Sage Otolaryngology

This podcast concludes the remarkable tenure of John H. Krouse, MD, PhD, MBA, editor in chief of Otolaryngology–Head and Neck Surgery and OTO Open, the official journals of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF), and welcomes the incoming leadership of Cecelia E. Schmalbach, MD, MSc, as the new editor in chief. In his final podcast, Dr. Krouse ushers in a new era as he discusses with Dr. Schmalbach her plans for the future of both AAO-HNSF journals.   Click here to read the article.

This podcast highlights original research published in the August official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. The objective was to evaluate nodule height-to-width ratio as a continuous variable predicting likelihood of thyroid malignancy. In conclusion, our results support the association between greater height-to-width ratio and malignancy but suggest that a multilevel rather than binary variable improves prediction. The likelihood ratios at different intervals give a more nuanced view of how height-to-width ratio predicts malignancy. With continuing review of guidelines for thyroid nodule biopsy, it is important to consider these data for any point total attributed to shape.   Click here to read the article.

This podcast highlights original research published in the July official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. The objective was to determine the range of incidental mucosal changes in a general sinonasally asymptomatic population on radiology. In conclusion, the prevalence of incidental mucosal changes in a general asymptomatic population on radiology needs to be considered when making a diagnosis of chronic rhinosinusitis.   Click here to read the article.

This podcast highlights original research published in the June official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. There has never been a time in our society when we have been as willing and open in our discussions around issues of racial and ethnic inequalities, discrimination, systemic racism, and socioeconomic disparities. Within this dialogue on health inequalities, one soon comes to realize the strong interplay of bioethics, social justice, and systemic racism on health care and outcomes. Ethical questions pertaining to the rights of individual participants in research, criteria for inclusion and recruitment into studies, and the development of trusting relationships among communities, health systems, and governmental agencies continue to challenge us in achieving our goals of reducing health disparities and improving health care outcomes for our patients.   Click here to read the full issue.

This podcast highlights original research published in the May official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. Infants with posterior tongue-tie (PTT) can have substantial difficulty with breastfeeding and bottle-feeding. This study aimed to address the dearth in investigational objective data surrounding PTT release to better quantify the postoperative impacts of frenotomy for ankyloglossia. In conclusion, when measured 10 days after frenotomy for PTT, infants improve feeding parameters using an objective bottle-feeding system. Similar improvements are seen with patient-reported outcomes when PTT is released. Posterior tongue-tie is a valid clinical concern, and surgical release can improve infant and maternal symptoms.   Click here to read the full article.

This podcast highlights original research published in the April official journal of the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Foundation. There is little research on the rate and risk factors for revision tonsillectomy after primary intracapsular tonsillectomy. Our study aimed to determine the revision rate following intracapsular tonsillectomy, identify patient characteristics that may increase the probability of revision surgery, and report the tonsillar hemorrhage rate after revision. In conclusion, patients below age 4 years and patients with gastroesophageal reflux disease may be at increased risk of undergoing revision tonsillectomy after primary intracapsular tonsillectomy. These factors should be considered when selecting an intracapsular technique for primary tonsillectomy in pediatric patients.   Click here to read the full article.

This podcast highlights original research published in the March 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 aim of this study was to evaluate the hearing outcome of cochlear implantation in patients deafened by Ménière’s disease. In conclusion, cochlear implant in patients deafened by Ménière’s disease significantly improves word recognition scores regardless of whether medical or surgical treatment is used prior to implantation. The potential improvement in word recognition scores decreases after age 70 years.   Click here to read the full article.

This podcast discusses the implications for non-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.

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.

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 s

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.   Click here to read the full article.

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.   Click here to read the full article.

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 (ENEmi) and role of adjuvant concurrent chemoradiation (CRT) for ENEmi remain unclear. This study evaluates (1) the prognostic significance of ENEmi 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 ENEmi is associated with worse OS than pN+ without ENE. However, for patients with ENEmi, concurrent CRT is not associated with improved OS relative to RT. The optimal adjuvant paradigm for ENEmi requires additional investigation.   Click here to read the fu

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.   Click here to read the full article.

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.   Click here to read the full article.

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.   Click here to read the full article.

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.   Click here to read the full article.

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 numb

This podcast highlights original research published in the April 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 first pediatric tracheostomy tube change often occurs within 7 days after placement; however, the optimal timing is not known. The primary objective was to determine the rate of adverse events of an early tube change. Secondary objectives compared rates of significant peristomal wounds, sedation requirements, and expedited intensive care discharges. In conclusion, the first tracheostomy tube change in children can occur without adverse events on day 4, resulting in fewer significant peristomal wounds and earlier intensive care discharge.   Click here to read the full article.

This podcast discusses the implications for non-otolaryngologists of "Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations", published as a supplement to the April 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 purpose of this specialty-specific guideline is to identify quality improvement opportunities in postoperative pain management of common otolaryngologic surgical procedures. These opportunities are communicated through clear actionable statements with explanation of the support in the literature, evaluation of the quality of the evidence, and recommendations on implementation.   Click here to read the Guideline.