Pub Date : 2024-09-24DOI: 10.1016/j.amjoto.2024.104506
{"title":"Neurogenic cough: A commentary on the step-up approach and therapeutic considerations","authors":"","doi":"10.1016/j.amjoto.2024.104506","DOIUrl":"10.1016/j.amjoto.2024.104506","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-24DOI: 10.1016/j.amjoto.2024.104507
Soraya Fereydooni, Ashley R Wang, Hemali P Shah, Avanti Verma
{"title":"A national survey of otolaryngologists' perspectives on uses and barriers to palliative care.","authors":"Soraya Fereydooni, Ashley R Wang, Hemali P Shah, Avanti Verma","doi":"10.1016/j.amjoto.2024.104507","DOIUrl":"https://doi.org/10.1016/j.amjoto.2024.104507","url":null,"abstract":"","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142374979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-30DOI: 10.1016/j.amjoto.2024.104504
Purpose
This retrospective cohort study aims to evaluate the clinical, oncological, and functional outcomes of transoral non-robotic surgery for oropharyngeal squamous cell carcinoma (OPSCC).
Materials and methods
Data from 131 patients with surgically treated OPSCC (2010-2022) were analyzed. Patients who underwent exclusively transoral surgery were included in the study. The surgeries were performed under microscopic or endoscopic guidance and either a CO2 laser or an ultrasound/radiofrequency scalpel was used as a cutting instrument, depending on the characteristics and location of the tumor. Functional outcomes were assessed in terms of length of hospital stay, tracheostomy rate, duration of feeding tube dependency and complications. Survival outcomes were assessed in terms of overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS).
Results
Of 74 included patients, transoral surgery demonstrated safety with no major complications. Tracheotomy was performed in 51.4 % of cases, and was maintained for a median of 10 days. Complete swallowing recovery was restored in 97.3 % of cases, after a median of 5 days. The median length of hospital stay was 12 days. At 5 years, OS was 68.2 %, PFS was 58.2 % and DSS was 83.6 %.
Conclusion
The study confirms the safety and efficacy of a transoral approach for OPSCC. Having the capability to utilize and access a variety of tools provides the opportunity to tailor the technique to the individual patient and specific circumstances.
{"title":"Transoral non-robotic surgery for oropharyngeal squamous cell carcinoma","authors":"","doi":"10.1016/j.amjoto.2024.104504","DOIUrl":"10.1016/j.amjoto.2024.104504","url":null,"abstract":"<div><h3>Purpose</h3><p>This retrospective cohort study aims to evaluate the clinical, oncological, and functional outcomes of transoral non-robotic surgery for oropharyngeal squamous cell carcinoma (OPSCC).</p></div><div><h3>Materials and methods</h3><p>Data from 131 patients with surgically treated OPSCC (2010-2022) were analyzed. Patients who underwent exclusively transoral surgery were included in the study. The surgeries were performed under microscopic or endoscopic guidance and either a CO<sub>2</sub> laser or an ultrasound/radiofrequency scalpel was used as a cutting instrument, depending on the characteristics and location of the tumor. Functional outcomes were assessed in terms of length of hospital stay, tracheostomy rate, duration of feeding tube dependency and complications. Survival outcomes were assessed in terms of overall survival (OS), disease-free survival (DFS) and disease-specific survival (DSS).</p></div><div><h3>Results</h3><p>Of 74 included patients, transoral surgery demonstrated safety with no major complications. Tracheotomy was performed in 51.4 % of cases, and was maintained for a median of 10 days. Complete swallowing recovery was restored in 97.3 % of cases, after a median of 5 days. The median length of hospital stay was 12 days. At 5 years, OS was 68.2 %, PFS was 58.2 % and DSS was 83.6 %.</p></div><div><h3>Conclusion</h3><p>The study confirms the safety and efficacy of a transoral approach for OPSCC. Having the capability to utilize and access a variety of tools provides the opportunity to tailor the technique to the individual patient and specific circumstances.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1016/j.amjoto.2024.104502
Objective
A publicly available large language learning model platform may help determine current readability levels of otolaryngology patient education materials, as well as translate these materials to the recommended 6th-grade and 8th-grade reading levels.
Study design
Cross-sectional analysis.
Setting
Online using large language learning model, ChatGPT.
