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The use of structured reports (SR) has been shown to improve report completeness, time efficiency and interrater reliability in head and neck sonography (HNS). However, no data exists to date on the influence on report accuracy in terms of correct interpretation of findings. The aim of this study was to evaluate report accuracy as well as completeness using SR and free text reports (FTR). 128 participants of certified HNS courses were randomly assigned to create either SRs or FTR of predefined clinical cases. Demographic data, clinical training level and ultrasound experience of participants were documented prior to randomization. Each case included ultrasound images and clinical histories representing typical pathologies in HNS. Reports were independently evaluated by DEGUM-certified otorhinolaryngologists using standardized templates with respect to accuracy and completeness. SR demonstrated significantly higher accuracy ( p  < 0.001) as well as completeness ( p  < 0.001) compared to FTR. A strong positive correlation was found between completeness and accuracy using SR ( r  = 0.30, p  < 0.01) only. Additionally, use of SR was the only significant predictor of improved report accuracy ( p  < 0.01) and completeness ( p  < 0.01). Structured reporting significantly improves both completeness and accuracy in head and neck ultrasound reports. The use of SR may contribute to more consistent reporting quality in clinical and educational settings.

Even today, surgical reports are usually dictated in a free text form (FTR), leading to a wide range in report-quality. This study investigated the use of a fully structured panendoscopy report (SR) compared to FTRs. 64 panendoscopies were performed by three experienced head and neck surgeons. The surgical reports were created as both FTRs and SRs, which were examined regarding time to completion and content using a multilevel regression analysis. User satisfaction was evaluated using a questionnaire. There was no significant difference in time to complete the SRs compared to FTRs. The completeness ratings of SRs were significantly higher than for FTRs (81% vs. 66%, p  < 0.001), leading to increased report quality. Overall user satisfaction was higher for SRs than for conventional FTRs (VAS 8.1 vs. 3.5, p  < 0.001). The SRs proved to be fast to complete and more comprehensive with a higher completeness of content. Participating surgeons indicated that they preferred SRs over FTRs because of their advantages in terms of structure, guidance for inexperienced residents and non-native speakers. The data stratification also enables secondary data use to further develop deep learning algorithms in patient care and research.

Computed tomography (CT) scans represent the gold standard in the planning of functional endoscopic sinus surgeries (FESS). Yet, radiologists and otolaryngologists have different perspectives on these scans. In general, residents often struggle with aspects involved in both reporting and operation planning. The aim of this study was to compare the completeness of structured reports (SR) of preoperative CT images and structured operation planning (SOP) to conventional reports (CR) and conventional operation planning (COP) to potentially improve future treatment decisions on an individual level. In total, 30 preoperative CT scans obtained for surgical planning of patients scheduled for FESS were evaluated using SR and CR by radiology residents. Subsequently, otolaryngology residents performed a COP using free texts and a SOP using a specific template. All radiology reports and operation plannings were evaluated by two experienced FESS surgeons regarding their completeness for surgical planning. User satisfaction of otolaryngology residents was assessed by using visual analogue scales. Overall radiology report completeness was significantly higher using SRs regarding surgically important structures compared to CRs (84.4 vs. 22.0%, p<0.001). SOPs produced significantly higher completeness ratings (97% vs. 39.4%, p<0.001) regarding pathologies and anatomical variances. Moreover, time efficiency was not significantly impaired by implementation of SR (148 s vs. 160 s, p = 0.61) and user satisfaction was significantly higher for SOP (VAS 8.1 vs. 4.1, p<0.001). Implementation of SR and SOP results in a significantly increased completeness of radiology reports and operation planning for FESS. Consequently, the combination of both facilitates surgical planning and may decrease potential risks during FESS.

