American Journal of Otolaryngology最新文献_第3页

The effects of increased screen time on post-surgical pain and pain memory among children with sleep-disordered breathing 增加屏幕时间对睡眠呼吸障碍儿童术后疼痛和疼痛记忆的影响。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104550

Pengcheng Ma , Gang Li , Dongdong Meng , Ruijia Gan , Ping Fang , Chaobing Gao , Dong Wang

Adenotonsillectomy procedures can provide effective relief to children affected by sleep-disordered breathing (SDB), but the post-adenotonsillectomy pain management remains challenging, and the most effective approach to managing postoperative pain in these cases remains uncertain. The use of electronic media as a form of distraction therapy aimed at mitigating postoperative pain in children, it is unknown whether increases in screen time can effectively reduce persistent postoperative pain intensity or the incidence of negatively biased pain memories. A total of 107 SDB children undergoing adenotonsillectomy were enrolled and divided into two groups. Children in the intervention group were allowed to increase their screen time, while screen time was restricted for children in the control group. Child-reported pain intensity and negatively biased pain memories, pain-related fear were analyzed. The results indicated that no significant differences in initial postoperative pain intensity or fear were observed among groups. However, children in the intervention group did exhibit significantly reduced remembered Day 1 postoperative pain intensity (ηp² = 0.043, p = 0.035), memory of worst pain intensity (ηp² = 0.047, p = 0.027), and memory of worst pain-related fear (ηp² = 0.042, p = 0.036) as compared to controls. Subgroup analyses based on age and gender indicated that males and school-aged children presented with lower scores for negatively biased pain memories. Our study exhibited the association between screen time and post-surgical pain intensity and negatively biased pain memories, These findings suggest that increasing screen time represents an effective approach to the postoperative management of negatively biased pain memories in certain subsets of children with SDB.

腺扁桃体切除术可以有效缓解睡眠呼吸障碍（SDB）患儿的疼痛，但腺扁桃体切除术后的疼痛管理仍然具有挑战性，并且在这些病例中最有效的疼痛管理方法仍不确定。使用电子媒体作为一种旨在减轻儿童术后疼痛的分心治疗形式，目前尚不清楚屏幕时间的增加是否可以有效地减少持续的术后疼痛强度或负面偏见疼痛记忆的发生率。共纳入107例行腺扁桃体切除术的SDB患儿，分为两组。干预组的孩子被允许增加他们的屏幕时间，而对照组的孩子被限制屏幕时间。对儿童报告的疼痛强度、负偏痛记忆、疼痛相关恐惧进行分析。结果显示，各组术后疼痛强度和恐惧程度无显著差异。然而，与对照组相比，干预组儿童的术后第1天疼痛强度记忆（ηp2 = 0.043, p = 0.035）、最严重疼痛强度记忆（ηp2 = 0.047, p = 0.027）和最严重疼痛相关恐惧记忆（ηp2 = 0.042, p = 0.036）均显著降低。基于年龄和性别的亚组分析表明，男性和学龄儿童在负面偏见的疼痛记忆中得分较低。我们的研究显示了屏幕时间与术后疼痛强度和负偏痛记忆之间的关联，这些发现表明，增加屏幕时间是治疗某些SDB患儿术后负偏痛记忆的有效方法。

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引用次数: 0

Comparison of glucocorticoids combined with antiviral drugs versus glucocorticoids alone in the management of Bell's Palsy: A systematic review and meta-analysis of randomized clinical trials 糖皮质激素联合抗病毒药物与单独糖皮质激素治疗贝尔麻痹的比较：随机临床试验的系统回顾和荟萃分析

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104583

Yan Zhu , Tiantian Liang , Sha Liu , Jiasen Xu , He Zhao , Yan Wang , Jingjing Qiu , Dawei Liu , Yan Sun

Objective

This study aimed to compare the efficacy of glucocorticoids combined with antiviral drugs (GA) versus glucocorticoids alone (GO) in the treatment of Bell's Palsy.

Database reviewed

According to the PRISMA2020 guidelines, we searched PubMed, Embase, and the Cochrane Central Register of Controlled Trials for English articles from their inception to August 10, 2023, and performed a secondary search on October 31, 2024.