Methods
The Patient Education pages of the American Laryngological Association (ALA) and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) websites were accessed. Materials were input into ChatGPT (OpenAI, San Francisco, CA; version 3.5) and Microsoft Word (Microsoft, Redmond, WA; version 16.74). Programs calculated Flesch Reading Ease (FRE) scores, with higher scores indicating easier readability, and Flesch-Kincaid (FK) grade levels, estimating U.S. grade level required to understand text. ChatGPT was prompted to “translate to a 5th-grade reading level” and provide new scores. Scores were compared for statistical differences, as well as differences between ChatGPT and Word gradings.
Results
Patient education materials were reviewed and 37 ALA and 72 AAO-HNS topics were translated. Overall FRE scores and FK grades demonstrated significant improvements following translation of materials, as scored by ChatGPT (p < 0.001). Word also scored significant improvements in FRE and FK following translation by ChatGPT for AAO-HNS materials overall (p < 0.001) but not for individual topics or for subspecialty-specific categories. Compared with Word, ChatGPT significantly exaggerated the change in FRE grades and FK scores (p < 0.001).
Conclusion
Otolaryngology patient education materials were found to be written at higher reading levels than recommended. Artificial intelligence may prove to be a useful resource to simplify content to make it more accessible to patients.
研究设计横断面分析设置在线使用大型语言学习模型 ChatGPT方法访问美国喉科学协会(ALA)和美国耳鼻咽喉头颈外科学会(AAO-HNS)网站的患者教育页面。将材料输入 ChatGPT(OpenAI,加利福尼亚州旧金山;3.5 版)和 Microsoft Word(Microsoft,华盛顿州雷德蒙德;16.74 版)。程序计算弗莱什阅读容易度(FRE)分数,分数越高表示越容易阅读,同时计算弗莱什-金凯德(FK)年级水平,估计理解文本所需的美国年级水平。ChatGPT 会被提示 "翻译成五年级的阅读水平",并提供新的分数。对分数的统计差异以及 ChatGPT 和 Word 分级之间的差异进行比较。结果审阅了患者教育材料,翻译了 37 个 ALA 和 72 个 AAO-HNS 主题。根据 ChatGPT 的评分,翻译材料后 FRE 总分和 FK 等级均有显著提高(p < 0.001)。通过 ChatGPT 翻译 AAO-HNS 资料后,Word 的 FRE 和 FK 分数也有明显提高(p < 0.001),但个别主题或特定亚专科类别的 FRE 和 FK 分数没有提高。与 Word 相比,ChatGPT 明显夸大了 FRE 分数和 FK 分数的变化(p < 0.001)。人工智能可能被证明是一种有用的资源,可以简化内容,使患者更容易理解。
{"title":"Improving readability and comprehension levels of otolaryngology patient education materials using ChatGPT","authors":"","doi":"10.1016/j.amjoto.2024.104502","DOIUrl":"10.1016/j.amjoto.2024.104502","url":null,"abstract":"<div><h3>Objective</h3><p>A publicly available large language learning model platform may help determine current readability levels of otolaryngology patient education materials, as well as translate these materials to the recommended 6th-grade and 8th-grade reading levels.</p></div><div><h3>Study design</h3><p>Cross-sectional analysis.</p></div><div><h3>Setting</h3><p>Online using large language learning model, ChatGPT.</p></div><div><h3>Methods</h3><p>The Patient Education pages of the American Laryngological Association (ALA) and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) websites were accessed. Materials were input into ChatGPT (OpenAI, San Francisco, CA; version 3.5) and Microsoft Word (Microsoft, Redmond, WA; version 16.74). Programs calculated Flesch Reading Ease (FRE) scores, with higher scores indicating easier readability, and Flesch-Kincaid (FK) grade levels, estimating U.S. grade level required to understand text. ChatGPT was prompted to “translate to a 5th-grade reading level” and provide new scores. Scores were compared for statistical differences, as well as differences between ChatGPT and Word gradings.</p></div><div><h3>Results</h3><p>Patient education materials were reviewed and 37 ALA and 72 AAO-HNS topics were translated. Overall FRE scores and FK grades demonstrated significant improvements following translation of materials, as scored by ChatGPT (<em>p</em> < 0.001). Word also scored significant improvements in FRE and FK following translation by ChatGPT for AAO-HNS materials overall (<em>p</em> < 0.001) but not for individual topics or for subspecialty-specific categories. Compared with Word, ChatGPT significantly exaggerated the change in FRE grades and FK scores (<em>p</em> < 0.001).</p></div><div><h3>Conclusion</h3><p>Otolaryngology patient education materials were found to be written at higher reading levels than recommended. Artificial intelligence may prove to be a useful resource to simplify content to make it more accessible to patients.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-26DOI: 10.1016/j.amjoto.2024.104503
Objective
Compare the vestibulo-ocular reflex (VOR) gain, compensatory saccades and head and eye coordination during head impulses between patients with dizziness but normal VOR gain and healthy controls.