Background/Objectives: Somnological findings are often written as free texts, supported by questionnaires. The quality and structure of free-text reports (FTRs) vary between examiners and specialties, depending on the individual level of expertise and experience in sleep medicine. This study aimed to compare the quality of free-text reports (FTRs) and structured reports (SRs) from somnological consultations in otolaryngology for patients assessed for obstructive sleep apnea (OSA). Methods: This study compared free-text reports (FTRs) and structured reports (SRs) from 50 patients with suspected OSA, including medical history, clinical examination findings, and medical letters, all prepared by six examiners with similar experience levels. A web-based approach was used to develop a standardized template for structured somnological reporting. The completeness and time required for both FTRs and SRs were evaluated, and a questionnaire was administered to assess user satisfaction with each reporting method. Results: The completeness scores of SRs were significantly higher than those of FTRs (88% vs. 54.2%, p < 0.001). The mean time to complete an SR was significantly shorter than that for FTRs (10.2 vs. 16.8 min, p < 0.001). SRs had significantly higher user satisfaction compared to FTRs (VAS 8.3 vs. 2.2, p < 0.001). Conclusions: Compared to FTRs, SRs for OSA patients are more comprehensive and faster. The use of SR is more satisfactory for examiners and supports the learning effect.

Preservation of residual hearing remains a great challenge during cochlear implantation. Cochlear implant (CI) electrode array insertion induces changes in the microvasculature as well as nitric oxide (NO)-dependent vessel dysfunction which have been identified as possible mediators of residual hearing loss after cochlear implantation. A total of 24 guinea pigs were randomized to receive either a CI ( = 12) or a sham procedure (sham) by performing a cochleostomy without electrode array insertion ( = 12). The hearing threshold was determined using frequency-specific compound action potentials. To gain visual access to the stria vascularis, a microscopic window was created in the osseous cochlear lateral wall. Cochlear blood flow (CBF) and cochlear microvascular permeability (CMP) were evaluated immediately after treatment, as well as after 1 and 2 h, respectively. Finally, cochleae were resected for subsequent immunohistochemical analysis of the iNOS expression. The sham control group showed no change in mean CBF after 1 h (104.2 ± 0.7%) and 2 h (100.8 ± 3.6%) compared to baseline. In contrast, cochlear implantation resulted in a significant continuous decrease in CBF after 1 h (78.8 ± 8.1%, < 0.001) and 2 h (60.6 ± 11.3%, < 0.001). Additionally, the CI group exhibited a significantly increased CMP (+44.9% compared to baseline, < 0.0001) and a significant increase in median hearing threshold (20.4 vs. 2.5 dB SPL, = 0.0009) compared to sham after 2 h. Intriguingly, the CI group showed significantly lower iNOS-expression levels in the organ of Corti (329.5 vs. 54.33 AU, = 0.0003), stria vascularis (596.7 vs. 48.51 AU, < 0.0001), interdental cells (564.0 vs. 109.1 AU, = 0.0003) and limbus fibrocytes (119.4 vs. 18.69 AU, = 0.0286). Mechanical and NO-dependent microvascular dysfunction seem to play a pivotal role in residual hearing loss after CI electrode array insertion. This may be facilitated by the implantation associated decrease in iNOS expression. Therefore, stabilization of cochlear microcirculation could be a therapeutic strategy to preserve residual hearing.

In Germany, progress assessments in head and neck ultrasonography training have been carried out mainly theoretically and lack standardisation. Thus, quality assurance and comparisons between certified courses from various course providers are difficult. This study aimed to develop and integrate a direct observation of procedural skills (DOPS) in head and neck ultrasound education and explore the perceptions of both participants and examiners. Five DOPS tests oriented towards assessing basic skills were developed for certified head and neck ultrasound courses on national standards. DOPS tests were completed by 76 participants from basic and advanced ultrasound courses (n = 168 documented DOPS tests) and evaluated using a 7-point Likert scale. Ten examiners performed and evaluated the DOPS after detailed training. The variables of “general aspects” (6.0 Scale Points (SP) vs. 5.9 SP; p = 0.71), “test atmosphere” (6.3 SP vs. 6.4 SP; p = 0.92), and “test task setting” (6.2 SP vs. 5.9 SP; p = 0.12) were positively evaluated by all participants and examiners. There were no significant differences between a basic and advanced course in relation to the overall results of DOPS tests (p = 0.81). Regardless of the courses, there were significant differences in the total number of points achieved between individual DOPS tests. DOPS tests are accepted by participants and examiners as an assessment tool in head and neck ultrasound education. In view of the trend toward “competence-based” teaching, this type of test format should be applied and validated in the future.

