Human papillomavirus circulating tumor DNA assays as a mechanism for head and neck cancer equity in rural regions of the United States.

The rates of human papillomavirus-positive oropharyngeal cancer (HPV-OPC) are rising worldwide and in the United States, particularly in rural regions including Appalachia. Rural areas face unique health challenges resulting in higher cancer incidence and mortality rates, and this includes HPV-OPC. The recent advent of highly sensitive liquid biopsies for the non-invasive detection of HPV-OPC recurrence (circulating tumor HPV DNA, HPV ctDNA) has been swiftly adopted as part of surveillance paradigms.

Patient Experience of Head and Neck Surgery With Free Flap Reconstruction.

Importance: Major head and neck surgery with microvascular free tissue transfer reconstruction is complex, with considerable risk of morbidity. Little is known about patients' experiences, including decision-making prior to, and regret following, free flap surgery.

Objective: To characterize patient experiences and decision regret of patients undergoing head and neck reconstructive free flap surgery.

Prevalence of human papillomavirus in head and neck cancers at tertiary care centers in the United States over time.

Background: Human papillomavirus (HPV) is responsible for a growing proportion of oropharyngeal squamous cell carcinomas (OPSCCs) among men and White individuals. Whether similar trends apply to women, non-Whites, and non-oropharyngeal squamous cell carcinomas (non-OPSCCs) is unknown.

Methods: This is a cross-sectional analysis combining 2 multi-institutional case series of incident head and neck squamous cell carcinoma (HNSCC) cases.

Development of a web-based, patient-centered decision aid for oropharyngeal cancer treatment.

Objectives: Many patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) have the option of radiation- or surgery-based therapy, and would benefit from a treatment decision aid (DA) to make decisions congruent with their personal values. Our objective was to develop a patient-centered DA for patients with OPSCC that is comprehensible, usable, acceptable, and well-designed.

Materials And Methods: Decisional needs from a pilot study of OPSCC survivors and treating physicians were used to inform a web-based prototype DA.

Biologic and behavioral associations of estrogen receptor alpha positivity in head and neck squamous cell carcinoma.

Objectives: Tumor HPV status is an established independent prognostic marker for oropharynx cancer (OPC). Recent studies have reported that tumor estrogen receptor alpha (ERα) positivity is also associated with prognosis independent of HPV. Little is known about the biologic and behavioral predictors of ERα positivity in head and neck squamous cell cancer (HNSCC).

Epidemiologic distinctions between base of tongue and tonsil oropharyngeal carcinomas.

Background: Human papillomavirus (HPV)-positive tonsil and base of tongue (BOT) cancers have been considered together. However, important differences may exist.

Methods: Demographic and tumor characteristics, and survival, were compared by oropharyngeal cancer subsite from 2004 to 2016 in the National Cancer Database (NCDB).

RTOG-0129 risk groups are reproducible in a prospective multicenter heterogeneously treated cohort.

Background: Recursive partitioning analysis (RPA) from the Radiation Therapy Oncology Group (RTOG)-0129 has identified a low-risk group of patients with oropharynx cancer (OPC) who might benefit from therapeutic de-intensification. These risk groups have not yet been reproduced in an independent cohort treated heterogeneously. Therefore, the objective of this analysis was to validate the RPA risk groups and examine the prognostic impact of novel factors.

Otolaryngology burden of disease and surgical case triage in resource-limited settings: An example from Cameroon.

Objectives: Otolaryngology services worldwide faced an unprecedented demand for case triage during the SARS-CoV-2 pandemic. We propose and apply a novel case-leveling schema in a resource-limited setting. Describing the surgical burden of otolaryngologic disease in this setting may critically inform resource planning to address global surgical disparities.

Factors and Outcomes Associated With Temporal Bone Resection for Primary Parotid Malignancy.

Objective(s): Although parotid cancer invading into the temporal bone makes up only a small fraction of all parotid cancers, it is more common and relatively understudied compared with primary cancer of the external auditory canal. The objective of this study was to determine what factors are associated with receiving parotidectomy with temporal bone resection (TBR) and the immediate postoperative outcomes.

Methods: We reviewed the National Cancer Database (2004-2015) for patients with primary parotid malignancy who received parotidectomy with or without TBR.

Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer.

Background: Case-control studies from the early 2000s demonstrated that human papillomavirus-related oropharyngeal cancer (HPV-OPC) is a distinct entity associated with number of oral sex partners. Using contemporary data, we investigated novel risk factors (sexual debut behaviors, exposure intensity, and relationship dynamics) and serological markers on odds of HPV-OPC.

Methods: HPV-OPC patients and frequency-matched controls were enrolled in a multicenter study from 2013 to 2018.

Treatment decision-making among patients with oropharyngeal squamous cell cancer: A qualitative study.

Oropharyngeal squamous cell cancer (OPSCC) is now the most common site of head and neck squamous cell cancer. Despite the focus on treatment deintensification in clinical trials, little is known about the preferences, experiences and needs of patients with OPSCC when deciding between surgery and radiation therapy as primary treatment with curative intent. In this qualitative study, pre-treatment and post-treatment oropharyngeal cancer patients were recruited to take part in one-on-one interviews (n = 11 pre-treatment) and focus group discussions (n = 15 post-treatment) about treatment decision-making.

Impact of the COVID-19 pandemic on Otolaryngology trainee education.

Background: The COVID-19 pandemic has reduced clinical volume with a negative impact on trainee education.

