Pub Date : 2024-09-18DOI: 10.1101/2024.09.17.24313676
Bradley Hittle, Ahmad Odeh, Guillermo Maza, Brenda Shen, Bradley A Otto, Don Stredney, Gregory J Wiet, Kai Zhao
Objective: Planning and predicting functional outcomes of endoscopic sinus surgeries (e.g., nasal airflow) based solely on visualizing Computerized Tomography (CT) or endoscopy poses a challenge to produce optimal clinical outcomes. Study design: Technology development, retrospective case report. Methods A virtual surgery planning (VSP) tool is developed that can load any patient's CT data and allow surgeons to remove obstructive tissue using both visual and haptic feedback endoscopically. Pre-calculated airflow resistance, wall shear stress, pressure drop are displayed on the anatomy to identify potential sites of obstruction. After each virtual surgery, changes in nasal airflow can be computed, and the process is reiterated until an optimal result is reached. Results As proof-of-concept, a series of isolated or combined procedures were performed on CT of one patient, who had olfactory losses that may involve obstructions blocking the air/odor flow to the olfactory fossa (OF). For this patient, an isolated medial partial middle turbinectomy (PMT) demonstrated the best outcome, better than traditionally performed lateral PMT, while septal body reduction worsened air/odor flow to OF. Conclusion This proof of concept case report demonstrates the potential usefulness of VSP in preoperative planning based on objective benchmarks and could be a valuable tool for optimizing future surgical outcomes.
{"title":"Developing a virtual Endoscopic Surgery Planning system to optimize surgical outcomes","authors":"Bradley Hittle, Ahmad Odeh, Guillermo Maza, Brenda Shen, Bradley A Otto, Don Stredney, Gregory J Wiet, Kai Zhao","doi":"10.1101/2024.09.17.24313676","DOIUrl":"https://doi.org/10.1101/2024.09.17.24313676","url":null,"abstract":"Objective: Planning and predicting functional outcomes of endoscopic sinus surgeries (e.g., nasal airflow) based solely on visualizing Computerized Tomography (CT) or endoscopy poses a challenge to produce optimal clinical outcomes.\u0000Study design: Technology development, retrospective case report.\u0000Methods A virtual surgery planning (VSP) tool is developed that can load any patient's CT data and allow surgeons to remove obstructive tissue using both visual and haptic feedback endoscopically. Pre-calculated airflow resistance, wall shear stress, pressure drop are displayed on the anatomy to identify potential sites of obstruction. After each virtual surgery, changes in nasal airflow can be computed, and the process is reiterated until an optimal result is reached.\u0000Results\u0000As proof-of-concept, a series of isolated or combined procedures were performed on CT of one patient, who had olfactory losses that may involve obstructions blocking the air/odor flow to the olfactory fossa (OF). For this patient, an isolated medial partial middle turbinectomy (PMT) demonstrated the best outcome, better than traditionally performed lateral PMT, while septal body reduction worsened air/odor flow to OF. Conclusion\u0000This proof of concept case report demonstrates the potential usefulness of VSP in preoperative planning based on objective benchmarks and could be a valuable tool for optimizing future surgical outcomes.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-04DOI: 10.1101/2024.08.22.24312175
Emily E. McMahan, Hubert H. Lim
Bimodal neuromodulation combining sound therapy with electrical tongue stimulation using the Lenire device is emerging as an effective treatment for tinnitus. A single-arm retrospective chart review analyzes real-world outcomes for 220 tinnitus patients from the Alaska Hearing and Tinnitus Center for the recently FDA-approved Lenire treatment for the first time in a United States clinic. The primary endpoint examines the responder rate and mean change in Tinnitus Handicap Inventory (THI) after approximately 12 weeks of treatment in eligible patients with moderate or worse tinnitus. A responder represents a THI improvement of greater than seven points (i.e., minimal clinically important difference, MCID). Of 212 patients with available data, there was a high responder rate of 91.5% (95% CI: 86.9%, 94.5%) with a mean improvement of 27.8 ± 1.3 (SEM) points, and no device-related serious adverse events. Furthermore, a THI MCID of seven points represents a consistent criterion for clinical benefit based on real-world evidence.
