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Objectives: Artificial intelligence is evolving and significantly impacting health care, promising to transform access to medical information. With the rise of medical misinformation and frequent internet searches for health‐related advice, there is a growing demand for reliable patient information. This study assesses the effectiveness of ChatGPT in providing information and treatment options for chronic rhinosinusitis (CRS). Methods: Six inputs were entered into ChatGPT regarding the definition, prevalence, causes, symptoms, treatment options, and postoperative complications of CRS. International Consensus Statement on Allergy and Rhinology guidelines for Rhinosinusitis was the gold standard for evaluating the answers. The inputs were categorized into three categories and Flesch–Kincaid readability, ANOVA and trend analysis tests were used to assess them. Results: Although some discrepancies were found regarding CRS, ChatGPT's answers were largely in line with existing literature. Mean Flesch Reading Ease, Flesch–Kincaid Grade Level and passive voice percentage were (40.7%, 12.15%, 22.5%) for basic information and prevalence category, (47.5%, 11.2%, 11.1%) for causes and symptoms category, (33.05%, 13.05%, 22.25%) for treatment and complications, and (40.42%, 12.13%, 18.62%) across all categories. ANOVA indicated no statistically significant differences in readability across the categories (p‐values: Flesch Reading Ease = 0.385, Flesch–Kincaid Grade Level = 0.555, Passive Sentences = 0.601). Trend analysis revealed readability varied slightly, with a general increase in complexity. Conclusion: ChatGPT is a developing tool potentially useful for patients and medical professionals to access medical information. However, caution is advised as its answers may not be fully accurate compared to clinical guidelines or suitable for patients with varying educational backgrounds. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Background: The timing of tracheostomy for intensive care unit patients is controversial, with conflicting findings on early versus late tracheostomy. Methods: Patients undergoing tracheostomy from 2001through 2012 were identified from the Medical Information Mart for Intensive Care-III database. Early tracheostomy was defined as less than the 25th percentile of time from intensive care unit admission to tracheostomy (time to tracheostomy). Statistical analysis for tracheostomy timing on intensive care unit length of stay and mortality were conducted. Results: Of the 1,566 patients that were included, patients with early tracheostomy had shorter intensive care unit length of stay (27.32 vs 12.55 days, p < 0.001) and lower mortality (12.9 per cent vs 9.0 per cent, p = 0.039). Multivariate logistic regression analysis found an association between increasing time to tracheostomy and mortality (odds ratio: 1.029, 95 per cent confidence interval 1.007–1.051, p = 0.009). Conclusion: Our analysis revealed that patients with early tracheostomy were more likely to have shorter intensive care unit lengths of stay and lower mortality. Our data suggest that early tracheostomy should be given strong consideration in appropriately selected patients. [ABSTRACT FROM AUTHOR]

This article discusses the surgical approach and outcomes for the removal of juvenile nasopharyngeal angiofibromas (JNAs), which are benign but locally invasive tumors. The authors describe a graduated multi-angle, multi-corridor endoscopic approach that allows for safe resection of JNAs with low rates of morbidity. The study reviewed 15 cases and found that the use of multiple corridors increased surgical freedom and efficiency. All patients achieved gross total resection, although two patients experienced delayed tumor recurrence. The authors conclude that an individualized, tailored approach is effective for JNAs and can be customized based on the tumor's location and anatomical compartments. [Extracted from the article]

This article, published in the Journal of Neurological Surgery, compares the outcomes of endoscopic endonasal approaches versus transcranial approaches for the resection of craniopharyngiomas. The study includes 38 cases and evaluates surgical outcomes and technical nuances. Different classification systems for tumor location are also discussed. The results show that endonasal procedures have a lower rate of postoperative recurrence and may improve visual outcomes. The QST classification system appears to be correlated with the surgical approach and may be useful for approach selection in the future. [Extracted from the article]

