Evaluation of Cholesteatoma.

Evaluation of cholesteatoma depends on clinical history and examination, with microscope and/or endoscope. A history of hearing loss with a chronic draining ear, refractory to ototopical medication, raises suspicion for cholesteatoma. Symptoms of Eustachian tube dysfunction or prior ear surgery including ear tubes should be elicited.

Deep learning to predict risk of lateral skull base cerebrospinal fluid leak or encephalocele.

Purpose: Skull base features, including increased foramen ovale (FO) cross-sectional area, are associated with lateral skull base spontaneous cerebrospinal fluid (sCSF) leak and encephalocele. Manual measurement requires skill in interpreting imaging studies and is time consuming. The goal of this study was to develop a fully automated deep learning method for FO segmentation and to determine the predictive value in identifying patients with sCSF leak or encephalocele.

Management of Foreign Bodies in the Ear Canal.

Using the appropriate instruments and techniques for removing a foreign body from the external auditory canal facilitates the procedure and reduces the risk of complications. Most ear foreign bodies can be addressed on a nonurgent basis, but batteries and caustic materials warrant prompt removal. Referral to an otolaryngologist should be considered for difficult cases or after a failed attempt.

Transcervical intubation for massive self-inflicted neck wound transecting the epiglottis.

Background: Penetrating trauma to the larynx is a rare phenomenon with a high risk of mortality and morbidity due to the density of vital structures in the area (Demetriades et al., 1996). Most commonly, this type of injury is due to a gunshot wound or knife injury (Snow and Ballenger, 2003).

Expansion of the Foramen Ovale in Patients With Cerebrospinal Fluid Leak or Encephalocele.

Objective: Spontaneous cerebrospinal fluid (CSF) leaks are associated with elevated intracranial pressure and idiopathic intracranial hypertension (IIH). Skull base erosion and widening of the foramen ovale have been reported in patients with IIH. This study sought to investigate changes in the size of the foramen ovale and foramen spinosum in patients with IIH, spontaneous CSF leak, and encephalocele.

Meat tenderizer assault and associated facial trauma: A case report.

Background: Blunt trauma to the face, head and neck is frequently encountered in violent assaults (Brink, 2009 [1]). There can be trauma to the cranium in high energy mechanisms, though interpersonal trauma is less likely to be associated with traumatic brain injury (TBI) (Salentijn et al., 2014 [2]).

Positive margins matter regardless of subsequent resection findings.

Objectives: In the resection of oral cavity squamous cell carcinoma (OCSCC), an intraoperative positive surgical margin (SM) communicated to the head and neck surgeon necessitates further resection of the area of identified involvement to achieve a final negative SM. The prognostic implication of initial positive SM when the final SM is negative is understudied.

Materials And Methods: We retrospectively reviewed 249 patients with non-metastatic (stage I-IVB) OCSCC who underwent a resection from 2010 to 2019 to assess the prognostic impact of an initial positive SM.

The effect of geographic rounding on hospitalist work experience: a mixed-methods study.

Objectives: To describe the structure and implementation of a model in which hospitalists focus on a particular hospital unit or area, referred to as 'geographic rounding,' and to analyze its effect on hospitalist efficiency, interruptions, after-hours work, and satisfaction.

Methods: The leadership of our academic hospital medicine group designed a geographic rounding intervention with the goal of improving provider satisfaction and mitigating burnout. Our quantitative analysis compared the pre-intervention and post-intervention time periods with regard to progress note completion time, after-hours progress note completion, secure messaging communication volume, and Mini-Z survey results.

Higher Readmission Rates After Hip Fracture Among Patients With Vestibular Disorders.

Objective: Falls in older adults are associated with high morbidity and mortality. Patients with vestibular disorders may have an increased risk. The purpose of this study was to examine the outcomes among patients with underlying vestibular disorders who have hip fractures and identify predictors of increased morbidity and mortality.

Population-based survival of pediatric rhabdomyosarcoma of the head and neck over four decades.

Objectives: Clinical trials have reported increases in the survival of pediatric rhabdomyosarcoma (RMS) from 25% in 1970 to 73% in 2001. The purpose of this study was to examine whether survival of pediatric patients with RMS of the head and neck improved at the US population level.

Methods: A population-based cohort of patients with rhabdomyosarcoma of the head and neck aged 0-19 years in the Surveillance, Epidemiology, and End Results (SEER) registry from 1973 to 2013 was queried.

Diffuse Spontaneous Laryngeal Hemorrhage with Trastuzumab.

Drug-induced epithelial hemorrhage of the endolarynx is an unusual etiology of hemoptysis. We present a case of hemoptysis in a young female patient undergoing treatment for metastatic breast cancer with trastuzumab emtansine. Though previously associated with diffuse spontaneous hemorrhage of the gingiva, there have not been reports of laryngeal hemorrhage with trastuzumab emtansine treatment.

Benign and Malignant Granular Cell Tumor of the Hypopharynx: Two Faces of a Rare Entity.

Granular cell tumors (GCT) are rare soft tissue tumors that involve the head and neck in 50% of patients. Two distinct variants of GCT, one benign (bGCT) and the other malignant (mGCT), involving the hypopharynx, a subsite of the larynx, are presented here. The clinical presentations, radiographic features, pathologic diagnosis in these two variants of GCT are discussed.

