Public Awareness of Cleidocranial Dysplasia After Season Releases of Stranger Things
This cross-sectional study uses Google Trends and cleidocranial dysplasia –related foundation website data to investigate the association of television portrayals of cleidocranial dysplasia with public interest and awareness of the disorder. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 20, 2020 Category: ENT & OMF Source Type: research

Cochlear Implant Access for Veterans
This study used GIS tools to analyze the 2016 US Census data of the number of veterans in different regions of the country to approximate a person-adjusted distance measur e of veteran access to cochlear implant services in the VHA. We would like to contribute the following comments and updates. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 20, 2020 Category: ENT & OMF Source Type: research

Stylocarotid Artery Syndrome —A Presentation of 2 Cases
This case report describes 2 patients who presented with styloid process elongation who were subsequently diagnosed with stylocarotid syndrome. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 20, 2020 Category: ENT & OMF Source Type: research

Cochlear Implant Access for Veterans —Reply
In Reply We are grateful to have the opportunity to respond to the letter by Cambron et al. With their help, we analyzed an updated 2019 data set using the same techniques we had previously applied to information from 2017 for use in our study.1 (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 20, 2020 Category: ENT & OMF Source Type: research

Comparison of Autologous vs Homologous Costal Cartilage Grafts in Dorsal Augmentation Rhinoplasty
This systematic review and meta-analysis compares the rates of complications associated with autologous vs homologous vs Tutoplast cartilage grafts in patients undergoing dorsal augmentation rhinoplasty. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 20, 2020 Category: ENT & OMF Source Type: research

Innovating Surgical Education using Video in the Otolaryngology Operating Room
This Viewpoint describes the usefulness of using first-person video-recording devices for training among head and neck surgeons. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 20, 2020 Category: ENT & OMF Source Type: research

Beyond the Crooked Smile —Exploring Individual-Specific Facets of Facial Paralysis
The face is a critical conduit through which humans interact with the world and one another. Facial paralysis presents a unique situation in which quality of life is altered by self-perception and societal impression because it is so visible and touches on the essential features of human interaction, including nonverbal cues and verbal speech. The role of facial paralysis in quality of life has been explored in the scientific literature. Patients with facial paralysis have lower scores for disease-specific quality of life, higher scores for depression, reduced self-reported attractiveness, and lower mood scores compared wi...
Source: JAMA Otolaryngology - Head and Neck Surgery - February 13, 2020 Category: ENT & OMF Source Type: research

Feasibility of Autologous Adipose Tissue –Derived Stromal Vascular Fraction in Scarred Vocal Folds
This nonrandomized controlled trial evaluates the feasibility and tolerability of local injections of autologous adipose tissue –derived stromal vascular fraction in patients with scarred vocal folds. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 13, 2020 Category: ENT & OMF Source Type: research

Factors Associated With Health-Related Quality of Life in Patients With Facial Palsy
This cross-sectional study identifies clinical, socioeconomic, personality, and mental health factors associated with health-related quality of life in patients with facial palsy. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 13, 2020 Category: ENT & OMF Source Type: research

Postrhinoplasty Infection With Residual ePTFE-Coated Silicone Implantation
This case report describes 2 patients who had undergone rhinoplasty using an expanded polytetrafluoroethylene-coated silicone implant and subsequently presented with postrhinoplasty infection. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 6, 2020 Category: ENT & OMF Source Type: research

Association of Multisensory Impairment With Quality of Life and Depression in English Older Adults
This cross-sectional study of 6147 English olderadults examines associations between concurrent multisensory impairments and aspects of well-being and mental health. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 6, 2020 Category: ENT & OMF Source Type: research

Temperature-Controlled Surgical Instruments vs Electrocautery in Tonsillectomy
This systematic review and meta-analysis of randomized clinical trials compares intraoperative and postoperative outcomes of temperature-controlled surgical instruments vs electrocautery in adolescents and adults undergoing tonsillectomy. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - February 6, 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 that w...
Source: JAMA Otolaryngology - Head and Neck Surgery - February 1, 2020 Category: ENT & OMF Source Type: research

