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Introduction: Artificial intelligence (AI) is transforming medicine through techniques like machine learning and deep learning. AI aids diagnosis, enhances patient care, and streamlines healthcare systems. Despite potential benefits, challenges of bias and trust must be managed. Tonsillitis is a common otolaryngological condition with economic implications. The study assesses ChatGPT’s utility in the diagnosis management of bacterial tonsillitis, highlighting its potential for patient-professional interaction. Methods: 2 methods evaluated ChatGPT 3.5 diagnostic ability for tonsillitis: patient-written cases and specialist-created cases. The scenarios involved real patients and fictional cases, assessed by 15 otolaryngologists and 5 pediatricians. Variables included diagnosis accuracy, recommendations quality, and message count. Results: A total of 35 conversations were conducted. ChatGPT achieved accurate diagnoses in 100% of cases, with an average of 3.7 ± 1.1 chat entries for diagnosis. No significant difference existed between professional and patient scenarios (p= 0.977). Recommendations were categorized: appropriate (48.57%), incomplete (45.71%), inappropriate (5.71%), with no significant intergroup difference (p= 0.196). ChatGPT consistently advised consulting a doctor and exhibited expertise in guiding medical consultations. Conclusion: ChatGPT demonstrates promise in providing medical insights and general advice. Its diagnostic accuracy for tonsillitis is notable, but it relies on static data and lacks individual history assessment. ChatGPT shows potential for diagnostics in simpler cases like tonsillitis, but accuracy for complex conditions needs refinement. Further research is needed for validation and broader application.

Objective: To develop a French Short Version of the Questionnaire of Olfactory Disorders-Negative Statements (Fr-sQOD) to assess the quality of life impairments of patients with olfactory dysfunction (OD).Methods: Patients with OD and controls were enrolled from 2 academic centers. Individuals completed the Fr-sQOD, an OD visual analog scale severity, and the French version of the sinonasal outcome tool-22 (SNOT-22). Cronbach α was used to measure the internal consistency of Fr-sQOD. The reliability and the external validity of Fr-sQOD were assessed through a test–retest approach and by correlating Fr-sQOD with SNOT-22 scores, respectively. The external validity was assessed by correlation analysis between Fr-sQOD and the result of an assessment of the severity of OD on a visual analog scale.Results: Eighty patients completed the evaluations. The internal consistency was adequate (Cronbach α .96), and the test–retest reliability was high in the entire cohort (rs= 0.877, P< .001). The correlation between Fr-sQOD total scores and the severity of OD was moderate but significant (rs= −0.431; P= .001) supporting an acceptable external validity. Patients with OD had a significantly higher score of Fr-sQOD than healthy individuals (P< .001), indicating a high internal validity.Conclusion: The Fr-sQOD is a reliable and valid self-administered tool in the evaluation of the impact of OD on quality of life of French-speaking patients.

Machine learning (ML)‐based facial nerve injury (FNI) forecasting grounded on multicentric data has not been released up to now. Three distinct ML models, random forest (RF), K‐nearest neighbor, and artificial neural network (ANN), for the prediction of FNI were evaluated in this mode. A retrospective, longitudinal, multicentric study was performed, including patients who went through parotid gland surgery for benign tumors at three different university hospitals. Seven hundred and thirty‐six patients were included. The most compelling aspects related to risk escalation of FNI were as follows: (1) location, in the mid‐portion of the gland, near to or above the main trunk of the facial nerve and at the top part, over the frontal or the orbital branch of the facial nerve; (2) tumor volume in the anteroposterior axis; (3) the necessity to simultaneously dissect more than one level; and (4) the requirement of an extended resection compared to a lesser extended resection. By contrast, in accordance with the ML analysis, the size of the tumor (>3 cm), as well as gender and age did not result in a determining favor in relation to the risk of FNI. The findings of this research conclude that ML models such as RF and ANN may serve evidence‐based predictions from multicentric data regarding the risk of FNI. Along with the advent of ML technology, an improvement of the information regarding the potential risks of FNI associated with patients before each procedure may be achieved with the implementation of clinical, radiological, histological, and/or cytological data.

Coronavirus disease 2019 (COVID-19) may lead to many otolaryngological disorders such as loss of smell and taste, sudden sensorineural hearing loss (SSNHL), facial palsy, and parotitis. The involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in vestibular neuritis (VN) has been reported in 2 adult patients but not really confirmed through objective testings. We present a case of a 13-year-old girl with left superior vestibular neuritis confirmed by Video Head Impulse Test during a proven COVID-19 infection. To the best of our knowledge, this is the first case associating VN and COVID-19 that was demonstrated with an objective peripheral assessment. Physicians may be aware about the occurrence of VN in patients with COVID-19, keeping in mind that this condition may develop not only in adults. Early detection of SARS-CoV-2 in this pandemic is required to prevent its spread.

