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Development and Validation of a Shortened Severity Measurement Tool for Tinnitus. 耳鸣严重程度简易测量工具的开发与验证
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-12 DOI: 10.1002/ohn.1076
Lauren Mueller, Emma R Dear, Juan Turcois, Madelyn R Frumkin, Harrison Smith, Dorina Kallogjeri, Thomas L Rodebaugh, Jay F Piccirillo

Objective: There is a need to develop and validate a brief questionnaire to measure tinnitus severity that can meet the needs of clinicians and researchers. The objective of this study is to demonstrate the validity and reliability of the 9-item Tinnitus Severity Short Form (TS-SF).

Study design: A cohort study of online survey respondents recruited in October 2020 from the American Tinnitus Association electronic mailing list with a 2-week follow-up time interval.

Setting: Online.

Methods: Face and content validity, factor analysis, internal consistency, convergent validity, reliability, and minimal clinically important difference (MCID) were analyzed.

Results: Of 1121 participants that started the survey, 325 (29%) completed the baseline TS-SF. Through confirmatory factor analysis, the 9-item survey demonstrated a bifactor model with a substantive distress factor and a method factor. The instrument had high internal consistency with Cronbach's α of .96. Convergent validity determined the TS-SF score to be a predictor of tinnitus severity. Of 261 follow-up respondents, the test-retest reliability of r = 0.69 (95% confidence interval, 0.62-0.75) was determined. The MCID was determined using a distribution approach to be a 12-point change.

Conclusion: The TS-SF demonstrates good internal consistency, validity, and reliability. This patient-reported outcome measure for tinnitus can be used in tinnitus treatment trials and clinical practice. The 9-item survey is less likely to result in respondent survey fatigue than longer surveys, and the 2-week reference interval allows for monitoring of tinnitus severity change in an appropriate timeframe.

目的:有必要开发并验证一种简短的耳鸣严重程度测量问卷,以满足临床医生和研究人员的需求。本研究旨在证明 9 项耳鸣严重程度简表(TS-SF)的有效性和可靠性:研究设计:2020 年 10 月从美国耳鸣协会电子邮寄名单中招募的在线调查对象的队列研究,随访时间间隔为 2 周:方法对表面和内容效度、因素分析、内部一致性、收敛效度、可靠性和最小临床重要差异(MCID)进行分析:在开始调查的 1121 名参与者中,有 325 人(29%)完成了基线 TS-SF。通过确认性因子分析,9 个项目的调查显示了一个包含实质性困扰因子和方法因子的双因子模型。该工具具有较高的内部一致性,Cronbach's α 为 0.96。聚合效度确定 TS-SF 分数可预测耳鸣的严重程度。在 261 名随访受访者中,测试-再测可靠性为 r = 0.69(95% 置信区间,0.62-0.75)。采用分布法确定的MCID为12点变化:TS-SF具有良好的内部一致性、有效性和可靠性。结论:TS-SF 具有良好的内部一致性、有效性和可靠性,可用于耳鸣治疗试验和临床实践。与时间较长的调查相比,9 个项目的调查不太可能导致受访者产生调查疲劳,而且 2 周的参考时间间隔可在适当的时间范围内监测耳鸣严重程度的变化。
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引用次数: 0
Standardized List Evaluating Apnea (SLEAP): A Comprehensive Survey to Define the Quality of Life in OSA.
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-03 DOI: 10.1002/ohn.1072
Mohamed Abdelwahab, Mikhail Saltychev, Matt Lechner, Elahe Adibi, Elizabeth Walker Wadsworth, Thomaz Fleury, Abdelwahab Rakha, Yasser Khafagy, Ahmed Abdelfattah, Ahmed A Al-Sayed, Courtney Chou, Ban Ali, Stanley Liu, Clete Kushida, Robson Capasso

Objective: To develop and validate a patient-reported outcome measure (PROM) to evaluate the quality of life (QoL) among patients with obstructive sleep apnea (OSA).

Study design: A prospective cohort study.

Settings: Tertiary referral center.

