Workforce Analysis of Laryngologists in the United States Between 1993 and 2022.

Introduction: This study queries the US laryngology workforce geographic distribution and density and models laryngology workforce trends through 2050.

Methods: A national database of fellowship-trained laryngologists (FTLs) and nonfellowship-trained laryngologists (nFTLs) practicing primarily laryngology was formed by identifying laryngologists via internet search, with validation by regional laryngologists and senior laryngologists on this manuscript. Demographic variables included residency and/or fellowship graduation year, institutional affiliation, and practice zip code.

Inter-rater and Intra-rater Reliability of Glottal Image Capture: A Mobile Application to Quantify Vocal Fold Bowing.

Background: Age-related vocal atrophy (ARVA) causes vocal fold bowing, impacting communication and quality of life. The assessment of vocal fold bowing is largely subjective. Glottal Image Capture (GlottIC) is a new mobile application that helps quantify vocal fold bowing.

Posterior Cricoarytenoid Muscle Chemodenervation Can Improve Voice in Recalcitrant Dysphonia in Unilateral Vocal Fold Paresis With Synkinesis.

Objectives: Patients with unilateral vocal fold paresis and unfavorable posterior cricoarytenoid (PCA) muscle synkinesis can be challenging to treat with medialization procedures alone. Arytenoid repositioning procedures are generally considered contraindicated in mobile vocal folds. We present two cases of persistent dysphonia following type I thyroplasty for vocal fold paresis that improved after botulinum toxin-A (BTX-A) injection into the PCA muscle.

Gender and Racial Demographic Trends in the US Laryngology Workforce (1993-2022).

Objectives: To analyze demographic trends in laryngology fellowship training in the United States from 1993 to 2022, comparing periods before and after formalization of the fellowship within the National Resident Matching Program (NRMP) in 2012.

Methods: A national database of fellowship-trained laryngologists (FTLs) and non-fellowship-trained laryngologists (nFTLs) practicing primarily laryngology was created by methodically compiling laryngologists via Internet search, with corroboration by regional laryngologists and vetting by senior laryngologists on this manuscript. Demographic variables included residency and/or fellowship graduation year, gender, race and ethnicity inferred through individuals' photos and surnames.

A review for non-antibiotic treatment of : new insight.

Gastric ulcers and gastric cancer are brought on by the bacteria, which colonizes under the stomach mucous membrane. Different medication regimens are used to remove it, but the illness returns and becomes more resistant, which lowers the treatment rates. Additionally, this bacterium now exhibits a skyrocketing level of multi-drug resistance, necessitating recurrent therapeutic treatments.

Anti-CTLA-4 nanobody as a promising approach in cancer immunotherapy.

Cancer is one of the most common diseases and causes of death worldwide. Since common treatment approaches do not yield acceptable results in many patients, developing innovative strategies for effective treatment is necessary. Immunotherapy is one of the promising approaches that has been highly regarded for preventing tumor recurrence and new metastases.

Glioma Stem Cells Are Sensitized to BCL-2 Family Inhibition by Compromising Histone Deacetylases.

Glioblastoma (GBM) remains an incurable disease with an extremely high five-year recurrence rate. We studied apoptosis in glioma stem cells (GSCs) in response to HDAC inhibition (HDACi) combined with MEK1/2 inhibition (MEKi) or BCL-2 family inhibitors. MEKi effectively combined with HDACi to suppress growth, induce cell cycle defects, and apoptosis, as well as to rescue the expression of the pro-apoptotic BH3-only proteins BIM and BMF.

Epidural Abscess After Injection Pharyngoplasty: A Case Report.

VPI occurs when the seal between the oral and nasal cavities does not doesn't close completely. One of the treatment options is an injection pharyngoplasty (IP). We are presenting a life threating -threatening case of epidural abscess after in- office injection pharyngoplasty IP.

Comparative Treatment Outcomes for Idiopathic Subglottic Stenosis: 5-Year Update.

The North American Airway Collaborative (NoAAC) previously published a 3-year multi-institutional prospective cohort study showing variation in treatment effectiveness between 3 primary surgical techniques for idiopathic subglottic stenosis (iSGS). In this report, we update these findings to include 5 years of data evaluating treatment effectiveness. Patients in the NoAAC cohort were re-enrolled for 2 additional years and followed using the prespecified published protocol.

Defining the Performance of Clinician's Ability to Screen for Laryngeal Mass From Voice.

Objective: Defining a clinician's ability to perceptually identify mass from voice will inform the feasibility, design priorities, and performance standards for tools developed to screen for laryngeal mass from voice. This study defined clinician ability of and examined the impact of expertise on screening for laryngeal mass from voice.

Study Design: Task comparison study between experts and nonexperts rating voices for the probability of a laryngeal mass.

Treatments for Age-related Vocal Atrophy: A Systematic Review.

Objective: Age-related vocal atrophy (ARVA) can dramatically affect voice, communication, and quality of life. The objectives of this systematic review were to (1) determine whether treatments for ARVA were superior to controls (2) compare the relative efficacy of procedural and behavioral treatments (3) review the various types of outcome measures, and (4) evaluate the quality of studies.

Review Methods: The literature was searched using strategies designed by a medical librarian (2/18/21, updated 3/9/22).

Tracheotomy care simulation training program for inpatient providers.