Methods: Survey study of Otolaryngology trainees in North America, during the COVID-19 pandemic in April 2020.

Results: Of 216 respondents who accessed the survey, 175 (83%) completed the survey.

The Role of Age and Merkel Cell Polyomavirus in Oral Cavity Cancers.

The incidence of oral tongue cancer, the majority subsite of oral cavity cancer, is rising among young people with less exposure to tobacco and alcohol. Viral causes have been proposed, including Merkel cell polyomavirus (MCPyV). We evaluated patient and tumor characteristics among 126 incident oral cavity cancers (OCCs).

Risk factors for human papillomavirus-positive nonoropharyngeal squamous cell carcinoma.

Background: Human papillomavirus (HPV)-positive oropharyngeal cancer (HPV-OPC) is distinct from HPV-unassociated head and neck cancer. However, whether risk factors for HPV-positive oropharyngeal and nonoropharyngeal squamous cell cancer are the same is unclear.

Methods: Incident cases of HPV-positive head and neck cell cancer and matched non-cancer controls were enrolled in a multi-institutional, prospective study examining risk factors, biomarkers, and survival.

HPV-positive Squamous Cell Carcinoma of the Larynx, Oral Cavity, and Hypopharynx: Clinicopathologic Characterization With Recognition of a Novel Warty Variant.

Human papillomavirus (HPV) is a principal driver for most oropharyngeal squamous cell carcinomas (OPSCCs), where it is strongly associated with improved survival. HPV is much less frequently detected in squamous cell carcinomas arising in nonoropharyngeal sites (non-OPSCCs), and its pathogenic role and prognostic value in these tumors is unclear. We evaluated the clinicopathologic features of 52 non-OPSCCs considered HPV-positive based upon p16 immunohistochemistry and direct HPV detection using RNA in situ hybridization (ISH), DNA ISH, or real-time DNA polymerase chain reaction.

Distinct biomarker and behavioral profiles of human papillomavirus-related oropharynx cancer patients by age.

Background: HPV-positive oropharynx squamous cell cancer (HPV-OPC) patients were initially described as younger, however incidence has increased among older age-groups. It is unknown why some patients present at a younger age and others at a later age.

Methods: Multi-institutional prospective study of HPV-OPC cases (n = 163) and matched controls (n = 345) with detailed behavioral survey, and serum tested for HPV antibodies by fluorescent bead-based technology.

The association between diabetes and olfactory impairment in adults: A systematic review and meta-analysis.

Background: Evidence suggests that olfactory impairment (OI) may be a degenerative neurologic complication of diabetes; however, the association is not yet well established. The objective of this work was to systematically review existing literature on the association between diabetes and OI in adults, with meta-analysis of evaluable studies.

Methods: A literature search encompassing 358 abstracts from the last 75 years in PubMed, EMBASE, and Cochrane was performed.

Priorities of human papillomavirus-associated oropharyngeal cancer patients at diagnosis and after treatment.

Introduction: Little is known regarding how human papillomavirus-positive oropharyngeal cancer (HPV-OPC) patient goals change with treatment. This study evaluates whether patient ranking of non-oncologic priorities relative to cure and survival shift after treatment as compared to priorities at diagnosis.

Materials And Methods: This is a prospective study of HPV-OPC patient survey responses at diagnosis and after treatment.

Predictive value of olfactory impairment for cognitive decline among cognitively normal adults.

Objective: Dementia affects over 47 million people worldwide. Olfactory impairment (OI) is a well-established predictive marker of conversion to dementia among those with mild cognitive impairment. This systematic review aims to describe the predictive value of OI for future cognitive decline among cognitively normal adults.

Sex differences in HPV immunity among adults without cancer.

The incidence of human papillomavirus (HPV)-associated head and neck cancers is rising, particularly among men. Whether observed epidemiological differences in sex are explained by differences in sexual exposure and/or by immune response is unclear. In this cross-sectional, multi-institutional study, seroprevalence of antibodies to HPV L1 capsid antigen was compared by patient characteristics among 374 adult patients without cancer.

Priorities, concerns, and regret among patients with head and neck cancer.

Background: In the era of deintensification, little data are available regarding patients' treatment preferences. The current study evaluated treatment-related priorities, concerns, and regret among patients with head and neck squamous cell cancer (HNSCC).

Methods: A total of 150 patients with HNSCC ranked the importance of 10 nononcologic treatment goals relative to the oncologic goals of cure and survival.

Treatment preferences in human papillomavirus-associated oropharyngeal cancer.

The population of survivors with human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPV-OPSCC) is rising. The improved prognosis of this etiologic subset is reflected in new staging guidelines as well as ongoing deintensification trials aiming to preserve excellent survival while decreasing treatment-related toxicities. However, as staging criteria and treatment standards evolve in the era of transoral surgery and deintensification, little is known regarding the needs and treatment preferences of patients with HPV-OPSCC.

Case report: presentation of delayed tracheal perforation after hemithyroidectomy.

Hemithyroidectomy is a low-risk, outpatient procedure commonly performed for benign and some small, differentiated thyroid malignancies. Delayed tracheal perforation following thyroid surgery is exceedingly rare and has previously only been reported after total thyroidectomy. We describe a 25-year-old patient who underwent an unremarkable right hemithyroidectomy to remove a 4-centimeter fine needle aspiration cytologically indeterminate thyroid nodule, and presented 4 weeks later with acute anterior neck swelling and subcutaneous emphysema after strenuous exercise.