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Otolaryngology—Head and Neck Surgery

Tal Marom, Oded Kraus, Nadeem Habashi, Sharon Ovnat Tamir
OBJECTIVE: To review new experimental techniques for the diagnosis of otitis media (OM). DATA SOURCES: Literature search in English in the following databases: MEDLINE (via PubMed), Ovid Medline, Google Scholar, and Clinical Evidence (BMJ Publishing) between January 1, 2005, and April 30, 2018. Subsequently, articles were reviewed and included only if relevant. REVIEW METHODS: MeSH terms: ["diagnosis"] AND [all forms of OM] AND ["human"] AND ["ear"] and ["tympanic membrane"]...
November 6, 2018: Otolaryngology—Head and Neck Surgery
Alan D Workman, Arjun K Parasher, Mariel T Blasetti, James N Palmer, Nithin D Adappa, Jordan T Glicksman
Large cohort studies of chronic rhinosinusitis (CRS) prevalence often include patients who have been inappropriately diagnosed with the disease. In this investigation, new patients presenting to a tertiary rhinology practice completed a screening questionnaire that included questions about self-reported CRS status, demographic information, and symptomatology. Treating rhinologists evaluated patients according to clinical practice guideline criteria for CRS; 91 patients were ultimately diagnosed with CRS. The sensitivity of self-report for CRS was 84%; the specificity was 82%; and the estimated negative predictive value ranged from 97% to 99%...
November 6, 2018: Otolaryngology—Head and Neck Surgery
Jessica D McDermott, Megan Eguchi, William A Stokes, Arya Amini, Mohammad Hararah, Ding Ding, Allison Valentine, Cathy J Bradley, Sana D Karam
OBJECTIVE: Opioid use and abuse is a national health care crisis, yet opioids remain the cornerstone of pain management in cancer. We sought to determine the risk of acute and chronic opioid use with head and neck squamous cell cancer (HNSCC) treatment. STUDY DESIGN: Retrospective population-based study. SETTING: Surveillance, Epidemiology and End Results (SEER)-Medicare database from 2008 to 2011. SUBJECTS AND METHODS: In total, 976 nondistant metastatic oral cavity and oropharynx patients undergoing cancer-directed treatment enrolled in Medicare were included...
November 6, 2018: Otolaryngology—Head and Neck Surgery
Pavlina Sverak, Meredith E Adams, Stephen J Haines, Samuel C Levine, David Nascene, Katherine Sommer, Kathryn Dusenbery, Tina C Huang, Christopher Moertel
OBJECTIVE: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Seventeen consecutive patients with NF2 received bevacizumab treatment for vestibular schwannomas, including 2 patients treated to maintain cochlear implant performance...
October 30, 2018: Otolaryngology—Head and Neck Surgery
Bruno Teixeira Moraes, Noemi Grigoletto De Biase
OBJECTIVE: To determine the prevalence of minor structural alterations (MSA) in the vocal fold cover in a population submitted to extralaryngeal site surgery and to characterize them according to morphological and epidemiological parameters. STUDY DESIGN: This was a cross-sectional and observational study. SETTING: Tertiary referral medical center. SUBJECTS AND METHODS: A total of 147 patients underwent general anesthesia for extralaryngeal site surgery indicated for a procedure extraneous to the study and irrespective of the presence of vocal complaint...
October 23, 2018: Otolaryngology—Head and Neck Surgery
Geoffrey Casazza, M Elise Graham, Douglas Nelson, David Chaulk, David Sandweiss, Jeremy Meier
OBJECTIVE: To review the presentation and treatment of children diagnosed with bacterial tracheitis at our institution and to review the available literature focusing on key presenting symptoms and clinical outcomes of children diagnosed with bacterial tracheitis. STUDY DESIGN: Case series with literature review. SETTING: Tertiary children's hospital and available literature. SUBJECTS AND METHODS: Case series of children with bacterial tracheitis retrospectively reviewed at a tertiary children's hospital...
October 23, 2018: Otolaryngology—Head and Neck Surgery
Alhasan N Elghouche, Zachary E Pflum, Cecelia E Schmalbach
OBJECTIVE: The primary objective was to define and quantify the relationship between immunosuppression and prognosis in patients with cutaneous squamous cell carcinoma of the head and neck. DATA SOURCES: Ovid/Medline, PubMed, Embase, and Scopus were searched from inception through June 5, 2017, with cross-referenced subject headings of squamous cell carcinoma, skin neoplasms, head and neck neoplasms, and prognosis. Additional gray literature was queried. REVIEW METHODS: All prospective, retrospective, and cohort studies in the English literature investigating prognosis in patients with head and neck cutaneous squamous cell carcinoma were eligible for inclusion...
