1,721,003 research outputs found
Democratizing cancer detection: artificial intelligence-enhanced endoscopy could address global disparities in head and neck cancer outcomes
No full textIntroduction: This article explores the potential role of artificial intelligence (AI) in enhancing the early detection and diagnosis of head and neck squamous cell carcinoma (HNSCC). Discussion: The latest data reflecting the growing disparity in HNSCC incidence and mortality across different regions and socioeconomic groups are reviewed, stressing the importance of early detection in improving outcomes. The potential role of AI in improving the accuracy and consistency of endoscopic procedures, particularly in resource-limited settings with limited access to specialized healthcare is discussed. By analyzing current technologies and case studies, the review highlights how AI can democratize access to early cancer detection, improve survival rates, and reduce the financial burden on patients. The integration of AI into healthcare systems can lead to significant cost savings and enhanced accessibility, particularly in underserved populations, where HNSCC is projected to rise dramatically in the coming decades
From data analysis to paper writing: How Artificial intelligence is changing the face of scientific literature
No full textComments on: “Vocal Cord Leukoplakia Classification Using Siamese Network Under Small Samples of White Light Endoscopy Images”
No full textGood and bad indications for adjuvant radiotherapy after transoral laser microsurgery for laryngeal cancer
No full textPurpose of review To summarize current evidence regarding the indication of adjuvant treatment after transoral laser microsurgery (TOLMS).Recent findings Apart from well known risk factors, margins represent the key point in the decision-making.If margins are affected, additional treatment is mandatory.One exception could be the presence of one superficial margin in early tumors that can be strictly followed up by fiberendoscopy.As a general rule, the best option is margin-revision surgery by repeating TOLMS or switching to open partial surgery.(Chemo) radiotherapy can be also considered, being total laryngectomy the last alternative.In locally advanced tumors with uncertain margins (e.g.posterior paraglottic space invasion, vertical anterior commissure reaching the cartilage during primary resection), adjuvant treatment may improve local control with laser but with little impact on disease-specific or overall survival.In this scenario, QoL may be in part reduced after radiotherapy, although recent studies suggest that functional outcomes are favorable.Therefore, decision should be discussed individually with the patient, especially if a total laryngectomy is the only alternative after a possible relapse.Summary Considerable work needs to be done to identify those cases that may benefit from adjuvant treatment after TOLMS, including a detailed description of functional outcomes
Exploring the landscape of AI-assisted decision-making in head and neck cancer treatment: a comparative analysis of NCCN guidelines and ChatGPT responses
No full textPurpose: Recent breakthroughs in natural language processing and machine learning, exemplified by ChatGPT, have spurred a paradigm shift in healthcare. Released by OpenAI in November 2022, ChatGPT rapidly gained global attention. Trained on massive text datasets, this large language model holds immense potential to revolutionize healthcare. However, existing literature often overlooks the need for rigorous validation and real-world applicability. Methods: This head-to-head comparative study assesses ChatGPT's capabilities in providing therapeutic recommendations for head and neck cancers. Simulating every NCCN Guidelines scenarios. ChatGPT is queried on primary treatments, adjuvant treatment, and follow-up, with responses compared to the NCCN Guidelines. Performance metrics, including sensitivity, specificity, and F1 score, are employed for assessment. Results: The study includes 68 hypothetical cases and 204 clinical scenarios. ChatGPT exhibits promising capabilities in addressing NCCN-related queries, achieving high sensitivity and overall accuracy across primary treatment, adjuvant treatment, and follow-up. The study's metrics showcase robustness in providing relevant suggestions. However, a few inaccuracies are noted, especially in primary treatment scenarios. Conclusion: Our study highlights the proficiency of ChatGPT in providing treatment suggestions. The model's alignment with the NCCN Guidelines sets the stage for a nuanced exploration of AI's evolving role in oncological decision support. However, challenges related to the interpretability of AI in clinical decision-making and the importance of clinicians understanding the underlying principles of AI models remain unexplored. As AI continues to advance, collaborative efforts between models and medical experts are deemed essential for unlocking new frontiers in personalized cancer care
