American Journal of Otolaryngology最新文献

{"title":"Effectiveness of drug-induced sleep endoscopy in improving patients selection and outcomes of mandibular advancement device therapy for obstructive sleep apnea: A multicenter case-control study","authors":"Giannicola Iannella ,&nbsp;Sergio Terranova ,&nbsp;Marco Brunori ,&nbsp;Claudio Vicini ,&nbsp;Alberto Caranti ,&nbsp;Ruggero Campisi ,&nbsp;Vincenzo De Ceglie ,&nbsp;Manuele Casale ,&nbsp;Antonio Moffa ,&nbsp;Fabrizio Salamanca ,&nbsp;Federico Leone ,&nbsp;Andrea De Vito ,&nbsp;Giovanni Cammaroto ,&nbsp;Salvatore Cocuzza ,&nbsp;Antonino Maniaci ,&nbsp;Armando De Virgilio ,&nbsp;Jerome R. Lechien ,&nbsp;Carlos-Miguel Chiesa-Estomba ,&nbsp;Luigi A. Vaira ,&nbsp;Paolo Boscolo-Rizzo ,&nbsp;Annalisa Pace","doi":"10.1016/j.amjoto.2025.104740","DOIUrl":"10.1016/j.amjoto.2025.104740","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate, in Obstructive sleep apnea (OSA) patients, the use of pre-treatment drug-induced sleep endoscopy (DISE) as a patient selection tool, that could improve the outcomes of mandibular advancement device (MAD) therapy. A multicenter retrospective case-control study has been performed.</div></div><div><h3>Methods</h3><div>A multicenter case-control study with two parallel arms was conducted to compare functional outcomes in patients undergoing MAD therapy. Group A (n = 118) received MAD therapy based solely on static clinical assessments, including dentoskeletal features, oropharyngeal anatomy, and upper airway endoscopy. Group B (n = 87) underwent pre-treatment DISE to dynamically evaluate the site, type, and pattern of upper airway collapse, thereby guiding patient selection for MAD therapy.</div></div><div><h3>Results</h3><div>In Group A, the mean pre-treatment apnea-hypopnea index (AHI) was 28.1, decreasing significantly to 12.4 post-treatment (p = 0.0001). In Group B, the mean AHI decreased from 31.3 to 9.5 (p = 0.0001). The Delta apnea-hypopnea index (ΔAHI) was significantly greater in Group B (−21.7) than in Group A (−16.6; p = 0.04). Similarly, the Delta Oxigen desaturation index (ΔODI) was −18.6 in Group B versus −14.1 in Group A (p = 0.04). The therapeutic success rate was significantly higher in Group B (82.7 %) compared to Group A (60.1 %) (p = 0.001).</div></div><div><h3>Conclusion</h3><div>In OSA patients, a pre-treatment DISE evaluation, improves the selection of appropriate candidates for MAD therapy by enabling dynamic assessment of upper airway collapsibility during a pharmacologically induced sleep. This targeted selection results in significantly better therapeutic outcomes for MAD therapy for the OSA treatment.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"47 1","pages":"Article 104740"},"PeriodicalIF":1.7,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537361","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}

{"title":"Machine learning model for predicting hearing preservation after vestibular schwannoma surgery: A meta-analysis","authors":"Paweł Łajczak ,&nbsp;Emma Ann Finnegan ,&nbsp;Enzo von Quednow ,&nbsp;Fabio Victor Vieira Rocha ,&nbsp;Yasmin Picanço Silva ,&nbsp;Oguz Kagan Sahin ,&nbsp;Walter Fagundes","doi":"10.1016/j.amjoto.2025.104727","DOIUrl":"10.1016/j.amjoto.2025.104727","url":null,"abstract":"<div><h3>Introduction</h3><div>Vestibular schwannomas (VS) are benign tumors that can cause hearing loss, tinnitus and balance disorders. Radiosurgery and open surgery remain the primary treatments, but predicting hearing preservation post-surgery remains challenging due to a variety of factors. Machine learning (ML) has emerged as a promising tool for predicting hearing outcomes in VS patients. This meta-analysis aims to systematically evaluate the diagnostic accuracy of ML models in predicting hearing preservation in VS patients undergoing surgery.</div></div><div><h3>Methods</h3><div>We conducted a systematic review and meta-analysis following PRISMA-DTA guidelines, including studies that applied ML to predict hearing preservation in VS patients undergoing surgery. Studies were selected based on predefined inclusion criteria, and diagnostic accuracy metrics, such as sensitivity, specificity and accuracy were extracted.</div></div><div><h3>Results</h3><div>A total of 15 models from 3 studies were included. The overall pooled sensitivity was 0.856 (95% CI 0.758–0.919), specificity was 0.853 (95% CI 0.713–0.931), and accuracy was 0.839 (95% CI 0.748–0.902). The area under the summary ROC curve was 0.883 (95% CI 0.770–0.910), indicating high diagnostic effectiveness. Significant heterogeneity was observed.</div></div><div><h3>Conclusions</h3><div>ML models achieve high accuracy in predicting hearing preservation in VS patients undergoing surgery. However, significant heterogeneity exists across studies, indicating the need for further research to optimize model performance and enhance their generalizability across diverse patient populations. ML has the potential to assist clinicians in providing personalized treatment strategies and improving patient outcomes in the management of vestibular schwannomas.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104727"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145494190","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}

