Is imaging necessary in pediatric patients with isolated tinnitus?

Objectives: Tinnitus is a common otologic complaint which can range from bothersome to debilitating. Imaging is frequently utilized to rule out tumors, fractures, and other causes but can also cause significant medical and economic burden for patients. Furthermore, the pediatric population may require sedation for imaging.

Network Analysis of Women in Otolaryngology and Demographic Trends.

Objective: This study analyzes gender disparities between men and women otolaryngology faculty in the top 20 otolaryngology departments ranked by research output and discusses the implications of these disparities.

Methods: This was a cross-sectional study of all articles published by faculty from January 2020 to December 2021 at the top 20 otolaryngology departments as ranked by Doximity's 2022 research output report. Integrated data from Web of Science, faculty directories, and NIH RePORT were used to collect data on faculty.

Cost-Effectiveness of Diffusion Weighted MRI Versus Planned Second-Look Surgery for Cholesteatoma.

Objective: To compare the cost-effectiveness of serial non-echo planar diffusion weighted MRI (non-EP DW MRI) versus planned second look surgery following initial canal wall up tympanomastoidectomy for the treatment of cholesteatoma.

Methods: A decision-analytic model was developed. Model inputs including residual cholesteatoma rates, rates of non-EP DW MRI positivity after surgery, and health utility scores were abstracted from published literature.

Relationship between socioeconomic status, exposure to airborne pollutants, and chronic rhinosinusitis disease severity.

Background: Air pollution directly interacts with airway mucosa, yet little is known about how pollutants affect upper airway inflammation. Studies have shown increased incidence of chronic rhinosinusitis (CRS), rhinitis, and asthma in areas with higher traffic pollution, and these neighborhoods are often associated with lower socioeconomic status (SES). The Area Deprivation Index (ADI) assesses neighborhood-level SES by zip code.

The true penalty of the waiting room: the role of wait time in patient satisfaction in a busy spine practice.

Objective: Most clinics collect routine data on performance metrics on physicians for outpatient visits. However, the relationship of these metrics with patient experience is unclear. The goal of this study was to investigate the relationships between the Consumer Assessment of Healthcare Providers and Systems Clinician and Group Survey (CG-CAHPS), the standard patient experience survey, and clinic performance metrics to understand the determinants of patient satisfaction and identify targets for improving patient experience.

Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency.

Background: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction relative to other conditions causing NAO. This preliminary study compares differences in NAO experienced by unilateral cleft lip nasal deformity (uCLND) subjects with noncleft subjects experiencing NAO.

Methods: Computational modeling techniques based on patient-specific computed tomography images were used to quantify the nasal airway anatomy and airflow dynamics in 21 subjects: 5 healthy normal subjects; 8 noncleft NAO subjects; and 8 uCLND subjects.

Sinonasal Quality of Life Outcomes After Extended Endonasal Approaches to the Skull Base.

 Endoscopic endonasal skull base surgery (EESBS) leads to significant alterations in sinonasal anatomy and physiology. However, there is limited data available on quality of life (QOL) outcomes following EESBS.  A retrospective review of patients undergoing EESBS from January 2014 to April 2017 was performed.

Recurrent and Progressive Facial Baroparesis on Flying Relieved by Eustachian Tube Dilation.

Objectives: Facial baroparesis is a rare phenomenon of seventh cranial nerve palsy traditionally reported in divers, with only 11 cases reported in aviation so far. It is important to correctly diagnose facial baroparesis given the differential diagnosis of stroke and decompression disease and offer appropriate treatment for recurrent cases.

Methods: The authors present the case of a patient with recurrent and progressive facial baroparesis treated with Eustachian tube balloon dilation.

Factors associated with opioid use after endoscopic sinus surgery.

Objectives/hypothesis: Responsible prescribing of postoperative pain medications is necessary in combatting the current opioid epidemic in the United States. The goal of this study was to determine which clinical factors affect opioid usage following functional endoscopic sinus surgery (FESS).

Study Design: Retrospective medical records study.

Pleomorphic Mantle Cell Lymphoma of the Tongue Base Presenting With Dysphagia.

Objectives: We aim to increase awareness of pleomorphic mantle cell lymphoma as a rare, but aggressive form of lymphoma with propensity for recurrence in secondary locations.

Methods: We report the case of a 70-year-old man who presented with chronic post-nasal drainage, dysphagia, and voice changes caused by a tongue base mass.