October 23, 2018: Otolaryngology—Head and Neck Surgery
R Grant Muller, Madhu P Mamidala, Samuel H Smith, Aaron Smith, Anthony Sheyn
OBJECTIVES: To investigate national and regional variations in pediatric tracheostomy rates, epidemiology, and outcomes from 2000 to 2012. STUDY DESIGN: Retrospective cohort analysis. SETTING: Previous research with the 1997 edition of the Kids' Inpatient Database (KID), a national database of pediatric hospital discharge data, demonstrated that rates and outcomes of pediatric tracheostomy vary among US geographic regions. The KID has since been released an additional 5 times, increasing in size with successive editions...
October 23, 2018: Otolaryngology—Head and Neck Surgery
Derrick Tint, Collin T Stabler, Arash Hanifi, Farzad Yousefi, Gary Linkov, Kenneth Hy, Ahmed M S Soliman, Nancy Pleshko
Objective To use mid-infrared (IR) spectroscopy to assess changes in the cartilaginous framework of human trachea during decellularization. Study Design Laboratory-based study. Setting Research laboratory. Methods Six cadaveric human tracheas were decellularized using a detergent enzymatic method (DEM). Tissue samples were obtained from each specimen after 0, 1, 10, and 25 DEM cycles for histologic and spectroscopic analysis. Decellularization was confirmed using hematoxylin and eosin (H&E) and 2-(4-amidinophenyl)-1H-indole-6-carboxamidine (DAPI) staining...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Shana M Zucker, Blair M Barton, Edward D McCoul
Objective Rhinitis medicamentosa (RM) is a common condition resulting from overuse of topical nasal decongestants. Despite the prevalence in otolaryngologic practice, a clear treatment protocol has not been established. Our objective was to review the current published literature pertaining to the treatment of RM with the possibility of finding data that support one treatment over another. Data Sources PubMed, Embase, Cochrane, and Web of Science databases were examined for patients diagnosed with RM resulting from chronic use of topical nasal decongestants...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Elliot Morse, Rance J T Fujiwara, Saral Mehra
Objective To characterize the association between industry payments and prescriptions of 2 brand-name proton-pump inhibitors (PPIs). Study Design Cross-sectional retrospective. Setting Physicians nationwide. Subjects and Methods We identified all physicians receiving industry payments for Dexilant and Nexium 2014-2015 from the Open Payments database. We linked this to records of prescriptions for PPIs paid for by Medicare Part D these same years and compared the proportion of prescriptions written for Dexilant and Nexium in industry-compensated vs nonindustry compensated physicians...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Julie Bao Anh Do, Audrey Bellerive, Anne-Sophie Julien, Jacques E Leclerc
Objective To assess the dental class occlusion and lateral cephalometry of children with conservatively treated Pierre Robin sequence (PRS) and to identify associations between these findings and prepalatoplasty cleft palate measurements. Study Design Retrospective cohort study. Subjects and Methods Among 22 patients with PRS, the following data were prospectively collected: demographics and preoperative cleft palate measurements. After patients reached age 6 years, an orthodontist assessed dental occlusion class and performed a lateral cephalometric analysis...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Anirudh Saraswathula, Uchechukwu C Megwalu
Objectives To evaluate the impact of insurance status on survival among patients with major salivary gland cancer. Study Design Retrospective cohort study. Setting SEER program. Subjects and Methods We included patients aged <65 years diagnosed with major salivary gland cancers from 2007 to 2013. Those aged ≥65 years were excluded due to issues ascertaining insurance status. The independent variable was insurance status (insured, uninsured, or Medicaid); the primary outcome measure was overall survival (OS); and the secondary outcome measure was disease-specific survival (DSS)...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Theresa Tharakan, Sydney Jiang, Judd Fastenberg, Thomas J Ow, Bradley Schiff, Richard V Smith, Vikas Mehta
Objectives To examine opioid-prescribing patterns after endocrine surgery. To evaluate factors associated with postoperative pain and opioid use. Study Design Cross-sectional. Setting Academic university health system. Subjects and Methods The study sample included 209 patients who underwent total thyroidectomy, hemithyroidectomy, or parathyroidectomy by 4 surgeons between August 2015 and November 2017. Eighty-nine patients completed a phone survey about postoperative pain and opioid use. Prescription, demographic, and comorbidity data were collected retrospectively...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Alexander L Luryi, Michael LaRouere, Seilesh Babu, Dennis I Bojrab, John Zappia, Eric W Sargent, Christopher A Schutt
