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Dumkliang A, Pentrakan A, Dumkliang E. Epidemiological Profile of Ear, Nose, and Throat (ENT) Diseases in the Outpatient Department at Thung Song Hospital, a General Hospital in Southern Thailand, from 2016 to 2019. Indian J Otolaryngol Head Neck Surg 2024; 76:2531-2536. [PMID: 38883503 PMCID: PMC11169439 DOI: 10.1007/s12070-024-04560-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 02/12/2024] [Indexed: 06/18/2024] Open
Abstract
The demand for ear, nose, and throat (ENT) care significantly contributes to the workload in outpatient departments (OPDs) worldwide, including Thailand. However, the epidemiology of ENT diseases in Thai OPDs has not been thoroughly reported. Therefore, this study aimed to assess and describe the epidemiology of these conditions among patients attending the ENT clinic at Thung Song Hospital, marking the first epidemiological report of southern Thailand. This retrospective, descriptive study spanned four years and observed the number of ENT patients. The comprehensive dataset revealed a total of 34,848 ENT visits and 12,712 new cases within the ENT clinic's OPD, averaging 3,178 case instances annually. Notably, over a quarter of the patients were classified as elderly, aged 60 years or older. Of significance, the prevalence of ENT diseases among females exceeded that of males by more than 15% each year. Specific age groups revealed distinct prevalent conditions: otitis externa was most common among children, benign tumors prevailed in adults, and sensorineural hearing loss was prominent among the elderly. This study endeavor aims to deepen the understanding of the epidemiology of these diseases. Such investigations could guide the refinement of healthcare approaches targeting ENT-related ailments.
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Affiliation(s)
- Arunrat Dumkliang
- Division of Ear, Nose, and Throat (ENT) Diseases, Thung Song Hospital, Nakhon Si Thammarat, 80110 Thailand
| | - Amarawan Pentrakan
- Department of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, 90110 Thailand
| | - Ekachai Dumkliang
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Prince of Songkla University, Songkhla, 90110 Thailand
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Taciuc IA, Dumitru M, Vrinceanu D, Gherghe M, Manole F, Marinescu A, Serboiu C, Neagos A, Costache A. Applications and challenges of neural networks in otolaryngology (Review). Biomed Rep 2024; 20:92. [PMID: 38765859 PMCID: PMC11099604 DOI: 10.3892/br.2024.1781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 04/05/2024] [Indexed: 05/22/2024] Open
Abstract
Artificial Intelligence (AI) has become a topic of interest that is frequently debated in all research fields. The medical field is no exception, where several unanswered questions remain. When and how this field can benefit from AI support in daily routines are the most frequently asked questions. The present review aims to present the types of neural networks (NNs) available for development, discussing their advantages, disadvantages and how they can be applied practically. In addition, the present review summarizes how NNs (combined with various other features) have already been applied in studies in the ear nose throat research field, from assisting diagnosis to treatment management. Although the answer to this question regarding AI remains elusive, understanding the basics and types of applicable NNs can lead to future studies possibly using more than one type of NN. This approach may bypass the actual limitations in accuracy and relevance of information generated by AI. The proposed studies, the majority of which used convolutional NNs, obtained accuracies varying 70-98%, with a number of studies having the AI trained on a limited number of cases (<100 patients). The lack of standardization in AI protocols for research negatively affects data homogeneity and transparency of databases.