Methods: We developed a 15-item English questionnaire that was administered to 176 adults with OSA and 22 adult controls without symptoms of OSA in a tertiary sleep surgery clinic between June 2021 and December 2021. The internal consistency and test-retest reliability were measured using the Cronbach's α and the intraclass correlation coefficient, respectively. The 2-sample Wilcoxon rank-sum (Mann-Whitney) test was applied to compare the 2 groups. Convergent validity of the test scores of the questionnaire was compared to previously validated outcome measures and objective sleep study outcomes using the Spearman correlation coefficient.

Results: Of the 198 respondents (176 cases and 22 controls); 71% were men and 29% were women. The internal consistency was excellent with the α of .92 (lower 95% confidence limit of 0.90). All the test-retest correlations were positive, significant, and strong ranging from 0.50 to 0.90. The differences between cases and controls were statistically significant for all the items and for the total score. The total score of the questionnaire with the Epworth Sleepiness Scale and objective OSA measures was moderate to strong.

Conclusions and relevance: The new tool provides a validated PROM to evaluate the QoL among OSA patients specifically, with excellent internal consistency, reasonable test-retest reliability, discriminant validity, and construct validity.

Level of evidence: Level 4.

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引用次数: 0
Methodology of cfHPV-DNA Detection in Head and Neck Cancer: A Systematic Review and Meta-analysis.
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-03 DOI: 10.1002/ohn.1056
Jerin Thomas, Eden Mazzara, Meytal Guller, Hannah Landsberger, Tristan Tham, Dylan Cooper, Lucio Pereira, Dev Kamdar, Douglas Frank, Brett Miles, Rajarsi Mandal

Objective: We aim to compare the diagnostic accuracy of the different methodologies used in the detection of cell-free human papillomavirus (HPV) DNA in HPV-associated head and neck squamous cell carcinoma detection using bivariate analysis methods.

Data sources: Pubmed, Embase, and Scopus were queried using a broad search strategy to search for relevant studies.

Review methods: Test characteristics were extracted from 33 studies following literature screening, and underwent analyses utilizing a bivariate approach. Summary statistics were identified for each type of methodology, and forest plots and summary receiver operating characteristic curves were constructed. Bias was estimated using Deek's Funnel Plot and the QUADAS-2 tool.

Results: In terms of diagnostic accuracy, digital droplet polymerase chain reaction (ddPCR) based testing exhibited the highest diagnostics odds ratio at 138 (59.5, 318), followed closely by next-generation sequencing (NGS) at 120 (39.7, 362), then by polymerase chain reaction (PCR) at 31.4 (14.4, 68.6), and quantitative PCR at 8.74 (4.63, 16.5).

Conclusion: NGS and ddPCR are comparable in overall diagnostic accuracy, bringing into question their relative roles in diagnosis and screening. Cost-effective ddPCR assays may serve as useful diagnostic and screening tests in the clinic with their low false positive rates and high sensitivity. However, NGS assays also offer high sensitivity and companion metrics, suggesting they may have a more precise role in disease monitoring. Importantly, assay development and benchmarking need further standardization to improve comparison between assays. Finally, saliva-based testing needs to be further investigated using NGS and ddPCR to further understand its limitations in disease detection and monitoring.

