JAMA Otolaryngology –Head & amp; Neck Surgery
Mission Statement:  JAMA Otolaryngology–Head& Neck Surgery provides timely information for physicians and scientists concerned with diseases of the head and neck. Given the diversity of structure and function based in this anatomic region, JAMA Otolaryngology –Head& Neck Surgery publishes clinical, translational, and population health research from an array of disciplines. We place a high priority on strong study designs that accurately identify etiologies, evaluate diagnostic strategies, and distinguish among treatment options and outcomes. Our objectives are to (1) publish original contributions th...
Source: JAMA Otolaryngology - Head and Neck Surgery - October 1, 2020 Category: ENT & OMF Source Type: research

Seemingly Innocuous Sore Throat in a 21-Year-Old Man
A 21-year-old Chinese man with no relevant medical history with a recurrent sore throat associated with hoarseness of voice for 3 months ’ duration. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

A Painful Right Maxillary Swelling
A 19-year-old woman presented with a 3-month history of right-sided maxillary pain and swelling, and an impacted right maxillary first premolar. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

A New Buzz for Tinnitus —It’s in the Genes!
“Does tinnitus run in your family?” Seldom is that question asked by clinicians to their patients with tinnitus, but why would they ask? Audiologists and ear, nose, and throat specialists see patients with tinnitus in association with either conductive or sensorineural hearing loss, which has le d to the clinical dogma that tinnitus is secondary and by definition a symptom arising from the hearing disorder. However, tinnitus may occur in absence of any detectable auditory dysfunction, most particularly in young individuals, which raises the question on the origins of these more sporadic cas es of phantom percep...
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

Novel Decision Support Interventions for Low-risk Thyroid Cancer
This quality improvement study examines a patient-oriented intervention to support decision-making about low-risk thyroid cancer treatment. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

Novel Risk Loci in Tinnitus and Causal Inference With Neuropsychiatric Disorders
This genome-wide association study with mendelian randomization identifies genetic risk loci associated with tinnitus, determines genetic correlations, and infers relationships of tinnitus with hearing loss and neuropsychiatric disorders and traits. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

Comparison of Parotidectomy With Observation for Treatment of Pleomorphic Adenoma in Adults
This decision analytical model compares parotidectomy with observation for the management of pleomorphic adenoma of the parotid gland in adults 50 years or older by age. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

Physical Therapy for Iatrogenic Facial Paralysis
This systematic review investigates whether noninvasive physical therapy compared with no physical therapy or other intervention improves facial nerve outcomes in adults with iatrogenic facial paralysis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 24, 2020 Category: ENT & OMF Source Type: research

A Radiolucency Associated With an Impacted Mandibular Canine Tooth in an Adult Man
A man in his 40s presented with mobility of the anterior mandibular dentition; clinical examination revealed fullness on the mentolabial fold, but no gross facial asymmetry or mental nerve paresthesia. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

An Unusual Retropharyngeal Lesion
A female smoker in her 50s was referred for hyperparathyroidism and a multinodular goiter. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

Noncongenital Pediatric Mature Teratoma of the Mandible
This case report describes a young African American girl who presented with a 2-month history of left cheek swelling and pain associated with an enlarging jaw mass that was determined to be a mature teratoma. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

Hyperprogression of a Sinonasal Squamous Cell Carcinoma Following PD-1 Checkpoint Blockade
This case report describes man in his 60s who presented with a maxillary sinus squamous cell carcinoma and experienced hyperprogression following treatment with pembrolizumab. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

Efficacy of Intranasal Timolol for Hereditary Hemorrhagic Telangiectasia –Associated Epistaxis
This randomized clinical trial uses data from existing patients at a tertiary care facility to assess the efficacy of intranasal thermosensitive timolol gel in treating moderate-to-severe recurrent hereditary hemorrhagic telangiectasia –associated epistaxis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

In Vitro Efficacy of a Povidone-Iodine Nasal Antiseptic for Rapid Inactivation of SARS-CoV-2
This cross-sectional study assesses the efficacy of nasal povidone-iodine against in vitro transmission of severe acute respiratory syndrome coronavirus 2. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

COVID-19 Nasopharyngeal Swab Testing and False-Negative Results From an Anatomical Misconception
This Viewpoint describes how a commonly held false presumption of nasal and nasopharyngeal anatomy may contribute to false-negative results in severe acute respiratory syndrome coronavirus 2 testing. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 17, 2020 Category: ENT & OMF Source Type: research