Objective The surgical management of nasal septal defects due to perforations, malformations, congenital cartilage absence, traumatic defects, or tumors would benefit from availability of optimally matured septal cartilage substitutes. Here, we aimed to improve in vitromaturation of 3-dimensional (3D)-printed, cell-laden polycaprolactone (PCL)-based scaffolds and test their in vivoperformance in a rabbit auricular cartilage model.Design Rabbit auricular chondrocytes were isolated, cultured, and seeded on 3D-printed PCL scaffolds. The scaffolds were cultured for 21 days in vitrounder standard culture media and normoxia or in prochondrogenic and hypoxia conditions, respectively. Cell-laden scaffolds (as well as acellular controls) were implanted into perichondrium pockets of New Zealand white rabbit ears (N= 5 per group) and followed up for 12 weeks. At study end point, the tissue-engineered scaffolds were extracted and tested by histological, immunohistochemical, mechanical, and biochemical assays.Results Scaffolds previously matured in vitrounder prochondrogenic hypoxic conditions showed superior mechanical properties as well as improved patterns of cartilage matrix deposition, chondrogenic gene expression (COL1A1, COL2A1, ACAN, SOX9, COL10A1), and proteoglycan production in vivo, compared with scaffolds cultured in standard conditions.Conclusions In vitromaturation of engineered cartilage scaffolds under prochondrogenic conditions that better mimic the in vivoenvironment may be beneficial to improve functional properties of the engineered grafts. The proposed maturation strategy may also be of use for other tissue-engineered constructs and may ultimately impact survival and integration of the grafts in the damaged tissue microenvironment.

IMPORTANCE: The workload of many residents and fellows in otolaryngology–head and neck surgery has particularly increased during the COVID-19 pandemic; however, outcomes associated with mental health status and sleep remain unclear. OBJECTIVE: To assess the sleep, mental status, and alcohol and tobacco consumption habits of residents and fellows before the COVID-19 pandemic (before March 10, 2020) and during the pandemic period (after March 10, 2020). DESIGN, SETTING, AND PARTICIPANTS: This cohort study included residents and fellows of 6 university hospitals of European regions with a high prevalence of COVID-19 cases. Survey development, data collection, and analyses were performed from March 10, 2020, to June 30, 2021. MAIN OUTCOMES AND MEASURES: Residents and fellows were invited to respond to a survey assessing management of treatment in patients with COVID-19 and related work features; stress and mental health status (Beck Depression Inventory); sleep features (Insomnia Severity Index); and alcohol and tobacco consumption. RESULTS: Of 220 potential participants, 128 residents and fellows (58.2%) completed the evaluations. No demographic data on mean (SD) age and sex or gender were collected. The prepandemic mean (SD) score of the Beck Depression Inventory (3.1 [2.8]) significantly increased after the start of the pandemic (mean [SD] score, 4.2 [4.1]; difference, –1.1; 95% CI, −1.96 to −0.24; d = 0.31), and the prepandemic mean (SD) score of the Insomnia Severity Index (4.9 [4.1) significantly increased after the start of the pandemic (mean [SD] score, 6.0 [4.9]; difference, 1.1; 95% CI, 0.00-2.2; d = 0.25). Insomnia concerned 46% of participants (51 of 112), and depression concerned 47% of participants (55 of 116) during the pandemic. The mean (SD) prepandemic alcohol consumption (1.7 [2.3] IU per week) significantly increased after the start of the pandemic (mean [SD], 2.9 [4.0] IU per week; difference, 1.2; 95% CI, 0.40-2.00; d = 0.37). Residents and fellows who were mobilized in COVID-19 units reported significant increases of workload (r = 0.2; 95% CI, 0.1-0.3), stress level (r = 0.2; 95% CI, 0.1-0.3), and alcohol consumption (for 5-10 IU per week: mean [SD] prepandemic, 11 [8] IU per week vs postpandemic, 20 [16] IU per week; d = 0.37) and a worsening of sleep status (for moderate insomnia: mean [SD] prepandemic Insomnia Severity Index, 4 [3] vs postpandemic, 15 [12]; d = 0.25). There was a significant association between alcohol consumption and the Beck Depression Inventory score (r = 0.4; 95% CI, 0.2-0.6). The mean (SD) consumption of tobacco decreased from 2.1 (1.3) to 0.9 (1.5) (difference, –1.20; 95% CI, −1.50 to −0.85; d = 0.85). CONCLUSIONS AND RELEVANCE: Results of this cohort study suggest that the workload of residents and fellows increased during the pandemic, which may be associated with a worsening of mental health and sleep status and an increase of alcohol consumption.

Introduction: Pharyngocutaneous fistula (PCF) remains the most frequent complication following total laryngectomy (TL). Pharyngeal closure with a surgical stapler (SAPC) has been proposed as an effective closure technique that decreases the rate of PCF, reduces surgical time, decreases the length of hospital stay, and shortens the time required before safely initiating oral feeding. Methods: This study involved a systematic review and meta-analysis of patients with laryngeal cancer who underwent TL and with subsequent stapler pharyngeal closure, in order to analyse the current literature regarding the role of SAPC after TL. Results: The incidence of PCF in the stapler-assisted suture group (SASG) was 9.5% (95% CI 8.2–15.9%), with a mean absolute deviation of 1.12, while in the hand-suture group (HSG) group the incidence was 23.4% (95% CI 23–26.1%), with a mean absolute deviation of 5.71 (p= 0.01). Conclusions: SAPC may decrease the risk of PCF in patients following TL. Based on the current data, SAPC appears to shorten the surgical time and the length of hospital stay. Nevertheless, prospective randomized trials are required to validate these findings.