{"title":"Methodology of cfHPV-DNA Detection in Head and Neck Cancer: A Systematic Review and Meta-analysis.","authors":"Jerin Thomas, Eden Mazzara, Meytal Guller, Hannah Landsberger, Tristan Tham, Dylan Cooper, Lucio Pereira, Dev Kamdar, Douglas Frank, Brett Miles, Rajarsi Mandal","doi":"10.1002/ohn.1056","DOIUrl":"https://doi.org/10.1002/ohn.1056","url":null,"abstract":"<p><strong>Objective: </strong>We aim to compare the diagnostic accuracy of the different methodologies used in the detection of cell-free human papillomavirus (HPV) DNA in HPV-associated head and neck squamous cell carcinoma detection using bivariate analysis methods.</p><p><strong>Data sources: </strong>Pubmed, Embase, and Scopus were queried using a broad search strategy to search for relevant studies.</p><p><strong>Review methods: </strong>Test characteristics were extracted from 33 studies following literature screening, and underwent analyses utilizing a bivariate approach. Summary statistics were identified for each type of methodology, and forest plots and summary receiver operating characteristic curves were constructed. Bias was estimated using Deek's Funnel Plot and the QUADAS-2 tool.</p><p><strong>Results: </strong>In terms of diagnostic accuracy, digital droplet polymerase chain reaction (ddPCR) based testing exhibited the highest diagnostics odds ratio at 138 (59.5, 318), followed closely by next-generation sequencing (NGS) at 120 (39.7, 362), then by polymerase chain reaction (PCR) at 31.4 (14.4, 68.6), and quantitative PCR at 8.74 (4.63, 16.5).</p><p><strong>Conclusion: </strong>NGS and ddPCR are comparable in overall diagnostic accuracy, bringing into question their relative roles in diagnosis and screening. Cost-effective ddPCR assays may serve as useful diagnostic and screening tests in the clinic with their low false positive rates and high sensitivity. However, NGS assays also offer high sensitivity and companion metrics, suggesting they may have a more precise role in disease monitoring. Importantly, assay development and benchmarking need further standardization to improve comparison between assays. Finally, saliva-based testing needs to be further investigated using NGS and ddPCR to further understand its limitations in disease detection and monitoring.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Perioperative Use of Systemic Steroids Within Otolaryngology-Head and Neck Surgery: Evidence-Based Guidance for Clinicians.
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-03 DOI: 10.1002/ohn.1067
Allison K Ikeda, Raluca Gray, Victoria Lee, James Dixon Johns, Selena Briggs, Nikhila R Raol, Uchechukwu C Megwalu, Stephanie Joe, Frank Garritano, Michael J Brenner, Edward D McCoul

Objective: To review and synthesize the available evidence for use of perioperative systemic steroids for otolaryngologic surgical procedures.

Data sources: A comprehensive literature review with evidence-informed recommendations.

Review methods: Databases were queried for medical subject heading terms and keywords related to perioperative systemic corticosteroids use for comprehensive otolaryngology and subspecialty procedures including otologic, sinonasal, sleep, laryngeal, head and neck, facial plastics, and pediatric surgery. Perioperative period included preoperative (up to 7 days prior to surgery), intraoperative (on the day of surgery), and postoperative (initiated within 24 hours after surgery) timeframes.

Conclusions: Evidence from clinical practice guidelines, systematic reviews, and original research studies supports perioperative systemic corticosteroid use for specific otolaryngologic indications. Numerous studies support perioperative steroid use for nausea, vomiting, or edema in tonsillectomy, rhinoplasty, and thyroidectomy, although formal guideline recommendations are limited. Strong evidence supports perioperative steroid use before and after endoscopic sinus surgery for chronic rhinosinusitis with polyposis and fungal sinusitis. Evidence of benefit is sparse or absent on systemic perioperative steroid use for the middle and inner ear, laryngeal, salivary gland surgery, and reconstructive facial plastic surgery.

Implications for practice: Although perioperative administration of systemic steroids is routinely performed for many otolaryngologic surgeries, high-level evidence is limited to specific contexts. Evidence supports the benefit for reducing nausea, vomiting, or edema for several otolaryngologic procedures, as well as for either chronic rhinosinusitis with polyposis or fungal sinusitis. However, these benefits need to be weighed against risks, and further investigations are needed to define the role for perioperative steroids in otolaryngology.

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引用次数: 0
Long-Term Outcomes of Temporal Bone Aneurysmal Bone Cysts: Ambispective Study With Systematic Review and Pooled Analysis.
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-03 DOI: 10.1002/ohn.1073
Nidhin Das K, Anant Mehrotra, Amit Keshri, Mohit Sinha, Nazrin Hameed, Kalyan Chidambaram, Mohd Aqib, Awadesh Kumar Jaiswal, Ravisankar Manogaran

Objective: To analyse the clinical, radiological, and surgical management of temporal bone aneurysmal bone cysts (ABCs) and identify factors affecting outcomes.

Study design: Ambispective study.

Setting: A single tertiary care institution.