{"title":"National trends in the utilization of office-based transnasal esophagoscopy","authors":"Lauren Kwa ,&nbsp;Ashley Bodnar ,&nbsp;Maxwell Scher ,&nbsp;Jacob Pieter Noordzij ,&nbsp;Lauren Tracy","doi":"10.1016/j.amjoto.2025.104746","DOIUrl":"10.1016/j.amjoto.2025.104746","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze national trends in the prevalence of office-based transnasal esophagoscopy (TNE) procedures and compare with traditional operating room-based procedures utilizing transoral flexible and rigid esophagoscopy.</div></div><div><h3>Methods</h3><div>From 2013 to 2022, the US Medicare Part B claims database was searched for Current Procedural Terminology (CPT) codes 43,197/43198: diagnostic transnasal flexible esophagoscopy/with biopsy, 43200/43202: diagnostic transoral flexible esophagoscopy/with biopsy, 43191/43193: diagnostic rigid esophagoscopy/with biopsy. For each CPT code, the total number of charges billed to the Medicare database in each calendar year were recorded and analyzed using trendlines and linear regression.</div></div><div><h3>Results</h3><div>From 2013 to 2022, there was a significant decrease in the prevalence of transoral flexible esophagoscopy, both diagnostic (trendline slope = −1078, R² = 0.83) and with biopsy (trendline slope = −192, R² = 0.80). The prevalence of rigid esophagoscopy, both diagnostic and with biopsy, remained stable (trendline slope = −51, R² = 0.14; trendline slope = −9.6, R² = 0.26, respectively). Diagnostic TNE represented a small percentage of total diagnostic esophagoscopies performed (range: 9.37–14.94 %), and this percentage remained relatively constant over time (trendline slope = 0.0017, R² = 0.08). TNE with biopsy was a small percentage of total esophageal biopsy procedures (range: 6.54–10.66 %), with a slight increase over time as a percentage of all esophageal biopsies performed (trendline slope = 0.0037, R² = 0.48).</div></div><div><h3>Conclusion</h3><div>Benefits of office-based TNE procedures include the avoidance of general anesthesia, shorter procedure times, and cost savings. However, TNE remains a small percentage of all esophagoscopies performed, without significant trends toward increased utilization. Further investigation is needed to evaluate the lack of utilization of these office-based procedures.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104746"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412976","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}

{"title":"Audiovisual speech perception in Mandarin cochlear implant users across age and listening conditions","authors":"Wen-Ching Chuang ,&nbsp;Chia-Chen Lin ,&nbsp;Yu-Chien Wang ,&nbsp;Shih-Lung Chen ,&nbsp;Che-Ming Wu","doi":"10.1016/j.amjoto.2025.104741","DOIUrl":"10.1016/j.amjoto.2025.104741","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate how visual cues influence speech recognition in Mandarin-speaking cochlear implant (CI) users and examine age-related differences in audiovisual (AV) integration across varying sound intensities and noise conditions.</div></div><div><h3>Design</h3><div>A cross-sectional observational study comparing performance in visual-only (VO), audio-only (AO), and AV conditions using standardized Mandarin monosyllabic word and sentence tests. Study Sample: Seventy-two participants were recruited, including 40 CI users (22 children, 18 adults) and 32 normal-hearing (NH) controls (16 children, 16 adults). All CI users were unilateral recipients of Cochlear™ Nucleus® devices.</div></div><div><h3>Results</h3><div>AV input significantly enhanced word recognition in CI users, particularly under degraded conditions (low intensity or high noise), consistent with the principle of inverse effectiveness. CI children outperformed adults in AV word tasks, whereas adults had better sentence comprehension. VO performance was comparable between CI and NH groups, suggesting effective visual compensation among CI users. The most pronounced AV benefit was observed at 0 dB signal-to-noise ratio, where AV sentence scores approached AO performance at +5 dB.</div></div><div><h3>Conclusion</h3><div>AV cues play a critical role in speech perception for Mandarin-speaking CI users, especially under acoustically challenging conditions. Age-specific patterns in AV integration suggest differential reliance on visual input and linguistic strategies. These findings support the inclusion of AV and VO tasks in clinical assessments and underscore the importance of multimodal rehabilitation approaches, particularly for pediatric CI users.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104741"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407910","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}

