Central Vertigo and Hearing Loss in an African Swimmer
A 46-year-old East African swimmer presented with a 1-month history of progressive left hearing loss and vertigo; he also reported asthenia, sleep disorders, and urinary frequency. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 14, 2019 Category: ENT & OMF Source Type: research

Risk Factors for 30-Day Readmission of Otolaryngology Patients
Nearly 2 decades have passed since the 2001 publication ofCrossing the Quality Chasm by the Institute of Medicine. This effort helped define the framework of understanding health care quality in the United States: level A, the experience of patients; level B, the microsystem that delivers care; level C, the organization that houses and supports these microsystems; and level D, the regulatory, policy, accreditation, and payment system that regulates and controls level C organizations. In addition, the 6 aims for improvement were defined as safety, timeliness, equity, efficacy, efficiency, and patient centeredness. Efficacy ...
Source: JAMA Otolaryngology - Head and Neck Surgery - March 14, 2019 Category: ENT & OMF Source Type: research

Choral Singing and Vocal Health
The potential associations of being a choral singer with one ’s overall vocal health has been a subject of considerable research interest for the fully developed adult voice, but there is less known about the effects of choral singing on the developing larynx particularly for the prepubescent child. Although several studies have reported the positive associ ation of regular singing and individual voice training with vocal efficiency and health among children, whether this translates to a reduction in risk of voice disorders has also not been previously well investigated, to my knowledge. In contrast, other researcher...
Source: JAMA Otolaryngology - Head and Neck Surgery - March 14, 2019 Category: ENT & OMF Source Type: research

Extracranial Olfactory Ensheathing Cell Tumor
This case report describes a woman who presented with left-sided epistaxis from a 4.8-cm mass in the left nasal cavity extending from the left olfactory cleft. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 14, 2019 Category: ENT & OMF Source Type: research

Readmission Determinants and Benefit of Experienced Surgeons in Otolaryngology Procedures
This study examines the association of surgical and hospital volume and patient characteristics with 30-day readmission rates after inpatient otolaryngology surgery. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 14, 2019 Category: ENT & OMF Source Type: research

Association Between Development of Pediatric Voice Disorders and Singing in Children ’s Choir
This cohort study evaluates the association between singing in a children ’s choir and the development of pediatric voice disorders. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 14, 2019 Category: ENT & OMF Source Type: research

An Aggressive Diffuse Supraorbital Mass
A white man in his 70s presented with a gradually enlarging right supraorbital mass that had been neglected for 4 years. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 7, 2019 Category: ENT & OMF Source Type: research

Immune Status and Immunotherapy in Advanced Cutaneous Squamous Cell Carcinoma
While only a small percentage of patients present with metastatic cutaneous squamous cell carcinoma (cSCC) of the head and neck (McSCCHN), the association of lymph node metastasis (LNM) with reduced survival necessitates diligent study of this patient population. Sahovaler et al conducted a systematic review and meta-analysis of all published studies on the risk factors for overall survival (OS), locoregional control, locoregional recurrence, and disease-specific survival (DSS) for patients with McSCCHN. Patient demographics, immune status, nodal status, pathologic characteristics, treatment, and outcomes were assessed amo...
Source: JAMA Otolaryngology - Head and Neck Surgery - March 7, 2019 Category: ENT & OMF Source Type: research

Survival After Cardiac Metastasis in Malignant Disease of the Head and Neck
This case report describes a man in his 40s who presented with complaints of swelling in the right side of neck and left-sided palatal mass that was biopsied and yielded positive results for poorly differentiated carcinoma. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 7, 2019 Category: ENT & OMF Source Type: research

Outcomes of Cutaneous SCC in the Head and Neck Region With Regional Lymph Node Metastasis
This systematic review and meta-analysis of 20 observational studies and 1 randomized clinical trial, including a total of 3534 patients, evaluates outcomes of cutaneous squamous cell carcinoma in the head and neck region with regional lymph node metastasis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 7, 2019 Category: ENT & OMF Source Type: research

Expansion Sphincter Pharyngoplasty for Lateral Pharyngeal Collapse in Obstructive Sleep Apnea
This cohort study examines the indications for and outcomes of expansion sphincter pharyngoplasty for patients with obstructive sleep apnea and lateral pharyngeal wall collapse. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - March 7, 2019 Category: ENT & OMF Source Type: research

