Third Proceedings of The North American Airway Collaborative (NoAAC): Consensus Statement on Trial Design for Airway Stenosis.

Importance: Airway stenosis is a rare but debilitating disorder that significantly degrades the quality of life in affected patients. Treatments are primarily surgical, and disease management lacks established medical therapies. The North American Airway Collaborative held its third symposium at The Johns Hopkins Hospital in Baltimore, Maryland, on April 15, 2024, focused on strategies to advance the care of these patients.

Vocal Fold Medialization Procedures in Previously Radiated Patients: A Survey of Practice Patterns.

Background/objectives: Head and neck radiation therapy (HNRT) has traditionally been considered a contraindication to vocal fold medialization procedures. Although safety has been demonstrated, we hypothesize that actual management varies. This study evaluates practice patterns of otolaryngologists regarding vocal fold medialization in patients after HNRT.

Comparing cadaveric and 3D-printed laryngeal models in transcutaneous injection laryngoplasty.

Background: There is increasing focus on the development of high-quality simulation models for medical education. Cadaveric models, although considered more realistic, may be difficult to obtain and costly. The advent of three-dimensional (3D) printing has offered a low-cost, reliable, and reproducible alternative.

Retrograde Cricopharyngeus Dysfunction: The Jefferson Experience.

Objectives: To describe our center's experience with the identification and treatment of retrograde cricopharyngeus dysfunction (R-CPD), a syndrome involving the inability to belch previously described by only one institution. Additionally, because all patients initially learned of their condition and sought treatment as a result of social media posts, we queried their source and comfort with this form of medical referral.

Methods: Retrospective chart review of patients who underwent botulism toxin injection into the cricopharyngeus muscle for treatment of R-CPD from 2019 to 2022.

Combined Anterior Osteophytectomy and Cricopharyngeal Myotomy for Treatment of DISH-Associated Dysphagia.

Study Design: Retrospective observational case series.

Objective: To assess the outcome of patients with diffuse idiopathic skeletal hyperostosis (DISH) with dysphagia who underwent cricopharyngeal myotomy (CPM) in conjunction with anterior osteophytectomy (OP).

Methods: This is a retrospective observational study of 9 patients that received combined intervention by neurosurgeons and otolaryngologists.

Feasibility of Early Discharge after Open Hypopharyngeal Surgery for Dysphagia.

Objective: To determine the rate of surgical complications, unplanned readmission, and functional status after open hypopharyngeal surgery for dysphagia with early return to oral diet and hospital discharge.

Methods: Retrospective chart review of patients who underwent open hypopharyngeal surgery for management of dysphagia from March 2013 to June 2018 at a single academic institution. A clear liquid diet is restarted the day of surgery and is advanced to a soft diet on postoperative day one.

The Role of Cricopharyngeal Myotomy After Anterior Cervical Decompression and Fusion Operations.

Background: Anterior cervical spine surgeries have low morbidity, sufficient surgical corridor, and quick recovery times. Although largely considered a safe and effective procedure to address cervical myelopathy, radiculopathy, and deformity, dysphagia is a frequent yet poorly understood adverse event. One treatment is cricopharyngeal myotomy (CPM), which aids in swallowing for patients with refractory issues after anterior cervical decompression and fusion (ACDF).

Safety of Outpatient Type 1 Thyroplasty.

Objective: Type 1 thyroplasty is an established procedure for the treatment of vocal fold paralysis to improve voice and swallowing outcomes. At our institution, we commonly perform this procedure on an outpatient basis in medically stable patients. With this study, we assess the safety of outpatient thyroplasty by examining complication and readmission rates, need for revision surgery, and predictors of these outcome measures.

Safety and efficacy of functional laryngectomy for end-stage dysphagia.

Objectives/hypothesis: To evaluate functional outcomes and complication rate after total laryngectomy (TL) for dysfunctional larynx with end-stage dysphagia.

Study Design: Retrospective chart review.

Methods: Chart review was performed on all patients who underwent TL from January 2008 to July 2016 at a single tertiary academic medical center.

Open vs. endoscopic cricopharyngeal myotomy; Is there a difference?

Introduction: The upper esophageal sphincter (UES) is composed largely of the cricopharyngeus muscle (CP) and acts as the gatekeeper to the esophagus. There are multiple methods of treating UES dysfunction, but myotomy has been shown to be the most definitive means. We aim to evaluate the difference between open and endoscopic CP myotomy (CPM).

A Rare Case of Carcinoma Cuniculatum Involving the Larynx in Association with a Saccular Cyst.

Carcinoma cuniculatum (CC), a rare, well-differentiated variant of squamous cell carcinoma, is uncommon in head and neck sites but when it does occur is most common in the oral cavity. Here we report a rare case of CC involving the larynx. A 49-year-old man presented with 10 months of worsening hoarseness and, despite multiple biopsies, no diagnosis of malignancy could be established.

Efficacy of large-diameter dilatation in cricopharyngeal dysfunction.