Methods: This study reviewed 6 cases of temporal bone ABCs treated between 2017 and 2024. Patient demographics, clinical presentation, imaging characteristics, surgical details, and outcomes were collected. A systematic review of the literature was conducted, adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, to compare institutional cases with published data. Statistical analyses were performed to identify predictors of treatment success and recurrence.

Results: The cohort had a mean age of 27.5 years. Presenting symptoms included scalp swelling, aural fullness, tinnitus, and hearing impairment. Imaging showed expansile lesions with fluid-fluid levels and bone erosion. All patients underwent gross total excision, with a mean intraoperative blood loss of 230.6 ml. One patient experienced temporary grade III facial palsy, which resolved within 3 months. No recurrences were observed during a mean follow-up of 35 months. A pooled analysis of 45 cases from the literature revealed that swelling in the temporal region was the most common presenting feature, and gross total resection was the most frequently employed treatment. Recurrences were rare and typically associated with subtotal resections or advanced-stage tumors.

Conclusion: Surgical excision, particularly gross total resection, is the treatment of choice for temporal bone ABCs, with a low recurrence rate. Stage and extent of resection are critical factors in predicting outcomes. This study enhances understanding of the diagnostic and therapeutic approaches for this rare condition.

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引用次数: 0
Should Assent Always Be Obtained From Pediatric Patients Undergoing Elective Procedures?
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-03 DOI: 10.1002/ohn.1046
Antoinette Esce, Jonathan Bolton, Tania Kraai
{"title":"Should Assent Always Be Obtained From Pediatric Patients Undergoing Elective Procedures?","authors":"Antoinette Esce, Jonathan Bolton, Tania Kraai","doi":"10.1002/ohn.1046","DOIUrl":"https://doi.org/10.1002/ohn.1046","url":null,"abstract":"","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Genetics of Nonsyndromic Microtia and Congenital Aural Atresia: A Scoping Review.
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-03 DOI: 10.1002/ohn.1060
Aparna Govindan, Carly Fiest, David W Chou, Mia Saade, Mingyang Gray, Maura Cosetti

Objective: To review the literature on genetics of nonsyndromic microtia and congenital aural atresia (CAA).

Data sources: Embase, Ovid (Medline), and Web of Science.

Review methods: The search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews. Included studies were original research studies discussing the genetics or pattern of inheritance of non-syndromic microtia and/or CAA, defined as microtia and/or CAA that was completely isolated except for the presence of hearing loss.

Results: Thirty studies met inclusion criteria, describing 40 unique genes and one susceptibility gene locus (4p15.32-4p16.2) associated with nonsyndromic microtia, CAA, or microtia and CAA. The 3 most cited genes describing microtia genetics alone were HOXA2, MUC6, and GSC. A single article describing nonsyndromic CAA alone identified the TSHZ1 as a candidate gene. Among 194 subjects from 18 manuscripts describing mendelian inheritance for non-syndromic microtia or microtia and CAA, 49% of the individuals were found to have autosomal dominant transmission, 4% had autosomal recessive, 5% had X-linked recessive, and 42% had no reported pattern of inheritance.

Conclusion: Current literature on the genetics of microtia and CAA is largely derived from genetic analysis of syndromic patients. Despite comprising over half of the clinical population, available data on non-syndromic patients remains limited. Understanding genetic polymorphisms and their correlation to phenotypic data more readily available to otolaryngologists offers the prospect of categorizing severity of anatomic malformation and hearing loss to guide future intervention, and improve ability to provide patient- and family-centered counseling.

