丧失(与无感觉丧失相比)的几率更高(OR, 3.16;95% CI, 2.00-4.99) vs农村(OR, 1.73;95% CI, 1.31-2.29)居民和西部居民(OR, 5.10;95% CI, 1.74-14.97) vs North (OR, 1.38;95% CI, 0.81-2.35)。结论和相关性:这些发现表明,老年人的感觉丧失与抑郁症有关,但因城市和地区而异。多系统感觉丧失的成年人可能是干预的重要目标群体。
{"title":"Residential Differences and Depression Among Older Adults With Dual Sensory Loss.","authors":"Ethan B Wang, Emmanuel E Garcia Morales, Alden L Gross, Frank R Lin, Nicholas S Reed, Jennifer A Deal","doi":"10.1001/jamaoto.2024.4488","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4488","url":null,"abstract":"<p><strong>Importance: </strong>Investigating rural-urban and regional differences in the association between dual sensory loss (concurrent hearing and vision loss) and depression may highlight gaps in sensory loss research and health care services, and by socioeconomic status. Whether urbanicity and region may modify associations between sensory loss and depression is unknown.</p><p><strong>Objective: </strong>To describe the rural-urban and regional differences in the association of dual sensory loss with depression among older adults.</p><p><strong>Design, setting, and participants: </strong>This cross-sectional study used data from wave 1 (April 2017-December 2019) of the population-based Longitudinal Aging Study in India (LASI). Participants were recruited from 35 states and union territories in India. LASI incorporated a multistage stratified area probability cluster sampling design to recruit participants 45 years and older and their spouses; 31 447 eligible participants 60 years of age or older were interviewed. Data analyses were conducted from May 17, 2022, to November 11, 2023.</p><p><strong>Exposures: </strong>Sensory loss (no sensory loss, hearing loss only, vision loss only, and dual sensory loss) was determined by respondents' self-reported perceived difficulty regarding hearing and vision function.</p><p><strong>Main outcomes and measures: </strong>The Composite International Diagnostic Interview (CIDI-SF) scale was used to identify major episodic depression. Logistic regression was used to estimate the odds ratios (ORs) and 95% CIs of depression comparing participants with vs without sensory loss, adjusting for demographic and clinical covariates. Rural-urban and regional differences were assessed by including interaction terms between these variables and sensory loss.</p><p><strong>Results: </strong>The study analysis included 27 927 participants (mean [SD] age, 68.0 [7.2] years; 14 477 [51%] females and 13 450 [49%] males). The fully adjusted models showed that the odds of depression with dual sensory loss (vs no loss) was higher in urban (OR, 3.16; 95% CI, 2.00-4.99) vs rural (OR, 1.73; 95% CI, 1.31-2.29) residents and among residents in the West (OR, 5.10; 95% CI, 1.74-14.97) vs North (OR, 1.38; 95% CI, 0.81-2.35) regions.</p><p><strong>Conclusions and relevance: </strong>These findings indicate that sensory loss is associated with depression in older adults, with differences by urbanicity and region. Adults with sensory loss across multiple systems may be an important group to target for intervention.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914828","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
Neoadjuvant GLP-1 Receptor Agonists in Sleep Surgery. 新辅助GLP-1受体激动剂在睡眠手术中的应用。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-02 DOI: 10.1001/jamaoto.2024.4593
Ryan Chin Taw Cheong, Kenny Peter Pang
{"title":"Neoadjuvant GLP-1 Receptor Agonists in Sleep Surgery.","authors":"Ryan Chin Taw Cheong, Kenny Peter Pang","doi":"10.1001/jamaoto.2024.4593","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4593","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914797","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
Clarification Regarding Insurance Disparities Among Patients With Head and Neck Cancer. 头颈癌患者保险差异的澄清。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-02 DOI: 10.1001/jamaoto.2024.4668
Ching-Nung Wu, Wei-Chun Cheng, James Cheng-Chung Wei
{"title":"Clarification Regarding Insurance Disparities Among Patients With Head and Neck Cancer.","authors":"Ching-Nung Wu, Wei-Chun Cheng, James Cheng-Chung Wei","doi":"10.1001/jamaoto.2024.4668","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4668","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914785","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
Bilateral Expansile Perigeniculate Lesions in a Patient With Idiopathic Intracranial Hypertension. 特发性颅内高压患者的双侧扩张性周赘病变。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-02 DOI: 10.1001/jamaoto.2024.4611
Lawrance Lee, Mihai Bentan, Nauman F Manzoor
{"title":"Bilateral Expansile Perigeniculate Lesions in a Patient With Idiopathic Intracranial Hypertension.","authors":"Lawrance Lee, Mihai Bentan, Nauman F Manzoor","doi":"10.1001/jamaoto.2024.4611","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4611","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914813","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
Clinical Perspectives on the Pathophysiology of Facial Synkinesis: A Narrative Review. 颜面联动病理生理的临床研究综述。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-02 DOI: 10.1001/jamaoto.2024.4489
Benjamin Rail, Dominic Henn, Y Edward Wen, Diana Tavares-Ferreira, Shai M Rozen