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Affiliation(s)
- Iulian-Alexandru Taciuc
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Mihai Dumitru
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050751 Bucharest, Romania
| | - Daniela Vrinceanu
- Department of ENT, ‘Carol Davila’ University of Medicine and Pharmacy, 050751 Bucharest, Romania
| | - Mirela Gherghe
- Department of Nuclear Medicine, ‘Carol Davila’ University of Medicine and Pharmacy, 022328 Bucharest, Romania
| | - Felicia Manole
- Department of ENT, Faculty of Medicine University of Oradea, 410073 Oradea, Romania
| | - Andreea Marinescu
- Department of Radiology and Medical Imaging ‘Carol Davila’ University of Medicine and Pharmacy, 050096 Bucharest, Romania
| | - Crenguta Serboiu
- Department of Cell Biology, Molecular and Histology, ‘Carol Davila’ University of Medicine and Pharmacy, 050096 Bucharest, Romania
| | - Adriana Neagos
- Department of ENT, ‘George Emil Palade’ University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Mures, Romania
| | - Adrian Costache
- Department of Pathology, ‘Carol Davila’ University of Medicine and Pharmacy, 020021 Bucharest, Romania
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Shah D, Sen J. Nalbuphine's Hemodynamic Impact in Ear, Nose, and Throat (ENT) Surgeries: A Comprehensive Review. Cureus 2024; 16:e52755. [PMID: 38389632 PMCID: PMC10881903 DOI: 10.7759/cureus.52755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
Nalbuphine, a semi-synthetic opioid, has gained attention for its analgesic properties, but its specific impact on hemodynamics in ear, nose, and throat (ENT) surgeries remains a subject of exploration. This comprehensive review aims to systematically analyze existing literature to understand the nuanced hemodynamic effects of nalbuphine during ENT procedures. Nalbuphine demonstrates promise as an analgesic agent in ENT surgeries with generally stable hemodynamic profiles. However, the variability in study designs and outcomes necessitates a cautious interpretation. The review underscores the need for standardized protocols and further research to elucidate patient-specific considerations, ensuring optimal utilization of nalbuphine in enhancing overall perioperative care for ENT patients.
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Affiliation(s)
- Dhruv Shah
- Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Jayashree Sen
- Anesthesia, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Richard K, Sanchez R, Amado B, Lubner R, Niconchuk J, Chen H, Phillips J, Kynes M, Belcher RH. Pediatric Otolaryngology Short-Term Mission Outcomes at a Surgical Mission Hospital in Guatemala. Otolaryngol Head Neck Surg 2024; 170:252-259. [PMID: 37466003 DOI: 10.1002/ohn.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 06/09/2023] [Accepted: 07/03/2023] [Indexed: 07/20/2023]
Abstract
OBJECTIVE The frequency of humanitarian surgical mission trips has grown over recent decades. Unfortunately, research on patient outcomes from these trips has not increased proportionately. We aim to analyze the safety and efficacy of surgeries in a low- and middle-income country missions-based surgery center in Guatemala City, Guatemala, and identify factors that influence surgical outcomes. STUDY DESIGN Retrospective cohort study. SETTING Guatemalan surgery center is called the Moore Center. METHODS Pediatric patients underwent otolaryngology surgery between 2017 and 2019. All patients required follow up. We analyzed the effect of patient, surgical, and geographic factors on follow up and complications with univariate and multivariate analyses. RESULTS A total of 1094 otolaryngologic surgeries were performed between 2017 to 2019, which comprised 37.4% adenotonsillectomies, 26.8% cleft lip (CL)/cleft palate (CP) repairs, 13.6% otologic, and 20% "other" surgeries. Patients traveled on average 88 km to the center (±164 km). Eighty-nine percent attended their first follow up and 55% attended their second. The 11% who missed their first follow up lived farther from the center (p < .001) and had a higher ASA classification (p < .001) than the 89% who did attend. Sixty-nine (6.3%) patients had 1 or more complications. CL/CP surgery was associated with more complications than other procedures (p < .001). Of 416 tonsillectomies, 4 patients (1%) had a bleeding episode with 2 requiring reoperation. CONCLUSION This surgical center models effective surgical care in low-resource areas. Complications and follow-up length vary by diagnosis. Areas to improve include retaining complex patients for follow up and reducing complications for CL/CP repair.