Methods

Studies describing the efficacy of (GA) for Bell's Palsy versus (GO). Patient demographics, cure rates, and results of subgroup analysis were collected. Stata 17.0 was used to perform the calculation and to draw relevant meta-analysis pictures. RevMan 5.4 was used to determine the source of bias and to summarize the risk of bias. Heterogeneity was assessed using Q-tests and I² statistics.

Results

A total of 10 RCTs enrolling 2893 participants were finally included in the meta-analysis. The treatment rate in the group of GA and the group of GO was 88.7 % and 83.2 %, respectively. The difference in the treatment rate between the two groups for Bell's Palsy was significant (relative risk (RR) = 1.09, 95 % confidence interval (CI) = 1.03–1.15), and significant heterogeneity was (I² = 63.6 %, p = 0.003 < 0.1).

Conclusions

This review suggests that GA may be an effective treatment for Bell's palsy. Compared with GO, GA can improve the cure rate of Bell's palsy.

目的：本研究旨在比较糖皮质激素联合抗病毒药物（GA）与单独糖皮质激素（GO）治疗贝尔麻痹的疗效。数据库审查：根据PRISMA2020指南，我们检索了PubMed、Embase和Cochrane Central Register of Controlled Trials，检索了从开始到2023年8月10日的英文文章，并在2024年10月31日进行了二次检索。方法：研究描述（GA）与（GO）治疗贝尔氏麻痹的疗效。收集患者人口统计资料、治愈率和亚组分析结果。采用Stata 17.0进行计算并绘制相关meta分析图。采用RevMan 5.4确定偏倚来源，总结偏倚风险。采用q检验和I2统计量评估异质性。结果：最终纳入10项随机对照试验，共纳入2893名受试者。GA组和GO组的治愈率分别为88.7%和83.2%。两组间贝尔麻痹治愈率差异有统计学意义(相对危险度（RR) = 1.09, 95%可信区间(CI) = 1.03 ~ 1.15），且异质性显著（I2 = 63.6%, p = 0.003）。结论：本综述提示GA可能是治疗贝尔麻痹的有效方法。与氧化石墨烯相比，GA能提高贝尔氏麻痹的治愈率。

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引用次数: 0

Factors associated with new-onset of mental health disorders in Bell's palsy patients: A MarketScan database study 与贝尔氏麻痹患者新发精神健康障碍相关的因素：一项MarketScan数据库研究

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104547

Shaun Edalati , Sujay Ratna , Parul Agarwal , Ariel Harsinay , Joshua D. Rosenberg , Mingyang L. Gray

Objective

Limited research exists on mental health disorders (MHDs) in Bell's palsy patients. This study investigates risk factors associated with the development of MHDs in these patients.

Methods

MarketScan commercial and Medicare outpatient and prescription drug claims data were utilized to conduct this study on adults with Bell's palsy. Patients were identified using International Classification of Diseases, Ninth or Tenth Revision, Clinical Modification diagnosis codes from 2014 to 2020 data. A one-year washout period was applied where patients did not have any diagnosis of MHD before Bell's palsy diagnosis. Patients were included if they were continuously enrolled for at least two years. The primary outcome was new-onset of any MHDs within one year of diagnosis of Bell's palsy. Descriptive statistics and logistic regression model explored risk factors associated with the development of any MHDs.

Results

Out of 37,166 Bell's palsy patients (mean age 49; 50.4 % female), 8.27 % experienced new-onset MHDs, with anxiety being the most prevalent (3.88 %). Female sex [Adjusted odds ratio (AOR) 1.40, 95 % CI 1.30–1.51, p < 0.0001], increasing Charlson comorbidity index (AOR 1.11, 95 % CI 1.04–1.176, p = 0.001), and symptoms like headache (AOR 1.16, 95 % CI 1.34–1.81, p < 0.0001) and facial pain (AOR 1.71, 95 % CI 1.15–2.52, p = 0.007) were associated with increased odds of new-onset of MHDs.

Conclusion

Bell's palsy patients can develop MHDs within first year of diagnosis, although the incidence of MHDs in this cohort is lower than that of the general population. Several factors are associated with the development of MHDs. These findings underscore the significance of addressing mental health in Bell's palsy patients, offering valuable considerations for clinical care and future research.