Submucosal Masses of the Right Upper Lip
A woman in her 60s reported a several-week history of right upper lip submucosal masses with no tenderness, mucosal abnormality, or recent trauma to the lip. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 28, 2019 Category: ENT & OMF Source Type: research

Addition of 2 References and Discussion of These Studies
This article was corrected online. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 28, 2019 Category: ENT & OMF Source Type: research

Analysis of Venture Capital Investment in Therapeutic Otolaryngologic Devices
This cross-sectional analysis characterizes venture capital investments in otolaryngologic devices by therapeutic area using data from a private capital market data provider from 2008 through 2017. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 28, 2019 Category: ENT & OMF Source Type: research

Failure to Report Related Studies
In this study, we analyzed a cohort of 515 patients who had undergone free flap reconstruction at The Ohio State University Comprehensive Care Center (2006-2012) to assess risk factors associated with development of postoperative delirium after surgery. We identified a number of risk factors, including preoperative alcohol abstinence as predictor associated with a reduced risk of postoperative delirium. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 28, 2019 Category: ENT & OMF Source Type: research

Chondrosarcoma in the Mastoid Involving the Intratemporal Facial Nerve
This case study describes a man in his 60s who presented with a 2-year history of gradual-onset right facial weakness leading to paralysis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 28, 2019 Category: ENT & OMF Source Type: research

Association of Head and Neck Cancer With Mental Health Disorders in a Large Insurance Claims Database
This cohort study assesses the prevalence of mental health disorders and their associations with survival and recurrence among patients with head and neck cancer in a large insurance claims database. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 28, 2019 Category: ENT & OMF Source Type: research

Lacrimal Duct Obstruction in a Teenager
A teenaged girl with chronic sinusitis and a history of osseous lesions in the upper and lower jaws presented with epiphora, purulent drainage, and jaw pain. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 21, 2019 Category: ENT & OMF Source Type: research

Head and Neck Cancer Compared With Other Cancers —Does the Great Equalizer Equalize Equally?
When Andrew Lo, PhD, of the Massachusetts Institute of Technology Sloan School of Management stated, “Cancer is the great equalizer. Everyone is affected by it either themselves or through loved ones,” we might infer that the experience of this very human tragedy would cut through factors that can be divisive, such as race, sex, educational status, and socioeconomic status. The implication is t hat before cancer we are allequal, regardless of such factors. However, the recent work by Massa et al indicates that this may not be the case. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 21, 2019 Category: ENT & OMF Source Type: research

Vertebral Bodies, Anterior Erosion, and Compression by Tracheostomy Canula
This case report describes a man in his late teens with scoliosis, muscular dystrophy, and severe osteoporosis who presented with a 3-month history of tracheal discomfort and light bleeding during tracheal aspiration. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 21, 2019 Category: ENT & OMF Source Type: research

Comparison of the Financial Burden of Survivors of Head and Neck Cancer With Other Cancer Survivors
This analysis of US nationally representative survey data assessed the financial burdens of patients with head and neck cancer compared with patients with other types of cancer. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 21, 2019 Category: ENT & OMF Source Type: research

Evaluation of a Preoperative Risk Index for Patients Undergoing Head and Neck Cancer Surgery
This cohort study evaluates a preoperative adverse event risk index in patients from the ACS NSQIP database who underwent surgery for head and neck cancer between 2006 and 2016. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 21, 2019 Category: ENT & OMF Source Type: research

Eosinophilic Esophagitis —A Primer for Otolaryngologists
This narrative review discusses common presenting symptoms, associated otorhinolaryngology symptoms, diagnostic workup, endoscopic features, and treatment of eosinophilic esophagitis for the general otolaryngologist. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 21, 2019 Category: ENT & OMF Source Type: research

Emergence of Cheyne-Stokes Breathing after Hypoglossal Nerve Stimulator Implant in a Patient with Mixed Sleep Apnea
This is a case report of a man in his 60s with stage 3 chronic kidney disease, hypertension, hyperlipidemia, type 2 diabetes, bladder and kidney cancer, and depression who underwent hypoglossal nerve stimulator implantation and subsequently demonstrated a Cheyne-Stokes breathing pattern. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 14, 2019 Category: ENT & OMF Source Type: research

