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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
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引用次数: 0
Sore Throat and Lymphadenopathy in an Older Man.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.5036
Emmanuel Ribereau-Gayon, François Durupt, Matthieu Godinot
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引用次数: 0
Smell Recovery After Platelet-Rich Plasma After Trauma-Induced Anosmia.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.4992
Esther Wang, Zara M Patel
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引用次数: 0
Concerns Regarding Mouth Closure and Airflow in Obstructive Sleep Apnea-Reply.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.5076
Daniel Vena, Hyung Chae Yang, Scott A Sands
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引用次数: 0
Return to Work Up to 5 Years After the End of Treatment Among Patients With Head and Neck Cancer.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-06 DOI: 10.1001/jamaoto.2024.4991
Femke Jansen, Simone E J Eerenstein, Sara Arman, Birgit I Lissenberg-Witte, Jose A Hardillo, Robert P Takes, Ruud H Brakenhoff, Remco de Bree, Femke Lamers, Johannes A Langendijk, C René Leemans, Irma M Verdonck-de Leeuw

Importance: Adverse effects of cancer and its treatment may hamper return to work (RTW) among patients with head and neck cancer (HNC).

Objectives: To investigate RTW among patients with HNC from end of treatment to 5 years after treatment and associations of RTW with sociodemographic, clinical, work-related, personal, lifestyle, physical, and psychological factors and cancer-related symptoms.

Design, setting and participants: This prospective, longitudinal, multicenter cohort study of patients with HNC used data from the Netherlands Quality of Life and Biomedical cohort. This study focused on patients younger than 65 years (with a subanalysis of patients younger than 60 years) from time of cancer diagnosis (March 2014 to June 2018) to 5 years after end of treatment (January 2019 to July 2023). Data analysis occurred from April 2023 to August 2024.

Exposure: Standard clinical care.

Main outcomes and measures: Work status was measured at 3 and 6 months, and 1, 2, 3, 4, and 5 years after treatment using an adjusted version of the Productivity Cost Questionnaire. Cox regression analyses were performed to investigate factors (baseline, 3 months, and 6 months) associated with time to RTW.

Results: A total of 184 patients with HNC younger than 65 years (mean [SD] age, 55.4 [7.0] years; 146 men [79%]) were included and 77 (42%) had oropharyngeal cancer. RTW increased from 26% (42 of 160 individuals) at 3 months to 65% (89 of 137 individuals) at 1 year, after which it reduced to 52% (51 of 98 individuals) at 5 years. At 5 years after treatment, an additional 28 of 98 participants (29%) were retired. Minor surgery (vs major surgery) was associated with faster RTW from end of treatment onwards (hazard ratio [HR], 2.73; 95% CI, 1.17-6.37). Older age (HR, 0.97; 95% CI, 0.94-0.999) and more fatigue at 3 months (HR, 0.99; 95% CI, 0.98-0.995) were associated with slower RTW from 3 months onwards. Older age was also associated with slower RTW from 6 months onwards (HR, 0.96; 95% CI, 0.93-0.998). Among the 127 patients with HNC younger than 60 years, RTW was 72% (47 individuals) at 5 years after treatment. Advanced tumor stage (HR, 0.59; 95% CI, 0.39-0.90) and more fatigue (HR, 0.99; 95% CI, 0.98-0.999) were associated with slower RTW in this group.

Conclusion and relevance: This cohort study found that the majority of patients with HNC in the Netherlands returned to work within 1 year and that certain sociodemographic and clinical factors and cancer-related symptoms were associated with time to RTW. These results may inform patients with HNC and provide insight into potential targets, such as fatigue, to improve RTW.