{"title":"Genetics of Nonsyndromic Microtia and Congenital Aural Atresia: A Scoping Review.","authors":"Aparna Govindan, Carly Fiest, David W Chou, Mia Saade, Mingyang Gray, Maura Cosetti","doi":"10.1002/ohn.1060","DOIUrl":"https://doi.org/10.1002/ohn.1060","url":null,"abstract":"<p><strong>Objective: </strong>To review the literature on genetics of nonsyndromic microtia and congenital aural atresia (CAA).</p><p><strong>Data sources: </strong>Embase, Ovid (Medline), and Web of Science.</p><p><strong>Review methods: </strong>The search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for scoping reviews. Included studies were original research studies discussing the genetics or pattern of inheritance of non-syndromic microtia and/or CAA, defined as microtia and/or CAA that was completely isolated except for the presence of hearing loss.</p><p><strong>Results: </strong>Thirty studies met inclusion criteria, describing 40 unique genes and one susceptibility gene locus (4p15.32-4p16.2) associated with nonsyndromic microtia, CAA, or microtia and CAA. The 3 most cited genes describing microtia genetics alone were HOXA2, MUC6, and GSC. A single article describing nonsyndromic CAA alone identified the TSHZ1 as a candidate gene. Among 194 subjects from 18 manuscripts describing mendelian inheritance for non-syndromic microtia or microtia and CAA, 49% of the individuals were found to have autosomal dominant transmission, 4% had autosomal recessive, 5% had X-linked recessive, and 42% had no reported pattern of inheritance.</p><p><strong>Conclusion: </strong>Current literature on the genetics of microtia and CAA is largely derived from genetic analysis of syndromic patients. Despite comprising over half of the clinical population, available data on non-syndromic patients remains limited. Understanding genetic polymorphisms and their correlation to phenotypic data more readily available to otolaryngologists offers the prospect of categorizing severity of anatomic malformation and hearing loss to guide future intervention, and improve ability to provide patient- and family-centered counseling.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Video Otoscopy as a Novel Teaching and Remote Otolaryngology Consultation Tool at an Academic Medical Center. 视频耳镜作为一种新型教学和远程耳鼻喉科会诊工具在学术医学中心的应用。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI: 10.1002/ohn.894
Arianna Winchester, Michael Chow, William Chiang, Scott Rickert

Objective: Assess the use of video otoscopy (VO) as a tool for teaching Emergency Department (ED) residents and remote Otolaryngology consultation.

Study design: Survey and retrospective chart review.

Setting: Tertiary care center.

Methods: Emergency Medicine resident physicians completed an otologic skill self-assessment and pathology followed by an interactive training on VO and postintervention assessment after 9 months of use. Outcomes compared change in pre- to posttraining scores. ED consultations using VO during this time period were reviewed to detect differences between the presumed diagnosis/treatment based only on phone consultation and VO image compared to the final diagnosis/treatment after in-person Otolaryngology consultation.

Results: Forty-six (63.1%) ED residents participated. Diagnostic accuracy improved by 20.7% overall. The most improved diagnoses were of a normal ear canal (+75%), tympanosclerosis (+58.4%), and ear canal foreign body (+57.1%); most challenging were external auditory canal cyst (-13.6%), hemotympanum (-11.3%), and cerumen (-1.9%). Cholesteatoma did not improve because all responses were incorrect; neither did tympanic membrane perforation because all were correct. Confidence in the otologic exam and anatomy also increased (P < .01). Thirteen consults used VO and 3 (23.1%) had a change in diagnosis/treatment after in-person Otolaryngology evaluation.

Conclusion: Training on the use of VO significantly improves the confidence and diagnostic skills of ED providers for many pathologies. This application suggests the efficacy of an otologic e-consultation model.

