Esophageal Dysphagia in Adults: When It Sticks.

Esophageal dysphagia is a common yet difficult to diagnose condition. This article underscores the role of detailed patient history and physical examinations, including prompt endoscopic evaluation, for accurate differentiation between esophageal and oropharyngeal dysphagia. The authors discuss the heightened importance of early intervention in certain patient groups, such as elderly individuals and patients with head and neck cancer, to mitigate the risk of malnutrition and infection.

Can EAT-10 Become EAT-5? Improving Measurement Efficiency of Dysphagia with Item Response Theory.

Objectives: To assess: (1) the Eating Assessment Tool (EAT-10) with item response theory (IRT) to determine which individual items provide the most information, (2) the extent to which dysphagia is measured with subsets of items while maintaining precise score estimates, and (3) if 5-item scales have the differing discriminatory ability, as compared to the parent 10-item instrument.

Methods: Prospectively collected data from 2,339 patients who completed the EAT-10 questionnaire during evaluation at a tertiary care otolaryngology clinic were utilized. IRT analyses provided discrimination and location parameters associated with individual questions.

Predictive Outcomes of Deep Learning Measurement of the Anterior Glottic Angle in Bilateral Vocal Fold Immobility.

Objective: (1) To compare maximum glottic opening angle (anterior glottic angle, AGA) in patients with bilateral vocal fold immobility (BVFI), unilateral vocal fold immobility (UVFI) and normal larynges (NL), and (2) to correlate maximum AGA with patient-reported outcome measures.

Methods: Patients wisth BVFI, UVFI, and NL were retrospectively studied. An open-source deep learning-based computer vision tool for vocal fold tracking was used to analyze videolaryngoscopy.

Benefits of Side-Firing Optical Fibers in Endoscopic Laser Treatment of the Larynx.

Objective: To elucidate potential tissue coverage of side-firing optical fibers in office-based endoscopic laser treatment of larynx, as well as to demonstrate their enhanced ability to address challenging anatomic areas.

Method: We performed a comparative study of four different fiber designs: a traditional forward-facing fiber, and three side-firing fibers that emit light at an angle of 45°, 70°, and 90°, respectively. The study was conducted in simulation, using eight three-dimensional models of the human larynx generated from microtomography x-ray scans.

Does Ibuprofen Increase Bleed Risk for Pediatric Tonsillectomy?

Objective: To evaluate risk factors for pediatric posttonsillectomy hemorrhage (PTH) and the need for transfusion using a national database.

Study Design: Retrospective cohort study.

Setting: The study was conducted using the Pediatric Health Information System (PHIS) database.

National Variation of Insurance Coverage for Gender-Affirming Facial Feminization Surgery.

Gender-affirming surgery may be pursued by individuals experiencing gender dysphoria. Although genital and chest procedures are classified as medically necessary, facial feminization surgeries (FFSs) are often considered cosmetic. Insurance companies may limit coverage of these procedures, especially in states less supportive of transgender individuals.

Assessment of Gender Differences in Clinical Productivity and Medicare Payments Among Otolaryngologists in 2017.

Importance: Women comprise an increasing proportion of the otolaryngology workforce. Prior studies have demonstrated gender-based disparity in physician practice and income in other clinical specialties; however, research has not comprehensively examined whether gender-based income disparities exist within the field of otolaryngology.

Objective: To determine whether diversity of practice, clinical productivity, and Medicare payment differ between male and female otolaryngologists and whether any identified variation is associated with practice setting.

Does the Reflux Symptom Index Predict Increased Pharyngeal Events on HEMII-pH Testing and Correlate with General Quality of Life?

Objectives: To determine the ability of the reflux symptom index (RSI) to predict objective impedance and pH-probe testing, and to examine the relationship between disease-specific and general health status in patients diagnosed with laryngopharyngeal reflux (LPR).

Methods: Adults presenting to a tertiary care academic center with a primary voice complaint completed the RSI and the Patient-Reported Outcomes Measurement Information System 10-item global health instrument (PROMIS). An RSI score ≥13 was considered abnormal.

Can voice disorders matter as much as life-threatening comorbidities to patients' general health?

Objective: National initiatives and funding agencies may deprioritize voice disorders relative to conditions such as malignancy, pulmonary, or cardiac disease. It is unknown whether the impact of voice problems is outweighed by other potentially more serious disease states. Our objective was thus to quantify the extent to which voice contributes to general health status when adjusting for concurrent, more life-threatening comorbidities.

Is a voice-specific instrument more indicative of stroboscopy results than common clinical queries?

Objectives: To determine whether the Voice Handicap Index-10 (VHI-10) predicts diagnoses made via laryngoscopy/stroboscopy, as compared to common clinical inquiries about vocal characteristics.

Methods: We prospectively collected data from a cohort of 204 consecutive patients newly presenting for ambulatory laryngology evaluation. Each patient completed the VHI-10 and 16 concurrent mainstream queries about vocal characteristics such as weakness, breathiness, fatiguability, or inability to shout.