Objectives: Tracheotomy complications can be life-threatening. Many of these complications may be avoided with proper education of health care providers. Unfortunately, access to high-quality tracheotomy care curricula is limited.

Quantification of Vocal Fold Atrophy in Age-Related and Parkinson's Disease-Related Vocal Atrophy.

Objective: Vocal fold atrophy (VFA) is associated with aging and Parkinson's disease (PD). Clinical diagnosis of VFA depends on several visual-perceptual laryngostroboscopy findings that are inherently subjective. The purpose of this study was to use quantitative measurements to; (1) examine the relationships between VFA and dysphonia severity and (2) evaluate differences in VFA in patients with age-related VFA versus PD.

Engineered interfaces between perovskite LaLiTiO electrolyte and Li metal for solid-state batteries.

Perovskite LaLiTiO (LLTO) materials are promising solid-state electrolytes for lithium metal batteries (LMBs) due to their intrinsic fire-resistance, high bulk ionic conductivity, and wide electrochemical window. However, their commercialization is hampered by high interfacial resistance, dendrite formation, and instability against Li metal. To address these challenges, we first prepared highly dense LLTO pellets with enhanced microstructure and high bulk ionic conductivity of S cm at room temperature.

Extreme Sawtooth-Sign in Motor Neuron Disease (MND) suggests Laryngeal Resistance to Forced Expiratory Airflow.

Objective: The impact of laryngeal dysfunction on airflow has not been well characterized in motor neuron disease (MND). This study aimed to detect and characterize extreme airflow oscillations informally observed during volitional cough and forced vital capacity (FVC) tasks in individuals with MND who demonstrated neurolaryngeal impairments including reduced speed and extent of vocal fold abduction compared to healthy controls during volitional cough expulsion. The extreme airflow oscillations in the MND group, when viewed as a flow-volume loop, appeared similar to the "sawtooth-sign.

Update on Tracheostomy and Upper Airway Considerations in the Head and Neck Cancer Patient.

Patients with head and neck cancer account for a large proportion of perioperative airway events. Further, these patients frequently require tracheostomy placement, which is one of the most common surgical procedures. This article reviews updated techniques in managing a difficult airway in patients with head and neck cancer, such as strategies for intubation/extubation, methods of tubeless laryngeal surgery, and techniques and relevant topics in tracheostomy management.

Safety and Predictors of 30-Day Adverse Events of Laryngeal Framework Surgery: An Analysis of ACS-NSQIP data.

Objectives/hypothesis: To characterize and identify predictors of 30-day adverse events in patients undergoing laryngeal framework surgery (LFS).

Study Design: This study is a retrospective analysis of the National Surgical Quality Improvement dataset.

Methods: LFS cases were identified from the American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) database from 2008 to 2018.

Sensitivity of the Communicative Participation Item Bank for Measuring Patient-Reported Outcomes After Treatment of Unilateral Vocal Fold Immobility.

Importance: The Communicative Participation Item Bank (CPIB) is a patient-reported outcome measure assessing the association between communication disorders and participation in daily communication. To our knowledge, no prior research has examined whether CPIB scores change after treatment of unilateral vocal fold immobility (UVFI).

Objective: To compare CPIB scores before and after treatment of UVFI and with patient-defined target treatment outcomes and other common clinical outcomes after UVFI intervention.

Assessing the Clinical Utility of the Early Postoperative Pharyngogram in Hypopharyngeal Surgery for Dysphagia.

Objectives/hypothesis: To evaluate the clinical utility of postoperative contrast x-ray pharyngograms (XRP) for detecting pharyngoesophageal leaks following hypopharyngeal dysphagia surgery.

Study Design: Retrospective cohort study.

Methods: Medical records were reviewed of patients undergoing endoscopic (E-) or open (O-) Zenker's diverticulectomy (-ZD) with cricopharyngeal myotomy (-CPM) and CPM alone from 2008 to 2020 at one academic institution.

Association of Social Determinants of Health with Time to Diagnosis and Treatment Outcomes in Idiopathic Subglottic Stenosis.

Objectives: To examine whether social determinants of health (SDH) factors are associated with time to diagnosis, treatment selection, and time to recurrent surgical intervention in idiopathic subglottic stenosis (iSGS) patients.

Methods: Adult patients with diagnosed iSGS were recruited prospectively (2015-2017) via clinical providers as part of the North American Airway Collaborative (NoAAC) and via an online iSGS support community on Facebook. Patient-specific SDH factors included highest educational attainment (self-reported), median household income (matched from home zip code via U.

Comparative Treatment Outcomes for Patients With Idiopathic Subglottic Stenosis.

Importance: Surgical treatment comparisons in rare diseases are difficult secondary to the geographic distribution of patients. Fortunately, emerging technologies offer promise to reduce these barriers for research.

Objective: To prospectively compare the outcomes of the 3 most common surgical approaches for idiopathic subglottic stenosis (iSGS), a rare airway disease.

The minimal clinically important difference of the dyspnea index in laryngotracheal stenosis.

Objective: The Dyspnea Index (DI) is a validated patient-reported outcome (PRO) instrument that has been used in the management of laryngotracheal stenosis (LTS). The minimal clinically important difference (MCID) is an established concept to help determine the change in a PRO instrument that reflects meaningful change for the patient. It is not known what change in the DI is of clinical significance in airway surgery.