目的:评估视频耳镜(VO)作为急诊科住院医生教学和远程耳鼻喉科会诊工具的使用情况:评估视频耳镜(VO)作为急诊科(ED)住院医生教学和远程耳鼻喉科会诊工具的使用情况:研究设计:调查和回顾性病历审查:研究设计:调查和回顾性病历:方法:急诊科住院医师完成耳科技能自我评估和病理评估,然后进行 VO 互动培训,并在使用 9 个月后进行干预后评估。结果比较了培训前与培训后得分的变化。在此期间,对使用 VO 的急诊室会诊进行了回顾,以检测仅根据电话会诊和 VO 图像推测的诊断/治疗与耳鼻喉科会诊后最终诊断/治疗之间的差异:46名(63.1%)耳鼻喉科住院医师参与了这项研究。诊断准确率总体提高了 20.7%。诊断准确率提高最多的是正常耳道(+75%)、鼓室硬化(+58.4%)和耳道异物(+57.1%);最具挑战性的是外耳道囊肿(-13.6%)、血性鼓室(-11.3%)和耵聍(-1.9%)。胆脂瘤没有得到改善,因为所有回答都不正确;鼓膜穿孔也没有得到改善,因为所有回答都正确。对耳科检查和解剖的信心也有所提高(P使用 VO 的培训可显著提高急诊室医疗人员对许多病症的信心和诊断技能。这一应用表明了耳科电子会诊模式的有效性。
{"title":"Video Otoscopy as a Novel Teaching and Remote Otolaryngology Consultation Tool at an Academic Medical Center.","authors":"Arianna Winchester, Michael Chow, William Chiang, Scott Rickert","doi":"10.1002/ohn.894","DOIUrl":"10.1002/ohn.894","url":null,"abstract":"<p><strong>Objective: </strong>Assess the use of video otoscopy (VO) as a tool for teaching Emergency Department (ED) residents and remote Otolaryngology consultation.</p><p><strong>Study design: </strong>Survey and retrospective chart review.</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Methods: </strong>Emergency Medicine resident physicians completed an otologic skill self-assessment and pathology followed by an interactive training on VO and postintervention assessment after 9 months of use. Outcomes compared change in pre- to posttraining scores. ED consultations using VO during this time period were reviewed to detect differences between the presumed diagnosis/treatment based only on phone consultation and VO image compared to the final diagnosis/treatment after in-person Otolaryngology consultation.</p><p><strong>Results: </strong>Forty-six (63.1%) ED residents participated. Diagnostic accuracy improved by 20.7% overall. The most improved diagnoses were of a normal ear canal (+75%), tympanosclerosis (+58.4%), and ear canal foreign body (+57.1%); most challenging were external auditory canal cyst (-13.6%), hemotympanum (-11.3%), and cerumen (-1.9%). Cholesteatoma did not improve because all responses were incorrect; neither did tympanic membrane perforation because all were correct. Confidence in the otologic exam and anatomy also increased (P < .01). Thirteen consults used VO and 3 (23.1%) had a change in diagnosis/treatment after in-person Otolaryngology evaluation.</p><p><strong>Conclusion: </strong>Training on the use of VO significantly improves the confidence and diagnostic skills of ED providers for many pathologies. This application suggests the efficacy of an otologic e-consultation model.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1721-1727"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Myringoplasty Using Human Birth Tissue Allografts to Repair Large Tympanic Membrane Perforations. 使用人类胎儿组织异体移植修复鼓膜大面积穿孔的鼓膜成形术
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-01 Epub Date: 2024-07-17 DOI: 10.1002/ohn.905
Nickolas A Alsup, Kyle P Davis, Gresham T Richter, Larry D Hartzell

Objective: Examine outcomes among a series of pediatric patients who underwent myringoplasty using human birth tissue (BT) for repair of large tympanic membrane (TM) perforations.

Study design: Case series.

Setting: Single-institution pediatric hospital.

Methods: Retrospective chart review of patients treated with BT during a 4-year study period. Subjects who underwent myringoplasty for large (size 40% or greater) TM perforations were included for this study. Patients with a stable perforation of at least 1 month's duration preoperatively who then followed up for at least 3 months postoperatively met inclusion criteria.

Results: Six subjects were included in this study. One subject underwent bilateral repair; thus, this series includes a total of 7 perforations. TM perforations ranged from 40% to 70% of the TM. At initial follow-up (median of 2 months), 5 of the 7 perforations had healed. One of these 5 had evidence of a 10% recurrent perforation at 5 months, which subsequently healed. Of the 2 patients not healed at initial follow-up, 1 had only a residual pinpoint perforation that subsequently healed; the other had a persistent 30% perforation that was possibly related to their postoperative recovery period, which was complicated by a respiratory viral illness.

Conclusion: For large TM perforations, myringoplasty with BT grafts may be a viable alternative to longer, more invasive procedures like tympanoplasty. Larger, randomized, prospective studies are needed.

