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Otolaryngology—Head and Neck Surgery

Juliana Bonilla-Velez, Mariah Small, Francisco J Bonilla-Escobar, Matthew Sharum, Ozlem E Tulunay-Ugur
Objective To compare voice and swallowing outcomes after treatment in younger adult (<65 years) and geriatric (≥65 years) patients with unilateral vocal fold paralysis (UVFP). Study Design Case series with chart review. Setting Tertiary care center. Subjects and Methods The cases of patients presenting to a tertiary voice clinic with UVFP between June 2005 and February 2015 were reviewed. Clinical characteristics and outcomes in a geriatric subset were compared with those in younger adult group. Results A total of 206 patients met our inclusion criteria (n = 110, <65 years; n = 96, ≥65 years)...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Nir Hirshoren, Olivia Ruskin, Lachlan J McDowell, Matthew Magarey, Stephen Kleid, Benjamin J Dixon
Objectives Extent of parotidectomy and neck dissection for metastatic cutaneous squamous cell carcinoma (cSCC) to the parotid is debated. We describe our experience, analyzing outcomes (overall survival and regional recurrence) associated with surgical extent and adjuvant treatment. Study Design A retrospective cohort study of parotidectomy with or without neck dissection for metastatic cSCC. Setting A tertiary referral cancer center in Australia. Subjects and Methods The study group consisted of patients with metastatic cSCC involving the parotid gland who underwent a curative-intent parotidectomy (superficial or total), with or without neck dissection, between 2003 and 2014...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Ellen S Deutsch
Physician psychological wellness is an emergent outcome resulting from dynamic interactions among complex conditions. We may enhance opportunities for physician wellness by applying principles developed to improve another emergent outcome: patient safety. The Safety I approach to patient safety focuses on "what went wrong" and considers humans a liability. Safety II is a powerful complementary approach that focuses on "what went right" and values human creativity. These contrasting perspectives are described in the context of patient safety, but the underlying principles have relevance for physician psychological wellness...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Vikranth Visvanathan, Vamsidhar Vallamkondu, Sanjiv K Bhimrao
Objectives Surgical repair of a tympanic membrane perforation is a common otologic procedure. However, achieving a successful closure can be challenging, especially if the anterior margin of the tympanic membrane is involved. The aim of this study was to systematically review the literature on evidence published in closure of anterior tympanic membrane perforations. Data Sources The following data sources were searched: Cochrane Central Register of Controlled Trials (1997 to August, 3 2017), MEDLINE (February 1948 to August 3, 2017), and Embase (1975 to August 3, 2017)...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Jacob T Cohen, Taiser Bishara, Vladimir Trushin, Limor Benyamini
Objective To examine the adverse events and time to diagnosis of in-office laryngeal biopsy (IOB) procedures. Study Design Retrospective cohort study. Setting Outpatient clinic-tertiary referral medical center. Subjects and Methods A total of 390 IOBs were included in this study. Data on demographic characteristics, outcomes, and complications were collected. Complications were classified as severe-necessitating further intervention or admission-or mild and self-limited. Delay in diagnosis, assessed as a complication of IOB, was calculated as the time from initial examination to final diagnosis...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Allison K Ikeda, Paul Hong, Stacey L Ishman, Stephanie A Joe, Gregory W Randolph, Jennifer J Shin
In our previous installment, we introduced shared decision making (SDM) as a collaborative process in which patients, families, and clinicians develop a mutually optimized treatment plan when more than 1 reasonable treatment option exists. In this subsequent installment of our Evidence-Based Medicine in Otolaryngology Series, we expand on the topic of SDM, including the related current state of clinical decision making, the impact of SDM on health care utilization and patient satisfaction, the potential role of system and society changes, the experience with SDM as it relates to race and ethnicity, existing financial incentives, and the validated instruments that assess the extent to which SDM occurs...
March 1, 2018: Otolaryngology—Head and Neck Surgery
(no author information available yet)
Ferrandino R, Roof S, Ma Y, et al. Unplanned 30-day readmissions after parathyroidectomy in patients with chronic kidney disease: a nationwide analysis. Otolaryngol Head Neck Surg. 2017;157:955-965. (Original DOI: 10.1177/0194599817721154) In this article, the funding information was not included. The funding source section should have read as follows: "R.F. was supported by the National Center for Advancing Translational Sciences under award 1TL1TR001434-03. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health...
March 1, 2018: Otolaryngology—Head and Neck Surgery
David D Walker, Michael Z David, Dominic Catalano, Robert Daum, Michael B Gluth
Objective Despite the rising incidence of methicillin-resistant Staphylococcus aureus (MRSA) otologic infections, choice of treatment remains controversial. Only fluoroquinolone-containing ototopical preparations are approved by the US Food and Drug Administration for middle ear application. Furthermore, American Academy of Otolaryngology-Head and Neck Surgery Foundation guidelines advocate ototopical monotherapy for both tympanostomy tube otorrhea and acute otitis externa. Unfortunately, MRSA may be ciprofloxacin resistant...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Thomas J Ow, Kayte Spector-Bagdady, Ethan Cowan, Andrew G Shuman
No abstract text is available yet for this article.