{"title":"Effectiveness of bimodal neuromodulation for tinnitus treatment in a real-world clinical setting in United States: A retrospective chart review","authors":"Emily E. McMahan, Hubert H. Lim","doi":"10.1101/2024.08.22.24312175","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312175","url":null,"abstract":"Bimodal neuromodulation combining sound therapy with electrical tongue stimulation using the Lenire device is emerging as an effective treatment for tinnitus. A single-arm retrospective chart review analyzes real-world outcomes for 220 tinnitus patients from the Alaska Hearing and Tinnitus Center for the recently FDA-approved Lenire treatment for the first time in a United States clinic. The primary endpoint examines the responder rate and mean change in Tinnitus Handicap Inventory (THI) after approximately 12 weeks of treatment in eligible patients with moderate or worse tinnitus. A responder represents a THI improvement of greater than seven points (i.e., minimal clinically important difference, MCID). Of 212 patients with available data, there was a high responder rate of 91.5% (95% CI: 86.9%, 94.5%) with a mean improvement of 27.8 ± 1.3 (SEM) points, and no device-related serious adverse events. Furthermore, a THI MCID of seven points represents a consistent criterion for clinical benefit based on real-world evidence.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223761","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective Objective To study the age distribution characteristics of otitis media with effusion in children and provide a basis for the selection of the timing of tympanic membrane perforation repair in children.
目的 研究儿童中耳炎伴渗出液的年龄分布特点，为儿童鼓膜穿孔修补术时机的选择提供依据。
{"title":"Age distribution characteristics of 1915 cases of otitis media with effusion in children","authors":"Mingyang Li, Xiangyu Chen, Jingyue Xu, Zihan Liu, Cuncun Xie, Xiaodong Jia, Shaoguang Ding, Guangke Wang, Hongjian Liu","doi":"10.1101/2024.09.03.24313029","DOIUrl":"https://doi.org/10.1101/2024.09.03.24313029","url":null,"abstract":"<strong>Objective</strong> Objective To study the age distribution characteristics of otitis media with effusion in children and provide a basis for the selection of the timing of tympanic membrane perforation repair in children.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142179404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-13DOI: 10.1101/2024.08.12.24311896
W. Wiktor Jedrzejczak, Malgorzata Pastucha, Henryk Skarzynski, Krzysztof Kochanek
Introduction: An effective way of testing chatbots is to ask them for references since such items can be easily verified. The purpose of this study was to compare the ability of ChatGPT–4 and Gemini Advanced to select accurate references on common topics in otorhinolaryngology. Methods: ChatGPT–4 and Gemini Advanced were asked to provide references on 25 topics within the otorhinolaryngology category of Web of Science. Within each topic, we set as target the most cited papers which had "guidelines" in the title. The chatbot responses were collected on three consecutive days to take into account possible variability. The accuracy and reliability of the provided references were evaluated. Results: Across the three days, the accuracy of ChatGPT–4 was 29–45% while that of Gemini Advanced was 10–17%. Common errors included false author names, false DOI numbers, and incomplete information. Lower percentage errors were associated with higher number of citations. Conclusions: Both chatbots performed poorly in finding references, although ChatGPT–4 provided higher accuracy than Gemini Advanced.
