Evaluating ChatGPT-4's performance as a digital health advisor for otosclerosis surgery.

Purpose: This study aims to evaluate the effectiveness of ChatGPT-4, an artificial intelligence (AI) chatbot, in providing accurate and comprehensible information to patients regarding otosclerosis surgery. Methods: On October 20, 2023, 15 hypothetical questions were posed to ChatGPT-4 to simulate physician-patient interactions about otosclerosis surgery. Responses were evaluated by three independent ENT specialists using the DISCERN scoring system. The readability was evaluated using multiple indices: Flesch Reading Ease (FRE), Flesch-Kincaid Grade Level (FKGL), Gunning Fog Index (Gunning FOG), Simple Measure of Gobbledygook (SMOG), Coleman-Liau Index (CLI), and Automated Readability Index (ARI). Results: The responses from ChatGPT-4 received DISCERN scores ranging from poor to excellent, with an overall score of 50.7 ± 8.2. The readability analysis indicated that the texts were above the 6th-grade level, suggesting they may not be easily comprehensible to the average reader. There was a significant positive correlation between the referees' scores. Despite providing correct information in over 90% of the cases, the study highlights concerns regarding the potential for incomplete or misleading answers and the high readability level of the responses. Conclusion: While ChatGPT-4 shows potential in delivering health information accurately, its utility is limited by the level of readability of its responses. The study underscores the need for continuous improvement in AI systems to ensure the delivery of information that is both accurate and accessible to patients with varying levels of health literacy. Healthcare professionals should supervise the use of such technologies to enhance patient education and care.

Evaluating the Success of ChatGPT in Addressing Patient Questions Concerning Thyroid Surgery.

OBJECTIVE: This study aimed to evaluate the utility and efficacy of ChatGPT in addressing questions related to thyroid surgery, taking into account accuracy, readability, and relevance. METHODS: A simulated physician-patient consultation on thyroidectomy surgery was conducted by posing 21 hypothetical questions to ChatGPT. Responses were evaluated using the DISCERN score by 3 independent ear, nose and throat specialists. Readability measures including Flesch Reading Ease), Flesch-Kincaid Grade Level, Gunning Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, and Automated Readability Index were also applied. RESULTS: The majority of ChatGPT responses were rated fair or above using the DISCERN system, with an average score of 45.44 ± 11.24. However, the readability scores were consistently higher than the recommended grade 6 level, indicating the information may not be easily comprehensible to the general public. CONCLUSION: While ChatGPT exhibits potential in answering patient queries related to thyroid surgery, its current formulation is not yet optimally tailored for patient comprehension. Further refinements are necessary for its efficient application in the medical domain.

Comprehensiveness of online sources for patient education on otosclerosis.

Purpose: This study aimed to assess the readability indices of websites including educational materials on otosclerosis. Methods: We performed a Google search on 19 April 2023 using the term "otosclerosis." The first 50 hits were collected and analyzed. The websites were categorized into two groups: websites for health professionals and general websites for patients. Readability indices were calculated using the website https://www.webfx.com/tools/read-able/. Results: A total of 33 websites were eligible and analyzed (20 health professional-oriented and 13 patient-oriented websites). When patient-oriented websites and health professional-oriented websites were individually analyzed, mean Flesch Reading Ease scores were found to be 52.16 ± 14.34 and 46.62 ± 10.07, respectively. There was no significant difference between the two groups upon statistical analysis. Conclusion: Current patient educational material available online related to otosclerosis is written beyond the recommended sixth-grade reading level. The quality of good websites is worthless to the patients if they cannot comprehend the text.

Caregiver Burnout in Pediatric Laryngomalacia: The Role of Clinical and Psychological Factors.

INTRODUCTION: This study aims to assess caregiver burnout in relation to children diagnosed with laryngomalacia and identify factors influencing burnout levels. MATERIALS AND METHODS: A cohort of 101 caregivers of children with laryngomalacia was studied. Burnout was assessed using the Zarit burden interview (ZBI), while the Hamilton anxiety and Hamilton depression scales were employed to gauge psychological distress. The relationship between burnout and variables like the severity of laryngomalacia, the presence of comorbidities, the child's age, and caregiver demographics was examined using statistical tools in SPSS Statistics version 28.0 (IBM Corp., Armonk, NY, USA). RESULTS: Caregiver burnout decreased as the child's age increased. A direct correlation was observed between the severity of laryngomalacia and caregiver burnout. The presence of comorbidities in children increased caregiver burnout. Moreover, caregivers with increased levels of depression and anxiety exhibited higher burnout levels. No significant correlation was found between caregiver burnout and socioeconomic status or educational level. CONCLUSION: The severity of laryngomalacia, the child's age, the presence of comorbidities, and caregivers' psychological health are significant influencers of caregiver burnout. Healthcare professionals should offer targeted support to caregivers, addressing both their physical and psychological needs.

