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Background Despite a high prevalence of chronic otitis media and related complications, many African dispensaries and clinics lack microscopes or fiberoptic equipment for examining external ear ducts and tympanic membranes. Method An alternative, inexpensive, and readily available device designed for ear wax removal is presented as a clinical ear and anterior nasal cavity examination tool. The device connects to Wi-Fi or cellular networks, providing high-definition images of the ear and anterior nasal cavity through a smartphone interface. Its use, utility, strengths, and limitations are discussed. Conclusion This paper describes a novel, cost-effective, and user-friendly device for examining the external ear, tympanic membrane, and anterior nasal cavity of patients throughout humanitarian missions.

Objectives To investigate the prevalence and the evolution of olfactory disorders (OD) related to coronavirus disease 2019 (COVID-19) in patients infected during the first and the second European waves. Methods From March 2020 to October 2020, COVID-19 patients with OD were recruited and followed over the 12-month post-infection. The following data were collected: demographic, treatments, vaccination status, and olfactory function. Olfaction was assessed with the Olfactory Disorder Questionnaire (ODQ), and threshold, discrimination, and identification (TDI) test. Outcomes were compared between patients of the first wave (group 1: wild/D614G virus) and the second wave (group 2: B.1.1.7. Alpha variant) at 1-, 3- and 12-month post-infection. Results Sixty patients completed the evaluations accounting for 33 and 27 patients in group 1 and 2, respectively. The 1-month TDI score (23.7 ± 5.3) was significantly lower in group 2 compared to group 1 (29.8 ± 8.7; p =  0.017). Proportion of normosmic patients at 1-month post-infection was significantly higher in group 1 compared to group 2 ( p =  0.009). TDI scores only significantly increased from 1- to 3-month post-infection in anosmic and hyposmic patients. Focusing on There was a negative association between the 1-month ODQ and the 1-month TDI ( r s  = − 0.493; p =  0.012). ODQ was a significant predictor of TDI scores at 3- and 12-month post-infection. The 12-month prevalence of parosmia was 60.6% in group 1 and 42.4% in group 2, respectively. There was no significant influence of oral corticosteroid treatment, adherence to an olfactory training and vaccination status on the olfactory outcomes. Conclusions Patients of the second wave (Alpha B.1.1.7. variant) reported significant higher proportion of psychophysical test abnormalities at 1-month post-infection than patients infected during the first wave (D614G virus).

Introduction: To evaluate the recovery rate of loss of smell (LOS) with objective olfactory testing in COVID-19 patients. Methods: Adults with confirmed COVID-19 and self-reported sudden LOS were prospectively recruited through a public call from the University of Mons (Belgium). Epidemiological and clinical data were collected using online patient-reported outcome questionnaires. Patients benefited from objective olfactory evaluation (Sniffin-Sticks-test) and were invited to attend for repeated evaluation until scores returned to normal levels. Results: From March 22 to May 22, 2020, 88 patients with sudden-onset LOS completed the evaluations. LOS developed after general symptoms in 44.6% of cases. Regarding objective evaluation, 22 patients (25.0%) recovered olfaction within 14 days following the onset of LOS. The smell function recovered between the 16th and the 70th day post-LOS in 48 patients (54.5%). At the time of final assessment at 2 months, 20.5% of patients ( N = 18) had not achieved normal levels of olfactory function. Higher baseline severity of olfactory loss measured using Sniffin-Sticks was strongly predictive of persistent loss ( p < 0.001). Conclusion: In the first 2 months, 79.5% of patients may expect to have complete recovery of their olfactory function. The severity of olfactory loss, as detected at the first Sniffin-Sticks-test, may predict the lack of mid-term recovery.

Objective To validate a French version of the Olfactory Disorders Questionnaire (Fr-ODQ). Methods Patients with olfactory disorder (OD) and controls were enrolled from two medical centers. Individuals completed the Fr-ODQ and the French version of the sinonasal outcome tool-22 (SNOT-22). The extended Sniffin'Sticks procedure was used to test odor Threshold, Discrimination, and Identification (TDI). Cronbach’s alpha was used to measure the internal consistency of Fr-ODQ. The reliability and the external validity were evaluated through a test–retest approach and by correlating Fr-ODQ and SNOT-22 scores. Results Eighty-nine patients with OD and 65 healthy individuals completed the evaluations. The Cronbach’s alpha was 0.827, reporting adequate internal consistency. The test–retest reliability was high ( r s  = 0.944, p  = 0.001). The external validity was adequate regarding the significant correlation between Fr-ODQ and SNOT-22 ( r s  = 0.498; p  = 0.001). Patients with OD reported a significant higher score of Fr-ODQ than healthy individuals ( p  < 0.001), indicating a high internal validity. The baseline Fr-ODQ significantly improved after 3-month olfactory training, which corroborated the improvement of TDI scores. Conclusion The Fr-ODQ is the first patient-reported outcome questionnaire validated for French speaking patients. Fr-ODQ is reliable and valid for the evaluation of the olfactory dysfunction and the related impact on quality of life of French-speaking patients.

