Factors Associated With Attrition Among Otolaryngology-Head and Neck Surgery Residents: A 10-Year Analysis.

Objective: To identify the risk factors for Otolaryngology-Head and Neck Surgery (OHNS) resident attrition.

Study Design: Retrospective cohort study.

Setting: Annual Graduate Medical Education track survey.

Surgical Management of the Neck in Oral Cavity Squamous Cell Carcinoma.

Oral cavity cancer remains a significant cause of morbidity and mortality globally, with a poor prognosis once the disease has metastasized to cervical lymph nodes. The anatomy of lymphatic drainage in the neck gives us a roadmap to follow when assessing for metastasis, although the predictive factors are still not well understood. The mainstay of treatment continues to be neck dissection.

Parental leave and family building experiences among head and neck surgeons in the United States: Career impact and opportunities for improvement.

Background: The availability of paid parental leave is an important factor for retention and wellness. The experiences of head and neck surgeons with parental leave have never been reported.

Methods: A survey was electronically distributed to head and neck subspecialty surgeons in the United States.

Carotid endarterectomy for the management of carotid stenosis occurring concurrently with head and neck cancer.

Purpose Of Review: Currently, most patients with concurrent head and neck cancer (HNC) and carotid stenosis (CS) are treated disjointedly for their oncologic and vascular lesions. The purpose of this review is to evaluate literature exploring a novel approach to these cases that poses several advantages, in which carotid endarterectomy (CEA) is performed simultaneously with surgical resection of HNC.

Recent Findings: Carotid stenosis is a common comorbidity of patients presenting with head and neck cancer as these pathologies have overlapping risk factors.

The Tumor Immune Microenvironment Architecture Correlates with Risk of Recurrence in Head and Neck Squamous Cell Carcinoma.

Unlabelled: Emerging evidence suggests that not only the frequency and composition of tumor-infiltrating leukocytes but also their spatial organization might be a major determinant of tumor progression and response to therapy. Therefore, mapping and analyzing the fine tumor immune architecture could potentially provide insights for predicting cancer prognosis. Here, we performed an explorative, prospective clinical study to assess whether structures within the tumor microenvironment can predict recurrence after salvage surgery in head and neck squamous cell carcinoma (HNSCC).

Cautionary case for radial forearm free flap use in trisomy 21.

Background: The radial forearm free flap (RFFF) is considered a workhorse for head and neck cancer reconstructive surgery due to its generally consistent anatomy, pliability, long pedicle, and accessible harvest location.

Methods: A 63-year-old male with trisomy 21 and recurrent midface basal cell carcinoma presented for surgical management. The patient underwent tumor resection including left infrastructure maxillectomy with ipsilateral rhinectomy.

Surgical Management of Advanced Glottic Cancer.

In advanced glottic cancer, it is widely known that definitive chemoradiation can result in comparable survival outcomes to primary surgery. This deserves consideration given the immense effects total laryngectomy (TL) has on patients. It is important to consider that not all advanced glottic tumors should be treated in the same way, and surgical management remains a critical consideration for optimization of local control and survival outcomes.

Redefining Perineural Invasion in Head and Neck Cutaneous Squamous Cell Carcinoma.

Objective: Perineural invasion (PNI) negatively affects disease-specific survival in patients with head and neck cutaneous squamous cell carcinoma (HNcSCC). We aim to analyze the prognostic implications of PNI-related features.

Study Design: Retrospective cohort study.

Molecular and Cellular Mechanisms of Perineural Invasion in Oral Squamous Cell Carcinoma: Potential Targets for Therapeutic Intervention.

The most common oral cavity cancer is squamous cell carcinoma (SCC), of which perineural invasion (PNI) is a significant prognostic factor associated with decreased survival and an increased rate of locoregional recurrence. In the classical theory of PNI, cancer was believed to invade nerves directly through the path of least resistance in the perineural space; however, more recent evidence suggests that PNI requires reciprocal signaling interactions between tumor cells and nerve components, particularly Schwann cells. Specifically, head and neck SCC can express neurotrophins and neurotrophin receptors that may contribute to cancer migration towards nerves, PNI, and neuritogenesis towards cancer.

Manifestations of Human Papillomavirus in the Head and Neck.