Methods
Video head impulses test (vHIT; ICS impulse, Otometrics, Denmark) was reviewed in 40 participants (20 patients with dizziness; 20 controls). VOR gain, saccades characteristics (frequency of occurrence, amplitude, latency) and time difference between head and eye velocity was compared.
Results
No significant difference between groups was observed for VOR gain. However, saccade frequency was greater and time difference between head and eye was prolonged in patients with dizziness. No significant difference was observed for saccade amplitude, nor for saccade latency between groups.
Conclusions
The present study highlights that saccades observed in patients with normal VOR gain could reflect a clinical marker for dizziness in patients with normal VOR gain. We propose that theses saccades are caused by a prolonged time delay between head and eye velocity leading to a gaze position error.
Significance
The results support previous findings suggesting additional value of saccades and time delay when interpreting vHIT results. This study goes further by proposing time delay as a possible mechanism to explain increased saccade frequency in dizzy patients with normal VOR gain.
目的 比较头晕但 VOR 增益正常的患者与健康对照组在头部冲动时的前庭-眼反射(VOR)增益、代偿性眼球移动和头眼协调情况。方法 对 40 名参与者(20 名头晕患者;20 名对照组)进行视频头部冲动测试(vHIT;ICS impulse,Otometrics,丹麦)。比较了VOR增益、囊回特性(发生频率、振幅、潜伏期)以及头眼速度的时间差。然而,眩晕患者的囊回频率更高,头眼速度时间差更长。结论 本研究强调,在 VOR 增益正常的患者中观察到的囊状移动可反映出头晕的临床标记。我们认为,这些眼球移动是由于头部和眼球速度之间的时间延迟过长导致注视位置错误所致。研究结果支持了之前的研究结果,即在解释 vHIT 结果时,眼球移动和时间延迟具有额外的价值。本研究进一步提出,时间延迟是解释VOR增益正常的眩晕患者囊回频率增加的可能机制。
{"title":"Analysis of head and eye dynamic may explain saccades in dizzy patients with normal VOR gain","authors":"","doi":"10.1016/j.amjoto.2024.104503","DOIUrl":"10.1016/j.amjoto.2024.104503","url":null,"abstract":"<div><h3>Objective</h3><p>Compare the vestibulo-ocular reflex (VOR) gain, compensatory saccades and head and eye coordination during head impulses between patients with dizziness but normal VOR gain and healthy controls.</p></div><div><h3>Methods</h3><p>Video head impulses test (vHIT; ICS impulse, Otometrics, Denmark) was reviewed in 40 participants (20 patients with dizziness; 20 controls). VOR gain, saccades characteristics (frequency of occurrence, amplitude, latency) and time difference between head and eye velocity was compared.</p></div><div><h3>Results</h3><p>No significant difference between groups was observed for VOR gain. However, saccade frequency was greater and time difference between head and eye was prolonged in patients with dizziness. No significant difference was observed for saccade amplitude, nor for saccade latency between groups.</p></div><div><h3>Conclusions</h3><p>The present study highlights that saccades observed in patients with normal VOR gain could reflect a clinical marker for dizziness in patients with normal VOR gain. We propose that theses saccades are caused by a prolonged time delay between head and eye velocity leading to a gaze position error.</p></div><div><h3>Significance</h3><p>The results support previous findings suggesting additional value of saccades and time delay when interpreting vHIT results. This study goes further by proposing time delay as a possible mechanism to explain increased saccade frequency in dizzy patients with normal VOR gain.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142122612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-16DOI: 10.1016/j.amjoto.2024.104501
Objective
To evaluate the extent of payments from medical device and pharmaceutical companies to editorial board members of leading otolaryngology journals.
Methods
Editorial board members of the top 10 otolaryngology journals from Google Scholar rankings were identified in this cross-sectional study.