{"title":"Comparison of ChatGPT and Gemini as sources of references in otorhinolaryngology","authors":"W. Wiktor Jedrzejczak, Malgorzata Pastucha, Henryk Skarzynski, Krzysztof Kochanek","doi":"10.1101/2024.08.12.24311896","DOIUrl":"https://doi.org/10.1101/2024.08.12.24311896","url":null,"abstract":"Introduction: An effective way of testing chatbots is to ask them for references since such items can be easily verified. The purpose of this study was to compare the ability of ChatGPT–4 and Gemini Advanced to select accurate references on common topics in otorhinolaryngology.\u0000Methods: ChatGPT–4 and Gemini Advanced were asked to provide references on 25 topics within the otorhinolaryngology category of Web of Science. Within each topic, we set as target the most cited papers which had \"guidelines\" in the title. The chatbot responses were collected on three consecutive days to take into account possible variability. The accuracy and reliability of the provided references were evaluated.\u0000Results: Across the three days, the accuracy of ChatGPT–4 was 29–45% while that of Gemini Advanced was 10–17%. Common errors included false author names, false DOI numbers, and incomplete information. Lower percentage errors were associated with higher number of citations.\u0000Conclusions: Both chatbots performed poorly in finding references, although ChatGPT–4 provided higher accuracy than Gemini Advanced.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142179408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-02DOI: 10.1101/2024.08.01.24311230
Robert H Margolis, Victoria Sanchez, Lisa L Hunter, Aparna Rao, Suzannah Boyle, Lina Motlagh Zadeh, Amelia N Wong
Objectives: Air-conduction (AC) and bone conduction (BC) thresholds were measured to evaluate standard reference threshold values and recommend revisions to the audiometer standards. Design: AC and BC thresholds were measured from listeners with normal hearing (NH) and sensorineural hearing loss (SNHL) at three sites with recently calibrated audiometers. Study Sample: NH participants (n = 53) were selected based on age (18 to 25 years), normal AC thresholds, tympanometry and otoscopy, and absence of otologic disease. SNHL participants (n = 49) were selected based on AC thresholds, tympanometry and otoscopy, and absence of otologic disease. Results: AC thresholds obtained from NH listeners with the Radioear DD450 earphone averaged 3.7 dB HL. Air bone gaps (ABGs) occurred in NH and SNHL listeners above 2000 Hz and SNHL listeners at 250 Hz. ABGs were larger in SNHL listeners than NH listeners. Conclusions: Small corrections to the standard circumaural earphone RETSPLs are recommended for use with the DD450 earphone. The causes of ABGs in listeners without conductive pathology are discussed. False ABGs place patients at risk for unnecessary medical and surgical intervention. Reference threshold levels are recommended that will achieve two objectives: 1) AC thresholds from young NH listeners should average 0 dB HL; 2) ABGs from listeners with normal middle-ear function should average 0 dB.
{"title":"AIR-CONDUCTION AND BONE-CONDUCTION REFERENCE THRESHOLD LEVELS: A MULTICENTER STUDY","authors":"Robert H Margolis, Victoria Sanchez, Lisa L Hunter, Aparna Rao, Suzannah Boyle, Lina Motlagh Zadeh, Amelia N Wong","doi":"10.1101/2024.08.01.24311230","DOIUrl":"https://doi.org/10.1101/2024.08.01.24311230","url":null,"abstract":"Objectives: Air-conduction (AC) and bone conduction (BC) thresholds were measured to evaluate standard reference threshold values and recommend revisions to the audiometer standards.\u0000Design: AC and BC thresholds were measured from listeners with normal hearing (NH) and sensorineural hearing loss (SNHL) at three sites with recently calibrated audiometers.\u0000Study Sample: NH participants (n = 53) were selected based on age (18 to 25 years), normal AC thresholds, tympanometry and otoscopy, and absence of otologic disease. SNHL participants (n = 49) were selected based on AC thresholds, tympanometry and otoscopy, and absence of otologic disease.\u0000Results: AC thresholds obtained from NH listeners with the Radioear DD450 earphone averaged 3.7 dB HL. Air bone gaps (ABGs) occurred in NH and SNHL listeners above 2000 Hz and SNHL listeners at 250 Hz. ABGs were larger in SNHL listeners than NH listeners.\u0000Conclusions: Small corrections to the standard circumaural earphone RETSPLs are recommended for use with the DD450 earphone. The causes of ABGs in listeners without conductive pathology are discussed. False ABGs place patients at risk for unnecessary medical and surgical intervention. Reference threshold levels are recommended that will achieve two objectives: 1) AC thresholds from young NH listeners should average 0 dB HL; 2) ABGs from listeners with normal middle-ear function should average 0 dB.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"75 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141886705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-31DOI: 10.1101/2024.07.30.24311207
