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  • 1
    Online Resource
    Online Resource
    Team Consistency in Reducing Operative Time in Head and Neck Surgery with Microvascular Free Flap Reconstruction
    Wiley ; 2023
    In:  The Laryngoscope Vol. 133, No. 9 ( 2023-09), p. 2154-2159
    Details
    In: The Laryngoscope, Wiley, Vol. 133, No. 9 ( 2023-09), p. 2154-2159
    Abstract: To evaluate the impact of consistent surgical teams on procedure duration in head and neck free tissue transfer, and to evaluate the length of stay and readmission rates with consistent teams. Methods A retrospective chart review of head and neck microvascular reconstruction by a single surgeon between August 2017 and November 2021 was performed. Procedure duration, wound complications, length of stay, and 30‐day readmissions were analyzed. One circulating nurse (CN) and surgical technologist (ST) were considered “consistent” due to their prior work with the primary surgeon. All others were considered “ad hoc.” Teams were “Consistent CN + ST,” “Consistent ST,” “Consistent CN,” or “Ad hoc.” Procedure duration between groups was compared via analysis of variance. Multivariate linear regression was performed to predict procedure duration. Results A total of 135 patients were included. Age, sex, and American Society of Anesthesiologists status did not significantly differ across groups ( p  = 0.963; p  = 0.467; p  = 0.908, respectively). The mean procedure duration was 339.3 min and differed significantly across all groups ( p  = 0.006, Cohen d  = 0.32). Compared to the Ad hoc group, consistent teams demonstrated significant reductions in mean procedure duration (Consistent CN + ST: 58.4 min, p  = 0.001, Cohen d  = 0.67; Consistent ST: 51.6 min, p  = 0.013, Cohen d  = 0.61; Consistent CN: 44.5 min, p  = 0.031, Cohen d  = 0.52). Controlling for other factors, the ad hoc team predicted increased procedure duration on multivariate analysis ( 57.38, 19.92–94.85, p   〈  0.003). Wound complications, length of stay, and readmission rates did not differ significantly across groups ( p  = 0.940; p  = 0.174; p  = 0.935, respectively). Conclusion Consistent CN and ST improve operative efficiency in head and neck‐free tissue transfer. Future studies may evaluate the impact of team consistency on complications, physician burnout, and health systems costs. Level of Evidence 3 Laryngoscope , 133:2154–2159, 2023
    Type of Medium: Online Resource
    ISSN: 0023-852X , 1531-4995
    URL: Issue
    URL: Article
    DOI: 10.1002/lary.v133.9
    DOI: 10.1002/lary.30542
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2026089-1
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  • 2
    Online Resource
    Online Resource
    Incidence of synchronous malignancies found during triple endoscopy in head and neck cancer
    Elsevier BV ; 2022
    In:  American Journal of Otolaryngology Vol. 43, No. 2 ( 2022-03), p. 103349-
    Details
    In: American Journal of Otolaryngology, Elsevier BV, Vol. 43, No. 2 ( 2022-03), p. 103349-
    Type of Medium: Online Resource
    ISSN: 0196-0709
    URL: Article
    DOI: 10.1016/j.amjoto.2021.103349
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2041649-0
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  • 3
    Online Resource
    Online Resource
    Utility of intraoperative neural response telemetry in pediatric cochlear implants
    Elsevier BV ; 2022
    In:  International Journal of Pediatric Otorhinolaryngology Vol. 162 ( 2022-11), p. 111298-
    Details
    In: International Journal of Pediatric Otorhinolaryngology, Elsevier BV, Vol. 162 ( 2022-11), p. 111298-
    Type of Medium: Online Resource
    ISSN: 0165-5876
    URL: Article
    DOI: 10.1016/j.ijporl.2022.111298
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2224872-9
    detail.hit.zdb_id: 2009657-4
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  • 4
    Online Resource
    Online Resource
    Assessing the Risk of Adjuvant Radiotherapy Initiation Delays With Social Support Surveys
    Wiley ; 2023
    In:  Otolaryngology–Head and Neck Surgery Vol. 169, No. 4 ( 2023-10), p. 928-937
    Details
    In: Otolaryngology–Head and Neck Surgery, Wiley, Vol. 169, No. 4 ( 2023-10), p. 928-937