Results: Partial excision and pathology showed a pleomorphic mantle cell lymphoma, and radiation treatment was completed.

Chief complaints and feedback from clinic satisfaction tool: Thematic analysis of a new outpatient communication tool.

Objectives: Up to half of all patients leave their outpatient clinic visit with an uncommunicated need. We designed the clinic satisfaction tool (CST) as a low-cost, highly utilised assessment of the spine clinic experience that improved communication in our multidisciplinary spine practice. The purpose of this study was to qualitatively analyse chief complaints and feedback from the CSTs to determine how spine clinic patients used the form, identify the most prevalent concerns and mark areas for improvement.

Airway findings in children with tracheostomies: When is diagnostic bronchoscopy and laryngoscopy indicated?

Objectives: To determine the utility of diagnostic laryngoscopy and bronchoscopy in children with tracheostomies and to describe the incidence of airway findings.

Methods: Retrospective cohort study examining children with tracheostomies who underwent direct laryngoscopy and bronchoscopy (DLB) at Duke University Hospital between 2008 and 2016.

Results: A total of 81 patients who underwent 114 bronchoscopies met inclusion criteria.

Factors Associated with Revision Surgery after Balloon Sinuplasty.

Objective: Although balloon sinuplasty (BSP) is increasing in popularity, little is known about which patients are the ideal candidates. The objective of this study is to investigate factors that may be associated with BSP failure.

Study Design: Retrospective review.

Clinic Satisfaction Tool Improves Communication and Provides Real-Time Feedback.

Background: Patient-reported assessments of the clinic experience are increasingly important for improving the delivery of care. The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey is the current standard for evaluating patients' clinic experience, but its format gives 2-mo delayed feedback on a small proportion of patients in clinic. Furthermore, it fails to give specific actionable results on individual encounters.

Noninvasive optical spectroscopy for identification of non-melanoma skin cancer: Pilot study.

Objective: Optical spectroscopy offers a noninvasive alternative to biopsy as a first-line screening tool for suspicious skin lesions. This study sought to define several optical parameters across malignant and benign tissue types.

Study Design: Prospective pilot trial utilizing the Zenalux IM1 optical spectroscopy device from April 2016 to February 2017.

Recurrent post-tonsillectomy bleeding due to an iatrogenic facial artery pseudoaneurysm.

This is a report of an illustrative case of recurrent post-tonsillectomy bleeding that was caused by an iatrogenic facial artery pseudoaneurysm and controlled by endovascular embolization. A 37 year-old female who underwent bilateral tonsillectomy for chronic tonsillitis had recurrent secondary hemorrhage despite multiple operative interventions to control the bleeding. Because of the recurrent nature of the bleeding, an angiography of the external carotid artery was performed demonstrating a pseudoaneurysm of the left facial artery with active extravasation.

Correlation between sinus and lung cultures in lung transplant patients with cystic fibrosis.

Background: Lung transplantation has revolutionized the treatment of end-stage pulmonary disease due to cystic fibrosis. However, infection of the transplanted lungs can lead to serious complications, including graft failure and death. Although many of these patients have concurrent sinusitis, it is unclear whether bacteria from the sinuses can infect the allograft.

Investigating the effects of laryngotracheal stenosis on upper airway aerodynamics.

Objective: Very little is known about the impact of laryngotracheal stenosis (LTS) on inspiratory airflow and resistance, especially in air hunger states. This study investigates the effect of LTS on airway resistance and volumetric flow across three different inspiratory pressures.

Methods: Head-and-neck computed tomography scans of 11 subjects from 2010 to 2016 were collected.

Penetrating Craniomaxillofacial Injury Caused by a Pneumatic Nail Gun.

Craniomaxillofacial injuries can be complex, requiring a multidisciplinary approach. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. A 26-year-old man presented with a penetrating nail gun injury through the oral and nasal cavities.

Humor therapy: relieving chronic pain and enhancing happiness for older adults.

The present study examined the effectiveness of a humor therapy program in relieving chronic pain, enhancing happiness and life satisfaction, and reducing loneliness among older persons with chronic pain. It was a quasiexperimental pretest-posttest controlled design. Older persons in a nursing home were invited to join an 8-week humor therapy program (experimental group), while those in another nursing home were treated as a control group and were not offered the program.