Lisa Reisinger, Nathan Weisz
Background: Aging is related to deterioration of bodily and neural functions, leading to various disorders and symptoms, including the development of dementia, hearing loss, or tinnitus. Understanding how these phenomena are intertwined and how aging affects those is crucial for prevention and the future development of interventions. Methods: We utilized the UK Biobank which includes a total of 502,382 participants between 40 and 70 years old. We used logistic regression models and cox proportional hazard models and compared hazard ratios. Results: The odds of reporting tinnitus in the older age group (i.e., older than 58 years) were increased by 43.3% and a one decibel increase in the SRT enhanced the odds for tinnitus by 13.5%. For our second analysis regarding hearing loss, the risk of dementia increased by 9.2% with an increase by one decibel in the SRT score. In terms of aging, each additional year increased the risk by 19.2%. Tinnitus alone showed a significant influence with a hazard ratio of 52.1%, however, when adding hearing loss, age and various covariates, the effect vanished. Conclusion: Findings confirm that tinnitus is indeed related to aging, but presumably independent of the aging processes accompanying the development of dementia. This highlights the urge to further investigate the impact of aging on neural processes that are relevant for alterations in the auditory systems (e.g., leading to the development of tinnitus or hearing loss) as well as for increased vulnerability in terms of neurodegenerative diseases. Keywords: ageing, dementia, hearing loss, tinnitus, UK Biobank
{"title":"Chronic Tinnitus is Associated with Aging but not Dementia","authors":"Lisa Reisinger, Nathan Weisz","doi":"10.1101/2024.07.30.24311207","DOIUrl":"https://doi.org/10.1101/2024.07.30.24311207","url":null,"abstract":"Background: Aging is related to deterioration of bodily and neural functions, leading to various disorders and symptoms, including the development of dementia, hearing loss, or tinnitus. Understanding how these phenomena are intertwined and how aging affects those is crucial for prevention and the future development of interventions.\u0000Methods: We utilized the UK Biobank which includes a total of 502,382 participants between 40 and 70 years old. We used logistic regression models and cox proportional hazard models and compared hazard ratios.\u0000Results: The odds of reporting tinnitus in the older age group (i.e., older than 58 years) were increased by 43.3% and a one decibel increase in the SRT enhanced the odds for tinnitus by 13.5%. For our second analysis regarding hearing loss, the risk of dementia increased by 9.2% with an increase by one decibel in the SRT score. In terms of aging, each additional year increased the risk by 19.2%. Tinnitus alone showed a significant influence with a hazard ratio of 52.1%, however, when adding hearing loss, age and various covariates, the effect vanished.\u0000Conclusion: Findings confirm that tinnitus is indeed related to aging, but presumably independent of the aging processes accompanying the development of dementia. This highlights the urge to further investigate the impact of aging on neural processes that are relevant for alterations in the auditory systems (e.g., leading to the development of tinnitus or hearing loss) as well as for increased vulnerability in terms of neurodegenerative diseases.\u0000Keywords: ageing, dementia, hearing loss, tinnitus, UK Biobank","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141863619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-01DOI: 10.1101/2024.06.30.24309685
Shitong Mao, Jihong Wang, Holly McMillan, Abdallah Sherif Radwan Mohamed, Sheila Buoy, Sara Ahmed, Samuel L Mulder, Mohamed A. Naser, Renjie He, Kareem A. Wahid, Melissa Chen, Yao Ding, Amy C. Moreno, Stephen Y. Lai, Clifton D. Fuller, Katherine A. Hutcheson, MD Anderson Head and Neck Cancer Symptom Working Group
