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Key points: EPX activity has been correlated with eCRS diagnosis and baseline disease severity.Herein, EPX activity is shown to correlate with post‐operative antibiotic and steroid use in CRS.EPX activity has potential to act as a prognostic biomarker of CRS disease severity and control. [ABSTRACT FROM AUTHOR]

Key Points AI‐based CT sinus analysis may have advantages over visual based systems, for example, Lund–Mackay score. Here, we show multi‐institutional validation of an AI algorithm using novel OMC classification. Significant, robust correlations are seen between algorithm outputs and clinical outcomes. AI‐based CT sinus analysis may have advantages over visual based systems, for example, Lund–Mackay score.Here, we show multi‐institutional validation of an AI algorithm using novel OMC classification.Significant, robust correlations are seen between algorithm outputs and clinical outcomes. [ABSTRACT FROM AUTHOR]

This article, published in the Journal of Neurological Surgery, explores the factors that contribute to the recurrence of Cushing's disease (CD) after transsphenoidal surgery. The study analyzed data from the Registry of Adenomas of the Pituitary and Related Disorders (RAPID) database, which included 383 CD patients. The results showed that patients who experienced recurrence had a longer postoperative hospital stay, larger tumor volumes, and a higher rate of failed prior treatment. Younger age and the absence of cavernous sinus invasion were identified as potential protective factors against recurrence. The findings suggest that early detection and treatment of tumors may improve outcomes for CD patients. [Extracted from the article]

Objective: The study aimed to investigate otolaryngologists' knowledge, trust, acceptance, and concerns with clinical applications of artificial intelligence (AI). Methods: This study used mixed methods with survey and semistructured interviews. Survey was e‐mailed to American Rhinologic Society members, of which a volunteer sample of 86 members responded. Nineteen otolaryngologists were purposefully recruited and interviewed until thematic saturation was achieved. Results: Seventy‐six respondents (10% response rate) completed the majority of the survey: 49% worked in academic settings and 43% completed residency 10 or fewer years ago. Of 19 interviewees, 58% worked in academic settings, and 47% completed residency 10 or fewer years ago. Familiarity: Only 8% of survey respondents reported having AI training in residency, although 72% had familiarity with general AI concepts; 0 interviewees had personal experience with AI in clinical settings. Expected uses: Of the surveyed otolaryngologists, 82% would use an AI‐based clinical decision aid and 74% were comfortable with AI proposing treatment recommendations. However, only 44% of participants would trust AI to identify malignancy and 53% to interpret radiographic images. Interviewees trusted AI for simple tasks, such as labeling septal deviation, more than complex ones, such as identifying tumors. Factors influencing AI adoption: 89% of survey participants would use AI if it improved patient satisfaction, 78% would be willing to use AI if experts and studies validated the technologies, and 73% would only use AI if it increased efficiency. Sixty‐one percent of survey respondents expected AI incorporation into clinical practice within 5 years. Interviewees emphasized that AI adoption depends on its similarity to their clinical judgment and to expert opinion. Concerns included nuanced or complex cases, poor design or accuracy, and the personal nature of physician‐patient relationships. Conclusion: Few physicians have experience with AI technologies but expect rapid adoption in the clinic, highlighting the urgent need for clinical education and research. Otolaryngologists are most receptive to AI "augmenting" physician expertise and administrative capacity, with respect for physician autonomy and maintaining relationships with patients. Level of Evidence: Level VI, descriptive or qualitative study. [ABSTRACT FROM AUTHOR]

Background: Collection of biologic samples from the nasal cavity and paranasal sinuses is of critical importance to the study of infectious or inflammatory conditions that affect both upper and lower airways. Numerous techniques for the study of ex‐vivo samples exist, with specific applications, strengths, and weaknesses associated with each of them. In this compendium we summarize the available methods for collection of primary human samples and incorporate expert discussion of the pros, cons, and applications associated with each technique. Methods: An expert panel containing members of the American Rhinologic Society's Research and Grants Committee compiled this educational reference. Rationale for use and the potential advantages and disadvantages are discussed. Research protocols and key references are enumerated. Results: Sampling of the nasal cavity and paranasal sinuses can be achieved through a number of methods. Nonspecific sinonasal secretions may be collected via forced exhalation, nasal lavage, and nasal spray aspiration. Targeted collection of sinonasal secretions may be achieved via endoscopic placement of absorbent matrices. Nasal cytology or collection of superficial epithelium may be completed via brushing or scraping of endonasal structures. Collection of mucosal biopsies may be completed via sinonasal explant or full‐thickness biopsy. Conclusion: Multiple sampling techniques are available to collect biologic samples from the sinonasal cavity. These techniques differ in their ease of application, reproducibility, sample yield, and utility for different sinonasal pathologies or research goals. An appreciation of the benefits and drawbacks of each approach will allow investigators to select the techniques most appropriate for achieving research objectives. [ABSTRACT FROM AUTHOR]

Objective: The role of elective neck dissection (END) in patients with stage I (T1N0) and II (T2N0) squamous cell carcinoma of the oral cavity remains a controversial topic. We investigate the need for END by establishing a true incidence of occult nodal disease as a function of T stage DATA SOURCES: MEDLINE, Google Scholar, Scopus.Review Methods: Studies were selected using a set of inclusion and exclusion criteria. Meta-analysis using a random-effects model was employed to generate an odds ratio (OR) comparing the incidence of occult metastasis between T1 and T2 tumors, as well as regional recurrence rates between patients receiving END versus observation.Results: Thirty-nine publications comprising five randomized controlled trials and 34 retrospective studies were selected for inclusion, yielding over 4,300 patients for analysis. The overall incidence of occult nodal metastasis, weighted by study size, was found to be 23%. Patients with T2 tumors have a significantly higher odds of having occult nodal disease (OR: 2.6, 95% confidence interval [CI]: 2.0-3.4) over patients with T1 tumors. We also demonstrate that for patients who are observed, the odds of recurrence are significantly higher (OR: 4.18, 95% CI: 2.78-6.28) compared to those who undergo END, although statistically significant interstudy heterogeneity was observed.Conclusions: END should be reserved for stage II tumors given the significantly higher rate of occult metastasis. Observation may be more appropriate for stage I cancers. Laryngoscope, 129:E284-E298, 2019. [ABSTRACT FROM AUTHOR]