    Abstract: In patients with head and neck squamous cell carcinoma (HNSCC), initiating postoperative radiotherapy (PORT) greater than 42 days after surgery is associated with a higher risk of poor survival outcomes. Social support has been shown to modulate behaviors related to care‐seeking and treatment adherence. In this study, we sought to determine the relationship between social support metrics and PORT delays. Study Design Prospective cohort study. Setting Single tertiary medical center. Methods Patients with HNSCC who underwent primary surgical excision requiring PORT were prospectively enrolled. Patient‐perceived social support metrics were assessed using the Medical Outcomes Study Social Support Survey (MOS‐SSS) at initial presurgical evaluation. Associations with PORT delays were evaluated via univariable and multivariable logistic regression analysis. Results A total of 111 patients met the inclusion criteria for the study. An additional 28 patients were recommended to receive PORT but did not initiate treatment and were included for secondary analysis. All four subscales of the MOS‐SSS (positive social interaction, affectionate support, tangible support, and emotional/informational support) were significantly associated with PORT initiation delays on univariable analysis. On multivariable analysis, the overall MOS‐SSS score (odds ratio [OR] 2.08, 1.15‐4.35, p  = .028) was significantly associated with PORT initiation delays. On secondary analysis, lower tangible support was associated with a lack of PORT initiation (OR 1.63, 1.05‐2.54, p  = .028). Conclusion Social support metrics were significantly associated with PORT delays, which may help promote tighter scheduling and closer monitoring of high‐risk patients.
    Type of Medium: Online Resource
    ISSN: 0194-5998 , 1097-6817
    URL: Issue
    URL: Article
    DOI: 10.1002/ohn.v169.4
    DOI: 10.1002/ohn.270
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2008453-5
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  • 5
    Online Resource
    Online Resource
    A Rare Case of Myopericytoma in the Mastoid
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Otology & Neurotology Vol. 42, No. 9 ( 2021-10), p. e1404-e1405
    Details
    In: Otology & Neurotology, Ovid Technologies (Wolters Kluwer Health), Vol. 42, No. 9 ( 2021-10), p. e1404-e1405
    Type of Medium: Online Resource
    ISSN: 1531-7129 , 1537-4505
    URL: Article
    DOI: 10.1097/MAO.0000000000003173
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 2058738-7
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  • 6
    Online Resource
    Online Resource
    Association of Social-Ecological Factors With Delay in Time to Initiation of Postoperative Radiation Therapy : A Prospective Cohort Study
    American Medical Association (AMA) ; 2023
    In:  JAMA Otolaryngology–Head & Neck Surgery Vol. 149, No. 6 ( 2023-06-01), p. 477-
    Details
    In: JAMA Otolaryngology–Head & Neck Surgery, American Medical Association (AMA), Vol. 149, No. 6 ( 2023-06-01), p. 477-
    Abstract: Timely initiation of postoperative radiation therapy (PORT) is associated with reduced recurrence rates and improved overall survival in patients with head and neck squamous cell carcinoma (HNSCC). Measurement of the association of social-ecological variables with PORT delays is lacking. Objective To assess individual and community-level factors associated with PORT delay among patients with HNSCC. Design, Setting, and Participants This prospective cohort study carried out between September 2018 and June 2022 included adults with untreated HNSCC who were enrolled in a prospective registry at a single academic tertiary medical center. Demographic information and validated self-reported measures of health literacy were obtained at baseline visits. Clinical data were recorded, and participant addresses were used to calculate the area deprivation index (ADI), a measure of community-level social vulnerability. Participants receiving primary surgery and PORT were analyzed. Univariable and multivariable regression analysis was performed to identify risk factors for PORT delays. Exposures Surgical treatment and PORT. Main Outcomes and Measures The primary outcome was PORT initiation delay ( & amp;gt;42 days from surgery). Risk of PORT initiation delay was evaluated using individual-level (demographic, health literacy, and clinical data) and community-level information (ADI and rural-urban continuum codes). Results Of 171 patients, 104 patients (60.8%) had PORT delays. Mean (SD) age of participants was 61.0 (11.2) years, 161 were White (94.2%), and 105 were men (61.4%). Insurance was employer-based or public among 65 (38.5%) and 75 (44.4%) participants, respectively. Mean (SD) ADI (national percentile) was 60.2 (24.4), and 71 (41.8%) resided in rural communities. Tumor sites were most commonly oral cavity (123 [71.9%]), with 108 (63.5%) classified as stage 4 at presentation. On multivariable analysis, a model incorporating individual-level factors with health literacy in addition to community-level factors was most predictive of PORT delay (AOC= 0.78; R 2 , 0.18). Conclusions and Relevance This cohort study provides a more comprehensive assessment of predictors of PORT delays that include health literacy and community-level measures. Predictive models that incorporate multilevel measures outperform models with individual-level factors alone and may guide precise interventions to decrease PORT delay for at-risk patients with HNSCC.