Importance Quantifying Head and Neck Lymphedema and Fibrosis (HN-LEF) is crucial in the investigation and management of this highly prevalent treatment sequelae in head and neck cancer (HNC). The HN-LEF grading system classifies physically palpable soft-tissue injury categorically. Imaging biomarkers from MRI may serve to complement or validate physical HN-LEF grading when assessing the effectiveness of therapeutic interventions or toxicity profiles of patients. Objective To explore the relationship between 1) physical HN-LEF classification in submental and oral regions of interest (ROI) and the MRI T1- and T2-weighted signal intensity (SI) in close proximity regions, and 2) a novel HN-LEF score and MRI T1 and T2 structural volumes. Design: Post hoc analysis of pilot single-arm MANTLE trial (NCT03612531). Setting: Single institution, NCI-designated comprehensive cancer center. Participants A total of 16 individuals (mean [SD] age, 68.28 [7.0] years; 3[19%] female) enrolled in the MANTLE trial underwent MRI. All participants were disease-free at least two years post radiotherapy with grade ≥2 fibrosis (in any cervical ROI) and grade ≥2 dysphagia (per DIGEST). Over a 12-week period, participants engaged in manual therapy sessions accompanied by concurrent standardized multiparametric, serial MRI examinations and palpation-based HN-LEF evaluations at 3-time points: baseline, post-manual therapy, and post-washout. Exposures: The independent variable HN-LEF included its categorical classification (No-LEF, A-B = edema, C= edema + fibrosis, D=fibrosis) and a novel metric (10-point scale) derived from the HN-LEF categories (considering both type and severity classification). Main Outcomes and Measures: The T1- and T2-weighted MRI SI was examined by Kruskal-Wallis tests in relation to HN-LEF categories and the novel HN-LEF score. We hypothesized higher T2 SI in edema states, higher T1 SI in fibrotic states, and decreasing structural volume as the HN-LEF score increased. Results: We identified differences in mean ranks among HN-LEF categories in relation to the MRI SI (A-B and C are higher than D and No-LEF for T2 SI, and A-B is the highest for T1). Furthermore, six pairs of FOM volumes on MRI demonstrated a strong negative correlation (p<0.05) with the HN-LEF score at adjacent palpable sites: digastric vs. submental left (ρ = -0.421; 95% CI, -0.65~ -0.10, T1), mylohyoid vs. submental left (ρ = -0.36; 95% CI, -0. 62~ 0.03, T1), digastric vs. submental left (ρ = --0.45; 95% CI, -0. 72~ -0.06, T2), genioglossus vs. Intraoral left (ρ = -0.47; 95% CI, -0. 74~ -0.07, T2), mylohyoid vs. Intraoral left (ρ = -0.48; 95% CI, -0. 75~ -0.09, T2), tongue base vs. Intraoral left (r = -0.42; 95% CI, -0. 71~ -0.01, T2). Conclusions and Relevance This exploratory analysis provides hypothesis-generating data supporting further study of MRI SI as an imaging biomarker of edematous soft tissue states after RT in HNC, but does not support the hypothesized T2 SI relationship
重要性 头颈部淋巴水肿和纤维化（HN-LEF）的量化对于头颈部癌症（HNC）这种高发的治疗后遗症的调查和管理至关重要。HN-LEF 分级系统对可触及的软组织损伤进行了分类。在评估治疗干预措施的有效性或患者的毒性概况时，MRI 的成像生物标志物可作为物理 HN-LEF 分级的补充或验证。目的 探讨 1) 下额和口腔感兴趣区（ROI）的物理 HN-LEF 分级与邻近区域的 MRI T1 和 T2 加权信号强度（SI）之间的关系，以及 2) 新型 HN-LEF 评分与 MRI T1 和 T2 结构体积之间的关系。设计：对试点单臂MANTLE试验（NCT03612531）进行事后分析：单一机构、NCI指定的综合癌症中心。参与者 共有 16 人（平均 [SD] 年龄为 68.28 [7.0] 岁；3[19%] 为女性）参加了 MANTLE 试验，并接受了磁共振成像检查。所有参与者均在放疗后至少两年无病，纤维化≥2级（任何颈椎ROI），吞咽困难≥2级（根据DIGEST）。在为期 12 周的时间里，参与者在接受手法治疗的同时，还在 3 个时间点（基线、手法治疗后和冲洗后）接受了标准化多参数、连续 MRI 检查和基于触诊的 HN-LEF 评估：自变量HN-LEF包括其分类（无LEF、A-B=水肿、C=水肿+纤维化、D=纤维化）和从HN-LEF分类中得出的新指标（10分制）（同时考虑类型和严重程度分类）：通过Kruskal-Wallis检验对T1和T2加权MRI SI与HN-LEF类别和新的HN-LEF评分的关系进行检验。我们假设水肿状态下的 T2 SI 较高，纤维化状态下的 T1 SI 较高，结构体积随着 HN-LEF 分数的增加而减少。结果：我们发现 HN-LEF 类别的平均等级与 MRI SI 存在差异（就 T2 SI 而言，A-B 和 C 高于 D 和 No-LEF；就 T1 而言，A-B 最高）。此外，核磁共振成像上的六对 FOM 体积与相邻可触及部位的 HN-LEF 评分呈强负相关（p<0.05）：掘腹部 vs. 左下方（ρ = -0.421; 95% CI, -0.65~ -0.10，T1）、肌舌骨 vs. 左侧下颌骨（ρ = -0.36；95% CI，-0.62~ 0.03，T1）、舌骨 vs. 左侧下颌骨（ρ = --0.45；95% CI，-0.72~ -0.06，T2）、舌根 vs. 口内左侧（ρ = -0.47；95% CI，-0.74~ -0.07，T2）、肌舌骨 vs. 左侧下颌骨（ρ = -0.45；95% CI，-0.72~ -0.06，T2）、舌根 vs. 口内左侧（ρ = -0.47；95% CI，-0.74~ -0.结论和相关性 该探索性分析提供了支持进一步研究 MRI SI 作为 HNC RT 后水肿软组织状态成像生物标志物的假设生成数据，但并不支持假设的 T2 SI 与纤维组织状态的关系。新型 HN-LEF 评分与结构体积之间的反相关性表明，假设结构体积随着患者从水肿状态转为纤维化状态而减小，那么这种新型指标具有潜在的有效性。这项研究强调了利用成像指标增强 LEF 定量的潜力，这可能会进一步帮助早期检测和精确测量放疗后 HNC 患者的淋巴水肿和纤维化严重程度。
{"title":"Exploring quantitative MRI biomarkers of head and neck post-radiation lymphedema and fibrosis: Post hoc analysis of a prospective trial","authors":"Shitong Mao, Jihong Wang, Holly McMillan, Abdallah Sherif Radwan Mohamed, Sheila Buoy, Sara Ahmed, Samuel L Mulder, Mohamed A. Naser, Renjie He, Kareem A. Wahid, Melissa Chen, Yao Ding, Amy C. Moreno, Stephen Y. Lai, Clifton D. Fuller, Katherine A. Hutcheson, MD Anderson Head and Neck Cancer Symptom Working Group","doi":"10.1101/2024.06.30.24309685","DOIUrl":"https://doi.org/10.1101/2024.06.30.24309685","url":null,"abstract":"Importance Quantifying Head and Neck Lymphedema and Fibrosis (HN-LEF) is crucial in the investigation and management of this highly prevalent treatment sequelae in head and neck cancer (HNC). The HN-LEF grading system classifies physically palpable soft-tissue injury categorically. Imaging biomarkers from MRI may serve to complement or validate physical HN-LEF grading when assessing the effectiveness of therapeutic interventions or toxicity profiles of patients.