Tracheoesophageal Puncture Outcomes at a Safety Net Hospital.

Tracheoesophageal puncture (TEP) is the gold standard for voice rehabilitation after total laryngectomy (TL). Retrospective analysis was performed of TEP outcomes in patients between 2013 and 2020 at a single tertiary hospital. TEP was performed primarily in 79%, secondarily in 6%, and not placed in 15% of 226 patients.

Feasibility and efficacy of home-based lymphedema exercises for head and neck cancer patients at a safety net hospital.

Purpose: Lymphedema therapy is an effective tool in mitigating head and neck lymphedema morbidity and long-term fibrosis. Studies have shown the efficacy of facility-based therapy; however, access can be limited by sociodemographic factors, including socioeconomic status and transportation. This study evaluates the feasibility and effectiveness of home-based lymphedema therapy in a socially vulnerable patient population.

Survival Outcomes of Total Laryngectomy: Evaluating the Intersection of Race and Social Determinants.

Objective: Analyze joint effects of race and social determinants on survival outcomes for patients undergoing total laryngectomy for advanced or recurrent laryngeal cancer at a tertiary care institute.

Methods: Retrospective chart review of adult patients undergoing total laryngectomy for laryngeal cancer at a tertiary care center from 2013 to 2020. Extracted data included demographics, pathological staging and features, treatment modalities, and outcomes such as recurrence, fistula formation, and 2- and 5-year disease-free survival (DFS) and overall survival (OS).

Allyship to Advance Diversity, Equity, and Inclusion in Otolaryngology: What We Can All Do.

Purpose Of Review: To summarize the current literature on allyship, providing a historical perspective, concept analysis, and practical steps to advance equity, diversity, and inclusion. This review also provides evidence-based tools to foster allyship and identifies potential pitfalls.

Recent Findings: Allies in healthcare advocate for inclusive and equitable practices that benefit patients, coworkers, and learners.

Outcomes of Head and Neck Free Tissue Transfer in Renal Failure Patients.

Objective: To assess if there is increased risk of free flap failure in renal failure patients undergoing head and neck reconstruction. We seek to primarily assess free flap outcomes based on stages of chronic kidney disease (CKD) and secondarily determine increased risk for postoperative complications.

Methods: Retrospective chart review was performed at five tertiary care centers.

Swallowing Function After Treatment of Laryngeal Cancer.

Dysphagia is a common functional outcome following treatment of laryngeal cancer. Despite curative advances in both nonsurgical and surgical approaches, preserving and optimizing swallowing function is critical. Understanding the nature and severity of dysphagia depending on initial tumor staging and treatment modality and intensity is crucial.

A case of head and neck cutaneous squamous cell carcinoma highlighting aggressive perineural features.

Cutaneous squamous cell carcinoma (cSCC) is the second most common nonmelanoma skin cancer in the United States following basal cell carcinoma. The majority are successfully cured by surgical excision or Mohs microsurgery. A subset of cSCCs are more aggressive and likely to recur locally, spread to regional lymph nodes or even distantly, and can even result in death.

Head and neck squamous cell carcinomas among males of the three largest Asian diasporas in the US, 2004-2013.

Background: Head and neck squamous cell carcinomas (HNSCC) have not been fully examined in the Asian diasporas in the US, despite certain Asian countries having the highest incidence of specific HNSCCs.

Methods: National Cancer Database was used to compare 1046 Chinese, 887 South Asian (Indian/Pakistani), and 499 Filipino males to 156,927 Non-Hispanic White (NHW) males diagnosed with HNSCC between 2004-2013. Multinomial logistic regression was used to assess the association of race/ethnicity with two outcomes - site group and late-stage diagnosis.

Modified Manikin for Tracheoinnominate Artery Fistula.

Audience: This simulator is designed to instruct emergency medicine residents in tracheostomy training that involves bleeding from the tracheostomy site. Any resident, fellow, or attending physician who cares for patients with complications from their tracheostomy might benefit from this innovation.

Introduction: The emergency medicine provider must maintain proficiency in caring for patients with complications from their tracheostomy.

Tracheoinnominate Artery Fistula.

Audience: This simulation provides training for emergency medicine residents in the stepwise management of a patient who presents with bleeding from a tracheoinnominate artery fistula. Additional learners who might benefit from this simulation are otolaryngology and general surgery residents as well as critical care fellows.

Introduction: Hemorrhage from a tracheoinnominate artery fistula (TIAF) is a rare but life-threatening complication in a patient with a recent tracheostomy.

Enhanced Recovery After Surgery Nutrition Protocol for Major Head and Neck Cancer Surgery.

Objective: To determine whether an enhanced recovery after surgery (ERAS) nutrition protocol is reasonably possible among our head and neck cancer (HNC) population with respect to system feasibility and patient compliance. Second, we aim to identify improvements in patient outcomes as a result.

Methods: Preexperimental research design among patients undergoing major HNC surgery after implementation of the ERAS nutrition protocol from July 2018 to July 2019 as quality improvement (QI).