Objective Obstructive sleep apnea is an independent risk factor for cardiovascular diseases, particularly resistant hypertension. For patients who are noncompliant or unable to tolerate continuous positive airway pressure therapy, surgical treatment may serve as a viable alternative. In this study, we evaluated the impact of multilevel sleep surgery on blood pressure levels in patients with resistant hypertension. Methods This is a bicentric retrospective observational study of 50 patients with severe obstructive sleep apnea and resistant hypertension who underwent multilevel targeted sleep surgery. Results Clinical improvement was objectively confirmed by polygraphy performed 6 months after surgery, demonstrating a significant reduction in the mean Apnea–Hypopnea Index from 44.98 ± 14.94 to 22.16 ± 7.30 (P < 0.005). Furthermore, the adjusted mean preoperative systolic blood pressure decreased from 150 ± 14.77 to 124 ± 17.14 mmHg (P < 0.001), while diastolic blood pressure decreased from 94 ± 5.3 to 80 ± 7.2 mmHg (P < 0.001). Notably, 20 patients (40%) no longer required antihypertensive medication after surgery. Discussion To the best of our knowledge, this study is the first clinical trial to evaluate the efficacy of multilevel surgery in improving resistant systemic hypertension in patients with multilevel airway obstruction and severe obstructive sleep apnea syndrome. Conclusions This study highlights the potential of multilevel sleep surgery as an effective intervention for improving blood pressure control in patients with resistant hypertension and severe obstructive sleep apnea.

Purpose Tracheoesophageal speech is considered the gold standard for rehabilitation following total laryngectomy. The main reason of voice prosthesis failure is the endoprosthesis leakage. Provox ActiValve ® incorporates a magnet-based valve system to achieve active closure of the valve to treat these leakages, with the drawback of being significantly more expensive. The aim of the study was to compare the Provox Vega ® and Provox ActiValve ® duration and costs in patients with replacements increase due to endoprosthetic leakage. Methods Prospective case-crossover study in laryngectomized patients with Provox Vega ® and endoprosthesis leakage to whom a Provox ActiValve ® was placed. Survival and possible factors that affect voice prosthesis were studied using Kaplan–Meier curves and Cox Proportional Hazards Regression. Cost-effectiveness analysis from the perspective of the Spanish Public National Health System with incremental cost-effectiveness calculation was performed. Results A total of 159 prostheses were evaluated. The most frequent reason for replacement was the endoprosthesis leakage ( N  = 129; 83.77%) in both models. The mean duration-time of Provox Vega ® was 44.77 ± 2.82 days (CI 95%, 39.18–50.35; median 36 days), and 317.34 ± 116.8 days (CI 95% 86.66–548; median 286 days) for the Provox ActiValve ® ( p  < 0.000). For every replacement not made thanks to the Provox ActiValve ® there was saving of 133.97€ Conclusions The Provox ActiValve ® is a cost-effective solution in patients with increased prosthesis replacements due to endoprosthetic leakage, reducing the number of changes and cost compared to Provox Vega ® .

(1) Background: Oral cavity cancer represents the most common site of origin of head and neck mucosal malignancies. A few limited studies have suggested that chronic irritation, particularly in non-healing ulcers, and fibrotic tissue from poor dentition or ill-fitting dentures had a role in developing mouth cancer. This scoping review aims to evaluate the existing evidence concerning Oral Cavicty Cancer (OCC) in non-smokers/non-drinkers and the relationship with dental trauma. (2) Methods: A scoping review of the PubMed, Embase, and Web of Science databases was completed in adherence with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews checklist. (3) Results: Of the 33 articles that met inclusion, in 6 of them authors discussed the role of topography in dental trauma, in 11 articles authors discussed the carcinogenesis mechanism involved in chronic mucosal trauma, in 17 articles data on ill-fitting dentures was included, 4 studies dealt with the effect of broken/sharp teeth on mucosal damage, and in 7 studies the role of oral hygiene was covered. Less frequently discussed topics included gender, risk of neck nodes, and the role of potentially malignant oral disorders. (4) Conclusions: The available literature suggests a potential connection between chronic dental trauma and the development of OCC. Studies have highlighted factors such as denture use and ill-fitting dental appliances as contributors to an increased risk of oral cancer. Interestingly, we still miss data to support the hypothesis that women, particularly those without toxic habits like smoking or alcohol consumption, appear to be disproportionately affected by oral cancer related to chronic dental trauma.