Objective To compare characteristics between traumatic and idiopathic benign paroxysmal positional vertigo (BPPV) focusing on outcomes. Study Design Retrospective chart review. Setting High-volume tertiary otology center. Subjects and Methods Records of patients with BPPV treated at a single institution from 2007 to 2017 were analyzed. Traumatic BPPV was defined as BPPV symptoms beginning within 30 days following head trauma. Patient, disease, treatment, and outcome characteristics were compared between traumatic and idiopathic BPPV groups...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Elliot Morse, Elisa Berson, Rance Fujiwara, Benjamin Judson, Saral Mehra
Objective To characterize treatment delays in hypopharyngeal cancer, identify factors associated with delays, and associate delays with overall survival. Study Design Retrospective cohort. Setting Commission on Cancer hospitals nationwide. Subjects and Methods We included patients in the National Cancer Database who were treated for hypopharyngeal cancer with primary radiation, concurrent chemoradiation, or induction chemotherapy and radiation. We identified median durations of diagnosis to treatment initiation (DTI), radiation treatment duration (RTD), and diagnosis to treatment end (DTE)...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Garrett D Locketz, Jason D Brant, Nithin D Adappa, James N Palmer, Andrew N Goldberg, Patricia A Loftus, Rakesh K Chandra, Benjamin S Bleier, Sarina K Mueller, Richard R Orlandi, Madeleine Becker, Cindy A Dorminy, Sophia D Becker, Mariel Blasetti, Daniel G Becker
Objective To survey patients following sinonasal surgery regarding postoperative pain and opioid use. Study Design Patients were surveyed for 4 days following sinus and/or nasal surgery regarding their pain level and use of prescribed opioids. Setting Four academic medical centers and 1 private practice institution. Subjects Consecutive adult patients undergoing sinonasal surgery. Results A total of 219 subjects met criteria and were included for analysis; 134 patients (61%) took 5 or fewer combination oxycodone (5-mg) and acetaminophen (325-mg) tablets in the first 3 postoperative days, and 196 patients (89...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Steven Coppess, Reema Padia, David Horn, Sanjay R Parikh, Andrew Inglis, Randall Bly, John Dahl, Daniel Dudley, Kaalan Johnson
Objective While the Benjamin-Inglis classification system is widely used to categorize laryngeal clefts, it does not clearly differentiate a type 1 cleft from normal anatomy, and there is no widely accepted or validated protocol for systematically evaluating interarytenoid mucosal height. We sought to propose the interarytenoid assessment protocol as a method to standardize the description of the interarytenoid anatomy and to test its reliability. Study Design Retrospective review of endoscopic videos. Setting Pediatric academic center...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Craig A Bollig, Jeffrey B Jorgensen, Robert P Zitsch, Laura M Dooley
Objective To determine if the routine use of intraoperative frozen section (iFS) results in cost savings among patients with nodules >4 cm with nonmalignant cytology undergoing a thyroid lobectomy. Study Design Case series with chart review; cost minimization analysis. Setting Single academic center. Subjects and Methods Records were reviewed on a consecutive sample of 48 patients with thyroid nodules >4 cm and nonmalignant cytology who were undergoing thyroid lobectomy in which iFS was performed between 2010 and 2015...
October 16, 2018: Otolaryngology—Head and Neck Surgery
Robert J Morrison, Nicolas-George Katsantonis, Kevin M Motz, Alexander T Hillel, C Gaelyn Garrett, James L Netterville, Christopher T Wootten, Susan M Majka, Timothy S Blackwell, Wonder P Drake, Alexander Gelbard
Objective To characterize the phenotype and function of fibroblasts derived from airway scar in idiopathic subglottic stenosis (iSGS) and to explore scar fibroblast response to interleukin 17A (IL-17A). Study Design Basic science. Setting Laboratory. Subjects and Methods Primary fibroblast cell lines from iSGS subjects, idiopathic pulmonary fibrosis subjects, and normal control airways were utilized for analysis. Protein, molecular, and flow cytometric techniques were applied in vitro to assess the phenotype and functional response of disease fibroblasts to IL-17A...
October 16, 2018: Otolaryngology—Head and Neck Surgery
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