目的：对贝尔氏麻痹患者的心理健康障碍（MHDs）研究有限。本研究调查了这些患者中与MHDs发展相关的危险因素。方法：利用MarketScan商业和医疗保险门诊和处方药索赔数据对成人贝尔麻痹患者进行研究。使用2014 - 2020年数据的《国际疾病分类》第九或第十版临床修改诊断代码对患者进行识别。在贝尔麻痹诊断前没有任何MHD诊断的患者应用一年的洗脱期。如果患者连续登记至少两年，则纳入研究。主要结果是贝尔氏麻痹诊断后一年内任何mhd的新发。描述性统计和逻辑回归模型探讨了与任何mhd发展相关的危险因素。结果：37166例贝尔氏麻痹患者(平均年龄49岁；50.4%（女性），8.27%经历过新发MHDs，其中焦虑最为普遍（3.88%）。调整优势比（AOR） 1.40, 95% CI 1.30-1.51， p结论：贝尔氏麻痹患者可在诊断后一年内发生mhd，但该队列中mhd的发生率低于一般人群。有几个因素与mhd的发展有关。这些发现强调了解决贝尔麻痹患者心理健康问题的重要性，为临床护理和未来的研究提供了有价值的考虑。

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引用次数: 0

The real prognostic role of laryngeal dysplasia in patients affected by invasive cancer 喉部发育不良对侵袭性癌患者预后的影响。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104535

Francesco Chu , Francesco Bandi , Giacomo Pietrobon , Marta Tagliabue , Stefano Zorzi , Rita De Berardinis , Pietro Benzi , Mohssen Ansarin

Purpose

Transoral laser microsurgery is the mainstay in treating early-stage laryngeal squamous cell carcinoma. However, consensus is lacking in non-radical surgery for infiltrating cancer, and even doubts are cast for patients with laryngeal dysplasia at the resection margins. In this study we aim to assess the prognostic significance of laryngeal dysplasia at the surgical margins in patients radically treated for infiltrating cancer.

Materials and methods

Patients treated between 2000 and 2020 for infiltrating cancer were included. We selected patients whose final histopathological report confirmed radical excision for infiltrating cancer. The cohort was further divided into two subgroups according to the presence or the absence of dysplastic resection margins. All patients underwent follow up to assess oncological outcomes, and the results from the two subgroups were compared to assess the prognostic relevance of laryngeal dysplasia.

Results

A cohort of 281 patients was evaluated. From the statistical analysis, the supraglottic extension of infiltrating cancer and deep muscle infiltration were associated worse oncological outcomes. Conversely, the presence of critical dysplastic margins, dysplastic severity and the number of positive margins were not linked to worse outcomes.

Conclusion

In our experience, the presence of dysplasia at the resection margins does not affect patient survival. Thus, revision surgery for critical dysplastic margins, following radical excision of infiltrating carcinoma should not be performed. Instead, patients may undergo endoscopic monitoring, thereby avoiding unnecessary overtreatment and potential negative effects on voice outcomes.

目的：经口激光显微手术是治疗早期喉部鳞状细胞癌的主要方法。然而，浸润性癌的非根治性手术治疗缺乏共识，甚至对切除边缘喉发育不良的患者也存在怀疑。在这项研究中，我们的目的是评估手术边缘喉发育不良对浸润性癌患者的预后意义。材料与方法：纳入2000 - 2020年间因浸润性癌接受治疗的患者。我们选择最终组织病理学报告证实根治性切除浸润性癌症的患者。根据切除边缘是否存在发育不良，将该队列进一步分为两个亚组。所有患者均接受随访以评估肿瘤预后，并比较两个亚组的结果以评估喉发育不良与预后的相关性。结果：对281例患者进行了队列评估。从统计学分析来看，浸润性癌的声门上延伸和深肌浸润与较差的肿瘤预后相关。相反，临界发育不良边缘的存在、发育不良严重程度和阳性边缘的数量与较差的结果无关。结论：根据我们的经验，在切除边缘存在发育不良并不影响患者的生存。因此，对于浸润性癌根治性切除后的严重发育不良边缘不应进行翻修手术。相反，患者可以接受内镜监测，从而避免不必要的过度治疗和对语音预后的潜在负面影响。

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引用次数: 0

How reliable is artificial intelligence in the diagnosis of cholesteatoma on CT images? 人工智能在CT图像上诊断胆脂瘤的可靠性如何？

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104519

Avallone Emilio , Pietro De Luca , Timm Max , Siani Agnese , Viola Pasquale , Ralli Massimo , Chiarella Giuseppe , Ricciardiello Filippo , Salzano Francesco Antonio , Scarpa Alfonso

Purpose

This study analysed the main artificial intelligence (AI) models for the diagnosis of cholesteatoma on computed tomography (CT), evaluating their performance and comparing them with each other. The increasing application of AI in radiology requires a systematic comparison of available methodologies.

