{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T05:16:04Z","timestamp":1790831764722,"version":"4.1.0"},"reference-count":51,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T00:00:00Z","timestamp":1596499200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100013482","name":"beryl institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013482","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>The purpose of this study was to explore the use of immersive and interactive virtual reality (VR) for analgesia, anxiety reduction, and overall satisfaction in patients undergoing outpatient postoperative debridements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Randomized crossover\u2010controlled trial.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic outpatient clinic.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Adult patients who had functional endoscopic sinus surgery and skull base surgery and were undergoing office\u2010based postoperative nasal endoscopy and debridement were recruited and followed for 2 consecutive office visits. Participants were randomized to receive either the control or experimental analgesia for the first postoperative visit (PO1) and crossed over into the opposite treatment arm during the second postoperative visit (PO2). Outcomes included procedural pain, anxiety and satisfaction scores, procedural time, and reflexive head movements per minute (RHM).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010two participants were recruited. At PO1, 39 received standard analgesia, and 43 received an immersive VR experience. At PO1, the VR group experienced significantly less anxiety (<jats:italic>P<\/jats:italic> =. 043) and fewer RHM (<jats:italic>P<\/jats:italic> =. 00016) than the control group. At PO2, the VR group experienced significantly fewer RHM (<jats:italic>P<\/jats:italic> =. 0002). At PO2, patients who received the experimental treatment after initially receiving the control treatment had significantly decreased pain, anxiety, and RHM. This effect was not seen in the second group. Overall, 69.51% of patients felt that the VR treatment was better; 19.51% thought that it was the same; and 9.76% found it to be worse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VR technology holds promise as a nonpharmacologic analgesic and anxiolytic intervention for otolaryngology office\u2010based procedures. Further study of VR use in other procedures is warranted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence:<\/jats:title><jats:p>1, randomized controlled trial.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599820942215","type":"journal-article","created":{"date-parts":[[2020,8,4]],"date-time":"2020-08-04T04:11:44Z","timestamp":1596514304000},"page":"580-588","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":36,"title":["Virtual Reality as Distraction Analgesia for Office\u2010Based Procedures: A Randomized Crossover\u2010Controlled Trial"],"prefix":"10.1002","volume":"164","author":[{"given":"Mingyang L.","family":"Gray","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Y.","family":"Goldrich","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean","family":"McKee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Schaberg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Del Signore","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Govindaraj","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred Marc","family":"Iloreta","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,8,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000064"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.7205\/MILMED-D-13-00343"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00457.2012"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.wnr.0000127826.73576.91"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.10244"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(99)00275-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2004.06.013"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2006.04.006"},{"issue":"1","key":"e_1_2_10_10_1","first-page":"27","article-title":"Interactivity influences the magnitude of virtual reality analgesia","volume":"2","author":"Wender R","year":"2009","journal-title":"J Cyber Ther Rehabil"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000270205.45146.db"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-5-1"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0b013e3182777904"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1089\/cyber.2014.0058"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e318164d2cc"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2011.11.010"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2009.06.199"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2010.07.007"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.12626"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/BCR.0000000000000019"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.burns.2008.08.017"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1177\/1043454218782138"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jopan.2017.12.010"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1089\/109493103322725450"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.chi.0000135621.23145.05"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1089\/cpb.2006.9.207"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/jpepsy\/jsx129"},{"issue":"8","key":"e_1_2_10_28_1","article-title":"Comparison between the analgesic effect of two techniques on the level of pain perception during venipuncture in children up to 7 years of age: a quasi\u2010experimental study","volume":"8","author":"Gupta HV","year":"2014","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/jspn.12201"},{"issue":"6","key":"e_1_2_10_30_1","first-page":"593","article-title":"Virtual reality as a distraction intervention for older children receiving chemotherapy","volume":"26","author":"Schneider SM","year":"2000","journal-title":"Pediatr Nurs"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8010002"},{"issue":"3","key":"e_1_2_10_32_1","first-page":"219","article-title":"The effect of virtual reality on pain in primiparity women during episiotomy repair: a randomize clinical trial","volume":"40","author":"JahaniShoorab N","year":"2015","journal-title":"Iran J Med Sci"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.2217\/pmt-2017-0040"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.3233\/PRM-180534"},{"issue":"1","key":"e_1_2_10_35_1","article-title":"Effects of distraction using virtual reality glasses during lumbar punctures in adolescents with cancer","volume":"29","author":"Sander Wint S","year":"2002","journal-title":"Oncol Nurs Forum"},{"issue":"4","key":"e_1_2_10_36_1","first-page":"117","article-title":"The impact of virtual reality distraction on pain and anxiety during dental treatment in 4\u20106 year\u2010old children: a randomized controlled clinical trial","volume":"6","author":"Asl Aminabadi N","year":"2012","journal-title":"J Dent Res Dent Clin Dent Prospects"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0200987"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2017.0935"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199-198909000-00006"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-198501040-00007"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10484-011-9174-x"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.1089\/g4h.2015.0046"},{"key":"e_1_2_10_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejca.2007.06.002"},{"key":"e_1_2_10_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/SMJ.0b013e31828de613"},{"key":"e_1_2_10_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.12087"},{"key":"e_1_2_10_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-8258(03)00147-1"},{"issue":"10","key":"e_1_2_10_47_1","first-page":"631","article-title":"Patient anxiety during gynecologic examinations: behavioral indicators","volume":"42","author":"Reddy DM","year":"1997","journal-title":"J Reprod Med"},{"key":"e_1_2_10_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21121"},{"key":"e_1_2_10_49_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0167523"},{"issue":"6","key":"e_1_2_10_50_1","first-page":"527","article-title":"The frequency of occurrence and severity of side\u2010effects of immersion virtual reality","volume":"65","author":"Regan EC","year":"1994","journal-title":"Aviat Space Environ Med"},{"key":"e_1_2_10_51_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2007.09.004"},{"key":"e_1_2_10_52_1","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/151702"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820942215","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599820942215","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599820942215","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T13:37:30Z","timestamp":1760967450000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599820942215"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,4]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1177\/0194599820942215"],"URL":"https:\/\/doi.org\/10.1177\/0194599820942215","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,4]]},"assertion":[{"value":"2019-09-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-06-22","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2020-08-04","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}