Large Bilobed Flap for Head and Neck Reconstruction: Technique and Outcomes.

Background: Head and neck reconstruction after resection of cutaneous malignancies spans the entire reconstructive ladder. Local flaps, such as the bilobed flap, offer excellent versatility, negligible morbidity, and minimal hospitalization. However, there is sparse data regarding the bilobed flap for large defects of the head and neck.

Social Determinants of Health and Language and Academic Outcomes in Pediatric Cochlear Implantation: A Systematic Review and Meta-Analysis.

Importance: Cochlear implants can restore sound and enable speech and language development for children with severe to profound sensorineural hearing loss. Long-term outcomes of pediatric cochlear implant recipients are variable. Although the association between social determinants of health (SDH) and pediatric cochlear implant outcomes has been explored, the strength of this association has not been quantitatively synthesized in the literature.

Safety of Small-Diameter Endotracheal Tubes in Microlaryngeal Surgery.

Objectives: Microlaryngeal surgeries require unique considerations for airway management to facilitate patient safety and adequate surgical exposure. Small-diameter endotracheal tubes (ETTs) are widely used but have raised concerns regarding patient safety, including questions about the potential for barotrauma, effective ventilation, and adequate oxygenation. We hypothesize that small ETTs will prove to be safe in a variety of cases.

Predictors of Response to Cognitive Behavioral Therapy in Patients With Tinnitus.

Importance: Clinical guidelines recommend cognitive behavioral therapy (CBT) as a treatment for tinnitus. However, patient response to CBT is variable, and currently, there are no known predictors of response to CBT treatment for tinnitus.

Objective: To identify the clinical predictors of patient response to CBT for treatment of tinnitus.

Clinical studies in COVID-related olfactory disorders: Review of an institutional experience.

Objective: To share a single institutional experience with clinical research on COVID-related olfactory dysfunction (OD).

Data Source/method: Narrative review of published original data and ongoing clinical trials on COVID-related OD at Washington University from 2020 to 2023.

Results: There were three new diagnostic-/patient-reported outcome measures developed and tested.

Tracheostomy Incidence and Complications: A National Database Analysis.

Objective: To describe the incidence of tracheostomy-related complications and identify prognostic risk factors.

Study Design: Administrative database analysis.

Setting: Outpatient and inpatient insurance claims records obtained from a national database.

Mandibular Advancement vs Combined Airway and Positional Therapy for Snoring: A Randomized Clinical Trial.

Importance: Approximately 150 million individuals in the US snore in the absence of obstructive sleep apnea (primary snoring), but few studies have examined the efficacy of treatments for snoring or evaluated the effect of snoring in sleeping partners.

Objective: To evaluate the efficacy of 2 treatments for primary snoring.

Design, Setting, And Participants: This pilot randomized clinical trial that included a convenience sample of people who snore without sleep apnea and their sleeping partner who underwent 4 weeks of snoring treatment was conducted at an academic medical center between October 3, 2022, and July 3, 2023.

Telemedicine critical care availability and outcomes among mechanically ventilated patients.

Purpose: Telemedicine Critical Care (TCC) improves adherence to evidence based protocols associated with improved mortality among patients receiving invasive mechanical ventilation (IMV). We sought to evaluate the relationship between hospital availability of TCC and outcomes among patients receiving IMV.

Materials And Methods: We performed a cross-sectional study of 66,522 adults who received IMV for non-postoperative acute respiratory failure at 318 non-federal hospitals in New York, Massachusetts, Maryland, and Florida in 2018.

Individual Patient Comorbidities and Effect on Cochlear Implant Performance.

Objective: To examine the association between preoperative comorbidities and cochlear implant speech outcomes.

Study Design: Retrospective cohort.

Setting: Tertiary referral center.

Prognostic Factors for Survival Using a Clinical Severity Staging System Among Patients With Acute Invasive Fungal Sinusitis.

Importance: Despite the aggressive progression of fulminant acute invasive fungal sinusitis (AIFS), data on prognostic factors have been disparate, hindering the development of a staging system. A composite staging system may improve prognostication for patient counseling and conduct of clinical research.

Objective: To identify prognostically important factors in AIFS and to incorporate the factors into a comprehensive Functional Severity Staging System and Clinical Severity Staging System.

Smoking, Drinking, and Dietary Risk Factors for Head and Neck Cancer in Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Participants.

Importance: There is a paucity of large-scale prospective studies evaluating the risk of developing head and neck cancer (HNC) associated with smoking, drinking, and dietary habits.

Objective: To determine the association of smoking, drinking, and dietary habits with the risk of developing HNC.