    Type of Medium: Online Resource
    ISSN: 2168-6181
    URL: Article
    DOI: 10.1001/jamaoto.2023.0308
    Language: English
    Publisher: American Medical Association (AMA)
    Publication Date: 2023
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  • 7
    Online Resource
    Online Resource
    Long-term trends in body mass index throughout upper airway stimulation treatment: does body mass index matter?
    American Academy of Sleep Medicine (AASM) ; 2023
    In:  Journal of Clinical Sleep Medicine Vol. 19, No. 6 ( 2023-06), p. 1061-1071
    Details
    In: Journal of Clinical Sleep Medicine, American Academy of Sleep Medicine (AASM), Vol. 19, No. 6 ( 2023-06), p. 1061-1071
    Type of Medium: Online Resource
    ISSN: 1550-9389 , 1550-9397
    URL: Article
    DOI: 10.5664/jcsm.10496
    Language: English
    Publisher: American Academy of Sleep Medicine (AASM)
    Publication Date: 2023
    detail.hit.zdb_id: 2210082-9
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  • 8
    Online Resource
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    Association of Ear Anomalies and Hearing Loss Among Children With 22q11.2 Deletion Syndrome
    Wiley ; 2023
    In:  Otolaryngology–Head and Neck Surgery Vol. 168, No. 4 ( 2023-04), p. 856-861
    Details
    In: Otolaryngology–Head and Neck Surgery, Wiley, Vol. 168, No. 4 ( 2023-04), p. 856-861
    Abstract: To identify inner and middle ear anomalies in children with 22q11.2 deletion syndrome (22q11DS) and determine associations with hearing thresholds. Study Design Retrospective study. Setting Two tertiary care academic centers. Methods Children presenting with 22q11DS between 2010 and 2020 were included. Temporal bone imaging with computed tomography or magnetic resonance imaging was reviewed by 2 neuroradiologists. Results Twenty‐two patients (12 female, 10 male) were identified. Forty‐four ears were evaluated on imaging. There were 15 (34%) ears with abnormal semicircular canals, 14 (32%) with abnormal vestibules, 8 (18%) with abnormal ossicles, 6 (14%) with enlarged vestibular aqueducts, 4 (9.1%) with abnormal facial nerve canals, and 4 (9.1%) with cochlear anomalies. There were 25 ears with imaging and audiometric data. The median pure tone average (PTA) for ears with any structural abnormality was 41.0 dB, as compared with 28.5 dB for ears without any structural abnormality ( P = .21). Of 23 ears with normal imaging, 6 (26%) had hearing loss in comparison with 13 (62%) of 21 ears with abnormalities ( P = .02). Total number of anomalies per ear was positively correlated with PTA (Pearson correlation coefficient, R = 0.479, P = .01). PTA was significantly higher in patients with facial nerve canal anomalies ( P = .002), vestibular aqueduct anomalies ( P = .05), and vestibule anomalies ( P = .02). Conclusions Semicircular canal, ossicular, vestibular aqueduct, and vestibular anomalies were detected in children with 22q11DS, especially in the setting of hearing loss. Careful evaluation of anatomic anomalies is needed prior to surgical intervention in these patients.
