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Otolaryngology—Head and Neck Surgery

Chloe Matovina, Andrew C Birkeland, Suzanna Zick, Andrew G Shuman
OBJECTIVE: Complementary and alternative medicine, or integrative medicine, has become increasingly popular among patients with head and neck cancer. Despite its increasing prevalence, many patients feel uncomfortable discussing such therapies with their physicians, and many physicians are unaware and underequipped to evaluate or discuss their use with patients. The aim of this article is to use recent data to outline the decision making inherent to integrative medicine utilization among patients with head and neck cancer, to discuss the ethical implications inherent to balancing integrative and conventional approaches to treatment, and to highlight available resources to enhance head and neck cancer providers' understanding of integrative medicine...
October 11, 2016: Otolaryngology—Head and Neck Surgery
(no author information available yet)
Hubbard MA, Khalil AA, Schoeff SS, et al. Nanoimmunoassay to detect responses in head and neck cancer: feasibility in a mouse model. Otolaryngol Head Neck Surg 2014;151:92-99. (Original DOI: 10.1177/0194599814528302).
October 11, 2016: Otolaryngology—Head and Neck Surgery
Matthew E Smith, James R Tysome
OBJECTIVE: Balloon eustachian tuboplasty (BET) has entered clinical use as a treatment for eustachian tube dysfunction. Some surgeons perform myringotomy prior to BET due to concerns that the increase in middle ear (ME) pressure caused by BET may cause otic barotrauma. We investigated the ME pressure changes occurring during BET in cadavers. STUDY DESIGN: Human cadaver investigation of a surgical technique SETTING: Laboratory study at a tertiary referral center...
October 11, 2016: Otolaryngology—Head and Neck Surgery
Vishal J Patel, Nai-Wei Chen, Vicente A Resto
OBJECTIVE: To determine whether patient race and ethnicity affect nasopharyngeal cancer survival. STUDY DESIGN: Retrospective database analysis. SETTING: National Cancer Institute's SEER database (Surveillance, Epidemiology, and End Results), 1988-2010. SUBJECTS AND METHODS: Nasopharyngeal carcinoma cases were extracted according to site codes and histology recode-broad groupings. The cohort of 5427 patients was used to calculate disease-specific survival in regard to race and ethnicity...
October 4, 2016: Otolaryngology—Head and Neck Surgery
Neil S Patel, Kathryn M Van Abel, Michael J Link, Colin L W Driscoll, Jamie J Van Gompel, Brian A Neff, John I Lane, Matthew L Carlson
OBJECTIVE: Demonstrate the association of radiographic dural enhancement with increased tumor adherence at the porus acusticus, which may influence completeness of resection and facial nerve outcome. STUDY DESIGN: Case series with chart review. SETTING: Academic referral center. SUBJECTS AND METHODS: A total of 205 consecutive patients with histopathologically confirmed vestibular schwannoma (VS) were evaluated. Patients with tumors exhibiting dural enhancement on postgadolinium T1-weighted magnetic resonance imaging were identified and compared with matched controls...
October 4, 2016: Otolaryngology—Head and Neck Surgery
Phoebe Kuo, R Peter Manes, Zachary G Schwam, Benjamin L Judson
OBJECTIVE: Sinonasal undifferentiated carcinoma is a rare and aggressive malignancy of the nasal cavity and paranasal sinuses. Multi-institutional studies examining outcomes of combined modality treatment versus other treatment modalities have not been performed. The objective of our study was to present outcomes for multimodality therapy through use of the National Cancer Database. STUDY DESIGN: Retrospective cohort study. SETTING: National Cancer Database...