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Affiliation(s)
- Kelsey Richard
- Medical Doctorate Program, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Barbara Amado
- Centro Quirugico Pediatrico Moore, Guatemala City, Guatemala
| | - Rory Lubner
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jonathan Niconchuk
- Department of Anesthesia, Pediatric Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Heidi Chen
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - James Phillips
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Vanderbilt Children's Hospital, Nashville, Tennessee, USA
| | - Matthew Kynes
- Department of Anesthesia, Pediatric Division, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Ryan H Belcher
- Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA
- Department of Pediatric Otolaryngology-Head and Neck Surgery, Vanderbilt Children's Hospital, Nashville, Tennessee, USA
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Kim EK, Shrime MG. Cost of open access publishing in otolaryngology-head and neck surgery. World J Otorhinolaryngol Head Neck Surg 2023; 9:352-356. [PMID: 38059140 PMCID: PMC10696265 DOI: 10.1002/wjo2.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 07/20/2022] [Indexed: 11/12/2022] Open
Abstract
Objective Open access (OA) publishing makes research more accessible but is associated with steep article processing charges (APCs). The study objective was to characterize the APCs of OA publishing in otolaryngology-head and neck surgery (OHNS) journals. Methods We conducted a cross-sectional analysis of published policies of 110 OHNS journals collated from three databases. The primary outcomes were the publishing model, APC for original research, and APC waiver policy. Results We identified 110 OHNS journals (57 fully OA, 47 hybrid, 2 subscription-only, 4 unknown model). After excluding 12 journals (2 subscription-only, 4 unknown model, 5 OA with unspecified APCs, and 1 OA that accepts publications only from society members), we analyzed 98 journals, 23 of which did not charge APCs. Among 75 journals with nonzero APCs, the mean and median APCs were $2452 and $2900 (interquartile range: $1082-3520). Twenty-five journals (33.3%) offered APC subsidies for authors in low- and middle-income countries (LMICs) and/or on a case-by-case basis. Eighty-five and 25 journals were based in high-income countries (HICs) and LMICs, respectively. The mean APC was higher among HIC journals than LMIC journals ($2606 vs. $958, p < 0.001). Conclusion APCs range from tens to thousands of dollars with limited waivers for authors in LMICs.
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Affiliation(s)
- Eric K. Kim
- Program in Global Surgery and Social ChangeHarvard Medical SchoolBostonMassachusettsUSA
- School of MedicineUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Mark G. Shrime
- Program in Global Surgery and Social ChangeHarvard Medical SchoolBostonMassachusettsUSA
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Jaradeh K, Tang A, Czechowicz JA, Jacobson L, Raphael E. Prevalence of otolaryngological disease in a refugee population compared to US-born patients. Laryngoscope Investig Otolaryngol 2023; 8:394-400. [PMID: 37090888 PMCID: PMC10116955 DOI: 10.1002/lio2.1021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/26/2023] [Accepted: 01/31/2023] [Indexed: 02/17/2023] Open
Abstract
Objective Limited data exists regarding otolaryngological (ENT) disease in refugees and we aim to characterize its prevalence. Methods This is a retrospective descriptive chart review of adult US-born, immigrant, and refugee patients receiving care at a primary care clinic between 2014 and 2017. We report the prevalence of ENT disease by immigration status. Bivariable and multivariable logistic regression models were conducted to assess differences in prevalence of ENT disease by immigration status. Results Of 995 patients included, 202 US-born, 450 immigrants, and 343 were refugees. Immigrants were older (46 years vs. 34 years among refugees, 35.5 years among US-born, p < .001) and more likely to be women (64% vs. 52% among refugees and 56% among US-born, p = .003). Among refugees, 27% were Central American, 22% Chinese, and 9.3% Middle Eastern. Hearing loss and allergic rhinitis were the top two diagnoses among the three groups of immigration status. More refugees had at least 1 ENT diagnosis compared to the other groups (16% vs 14% among immigrants and 6% US-born, p < .001). Refugees were more likely to have at least 1 ENT diagnosis compared to US-born individuals (age and gender adjusted [aOR] 3.40, 95% CI [1.80-6.95], p < .001) and immigrants (aOR 1.62, [1.05-2.51], p = .03). Conclusion ENT disease is prevalent among refugees, necessitating standardized evaluation during refugee health assessments and identifying barriers to referral and treatment. Level of evidence 2b.