研究目的研究设计:病例系列:研究设计:病例系列:研究设计:病例系列:方法:对 4 年研究期间接受 BT 治疗的患者进行回顾性病历审查。研究对象包括因 TM 大面积穿孔(大小为 40% 或以上)而接受耳膜成形术的患者。术前穿孔稳定至少 1 个月,术后随访至少 3 个月的患者符合纳入标准:本研究共纳入六名受试者。结果:本研究共纳入六名受试者,其中一名受试者接受了双侧修复术,因此本系列共包括七例穿孔。颞下颌关节穿孔占颞下颌关节的 40% 至 70%。在最初的随访中(中位数为 2 个月),7 个穿孔中有 5 个已经愈合。其中一名患者在 5 个月时有证据显示穿孔复发了 10%,随后痊愈。在初次随访时未痊愈的两名患者中,一名患者仅有一个残留的针尖穿孔,随后痊愈;另一名患者有一个持续存在的30%穿孔,可能与术后恢复期有关,术后恢复期因呼吸道病毒性疾病而变得复杂:结论:对于大面积的鼓室穿孔,使用 BT 移植物进行鼓室成形术可能是一种可行的替代方法,可替代鼓室成形术等时间更长、创伤更大的手术。需要进行更大规模的随机前瞻性研究。
{"title":"Myringoplasty Using Human Birth Tissue Allografts to Repair Large Tympanic Membrane Perforations.","authors":"Nickolas A Alsup, Kyle P Davis, Gresham T Richter, Larry D Hartzell","doi":"10.1002/ohn.905","DOIUrl":"10.1002/ohn.905","url":null,"abstract":"<p><strong>Objective: </strong>Examine outcomes among a series of pediatric patients who underwent myringoplasty using human birth tissue (BT) for repair of large tympanic membrane (TM) perforations.</p><p><strong>Study design: </strong>Case series.</p><p><strong>Setting: </strong>Single-institution pediatric hospital.</p><p><strong>Methods: </strong>Retrospective chart review of patients treated with BT during a 4-year study period. Subjects who underwent myringoplasty for large (size 40% or greater) TM perforations were included for this study. Patients with a stable perforation of at least 1 month's duration preoperatively who then followed up for at least 3 months postoperatively met inclusion criteria.</p><p><strong>Results: </strong>Six subjects were included in this study. One subject underwent bilateral repair; thus, this series includes a total of 7 perforations. TM perforations ranged from 40% to 70% of the TM. At initial follow-up (median of 2 months), 5 of the 7 perforations had healed. One of these 5 had evidence of a 10% recurrent perforation at 5 months, which subsequently healed. Of the 2 patients not healed at initial follow-up, 1 had only a residual pinpoint perforation that subsequently healed; the other had a persistent 30% perforation that was possibly related to their postoperative recovery period, which was complicated by a respiratory viral illness.</p><p><strong>Conclusion: </strong>For large TM perforations, myringoplasty with BT grafts may be a viable alternative to longer, more invasive procedures like tympanoplasty. Larger, randomized, prospective studies are needed.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1866-1871"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Unveiling the Impact of Smoking on Allergic Rhinitis: Disease Severity and Efficacy of Subcutaneous Immunotherapy. 揭示吸烟对过敏性鼻炎的影响:疾病严重程度与皮下免疫疗法的疗效。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-12-01 Epub Date: 2024-08-10 DOI: 10.1002/ohn.937
Xuan Yuan, Liyuan Liu, Benjian Zhang, Shaobing Xie, Lai Meng, Wei Zhong, Jiaxin Jia, Hua Zhang, Weihong Jiang, Zhihai Xie

Objective: To evaluate the impact of smoking statuses on disease severity and subcutaneous immunotherapy (SCIT) efficacy in allergic rhinitis (AR).

Study design: Open observational cohort study.

Setting: Tertiary referral center.

Methods: Five hundred and five AR patients undergoing dust mite allergen SCIT were categorized into never smokers, former smokers, and current smokers. AR severity was assessed using widely employed questionnaires. The changes in questionnaire scores pre- and post-SCIT were evaluated for SCIT efficacy. The differences in disease severity and SCIT efficacy were compared for different smoking statuses among AR patients.