Importance: Facial synkinesis refers to pathologic cocontraction and baseline hypertonicity of muscles innervated by the facial nerve, commonly attributed to the aberrant regeneration of nerve fibers following injury. The pathomechanism and optimal treatment of facial synkinesis remain unclear. The goal of this review is to highlight current understanding of the epidemiology, pathophysiology, clinical presentation, assessment, and treatment of facial synkinesis.

Observations: Research into the epidemiology and risk factors of facial synkinesis is limited due to a lack of large databases tracking patients with facial palsy, inherent selection bias, and the wide range of symptom severity. Misguided nerve regeneration, polyneuronal innervation, and cortical changes are implicated in the development of synkinesis, and a better understanding of these mechanisms is required to develop new treatments. The clinical presentation of facial synkinesis varies considerably among patients, and important prognostic questions regarding timing of onset and progression of symptoms remain incompletely answered. Current management options for facial synkinesis include noninvasive modalities, chemodenervation, myectomy, and selective neurectomy. Potential new treatments for facial synkinesis are being investigated in animal models, but few have been tested in humans.

Conclusions and relevance: The treatment of facial synkinesis is currently hindered by limitations in clinical research and understanding of pathomechanism. Current studies predominantly yield level 4 evidence or lower. The development of large datasets of patients with facial palsy and the translation of basic science evidence to humans will facilitate the advancement of new treatments.