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Affiliation(s)
- Katrin Jaradeh
- School of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Alice Tang
- School of MedicineUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Josephine A. Czechowicz
- Department of Otolaryngology‐Head & Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Lia Jacobson
- Department of Otolaryngology‐Head & Neck SurgeryUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Eva Raphael
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
- Department of Family and Community MedicineUniversity of California San FranciscoSan FranciscoCaliforniaUSA
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Ali HM, Lee SYH, Jashek-Ahmed F, Seguya A, Faucett E, Van Beck J, Stapleton E, Peer S, Husain IA, Wiedermann J, Salano V. Gender Disparities in Otolaryngology: A Case Report Reflecting Global Perspectives. Laryngoscope 2023; 133:547-551. [PMID: 36286081 DOI: 10.1002/lary.30455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/03/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To explore the impact of female sex on the experiences of trainees and surgeons in otolaryngology from LMIC and HIC. METHODS This study includes perspectives of five consultants and two resident physicians from the United States, United Kingdom, Uganda, Kenya and South Africa. RESULTS Six themes emerged from these interviews. Overall, LMIC and HIC women shared similar experiences of microaggressions during patients, working along ancillary staff, related to pregnancy, imposter syndrome, difficulties during job search, and unique barriers as consultant. CONCLUSIONS The findings of this study highlight that gender disparities are present at all levels in Otolaryngology but can present differently depending on context. Laryngoscope, 133:547-551, 2023.
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Affiliation(s)
- Hawa M Ali
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Stellina Y H Lee
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
| | - Farizeh Jashek-Ahmed
- Department of Otolaryngology, Queens Hospital, Barking, Havering and Redbridge University Hospitals NHS Trust, Romford, United Kingdom
| | - Amina Seguya
- Department of ENT Surgery, Mulago National Referral Hospital, Kampala, Uganda
| | - Erynne Faucett
- Department of Otolaryngology-Head and Neck Surgery, Phoenix Children's Hospital, Phoenix, Arizona, U.S.A
| | | | - Emma Stapleton
- Department of Otolaryngology, Manchester University, Machester, United Kingdom
| | - Shazia Peer
- Department of Otolaryngology-Head and Neck Surgery, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - Inna A Husain
- Department of Otorrhinolaryngology, Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A
| | - Joshua Wiedermann
- Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, U.S.A
| | - Valerie Salano
- Department of Otolaryngology, Nyahururu County Hospital, Nyahururu, Kenya
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Lukama L, Aldous C, Michelo C, Kalinda C. Ear, Nose and Throat (ENT) disease diagnostic error in low-resource health care: Observations from a hospital-based cross-sectional study. PLoS One 2023; 18:e0281686. [PMID: 36758061 PMCID: PMC9910637 DOI: 10.1371/journal.pone.0281686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/28/2023] [Indexed: 02/10/2023] Open
Abstract
Although the global burden of ear, nose and throat (ENT) diseases is high, data relating to ENT disease epidemiology and diagnostic error in resource-limited settings remain scarce. We conducted a retrospective cross-sectional review of ENT patients' clinical records at a resource-limited tertiary hospital. We determined the diagnostic accuracy and appropriateness of patient referrals for ENT specialist care using descriptive statistics. Cohens kappa coefficient (κ) was calculated to determine the diagnostic agreement between non-ENT clinicians and the ENT specialist, and logistic regression applied to establish the likelihood of patient misdiagnosis by non-ENT clinicians. Of the 1543 patients studied [age 0-87 years, mean age 25(21) years (mean(SD)], non-ENT clinicians misdiagnosed 67.4% and inappropriately referred 50.4%. Compared to those aged 0-5 years, patients aged 51-87 years were 1.77 (95%CI: 1.03-3.04) fold more likely to have a referral misdiagnosis for specialist care. Patients with ear (aOR: 1.63; 95% CI: 1.14-2.33) and those with sinonasal diseases (aOR: 1.80; 95% CI: 1.14-2.45) had greater likelihood of referral misdiagnosis than those with head and neck diseases. Agreement in diagnosis between the ENT specialist and non-ENT clinicians was poor (κ = 0.0001). More effective, accelerated training of clinicians may improve diagnostic accuracy in low-resource settings.
