OTO Journal

This podcast discusses the implications for otolaryngologists of "Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations", published as a supplement to the February 2022 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

The purpose of this clinical practice guideline update is to reassess and update recommendations in the prior guideline from 2013 and to provide clinicians with trustworthy, evidence-based recommendations on patient selection and surgical indications for managing tympanostomy tubes in children.

Click here to read the Guideline.

This podcast highlights original research published in the January 2022 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

The aging US population requires an increasing volume of otolaryngology–head and neck surgery services, yet the otolaryngologist physician workforce remains static. Advanced practice providers (APPs), including physician assistants and nurse practitioners, improve access across the continuum of primary and subspecialty health care.

In conclusion, the demand for health care services in otolaryngology care will increasingly exceed otolaryngologist surgeon workforce capacity. APPs are valuable partners in meeting growing needs of the population. While further data are needed to determine the optimal models of high-quality care, it is clear that APPs will be play an ever-greater role in shaping the specialty. Successful growth in otolaryngology–head and neck surgery requires a culture that supports effective integration of APPs across diverse practice settings. Progress also requires open-mindedness on the part of both providers and patients in embracing evolving models of care.

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This podcast highlights original research published in the December 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

Subglottic stenosis (SGS) is a known complication of granulomatosis with polyangiitis (GPA). We investigated the impact of medical and surgical interventions on the surgical dilation interval and characterized patients with glottic involvement.

In conclusion, although GPA is classically thought to affect the subglottis, it also involves the glottis in a subset of patients. These patients have greater complaints of dysphonia and require more frequent surgery. Systemic therapy may increase dilation intervals. In this preliminary study, patients taking leflunomide demonstrated an improvement, highlighting the need for further study of immunosuppression regimens in the treatment of GPA-associated SGS.

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This podcast highlights original research published in the November 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

The objective was to review long-term clinical and quality-of-life outcomes following free flap reconstruction for osteonecrosis.

In conclusion, the majority of patients maintained or had advancement in diet following reconstruction, with low rates of osteonecrosis or cancer recurrence and above-average scores on UW-QOL survey suggesting good return of function and quality of life.

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This podcast highlights original research published in the October 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

Pathologic extranodal extension (ENE) is an important adverse feature for human papillomavirus (HPV)–negative head and neck squamous cell carcinoma (HNSCC), but the prognostic significance of microscopic ENE (ENE_mi) and role of adjuvant concurrent chemoradiation (CRT) for ENE_mi remain unclear. This study evaluates (1) the prognostic significance of ENE_mi in HPV-negative HNSCC and (2) whether adjuvant CRT is associated with improved overall survival (OS) for these patients.

In conclusion, for patients with HPV-negative HNSCC, pN+ with ENE_mi is associated with worse OS than pN+ without ENE. However, for patients with ENE_mi, concurrent CRT is not associated with improved OS relative to RT. The optimal adjuvant paradigm for ENE_mi requires additional investigation.

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This podcast highlights original research published in the September 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

Traumatic brain injury (TBI) is the leading cause of acquired long-term disability during childhood, and it may result in wide range of negative developmental consequences. Auditory dysfunction is generally recognized to be a possible sequela of pediatric TBI. Unfortunately, few contemporary studies have quantified the association between head injury and hearing loss in the pediatric population.

In conclusion, findings suggest a notable association between TBI and hearing loss. Children with a history of TBI are 2.67 times more likely to have concurrent hearing complaints.

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This podcast highlights original research published in the August 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

The objective was to evaluate the presence of bitter taste receptors (T2Rs) in the middle ear and to examine their relationship with chronic ear infections.

In conclusion, T2Rs were found within the middle ear of every patient sampled; the rs1376251 allele of TAS2R50 appears to be related to chronic ear infections. These receptors are an intriguing target for future research and possible drug targeting.

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This podcast highlights original research published in the July 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

Nurse practitioners and physician assistants form a growing advanced practice provider (APP) group. We aim to analyze the trends and types of services provided by APPs in otolaryngology.

In conclusion, due to increasing numbers, APPs are accounting for more patient visits and procedures over time. The physician workforce and the numbers of procedures performed per physician have remained relatively stable from 2012 to 2017. Increasing complexity of patients seen and a broader range of procedures offered by work-experienced or postgraduate-trained APPs may further improve access to health care in the face of possible physician shortages.

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This podcast highlights original research published in the June 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

The objective was to characterize the relationship between objective tympanogram values and patient-reported symptoms and associations with common comorbid conditions.

In conclusion, patients with symptoms of ETD may have a TPP within a range typically considered normal per conventional standards. This suggests that the currently accepted interpretation of tympanometry findings may be insensitive for the diagnosis of less severe cases of ETD.

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This podcast highlights original research published in the May 2021 issue of Otolaryngology–Head and Neck Surgery, the official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation.

Part 1 objective: To assess the prevalence of distress and burnout in otolaryngology trainees, including associations with relevant sociodemographic and professional factors, and to compare these results with those of attending otolaryngologists.

Part 2 objective: To ascertain the prevalence of and associations with distress and professional burnout among academic otolaryngology attending physicians.

Part 1 conclusion: Otolaryngology trainees experience significant work-place distress (49%) and burnout (35%). Gender, HW, and NOC had the strongest associations with distress and burnout.

Part 2 conclusion: Distress or professional burnout occurs in more than a quarter of academic otolaryngology attending physicians, whereas the prevalence of depression or anxiety is approximately 10%. The number of hours worked per week had the strongest association with distress and burnout. These findings may be used to develop and implement programs to promote physician well-being and mitigate professional burnout.

Click here to read the full part 1 article.

Click here to read the full part 2 article.