Is ChatGPT accurate and reliable in answering questions regarding head and neck cancer?

Background and objective: Chat Generative Pre-trained Transformer (ChatGPT) is an artificial intelligence (AI)-based language processing model using deep learning to create human-like text dialogue. It has been a popular source of information covering vast number of topics including medicine. Patient education in head and neck cancer (HNC) is crucial to enhance the understanding of patients about their medical condition, diagnosis, and treatment options. Therefore, this study aims to examine the accuracy and reliability of ChatGPT in answering questions regarding HNC. Methods: 154 head and neck cancer-related questions were compiled from sources including professional societies, institutions, patient support groups, and social media. These questions were categorized into topics like basic knowledge, diagnosis, treatment, recovery, operative risks, complications, follow-up, and cancer prevention. ChatGPT was queried with each question, and two experienced head and neck surgeons assessed each response independently for accuracy and reproducibility. Responses were rated on a scale: (1) comprehensive/correct, (2) incomplete/partially correct, (3) a mix of accurate and inaccurate/misleading, and (4) completely inaccurate/irrelevant. Discrepancies in grading were resolved by a third reviewer. Reproducibility was evaluated by repeating questions and analyzing grading consistency. Results: ChatGPT yielded "comprehensive/correct" responses to 133/154 (86.4%) of the questions whereas, rates of "incomplete/partially correct" and "mixed with accurate and inaccurate data/misleading" responses were 11% and 2.6%, respectively. There were no "completely inaccurate/irrelevant" responses. According to category, the model provided "comprehensive/correct" answers to 80.6% of questions regarding "basic knowledge", 92.6% related to "diagnosis", 88.9% related to "treatment", 80% related to "recovery - operative risks - complications - follow-up", 100% related to "cancer prevention" and 92.9% related to "other". There was not any significant difference between the categories regarding the grades of ChatGPT responses (p=0.88). The rate of reproducibility was 94.1% (145 of 154 questions). Conclusion: ChatGPT generated substantially accurate and reproducible information to diverse medical queries related to HNC. Despite its limitations, it can be a useful source of information for both patients and medical professionals. With further developments in the model, ChatGPT can also play a crucial role in clinical decision support to provide the clinicians with up-to-date information.

Age at diagnosis, neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognoticators in pediatric sinonasal rhabdomyosarcoma.

BACKGROUND: The relationship between pretreatment blood parameters and clinical outcomes of patients with pediatric sinonasal rhabdomyosarcomas has not been described. The purpose of this study was to determine the prognostic factors and certain laboratory parameters that affect the survival and long-term survival in pediatric sinonasal rhabdomyosarcoma. METHODS: Medical records of pediatric sinonasal rhabdomyosarcoma cases who were treated and followed up between 2004 and 2020 in Hacettepe University were retrospectively reviewed. The relationship between clinical features, laboratory parameters and survival was investigated. RESULTS: Age at the time of diagnosis, pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) had significant effect on survival (p < 0,004, p < 0,037, p < 0,016, respectively). Survival rate was higher in patients younger than 10 (≤10 years of age) at the time of diagnosis (p = 0,004), patients with a NLR of 2 or below (≤2) (p = 0,037), and patients with a PLR of 150 or below (≤150) (p = 0,016). ≤ 10 years of age at the time of diagnosis was found as an independent prognostic factor affecting survival (hazard ratio [HR], 5382; 95 % confidence interval [CI], 1476- 19,623; P = 0,011). In addition, a pretreatment PLR of 150 or below (≤150) was found as another independent prognostic factor that affects survival (hazard ratio [HR], 4386; 95 % confidence interval [CI], 1161- 16,567; P = 0,029). CONCLUSIONS: Preoperative NLR and PLR may be important parameters to predict the prognosis of pediatric sinonasal rhabdomyosarcoma. Further research with larger patient groups are warranted.

Candidate Angiogenesis-Related Biomarkers in Patients with Laryngeal Carcinoma (AngLaC): A Prospective Cohort Study.