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Affiliation(s)
- Lufunda Lukama
- Department of Otorhinolaryngology, Head and Neck Surgery, Ndola Teaching Hospital, Ndola, Zambia
- College of Health Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
- * E-mail:
| | - Colleen Aldous
- College of Health Sciences, Nelson R Mandela School of Clinical Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Charles Michelo
- School of Public Health, Department of Epidemiology, Harvest University, Lusaka, Zambia
- Strategic Centre for Health Systems Metrics & Evaluations (SCHEME), School of Public Health, University of Zambia, Lusaka, Zambia
| | - Chester Kalinda
- Bill and Joyce Cummings Institute of Global Health, University of Global Health Equity, Kigali, Rwanda
- Howard College Campus, College of Health Sciences, School of Public Health and Nursing, University of KwaZulu-Natal, Durban, South Africa
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Machine Learning in the Management of Lateral Skull Base Tumors: A Systematic Review. JOURNAL OF OTORHINOLARYNGOLOGY, HEARING AND BALANCE MEDICINE 2022. [DOI: 10.3390/ohbm3040007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The application of machine learning (ML) techniques to otolaryngology remains a topic of interest and prevalence in the literature, though no previous articles have summarized the current state of ML application to management and the diagnosis of lateral skull base (LSB) tumors. Subsequently, we present a systematic overview of previous applications of ML techniques to the management of LSB tumors. Independent searches were conducted on PubMed and Web of Science between August 2020 and February 2021 to identify the literature pertaining to the use of ML techniques in LSB tumor surgery written in the English language. All articles were assessed in regard to their application task, ML methodology, and their outcomes. A total of 32 articles were examined. The number of articles involving applications of ML techniques to LSB tumor surgeries has significantly increased since the first article relevant to this field was published in 1994. The most commonly employed ML category was tree-based algorithms. Most articles were included in the category of surgical management (13; 40.6%), followed by those in disease classification (8; 25%). Overall, the application of ML techniques to the management of LSB tumor has evolved rapidly over the past two decades, and the anticipated growth in the future could significantly augment the surgical outcomes and management of LSB tumors.
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Viscaino M, Talamilla M, Maass JC, Henríquez P, Délano PH, Auat Cheein C, Auat Cheein F. Color Dependence Analysis in a CNN-Based Computer-Aided Diagnosis System for Middle and External Ear Diseases. Diagnostics (Basel) 2022; 12:diagnostics12040917. [PMID: 35453965 PMCID: PMC9031192 DOI: 10.3390/diagnostics12040917] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/15/2022] [Accepted: 03/23/2022] [Indexed: 02/01/2023] Open
Abstract
Artificial intelligence-assisted otologic diagnosis has been of growing interest in the scientific community, where middle and external ear disorders are the most frequent diseases in daily ENT practice. There are some efforts focused on reducing medical errors and enhancing physician capabilities using conventional artificial vision systems. However, approaches with multispectral analysis have not yet been addressed. Tissues of the tympanic membrane possess optical properties that define their characteristics in specific light spectra. This work explores color wavelengths dependence in a model that classifies four middle and external ear conditions: normal, chronic otitis media, otitis media with effusion, and earwax plug. The model is constructed under a computer-aided diagnosis system that uses a convolutional neural network architecture. We trained several models using different single-channel images by taking each color wavelength separately. The results showed that a single green channel model achieves the best overall performance in terms of accuracy (92%), sensitivity (85%), specificity (95%), precision (86%), and F1-score (85%). Our findings can be a suitable alternative for artificial intelligence diagnosis systems compared to the 50% of overall misdiagnosis of a non-specialist physician.
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Affiliation(s)
- Michelle Viscaino
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso 2390382, Chile;
- Advanced Center of Electrical and Electronic Engineering, Valparaíso 2390136, Chile;
| | - Matias Talamilla
- Interdisciplinary Program of Physiology and Biophysics, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Santiago 8320328, Chile; (M.T.); (J.C.M.)
| | - Juan Cristóbal Maass
- Interdisciplinary Program of Physiology and Biophysics, Institute of Biomedical Sciences (ICBM), Faculty of Medicine, University of Chile, Santiago 8320328, Chile; (M.T.); (J.C.M.)