Effectiveness of Training: Airway Management of Tracheostomized Pediatric Patients by Pediatric Residents and Anesthesiology Residents.

To evaluate the effect of training on increasing baseline knowledge of pediatrics and anesthesia residents about airway management of pediatric patients with tracheostomy. It is a prospective, descriptive, before and after survey study. A questionnaire was conducted to measure the baseline knowledge of pediatrics and anesthesia residents about airway management in patients with pediatric tracheotomy. The same questionnaire was repeated after the education. Of the 63 participants, 42 were pediatric residents and 21 were anesthesiology residents. While the number of participants who answered the cuff part, inner cannula part, obturator part and balloon part of the tracheostomy tube correctly before the training was 27, 4, 10, and 12, respectively, these numbers increased to 53, 52, 57, and 55 after the training. There was a statistically significant improvement after the training in the correct response of the cuff, inner cannula, obturator, and balloon sections. A statistically significant improvement was observed in the answers received after the training for all 7 questions regarding the clinical scenario of accidental decannulation and tracheostomy bleeding compared to the pre-training. There was a statistical improvement in part where the participants rated themselves. In conclusion, training increases the ability of healthcare professionals to cope with life-threatening complications related to pediatric tracheotomy. A standardized education program on pediatric tracheostomy should be included in the routine programs of associated departments such as emergency medicine, anesthesia, and pediatrics residencies.

Comprehensiveness of online sources for patient education on hereditary hearing impairment.

Introduction: The present study aimed at investigating the readability of online sources on hereditary hearing impairment (HHI). Methods: In August 2022, the search terms "hereditary hearing impairment", "genetic deafness", hereditary hearing loss", and "sensorineural hearing loss of genetic origin" were entered into the Google search engine and educational materials were determined. The first 50 websites were determined for each search. The double hits were removed and websites with only graphics or tables were excluded. Websites were categorized into either a professional society, a clinical practice or a general health information website. The readability tests to evaluate the websites included: Flesch Reading Ease, Flesch-Kincaid grade level, Gunning-Fog Index, Simple Measure of Gobbledygook, Coleman-Liau Index, Automated Readability Index. Results: Twentynine websites were included and categorized as from 4 professional societies, 11 from clinical practices and 14 providing general information. All analyzed websites required higher reading levels than sixth grade. On average 12-16 years of education is required to read and understand the websites focused on HHI. Although general health information websites have better readability, the difference was not statistically significant. Discussion: The readability scores of every type of online educational materials on HHI are above the recommended level indicating that not all patients and parents can comprehend the information they seek for on these websites.

Evaluating YouTube as a source of patient information for pediatric tracheostomy care.

OBJECTIVES: To evaluate YouTube's usefulness as a source of information concerning pediatric tracheostomy care. MATERIALS AND METHODS: On August 10, 2022, the top 50 YouTube search results for "pediatric tracheostomy care" were displayed. Each video was evaluated by a jury of three otolaryngologists with at least 2 years of professional experience in pediatric otolaryngology using DISCERN, scoring system of Journal of the American Medical Association (JAMA), and the Global Quality Score (GQS). RESULTS: After exclusion criteria 24 videos were evaluated. Fifteen of the evaluated videos were produced by health professionals, and the other nine videos were produced by independent users. The average duration of the videos were 337.5 s, varying between 82 s and 1364 s. The average Discern score of videos produced by health professionals was 38.9 ± 13, compared to 36.6 ± 14 for independent users. The mean JAMA score was 1.04 ± 0.68 for health professionals and 1.11 ± 0.94 for independent users. The GQS score was 2.82 ± 0.73 for health professionals and 3.19 ± 0.84 for independent users. There was no statistically significant difference between the two groups for Discern, JAMA, and GQS scoring. CONCLUSION: YouTube does not seem to be a good option for parents to get useful information about pediatric tracheostomy care at this time. Health professionals should provide websites with high-quality materials to improve awareness of pediatric tracheostomy care.

Anatomical and functional long-term results of endoscopic butterfly inlay myringoplasty.