Payments between 2017 and 2022 were identified via the Open Payments Database from the Centers for Medicare and Medicaid Services. All payment data was adjusted for inflation in 2022 US dollars. Descriptive analyses were performed and journal websites were evaluated for individual editor disclosures.
Results
Out of 581 board members, 306 (53 %) received industry payments between 2017 and 2022, median journal percentage 55 % (interquartile range: 26.5 %–73.5 %). A sum of $45.8 million was paid out between 2017 and 2022, comprising $32.0 million in associated research funding, $1.2 million in research payments, $1.4 million in ownership and investment interests, and $11.2 million in general payments. The largest general payments were made out for “services other than consulting and speaking” ($3.9 million), “consulting” ($3.8 million), “travel and lodging” ($0.99 million), “education” ($0.87 million), “royalty or license” ($0.56 million), and “food and beverage” ($0.55 million). Individual editor disclosures were only available for International Forum of Allergy and Rhinology (9 % of all included editors).
Conclusions
Industry payments to editors of otolaryngology journals are not uncommon. We highlight the need for improved reporting of individual editor disclosures for transparency to journal readers and for minimizing biased editorial decisions.
{"title":"Evaluating industry payments to editorial board members of otolaryngology journals","authors":"","doi":"10.1016/j.amjoto.2024.104501","DOIUrl":"10.1016/j.amjoto.2024.104501","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the extent of payments from medical device and pharmaceutical companies to editorial board members of leading otolaryngology journals.</p></div><div><h3>Methods</h3><p>Editorial board members of the top 10 otolaryngology journals from Google Scholar rankings were identified in this cross-sectional study.</p><p>Payments between 2017 and 2022 were identified via the Open Payments Database from the Centers for Medicare and Medicaid Services. All payment data was adjusted for inflation in 2022 US dollars. Descriptive analyses were performed and journal websites were evaluated for individual editor disclosures.</p></div><div><h3>Results</h3><p>Out of 581 board members, 306 (53 %) received industry payments between 2017 and 2022, median journal percentage 55 % (interquartile range: 26.5 %–73.5 %). A sum of $45.8 million was paid out between 2017 and 2022, comprising $32.0 million in associated research funding, $1.2 million in research payments, $1.4 million in ownership and investment interests, and $11.2 million in general payments. The largest general payments were made out for “services other than consulting and speaking” ($3.9 million), “consulting” ($3.8 million), “travel and lodging” ($0.99 million), “education” ($0.87 million), “royalty or license” ($0.56 million), and “food and beverage” ($0.55 million). Individual editor disclosures were only available for International Forum of Allergy and Rhinology (9 % of all included editors).</p></div><div><h3>Conclusions</h3><p>Industry payments to editors of otolaryngology journals are not uncommon. We highlight the need for improved reporting of individual editor disclosures for transparency to journal readers and for minimizing biased editorial decisions.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0196070924002874/pdfft?md5=e61f1f0a4bd01be2f44b352a910b5408&pid=1-s2.0-S0196070924002874-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142040243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1016/j.amjoto.2024.104471
Objective
To compare the graft success rates and hearing outcomes of underlay myringoplasty with or without perichondrium tucking of the attached perichondrium, graft perforation margins when repairing chronic large central dry perforations.
Study design
Randomized controlled trial.
Material and methods
Chronic large central dry perforations were prospectively randomized to tucking perichondrium graft underlay (TPGU) and no-tucking perichondrium graft underlay (NTPG) groups. The graft outcomes and complications were compared between the two groups at 12 months postoperatively.
Results
In total, 61 patients with large central dry perforations were included. All patients completed 12-month follow-ups. Residual perforations occurred in 0.0 % of the TPGU group and in 12.9 % of the NTPG group (P = 0.129), and re-perforations occurred within 6 months in 0.0 % and 3.2 % of the two groups, respectively (P = 0.987). The graft success rates were 100.0 % (30/30) and 83.9 % (26/31) (P = 0.067). No significant between-group differences were observed in terms of preoperative (P = 0.547) or postoperative (P = 0.612) air bone gaps (ABGs) or mean ABG gains (P = 0.597). No graft-related complications were observed in either group during follow-up. No patients exhibited significant graft blunting or medialization; graft lateralization was noted in one patient of the NTPG group.