- Department of Otolaryngology, Hospital Clínico Universidad de Chile, Faculty of Medicine, University of Chile, Santiago 8320328, Chile;
- Unit of Otolaryngology, Department of Surgery, Clínica Alemana de Santiago, Facultad de Medicina Clínica Alemana-Universidad del Desarrollo, Santiago 0323142, Chile
| | - Pablo Henríquez
- Department of Otolaryngology, Hospital Clínico Universidad de Chile, Faculty of Medicine, University of Chile, Santiago 8320328, Chile;
- Medical Sciences Doctorate Program, Postgraduate School, Faculty of Medicine, University of Chile, Santiago 8320328, Chile
| | - Paul H. Délano
- Advanced Center of Electrical and Electronic Engineering, Valparaíso 2390136, Chile;
- Department of Otolaryngology, Hospital Clínico Universidad de Chile, Faculty of Medicine, University of Chile, Santiago 8320328, Chile;
- Department of Neuroscience, Faculty of Medicine, University of Chile, Santiago 8320328, Chile
| | - Cecilia Auat Cheein
- Facultad de Ciencias Médicas, Universidad Nacional de Santiago del Estero, Santiago del Estero 4200, Argentina;
| | - Fernando Auat Cheein
- Department of Electronic Engineering, Universidad Técnica Federico Santa María, Valparaíso 2390382, Chile;
- Advanced Center of Electrical and Electronic Engineering, Valparaíso 2390136, Chile;
- Correspondence:
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Tan BKJ, Ng FYC, Song HJJMD, Tan NKW, Ng LS, Loh WS. Associations of Hearing Loss and Dual Sensory Loss With Mortality: A Systematic Review, Meta-analysis, and Meta-regression of 26 Observational Studies With 1 213 756 Participants. JAMA Otolaryngol Head Neck Surg 2022; 148:220-234. [PMID: 34967895 PMCID: PMC8719275 DOI: 10.1001/jamaoto.2021.3767] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
IMPORTANCE Hearing loss (HL) and dual sensory loss (DSL) are prevalent, disabling, and associated with numerous age-related health conditions, including dementia and frailty. To date, no evidence-based summary of their mortality risk is available. OBJECTIVE To clarify the epidemiological associations between HL/DSL and mortality. DATA SOURCES PubMed, Embase, and Cochrane Library, from inception until June 18, 2021. STUDY SELECTION Two blinded reviewers selected observational or interventional studies, published as full-length English articles in peer-reviewed journals, that reported the presence or severity of HL or DSL (ie, comorbid HL and vision loss), whether objectively measured or self-reported, in association with any mortality estimate, among adults 18 years and older. DATA EXTRACTION AND SYNTHESIS Two reviewers extracted data and evaluated study bias using the Newcastle-Ottawa Scale, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)/Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines and a PROSPERO-registered protocol. The analysis pooled maximally adjusted estimates using mixed-effects models, measured heterogeneity using I2, investigated sources of heterogeneity using meta-regression and subgroup meta-analyses, examined and adjusted for publication bias, performed influence and cumulative meta-analyses, and assessed evidence quality using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. MAIN OUTCOMES AND MEASURES Hazard ratios (HRs) for all-cause, cardiovascular, or other mortality estimates. RESULTS This review included 14 retrospective and 12 prospective observational studies (1 213 756 participants) from 3220 records. Risk of bias was low to moderate; exclusion of 3 high-risk studies did not alter conclusions. Hearing loss was associated with excess all-cause mortality (HR, 1.13; 95% CI, 1.07-1.19; I2 = 77%; n = 21; 95% prediction interval [PI], 0.93-1.37) and cardiovascular mortality (HR, 1.28; 95% CI, 1.10-1.50; I2 = 60%; n = 6; 95% PI, 0.84-1.96), while DSL was associated with larger excess risks (all-cause: HR, 1.40; 95% CI, 1.30-1.51; I2 = 34%; n = 10; 95% PI, 1.18-1.66; cardiovascular: HR, 1.86; 95% CI, 1.31-2.65; I2 = 0%; n = 2), after adjustment for demographics and comorbidities. Prespecified meta-regression sufficiently explained heterogeneity, with longer follow-up duration weakening the pooled association, leaving low (29%) residual heterogeneity. Meta-regression among audiometric studies showed a dose-response association (doubling of HR per 30-dB increase in HL). Self-reported and audiometric effect sizes were similar, with lower heterogeneity in the latter. Associations were robust to trim-and-fill adjustment for publication bias and single-study influence and cumulative meta-analyses. Associations with accident/injury, cancer, and stroke mortality were inconclusive, with only 1 to 3 studies. Overall evidence quality was moderate. CONCLUSIONS AND RELEVANCE In this systematic review and meta-analysis, HL and DSL were associated with excess all-cause and cardiovascular mortality. Physicians caring for patients with HL should consider its relevance to general health and longevity.