Methods

A systematic literature review was conducted, selecting relevant articles from the main databases. The included studies had to fulfil specific criteria regarding methodology, use of AI models for cholesteatoma diagnosis and results in terms of sensitivity and specificity.

Results

The meta-analysis included three studies evaluating the MobilenetV2, Densenet201 and Resnet50 AI models. All models demonstrated high levels of sensitivity and specificity in the diagnosis of cholesteatoma at CT. No statistically significant differences were found between the performance of the various models, suggesting a robust common diagnostic capability between the different neural network architectures.

Conclusions

AI is making rapid progress in imaging, with recent studies already showing remarkable performance in cholesteatoma diagnosis. The speed of technological development is promising. However, to ensure safe and effective implementation in clinical practice, further studies are needed to validate and standardise these AI models. Future research should focus not only on the diagnostic accuracy, but also on the robustness, reproducibility and clinical integration of these emerging technologies.

目的：分析目前用于胆脂瘤CT诊断的主要人工智能（AI）模型，并对其性能进行评价和比较。人工智能在放射学中的应用越来越多，需要对现有方法进行系统的比较。方法：从主要数据库中选取相关文献进行系统的文献综述。纳入的研究必须在方法学、使用人工智能模型进行胆脂瘤诊断以及结果的敏感性和特异性方面满足特定标准。结果：meta分析包括三项研究，评估MobilenetV2、Densenet201和Resnet50人工智能模型。所有模型均显示出高水平的CT诊断胆脂瘤的敏感性和特异性。不同模型的性能之间没有统计学上的显著差异，这表明不同神经网络架构之间具有强大的通用诊断能力。结论：人工智能在影像学方面进展迅速，最近的研究已经显示出在胆脂瘤诊断方面的显著表现。技术发展的速度是有希望的。然而，为了确保在临床实践中安全有效地实施，需要进一步的研究来验证和标准化这些人工智能模型。未来的研究不仅要关注诊断的准确性，还要关注这些新兴技术的稳健性、可重复性和临床整合性。

{"title":"How reliable is artificial intelligence in the diagnosis of cholesteatoma on CT images?","authors":"Avallone Emilio , Pietro De Luca , Timm Max , Siani Agnese , Viola Pasquale , Ralli Massimo , Chiarella Giuseppe , Ricciardiello Filippo , Salzano Francesco Antonio , Scarpa Alfonso","doi":"10.1016/j.amjoto.2024.104519","DOIUrl":"10.1016/j.amjoto.2024.104519","url":null,"abstract":"<div><h3>Purpose</h3><div>This study analysed the main artificial intelligence (AI) models for the diagnosis of cholesteatoma on computed tomography (CT), evaluating their performance and comparing them with each other. The increasing application of AI in radiology requires a systematic comparison of available methodologies.</div></div><div><h3>Methods</h3><div>A systematic literature review was conducted, selecting relevant articles from the main databases. The included studies had to fulfil specific criteria regarding methodology, use of AI models for cholesteatoma diagnosis and results in terms of sensitivity and specificity.</div></div><div><h3>Results</h3><div>The meta-analysis included three studies evaluating the MobilenetV2, Densenet201 and Resnet50 AI models. All models demonstrated high levels of sensitivity and specificity in the diagnosis of cholesteatoma at CT. No statistically significant differences were found between the performance of the various models, suggesting a robust common diagnostic capability between the different neural network architectures.</div></div><div><h3>Conclusions</h3><div>AI is making rapid progress in imaging, with recent studies already showing remarkable performance in cholesteatoma diagnosis. The speed of technological development is promising. However, to ensure safe and effective implementation in clinical practice, further studies are needed to validate and standardise these AI models. Future research should focus not only on the diagnostic accuracy, but also on the robustness, reproducibility and clinical integration of these emerging technologies.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104519"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765518","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}

引用次数: 0

Cost effectiveness analysis of BRAFV600E testing for low-risk papillary thyroid microcarcinomas BRAFV600E检测低风险甲状腺乳头状微癌的成本-效果分析

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104559

Idit Tessler , Moshe Leshno , Eran E. Alon , Gilad Feinmesser , Galit Avior

Objective

Given the good prognosis of low-risk papillary thyroid microcarcinomas (lrPTMCs), accurate risk stratification is valuable to optimize management: active surveillance (AS) vs. hemithyroidectomy (HT). BRAF^V600E positive lrPTMC is associated with increased recurrence risk; hence, AS was suggested for mutation-negative lrPTMC. This study aims to evaluate the cost-effectiveness of BRAF^V600E testing for lrPTMC.