Objectives/hypothesis: To investigate patient outcomes with large-diameter bougienage in isolated cricopharyngeal dysfunction and understand how esophageal dilatation can be used as an effective diagnostic and therapeutic modality in treating dysphagia.

Study Design: Retrospective review.

Methods: A retrospective chart review was performed on 46 patients meeting the criteria for cricopharyngeal dysphagia from 2004 to 2008 presenting in the outpatient setting.

Laryngeal alveolar rhabdomyosarcoma involving the true vocal fold in an adult: Case report.

Rhabdomyosarcoma of the larynx is extremely rare in adults, as only 17 well-documented cases have been previously reported in the English-language literature. Of these, only 2 cases (both male) involved the alveolar subtype of rhabdomyosarcoma, and neither involved the true vocal folds. We report a case of alveolar rhabdomyosarcoma of the true vocal fold in 54-year-old woman.

Detection of Merkel cell carcinoma polyomavirus in mucosal Merkel cell carcinoma.

A 61-year-old woman presented with solitary lymphadenopathy suspicious for lymphoma. An excisional biopsy of a right inguinal lymph node demonstrated metastatic Merkel cell carcinoma (MCC). No skin lesions were detected, but a primary nasopharyngeal mass was identified.

Readability analysis of patient information on the American Academy of Otolaryngology-Head and Neck Surgery website.

Objective: To evaluate the readability of patient-oriented online health information (OHI) presented on the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) website.

Study Design: Review of the Flesch-Kincaid (FK) grade level for 104 articles on the AAO-HNS website.

Methods: The FK grade level for 104 articles was determined using the readability calculator available within Microsoft Office Word 2003.

Lingual abscess from a grill cleaning brush bristle.

Objectives: 1) Describe the clinical presentation of a lingual abscess secondary to a foreign body. 2) Discuss the workup of glossopharyngeal neuralgia (GN). 3) Review existing literature.

Tracheal stenosis after placement of percutaneous dilational tracheotomy.

Objectives: Percutaneous dilational tracheotomy procedures have been used successfully as a bedside alternative to open surgical tracheotomy. At our institution, we have seen patients with tracheal injuries following this procedure. In this paper, we review those cases to demonstrate that tracheal stenosis is a potential long-term complication of percutaneous dilational tracheotomy.

Identification and monitoring of the recurrent laryngeal nerve during thyroidectomy.

Careful dissection of the recurrent laryngeal nerve (RLN) represents perhaps the most critical component of thyroidectomy. It long has been established that routine identification of the nerve reduces the risk of iatrogenic injury. In recent years, much attention has been paid to the role that functional monitoring plays in identification and preservation of the RLN.

Cervical discitis and epidural abscess after tonsillectomy.

Unlabelled: Approximately 6 weeks after an uncomplicated tonsillectomy for chronic tonsillitis, a 37-year-old woman presented to our emergency department with complaints of odynophagia and cervical pain persistent since surgery. Computed tomographic and magnetic resonance imaging revealed cervical spinal osteomyelitis with epidural abscess at C2 to 3. The patient underwent treatment with intravenous antibiotics, operative debridement, and cervical spinal stabilization.

A third branchial pouch cyst presenting as a lateral neck mass in an adult.

Anomalies of the branchial apparatus occur with some frequency in the adult and pediatric populations. Branchial anomalies are most often derivatives of the first or second pouch. Branchial anomalies involving the third pouch may present as cysts, sinuses, fistulas, and ectopic glands.

Treatment of chronic posterior laryngitis with esomeprazole.

Objective: To evaluate the efficacy of acid-suppressive therapy with the proton pump inhibitor esomeprazole on the signs and symptoms of chronic posterior laryngitis (CPL) in patients with suspected reflux laryngitis.

Study Design: Prospective, multicenter, randomized, parallel-group trial that compared twice-daily esomeprazole 40 mg with placebo for 16 weeks.

Methods: Eligible patients had a history of one or more CPL symptoms (throat clearing, cough, globus, sore throat, or hoarseness) and laryngoscopic signs indicating reflux laryngitis based on CPL index (CPLI) scores measured during a screening laryngoscopy.

Increased incidence of carcinoma of the tongue in patients with systemic sclerosis.

Objective: To describe the incidence of carcinoma of the tongue in a large cohort of patients with systemic sclerosis (SSc).

Methods: In total, 769 patients with SSc were prospectively followed over 16 years for the development of cancer. Patients with a diagnosis of carcinoma of the tongue were identified to determine the incidence of this cancer in SSc.

Thyroplasty revisions: frequency and predictive factors.

Unlabelled: Thyroplasty is the most commonly performed type of laryngeal framework surgery, and the surgical indications are gradually being expanded. Although many reports have described thyroplasty results and rates of success, no study has attempted to determine predictors of the need for revisions or other secondary surgical procedures.

Methods: Retrospective review of 118 primary thyroplasty procedures performed on 96 patients.