{"title":"Oncocytic lipoadenoma of the submandibular gland case report","authors":"Mina A. Beshy ,&nbsp;Fayssal Alqudrah ,&nbsp;Isago Jerrett ,&nbsp;Andrew M. Parrott ,&nbsp;Taha A. Mur","doi":"10.1016/j.amjoto.2025.104749","DOIUrl":"10.1016/j.amjoto.2025.104749","url":null,"abstract":"<div><h3>Introduction</h3><div>Oncocytic lipoadenomas represent a rare, benign variant of salivary gland tumors (SGT). The parotid gland is the most common location for these tumors, accounting for 85 % of cases, followed by the submandibular gland. There have only been 7 reported cases of submandibular gland oncocytic lipoadenomas documented to date.</div></div><div><h3>Main concerns</h3><div>Herein, we present a case of an asymptomatic 47-year-old female with no significant past medical history who was incidentally diagnosed with a mass of the submandibular gland. We proceeded with complete surgical excision of the left submandibular gland, along with a neck dissection to ensure the removal of any potentially neoplastic tissue.</div></div><div><h3>Primary diagnosis and outcomes</h3><div>Histopathologic analysis of the excised mass revealed lobulated adipocytic tissue intermixed with small, scattered foci of salivary gland tissue, and several areas of oncocytic glandular tissue surrounded by patchy chronic inflammation, consistent with previously reported findings of oncocytic lipoadenomas.</div></div><div><h3>Conclusions</h3><div>This case underscores the rarity of this benign entity and highlights its inclusion in the differential diagnosis of salivary gland masses. Furthermore, it emphasizes the importance of diagnostic imaging and histopathologic analysis following core needle biopsy, as biopsy alone may not provide sufficient diagnostic clarity.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104749"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407766","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}

{"title":"HSNet: An adaptive fusion network based on laryngoscope–speech multimodal data for laryngeal disease classification","authors":"Mei Wei ,&nbsp;Xiu Zhang ,&nbsp;Lei Geng ,&nbsp;Wei Wang ,&nbsp;Zhitao Xiao ,&nbsp;Yanbei Liu","doi":"10.1016/j.amjoto.2025.104731","DOIUrl":"10.1016/j.amjoto.2025.104731","url":null,"abstract":"<div><h3>Objective</h3><div>To design and implement a deep learning-based multimodal data fusion classification model that integrates laryngoscope images and voice signals to improve the diagnostic accuracy of laryngeal diseases, enabling rapid and precise identification for clinical support.</div></div><div><h3>Results</h3><div>The model demonstrated high classification accuracy and robustness, achieving an overall accuracy of 87.92 % on the independent test set. Precision, recall, specificity, and F1-score were 0.879, 0.887, 0.966, and 0.883, respectively. The model outperformed single-modal approaches and existing multimodal frameworks.</div></div><div><h3>Conclusion</h3><div>The proposed HSNet effectively integrates hierarchical features from laryngoscope images and voice modalities, enabling accurate classification of six laryngeal diseases. This method holds significant potential for clinical applications.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104731"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145385277","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}