Incomplete Picture of Otolaryngologist Performance in the Merit-Based Incentive Payment System
To the Editor I appreciate the hard work and excellent analysis of Merit-Based Incentive Payment System (MIPS) performance in the article by Xiao et al, “Otolaryngologist Performance in the Merit-Based Incentive Payment System in 2017.” However, I have 1 major concern with the article’s depiction of otolaryngologists’ performance because it leaves the impression with the readership that this is a complete picture of 2017 MIPS performance. Sp ecifically, the Individual Eligible Clinician File with MIPS scores (both individual and group) has only 376 170 rows, compared with more than 1 000 000 c...
Source: JAMA Otolaryngology - Head and Neck Surgery - September 10, 2020 Category: ENT & OMF Source Type: research

Spontaneous Cerebrospinal Fluid Leak in a Transgender Man
This case report describes a transgender man in his 20s who presented with 9 months of right-sided rhinorrhea and spontaneous drainage of clear, salty nasal discharge consistent with idiopathic intracranial hypertension. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 10, 2020 Category: ENT & OMF Source Type: research

Sinonasal Teratocarcinosarcoma
This case report describes a man in his 20s who presented with a 2-month history of epistaxis and progressive nasal obstruction and was subsequently diagnosed with a sinonasal teratocarcinosarcoma. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 10, 2020 Category: ENT & OMF Source Type: research

Incomplete Picture of Otolaryngologist Performance in the Merit-Based Incentive Payment System —Reply
In Reply We appreciate Dr Lum ’s interest in our work. Based on our understanding of eligibility criteria for the Merit-Based Incentive Payment System (MIPS) and the Physician Compare data sets, we believe her concerns about the generalizability of our findings are overstated. Dr Lum correctly notes that the Individual Eligibl e Clinician file includes performance scores for approximately 36% of all MIPS-eligible clinicians. However, this statistic is not generalizable to otolaryngologists. In the final rule establishing the MIPS, the Centers for Medicare& Medicaid Services estimated that fewer than 7812 otolaryn...
Source: JAMA Otolaryngology - Head and Neck Surgery - September 10, 2020 Category: ENT & OMF Source Type: research

Association of Hypertension With the Risk and Severity of Epistaxis
This cohort study uses a nationwide population cohort to evaluate the risk of epistaxis in patients with hypertension and assesses the association of hypertension with the methods of managing epistaxis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 10, 2020 Category: ENT & OMF Source Type: research

COVID-19, Disparities, and Opportunities for Equity in Otolaryngology —Unequal America
This Viewpoint discusses the disproportionate burdens related to COVID-19 experienced by minority populations as well as strategies to limit disparities in health care, access, and outcomes. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 10, 2020 Category: ENT & OMF Source Type: research

Progressive Upper Airway Obstruction and Dysphagia in a Child With Supraglottic Edema
A 9-year-old boy presents with progressive dyspnea, snoring, dysphagia, and weight loss; biopsy and culture results revealed diffuse non-necrotizing granulomas and oropharyngeal flora with negative acid-fast bacilli and Grocott methenamine silver stains. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Omission of Funding Source
In the Research Letter titled, “SARS-CoV-2 Virus Isolated From the Mastoid and Middle Ear: Implications for COVID-19 Precautions During Ear Surgery,” published on July 23, 2020, funding from the National Institutes of Health was omitted. The funding and role of the funder has been added. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Mapping the Brain Effects of Hearing Loss
This study demonstrates novel longitudinal findings that suggest that structural change in the brain may underlie the association of HL with cognitive decline and dementia. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Tracheostomy During COVID-19 Pandemic
To the Editor Tay et al should be complimented on their Viewpoint “Surgical Considerations for Tracheostomy During the COVID-19 Pandemic: Lessons Learned From the Severe Acute Respiratory Syndrome Outbreak” highlighting preoperative and perioperative recommendations for tracheostomy during the coronavirus disease 2019 (COVID-19) pandemic. The authors searched the literature for tracheostomies performed during the previous outbreak of severe acute respiratory syndrome (SARS), finding 3 case series and 2 case reports (23 procedures). Lessons learned from those experiences were summarized into 5 points. The need f...
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Reconstruction of Nasopharynx Defect Using a Free Flap After Endoscopic Nasopharyngectomy
This case report describes of a man in his 60s with nasopharyngeal carcinoma who underwent concurrent chemoradiotherapy and subsequently developed local recurence. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Atypical Presentation of Langerhans Cell Histiocytosis of the Skull
This case report describes a man in his 20s who presented with a 4-week history of progressive swelling of the midline forehead, recurrent headache, and sinus pain, and was subsequently diagnosed with Langerhans cell histiocytosis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Tracheostomy During COVID-19 Pandemic —In Search of Lost Timing—Reply
In Reply We thank Cazzador et al for their appreciation of the Viewpoint “Surgical Considerations for Tracheostomy During the COVID-19 Pandemic: Lessons Learned From the Severe Acute Respiratory Syndrome Outbreak.” Since the publication, several other groups have also developed guidelines for tracheostomy in the context of coronavirus disease 2019 (COVID-19), with si milar goals of minimizing perioperative aerosolization risks. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Outcomes of a Telephone-Based Questionnaire to Follow Up Patients Treated for Oral Cancer
This diagnostic study uses data from patients treated for oral cancer at a tertiary care cancer center in India to investigate the clinical value of a telephone-based questionnaire in detecting cancer recurrence during follow-up evaluation. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Predictors of Behavioral Changes After Adenotonsillectomy in Pediatric Obstructive Sleep Apnea
This secondary analysis compares the use of objective physiological measures with subjective caregiver symptom reports to identify the association between sleep disruption with or without intermittent hypoxemia and behavior in children who underwent surgical treatment for obstructive sleep apnea. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Association of Poorer Hearing With Longitudinal Change in Cerebral White Matter Microstructure
This cohort study examines the association of poorer hearing with baseline and change in white matter microstructure among older adults. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

