Central auditory nervous system dysfunction (CANSD) can manifest as hearing difficulty in the absence of audiometric abnormalities. Effects of noise or jet fuel exposure on the CANS are documented in animal models and humans. This study screened military personnel using the modified Amsterdam Inventory for Auditory Disability (mAIAD) to assess whether concurrent jet fuel and noise (JFN) exposures potentiate central auditory difficulties compared to noise only exposures. A total of 48 age- and sex-matched participants were recruited: 24 military bulk fuel specialists (JFN) and 24 military personnel without jet fuel exposure. All participants completed the mAIAD, the Noise Exposure Questionnaire, and basic audiological testing. Results revealed non-significant differences in pure-tone thresholds between groups, but the JFN group had higher noise exposures. Additionally, the JFN group revealed consistently lower mAIAD scores compared to the noise only group. Interestingly, a JFN stratified subgroup reporting more listening difficulty exhibited statistically significant lower mAIAD scores in the speech intelligibility in noise subdomain. These preliminary data suggest that jet fuel exposure may potentiate noise-induced CANSD, such as speech-in-noise difficulties. Such difficulties may be more prominent among specific military personnel with combined exposures. Hearing conservation programs could add CANSD screening by use of the mAIAD.

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Objective To describe the changes in the quality of the Otolaryngology‐Head and Neck Surgery (OTOHNS) literature over the last decade, and compare it to other surgical‐based fields. Methods Based on impact factors, the top eight clinical U.S. OTOHNS journals were selected, and articles were analyzed from 2020 (Oto 2020) and compared to 2010 (Oto 2010). This was done similarly for Neurosurgery, Orthopedic, Ophthalmology, and General Surgery journals in 2020 (non‐Oto). To limit bias and account for random variability, the first 10 research articles from each journal in each group were included. Data regarding the study type, level of evidence, use of confidence intervals, and funding source were collected. Results Based on an a priori power analysis, 160 articles were analyzed for Oto 2010 and Oto 2020. Compared to Oto 2020, Oto 2010 had more level 1 and 2 evidence (12 vs. 4; p = 0.032) and less reporting of confidence intervals (10 vs. 32; p < 0.001). Comparing the top 160 articles from 2020 from Non‐Oto and OTOHNS (Oto), Non‐Oto had more level 1 and 2 evidence (19 vs. 6; p = 0.0047), more randomized controlled trials (8 vs. 1; p = 0.016), and less reporting of confidence intervals (42 vs. 58; p = 0.009). Conclusion High quality studies remain relatively scarce in the OTOHNS literature. Although reporting of confidence intervals has improved over the last decade, aggregate levels of evidence and extramurally funded studies lag behind other surgical‐based fields. Better study design will provide stronger evidence basis, in hopes of improving clinical care. Level of Evidence N/A Laryngoscope, 133:1853–1856, 2023