Study design & setting

Decision tree cost-effectiveness analytic model.

Methods

We performed a cost-effectiveness analysis of the management strategies for lrPTMCs: AS, HT, and BRAF^V600E genetic testing (GT), in which treatment pathways were determined by BRAF^V600E status. Data on probabilities and complications were derived from current literature. One- and two-way sensitivity analyses were conducted to ascertain model robustness.

Results

Our model found GT as the cost-effective strategy, providing an additional 0.35 QALYs and an additional cost of $902 with an Incremental Cost-effectiveness ratio of $2542 compared to AS. In contrast, surgical intervention showed a lower utility with an increased cost of $381, positioning GT as the preferred strategy. Sensitivity analysis identified age at diagnosis as the most influential factor for cost-effectiveness between AS and GT; younger patients exhibited a lower ICER, indicating greater cost savings per QALY, till up to age 48 years, where AS becomes favorable. GT consistently outperformed QALY gains across varying incidences of BRAF^V600E positivity tumors.

Conclusions

In conclusion, this study demonstrates the economic and clinical advantages of incorporating BRAF^V600E genetic testing in the management of lrPTMCs. Our model supports further real-life studies of BRAF^V600E testing for lrPTMCs.

目的：考虑到低风险乳头状甲状腺微癌（lrPTMCs）预后良好，准确的风险分层对于优化治疗是有价值的：主动监测（AS）还是半甲状腺切除术（HT）。BRAFV600E阳性lrPTMC与复发风险增加相关；因此，AS被认为是突变阴性的lrPTMC。本研究旨在评估BRAFV600E检测lrPTMC的成本效益。研究设计与设置：决策树成本效益分析模型。方法：我们对lrPTMCs的管理策略进行了成本-效果分析：AS、HT和BRAFV600E基因检测（GT），其中治疗途径由BRAFV600E状态决定。概率和并发症的数据来源于当前文献。进行了单向和双向敏感性分析以确定模型的稳健性。结果：我们的模型发现GT是具有成本效益的策略，与as相比，它提供了额外的0.35个QALYs和902美元的额外成本-效果比，增量成本-效果比为2542美元。相比之下，手术干预显示出较低的效用，增加了381美元的费用，使GT成为首选策略。敏感性分析发现，诊断年龄是影响as和GT成本效益的最重要因素；年轻患者表现出较低的ICER，表明每个QALY节省更多的成本，直到48岁，AS变得有利。在不同发病率的BRAFV600E阳性肿瘤中，GT的表现始终优于QALY。结论：总之，本研究证明了将BRAFV600E基因检测纳入lrptmc管理的经济和临床优势。我们的模型支持BRAFV600E对lptmc的进一步实际研究。

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引用次数: 0

Disparities in completing testing for SARS-CoV-2 prior to otolaryngology procedures 在耳鼻喉科手术前完成SARS-CoV-2检测的差异。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104543

Amber D. Shaffer, Jennifer L. McCoy , Joseph E. Dohar

Objectives

To determine what patient characteristics are associated with completing asymptomatic pre-operative testing for SARS-CoV-2.

Methods

Charts from consecutive patients undergoing ambulatory surgery in otolaryngology at a tertiary care children's hospital from May 4 until May 26, 2020, were reviewed. If two or more siblings were scheduled, only the first sibling was included. Demographics, surgical details, and results of asymptomatic pre-operative testing for SARS-CoV-2 were collected. Patients who completed pre-operative testing were compared with those who did not using logistic regression or Wilcoxon rank-sum tests, α = 0.05.

Results

216 patients were included. 56.5 % were male, and median age at surgery was 2 years (range 4 months–20 years). 88 patients (40.7 %) had pre-operative SARS-CoV-2 RT-PCR testing. 97.7 % of sampling occurred 2–3 days prior to the procedure, and 98.9 % of results were available within 2 days. The virus was not detected in any cases. In multiple logistic regression, undergoing surgery at the main hospital location rather than a satellite location (OR: 3.13, p = 0.003) and greater median household income for zip (OR: 1.18/$10,000, p = 0.042) were associated with completing pre-operative testing. However, race, insurance type, surgeon, patient age, previous no-show appointments, and household composition did not alter the odds of completing pre-operative testing.