\u0000Objective To explore the relationship between 1) physical HN-LEF classification in submental and oral regions of interest (ROI) and the MRI T1- and T2-weighted signal intensity (SI) in close proximity regions, and 2) a novel HN-LEF score and MRI T1 and T2 structural volumes. Design: Post hoc analysis of pilot single-arm MANTLE trial (NCT03612531).\u0000Setting: Single institution, NCI-designated comprehensive cancer center. Participants A total of 16 individuals (mean [SD] age, 68.28 [7.0] years; 3[19%] female) enrolled in the MANTLE trial underwent MRI. All participants were disease-free at least two years post radiotherapy with grade ≥2 fibrosis (in any cervical ROI) and grade ≥2 dysphagia (per DIGEST). Over a 12-week period, participants engaged in manual therapy sessions accompanied by concurrent standardized multiparametric, serial MRI examinations and palpation-based HN-LEF evaluations at 3-time points: baseline, post-manual therapy, and post-washout.\u0000Exposures: The independent variable HN-LEF included its categorical classification (No-LEF, A-B = edema, C= edema + fibrosis, D=fibrosis) and a novel metric (10-point scale) derived from the HN-LEF categories (considering both type and severity classification).\u0000Main Outcomes and Measures: The T1- and T2-weighted MRI SI was examined by Kruskal-Wallis tests in relation to HN-LEF categories and the novel HN-LEF score. We hypothesized higher T2 SI in edema states, higher T1 SI in fibrotic states, and decreasing structural volume as the HN-LEF score increased. Results: We identified differences in mean ranks among HN-LEF categories in relation to the MRI SI (A-B and C are higher than D and No-LEF for T2 SI, and A-B is the highest for T1). Furthermore, six pairs of FOM volumes on MRI demonstrated a strong negative correlation (p<0.05) with the HN-LEF score at adjacent palpable sites: digastric vs. submental left (ρ = -0.421; 95% CI, -0.65~ -0.10, T1), mylohyoid vs. submental left (ρ = -0.36; 95% CI, -0. 62~ 0.03, T1), digastric vs. submental left (ρ = --0.45; 95% CI, -0. 72~ -0.06, T2), genioglossus vs. Intraoral left (ρ = -0.47; 95% CI, -0. 74~ -0.07, T2), mylohyoid vs. Intraoral left (ρ = -0.48; 95% CI, -0. 75~ -0.09, T2), tongue base vs. Intraoral left (r = -0.42; 95% CI, -0. 71~ -0.01, T2).\u0000Conclusions and Relevance This exploratory analysis provides hypothesis-generating data supporting further study of MRI SI as an imaging biomarker of edematous soft tissue states after RT in HNC, but does not support the hypothesized T2 SI relationship ","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141530225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1101/2024.06.26.24309528
Katrien Kestens, Emma Lepla, Flore Vandoorne, Dorien Ceuleers, Louise Van Goylen, Hannah Keppler
Introduction Understanding how listeners execute a dual-task paradigm for listening effort would provide a benchmark for future studies and clinical implementations. Therefore, this study aimed to examine the impact of instructions on the prioritization strategy employed by individuals during a dual-task paradigm for listening effort by assessing dual-task interference. Methods The dual-task paradigm consisted of a primary speech understanding task in different listening conditions and a secondary visual memory task, both performed separately (baseline) and simultaneously (dual-task). Twenty-three normal-hearing participants (mean age: 36.8 years; 14 females) were directed to prioritize the primary speech understanding task in the dual-task condition, whereas another twenty-three (matched for age, gender, and education level) received no specific instructions regarding task priority. Both groups performed the dual-task paradigm twice (mean interval: 14.8 days). Dual-task interference was assessed by plotting the dual-task effect of the primary and secondary task against each other. Participants were classified based on their patterns of interference. Results The prioritizing group had more participants who achieved stable or better scores on the primary task in the dual-task condition compared to baseline. However, there was considerable variability in the prioritizing strategy employed at the individual level across listening conditions and test moments, regardless the given prioritization instructions. Conclusion Providing prioritization instructions was insufficient to ensure that an individual will mainly focus on the primary task and will stick to this strategy across listening conditions and test moments. These results raised certain reservations about the current usage of dual-task paradigms for listening effort.
