Browsing by Author "Illing, Elisa"

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    Epithelial–Myoepithelial Carcinoma of the Lacrimal Sac and Literature Review of the Lacrimal System
    (SAGE Publishing, 2020-04-20) Sharma, Dhruv; Neiweem, Ashley; Davis, Kyle; Prendes, Mark; Chundury, Rao; Illing, Elisa; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background Epithelial–myoepithelial carcinomas make up less than 0.1% of head and neck malignancies and are regarded as rare, low-grade malignant neoplasms of the salivary gland. They are thought to arise from intercalated ducts with histopathology showing a classic biphasic morphology of an outer layer of myoepithelial cells and inner layer of epithelial cells. These tumors most commonly occur in the parotid gland; however, rare cases have also been described in the nasal cavity, nasopharynx, subglottis, base of tongue, and the lacrimal gland. Objective To describe the clinical presentation, surgical management, and histopathology of the first reported case of lacrimal sac epithelial–myoepithelial carcinoma. To conduct a literature review of this malignancy, which is present in the lacrimal system. Methods Case report (n = 1) and literature review. Results We report a case of a 72-year-old man presenting with epiphora and a lacrimal sac mass with intranasal extension on imaging and nasal endoscopy. A combined endoscopic endonasal and open approach provided successful definitive treatment for final pathologic diagnosis of epithelial–myoepithelial carcinoma of the lacrimal sac, with orbital reconstruction and lacrimal stenting providing good cosmetic and functional results. Conclusions After PubMed database search for any case series or reports of lacrimal system epithelial–myoepithelial carcinomas, we believe this is the first documented case originating from the lacrimal sac. Although the histopathology of this tumor is distinct, unusual location and clinical presentation may pose significant diagnostic difficulties.
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    Is ChatGPT 3.5 smarter than Otolaryngology trainees? A comparison study of board style exam questions
    (Public Library of Science, 2024-09-26) Patel, Jaimin; Robinson, Peyton; Illing, Elisa; Anthony, Benjamin; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Objectives: This study compares the performance of the artificial intelligence (AI) platform Chat Generative Pre-Trained Transformer (ChatGPT) to Otolaryngology trainees on board-style exam questions. Methods: We administered a set of 30 Otolaryngology board-style questions to medical students (MS) and Otolaryngology residents (OR). 31 MSs and 17 ORs completed the questionnaire. The same test was administered to ChatGPT version 3.5, five times. Comparisons of performance were achieved using a one-way ANOVA with Tukey Post Hoc test, along with a regression analysis to explore the relationship between education level and performance. Results: The average scores increased each year from MS1 to PGY5. A one-way ANOVA revealed that ChatGPT outperformed trainee years MS1, MS2, and MS3 (p = <0.001, 0.003, and 0.019, respectively). PGY4 and PGY5 otolaryngology residents outperformed ChatGPT (p = 0.033 and 0.002, respectively). For years MS4, PGY1, PGY2, and PGY3 there was no statistical difference between trainee scores and ChatGPT (p = .104, .996, and 1.000, respectively). Conclusion: ChatGPT can outperform lower-level medical trainees on Otolaryngology board-style exam but still lacks the ability to outperform higher-level trainees. These questions primarily test rote memorization of medical facts; in contrast, the art of practicing medicine is predicated on the synthesis of complex presentations of disease and multilayered application of knowledge of the healing process. Given that upper-level trainees outperform ChatGPT, it is unlikely that ChatGPT, in its current form will provide significant clinical utility over an Otolaryngologist.
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    YouTube Videos Demonstrating the Nasopharyngeal Swab Technique for SARS-CoV-2 Specimen Collection: Content Analysis
    (JMIR, 2021-01) Itamura, Kyohei; Wu, Arthur; Illing, Elisa; Ting, Jonathan; Higgins, Thomas; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background: Real-time polymerase chain reaction using nasopharyngeal swabs is currently the most widely used diagnostic test for SARS-CoV-2 detection. However, false negatives and the sensitivity of this mode of testing have posed challenges in the accurate estimation of the prevalence of SARS-CoV-2 infection rates. Objective: The purpose of this study was to evaluate whether technical and, therefore, correctable errors were being made with regard to nasopharyngeal swab procedures. Methods: We searched a web-based video database (YouTube) for videos demonstrating SARS-CoV-2 nasopharyngeal swab tests, posted from January 1 to May 15, 2020. Videos were rated by 3 blinded rhinologists for accuracy of swab angle and depth. The overall score for swab angle and swab depth for each nasopharyngeal swab demonstration video was determined based on the majority score with agreement between at least 2 of the 3 reviewers. We then comparatively evaluated video data collected from YouTube videos demonstrating the correct nasopharyngeal swab technique with data from videos demonstrating an incorrect nasopharyngeal swab technique. Multiple linear regression analysis with statistical significance set at P=.05 was performed to determine video data variables associated with the correct nasopharyngeal swab technique. Results: In all, 126 videos met the study inclusion and exclusion criteria. Of these, 52.3% (66/126) of all videos demonstrated the correct swab angle, and 46% (58/126) of the videos demonstrated an appropriate swab depth. Moreover, 45.2% (57/126) of the videos demonstrated both correct nasopharyngeal swab angle and appropriate depth, whereas 46.8% (59/126) of the videos demonstrated both incorrect nasopharyngeal swab angle and inappropriate depth. Videos with correct nasopharyngeal swab technique were associated with the swab operators identifying themselves as a medical professional or as an Ear, Nose, Throat–related medical professional. We also found an association between correct nasopharyngeal swab techniques and recency of video publication date (relative to May 15, 2020). Conclusions: Our findings show that over half of the videos documenting the nasopharyngeal swab test showed an incorrect technique, which could elevate false-negative test rates. Therefore, greater attention needs to be provided toward educating frontline health care workers who routinely perform nasopharyngeal swab procedures.