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引用次数: 0
JAMA Otolaryngology-Head & Neck Surgery.
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.3429
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引用次数: 0
Frequency-to-Place Mismatch and Cochlear Implant Outcomes by Electrode Type. 频率-位置不匹配与电极类型的人工耳蜗植入结果。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4158
Andrea DeFreese, Katelyn Berg, Jack Noble, Benoit Dawant, Jourdan Holder, Susan Amberg, Christine Brown, Emily Burg, Nichole Dwyer, Allyson Sisler-Dinwiddie, Tayler Sparrow, Linsey Sunderhaus, Stephanie Yaras, Marc Bennett, Taha Jan, Aaron Moberly, Matthew O'Malley, Ankita Patro, Elizabeth Perkins, Kareem Tawfik, David Haynes, René Gifford
<p><strong>Importance: </strong>Speech recognition outcomes with a cochlear implant (CI) are highly variable. One factor suggested to correlate with CI-aided speech recognition is frequency-to-place mismatch, or the discrepancy between the natural tonotopic organization of the cochlea and the electric frequency allocation of the CI electrodes within the patient's cochlea.</p><p><strong>Objective: </strong>To evaluate the association between frequency-to-place mismatch and speech recognition outcomes in a large cohort of postlingually deafened adult CI users, while controlling for various clinical factors known to be associated with those outcomes.</p><p><strong>Design, setting, and participants: </strong>This retrospective cohort study used data from a CI program at a tertiary medical center and included CIs from postlingually deafened adult CI users. After excluding patients whose data were not logged, patients with implantations occurring between 2016 and 2023 were included in the analysis. The data were extracted in November 2023.</p><p><strong>Main outcomes and measures: </strong>Results of the Consonant-Nucleus-Consonant (CNC) monosyllabic word recognition test measured in the CI-aided alone condition 1 month, 3 months, 6 months, and 12 months after activation served as the main outcome. The independent variables included frequency-to-place mismatch, electrode array type, mean modiolar distance, electrode position, age at implantation, biological sex, contralateral hearing abilities, time since CI activation (test interval), and daily device use.</p><p><strong>Results: </strong>In 498 CIs from 447 postlingually deafened adults (mean [SD] age, 63.1 [17.1] years; 271 [54.4%] CIs with male users), frequency-to-place mismatch was negatively correlated with CI-aided speech recognition outcomes, but the association was only significant for precurved electrode arrays and not straight electrode arrays. In the linear mixed effects model for straight electrode arrays, only test interval (β = 1.14 [95% CI, 0.90-1.38]) and daily device use (β = 0.90 [95% CI, 0.42-1.38]) were correlated with the improvement of word recognition over the first year of device use. In the model for precurved electrode arrays, mismatch at 1500 Hz (β = -0.011 [95% CI, -0.011 to -0.006]), scalar location (β = 16.37 [95% CI, 9.01 to 23.74]), test interval (β = 1.18 [95% CI, 1.18-1.41]) and daily device use (β = 1.65 [95% CI, 1.15-2.14]) all were significantly associated with the improvement of word recognition over the first year of device use.</p><p><strong>Conclusions and relevance: </strong>In this cohort study of postlingually deafened adult CI users, including both straight and precurved electrode arrays, daily device use and time since CI activation were found to be significantly associated with improved CI-aided speech recognition outcomes. Frequency-to-place mismatch at 1500 Hz and scalar location were associated with word recognition only for precurved arrays. These fin
重要性:人工耳蜗(CI)的语音识别结果是高度可变的。与人工耳蜗辅助语音识别相关的一个因素是频率-位置不匹配,即耳蜗的自然张力组织与患者耳蜗内人工耳蜗电极的电频率分配之间的差异。目的:在控制已知与这些结果相关的各种临床因素的情况下,评估大量语后聋成人CI使用者中频率-位置不匹配与语音识别结果之间的关系。设计、环境和参与者:本回顾性队列研究使用来自三级医疗中心CI项目的数据,包括来自语后失聪成人CI使用者的CI。在排除了未记录数据的患者后,将2016年至2023年期间植入的患者纳入分析。这些数据是在2023年11月提取的。主要观察指标:激活后1个月、3个月、6个月、12个月的ci辅助单独条件下的辅音-核-辅音(CNC)单音节单词识别测试结果为主要观察指标。自变量包括频率与位置不匹配、电极阵列类型、平均模摩尔距离、电极位置、植入年龄、生物性别、对侧听力、CI激活时间(测试间隔)和日常设备使用情况。结果:447例语后聋成人498例ci(平均[SD]年龄63.1[17.1]岁;271[54.4%]男性用户),频率-位置不匹配与ci辅助语音识别结果呈负相关,但这种关联仅对预弯曲电极阵列显著,而对直电极阵列不显著。在直线电极阵列的线性混合效应模型中,只有测试间隔(β = 1.14 [95% CI, 0.90-1.38])和每日设备使用(β = 0.90 [95% CI, 0.42-1.38])与设备使用一年内单词识别的改善相关。在预弯曲电极阵列模型中,1500 Hz的失配(β = -0.011 [95% CI, -0.011至-0.006])、标量位置(β = 16.37 [95% CI, 9.01至23.74])、测试间隔(β = 1.18 [95% CI, 1.18至1.41])和日常设备使用(β = 1.65 [95% CI, 1.15至2.14])都与设备使用第一年的单词识别改善显著相关。结论和相关性:在这项对语后失聪成人CI使用者的队列研究中,包括直电极和预弯曲电极阵列,发现日常设备使用和CI激活后的时间与CI辅助语音识别结果的改善显着相关。1500 Hz频率与位置不匹配和标量位置仅与预弯曲阵列的单词识别有关。这些发现表明,对于使用直线阵列的患者,任何由频率与位置不匹配产生的干扰都可以通过适应来克服,这可以通过日常设备使用来支持。然而,对于使用预弯曲阵列的患者,日常设备使用可能不足以完全克服电极放置因素,包括标量位置和不匹配。
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引用次数: 0
Oropharyngeal Necrotizing Fasciitis in a Previously Healthy Patient. 一名健康患者的口咽坏死性筋膜炎
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.3987
Oleksandr Butskiy, Gina Trinh
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引用次数: 0
Musicality as a Health-Relevant Factor for Hearing Outcomes. 音乐性是听力结果的健康相关因素。
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4157
Srishti Nayak, Aaron C Moberly, Terrin N Tamati
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引用次数: 0
A Large Sinonasal Mass in a Male Patient. 一名男性患者的巨大鼻窦肿块
IF 6 1区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2025-02-01 DOI: 10.1001/jamaoto.2024.4005
Sei Y Chung, Parker Lawson, Anne C McLean
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JAMA otolaryngology-- head & neck surgery
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