Lengthening Temporalis Myoplasty: Objective Outcomes and Site-Specific Quality-of-Life Assessment
Full text linkObjective Evaluate outcomes of the lengthening temporalis myoplasty in facial reanimations. Study Design Case series with planned data collection. Setting Ospedali Riuniti, Bergamo, and AOUC Careggi, Florence, Italy. Subjects and Methods From 2011 to 2016, 11 patients underwent lengthening temporalis myoplasty; demographic data were collected for each. Pre- and postoperative photographs and videos were recorded and used to measure the smile angle and the excursion of the oral commissure, according to the SMILE system (Scaled Measurements of Improvement in Lip Excursion). All patients were tested with the Facial Disability Index, and they also completed a questionnaire about the adherence to physiotherapy indications. Results All patients demonstrated a significant improvement in functional parameters and in quality of life. On the reanimated side, the mean z-line and a-value, measured when smiling, significantly improved in all patients: from 22.6 mm (95% CI, 20.23-25.05) before surgery to 30.9 mm (95% CI, 27.82-33.99) after surgery ( P < .001) and from 100.5° (95% CI, 93.96°-107.13°) to 111.6° (95% CI, 105.63°-117.64°; P < .001), respectively. The mean postoperative dynamic gain, passing from rest to a full smile at the reanimated side, was 3.1 mm (95% CI, 1.30-4.88) for the z-line and 3.3° (95% CI, 1.26°-5.29°) for the a-value. The Facial Disability Index score increased from a preoperative mean of 33.4 points (95% CI, 28.25-38.66) to 49.9 points (95% CI, 47.21-52.60) postoperatively ( P < .001). Conclusions The lengthening temporalis myoplasty can be successfully used for smile reanimation, with satisfying functional and quality-of-life outcomes
Transoral robotic surgery in oropharyngeal squamous cell carcinoma: a comparative study between da Vinci Single-Port and da Vinci Xi systems
No full textBackground: The recently developed da Vinci single-port (SP) system offers potential advantages in maneuverability within narrower surgical spaces. This study aims to compare intra- and post-operative outcomes, technical advantages, and limitations of transoral resections using the da Vinci SP and da Vinci Xi systems for oropharyngeal squamous cell carcinoma (OPSCC).Methods: A single-center retrospective cohort study included patients with OPSCC who underwent transoral robotic surgery (TORS) after neoadjuvant chemotherapy (NCT). Data on pre-operative variables, intraoperative data, postoperative complications, and functional outcomes were collected.Results: A total of 209 patients (males: 175; mean age: 59.0 +/- 9.3) were included (SP: n = 136; Xi: n = 73). A significantly lower docking time was measured for the SP group (5.7 +/- 2.5 min vs. 10.0 +/- 4.4 min; p <.001). Similarly, the console time was reduced for the SP group though not reaching statistical significance (76.3 +/- 30.7 min vs. 88.1 +/- 36.9 min; p =.06). A greater proportion of patients showed wide negative resection margins in the SP group (71 % vs. 56 %; p =.10), although not statistically significant. No significant differences were observed in complication rates or postoperative functional outcomes.Discussion: This study demonstrates the safety and efficacy of the da Vinci SP system in oropharyngeal surgery, with potential advantages in terms of reduced docking and console times. The findings suggest that the SP system offers improved maneuverability and instrument placement compared to the da Vinci Xi system
Office-based procedures in laryngology
No full textDevelopment of transnasal fiberoptic laryngoscopy, integration of an operative channel (OC), the advent of high-definition television imaging, with improvements in laser technology, cleared the way for office-based laryngology. Three treatment categories can be identified: bioendoscopy-guided biopsy; laryngeal injection; laser-assisted surgery
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