Human papillomavirus (HPV)-positive oropharyngeal cancers (OPC) are increasing due to infection with the virus. Most of the patients diagnosed with HPV-positive OPC are white men with numerous lifetime sexual partners who have smoked marijuana excessively. In working up the patient, it is important to obtain an extensive history and physical examination and obtain proper imaging.

False-positive reverse transcriptase polymerase chain reaction screening for SARS-CoV-2 in the setting of urgent head and neck surgery and otolaryngologic emergencies during the pandemic: Clinical implications.

Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT-PCR) for novel coronavirus in preoperative screening.

Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk of viral transmission. Positive tests were repeated.

Changes in head and neck oncologic practice during the COVID-19 pandemic.

Introduction: The COVID-19 pandemic has raised controversies regarding safe and effective care of patients with head and neck cancer. It is unknown how much the pandemic has changed surgeon practice.

Methods: A questionnaire was distributed to head and neck surgeons assessing opinions related to treatment and concerns for the safety of patients, self, family, and staff.

Update on anterior skull base reconstruction.

Purpose Of Review: Anterior skull base reconstruction has rapidly evolved over the past few years as endoscopic approaches to resect tumors in this region have become more established. The present review evaluates the robust amount of new literature on this topic over the past year with particular attention to minimally invasive methods for reconstruction.

Recent Findings: Although vascularized local flaps remain the mainstay reconstructive choice when available for the anterior skull base, innovative techniques for all types of reconstruction, ranging from free grafts to free flaps continue to emerge.

Controversies in free tissue transfer for head and neck cancer: A review of the literature.

Background: Microvascular free tissue transfer provides superior functional outcomes when reconstructing head and neck cancer defects. Careful patient selection and surgical planning is necessary to ensure success, as many preoperative, intraoperative, and postoperative patient and technical factors may affect outcome.

Aims: To provide a concise, yet thorough, review of the current literature regarding free flap patient selection and management for the patient with head and neck.

Abnormal Microvasculature in Laryngectomy Mucosal Margins may be Associated with Increased Risk of Fistula.

Pharyngocutaneous fistula after laryngectomy is common and significantly increases the morbidity of the procedure. Intraoperative, objective variables that can reliably predict fistula formation would be useful to surgeons deciding how to reconstruct the laryngectomy defect. Retrospective chart review of 50 radiated patients and 10 non-radiated patients who underwent total laryngectomy at a single tertiary care institution.

Association of Clinical Risk Factors and Postoperative Complications With Unplanned Hospital Readmission After Head and Neck Cancer Surgery.

Importance: Unplanned hospital readmission is costly and in recent years has become a focus of health care legislation intended to reduce health care expenditures. Greater understanding of which perioperative complications are associated with hospital readmission after surgery for head and neck cancer is needed to reduce unplanned readmissions.

Objective: To determine which clinical risk factors and complications are associated with 30-day unplanned readmission after surgery for malignant neoplasms of the head and neck.

Reoperation following Adult Tonsillectomy: Review of the American College of Surgeons National Surgical Quality Improvement Program.

Objective: Tonsillectomy remains a common procedure in adults; however, there are few population-level data evaluating risk factors for reoperation.

Study Design: Retrospective review of national database.

Setting: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), 2005-2013.

Lymphoepithelial carcinoma of the major salivary glands: Predictors of survival in a non-endemic region.

Introduction: Lymphoepithelial carcinoma (LEC) of the salivary glands is extremely rare worldwide, with studies limited to small case reports and case series from endemic areas (Southern China, Arctic Inuits) and strong association to Epstein Barr Virus (EBV). Studies on non-endemic regions are even more limited given the reality of only sporadic cases in these areas. Using the National Cancer Database (NCDB), we present the largest study on salivary LEC from a non-endemic region, the United States.

IL-1 Receptor Antagonist Inhibits Early Granulation Formation.

Purpose: Using a functional model of airway granulation tissue in laryngotracheal stenosis, we investigated changes in histopathology and inflammatory markers within granulation tissue in response to an interleukin-1 receptor antagonist (IL-1Ra). This study allows us to further delineate the immune response to wound healing and potentially identify treatment markers.

Methods: Laryngotracheal complexes (LTCs) of donor mice underwent direct airway injury.