重要性:面神经联动是指受面神经支配的肌肉的病理性收缩和基线高张力,通常归因于损伤后神经纤维的异常再生。面部联觉的发病机制和最佳治疗方法尚不清楚。这篇综述的目的是强调当前对面部联动性的流行病学、病理生理学、临床表现、评估和治疗的理解。观察:由于缺乏追踪面瘫患者的大型数据库、固有的选择偏差以及症状严重程度范围广,对面瘫的流行病学和危险因素的研究受到限制。误导的神经再生、多神经元支配和皮质变化与联运动的发展有关,需要更好地了解这些机制来开发新的治疗方法。面部联动性的临床表现在不同的患者之间有很大的差异,关于症状发生和进展的时间的重要预后问题仍然没有得到完全的回答。目前面部神经联动性的治疗方案包括无创模式、化学神经支配、肌切除术和选择性神经切除术。面部联动的潜在新疗法正在动物模型中进行研究,但很少在人体中进行测试。结论及意义:由于临床研究的限制和对病理机制的了解,目前面部联动性的治疗受到阻碍。目前的研究主要得出4级或更低的证据。面瘫患者的大型数据集的开发和基础科学证据对人类的转化将促进新疗法的进步。
{"title":"Clinical Perspectives on the Pathophysiology of Facial Synkinesis: A Narrative Review.","authors":"Benjamin Rail, Dominic Henn, Y Edward Wen, Diana Tavares-Ferreira, Shai M Rozen","doi":"10.1001/jamaoto.2024.4489","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4489","url":null,"abstract":"<p><strong>Importance: </strong>Facial synkinesis refers to pathologic cocontraction and baseline hypertonicity of muscles innervated by the facial nerve, commonly attributed to the aberrant regeneration of nerve fibers following injury. The pathomechanism and optimal treatment of facial synkinesis remain unclear. The goal of this review is to highlight current understanding of the epidemiology, pathophysiology, clinical presentation, assessment, and treatment of facial synkinesis.</p><p><strong>Observations: </strong>Research into the epidemiology and risk factors of facial synkinesis is limited due to a lack of large databases tracking patients with facial palsy, inherent selection bias, and the wide range of symptom severity. Misguided nerve regeneration, polyneuronal innervation, and cortical changes are implicated in the development of synkinesis, and a better understanding of these mechanisms is required to develop new treatments. The clinical presentation of facial synkinesis varies considerably among patients, and important prognostic questions regarding timing of onset and progression of symptoms remain incompletely answered. Current management options for facial synkinesis include noninvasive modalities, chemodenervation, myectomy, and selective neurectomy. Potential new treatments for facial synkinesis are being investigated in animal models, but few have been tested in humans.</p><p><strong>Conclusions and relevance: </strong>The treatment of facial synkinesis is currently hindered by limitations in clinical research and understanding of pathomechanism. Current studies predominantly yield level 4 evidence or lower. The development of large datasets of patients with facial palsy and the translation of basic science evidence to humans will facilitate the advancement of new treatments.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914793","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
Clarification Regarding Insurance Disparities Among Patients With Head and Neck Cancer-Reply. 头颈癌患者保险差异的澄清:回复。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-02 DOI: 10.1001/jamaoto.2024.4671
Uchechukwu C Megwalu, Yifei Ma
{"title":"Clarification Regarding Insurance Disparities Among Patients With Head and Neck Cancer-Reply.","authors":"Uchechukwu C Megwalu, Yifei Ma","doi":"10.1001/jamaoto.2024.4671","DOIUrl":"https://doi.org/10.1001/jamaoto.2024.4671","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142914790","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
Association Between Olfactory Impairment and Frailty-Reply. 嗅觉障碍与虚弱之间的关系--回复。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-01 DOI: 10.1001/jamaoto.2024.3748
Brian Sheng Yep Yeo, Benjamin Kye Jyn Tan, Tze Choong Charn
{"title":"Association Between Olfactory Impairment and Frailty-Reply.","authors":"Brian Sheng Yep Yeo, Benjamin Kye Jyn Tan, Tze Choong Charn","doi":"10.1001/jamaoto.2024.3748","DOIUrl":"10.1001/jamaoto.2024.3748","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"87-88"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545491","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
Technology Alone Cannot Promote Optimal Childhood Development-Why Cochlear Implantation Must Be Accompanied by Social Intervention. 仅靠技术无法促进儿童的最佳发育--为什么人工耳蜗植入必须辅以社会干预?
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-01 DOI: 10.1001/jamaoto.2024.3565
Stayce Camparo, Liz Sablich, Dana Suskind
{"title":"Technology Alone Cannot Promote Optimal Childhood Development-Why Cochlear Implantation Must Be Accompanied by Social Intervention.","authors":"Stayce Camparo, Liz Sablich, Dana Suskind","doi":"10.1001/jamaoto.2024.3565","DOIUrl":"10.1001/jamaoto.2024.3565","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"38-39"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142620860","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
Association Between Olfactory Impairment and Frailty. 嗅觉障碍与体弱之间的关系
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-01 DOI: 10.1001/jamaoto.2024.3751
Sahar Assi, Varun Vohra, Nicholas R Rowan
{"title":"Association Between Olfactory Impairment and Frailty.","authors":"Sahar Assi, Varun Vohra, Nicholas R Rowan","doi":"10.1001/jamaoto.2024.3751","DOIUrl":"10.1001/jamaoto.2024.3751","url":null,"abstract":"","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"86-87"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545490","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
Tympanostomy Tube Insertion With and Without Adenoidectomy. 有无腺样体切除术的鼓室造口管植入术
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-01-01 DOI: 10.1001/jamaoto.2024.3584
Z Jason Qian, Mai Thy Truong, Jennifer C Alyono, Tulio Valdez, Kay Chang

Importance: The benefit of adenoidectomy on otologic outcomes after tympanostomy tube (TT) insertion is unclear. Results from prior work are challenging to interpret due to small sample sizes, heterogeneous study designs, and varying outcome measures.