Introduction Chatbot generative pre-trained transformer (ChatGPT) is a new artificial intelligence-powered language model of chatbot able to help otolaryngologists in practice and research. We investigated the accuracy of ChatGPT-3.5 and -4 in the referencing of manuscripts published in otolaryngology. Methods ChatGPT-3.5 and ChatGPT-4 were interrogated for providing references of the top-30 most cited papers in otolaryngology in the past 40 years including clinical guidelines and key studies that changed the practice. The responses were regenerated three times to assess the accuracy and stability of ChatGPT. ChatGPT-3.5 and ChatGPT-4 were compared for accuracy of reference and potential mistakes. Results The accuracy of ChatGPT-3.5 and ChatGPT-4.0 ranged from 47% to 60%, and 73% to 87%, respectively ( p  < 0.005). ChatGPT-3.5 provided 19 inaccurate references and invented 2 references throughout the regenerated questions. ChatGPT-4.0 provided 13 inaccurate references, while it proposed only one invented reference. The stability of responses throughout regenerated answers was mild ( k  = 0.238) and moderate ( k  = 0.408) for ChatGPT-3.5 and 4.0, respectively. Conclusions ChatGPT-4.0 reported higher accuracy than the free-access version (3.5). False references were detected in both 3.5 and 4.0 versions. Practitioners need to be careful regarding the use of ChatGPT in the reach of some key reference when writing a report.

Idiopathic rhinitis represents more than 50% of non-allergic rhinitis, a heterogeneous group that involves the symptomatic inflammation of the nasal mucosa. The TRPV1 receptor of unmyelinated C-type neurons appears to be involved in its pathophysiology. Histamine, whose main catabolic enzyme is DAO, is one of the mediators that can activate this receptor. The failure of DAO causes an increase in the level of histamine in the body and, consequently, the activation of TRPV1. The objective was to investigate the existence of a DAO enzyme activity deficit in idiopathic rhinitis and its correlation with symptoms. A cross-sectional study was conducted in 116 idiopathic rhinitis patients, and DAO activity, nasal peak inspiratory flow, and rhinitis severity were recorded. The prevalence of a DAO activity deficit was 41.38% (95%CI 0.33–0.50; p = 0.05). The DAO activity in patients with mild rhinitis was 52.93 ± 8.72 HDU/mL, in those with moderate rhinitis it was 120.33 ± 71.63 HDU/mL, and in those with severe rhinitis it was 92.58 ± 27.75 HDU/mL (p = 0.006). The NPIF in patients with a DAO activity deficit was 107.92 ± 34.05 L/min, compared to 72.35 ± 27.16 L/min in patients with normal enzymatic activity (p < 0.001), demonstrating a linear correlation between activity levels and nasal obstruction (−0.45; p < 0.001). Therefore, patients with a DAO deficiency and idiopathic rhinitis could present a milder disease course, because the repeated and continuous activation of TRPV1 led to a partial or total decrease in their response (desensitization). This new theory represents a different perspective for the study of idiopathic rhinitis and its relationship with TRPV1, with the regulation or modulation of the desensitization of TRPV1 being an important therapeutic target for patients with idiopathic rhinitis in the future.

Objectives To evaluate the reliability and validity of the Artificial Intelligence Performance Instrument (AIPI). Methods Medical records of patients consulting in otolaryngology were evaluated by physicians and ChatGPT for differential diagnosis, management, and treatment. The ChatGPT performance was rated twice using AIPI within a 7-day period to assess test–retest reliability. Internal consistency was evaluated using Cronbach’s α . Internal validity was evaluated by comparing the AIPI scores of the clinical cases rated by ChatGPT and 2 blinded practitioners. Convergent validity was measured by comparing the AIPI score with a modified version of the Ottawa Clinical Assessment Tool (OCAT). Interrater reliability was assessed using Kendall’s tau. Results Forty-five patients completed the evaluations (28 females). The AIPI Cronbach’s alpha analysis suggested an adequate internal consistency ( α  = 0.754). The test–retest reliability was moderate-to-strong for items and the total score of AIPI ( r s  = 0.486, p  = 0.001). The mean AIPI score of the senior otolaryngologist was significantly higher compared to the score of ChatGPT, supporting adequate internal validity ( p  = 0.001). Convergent validity reported a moderate and significant correlation between AIPI and modified OCAT ( r s  = 0.319; p  = 0.044). The interrater reliability reported significant positive concordance between both otolaryngologists for the patient feature, diagnostic, additional examination, and treatment subscores as well as for the AIPI total score. Conclusions AIPI is a valid and reliable instrument in assessing the performance of ChatGPT in ear, nose and throat conditions. Future studies are needed to investigate the usefulness of AIPI in medicine and surgery, and to evaluate the psychometric properties in these fields.