Conclusions
Endoscopic cartilage with tucking of the attached perichondrium perforation margins during underlay myringoplasty may improve the graft success rate compared to that of the cartilage push-through technique when repairing large central dry perforations; however, the hearing improvements were comparable in the two groups.
{"title":"Comparative study of endoscopic underlay myringoplasty with or without tucking of the attached perichondrium graft when repairing large central dry perforations","authors":"","doi":"10.1016/j.amjoto.2024.104471","DOIUrl":"10.1016/j.amjoto.2024.104471","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the graft success rates and hearing outcomes of underlay myringoplasty with or without perichondrium tucking of the attached perichondrium, graft perforation margins when repairing chronic large central dry perforations.</p></div><div><h3>Study design</h3><p>Randomized controlled trial.</p></div><div><h3>Material and methods</h3><p>Chronic large central dry perforations were prospectively randomized to tucking perichondrium graft underlay (TPGU) and no-tucking perichondrium graft underlay (NTPG) groups. The graft outcomes and complications were compared between the two groups at 12 months postoperatively.</p></div><div><h3>Results</h3><p>In total, 61 patients with large central dry perforations were included. All patients completed 12-month follow-ups. Residual perforations occurred in 0.0 % of the TPGU group and in 12.9 % of the NTPG group (<em>P</em> = 0.129), and re-perforations occurred within 6 months in 0.0 % and 3.2 % of the two groups, respectively (<em>P</em> = 0.987). The graft success rates were 100.0 % (30/30) and 83.9 % (26/31) (<em>P</em> = 0.067). No significant between-group differences were observed in terms of preoperative (<em>P</em> = 0.547) or postoperative (<em>P</em> = 0.612) air bone gaps (ABGs) or mean ABG gains (<em>P</em> = 0.597). No graft-related complications were observed in either group during follow-up. No patients exhibited significant graft blunting or medialization; graft lateralization was noted in one patient of the NTPG group.</p></div><div><h3>Conclusions</h3><p>Endoscopic cartilage with tucking of the attached perichondrium perforation margins during underlay myringoplasty may improve the graft success rate compared to that of the cartilage push-through technique when repairing large central dry perforations; however, the hearing improvements were comparable in the two groups.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991236","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1016/j.amjoto.2024.104496
Objective
To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC).
Methods
This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed.
Results
Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, P < 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (P = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (P > 0.05).
Conclusion
During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.
目的回顾性分析激光消融(LA)和微波消融(MWA)治疗甲状腺乳头状微癌(PTMC)的疗效和安全性。方法这是一项回顾性研究,研究对象为2019年10月至2023年3月期间接受热消融治疗PTMC的103例患者(109个结节),其中61例接受了LA治疗,48例接受了MWA治疗。患者平均年龄为(43.50±12.42)岁。消融术后,对不同时间点的肿瘤大小变化、局部复发、新病灶、淋巴结转移和并发症进行了评估和记录。分析了 LA 和 MWA 的可行性、成功率和安全性。在最后一次随访中,PTMC结节的平均体积从0.09±0.09毫升(LA组)减小到0.03±0.03毫升(MWA组)(均为P< 0.05)。各组之间的血容量变化无明显差异(P(组):0.520;P(组):0.520;P(组):0.520):0.520; P (groups over time):0.423),表明两组疗效相似。在随访期间,除 3 个月外,各组的体积缩小率也无明显差异(P = 0.023)。结论在短期随访中,超声引导 LA 和 MWA 治疗 PTMC 有效且安全,两种方法的治疗效果无明显差异。
{"title":"Efficacy and safety of laser ablation and microwave ablation to treat papillary thyroid microcarcinoma: A retrospective study","authors":"","doi":"10.1016/j.amjoto.2024.104496","DOIUrl":"10.1016/j.amjoto.2024.104496","url":null,"abstract":"<div><h3>Objective</h3><p>To retrospectively analyze the efficacy and safety of laser ablation (LA) and microwave ablation (MWA) in the treatment of papillary thyroid microcarcinoma (PTMC).</p></div><div><h3>Methods</h3><p>This was a retrospective study of 103 patients (109 nodules) who underwent thermal ablation for PTMC between October 2019 and March 2023; 61 underwent LA and 48 underwent MWA. The mean patients' age was 43.50 ± 12.42 years. After ablation, changes in tumor size at different time points, local recurrence, new lesions, lymph node metastasis, and complications were evaluated and recorded. The feasibility, success rate, and safety of LA and MWA were analyzed.</p></div><div><h3>Results</h3><p>Complete absence of enhancement on contrast-enhanced ultrasonography was observed in all target tumors after ablation. At the last follow-up, the mean volume of the PTMC nodules decreased from 0.09 ± 0.09 to 0.03 ± 0.03 ml (LA group) and from 0.11 ± 0.10 to 0.06 ± 0.08 ml (MWA group) (both, <em>P</em> < 0.05). There was no significant difference in volume change between the groups (P (groups): 0.520; P (groups over time): 0.423), indicating similar efficacy between the groups. There was also no significant difference in the volume reduction rate between the groups during follow-up, except for at 3 months (<em>P</em> = 0.023). The complication rates did not differ between the LA group (8.2 %) and MWA group (6.3 %) (<em>P</em> > 0.05).</p></div><div><h3>Conclusion</h3><p>During the short-term follow-up, ultrasound-guided LA and MWA were effective and safe for PTMC, and there were no significant differences in treatment outcomes between the methods.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142021389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1016/j.amjoto.2024.104499