{"title":"Utility of apparent diffusion coefficient values in preoperative MRI for sinonasal tumors: Categorization of benign tumors excluding Papillomas, Papillomas, and malignant tumors","authors":"Mami Matsunaga ,&nbsp;Masahiro Kikuchi ,&nbsp;Yuji Kitada ,&nbsp;Takayuki Nakagawa ,&nbsp;Sho Koyasu ,&nbsp;Yuji Nakamoto ,&nbsp;Koichi Omori","doi":"10.1016/j.amjoto.2025.104738","DOIUrl":"10.1016/j.amjoto.2025.104738","url":null,"abstract":"<div><h3>Objective</h3><div>The apparent diffusion coefficient (ADC), obtained from diffusion-weighted imaging (DWI) on MRI, quantifies water diffusion within tissues and is commonly used to distinguish benign from malignant tumors. In the sinonasal region, preoperative diagnosis is often challenging due to diverse histologies and limited biopsy samples. This study aimed to assess the utility of ADCmean values in categorizing sinonasal tumors into benign tumors (excluding papillomas), papillomas, and malignant tumors, and to evaluate their potential as a supplementary diagnostic tool.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 74 patients with sinonasal tumors who underwent surgery between January 2011 and April 2022 and had preoperative DWI-MRI for ADC measurement. Tumors were classified into three groups based on final pathology: benign tumors excluding papillomas (12 cases), papillomas (28 cases), and malignant tumors (34 cases). Receiver operating characteristic (ROC) analysis was used to determine ADCmean cutoff values for each category. Diagnostic accuracy of ADC-based classification was compared with that of preoperative biopsy. Additionally, 8 cases without biopsy due to technical or safety concerns were assessed using ADCmean values alone.</div></div><div><h3>Results</h3><div>Mean ADC values significantly differed across groups: 1.89 ± 0.37 × 10⁻³ mm²/s for benign tumors excluding papillomas, 1.38 ± 0.33 × 10⁻³ mm²/s for papillomas, and 1.06 ± 0.27 × 10⁻³ mm²/s for malignant tumors. ROC analysis yielded optimal cutoff values: &gt;1.57 for benign tumors excluding papillomas, 1.23–1.57 for papillomas, and &lt; 1.23 for malignant tumors. Based on these thresholds, tumors were categorized into high (&gt;1.57), intermediate (1.23–1.57), and low (&lt;1.23) ADC groups. ADC-based classification achieved 68.9 % accuracy (51/74), lower than biopsy (95.4 %, 63/66), but correctly predicted tumor categories in all three cases where biopsy results were discordant with final pathology. In 8 cases without biopsy, ADC-based categorization achieved 87.5 % accuracy (7/8).</div></div><div><h3>Conclusion</h3><div>ADCmean values from DWI-MRI can effectively differentiate between benign tumors excluding papillomas, papillomas, and malignant tumors. Although not as accurate as biopsy, ADC-based categorization adds diagnostic value, especially in cases where biopsy is inconclusive or infeasible. Combining ADC analysis with biopsy findings may improve preoperative diagnostic accuracy and assist clinical decision-making in managing sinonasal tumors.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104738"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412975","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}

{"title":"The clinical effect of second needle aspiration and repeated cytological investigation for same thyroid nodule","authors":"Tzahi Neuman ,&nbsp;Nir Zontag ,&nbsp;Karin Atlan ,&nbsp;Haggi Mazeh ,&nbsp;Nir Hirshoren","doi":"10.1016/j.amjoto.2025.104737","DOIUrl":"10.1016/j.amjoto.2025.104737","url":null,"abstract":"<div><h3>Introduction</h3><div>Thyroid nodules initially classified as Bethesda categories II, III, or IV are occasionally re-aspirated due to evolving clinical or ultrasonographic features, or as part of structured protocols. This real-world study aimed to (1) determine the frequency of changes in Bethesda classification following repeat fine-needle aspiration (FNA), (2) assess the relationship between Bethesda category shifts and the clinical indication for re-aspiration, and (3) evaluate malignancy rates in nodules that demonstrated cytologic reclassification.</div></div><div><h3>Methods</h3><div>A retrospective analysis of thyroid nodules that underwent more than one FNA between 2018 and 2024. Only nodules initially categorized as Bethesda II, III, or IV were included. Cytological outcomes were compared between the initial and repeat aspirations.</div></div><div><h3>Results</h3><div>A total of 429 nodules underwent repeat FNA, with 111 nodules meeting inclusion criteria. Among nodules initially classified as Bethesda II (benign), 40.4 % were upgraded to a higher Bethesda category on repeat aspiration. For nodules initially categorized as Bethesda III or IV, 13.6 and 21.6 % were upgraded, while 40.6 and 48.6 % were downgraded to a lower-risk category, respectively.</div><div>Malignancy rates correlated with upgraded cytology classifications: 55.6–80 % of nodules reclassified as Bethesda III / IV were malignant, while 66.7–100 % of nodules upgraded to Bethesda V / VI were confirmed as malignant on final pathology.</div></div><div><h3>Conclusions</h3><div>Repeat FNA of thyroid nodules - particularly when prompted by clinical assessment, sonographic changes, and institutional guidelines for indeterminate cytology - can significantly refine risk stratification. These findings support the high diagnostic utility of repeated aspiration in appropriate clinical scenarios.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104737"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407754","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}