October 4, 2016: Otolaryngology—Head and Neck Surgery
Omar H Ahmed, Sonya Marcus, Jenna R Tauber, Binhuan Wang, Yixin Fang, Richard A Lebowitz
OBJECTIVE: Perioperative lumbar drain (LD) use in the setting of endoscopic cerebrospinal fluid (CSF) leak repair is a well-established practice. However, recent data suggest that LDs may not provide significant benefit and may thus confer unnecessary risk. To examine this, we conducted a meta-analysis to investigate the effect of LDs on postoperative CSF leak recurrence following endoscopic repair of CSF rhinorrhea. DATA SOURCES: A comprehensive search was performed with the following databases: Ovid MEDLINE (1947 to November 2015), EMBASE (1974 to November 2015), Cochrane Review, and PubMed (1990 to November 2015)...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Jared A Shenson, Jennifer N Craig, Sarah L Rohde
OBJECTIVE: Total laryngectomy (TL) is a high-cost procedure with patients at risk for significant postoperative health care use. Face-to-face preoperative counseling provided by speech-language pathologists is a relatively inexpensive intervention that may improve care quality and decrease costs. We evaluated if preoperative counseling for patients undergoing TL was associated with differences in length of stay (LOS), use of the emergency department (ED), or unplanned readmissions within 30 days of discharge...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Austin S Lam, Sarah K Wise, Raj C Dedhia
OBJECTIVE: To assess the practice characteristics of adult sleep otolaryngologists within US otolaryngology residency training programs. STUDY DESIGN: Cross-sectional online survey. SETTING: Otolaryngology residency training programs. SUBJECTS AND METHODS: Program directors from 106 otolaryngology training programs in the United States were contacted. Program directors were instructed to forward a survey to otolaryngologists within the institution who provided Accreditation Council for Graduate Medical Education (ACGME) Otolaryngology Milestone Project feedback in "sleep-disordered breathing...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Rishabh Sethia, Thomas F Kerwin, Gregory J Wiet
OBJECTIVE: The aim of this report is to provide a review of the current literature for assessment of performance for mastoidectomy, to identify the current assessment tools available in the literature, and to summarize the evidence for their validity. DATA SOURCES: The MEDLINE database was accessed via PubMed. REVIEW METHODS: Inclusion criteria consisted of English-language published articles that reported use of a mastoidectomy performance assessment tool...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Kristen B Pytynia
The peer review process for scientific journals relies on the efforts of volunteer reviewers. Reviewers are selected due to their expertise in their fields. With so many demands on professional time, the benefits of participating in peer review may not be obvious. However, reviewers benefit by exposure to the latest developments in their fields, facilitating their keeping up-to-date with the latest publications. Tenure committees look favorably on participation in peer review, and invitations to review underscore that the reviewer is a respected subject matter expert...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Bailey A Milne-Davies, Patrick J Antonelli, Nicklas C Orobello, Carolyn O Dirain
OBJECTIVE: To assess collagen and α-tubulin levels of mouse tympanic membrane fibroblasts treated with quinolone and aminoglycoside antibiotics at concentrations found in eardrops. STUDY DESIGN: Prospective controlled cell culture study. SETTING: Academic tertiary medical center. SUBJECTS: Mouse tympanic membrane fibroblasts. METHODS: In experiment 1, fibroblasts were treated with the following for 24 or 48 hours: phosphate-buffered saline (negative control), dilute hydrochloric acid (positive control), 0...
September 27, 2016: Otolaryngology—Head and Neck Surgery
Matthew G Crowson, Joseph M Chen, Debara Tucci
OBJECTIVES: To investigate provincial cochlear implantation (CI) annual volume and cost trends. STUDY DESIGN: Database analysis. SETTING: National surgical volume and cost database. SUBJECTS AND METHODS: Aggregate-level provincial CI volumes and cost data for adult and pediatric CI surgery from 2005 to 2014 were obtained from the Canadian Institute for Health Information. Population-level aging forecast estimates were obtained from the Ontario Ministry of Finance and Statistics Canada...
September 20, 2016: Otolaryngology—Head and Neck Surgery
Magdy Abdalla Sayed El-Ahl, Mohammad Waheed El-Anwar
The aim of this study was to introduce and assess a new minimally invasive expansion pharyngoplasty for obstructive sleep apnea (OSA) using bilateral new advancement sutures without tonsillectomy. Among 24 patients who had OSA with Friedman stage II or III and type I Fujita, bilateral sutures were performed to advance and stabilize palatopharyngeus and palatoglossus muscles anterolaterally. Mean apnea hypopnea index decreased significantly from 28.6 ± 4.2 preoperatively to 8.9 ± 4.9 postoperatively. The lowest oxygen saturation increased significantly from 79...