Objective
The convergence of hearing impairment and language barriers presents unique communication challenges to patients and practicing otolaryngologists. Limited data exist comparing interpretation methods for patients with hearing loss. Patients with hearing loss rely on visual cues, lip-reading, written communication, and/or comprehensive interaction techniques, which may encounter limitations by remote services. Herein, we examine patient and otolaryngology provider satisfaction, cost, and encounter efficiency between virtual and in-person interpretation among adults who speak Mandarin and Cantonese.
Methods
This study is a prospective, randomized controlled trial in patients with moderate-to-severe bilateral hearing loss, Limited English Proficiency, and a primary language of Mandarin or Cantonese. Fifty-two patients were randomized to either in-person or virtual interpretation conditions. Patient satisfaction was measured using an 8-item Likert scale assessing communication effectiveness, encounter efficiency, and overall quality. Otolaryngology provider satisfaction was measured using a 1-item Likert scale. Encounter time, cost, and communication difficulty were measured and compared using independent sample t-tests.
Results
Patient and otolaryngology provider satisfaction scores were significantly higher with in-person interpretation (p < 0.05 for 7 of 8 patient items; physician mean score 4.9, p < 0.001, r = 0.54) compared to virtual interpretation (physician mean 3.8) conditions, while overall quality of the encounter remained the same. There was no significant difference in the length of encounters or in the number of times patients requested interpreter repetition between groups. A difference in average cost existed for in-person interpretation ($14.50) compared to video interpretation ($25) services for an average length appointment.
Conclusion
Patients and otolaryngologists reported higher overall satisfaction with in-person compared to virtual interpretation services. In-person interpretation yielded better comprehension in the hearing loss population among Mandarin and Cantonese-speaking patients and demonstrated a cost advantage over virtual interpretation.
{"title":"Is video interpretation compromising care for the hearing loss population?","authors":"","doi":"10.1016/j.amjoto.2024.104499","DOIUrl":"10.1016/j.amjoto.2024.104499","url":null,"abstract":"<div><h3>Objective</h3><p>The convergence of hearing impairment and language barriers presents unique communication challenges to patients and practicing otolaryngologists. Limited data exist comparing interpretation methods for patients with hearing loss. Patients with hearing loss rely on visual cues, lip-reading, written communication, and/or comprehensive interaction techniques, which may encounter limitations by remote services. Herein, we examine patient and otolaryngology provider satisfaction, cost, and encounter efficiency between virtual and in-person interpretation among adults who speak Mandarin and Cantonese.</p></div><div><h3>Methods</h3><p>This study is a prospective, randomized controlled trial in patients with moderate-to-severe bilateral hearing loss, Limited English Proficiency, and a primary language of Mandarin or Cantonese. Fifty-two patients were randomized to either in-person or virtual interpretation conditions. Patient satisfaction was measured using an 8-item Likert scale assessing communication effectiveness, encounter efficiency, and overall quality. Otolaryngology provider satisfaction was measured using a 1-item Likert scale. Encounter time, cost, and communication difficulty were measured and compared using independent sample <em>t</em>-tests.</p></div><div><h3>Results</h3><p>Patient and otolaryngology provider satisfaction scores were significantly higher with in-person interpretation (<em>p</em> < 0.05 for 7 of 8 patient items; physician mean score 4.9, <em>p</em> < 0.001, <em>r</em> = 0.54) compared to virtual interpretation (physician mean 3.8) conditions, while overall quality of the encounter remained the same. There was no significant difference in the length of encounters or in the number of times patients requested interpreter repetition between groups. A difference in average cost existed for in-person interpretation ($14.50) compared to video interpretation ($25) services for an average length appointment.</p></div><div><h3>Conclusion</h3><p>Patients and otolaryngologists reported higher overall satisfaction with in-person compared to virtual interpretation services. In-person interpretation yielded better comprehension in the hearing loss population among Mandarin and Cantonese-speaking patients and demonstrated a cost advantage over virtual interpretation.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-08-14DOI: 10.1016/j.amjoto.2024.104500
Objective
Given rising concern regarding antibiotic resistance, our objective was to evaluate antibiotic-resistant infections following leech therapy and to characterize the use of prophylactic antibiotics.