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Affiliation(s)
- Benjamin Kye Jyn Tan
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Faye Yu Ci Ng
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | | | - Nicole Kye Wen Tan
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore
| | - Li Shia Ng
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore,Department of Otolaryngology–Head & Neck Surgery, National University Health System (NUHS), Singapore
| | - Woei Shyang Loh
- Yong Loo Lin School of Medicine, National University of Singapore (NUS), Singapore,Department of Otolaryngology–Head & Neck Surgery, National University Health System (NUHS), Singapore
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Yao P, Witte D, Gimonet H, German A, Andreadis K, Cheng M, Sulica L, Elemento O, Barnes J, Rameau A. Automatic classification of informative laryngoscopic images using deep learning. Laryngoscope Investig Otolaryngol 2022; 7:460-466. [PMID: 35434326 PMCID: PMC9008155 DOI: 10.1002/lio2.754] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/05/2022] [Accepted: 01/31/2022] [Indexed: 12/23/2022] Open
Abstract
Objective This study aims to develop and validate a convolutional neural network (CNN)‐based algorithm for automatic selection of informative frames in flexible laryngoscopic videos. The classifier has the potential to aid in the development of computer‐aided diagnosis systems and reduce data processing time for clinician‐computer scientist teams. Methods A dataset of 22,132 laryngoscopic frames was extracted from 137 flexible laryngostroboscopic videos from 115 patients. 55 videos were from healthy patients with no laryngeal pathology and 82 videos were from patients with vocal fold polyps. The extracted frames were manually labeled as informative or uninformative by two independent reviewers based on vocal fold visibility, lighting, focus, and camera distance, resulting in 18,114 informative frames and 4018 uninformative frames. The dataset was split into training and test sets. A pre‐trained ResNet‐18 model was trained using transfer learning to classify frames as informative or uninformative. Hyperparameters were set using cross‐validation. The primary outcome was precision for the informative class and secondary outcomes were precision, recall, and F1‐score for all classes. The processing rate for frames between the model and a human annotator were compared. Results The automated classifier achieved an informative frame precision, recall, and F1‐score of 94.4%, 90.2%, and 92.3%, respectively, when evaluated on a hold‐out test set of 4438 frames. The model processed frames 16 times faster than a human annotator. Conclusion The CNN‐based classifier demonstrates high precision for classifying informative frames in flexible laryngostroboscopic videos. This model has the potential to aid researchers with dataset creation for computer‐aided diagnosis systems by automatically extracting relevant frames from laryngoscopic videos.
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Affiliation(s)
- Peter Yao
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Dan Witte
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Hortense Gimonet
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Alexander German
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Katerina Andreadis
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Michael Cheng
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Lucian Sulica
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Olivier Elemento
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Josue Barnes
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
| | - Anaïs Rameau
- Department of Otolaryngology‐Head and Neck Surgery, Sean Parker Institute for the Voice Weill Cornell Medicine New York New York USA
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Yao P, Usman M, Chen YH, German A, Andreadis K, Mages K, Rameau A. Applications of Artificial Intelligence to Office Laryngoscopy: A Scoping Review. Laryngoscope 2021; 132:1993-2016. [PMID: 34582043 DOI: 10.1002/lary.29886] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 01/16/2023]
Abstract
OBJECTIVES/HYPOTHESIS This scoping review aims to provide a broad overview of the applications of artificial intelligence (AI) to office laryngoscopy to identify gaps in knowledge and guide future research. STUDY DESIGN Scoping Review. METHODS Searches for studies on AI and office laryngoscopy were conducted in five databases. Title and abstract and then full-text screening were performed. Primary research studies published in English of any date were included. Studies were summarized by: AI applications, targeted conditions, imaging modalities, author affiliations, and dataset characteristics. RESULTS Studies focused on vocal fold vibration analysis (43%), lesion recognition (24%), and vocal fold movement determination (19%). The most frequently automated tasks were recognition of vocal fold nodules (19%), polyp (14%), paralysis (11%), paresis (8%), and cyst (7%). Imaging modalities included high-speed laryngeal videos (45%), stroboscopy (29%), and narrow band imaging endoscopy (7%). The body of literature was primarily authored by science, technology, engineering, and math (STEM) specialists (76%) with only 30 studies (31%) involving co-authorship by STEM specialists and otolaryngologists. Datasets were mostly from single institution (84%) and most commonly originated from Germany (23%), USA (16%), Spain (9%), Italy (8%), and China (8%). Demographic information was only reported in 39 studies (40%), with age and sex being the most commonly reported, whereas race/ethnicity and gender were not reported in any studies. CONCLUSION More interdisciplinary collaboration between STEM and otolaryngology research teams improved demographic reporting especially of race and ethnicity to ensure broad representation, and larger and more geographically diverse datasets will be crucial to future research on AI in office laryngoscopy. LEVEL OF EVIDENCE N/A Laryngoscope, 2021.