Objective: To examine factors associated with hospital safety net burden and its impact on survival for patients with sinonasal squamous cell carcinoma (SNSCC). Study Design: Retrospective database study. Setting: National Cancer Database from 2004 to 2016. Methods: SNSCC cases were identified in the National Cancer Database. Hospital safety net burden was defined by percentage of uninsured/Medicaid patients treated, namely ≤25% for low‐burden hospitals, 26% to 75% for medium‐burden hospitals, and >75% for high‐burden hospitals (HBHs). Univariate and multivariate analyses were used to investigate patient demographics, clinical characteristics, and overall survival. Results: An overall 6556 SNSCC cases were identified, with 1807 (27.6%) patients treated at low‐burden hospitals, 3314 (50.5%) at medium‐burden hospitals, and 1435 (21.9%) at HBHs. On multivariate analysis, Black race (odds ratio [OR], 1.39; 95% CI, 1.028‐1.868), maxillary sinus primary site (OR, 1.31; 95% CI, 1.036‐1.643), treatment at an academic/research program (OR, 20.63; 95% CI, 8.868‐47.980), and treatment at a higher‐volume facility (P <.001) resulted in increased odds of being treated at HBHs. Patients with grade III/IV tumor (OR, 0.70; 95% CI, 0.513‐0.949), higher income (P <.05), or treatment modalities other than surgery alone (P <.05) had lower odds. Survival analysis showed that hospital safety net burden status was not significantly associated with overall survival (log‐rank P =.727). Conclusion: In patients with SNSCC, certain clinicopathologic factors, including Black race, lower income, treatment at an academic/research program, and treatment at facilities in the West region, were associated with treatment at HBHs. Hospital safety net burden status was not associated with differences in overall survival. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Objective: The global Coronavirus disease 2019 (COVID-19) pandemic has resulted in an expansion of telemedicine. The purpose of this study is to present our experience with outpatient telemedicine visits within a single institution's Department of Otolaryngology during the initial COVID-19 era. Study Design: Retrospective chart review. Methods: This was a single-institution study conducted within the Department of Otolaryngology at an urban tertiary care center. Data on outpatient visits was obtained from billing and scheduling records from January 6 to May 28, 2020. Visits were divided into "pre-shutdown" and "post-shutdown" based on our state's March 23, 2020 COVID-19 shutdown date. Results: A total of 3447 of 4340 (79.4%) scheduled visits were completed in the pre-shutdown period as compared to 1451 of 1713 (84.7%) in the post-shutdown period. The proportion of telemedicine visits increased (0.7%-81.2%, P <.001). Overall visit completion rate increased following the shutdown (80.2%-84.7%, P <.001). Subspecialties with an increase in visit completion rate were general (76.9%-88.0%, P =.002), otology (77.4%-87.2%, P <.001), and rhinology (80.0%-86.2%, P =.003). Patients with Medicaid and Medicare had higher appointment completion rates following the transition to telemedicine visits (80.7%-85.7%, P =.002; 76.9%-84.7%, P =.001). Older age was associated with decreased appointment cancellation pre-shutdown (OR 0.994 [0.991-0.997], P <.001) but increased appointment cancellation post-shutdown (OR 1.008 [1.001-1.014], P =.015). Mean COVID-19 risk scores were unchanged (P =.654). Conclusions: COVID-19 has led to major changes in outpatient practice, with a significant shift from in-person to telemedicine visits following the mandatory shutdown. An associated increase in appointment completion rates was observed, reflecting a promising viable alternative to meet patient needs during this unprecedented time. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to analyze national trends in human papillomavirus (HPV) testing for patients diagnosed with sinonasal squamous cell carcinoma (SNSCC). Study Design: Retrospective database study. Setting: National Cancer Database (2010-2016). Methods: Cases from 2010 to 2016 with a primary SNSCC diagnosis and known HPV testing status were extracted from the National Cancer Database. Univariate and multivariate analyses were then performed to assess differences in socioeconomic, hospital, and tumor characteristics between tested and nontested patients. Results: A total of 2308 SNSCC cases were collected, with 1210 (52.4%) HPV tested and 1098 (47.6%) not tested. On univariate analyses, patient age, insurance, income quartile, population density, treatment facility location, and tumor grade were significantly