March 1, 2018: Otolaryngology—Head and Neck Surgery
Steven A Zuniga, Barbara Ebersole, Nausheen Jamal
Objective Examine the incidence of penetration/aspiration in patients with unilateral vocal fold immobility and investigate the relationship with self-reported perception of dysphagia. Study Design Case series with chart review. Setting Academic cancer center. Subjects and Methods Adult patients with unilateral vocal fold immobility diagnosed between 2014 and 2016 were reviewed. Patients were stratified into an aspiration group and a nonaspiration group using objective findings on flexible endoscopic evaluation of swallowing, as scored using Rosenbek's Penetration Aspiration Scale...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Michael P Veve, Joshua B Greene, Amy M Williams, Susan L Davis, Nina Lu, Yelizaveta Shnayder, David X Li, Salem I Noureldine, Jeremy D Richmon, Lawrence O Lin, Matthew M Hanasono, Patrik Pipkorn, Ryan S Jackson, Joshua D Hornig, Tyler Light, Mark K Wax, Yin Yiu, James Bekeny, Matthew Old, David Hernandez, Urjeet A Patel, Tamer A Ghanem
Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Justin C Sowder, Mar Janna Dahl, Kaitlin R Zuspan, Kurt H Albertine, Donald M Null, Mitchell D Barneck, J Fredrik Grimmer
Objective To (1) compare physiologic changes during rigid bronchoscopy during spontaneous and mechanical ventilation and (2) evaluate the efficacy of a helium-oxygen (heliox) gas mixture as compared with room air during rigid bronchoscopy. Study Design Crossover animal study evaluating physiologic parameters during rigid bronchoscopy. Outcomes were compared with predicted computational fluid analysis. Setting Simulated ventilation via computational fluid dynamics analysis and term lambs undergoing rigid bronchoscopy...
March 1, 2018: Otolaryngology—Head and Neck Surgery
Annika Jessen, Andrew D Ho, C Eduardo Corrales, Bevan Yueh, Jennifer J Shin
Objectives (1) To assess the 11-item Inner Effectiveness of Auditory Rehabilitation (Inner EAR) instrument with item response theory (IRT). (2) To determine whether the underlying latent ability could also be accurately represented by a subset of the items for use in high-volume clinical scenarios. (3) To determine whether the Inner EAR instrument correlates with pure tone thresholds and word recognition scores. Design IRT evaluation of prospective cohort data. Setting Tertiary care academic ambulatory otolaryngology clinic...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Jieun Roh, Sue Jean Mun
No abstract text is available yet for this article.
February 1, 2018: Otolaryngology—Head and Neck Surgery
Mohammad Amin Tabatabaiefar, Mohammad Reza Pourreza, Parisa Tahmasebi, Nader Saki, Morteza Hashemzadeh Chaleshtori, Rasoul Salehi, Javad Mohammadi-Asl
Objective Hearing loss (HL) is the most common sensory-neural defect and the most heterogeneous trait in humans, with the involvement of >100 genes, which make a molecular diagnosis problematic. Next-generation sequencing (NGS) is a new strategy that can overcome this problem. Study Design Descriptive experimental study. Setting Diagnostic laboratory. Subjects and Methods A comprehensive family history was obtained, and clinical evaluations and pedigree analysis were performed in a family with multiple individuals with HL...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Sneh Biyani, M Jedorah Benson, Sarah C DeShields, Tina D Cunningham, Cristina M Baldassari
Objective Due to limitations of polysomnography (PSG), novel ways to evaluate pediatric obstructive sleep apnea (OSA) are needed. Urinary leukotriene E4 (LTE4), an inflammatory marker, has been identified as a potential biomarker for pediatric OSA. The objective of the study was to assess whether urinary LTE4 levels correlate with OSA severity, as determined by obstructive apnea-hypopnea index (AHI) and nadir oxygen saturation. Study Design Prospective trial. Setting Tertiary care children's hospital. Subjects and Methods Children (age, 3-16 years) with sleep-disordered breathing (SDB) who were referred for PSG were included...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Grace Baik, Scott E Brietzke
Objectives To use decision analysis modeling to compare utility and cost outcomes of intracapsular tonsillectomy (ICT) and extracapsular tonsillectomy (ECT). To use sensitivity analysis to determine the most important factors influencing outcomes favoring one surgical method versus another. Study Design Decision analysis model. Setting Hypothetical cohort. Subjects and Methods A decision analysis model was created with computer software comparing the results of ICT and ECT. The model featured complications with completion tonsillectomy, such as postsurgical bleed, dehydration, and tonsillar regrowth...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Meredith Merz Lind, Marco Corridore, Cameron Sheehan, Melissa Moore-Clingenpeel, Tensing Maa
Objective To design and assess an advanced pediatric airway management course, through simulation-based team training and with multiple disciplines, to emphasize communication and cooperation across subspecialties and to provide a common skill set and knowledge base. Methods Trainees from anesthesiology, emergency medicine, critical care, pediatric surgery, and otolaryngology at a tertiary children's hospital participated in a 1-day workshop emphasizing airway skills and complex airway simulations. Small groups were multidisciplinary to promote teamwork...
February 1, 2018: Otolaryngology—Head and Neck Surgery
Divya Yerramilli, Kevin J Kovatch, Annie W Chan, Paul Swiecicki, Danielle N Margalit, Andrew G Shuman
No abstract text is available yet for this article.
February 1, 2018: Otolaryngology—Head and Neck Surgery
John D Cramer, Andrew G Shuman, Michael J Brenner
Objective The aim of this report is to present a cohesive evidence-based approach to reducing venous thromboembolism (VTE) in otolaryngology-head and neck surgery. VTE prevention includes deep venous thrombosis and pulmonary embolism. Despite national efforts in VTE prevention, guidelines do not exist for otolaryngology-head and neck surgery in the United States. Data Sources PubMed/MEDLINE. Review Methods A comprehensive review of literature pertaining to VTE in otolaryngology-head and neck surgery was performed, identifying data on incidence of thrombotic complications and the outcomes of regimens for thromboprophylaxis...
February 1, 2018: Otolaryngology—Head and Neck Surgery
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