Development of a Sleep Apnea –Specific Health State Utility Algorithm
This cohort study aims to develop and validate a utility scoring algorithm for a sleep apnea –specific quality-of-life instrument. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 30, 2020 Category: ENT & OMF Source Type: research

Associations of Retinal Vessel Caliber With Hearing Status in Childhood and Midlife
This population-based cross-sectional study investigates whether differences in retinal vessel caliber are associated with hearing threshold and hearing loss in mid-childhood and midlife. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 30, 2020 Category: ENT & OMF Source Type: research

Evolution of Surgical Management of Thyroid Nodular Disease
This Viewpoint discusses significant changes that the author has experienced in the treatment of patients with thyroid cancer throughout the last 4 decades. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 30, 2020 Category: ENT & OMF Source Type: research

Subcutaneous Emphysema of the Neck With Pneumomediastinum
This case report describes a man in his 30s who presented with facial swelling, neck pain, dysphagia, and odynophagia. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 23, 2020 Category: ENT & OMF Source Type: research

The Ever-Expanding Balloon —Is Profit Shaping Practice?
In the study by Kasle and colleagues in this issue of JAMA Otolaryngology –Head and Neck Surgery, the authors report that use of balloon catheter dilation of the sinuses is increasing rapidly, along with concomitant Medicare payments. The increase in payments in the study is stunning, even though it is only reflective of the Medicare population. Interestingly, this incr ease is driven by a relatively small proportion of otolaryngologist–head and neck surgeons. Estimates from industry colleagues suggest that more than 5500 otolaryngologist–head and neck surgeons perform sinus surgical procedures. In 2016, 382 surgeons (
Source: JAMA Otolaryngology - Head and Neck Surgery - January 23, 2020 Category: ENT & OMF Source Type: research

Evaluation of Factors Associated With Favorable Outcomes in Adults With Bell Palsy
This cohort study examines the factors that are associated with the favorable outcomes, defined as a House-Brackmann grade of II or lower, in patients treated for Bell palsy. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 23, 2020 Category: ENT & OMF Source Type: research

Medicare Reimbursement for Balloon Catheter Dilations for Surgeons Performing High Volumes
This analysis of US Medicare data evaluates the number of balloon catheter dilations performed between 2011 and 2017, including the percentage of procedures performed by surgeons who perform high volumes of this procedure, reimbursements, and national geographic distributions. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 23, 2020 Category: ENT & OMF Source Type: research

The Case for Value-Based Pricing of Corticosteroid-Eluting Sinus Stents
This Viewpoint describes the benefits of value-based pricing for corticosteroid-eluting sinus stents for drug manufacturers, patients, and clinicians. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 23, 2020 Category: ENT & OMF Source Type: research

An Abnormal Neck Mass in a Pediatric Patient
A 17-year-old boy presented with a 6-month history of a left-sided neck mass. Tests showed negative results for lymphoproliferative disorders, a malignant condition, and infectious diseases. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 16, 2020 Category: ENT & OMF Source Type: research

Surveillance Outcomes and Intensity of Salvage Therapy Among Human Papillomavirus –Associated Oropharyngeal Cancers
To the Editor We read with interest the report by Masroor et al, suggesting that among patients with human papillomavirus (HPV)-associated oropharyngeal cancers, National Comprehensive Cancer Network (NCCN)-recommended regular posttreatment clinical examinations did not detect recurrence or improve survival, compared with observation. Among the 22 of 233 study patients who had recurrent disease, the authors report that 10 were symptom directed and 11 were imaging detected, indicating that half of all recurrences were detected by imaging, which contradicts the NCCN ’s statement that most recurrences are reported by th...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 16, 2020 Category: ENT & OMF Source Type: research