PURPOSE: The aim of this study was to evaluate the long-term anatomical (graft success) and functional (audiological) results of endoscopic butterfly inlay myringoplasty. METHODS: The files of 56 patients (29 female, 27 male) who were diagnosed with noncomplicated chronic otitis media and underwent endoscopic butterfly inlay myringoplasty in 2014-2016 at a tertiary referral center were reviewed. Age, gender, follow-up time, perforation location (anterior, posterior and central), perforation size (small, medium), pre- and postoperative pure tone audiometry (PTA) thresholds, pre- and postoperative air-bone gaps (ABG) and complications were noted. RESULTS: Graft success rate was 98.2% in postoperative 12th month and 94.6% in postoperative 24th month. In all patients, mean PTA for air conduction was 35.2 ± 3.9 dB preoperatively and 27.5 ± 4.3 dB in postoperative 6th month, 25.1 ± 3.5 dB in postoperative 12th month and 20.4 ± 3.2 in postoperative 24th month. Preoperative mean ABG was 24.2 ± 3.8 dB, whereas 19.5 ± 4.3 dB 6 months after surgery, 17.1 ± 3.5 dB 12 months after surgery and 12.4 ± 3.1 dB 24 months after surgery. There was significant difference between pre- and postoperative PTA and ABG in all 6th, 12th, 24th month follow-up (p = 0.001 for all measurements). Three patients (5%) had myringitis after surgery. Two patients (3%) had total graft resorption. CONCLUSION: We suggested that endoscopic butterfly inlay myringoplasty is a safe surgical method with high graft success and effective hearing reconstruction. Follow-up is necessary for at least 2 years for precise anatomical and functional evaluation of the surgery.

Impact of Nasal Septal Surgery on Sleep Quality and Attention-Deficit/Hyperactivity Disorder.

OBJECTIVE: To evaluate the effect of nasal septal surgery on quality of life. METHODS: A total of 49 patients who underwent septoplasty and/or inferior turbinate radiofrequency operations for nasal septal deviation and inferior turbinate hypertrophy were prospectively enrolled in the study. All patients completed the adult attention-deficit/hyperactivity disorder scale (ADHD scale) and Pittsburgh sleep quality index (PSQI) before and after septoplasty. Acoustic rhinometric measurements were also recorded. RESULTS: Acoustic rhinometric measurements and PSQI showed statistically significant improvement after nasal surgery (P < 0.05), but no statistically significant difference was present between pre- and postoperative ADHD scores (P > 0.05). CONCLUSION: Besides the functional improvement of septoplasty, a long-lasting improvement in the quality of life is observed in patients with that undergo this surgery.

Pleomorphic adenoma of the larynx.

Pleomorphic adenoma (PA) is the most common benign neoplasm of the salivary glands. It usually occurs in major salivary glands, such as the parotid and submandibular glands. Occasionally, however, it occurs in the larynx. These lesions generally present as a slow-growing, painless mass. Malignant transformation is very rare, but it increases with time. The present report is the case of a 59-year-old male who presented with a complaint of hoarseness. Right vertical partial hemilaryngectomy revealed an intact, mucosa-covered, fleshy 2×1.5×1 cm mass in the supraglottic area of the larynx. Lesion had histological characteristics of a PA, and this was confirmed by immunohistochemical expression of cytokeratin, S100 protein, Glial fibrillary acidic protein (GFAP) and vimentin. Their histopathological identification is, however, not always straightforward; immunohistochemistry can contribute significantly to formulation of a definitive diagnosis and to the realization of appropriate follow-up.

Change in nasal congestion index after treatment in patients with chronic rhinosinusitis with nasal polyposis.

BACKGROUND: The management of chronic rhinosinusitis with nasal polyposis (CRSwNP) involves both surgical and medical approaches, and remains a controversial subject. OBJECTIVE: The objective of this prospective, randomized, controlled trial was to compare the medical and surgical treatments of CRSwNP in terms of their effect on the nasal congestion index (NCI). METHODS: Forty-eight patients with CRSwNP were randomized either to medical or surgical therapy. Pretreatment and 3- and 6-month posttreatment assessments of the visual analog scale score, the 20-Item Sino-Nasal Outcome Test, saccharine clearance time, nasal endoscopy, and NCI measurement with acoustic rhinometry were performed. Forty-one subjects were included in the analysis. RESULTS: Both the medical and surgical interventions for CRSwNP resulted in significant improvement in the visual analog scale score, 20-Item Sino-Nasal Outcome Test, saccharine clearance time, and nasal endoscopic examination scores. There was no difference between the two groups in terms of the percentage change from baseline for any of the parameters at the 6-month posttreatment assessment. NCI showed no significant difference from baseline. Similarly, no significant difference was found between the medical and surgical groups in terms of their effect on the NCI (p > 0.05). CONCLUSION: Because NCI does not correlate with standard subjective measures in outcomes for this group of patients, it cannot be used as an outcome measurement of treatment of subjects with CRSwNP. Results of this prospective randomized study did not find any additional benefit of surgical therapy over medical therapy in subjects with CRSwNP.