{"title":"The Impact of Instructions on Individual Prioritization Strategies in a Dual-Task Paradigm for Listening Effort","authors":"Katrien Kestens, Emma Lepla, Flore Vandoorne, Dorien Ceuleers, Louise Van Goylen, Hannah Keppler","doi":"10.1101/2024.06.26.24309528","DOIUrl":"https://doi.org/10.1101/2024.06.26.24309528","url":null,"abstract":"<strong>Introduction</strong> Understanding how listeners execute a dual-task paradigm for listening effort would provide a benchmark for future studies and clinical implementations. Therefore, this study aimed to examine the impact of instructions on the prioritization strategy employed by individuals during a dual-task paradigm for listening effort by assessing dual-task interference. <strong>Methods</strong> The dual-task paradigm consisted of a primary speech understanding task in different listening conditions and a secondary visual memory task, both performed separately (baseline) and simultaneously (dual-task). Twenty-three normal-hearing participants (mean age: 36.8 years; 14 females) were directed to prioritize the primary speech understanding task in the dual-task condition, whereas another twenty-three (matched for age, gender, and education level) received no specific instructions regarding task priority. Both groups performed the dual-task paradigm twice (mean interval: 14.8 days). Dual-task interference was assessed by plotting the dual-task effect of the primary and secondary task against each other. Participants were classified based on their patterns of interference. <strong>Results</strong> The prioritizing group had more participants who achieved stable or better scores on the primary task in the dual-task condition compared to baseline. However, there was considerable variability in the prioritizing strategy employed at the individual level across listening conditions and test moments, regardless the given prioritization instructions. <strong>Conclusion</strong> Providing prioritization instructions was insufficient to ensure that an individual will mainly focus on the primary task and will stick to this strategy across listening conditions and test moments. These results raised certain reservations about the current usage of dual-task paradigms for listening effort.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"59 13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141510672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-26DOI: 10.1101/2024.06.26.24309521
Anja L Winter, Sofie Henecke, Evelina Thunell, Mattias Swartz, Joakim Martinsen, Pernilla Sahlstrand Johansson, Johan N Lundstrom
The recommended treatment for hyposmia (clinically reduced sense of smell) is olfactory training using odors in containers that the patients smell twice a day for several weeks. Adherence to the olfactory training regimen is, however, generally low. We aimed to investigate if a new form of olfactory delivery via scented nasal inserts could enhance olfactory training adherence by allowing participants to be mobile while performing the training and thereby lower perceived intrusion in their everyday life, using a randomized controlled parallel-group design. Two groups of individuals with hyposmia underwent 8 weeks of olfactory training. One group (n=60) performed olfactory training using scented nasal inserts (nasal plugs that retain nasal patency) and one group (n=56) performed the standard care regiment currently recommended by the Swedish healthcare system. We assessed objective and subjective olfactory ability before and after olfactory training as well as adherence to training. While both groups significantly improved their objective and subjective olfactory abilities, training with nasal insert produced similar improvement as standard care in overall treatment outcome. However, there was a significantly greater increase in discrimination performance and lower dropout rate (6.7%) in the nasal insert compared to the standard care group (23.2%). Critically, the nasal insert group had a significantly higher adherence to the training regimen, i.e. fewer missed training sessions. In addition, they reported overall greater satisfaction with their treatment. These data suggest that olfactory training with nasal inserts could serve as a more effective form of treatment for hyposmia, due to patients improved adherence to protocol and increased tendency to finish their treatment regimen.