Reevaluating a Standardized Sedation Weaning Protocol for Pediatric Laryngotracheal Reconstruction
This quality improvement study examines how a new electronic health record affects a series of process, outcome, and balance measures for sedation weaning management in pediatric patients undergoing laryngotracheal reconstruction. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 14, 2019 Category: ENT & OMF Source Type: research

Reassessing the Safety of Bicycle Helmets
This Viewpoint proposes a reassessment of the safety of bicycle helmets for the protection of the middle and lower face. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 14, 2019 Category: ENT & OMF Source Type: research

Enlarging Right-Sided Tongue Mass in an Adult Male
An African American man with a history of bipolar disorder presented to the emergency department with an enlarging right-sided tongue mass that had caused mild discomfort and halitosis over the course of 1 week. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 7, 2019 Category: ENT & OMF Source Type: research

Does Chronic Rhinosinusitis Lead to Psychiatric Disease?
The Original Investigation by Kim and colleagues in this issue ofJAMA Otolaryngology –Head& Neck Surgery investigates the association between chronic rhinosinusitis (CRS) and common psychiatric disorders, a topic that has been often discussed but rarely subjected to large-scale, population-based study. The investigators used data from a national health service database during an 11-year period to determine the incidence and risk of depression and anxiety in a population with CRS. Building on previous reports of comorbidity prevalence, the investigators found an increased incidence and risk of new diagnoses of bot...
Source: JAMA Otolaryngology - Head and Neck Surgery - February 7, 2019 Category: ENT & OMF Source Type: research

App-Driven Postoperative Care in the Pediatric Tonsillectomy Population
This survey-based pilot study evaluates app-driven postoperative care in the pediatric tonsillectomy population. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 7, 2019 Category: ENT & OMF Source Type: research

Oculorespiratory Reflex During Repair of an Orbital Fracture
This case report describes a man in his 40s who experienced an oculorespiratory reflex affecting intraoperative ventilation during repair of a large, unilateral orbital floor fracture. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 7, 2019 Category: ENT & OMF Source Type: research

Depression and Anxiety in Chronic Rhinosinusitis
This cohort study evaluates the risk of depression and anxiety in patients with chronic rhinosinusitis by disease phenotype (with and without nasal polyps) in a nationwide insurance data set. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 7, 2019 Category: ENT & OMF Source Type: research

The Centers for Medicare & amp; Medicaid Services ’ Overhaul of Office-Visit Payments
This Viewpoint examines the Centers for Medicare& Medicaid Services ’ changes to the Medicare Physician Fee Schedule and how they might affect otolaryngologists and patients. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 7, 2019 Category: ENT & OMF Source Type: research

Labels Reversed in Figure 1
This article has been corrected online. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 1, 2019 Category: ENT & OMF Source Type: research

Error in Figure Labels
In the article titled “Is It Time to Rethink the Approach to Internal Nasal Valve Stenosis?,” the 2 Figure labels (a and b) were transposed so that the labels corresponded to the incorrect descriptions in the Figure caption. The Figure has been corrected online. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 1, 2019 Category: ENT & OMF Source Type: research

February Issue Highlights
(Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 1, 2019 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 that wi...
Source: JAMA Otolaryngology - Head and Neck Surgery - February 1, 2019 Category: ENT & OMF Source Type: research

A Large Tonsillar Mass in a Healthy Teenager
A previously healthy 18-year-old woman presented with a growth in the right oropharynx of 4 months ’ duration as well as voice changes, recent weight loss, and decreased appetite. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

Variation in Care Delivery and Diagnostic Modality Among the Medicare Population
In this issue ofJAMA Otolaryngology –Head& Neck Surgery, Hur et al suggest that during the past decade, the use of diagnostic nasal endoscopy in the Medicare population has increased substantially and this increase has not been paralleled by a similar increase in surgical ethmoidectomy. The overall increase in the number of endoscopies was also accompanied by marked variability in endoscopy utilization across different states, with some states showing a large increase and others showing smaller increases. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