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Affiliation(s)
- Peter Yao
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
| | - Moon Usman
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
| | - Yu H Chen
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
| | - Alexander German
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
| | - Katerina Andreadis
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
| | - Keith Mages
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
| | - Anaïs Rameau
- Department of Otolaryngology-Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medicine, New York, New York, U.S.A
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Zaidi S, Naik P, Ahmed S. Three-Dimensional printed instruments used in a Septoplasty: A new paradigm in Surgery. Laryngoscope Investig Otolaryngol 2021; 6:613-618. [PMID: 34401479 PMCID: PMC8356858 DOI: 10.1002/lio2.579] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 04/24/2021] [Accepted: 05/03/2021] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVE Three-dimensional (3D) printing has been rapidly adopted by different surgical disciplines. It has shown itself to have improved outcomes in education, pre-operative planning, and reconstruction. However, using 3D printing to create surgical instruments is a niche within the literature that has not yet been fully explored. The authors present a study in which it is hypothesized that 3D printing surgical instruments can be utilized successfully within ENT surgery. METHODS As one of the most common ENT operations worldwide, a septoplasty was chosen as the procedure to provide proof of concept. For the septoplasty, five instruments were printed: a scalpel handle, needle holders, toothed forceps, a Cottle/Freer elevator, and a Killian's speculum. The entire set took 224 minutes on average to print, weighed 36 g, and only used approximately 86 pence ($1.20 USD) worth of polylactic acid plastic to create. RESULTS All steps in performing a septoplasty on a human cadaver with the 3D printed tools were possible and were undertaken successfully. This yielded a similar outcome to using stainless steel with the added benefit of there being a large reduction in cost and the ability for rapid customization according to the surgeon's preferences. CONCLUSION As technology and mainstream interest in 3D printing develops, the availability of more precise Computer-Aided Design software will allow for more complex designs of tools to be created. Currently, 3D printing has been shown to be a promising method from which future surgical tools can be fashioned to meet the complex, dynamic demands of surgery. LEVEL OF EVIDENCE N/A.
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Affiliation(s)
- Syed Zaidi
- Department of OtolaryngologyQueen Elizabeth HospitalBirminghamUK
| | - Paresh Naik
- Department of OtolaryngologyQueen Elizabeth HospitalBirminghamUK
| | - Shahzada Ahmed
- Department of OtolaryngologyQueen Elizabeth HospitalBirminghamUK
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Hong SN, Kim JK, Kim DW. The Impact of Socioeconomic Status on Hospital Accessibility in Otorhinolaryngological Disease in Korea. Asia Pac J Public Health 2020; 33:287-292. [PMID: 33291954 DOI: 10.1177/1010539520977320] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aimed to investigate the impact of socioeconomic status (SES) on otorhinolaryngology disease severity status diagnosed at the first hospital visit. We conducted a retrospective study over 20 years (2000-2019). Otorhinolaryngological diseases included chronic rhinosinusitis (CRS), sensorineural hearing loss (SNHL), oral ulcer, and malignant neoplasms. A logistic regression model was employed to assess the effect of SES on the severity of each disease at the first hospital visit. The severity of CRS increased in patients with lower SES (P = .028). The severities of SNHL (P = .032) and oral ulcer (P < .001) also associated with SES. In contrast, between the low- and high-SES groups observed no differences in cancer stage (P = .845). Patients with SNHL, oral ulcer, and CRS had a more severe disease status in the low-SES group than in the high-SES group at the first hospital visit. Efforts to increase hospital accessibility for low-SES otorhinolaryngological patients should be made.
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Affiliation(s)
- Seung-No Hong
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
| | - Joon Kon Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
| | - Dae Woo Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Boramae Medical Center, Seoul, Korea
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