{"title":"Olfactory training using nasal inserts more effective due to increased adherence","authors":"Anja L Winter, Sofie Henecke, Evelina Thunell, Mattias Swartz, Joakim Martinsen, Pernilla Sahlstrand Johansson, Johan N Lundstrom","doi":"10.1101/2024.06.26.24309521","DOIUrl":"https://doi.org/10.1101/2024.06.26.24309521","url":null,"abstract":"The recommended treatment for hyposmia (clinically reduced sense of smell) is olfactory training using odors in containers that the patients smell twice a day for several weeks. Adherence to the olfactory training regimen is, however, generally low. We aimed to investigate if a new form of olfactory delivery via scented nasal inserts could enhance olfactory training adherence by allowing participants to be mobile while performing the training and thereby lower perceived intrusion in their everyday life, using a randomized controlled parallel-group design. Two groups of individuals with hyposmia underwent 8 weeks of olfactory training. One group (n=60) performed olfactory training using scented nasal inserts (nasal plugs that retain nasal patency) and one group (n=56) performed the standard care regiment currently recommended by the Swedish healthcare system. We assessed objective and subjective olfactory ability before and after olfactory training as well as adherence to training. While both groups significantly improved their objective and subjective olfactory abilities, training with nasal insert produced similar improvement as standard care in overall treatment outcome. However, there was a significantly greater increase in discrimination performance and lower dropout rate (6.7%) in the nasal insert compared to the standard care group (23.2%). Critically, the nasal insert group had a significantly higher adherence to the training regimen, i.e. fewer missed training sessions. In addition, they reported overall greater satisfaction with their treatment. These data suggest that olfactory training with nasal inserts could serve as a more effective form of treatment for hyposmia, due to patients improved adherence to protocol and increased tendency to finish their treatment regimen.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"118 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141510504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-25DOI: 10.1101/2024.06.25.24309468
Chen Xu, Lena Schell-Majoor, Birger Kollmeier
Objective The benefit of using smartphones for hearing tests in a non-supervised, rapid, and contactless way has drawn a lot of interest, especially if supra-threshold measures are assessed that go beyond audiogram-based measures alone. It is unclear, nevertheless, how well these measures compare to more supervised and regulated manual audiometric assessments. The aim of this study is to validate such smartphone-based methods against standardized laboratory assessments.
{"title":"Development and verification of non-supervised smartphone-based methods for assessing pure-tone thresholds and loudness perception","authors":"Chen Xu, Lena Schell-Majoor, Birger Kollmeier","doi":"10.1101/2024.06.25.24309468","DOIUrl":"https://doi.org/10.1101/2024.06.25.24309468","url":null,"abstract":"<strong>Objective</strong> The benefit of using smartphones for hearing tests in a non-supervised, rapid, and contactless way has drawn a lot of interest, especially if supra-threshold measures are assessed that go beyond audiogram-based measures alone. It is unclear, nevertheless, how well these measures compare to more supervised and regulated manual audiometric assessments. The aim of this study is to validate such smartphone-based methods against standardized laboratory assessments.","PeriodicalId":501185,"journal":{"name":"medRxiv - Otolaryngology","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141532202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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