A Neurotologist ’s Reflection From the Front Line
This essay highlights the lessons to be learned from the COVID-19 pandemic on the importance of recognizing communication difficulties among those with hearing impairment. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

Tracheostomy Timing for Patients With COVID-19 in the ICU
This Viewpoint examines the timing of performing tracheostomies, which are aerosol-generating procedures that may cause increased risk of COVID-19 transmission to health care workers. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - September 3, 2020 Category: ENT & OMF Source Type: research

JAMA Otolaryngology –Head & amp; Neck Surgery
Mission Statement:  JAMA Otolaryngology–Head& Neck Surgery provides timely information for physicians and scientists concerned with diseases of the head and neck. Given the diversity of structure and function based in this anatomic region, JAMA Otolaryngology –Head& Neck Surgery publishes clinical, translational, and population health research from an array of disciplines. We place a high priority on strong study designs that accurately identify etiologies, evaluate diagnostic strategies, and distinguish among treatment options and outcomes. Our objectives are to (1) publish original contributions th...
Source: JAMA Otolaryngology - Head and Neck Surgery - September 1, 2020 Category: ENT & OMF Source Type: research

Cochlear Implant Today …Pill Tomorrow
Hearing loss is the most common sensory disorder in humans. According to recent estimates by the World Health Organization, disabling hearing loss (>40 dB in the better-hearing ear in adults and>30 dB in the better-hearing ear in children) affects 466 million people worldwide, including 34 million children, and is expected to double to 900 million people by 2050. Left untreated, hearing loss is associated with health issues, deterioration in quality of life, and financial costs; the latter include costs associated with health care, education, loss of productivity, and societal costs, with a global burden estimated to...
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

A Cost-effective Solution to Limit Aerosol Transmission of Infectious Agents During Mastoid Drilling
To the Editor We read with interest the research letter published online on April 28, 2020, titled “A Simple Technique for Droplet Control During Mastoid Surgery.” Mastoid bone drilling is an aerosol-generating procedure with the potential to transmit infectious agents from the upper aerodigestive tract via the eustachian tube and middle ear. Although there are no coronavirus disease 2019–s pecific data, other studies have found common viruses in the middle ear and nasopharynx. To continue safely with emergency mastoid surgeries and other time-critical surgeries involving mastoid bone drilling during this...
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

A Cost-effective Solution to Limit Aerosol Transmission of Infectious Agents During Mastoid Drilling
To the Editor We were interested by the recent article by Carron, et al “A Simple Technique for Droplet Control During Mastoid Surgery” because we have also been considering the challenges of performing mastoidectomy in the coronavirus disease 2019 era. Mastoidectomy is an aerosol-generating procedure (AGP) owing to the use of drills and presence of potentially viru s-containing respiratory mucosa lining the mastoid air cells. The recommended personal protective equipment for AGPs is a FFP3 mask and a face visor to prevent aerosolized particles coming into contact with mucosal surfaces of the face, including th...
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Facial Nerve Intraneural Perineurioma Masquerading as a Schwannoma
This case report descreibes a woman in her 30s who presented with worsening left-sided facial weakness and was diagnosed with a perineurioma. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