Conclusions

Families were less likely to complete testing if surgery was being performed at a satellite location or if they lived in an area with lesser median household income. This work draws attention to the impact of socioeconomic factors on access to and compliance with pandemic mitigation measures, with important implications for future public health crises.

目的：确定哪些患者特征与完成SARS-CoV-2无症状术前检测相关。方法：回顾2020年5月4日至5月26日在某三级儿童医院连续接受耳鼻喉门诊手术的患者的病历。如果安排了两个或更多的兄弟姐妹，则只包括第一个兄弟姐妹。收集统计资料、手术细节和无症状术前SARS-CoV-2检测结果。完成术前检查的患者与未完成术前检查的患者进行比较，采用logistic回归或Wilcoxon秩和检验，α = 0.05。结果：共纳入216例患者。56.5%为男性，手术年龄中位数为2岁（4个月-20岁）。88例（40.7%）患者术前进行了SARS-CoV-2 RT-PCR检测。97.7%的采样发生在手术前2-3天，98.9%的结果在2天内可获得。在任何情况下都未检测到病毒。在多元逻辑回归中，在主要医院而不是卫星医院接受手术（OR: 3.13, p = 0.003）和更高的zip家庭收入中位数（OR: 1.18/ 10,000美元，p = 0.042）与完成术前检查相关。然而，种族、保险类型、外科医生、患者年龄、以前未就诊预约和家庭组成并没有改变完成术前检查的几率。结论：如果手术在卫星位置进行，或者如果他们生活在家庭收入中位数较低的地区，则家庭完成检测的可能性较低。这项工作提请注意社会经济因素对获得和遵守大流行缓解措施的影响，这对未来的公共卫生危机具有重要影响。

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引用次数: 0

Dual task iTUG to investigate increased fall risk among older adults with bilateral hearing loss iTUG的双重任务是调查双侧听力损失的老年人跌倒风险增加的情况。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104536

Maura Cosetti , Liraz Arie , Jennifer Kelly , Jennifer Ren , Anat V. Lubetzky

Objectives

To investigate fall risk among older adults with bilateral sensorineural hearing loss (BHL) by comparing single task (ST) and dual task (DT) performance on the instrumented “Timed Up & Go” test (iTUG). The TUG is a well-validated clinical tool for fall risk; addition of wireless sensors increases the test's sensitivity and allows for subcomponent analysis.

Methods

Adults with audiometrically confirmed normal hearing or BHL were prospectively recruited and screened for visual, musculoskeletal, neurologic, or vestibular pathology and Dizziness Handicap Inventory (DHI) < 10. Total and sub-component iTUG data in the ST and DT condition (serial subtraction) was collected.

Results

35 adults (50–78 years) were included: 20 (mean 69 years) with BHL and 15 controls (mean age 63 years). Total iTUG duration did not differ between groups in either the ST or DT condition. In sit-to-stand, BHL were significantly slower than controls (p < 0.03) in both ST and DT conditions. In the final subcomponent (stand-to-sit), a significant interaction was observed such that the BHL group were significantly slower with DT compared to the control group.

Conclusions

BHL performed slower on sub-component analysis of the iTUG compared with age-matched normal hearing controls. Slower times on the final iTUG phase for BHL may suggest a lower threshold for attentional capacity that may be cumulative. Further investigation into the impact of treatment (including amplification and training) is warranted.

目的：通过比较单任务（ST）和双任务（DT）在仪器化“定时起跑”测试（iTUG）中的表现，探讨老年双侧感音神经性听力损失（BHL）患者的跌倒风险。TUG是一种经过验证的评估跌倒风险的临床工具；无线传感器的增加增加了测试的灵敏度，并允许进行子组件分析。方法：前瞻性招募听力测量证实听力正常或BHL的成年人，并对其进行视觉、肌肉骨骼、神经或前厅病理和头晕障碍量表（DHI）的筛查。结果：纳入35名成年人（50-78岁）：20名BHL患者（平均69岁）和15名对照组（平均63岁）。在ST或DT条件下，两组间的iTUG总持续时间均无差异。在坐转立时，BHL明显慢于对照组(p结论：BHL在iTUG的亚成分分析中比年龄匹配的正常听力对照组慢。BHL的最后iTUG阶段较慢的时间可能表明注意能力的阈值较低，这可能是累积的。有必要进一步调查治疗的影响（包括放大和培训）。

