The Impact of MassPAT on Opioid Prescribing Patterns for Otolaryngology Surgeries.

Objective: Determine whether opioid prescriber patterns have changed for tonsillectomy, parotidectomy, and thyroidectomy after implementation of the Massachusetts Prescription Awareness Tool (MassPAT).

Study Design: Retrospective cohort study.

Setting: Single-center tertiary care hospital.

Results, Knowledge, and Attitudes Regarding an Incentive Compensation Plan in a Hospital-Based, Academic, Employed Physician Multispecialty Group.

Hospitals and healthcare systems are introducing incentive metrics into compensation plans that align with value-based payment methodologies. These incentive measures should be considered a practical application of the transition from volume to value and will likely replace traditional productivity-based compensation in the future. During the transition, there will be provider resistance and implementation challenges.

Practical applications of in-office fiberoptic transnasal esophagoscopy in the initial evaluation of patients with squamous cell cancer of the head and neck.

We conducted a study to analyze the effectiveness of transnasal esophagoscopy (TNE) as an alternative to operative endoscopy (OE) for the evaluation of primary head and neck cancers and for the surveillance of synchronous esophageal cancers. Our study population was made up of 96 consecutively presenting patients-75 men and 21 women, aged 45 to 88 years (mean: 64)-who were treated at our institution for squamous cell cancer of the head and neck. Of this group, 42 patients had been evaluated with TNE and 54 with OE.

A survey of current practices, attitudes, and knowledge regarding human papillomavirus-related cancers and vaccines among head and neck surgeons.

Importance: Understanding head and neck surgeons' current knowledge, practices, and opinions regarding human papillomavirus (HPV) education and prevention will enable efforts to assist surgeons in this important endeavor.

Objective: To assess knowledge, attitudes, and beliefs of head and neck surgeons regarding HPV education and vaccination.

Design, Setting, And Participants: Online survey of members of the American Head and Neck Society (AHNS) in late 2011 and early 2012.

Novel neoadjuvant immunotherapy regimen safety and survival in head and neck squamous cell cancer.

Background: Cellular immune suppression is observed in head and neck squamous cell cancer (HNSCC) and contributes to poor prognosis. Restoration of immune homeostasis may require primary cell-derived cytokines at physiologic doses. An immunotherapy regimen containing a biologic, with multiple-active cytokine components, and administered with cytoxan, zinc, and indomethacin was developed to modulate cellular immunity.

Nasal valve dysfunction: diagnosis and treatment.

Purpose Of Review: This article reviews the etiology and treatment options for nasal valve stenosis (NVS), a common cause of nasal obstruction. It is based on meta-analyses, published expert panel opinions, extensive literature review, and previously published results of our own clinical experience.

Recent Findings: Diagnosis and management of NVS continue to evolve.

Minimally invasive nasal valve repair: An evaluation using the NOSE scale.

Objective: To determine the efficacy of a new surgical procedure to correct symptoms of nasal obstruction secondary to internal nasal valve narrowing.

Design: Consecutive case series.

Setting: Tertiary care multispecialty clinic.

In-office surgical repair of nasal valve stenosis.

Background: Nasal valve (NV) stenosis is a well-known cause of nasal obstruction (NO) and congestion but it is often overlooked because the typical surgical therapies are complex and often associated with cosmetic changes. A simplified surgical procedure is needed to address straightforward stenosis of the NV in patients with no need of cosmetic improvement or cartilage grafting. The purpose of this article is to describe a simplified surgical procedure to relieve symptoms of NO without extensive surgical dissection, sedation, cartilage grafting, or cosmetic change.

Surgical reconstruction of lentigo maligna defects.

Objective: To review our experience with lentigo maligna, a melanoma in situ that occurs primarily on the head and neck in older adults, and reconstructive efforts applied in managing the large defects following lentigo maligna excision that are not amenable to primary closure.

Methods: We reviewed the records of 23 patients who underwent serial excision of lentigo maligna using a modified Mohs technique. We compared the sizes of the initial lesion and postexcision defect, examined photographs taken before and after surgery, and studied techniques used in reconstruction.

Transnasal esophagoscopy: a high-yield diagnostic tool.

Objectives: Transnasal esophagoscopy (TNE) reveals a wide range of esophageal findings. TNE technique, indications, outcomes, advantages, limitations, and impact on patient care are described.

Study Design: Retrospective chart review.

Endoscopic septoplasty.

Endoscopic septoplasty (ES) is gaining in popularity as surgeons come to appreciate the many advantages this procedure possesses compared to the traditional open approach. We present our experience and discuss advantages and disadvantages of ES. Particular attention is given to the use of ES in the correction of nasal valve obstruction.

Gastric distention in a spontaneously ventilating patient with a ProSeal laryngeal mask airway.

Partial upper airway obstruction during spontaneous respiration with a ProSeal laryngeal mask airway can result in gastric distention.