OBJECTIVE: Angiogenesis is indeed a vital process in the progression of carcinomas, including that of larynx. Therefore, this study (AngLaC) aimed to identify candidate angiogenesis-related biomarkers in laryngeal carcinoma patients. STUDY DESIGN: Prospective controlled cohort study. SETTING: Tertiary referral center. METHODS: In silico analyses of angiogenesis-related genes in laryngeal carcinoma were performed to determine candidate biomarkers. Serum levels of candidate biomarkers were determined via enzyme-linked immunosorbent assay in laryngeal carcinoma patients as well as in an age and gender-matched control group. The associations of the biomarkers with clinical parameters were investigated. RESULTS: The study included 60 laryngeal carcinoma patients and 20 healthy controls. The serum levels of osteopontin, IGFBP-3, VEGF, sVEGFR-1, and VEGFR-2 were significantly higher in the patient group (p < .001, p ≤ .001, p < .001, p < .01, p < .01, respectively). High osteopontin and sVEGFR-1 levels were associated with locoregional-recurrence (p = .024, p = .016, respectively). IGFBP-3 had the highest diagnostic sensitivity (81.4%) and specificity (80%) among the molecules that were investigated (p < .001). High sVEGFR-1 and low VEGFR-2 levels were associated with poor overall-survival (p = .037, p = .027, respectively). High osteopontin and sVEGFR-1 levels were associated with poor disease-specific survival rates (p = .035, p = .018, respectively). CONCLUSION: High serum levels of sVEGFR-1 and osteopontin as well as low serum levels of VEGFR-2 proved to be poor prognostic in terms of survival in laryngeal carcinoma. VEGF, sVEGFR1, VEGFR2, IGFBP-3, and osteopontin levels were found to be significantly increased in larynx cancer patients compared to the normal population. Further studies on osteopontin and sVEGFR-1 are required in order to determine their associations with recurrence.

The Efficacy of Gabapentin + Dexamethasone for Postoperative Analgesia Following Septoplasty: A Prospective Randomized Placebo-Controlled Trial.

AIMS: This study aimed to compare the efficacy of gabapentin, dexamethasone, and gabapentin + dexamethasone for pain control after septoplasty. MATERIALS AND METHODS: This prospective randomized trial included 120 patients that underwent septoplasty and were randomly divided into 4 groups: group G (preoperative gabapentin 600 mg p.o.); group D (intraoperative dexamethasone 8 mg i.v.); group GD (preoperative gabapentin 600 mg p.o. + intraoperative dexamethasone 8 mg i.v.); group C (placebo control). RESULTS: The median VAS score was significantly lower in groups G and GD at 1, 2, 4, 6, 12, and 24 hours postsurgery than in group C (P < .008 for all). The median VAS score was significantly lower in group D than in group C at 1, 2, and 4 hours postsurgery (P < .008 for all). There weren't any significant differences in the VAS score between groups D, G, and GD at any time point. Groups G, D, and GD had a significantly lower frequency of rescue analgesic use than group C; however, there were no differences between groups G, GD, and C (P < .001 and P = .108, respectively). CONCLUSION: Gabapentin, dexamethasone, and gabapentin + dexamethasone are equally more effective analgesics during the first 4 hours postsurgery than placebo. The addition of dexamethasone to gabapentin does not provide extra analgesia. Both gabapentin and gabapentin + dexamethasone have a more prolonged analgesic effect than dexamethasone alone.

Powered Micro-saw Versus Conventional Osteotome for Septorhinoplasty: A Prospective, Double-Blind, Comparative Study.