associated with HPV testing status. After multivariate logistic regression modeling, living in a suburban area had lower odds of HPV testing as compared with living in urban areas (odds ratio, 0.74 [95% CI, 0.55-0.99]; P =.041), while tumor grade III/IV had higher odds than grade I (odds ratio, 1.73 [95% CI, 1.29-2.33]; P <.001). HPV-tested patients had a similar 5-year overall survival to nontested patients (48.3% vs 45.3%, log-rank P =.405). A sharp increase in HPV testing rates was observed after 2010 (P <.001). Conclusion: Among patients with SNSCC, those with high-grade tumors were more likely to be tested for HPV, while patients with a suburban area of residence were less likely. Additionally, there was no significant survival benefit to HPV testing, with tested and nontested groups having similar overall survival. Level of evidence: 4. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: To investigate the morbidity and mortality of patients undergoing endoscopic sinus surgery (ESS) in the inpatient setting. Study Design: Retrospective database review. Methods: The Nationwide Inpatient Sample was queried for all ESS between 2008 and 2014. Using All Patients Refined Diagnosis Related Groups (APR‐DRG) codes, cases with APR‐DRG codes under Major Diagnostic Category 3 (Diseases and Disorders of the Ear, Nose, Mouth, and Throat) were designated as patients with primary otolaryngology diagnoses undergoing ESS (ORL), and all other codes were designated as patients with non‐otolaryngology pathologies as their primary reason for admission but undergoing ESS (non‐ORL). A univariate analysis and a logistic regression were used to compare patient demographics, comorbidities, disease severity, and mortality. Results: There were 8,305 ORL patients and 6,342 non‐ORL patients. ORL patients were more likely to be elective admissions (61.3% vs. 48.5%, P <.001), have a deviated nasal septum (17.9% vs. 12.3%, P <.001), nasal polyps (15.8% vs. 5.0%, P <.001), obstructive sleep apnea (10.7% vs. 5.2%, P <.001), and pulmonary disease (15.9% vs. 10.5%, P <.001). Non‐ORL patients had a higher likelihood of in‐hospital mortality (odds ratio [OR] 6.22, 95% confidence interval [CI] 3.29–11.78, P <.001), length of stay in the highest quartile (OR 2.43, 95% CI 2.16–2.74, P <.001), and a higher proportion had APR‐DRG subclasses indicating extreme severity of illness (19.3% vs. 4.3%, P <.001) or extreme risk of mortality (12.5% vs. 2.0%, P <.001). Conclusion: Patients undergoing ESS in the inpatient setting have a higher than expected mortality rate which can be associated with a non‐otolaryngology pathology as the primary reason for their admission. Level of Evidence: 4 Laryngoscope, 132:1523–1529, 2022 [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: To identify factors that may increase the risk of unplanned admission following elective outpatient endoscopic sinonasal surgery (ESS). Study Design: Retrospective analysis of the National Surgical Quality Improvement Program (NSQIP). Methods: All cases of ESS were extracted from the 2010 to 2018 NSQIP database using Current Procedural Terminology codes. Only cases coded as outpatient, elective, and nonemergent procedures were included. Unplanned admissions were defined as cases with a total hospital stay of 1 day or more. Univariate and multivariate analyses were performed to identify variables that independently predicted unanticipated admission. Results: A total of 971 cases met inclusion criteria, of which 274 (28.2%) were unanticipated admissions. Patients in the unplanned admission group were more likely to be older (46.8 vs. 41.1 years, P <.001), male (57.7% vs. 48.4%, P =.009), obese (54.8% vs. 43.8%, P =.003), and have hypertension (35.0% vs. 25.0%, P =.002). Unplanned admitted patients were also more likely to be included under American Society of Anesthesiologists (ASA) classification III‐IV (43.1% vs. 27.2%, P <.001). There were no significant differences in race, smoking, diabetes, or chronic steroid use. Unplanned admitted patients had a higher rate of surgical complications (2.9% vs. 1.0%, P =.041). Upon multivariate analysis, independent preoperative risk factors for unplanned admission included age (OR: 1.018, P =.002), male gender (OR: 1.415, P =.025), obesity (OR: 1.527, P =.008), and ASA III‐IV (OR 1.501, P =.018). Conclusions: Factors independently associated with unplanned admission following outpatient ESS were older age, male gender, obesity, and higher ASA. Identification of patients at risk may reduce unanticipated hospital admission after ESS. Level of Evidence: 4 Laryngoscope, 132:518–522, 2022 [ABSTRACT FROM AUTHOR]