Objective To evaluate the relationship between Twitter mentions and academic citations in otolaryngology literature. Study Design Retrospective cross-sectional analysis. Setting Altmetric Twitter mention and Google Scholar citation rosters. Methods Original research articles from 10 leading otolaryngology journals were assessed 26 months after print publication. Article Twitter mentions were tracked through the Altmetric Bookmarklet, and article citation data were determined through the Google Scholar search engine. Twitter mentions and citation metrics of articles were compared through 2-tailed t test analysis ( P < .05). Results Of all articles, 50.7% (152/300) had at least 1 Twitter mention. Of all article Twitter mentions, 25% (432/1758) happened within the first week of online publication dates, while 64% (1130/1758) occurred between online and print publication dates. Articles mentioned on Twitter had 1.6-fold more Google Scholar citations (8.6 ± 0.7, mean ± SD) than articles with no Twitter mentions (5.4 ± 0.4, P < .01). A total of 8% (24/300) of publications were tweeted by their authors. Articles self-tweeted by authors were associated with an 8.4-citation increase (14.8 ± 3.1) for Google Scholar when compared with articles not shared by their authors on Twitter (6.4 ± 0.4; 2.3-fold increase, P < .01). Conclusion Most otolaryngology articles are disseminated over Twitter, with greatest Twitter activity occurring before print publication date of articles. Citations within 2 years of release are positively associated with the number of mentions on Twitter. Article Twitter mentions may augment the academic influence of otolaryngology publications.
Background: The current global COVID-19 pandemic is caused by the novel coronavirus Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Given that SARS-CoV-2 is highly transmissible, surgical societies have recommended that procedures with a high risk of aerosolization be avoided or delayed. However, some high-risk procedures, such as those related to head and neck malignancies, cannot always be delayed. Care must be taken during aerosol-generating procedures to minimize viral transmission as much as possible. Preoperative testing for COVID-19, limited operating room personnel, adequate personal protective equipment, and surgical technique are factors to consider for high-risk procedures. Methods: This article presents the case of an awake tracheotomy performed for a transglottic mass causing airway obstruction. Results: With detailed planning and specific techniques, the amount of aerosolization was reduced, and the procedure was performed as safely as possible. Conclusion: This case provides a template for future aerosol-generating procedures during respiratory pandemics.
Objective To analyze how the COVID‐19 pandemic has influenced trends in head and neck squamous cell carcinoma (HNSCC) presentation and diagnosis—including referral patterns, stage at presentation, and time to diagnosis—over a longitudinal time course. Setting Multicenter tertiary care academic institution. Methods A retrospective review of patients with HNSCC presenting between January 1, 2019 and December 31, 2020 was performed. Patients were stratified into pre‐COVID and COVID cohorts based upon presentation date either before or after the COVID pandemic was declared a national emergency. Data was collected on demographics, referral site, symptoms, tumor characteristics, and time to diagnosis. Results Of 203 patients with HNSCC identified, 77.3% (157/203) were in the pre‐COVID cohort and 22.7% (46/203) were in the COVID cohort. Patients in the COVID cohort were more likely to present through inpatient or ER consultation (26% vs. 11%) than outpatient setting. There was a greater than 50% decrease in new tumor board case presentations per month in the COVID cohort (4.8) relative to the pre‐COVID (10.9) cohort. Cancer stage at presentation was similar between cohorts. Time from presentation to diagnosis was similar between the cohorts at approximately 30 days. Conclusions These results suggest that patients presenting during the COVID pandemic may have unique referral patterns. A significant decrease in tumor board presentations was noted, which may contribute to more delayed presentations that have yet to be observed. Further investigation with a larger sample size is warranted. Lay Summary The COVID‐19 pandemic may have changed where and how patients with head and neck cancer initially seek care. We found that patients with newly diagnosed head and neck cancer more often were initially seen in urgent settings than before the pandemic. Level of Evidence 3
Objectives: To present a novel location in which neurosarcoidomatous inflammation is identified and its accompanying presentation. Methods: The authors present a case of bilateral vocal fold paresis associated with non-caseating granulomatous inflammation of the cervical and intra-axial portions of the vagus nerve masquerading as a cranial nerve tumor. Results: Examination revealed bilateral vocal fold paresis and asymmetric palate elevation. MRI demonstrated enhancing bilateral jugular foramen masses, and neck ultrasound demonstrated bilateral thickened appearance of the vagus nerves. Vagus nerve biopsy demonstrated non-caseating granulomas. Conclusions: Neurosarcoidosis may contribute to variable cranial neuropathies. Vocal fold paresis is usually thought to arise from mediastinal compression of the left recurrent laryngeal nerve. Rarely, though, lesions may arise in other parts of the vagus nerve. Failure of response to steroids does not rule out the diagnosis, making tissue diagnosis important in some cases.
This ChatGPT-driven case report describes a unique presentation of neurosarcoidosis. The patient, a 58year-old female, initially presented with hoarseness and was found to have bilateral jugular foramen tumors and thoracic lymphadenopathy. Imaging revealed significant enlargement and thickening of the vagus nerve and a separate mass of the cervical sympathetic trunk. The patient was referred for an ultrasound-guided biopsy of the abnormal neck masses to establish a pathologic diagnosis. The patient subsequently underwent neck dissection for exposure of the vagus nerve and isolation of the great vessels in preparation for a transmastoid approach to the skull base. The presence of multifocal tumors prompted the need for a biopsy, which ultimately revealed sarcoid granulomas in the nervous system. The patient was diagnosed with neurosarcoidosis. This case highlights the potential for sarcoidosis to affect the nervous system, with multiple cranial nerve involvement, seizures, and cognitive impairment. It also emphasizes the need for a combination of clinical, radiological, and pathological findings for an accurate diagnosis of neurosarcoidosis. Additionally, this case highlights the utility of natural language processing (NLP), as the entire case report was written using ChatGPT. This report serves as a comparison of the quality of case reports generated by humans versus NLP algorithms. The original case report can be found in the references.
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