Methods
All reports of adverse events involving hirudotherapy (product code “NRN”) were retrieved from the U.S. Food and Drug Administration MAUDE database between 2012 and 2021. Antibiotic resistance was defined by bacterial culture or infection after antibiotic administration.
Results
Nineteen cases of antibiotic resistance involving hirudotherapy were identified. Only three cases of antibiotic resistance were discovered on routine testing and the remaining 16 cases were associated with patient injury. Positive blood cultures or fever were present in 26.3 % (n = 5) of cases. Cultures of the infection grew Aeromonas hydrophilia (n = 13; 68.4 %), Vibrio vulnificus (n = 3; 15.8 %), Pseudomonas aeruginosa (n = 2; 10.5 %), and Proteus vulgaris (n = 1; 5.3 %). There were nine (47.4 %) multi-drug resistant infections. Infection was most commonly resistant to fluoroquinolones (n = 9; 47.4 %), trimethoprim-sulfamethoxazole (n = 9; 47.4 %) and ertapenem (n = 4; 21.1 %).
Conclusion
Antibiotic-resistant infections involving hirudotherapy are frequently resistant to multiple drugs, including fluoroquinolones and trimethoprim-sulfamethoxazole. Resistance to ertapenem, a drug of last resort, was also documented. The findings presented in this study support growing literature that the trend in multi-drug resistance is more severe than previously reported.
{"title":"Analysis of antibiotic resistant infections associated with hirudotherapy","authors":"","doi":"10.1016/j.amjoto.2024.104500","DOIUrl":"10.1016/j.amjoto.2024.104500","url":null,"abstract":"<div><h3>Objective</h3><p>Given rising concern regarding antibiotic resistance, our objective was to evaluate antibiotic-resistant infections following leech therapy and to characterize the use of prophylactic antibiotics.</p></div><div><h3>Methods</h3><p>All reports of adverse events involving hirudotherapy (product code “NRN”) were retrieved from the U.S. Food and Drug Administration MAUDE database between 2012 and 2021. Antibiotic resistance was defined by bacterial culture or infection after antibiotic administration.</p></div><div><h3>Results</h3><p>Nineteen cases of antibiotic resistance involving hirudotherapy were identified. Only three cases of antibiotic resistance were discovered on routine testing and the remaining 16 cases were associated with patient injury. Positive blood cultures or fever were present in 26.3 % (<em>n</em> = 5) of cases. Cultures of the infection grew Aeromonas hydrophilia (<em>n</em> = 13; 68.4 %), <em>Vibrio vulnificus</em> (<em>n</em> = 3; 15.8 %), <em>Pseudomonas aeruginosa</em> (<em>n</em> = 2; 10.5 %), and <em>Proteus vulgaris</em> (<em>n</em> = 1; 5.3 %). There were nine (47.4 %) multi-drug resistant infections. Infection was most commonly resistant to fluoroquinolones (<em>n</em> = 9; 47.4 %), trimethoprim-sulfamethoxazole (n = 9; 47.4 %) and ertapenem (<em>n</em> = 4; 21.1 %).</p></div><div><h3>Conclusion</h3><p>Antibiotic-resistant infections involving hirudotherapy are frequently resistant to multiple drugs, including fluoroquinolones and trimethoprim-sulfamethoxazole. Resistance to ertapenem, a drug of last resort, was also documented. The findings presented in this study support growing literature that the trend in multi-drug resistance is more severe than previously reported.</p></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142087878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}