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引用次数: 0

Nocturnal mouth-taping and social media: A scoping review of the evidence 夜间录音和社交媒体：对证据的范围审查。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104545

Sarah K. Fangmeyer, Christopher D. Badger, Punam G. Thakkar

Objective

Across social media, nocturnal mouth-taping has been credited with benefits from increased energy and immunity to improved dental health. This scoping review summarizes the literature on mouth-taping and prominent social media claims pertaining to this practice.

Data Sources.

PubMed and Embase were searched using terms related to nocturnal mouth-taping. A search of TikTok was performed using the term “mouth taping.”

Review Methods.

Studies yielded by this literature search were reviewed for relevance and excluded if they did not assess mouth-taping during sleep. Study characteristics were extracted for analysis. TikTok videos discussing mouth-taping during sleep were evaluated, and videos lacking spoken or written words were excluded. The first fifty videos meeting inclusion and exclusion criteria were reviewed for claims regarding mouth-taping and presenter type.

Results

One hundred and seventy-seven unique studies were identified; nine met inclusion and exclusion criteria. Two studies found significant improvements in obstructive sleep apnea (OSA) metrics, one with mouth-taping alone and one with mouth-taping plus a mandibular advancement device. A study of non-OSA patients reported improved snoring with mouth-taping combined with other measures. A study of mouth-taping in asthma found no benefit. However, one study found that mouth-taping effectively reduced mouth leak during bilevel ventilation. The most common proposed advantages of mouth-taping on TikTok were improved sleep and oral health.

Conclusion

This is the first comprehensive literature review on mouth-taping. The literature on this subject is markedly heterogeneous, and there is little consensus on mouth-taping's benefits. Few TikTok claims regarding the practice have been evaluated. However, some research indicates that mouth-taping may be advantageous in OSA, snoring, and bilevel ventilation. Additional high-quality research is necessary to elucidate the role and efficacy of this practice.

目的：在社交媒体上，人们普遍认为夜间用胶带贴嘴可以增加精力和免疫力，改善牙齿健康。这一范围审查总结了口头录音和突出的社会媒体声称有关这一做法的文献。数据来源：PubMed和Embase使用与夜间嘴带相关的术语进行搜索。在TikTok上搜索的关键词是“口型录音”。回顾方法：本文献检索产生的研究被回顾相关性，如果它们没有评估睡眠时的嘴贴，则被排除。提取研究特征进行分析。对讨论睡眠时录音的抖音视频进行了评估，排除了没有口头或书面文字的视频。对前50个视频会议纳入和排除标准进行了审查，以确定关于口述录音和主持人类型的索赔。结果：确定了177项独特的研究；9例符合纳入和排除标准。两项研究发现阻塞性睡眠呼吸暂停（OSA）指标有显著改善，一项研究单独使用嘴带，另一项研究使用嘴带加下颌推进装置。一项针对非阻塞性睡眠呼吸暂停综合症患者的研究报告称，采用嘴贴结合其他措施可以改善打鼾。一项研究发现，用嘴贴治疗哮喘没有任何益处。然而，一项研究发现，在双层通气过程中，口贴有效地减少了口漏。在TikTok上用嘴录音最常见的好处是改善睡眠和口腔健康。结论：本文首次对口腔贴敷进行了全面的文献综述。关于这一主题的文献明显是异质的，并且对口贴的好处几乎没有共识。TikTok关于这种做法的说法很少得到评估。然而，一些研究表明，口腔贴敷可能有利于呼吸暂停，打鼾和双层通气。需要更多的高质量研究来阐明这种做法的作用和功效。