Quality-Adjusted Life Years and Disability-Adjusted Life Years Are Better With Concurrent Chemoradiation Therapy Than Induction Chemotherapy Followed by Chemoradiation Therapy in Nasopharyngeal Carcinoma.

Introduction As traditional measures such as overall survival (OS) or disease-free survival (DFS) alone do not give a holistic view of the outcomes of a treatment paradigm, we determine to add the evidence of quality-adjusted life year (QALY) and disability-adjusted life year (DALY) to the outcomes of the nasopharyngeal carcinoma patients (NCP) treated with definitive chemoradiation therapy (chemoRT) with or without induction chemotherapy (induction chemo). Methods This is a retrospective analysis of 85 NCPs treated at an academic state institution. The OS estimated by the Kaplan-Meier method and the multivariate Cox regression model determined the co-variables associated with the OS.

The Role of Mohs Surgery in Cutaneous Head and Neck Cancer.

Mohs micrographic surgery (MMS) represents an excellent means to address basal cell carcinoma and some squamous cell carcinomas (cSCCs) of the head and neck region, achieving excellent outcomes with respect to local recurrence rates and disease-specific survival. MMS by virtue of its technique maximally preserves uninvolved tissues of the head and neck, thereby maintaining form, cosmesis, and function to the greatest extent as dictated by the disease. However, the application of MMS for managing high-risk cSCC and melanoma requires additional investigation.

Open Versus Robotic Surgery for Oropharyngeal Cancer.

Transoral robotic surgery is a useful minimally invasive technique in the treatment of oropharyngeal squamous cell carcinoma, both human papilloma virus (HPV)-positive and HPV-negative patients in certain instances. This treatment modality often has proven useful for certain tumor persistences or recurrences. Good outcomes are possible given appropriate patient selection, both oncologically and functionally.

Frailty as a Predictor of Postoperative Outcomes among Patients with Head and Neck Cancer.

Objectives: To understand measures of frailty among preoperative patients and explain how these can predict perioperative outcomes among patients with head and neck cancer.

Study Design: Retrospective cross-sectional case series with chart review.

Setting: Academic tertiary medical center.

Society of Behavioral Medicine position statement: Society of Behavioral Medicine supports oral cancer early detection by all healthcare providers.

In response to the increasing incidence of certain oral and oropharyngeal cancers, the Society of Behavioral Medicine (SBM) calls on healthcare providers and legislators to expand awareness of oral and oropharyngeal cancer risk factors, increase early detection, and support policies that increase utilization of dental services. SBM supports the American Dental Association's 2017 guideline for evaluating potentially malignant oral cavity disorders and makes the following recommendations to healthcare providers and legislators. We encourage healthcare providers and healthcare systems to treat oral exams as a routine part of patient examination; communicate to patients about oral/oropharyngeal cancers and risk factors; encourage HPV vaccination for appropriate patients based on recommendations from the Advisory Committee on Immunization Practices; support avoidance of tobacco use and reduction of alcohol consumption; and follow the current recommendations for evaluating potentially malignant oral cavity lesions.

Survival outcomes for postoperative chemoradiation in intermediate-risk oral tongue cancers.

Background: The survival outcomes for surgery + postoperative radiotherapy (S+RT) or surgery + postoperative chemoradiation (S+CRT) was compared in patients having oral tongue cancers with intermediate-risk pathological features.

Methods: Using the National Cancer Database (NCDB), overall survival (OS) for S+RT or S+CRT was estimated using the Kaplan-Meier methods and Cox proportional hazard models in the entire population (n = 2803) and in a propensity-matched cohort (n = 1136).

Results: The 3-year OS was 73.

Measures of economic advantage associated with HPV-positive head and neck cancers among non-Hispanic black and white males identified through the National Cancer Database.

Background: National trends show dramatic increases in the incidence of HPV-related head and neck squamous cell carcinomas (HNSCCs) among black and white males. Using cases identified through the National Cancer Data Base, we assessed factors associated with HPV 16- or 16/18 positive HNSCCs among non-Hispanic black and white males diagnosed in the U.S.

Tumid lupus: An unexpected diagnosis for the otolaryngologist.

Tumid lupus is an uncommon variant of lupus erythematosus. Patients present with subcutaneous lesions. Ophthalmic literature reports disease manifestation as orbital inflammation.

Predictors and outcomes for chronic tracheostomy after chemoradiation for advanced laryngohypopharyngeal cancer.

Objectives/hypothesis: After concurrent chemoradiation for head and neck squamous cell cancer, patients with laryngeal incompetence may not recover function. We assessed variables predicting tracheostomy dependence as a measure of poor laryngeal function after chemoradiation.

Study Design: Retrospective

Methods: Analysis of 109 patients treated with chemoradiation for locoregionally advanced laryngohypopharyngeal squamous cell cancers between 1992 and 2013.

Evaluation of immunohistochemical fine sectioning for sentinel lymph node biopsy in oral squamous cell carcinoma.

Objective: To determine the level of sentinel lymph node sectioning necessary to accurately detect nodal micrometastasis.

Study Design: Cross-sectional.

Setting: Tertiary care university medical center.