Digitalization offers significant potential benefits to ultrasound education. This study compares the effectiveness of webinar teaching against face-to-face teaching in providing theoretical competencies in certified head and neck ultrasound (HNUS) courses. This prospective, controlled, multicenter study was conducted in 2023 at three universities with certified HNUS courses. One course used webinar lessons (S), and the others used face-to-face teaching (C). The control group courses (C) were held on two consecutive days. The first day of the study group course was held as a webinar (S) 1 week before the second day and was also recorded for preparatory purposes. All participants completed three assessments: a pre-course self-evaluation (Evaluation ), a post-course self-evaluation (Evaluation ), and a post-course theory test (Theory Test ). The evaluations used a Likert scale (1-7) to record the participants' subjective assessments of competencies and attitudes toward webinar teaching. Theory Test included multiple-choice and free-answer questions on the sonographic pathologies of lymph nodes, the soft tissue of the neck, and salivary glands. A group of inexperienced medical students (V) completed the Theory Test for validation purposes. 128 data sets were analyzed (31 S; 30 C; 47 V). Both groups, S and C, rated their competencies after the courses significantly higher than before (  < 0.01) but at a similar level in comparison with each other (  = 0.34). Both groups supported teaching theoretical content through webinars (S: 6.7 ± 0.5 vs. C: 6.2 ± 0.9). Both groups achieved similar results in the Theory Test (  = 0.54), significantly outperforming the validation group (  < 0.001). Our data suggest that webinars can be an effective alternative to face-to-face lessons in teaching theoretical competencies in HNUS. Participants gave overall positive evaluations of digital teaching methods. Our findings support evidence that digital learning methods are valuable for modern ultrasound education.

Background: Computed tomography (CT)-based image-guided surgery (IGS) is of great importance in functional endoscopic sinus surgery (FESS) and requires IGS-specific imaging protocols to ensure high intraoperative accuracy. This study aimed to compare photon-counting CT (PCCT), dual-energy dual-source CT (DECT), and spectral detector CT (SDCT) of the paranasal sinuses with respect to image quality, IGS accuracy and radiation dose. Methods: A formalin-fixed cadaver skull was examined using PCCT, DECT and SDCT at 100 kV tube voltage with descending tube currents (mAs). The setup of electromagnetic IGS was evaluated using a visual analog scale. Accuracy was analyzed endoscopically using defined anatomical landmarks. Diagnostic image quality as well as bone and soft tissue noise were assessed qualitatively using a 5-point Likert scale and quantitatively by determination of signal-to-noise ratio. Radiation dose was evaluated using the dose length product. Results: While PCCT datasets could be registered and navigated accurately down to 10 mAs (1.5 mm error at 10 mAs), both DECT and SDCT exhibited significantly increased inaccuracies below 40 mAs (4.35/5.15 mm for DECT/SDCT at 25 mAs). Using PCCT therefore enabled a 45% radiation dose reduction at the minimally required dose length product using PCCT. Quantitative and qualitative image quality were superior for PCCT compared to DECT and SDCT. Conclusions: PCCT provides excellent accuracy of anatomical landmarks in IGS with superior image quality of the paranasal sinuses in low-mA scans and substantially reduced radiation exposure.

The chorioallantoic-membrane (CAM)-assay is an established model for in vivo tumor research. Contrary to rodent-xenograft-models, the CAM-assay does not require breeding of immunodeficient strains due to native immunodeficiency. This allows xenografts to grow on the non-innervated CAM without pain or impairment for the embryo. Considering multidirectional tumor growth, limited monitoring capability of tumor size is the main methodological limitation of the CAM-assay for tumor research. Enclosure of the tumor by the radiopaque eggshell and the small structural size only allows monitoring from above and challenges established imaging techniques. We report the eligibility of ultrasonography for repetitive visualization of tumor growth and vascularization in the CAM-assay. After tumor ingrowth, ultrasonography was repetitively performed in ovo using a commercial ultrasonographic scanner. Finally, the tumor was excised and histologically analyzed. Tumor growth and angiogenesis were successfully monitored and findings in ultrasonographic imaging significantly correlated with results obtained in histological analysis. Ultrasonography is cost efficient and widely available. Tumor imaging in ovo enables the longitudinal monitoring of tumoral development, yet allowing high quantitative output due to the CAM-assays simple and cheap methodology. Thus, this methodological novelty improves reproducibility in the field of in vivo tumor experimentation emphasizing the CAM-assay as an alternative to rodent-xenograft-models.