{"title":"Nocturnal mouth-taping and social media: A scoping review of the evidence","authors":"Sarah K. Fangmeyer, Christopher D. Badger, Punam G. Thakkar","doi":"10.1016/j.amjoto.2024.104545","DOIUrl":"10.1016/j.amjoto.2024.104545","url":null,"abstract":"<div><h3>Objective</h3><div>Across social media, nocturnal mouth-taping has been credited with benefits from increased energy and immunity to improved dental health. This scoping review summarizes the literature on mouth-taping and prominent social media claims pertaining to this practice.</div><div>Data Sources.</div><div>PubMed and Embase were searched using terms related to nocturnal mouth-taping. A search of TikTok was performed using the term “mouth taping.”</div><div>Review Methods.</div><div>Studies yielded by this literature search were reviewed for relevance and excluded if they did not assess mouth-taping during sleep. Study characteristics were extracted for analysis. TikTok videos discussing mouth-taping during sleep were evaluated, and videos lacking spoken or written words were excluded. The first fifty videos meeting inclusion and exclusion criteria were reviewed for claims regarding mouth-taping and presenter type.</div></div><div><h3>Results</h3><div>One hundred and seventy-seven unique studies were identified; nine met inclusion and exclusion criteria. Two studies found significant improvements in obstructive sleep apnea (OSA) metrics, one with mouth-taping alone and one with mouth-taping plus a mandibular advancement device. A study of non-OSA patients reported improved snoring with mouth-taping combined with other measures. A study of mouth-taping in asthma found no benefit. However, one study found that mouth-taping effectively reduced mouth leak during bilevel ventilation. The most common proposed advantages of mouth-taping on TikTok were improved sleep and oral health.</div></div><div><h3>Conclusion</h3><div>This is the first comprehensive literature review on mouth-taping. The literature on this subject is markedly heterogeneous, and there is little consensus on mouth-taping's benefits. Few TikTok claims regarding the practice have been evaluated. However, some research indicates that mouth-taping may be advantageous in OSA, snoring, and bilevel ventilation. Additional high-quality research is necessary to elucidate the role and efficacy of this practice.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 1","pages":"Article 104545"},"PeriodicalIF":1.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142811567","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}

引用次数: 0

A non-local dual-stream fusion network for laryngoscope recognition 用于喉镜识别的非局部双流融合网络。

IF 1.8 4区医学 Q2 OTORHINOLARYNGOLOGY

American Journal of Otolaryngology

Pub Date : 2025-01-01 DOI: 10.1016/j.amjoto.2024.104565

Ran Wei , Yan Liang , Lei Geng , Wei Wang , Mei Wei

Purpose

To use deep learning technology to design and implement a model that can automatically classify laryngoscope images and assist doctors in diagnosing laryngeal diseases.

Materials and methods

The experiment was based on 3057 images (normal, glottic cancer, granuloma, Reinke's Edema, vocal cord cyst, leukoplakia, nodules and polyps) from the dataset Laryngoscope8. A classification model based on deep neural networks was developed and tested. Model performance was verified by a variety of evaluation measures, including accuracy, recall, specificity, F1-Score and area under the receiver operating characteristic curve. In addition, the Grad-Cam technology was used to visualize the feature map of the model to improve the interpretation of the network.

Results

The model has high classification accuracy and robustness, and can accurately classify various types of laryngoscope images. In the test set of independent individuals, the overall accuracy reaches 86.51 %, and the average area under curve value is 0.954. The performance of the model is significantly better than other existing algorithms.

Conclusion

This paper proposes a deep learning based automatic classification model for laryngoscope images. By integrating the output features of deep neural network ResNet and Transformer, eight laryngeal diseases can be accurately classified. This indicates that the proposed method can be effectively applied to the study of laryngeal diseases.

目的：利用深度学习技术设计并实现一个自动分类喉镜图像，辅助医生诊断喉部疾病的模型。材料和方法：实验基于来自喉镜数据集8的3057张图像（正常、声门癌、肉芽肿、莱因克水肿、声带囊肿、白斑病、结节和息肉）。开发并测试了基于深度神经网络的分类模型。通过准确率、召回率、特异性、F1-Score和受试者工作特征曲线下面积等多种评价指标来验证模型的性能。此外，利用Grad-Cam技术对模型的特征图进行可视化处理，提高了网络的解释能力。结果：该模型具有较高的分类精度和鲁棒性，能够对各类喉镜图像进行准确分类。在独立个体的测试集中，总体准确率达到86.51%，曲线下面积平均值为0.954。该模型的性能明显优于现有的其他算法。结论：提出了一种基于深度学习的喉镜图像自动分类模型。通过整合深度神经网络ResNet和Transformer的输出特征，可以对8种喉部疾病进行准确分类。这表明该方法可以有效地应用于喉部疾病的研究。

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引用次数: 0