    Type of Medium: Online Resource
    ISSN: 0194-5998 , 1097-6817
    URL: Article
    DOI: 10.1177/01945998221094219
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 9
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    Online Resource
    Quantifying Faculty Perception of Diversity, Equity, and Inclusion Within Academic Otolaryngology–Head and Neck Surgery Departments
    Wiley ; 2023
    In:  Otolaryngology–Head and Neck Surgery Vol. 169, No. 4 ( 2023-10), p. 890-898
    Details
    In: Otolaryngology–Head and Neck Surgery, Wiley, Vol. 169, No. 4 ( 2023-10), p. 890-898
    Abstract: Investigating faculty perceptions of diversity, equity, and inclusion (DEI) among academic otolaryngology programs. Study Design Quantitative survey. Setting Academic otolaryngology departments. Methods The DEI Inventory was developed by a multi‐institutional health equity consortium and disseminated within 16 academic otolaryngology programs. The inventory consisted of 25 items graded on a 5‐point Likert scale (strongly disagree to strongly agree), 2 yes/no questions, and 5 items reflecting overall DEI, stress, and burnout among academic otolaryngologists. Validated imposter phenomenon and personality trait measures were also included. Results The inventory received 158 (31.0%) partial and 111 (21.8%) full responses. No significant differences were identified in DEI scores by race. Compared to males, females reported lower scores on the overall DEI Inventory (3.6 vs 4.3, p   〈  .001). Female respondents also reported greater levels of imposter phenomenon than their male counterparts (53.2 vs 47.5, p  = .049). Conclusion Preliminary responses to our DEI Inventory suggest that faculty perception of DEI is not impacted by race. Female faculty report considerably lower perceptions of DEI than their male counterparts and experience greater levels of imposter phenomenon. The results of the DEI Inventory can help departments design meaningful interventions to improve levels of DEI among faculty.
    Type of Medium: Online Resource
    ISSN: 0194-5998 , 1097-6817
    URL: Issue
    URL: Article
    DOI: 10.1002/ohn.v169.4
    DOI: 10.1002/ohn.351
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2008453-5
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  • 10
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    Online Resource
    Intraoperative Neural Response Telemetry and Auditory Outcomes in Pediatric Cochlear Implantation
    Wiley ; 2023
    In:  Otolaryngology–Head and Neck Surgery Vol. 168, No. 5 ( 2023-05), p. 1178-1184
    Details
    In: Otolaryngology–Head and Neck Surgery, Wiley, Vol. 168, No. 5 ( 2023-05), p. 1178-1184
    Abstract: To evaluate the relationship between intraoperative neural response telemetry (NRT) and postoperative auditory testing outcomes in children. Study Design Retrospective study. Setting Tertiary‐care academic center. Methods Children who underwent cochlear implantation using the Cochlear Corporation device between 2010 and 2019 were included. Associations of average NRT and the slope of amplitude with postoperative auditory outcomes including functional auditory measure Infant‐Toddler Meaningful Auditory Integration Scale (IT‐MAIS), and speech perception testing (consonant‐nucleus‐consonant [CNC] , Pediatric AzBio [BABY BIO], Hearing In Noise Test [HINT] , and Northwestern University Children's Perception of Speech [NU‐CHIPS]), measured between 6 and 57 months after implantation, were assessed using Spearman's rank correlation ( ρ ). Results Thirty‐eight patients (19 female, 19 male) and 54 ears were included. The median age of implantation was 20.6 months (range 9.6 months to 10.6 years). Eight (21%) children had neurologic disorders such as stroke, epilepsy, cerebral palsy, and other causes. Thirteen (34%) children had connexin mutations. Average NRT was not significantly correlated with postoperative auditory outcomes (IT‐MAIS [ ρ  = −0.08, p  = .74], CNC [ ρ  = 0.19, p  = .32], BABY BIO [ ρ  = 0.21, p  = .29], HINT [ ρ  = 0.05, p  = .83]) and NU‐CHIPS ( ρ  = 0.21, p  = .28). The average slopes of amplitude and comfort level were not strongly correlated with any auditory outcomes ( p   〉  .05). Conclusions Intraoperative NRT was not correlated with any postoperative functional auditory outcomes. Patient counseling should include discussions that a subpar intraoperative cochlear response does not preclude favorable speech and auditory outcomes.
    Type of Medium: Online Resource
    ISSN: 0194-5998 , 1097-6817
    URL: Issue
    URL: Article
    DOI: 10.1002/ohn.v168.5
    DOI: 10.1002/ohn.176
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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