Results: Compared to never smokers, former and current smokers exhibited higher proportion of male, alcohol, and asthma (P < .05). Current smokers had a greater prevalence of allergic conjunctivitis than former smokers (P < .05). Before SCIT, AR severity was similar across 3 groups, even after adjusting for confounders (P > .05). Current smokers reported lower SCIT efficacy in the first year (P < .05). By the third year, 3 groups showed comparable long-term efficacy (P > .05). However, current smokers experienced a significant decrease in benefits 2 years post-SCIT (P < .05) and lower improvement rates at the end of the 3-years SCIT period and 2 years following SCIT (P < .05).

Conclusion: AR patients across different smoking statuses demonstrated similar baseline disease severity and long-time SCIT efficacy. Active smoking was associated with increased asthma risk, delayed early SCIT efficacy perception, reduced improvement over 3 years, and diminished benefits 2 years after SCIT. Prompt smoking cessation is crucial to mitigate these effects.

研究目的评估吸烟状态对过敏性鼻炎(AR)疾病严重程度和皮下免疫疗法(SCIT)疗效的影响:研究设计:开放式观察队列研究:地点:三级转诊中心:接受尘螨过敏原 SCIT 治疗的 55 名 AR 患者被分为从未吸烟者、曾经吸烟者和目前吸烟者。使用广泛使用的调查问卷评估AR的严重程度。根据 SCIT 前后问卷分数的变化评估 SCIT 的疗效。比较了不同吸烟状况的 AR 患者在疾病严重程度和 SCIT 疗效方面的差异:与从不吸烟者相比,曾经吸烟者和目前吸烟者的男性、酗酒和哮喘比例更高(P .05)。当前吸烟者在第一年的 SCIT 疗效较低(P .05)。然而,当前吸烟者在接受 SCIT 治疗后 2 年的疗效显著下降(P 0.05):不同吸烟状态的 AR 患者的基线疾病严重程度和长期 SCIT 疗效相似。主动吸烟与哮喘风险增加、SCIT 早期疗效感知延迟、3 年内改善程度降低以及 SCIT 2 年后获益减少有关。及时戒烟对减轻这些影响至关重要。
{"title":"Unveiling the Impact of Smoking on Allergic Rhinitis: Disease Severity and Efficacy of Subcutaneous Immunotherapy.","authors":"Xuan Yuan, Liyuan Liu, Benjian Zhang, Shaobing Xie, Lai Meng, Wei Zhong, Jiaxin Jia, Hua Zhang, Weihong Jiang, Zhihai Xie","doi":"10.1002/ohn.937","DOIUrl":"10.1002/ohn.937","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of smoking statuses on disease severity and subcutaneous immunotherapy (SCIT) efficacy in allergic rhinitis (AR).</p><p><strong>Study design: </strong>Open observational cohort study.</p><p><strong>Setting: </strong>Tertiary referral center.</p><p><strong>Methods: </strong>Five hundred and five AR patients undergoing dust mite allergen SCIT were categorized into never smokers, former smokers, and current smokers. AR severity was assessed using widely employed questionnaires. The changes in questionnaire scores pre- and post-SCIT were evaluated for SCIT efficacy. The differences in disease severity and SCIT efficacy were compared for different smoking statuses among AR patients.</p><p><strong>Results: </strong>Compared to never smokers, former and current smokers exhibited higher proportion of male, alcohol, and asthma (P < .05). Current smokers had a greater prevalence of allergic conjunctivitis than former smokers (P < .05). Before SCIT, AR severity was similar across 3 groups, even after adjusting for confounders (P > .05). Current smokers reported lower SCIT efficacy in the first year (P < .05). By the third year, 3 groups showed comparable long-term efficacy (P > .05). However, current smokers experienced a significant decrease in benefits 2 years post-SCIT (P < .05) and lower improvement rates at the end of the 3-years SCIT period and 2 years following SCIT (P < .05).</p><p><strong>Conclusion: </strong>AR patients across different smoking statuses demonstrated similar baseline disease severity and long-time SCIT efficacy. Active smoking was associated with increased asthma risk, delayed early SCIT efficacy perception, reduced improvement over 3 years, and diminished benefits 2 years after SCIT. Prompt smoking cessation is crucial to mitigate these effects.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1887-1896"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141913639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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