An Unlikely Cause of Headaches and Temporomandibular Joint Pain in a Young Woman
This case report describes a woman in her 20s who underwent chemoradiation for cervical carcinoma and subsequently presented with headaches and right-sided temporomandibular joint pain. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

A Cost-Effective Solution to Limit Aerosol Transmission of Infectious Agents During Mastoid Drilling —Reply
In Reply We thank Thong et al for their letter. We chose our method because it allows easy setup and takedown for continued microscope use after drilling is complete. We have taken to using the Sterile-Z Back Table Drape because it has a perforation down the middle to allow for easy break-away when it is no longer needed. As stated in our original Research Letter, we expect better modifications to come about, and otolaryngologists will always be a creative group. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Assessment of Speech Understanding After Cochlear Implantation in Adult Hearing Aid Users
This nonrandomized controlled trial investigates the safety and effectiveness of a single-ear cochlear implant in a group of optimized adult hearing aid users with and without mild cognitive impairment across a variety of outcome domains. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Quality of Life in Cochlear Implant Recipients 65 Years or Older
This secondary analysis of a nonrandomized clinical trial explores the audiometric and holistic effects of cochlear implantation in a group of adults 65 years or older compared with an optimized bilateral hearing aid condition. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Cochlear Implants for Adult Medicare Beneficiaries Who Meet Expanded Indications
This multicenter nonrandomized clinical trial examines the effectiveness of cochlear implants, as measured by improvement on the AzBio Sentence Test, for newly implanted Medicare beneficiaries who meet the expanded indications of an AzBio Sentence Test score of 41% to 60% in their best-aided condition. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Unilateral Cochlear Implants for Severe, Profound, or Moderate Sloping to Profound Bilateral Sensorineural Hearing Loss
This systematic review and consensus study uses a modified Delphi consensus process, informed by a systematic review of the literature and 30 international specialists, to develop 20 evidence-based consensus statements regarding the use of unilateral cochlear implants in adults with severe, profound, or moderate sloping to profound bilateral sensorineural hearing loss. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Understanding Patient Perspectives on Single-Sided Deafness
This Viewpoint encourages clinicians to listen to patient concerns regarding the varying treatment options available for single-sided deafness. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 27, 2020 Category: ENT & OMF Source Type: research

Enhancing Skull Base Structure Along the Carotid Sheath in a Patient With Oropharyngeal Squamous Cell Carcinoma
A 62-year-old man presents with metastatic p16-positive squamous cell carcinoma and a primary cancer in the right tonsil. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 20, 2020 Category: ENT & OMF Source Type: research

New Practical Telehealth Applications
This study showed that the remote clinicians could diagnose PTA with comparable accuracy (81%) using telehealth video examination, with minimal clinician variability. In the absence of an otolaryngologist, patients with PTAs often undergo computed tomography and experience prolonged emergency department visit wait times, hospital transfers and, occasionally, hospital admission. This study validates the use of telehealth consultation for one of the most common urgent consultations to otolaryngologists using widely available, low-cost, and easy-to-use technology. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 20, 2020 Category: ENT & OMF Source Type: research

Trying to Define Sinonasal Medications
To the Editor In his Original Investigation, McCoul expresses concern regarding confusion caused by the panoply of over-the-counter (OTC) sinonasal medications. But a more relevant question might be, what is a sinonasal medication? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 20, 2020 Category: ENT & OMF Source Type: research

Response to Electrochemotherapy in a Patient With Advanced Oropharyngeal Squamous Cell Carcinoma
This case report describes a 61-year-old man who presented with dysphagia, drooling, and an ulcerated mass in the right oropharyngeal region. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 20, 2020 Category: ENT & OMF Source Type: research

Trying to Define Sinonasal Medications —Reply
In Reply In his Letter to the Editor written in response to my article on over-the-counter (OTC) sinonasal medications, Weinberger succinctly addresses the problem of self-directed symptom relief by asking, what is a sinonasal medication? Consciously or unconsciously, the answer to this question drives countless individuals to local pharmacies in a quest for relief of what are perceived as sinus problems. Whether one actually has sinusitis, allergic rhinitis, or another upper respiratory infection is beside the point for these desperate individuals. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - August 20, 2020 Category: ENT & OMF Source Type: research