Objective: To evaluate the association between adenoidectomy and otologic outcomes using a US population-level sample of children who received TTs, producing generalizable results for widespread clinical application.

Design, setting, and participants: A matched cohort study was conducted using claims data from the Merative MarketScan Research Databases. The study included 601 848 children who received TTs between January 1, 2007, and December 31, 2021. Children who received adenoidectomy and TTs simultaneously (Ad+TT) were identified irrespective of the number of prior TTs. Control participants who received TTs without adenoidectomy were matched based on sex, age at the time of the procedure, and the number of prior TT procedures.

Exposures: Adenoidectomy without tonsillectomy was the primary exposure.

Main outcomes and measures: The primary outcomes were repeat TT insertion and subsequent oral antibiotic prescriptions after TT insertions. Multivariable logistic regression was used to quantify the effects of adenoidectomy and covariates on each outcome. Stratified analyses were performed in children younger than 4 years and 4 years or older.

Results: Overall, 601 848 children (median [IQR] age, 2 [1-4] years; range, 0-11 years; 351 078 [58.3%] male) who received TTs were identified. The Ad+TT cohort included 201 932 children, with an equal number in the matched cohort. In children younger than 4 years, Ad+TT was common and was associated with lower odds of subsequent oral antibiotics (odds ratio [OR], 0.59; 95% CI, 0.58-0.60) but higher odds of repeat TT insertions (OR, 1.24; 95% CI, 1.22-1.27). In children 4 years or older, Ad+TT was associated with lower odds of repeat TT insertions (OR, 0.78; 95% CI, 0.75-0.81) and subsequent oral antibiotics (OR, 0.63; 95% CI, 0.62-0.65).

Conclusions and relevance: This study found that in children younger than 4 years, Ad+TT was commonly performed and may have had a secondary benefit of reducing subsequent oral antibiotic courses; however, it was not associated with a reduction in the risks of repeat TT insertions. In children 4 years or older, Ad+TT was associated with a reduction in the risk of repeat TT insertions and subsequent oral antibiotics. Given these findings, Ad+TT may be offered in children 4 years or older to improve otologic outcomes.