{"title":"Advances in absorbable hemostatic materials for nasal bleeding and post-sinus surgery","authors":"Weiguo Li ,&nbsp;Shengqi Gan ,&nbsp;Gong Liang ,&nbsp;Linrong Wu ,&nbsp;Junjun Zhang ,&nbsp;Jiangyu Yan ,&nbsp;Dong Ye","doi":"10.1016/j.amjoto.2025.104732","DOIUrl":"10.1016/j.amjoto.2025.104732","url":null,"abstract":"<div><div>Nasal bleeding, especially following nasal or sinus surgery, significantly impacts patient recovery. Traditional hemostatic methods no longer meet the clinical needs of patients. With the advancement of treatment options for nasal bleeding, absorbable hemostatic materials, known for their excellent biocompatibility and degradability, have garnered widespread attention in the field of nasal hemostasis. This article aims to review the recent progress in research on hemostatic materials for nasal bleeding and post-operative nasal surgery. It analyzes the mechanisms of action of various types of hemostatic materials, including collagen-based, cellulose-based, alginate-based, and platelet-rich plasma (PRP) materials, discussing their clinical applications, advantages, and limitations. Finally, the article explores the future direction of nasal hemostatic materials, particularly the innovative development of bioactive absorbable materials and their potential applications in nasal bleeding. Overall, with the continuous emergence of novel materials, nasal hemostatic materials are expected to play an increasingly vital role in improving therapeutic outcomes, reducing recurrence, and enhancing the quality of life for patients.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104732"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145412977","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}

{"title":"Toasted: Is burnout affecting otolaryngology trainee career decisions?","authors":"Brandon D. Abell ,&nbsp;Victoria Fischman ,&nbsp;Laylaa Ramos Arriaza ,&nbsp;Cristina Cabrera-Muffly ,&nbsp;Anne Getz ,&nbsp;Andrew P. Johnson","doi":"10.1016/j.amjoto.2025.104735","DOIUrl":"10.1016/j.amjoto.2025.104735","url":null,"abstract":"<div><h3>Objective</h3><div>Burnout is prevalent in the medical field, including within Otolaryngology – Head and Neck Surgery. To date, no study has focused on the impact burnout plays on the future career choices of otolaryngology residents and fellows. Additionally, this study aimed to assess how perceptions of burnout among subspecialty teaching faculty impacted trainees' future career choices.</div></div><div><h3>Methods</h3><div>An anonymous, cross-sectional survey was distributed nationally to program directors and coordinators of all ACGME-accredited Otolaryngology—Head and Neck Surgery residency programs in the United States during the 2022 academic year, with a request to forward the survey to current residents and fellows.</div></div><div><h3>Results</h3><div>A total of 82 trainees (72 resident physicians and 10 fellows) responded to the survey, with an estimated resident physician response rate of 4 %. 35 of the 72 residents (49 %) were planning to or were in the process of applying for a fellowship position. Burnout was cited as a factor in whether or not to pursue fellowship training for 41.3 % of respondents, and as a factor in whether or not to pursue academic medicine in 46.9 % of respondents. Witnessed or perceived burnout among faculty members also played a role in future career decisions for 61 % of respondents. Qualitative analysis revealed themes including negotiating current and future comfort/ burnout, seeking balance, and the influence of perceived burnout.</div></div><div><h3>Conclusions</h3><div>Personal burnout and observed burnout among faculty impacts career decision-making in a significant percentage of otolaryngology residents and fellows. Efforts to mitigate burnout are crucial to avoid determent of career choices within otolaryngology.</div></div>","PeriodicalId":7591,"journal":{"name":"American Journal of Otolaryngology","volume":"46 6","pages":"Article 104735"},"PeriodicalIF":1.7,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145407735","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}