BACKGROUND: Various powered instruments are used to perform osteotomy. A consensus on the best method has not been established due to discrepancies in previous studies. This study aimed to compare the conventional osteotome and a powered micro-saw during septorhinoplasty. METHODS: The single-center, prospective cohort study included 60 patients that were grouped into two groups of 30 each. Group 1 underwent open septorhinoplasty using a conventional osteotome, and group 2 underwent open septorhinoplasty using a powered micro-saw. Postoperative edema, ecchymosis, pain, and nasal blockage were compared between groups. Preoperative and postoperative (6 months) functional and aesthetic outcomes were compared based on FACE-Q, SNOT-22, and T-NOSE scores. RESULTS: There were not any differences in age, gender, follow-up duration, the Brinkman index, or level of education between groups. Postoperative pain scores were significantly lower in group 2 on d 1 and d 3 postsurgery. Nasal blockage scores were significantly higher in group 1 on d 3 and d 7 postsurgery. Edema and ecchymosis scores were similar in both groups at all time points. Preoperative and postoperative (6 months) functional and aesthetic outcomes were also similar in both groups. CONCLUSION: Osteotomy using a powered micro-saw is an effective technique that results in less postoperative pain and nasal blockage than when using conventional osteotome. Early postoperative period edema and ecchymosis scores and long-term functional and aesthetic outcomes are similar when using a powered micro-saw and a conventional osteotome. Osteotomy using a powered micro-saw can be considered an alternative to using a conventional osteotome. LEVEL OF EVIDENCE II: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Olfactory acuity based on Brief Smell Identification Test (BSITⓇ) in migraine patients with and without aura: A cross-sectional, controlled study.

OBJECTIVE: The aim of this study was to evaluate olfactory acuity in migraine patients with and without aura (MwA and MwoA) MATERIAL AND METHODS: The study included 30 MwA patients, 30 MwoA patients, and 30 age- and gender-matched controls. Demographic features and odor-related symptoms (osmophobia, odor offensiveness, and odor-triggered attack status) were noted. Olfactory acuity was measured using the Brief Smell Identification Test (BSIT®), a 12-item derivative of the University of Pennsylvania Smell Identification Test (UPSIT®). BSIT® scores were compared between the migraine patients and controls. RESULTS: The mean BSIT® score did not differ significantly between the MwA patients (8.7 ± 0.9) and MwoA (9.17 ± 0.9) patients (P = 0.094); however, the mean score in the control group was higher (10.4 ± 0.6) than in the MwA and MwoA patients (P < 0.001). The mean BSIT® score did not differ significantly between patients with and without odor-triggered migraine attacks (9 ± 0.9 and 8.8 ± 0.8, respectively) (P = 0.4). Osmophobia and odor-triggered attacks were more common in the MwA patients than in the MwoA patients (odor-triggered attacks: 66% vs. 40% [P = 0.04]; osmophobia: 76.6% vs. 60% [P = 0.16]) CONCLUSION: Olfactory acuity is lower during attack-free periods in migraine patients, as compared to controls. Migraine aura status does not affect olfactory acuity. Odor-triggered attacks, osmophobia, and offensive odors between attacks were more common in the MwA patients than in the MwoA patients.

Laryngomalacia: patient outcomes following aryepiglottoplasty at a tertiary care center.

Laryngomalacia is the most common cause of stridor in neonates and infants. Most cases are mild and resolve spontaneously without treatment. Only severe cases with intolerable symptoms require surgical intervention; in such cases, supraglottoplasty is considered the treatment of choice. The aim of this study was to review and present the outcomes in patients with laryngomalacia who underwent aryepiglottoplasty-a type of supraglottoplasty. The medical records of children diagnosed as laryngomalacia who were followed up at Hacettepe University Hospital, Department of Otorhinolaryngology, between 2007 and 2012 were reviewed retrospectively. The study included 16 children who required surgical intervention. The mean age of the 16 children included in the study was 133 days (range: 7 days-48 months). Among the patients, 9 (56%) were male and 7 (44%) were female. In all, 7 patients (44%) had a comorbid condition. Laryngomalacia diagnoses were as follows: type I: n = 2, 13%; type II: n = 13, 81%; type III: n= 1, 6%. Stridor completely resolved in 10 of the children who underwent aryepiglottoplasty. Three patients required tracheotomy and 3 required revision supraglottoplasty; these six cases were considered as failed surgical treatment. The aryepiglottoplasty success rate was 63%. None of the patients had any intraoperative or postoperative complications. Despite the primarily benign nature of laryngomalacia, comorbid conditions can exacerbate symptoms and negatively affect the prognosis. Aryepiglottoplasty can be performed with high success and low complication rates in properly selected patients.