Treating Nicotine Dependence and Preventing Smoking Relapse in Cancer Patients.

Introduction: Despite the well-documented harmful effects of smoking, many cancer patients continue to smoke. Smoking cessation is critical to address in this population given the associated increase in treatment toxicity, risk of second primary tumors, decrease in treatment response and higher disease-specific and all-cause mortality with continued smoking following a cancer diagnosis. This review seeks to summarize the latest recommendations and guidelines on smoking cessation treatment for patients diagnosed with cancer, and the evidence behind those recommendations.

Head and neck cancers in India.

Head and neck cancers constitute a third of the cancer burden in India. These cancers have unique patient characteristics, presentation, and etiological differences from those in the West. Socioeconomic constraints, large patient population, scarcity of trained health workers, and inadequate infrastructure are major challenges faced in the management of these cancers.

Development of the Head and Neck Cancer Caregiving Task Inventory.

Purpose: Family caregivers provide vital support for patients with head and neck cancer (HNC), yet few studies have focused on HNC caregiving. Our objective was to develop and conduct initial validation of the HNC Caregiving Task Inventory, an instrument to characterize caregiving task burden in the HNC population.

Methods: This 5-phase instrument development project involved the conceptualization of caregiving task burden (Phase 1), initial instrument development (Phase 2), assessment of content validity through expert panel review (Phase 3), assessment of face validity through family caregiver review (Phase 4), and preliminary validation in a sample of 106 family caregivers (Phase 5).

National Trends in the Surgical Treatment of Non-advanced Medullary Thyroid Cancer (MTC): An Evaluation of Adherence with the 2009 American Thyroid Association Guidelines.

Background: Medullary thyroid cancer (MTC) represents the third most common type of thyroid cancer, and the prognosis depends on the stage of the disease at diagnosis and completeness of tumor resection. In 2009, the American Thyroid Association (ATA) published guidelines with evidence-based recommendations for the treatment of MTC. This study aimed to determine national adherence rates of the treatment according to the ATA guidelines specific for MTC.

Thyroidectomy Hemostasis.

Total thyroidectomy has significantly changed over the years from a morbid procedure to one that is performed routinely on an outpatient basis. This article reviews the history of thyroid surgery with regard to hemostasis, discusses surgical vascular anatomy, and describes the methods of hemostasis. It compares traditional hemostatic surgical techniques with newer techniques such as the Harmonic Scalpel and LigaSure hand pieces.

Supportive Care and Survivorship Strategies in Management of Squamous Cell Carcinoma of the Head and Neck.

Supportive care and survivorship strategies in the management of head and neck squamous cell carcinoma (HNSCC) revolve around continued collaborative efforts aimed at early identification and intervention for locoregional disease recurrence, second primary malignancy, management of treatment-related side effects, and provision for psychosocial support. Development of evidence-based guidelines and optimization of these strategies is increasingly important in the setting of improved survival of patients with HNSCC because of a variety of diagnostic and therapeutic advances and evolving demographics of HNSCC patient population, specifically, p16-associated oropharyngeal squamous cell carcinoma.

Smell and taste disorders.

Olfaction and taste promote satisfaction and protection in daily life. The astute facial plastic surgeon recognizes the importance of a baseline smell test to document the patients' olfactory status before surgery. After surgery, the surgeon must be alert to the possible mechanisms of hyposmia and anosmia and the pertinent treatment strategies.

Pediatric tracheotomy in special populations: comparison of operative times and survival.

We conducted a retrospective study to analyze various aspects of tracheotomy in children with abnormal laryngotracheal anatomy, a congenital cardiac anomaly, both, or neither. Our study population consisted of 53 children who had undergone tracheotomy performed by a single otolaryngologist; 12 patients had abnormal laryngotracheal anatomy and 9 had a cardiac anomaly. Mean operative times were significantly longer in both of these groups than they were in children with normal anatomy (69 vs.

Treatment planning for multiunit restorations--the use of diagnostic planning to predict implant and esthetic results in patients with congenitally missing teeth.

Patients afflicted with congenitally missing teeth are a unique patient population for consideration of treatment with osseointegrated implants. Frequently, these patients have limited development of the alveolar process and differences in spatial position relative to the opposing arch, which places emphasis on ancillary treatment with orthodontics and oral surgery. A thorough diagnostic workup should include an interdisciplinary approach to ensure optimal treatment and timing of treatment in those who are developing.

Grisel's syndrome: a case report and review of the literature.

Grisel's syndrome is non-traumatic atlantoaxial subluxation (AAS) secondary to an inflammatory process in the upper neck. It is a rare condition that occurs almost exclusively in children and has been associated with upper cervical infections and otolaryngologic procedures. A case of AAS secondary to an upper cervical infection is presented.

Clinical assessment of patients with smell and taste disorders.

Clinical assessment of the patient who has smell and taste disorders requires understanding of the etiology of the olfactory and gustatory disorders. Available clinical tests of olfactory and gustatory systems allow detecting and measuring the degree of the sensory loss, but are unable to determine the cause and give neither prognostic information nor therapeutic guidance. With physical examination, however, clinical history can help to establish the diagnosis and guide the treatment if available.