Introduction: Despite good results of transoral laser CO2microsurgery (CO2TOLMS) of the larynx, a lack of data related to the safety of this technique as a day-case procedure across the literature is evident.Materials and Methods: An observational, retrospective, non-randomized study.Results: One hundred four (62.6%) patients met the inclusion criteria, 96 (92.3%) patients were male, and 8 (7.7%) patients were female. The mean age of the study group was 66 ± 11 years (min: 34/max: 90). All the patients underwent CO2TOLMS were treated as an outpatient procedure. The glottis was the most common location affecting 97 (93.3%) patients, regarding the need of readmission, just 4 (3.8%) patients needed to be readmitted after surgery due to dyspnea secondary to laryngeal edema in 2 cases by laryngeal bleeding, and cervical emphysema in one case, respectively. Being just necessary to reintubate 1 patient (<1%) to control the bleeding. We didn’t find any statistical correlation between variables and the need for readmission of reintubation.Conclusion: According to our results, CO2TOLMS of the larynx can be safely performed as an outpatient procedure. To establish a proper protocol and to perform a careful preoperative assessment are essential to increase our success rate and to prevent any potential complication.

En la infección por SARS-CoV-2 la pérdida repentina del olfato y/o gusto han sido descritas como síntomas iniciales. El objetivo principal de este estudio es conocer la prevalencia de estos síntomas en España.

Objective: To investigate the coronavirus disease 2019 (COVID-19) status of patients with initial sudden olfactory anosmia (ISOA) through nasopharyngeal swabs for reverse transcription–polymerase chain reaction (RT-PCR) analysis and to explore their olfactory dysfunctions with psychophysical olfactory evaluation.Methods: A total of 78 ISOA patients were recruited from April 6, 2020, to April 10, 2020, through a public call of University of Mons (Mons, Belgium). Patients benefited from nasopharyngeal swabs and fulfilled the patient-reported outcome questionnaire. Among them, 46 patients performed psychophysical olfactory evaluation using olfactory identification testing. Based on the duration of the ISOA, 2 groups of patients were compared: patients with olfactory dysfunction duration ≤12 days (group 1) and those with duration >12 days (group 2).Results: In group 1, 42 patients (87.5%) had a positive viral load determined by RT-PCR and 6 patients (12.5%) were negative. In group 2, 7 patients (23%) had a positive viral load and 23 patients (77%) were negative. The psychophysical olfactory evaluation reported that anosmia and hyposmia occurred in 24 (52%) and 11 (24%) patients, respectively. Eleven patients were normosmic. The viral load was significantly higher in patients of group 1 compared with those of group 2.Conclusions: Coronavirus disease 2019 was detected in a high proportion of ISOA patients, especially over the first 12 days of olfactory dysfunction. Anosmia is an important symptom to consider in the detection of COVID-19 infection.

El objetivo del siguiente trabajo es la revisión de las modificaciones y avances en cirugía reconstructiva de tejidos blandos de la cavidad oral basándonos exclusivamente en los principales colgajos que dependen de arterias nominadas del sistema de la arteria facial.

El colgajo supraclavicular en isla es un colgajo rotacional pediculado que puede presentar ciertas ventajas en reconstrucción de cabeza y cuello en pacientes donde una reconstrucción microvascularizada no sea factible o aconsejable.

El carcinoma sarcomatoide puede aparecer en cualquier parte del cuerpo, siendo las glándulas salivales mayores su principal localización en cabeza y cuello, pero en la laringe representa aproximadamente un 1%. Cuenta con componentes epiteliales y mesenquimales, lo que ha llevado a plantear múltiples teorías acerca de su origen. Por esto su diagnóstico anatomopatológico puede ser un reto.

Atopic dermatitis (AD) is a chronic, itchy skin condition that affects 15–20% of children but may occur at any age. It is estimated that 16.5 million US adults (7.3%) have AD that initially began at age >2 years, with nearly 40% affected by moderate or severe disease. Therefore, a quantitative measurement that could track the evolution of AD severity could be extremely useful in assessing therapeutic efficacy. Currently, SCOring Atopic Dermatitis (SCORAD) is the most frequently used measurement in clinical practice. However, SCORAD has the following disadvantages: (i) time consuming—calculating SCORAD usually takes about 7–10 minutes per patient, which poses a heavy burden on dermatologists and (ii) inconsistency—owing to the complexity of SCORAD calculation, even well-trained dermatologists could give different scores for the same case. In this study, we introduce Automatic SCORAD, an automatic version of the SCORAD, on the basis of state-of-the-art convolutional neural networks that measure AD severity on the basis of skin lesion images. Overall, we have shown that Automatic SCORAD may prove to be a rapid and objective alternative method for the automatic assessment of AD, achieving results comparable with those of human expert assessment while reducing interobserver variability.