重要性:鼓室造口术(TT)插入后,腺样体切除术对耳科结果的益处尚不明确。由于样本量小、研究设计不统一以及结果测量方法不同,以往研究的结果很难解释:目的:利用美国接受过 TT 的儿童人群样本,评估腺样体切除术与耳科结果之间的关联,得出具有普遍意义的结果,以广泛应用于临床:使用 Merative MarketScan 研究数据库中的索赔数据进行了一项匹配队列研究。研究对象包括在 2007 年 1 月 1 日至 2021 年 12 月 31 日期间接受过 TT 治疗的 601 848 名儿童。同时接受腺样体切除术和 TTs(腺样体+TT)的儿童,无论之前接受过多少次 TTs,均被识别出来。根据性别、手术时的年龄以及之前接受过的 TT 手术次数,对未接受腺样体切除术而接受 TT 的对照组参与者进行配对:主要结果和测量指标:主要结果是重复插入 TT 和插入 TT 后的口服抗生素处方。多变量逻辑回归用于量化腺样体切除术和协变量对各项结果的影响。对小于 4 岁和大于 4 岁的儿童进行了分层分析:总体而言,共有 601 848 名儿童(中位数 [IQR] 年龄,2 [1-4] 岁;范围,0-11 岁;351 078 [58.3%] 男性)接受了 TT。Ad+TT 队列包括 201 932 名儿童,与配对队列中的人数相同。在 4 岁以下的儿童中,Ad+TT 很常见,与随后口服抗生素的几率较低(几率比 [OR],0.59;95% CI,0.58-0.60),但重复插入 TT 的几率较高(OR,1.24;95% CI,1.22-1.27)有关。在 4 岁或以上儿童中,Ad+TT 与较低的重复 TT 插入几率(OR,0.78;95% CI,0.75-0.81)和随后的口服抗生素(OR,0.63;95% CI,0.62-0.65)相关:本研究发现,在 4 岁以下儿童中,Ad+TT 是一种常见的治疗方法,其次要益处可能是减少了后续口服抗生素的疗程;但是,这与降低重复插入 TT 的风险无关。在 4 岁或 4 岁以上的儿童中,Ad+TT 可降低重复插入 TT 和随后口服抗生素的风险。鉴于这些研究结果,可为 4 岁或以上儿童提供 Ad+TT 以改善耳科治疗效果。
{"title":"Tympanostomy Tube Insertion With and Without Adenoidectomy.","authors":"Z Jason Qian, Mai Thy Truong, Jennifer C Alyono, Tulio Valdez, Kay Chang","doi":"10.1001/jamaoto.2024.3584","DOIUrl":"10.1001/jamaoto.2024.3584","url":null,"abstract":"<p><strong>Importance: </strong>The benefit of adenoidectomy on otologic outcomes after tympanostomy tube (TT) insertion is unclear. Results from prior work are challenging to interpret due to small sample sizes, heterogeneous study designs, and varying outcome measures.</p><p><strong>Objective: </strong>To evaluate the association between adenoidectomy and otologic outcomes using a US population-level sample of children who received TTs, producing generalizable results for widespread clinical application.</p><p><strong>Design, setting, and participants: </strong>A matched cohort study was conducted using claims data from the Merative MarketScan Research Databases. The study included 601 848 children who received TTs between January 1, 2007, and December 31, 2021. Children who received adenoidectomy and TTs simultaneously (Ad+TT) were identified irrespective of the number of prior TTs. Control participants who received TTs without adenoidectomy were matched based on sex, age at the time of the procedure, and the number of prior TT procedures.</p><p><strong>Exposures: </strong>Adenoidectomy without tonsillectomy was the primary exposure.</p><p><strong>Main outcomes and measures: </strong>The primary outcomes were repeat TT insertion and subsequent oral antibiotic prescriptions after TT insertions. Multivariable logistic regression was used to quantify the effects of adenoidectomy and covariates on each outcome. Stratified analyses were performed in children younger than 4 years and 4 years or older.</p><p><strong>Results: </strong>Overall, 601 848 children (median [IQR] age, 2 [1-4] years; range, 0-11 years; 351 078 [58.3%] male) who received TTs were identified. The Ad+TT cohort included 201 932 children, with an equal number in the matched cohort. In children younger than 4 years, Ad+TT was common and was associated with lower odds of subsequent oral antibiotics (odds ratio [OR], 0.59; 95% CI, 0.58-0.60) but higher odds of repeat TT insertions (OR, 1.24; 95% CI, 1.22-1.27). In children 4 years or older, Ad+TT was associated with lower odds of repeat TT insertions (OR, 0.78; 95% CI, 0.75-0.81) and subsequent oral antibiotics (OR, 0.63; 95% CI, 0.62-0.65).</p><p><strong>Conclusions and relevance: </strong>This study found that in children younger than 4 years, Ad+TT was commonly performed and may have had a secondary benefit of reducing subsequent oral antibiotic courses; however, it was not associated with a reduction in the risks of repeat TT insertions. In children 4 years or older, Ad+TT was associated with a reduction in the risk of repeat TT insertions and subsequent oral antibiotics. Given these findings, Ad+TT may be offered in children 4 years or older to improve otologic outcomes.</p>","PeriodicalId":14632,"journal":{"name":"JAMA otolaryngology-- head & neck surgery","volume":" ","pages":"40-46"},"PeriodicalIF":6.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11581585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142465678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
JAMA otolaryngology-- head & neck surgery
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1