Papillary Thyroid Microcarcinoma
A patient who was referred to our clinic for a second opinion on management of a small localized papillary thyroid cancer (PTC) asked, “Why should I have surgery to remove my thyroid if it’s such a good cancer?” At the time of diagnosis, her health care practitioner told her she had agood cancer and recommended thyroidectomy. This question directly relates to the work by Davies et al in this issue ofJAMA Otolaryngology –Head& Neck Surgery. However, it is important to first clarify some misconceptions about the experiences of patients with thyroid cancer. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

Phosphaturic Mesenchymal Tumor of the Cerebellopontine Angle
This case report describes an otherwise healthy woman in her 30s who presented with left-ear hearing loss, tinnitus, distorted hearing, and occasional otalgia of a few months ’ duration. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

Utilization of Nasal Endoscopy in the Medicare Population, 2000-2016
This study analyzes Medicare beneficiary and provider data from 2000 through 2016 to investigate trends in the number of nasal endoscopies performed among the Medicare population, reimbursement, and regional differences. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

Patient Experience of Thyroid Cancer Active Surveillance in Japan
This study evaluates the concerns about cancer, treatment decisions, and overall experience of Japanese patients under active surveillance for thyroid cancer. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

Toward a Broader, More Global Perspective for US Otolaryngology Residents
This essay discusses the benefits of the medical education system offering US otolaryngology residents the opportunity to gain a broader, more global perspective on the practice of otolaryngology. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

A Career in Global Surgery
This Viewpoint suggests that academic surgical departments are well positioned to lead global surgery efforts given their focus on teaching, innovation, and service. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 31, 2019 Category: ENT & OMF Source Type: research

No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor Attarha et al recommended that sound therapies using white noise should be avoided as treatments for tinnitus. This advice might stem from the authors ’ collective lack of clinical experience assessing and treating patients with tinnitus, or from their unfamiliarity with tinnitus management techniques and associated literature. In any case, before recommending that white noise should be avoided by patients with tinnitus, Attarha et al should bec ome more familiar with how a variety of sound therapies—including broadband sounds—often help this patient population. (Source: JAMA Otolaryngology ...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 24, 2019 Category: ENT & OMF Source Type: research

No Evidence of Broadband Noise Having Any Harmful Effect on Hearing
To the Editor We are writing in response to the article by Attarha, Bigelow, and Merzenich, which concluded, “Sound therapies using unstructured, random (white) noise should be avoided as a treatment for tinnitus.”(E1) Their recommendation was based on animal studies that revealed long-term exposure to low-level broadband noise (BBN) resulted in central auditory changes that “bear striking phenomenological overlap with the persistent, widespread disinhibition of the auditory system thought to underlie tinnitus in humans.”(E2) They noted that BBN delivered from ear-level devices to treat tinnitus pro...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 24, 2019 Category: ENT & OMF Source Type: research

Bullous Pemphigoid Presenting as Oropharyngeal Hemorrhage
This is a case report of a man who presented with oropharyngeal hemorrhage and impending airway compromise as the initial presentation of mucosal bullous pemphigoid. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 24, 2019 Category: ENT & OMF Source Type: research

No Evidence of Broadband Noise Having Any Harmful Effect on Hearing —Reply
In Reply Critiques of our article by Folmer and Henry et al suggest the concerns we raised about the potential harmful effects of chronic exposure to broad-band noise (BBN) are overstated, citing a lack of clinical evidence demonstrating correspondence between human symptoms and maladaptive neuroplasticity recorded in animal studies. Although we acknowledged the paucity of human studies addressing these questions in our review, we do not think it is safe to assume humans will be exempt from substantial, negative impacts of chronic BBN exposure documented in the central auditory pathways of animals. A main goal of our repor...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 24, 2019 Category: ENT & OMF Source Type: research

Speech Functioning and Neurocognition Before Head and Neck Cancer
This cohort study examines neurocognitive functioning in patients with head and neck cancer before treatment and investigates the association between neurocognition and speech functioning. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 24, 2019 Category: ENT & OMF Source Type: research

Association Between Migraine and Benign Paroxysmal Positional Vertigo in South Korea
This study evaluates representative patient data from the Korean National Health Insurance Service-National Sample Cohort to trace the incidence of benign paroxysmal positional vertigo among adults who experience migraine. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 24, 2019 Category: ENT & OMF Source Type: research