Design, Setting, And Participants: A nested cohort survival analysis of Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial participants was performed.

Validation of Minimal Clinically Important Difference (MCID) for University of Pennsylvania Smell Identification Test (UPSIT).

Background: The University of Pennsylvania Smell Identification Test is widely used to measure change in olfactory function, but a minimal clinically important difference (MCID) has not been well-established. A study published in 1997 regarding patients with head trauma reported an MCID of 4 but did not detail the methods used in the calculation.

Objective: To validate the MCID for UPSIT in patients with postviral, sinusitis, and procedure-associated olfactory loss.

Stellate Ganglion Block for the Treatment of COVID-19-Induced Olfactory Dysfunction: A Prospective Pilot Study.

Objective: The objective of this study was to explore the safety and feasibility of stellate ganglion blocks (SGBs) to treat persistent COVID-19-induced olfactory dysfunction (OD). Secondarily, the goal was to determine effect sizes to plan a future randomized clinical trial.

Study Design: Prospective case series.

Efficacy of Gabapentin For Post-COVID-19 Olfactory Dysfunction: The GRACE Randomized Clinical Trial.

Importance: The COVID-19 pandemic affected millions of people and has become a dominant etiology of olfactory dysfunction (OD). No interventions with definitive clinical utility exist. Gabapentin represents a potential therapy for COVID-19-induced OD.

Preexisting tumor-resident T cells with cytotoxic potential associate with response to neoadjuvant anti-PD-1 in head and neck cancer.

About 50% of patients with locally advanced head and neck squamous cell carcinoma (HNSCC) experience recurrences after definitive therapy. The presurgical administration of anti-programmed cell death protein 1 (PD-1) immunotherapy results in substantial pathologic tumor responses (pTR) within the tumor microenvironment (TME). However, the mechanisms underlying the dynamics of antitumor T cells upon neoadjuvant PD-1 blockade remain unresolved, and approaches to increase pathologic responses are lacking.

Development and Validation of the Parosmia Olfactory Dysfunction Outcomes Rating (DisODOR).

Objective: Develop and validate a quality-of-life (QoL) outcome measure for patients with dysosmia.

Study Design: Cross-sectional survey study.

Setting: Otolaryngology clinics, research registries, and Facebook support groups.

Identifying Predictors of Treatment Response in Meniere's Disease: A Clinical Severity Staging System.

Objective: Identify clinically important factors associated with conservative treatment response in Meniere's disease and incorporate these factors into a composite clinical severity staging system.

Study Design: Retrospective cohort.

Setting: Tertiary academic medical center.

Optimization of diagnostic and procedural codes to identify patients with acute invasive fungal sinusitis.

Acute invasive fungal sinusitis (IFS) is a rare disease with high mortality There is no designated International Classification of Diseases code for IFS We propose a novel method to identify IFS using optimized codes complemented by medications.

Acute Taste Dysfunction in Oropharyngeal Cancer Patients after Transoral Robotic Surgery.

Objectives: To compare taste changes after transoral robotic surgery (TORS) to taste changes in healthy controls.

Methods: Oropharyngeal cancer patients receiving TORS and healthy controls were recruited. Participants underwent posterolateral and whole-mouth psychophysical taste testing (identification, intensity, and hedonics) at baseline and at 2 weeks postoperatively (patients) or follow-up (controls).

Developing an Inclusive Scholarship Curriculum for Medical Students.

Problem: As part of a curriculum renewal, in 2020, Washington University School of Medicine in St. Louis sought to create an integrated curriculum that allows students to explore 4 academic career pathways (advocacy/global health, education, innovation, and research) and engage in scholarship activities-the Inquiry Curriculum. The curriculum needed to focus on foundational scholarship skills that would be applicable to all pathways.

Longitudinal Analysis of Early Hearing Detection and Intervention Program Performance.

Objectives: Early hearing detection and intervention (EHDI) is a newborn hearing screening system created to detect infants with hearing loss (HL) and intervene to reduce language and communication impairment. Early hearing detection (EHD) consists of three sequential stages: identification, screening, and diagnostic testing. This study longitudinally reviews each stage of EHD in each state and proposes a framework to improve utilization of EHD data.

Investigating Individual Variation Using Dynamic Structural Equation Modeling: A Tutorial with Tinnitus.

A growing body of research suggests that standard group-based models might provide little insight regarding individuals. In the current study, we sought to compare group-based and individual predictors of bothersome tinnitus, illustrating how researchers can use dynamic structural equation modeling (DSEM) for intensive longitudinal data to examine whether findings from analyses of the group apply to individuals. A total of 43 subjects with bothersome tinnitus responded to up to 200 surveys each.