September 20, 2016: Otolaryngology—Head and Neck Surgery
Nandini Govil, William M DeMayo, Barry E Hirsch, Andrew A McCall
OBJECTIVE: Surgeons often report musculoskeletal discomfort in relation to their practice, but few understand optimal ergonomic positioning. This study aims to determine which patient position-sitting versus supine-is ergonomically optimal for performing otologic procedures. STUDY DESIGN: Observational study. SETTING: Outpatient otolaryngology clinic setting in a tertiary care facility. SUBJECTS AND METHODS: We observed 3 neurotologists performing a standardized simulated cerumen debridement procedure on volunteers in 2 positions: sitting and supine...
September 20, 2016: Otolaryngology—Head and Neck Surgery
Mirabelle Sajisevi, Kristine Schulz, Derek D Cyr, Daniel Wojdyla, Richard M Rosenfeld, Debara Tucci, David L Witsell
OBJECTIVE: To estimate the nonadherence rate of pressure equalization (tympanostomy) tube (PET) placement in the preceding 3-year period before release of the 2013 American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guideline (CPG). STUDY DESIGN: Analysis of the Truven Health MarketScan Research Databases (2010-2012). SUBJECTS AND METHODS: Medical claims data from 2010 to 2012 were analyzed. Children aged ≤12 years with otitis media (OM)-related diagnoses were identified...
September 13, 2016: Otolaryngology—Head and Neck Surgery
A Sean Alemi, Chase M Heaton, William R Ryan, Ivan El-Sayed, Steven J Wang
OBJECTIVE: Cervical schwannomas are benign tumors that commonly present as asymptomatic masses and are managed with observation, radiation, or surgery. To our knowledge, the rate of volumetric change seen on serial imaging is not currently used to determine surgical candidacy. We assess average growth rates and determine whether growth rate of cervical schwannoma predicts having undergone surgery. STUDY DESIGN: Case series with chart review. SETTING: Quaternary academic medical center...
September 13, 2016: Otolaryngology—Head and Neck Surgery
Mohamad R Chaaban, Dong Zhang, Vicente Resto, James S Goodwin
OBJECTIVE: To determine the demographics and seasonal and geographic variation of epistaxis in the United States. STUDY DESIGN: Retrospective cohort analysis based on data from Medicare claims. SETTING: Emergency department visits. SUBJECTS AND METHODS: We used a 5% sample of Medicare data from January 2012 to December 2012. Our cohort included patients with an incident diagnosis of epistaxis during a visit to the emergency department, excluding those with a diagnosis in the prior 12 months...
September 13, 2016: Otolaryngology—Head and Neck Surgery
Yarah M Haidar, Sartaaj Walia, Ronald Sahyouni, Yaser Ghavami, Harrison W Lin, Hamid R Djalilian
Split-thickness skin graft (STSG) continues to be the preferred means of external auditory canal (EAC) reconstruction. We thus sought to describe our experience using skin from the posterior aspect of the auricle (SPAA) as a donor site in EAC reconstruction. Grafts were, on average, 5 × 10 mm in size and obtained with a No. 10 blade after tumescence injection. The cases of 39 patients who underwent 41 procedures were retrospectively reviewed. Of the 38 patients with both 3- and 6-month follow-ups, no postoperative stenosis or bony exposure occurred...
September 13, 2016: Otolaryngology—Head and Neck Surgery
Kershena Liao, Jennifer Blumenthal-Barby, Andrew G Sikora
OBJECTIVE: The factors influencing head and neck surgical oncologists' goals of care and decisions to initiate conversations about transitioning to palliative-intent treatment for patients with limited curative treatment options are incompletely understood. Lack of guidance for physicians on this topic can lead to inconsistent utilization of palliative services, as well as confusing, upsetting experiences for patients and families. We review the literature investigating the clinical factors, inter- and intrapersonal factors, and financial and health care system considerations that head and neck cancer physicians weigh during this decision-making process...
September 13, 2016: Otolaryngology—Head and Neck Surgery
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