The “Right Rate” of Tonsillectomy
To the Editor Tonsillectomy has been performed for thousands of years. In modern times, the operation went from being needed rarely to becoming almost routine. In New York, a random sample of 1000 school children was examined; reported in 1934, 60% were found to have undergone tonsillectomy. The remaining children were examined by school physicians; 45% were recommended for tonsillectomy. A second group of physicians examined those who were not; then a third group, the remainder. In each of the 3 successive rounds, 44% to 45% of children examined were recommended for tonsillectomy. At the end of the experiment, 94% of the ...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 16, 2020 Category: ENT & OMF Source Type: research

Surveillance Outcomes and Intensity of Salvage Therapy Among Human Papillomavirus –Associated Oropharyngeal Cancers—Reply
In Reply We appreciate the inquiry of Arvold and McBride into the recurrence patterns and salvage treatments of the cohort presented in our study. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 16, 2020 Category: ENT & OMF Source Type: research

Association of ACA Medicaid Expansions With Disease Stage and Treatment for Patients With HNSCC
This cohort study examines the association of Medicaid expansions as part of the Patient Protection and Affordable Care Act (ACA) with stage at diagnosis and time to treatment initiation for patients with head and neck squamous cell carcinoma (HNSCC). (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 16, 2020 Category: ENT & OMF Source Type: research

Barriers in Head and Neck Cancer for Patients in Resource-Limited Settings
This systematic review analyzes published studies to identify social and clinical factors in head and neck cancer treatment in low-income and lower-middle-income countries predominantly in South Asia. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 16, 2020 Category: ENT & OMF Source Type: research

Tonsillar Hypertrophy in a Patient With Obstructive Sleep Apnea
A man in his 40s with a medical history of obstructive sleep apnea, persistent fatigue, and headaches presented with dental malocclusion, growth in his tongue and feet, and swelling in his hands. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 9, 2020 Category: ENT & OMF Source Type: research

Minimizing Excess Opioid Prescribing for Acute Postoperative Pain
The United States is struggling with an epidemic of opioid abuse driven in part by postoperative opioid prescribing patterns. Opioid prescribing after surgery is one of the most common methods of initial opioid exposure and places patients at risk of developing opioid dependency. In otolaryngology, 6% of the patients who are opioid-naive develop postoperative iatrogenic opioid dependency, which contributes considerably to the epidemic because approximately 16 million otolaryngology operations are performed each year globally. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 9, 2020 Category: ENT & OMF Source Type: research

Concerns About Methodology in Study of Thyroid Nodule Gene Expression Classifier
To the Editor Valderrabano et al question the sensitivity and specificity of the Afirma gene expression classifier (GEC) from its pivotal clinical validation, and by extension, its negative predictive value (NPV). I disagree with their methodology and conclusions. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 9, 2020 Category: ENT & OMF Source Type: research

Concerns About Methodology in Study of Thyroid Nodule Gene Expression Classifier —Reply
In Reply We appreciate Dr Kloos ’s interest in our work, but respectfully disagree with his conclusions. He states that our analysis supports Afirma’s validated 94% or greater negative predictive value (NPV) on the basis that only 23 of the 1071 (2.1%) Afirma gene expression classifier (GEC) benign nodules were reported as mal ignant on surgical pathologic analysis. However, only a total of 149 such nodules were actually resected in the postmarketing studies, yielding a false-negative rate of 15.4% in these resected nodules, for an NPV of 84.6%. We recognize and acknowledge that selection bias likely exists in ...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 9, 2020 Category: ENT & OMF Source Type: research

Association of Hypocalcemia and Magnesium Disorders With Thyroidectomy
This cross-sectional study examines factors associated with hypocalcemia after total thyroidectomy and explores the association between hypocalcemia, magnesium disorders, and costs of care. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 9, 2020 Category: ENT & OMF Source Type: research

The Utility of Image Guidance in Endoscopic Sinus Surgery
This systematic review summarizes the literature on the impact of image-guided surgery on surgical outcomes and complications, newer applications in other endoscopic procedures, challenges associated with further study of the technique, and recent developments related to the technology. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 9, 2020 Category: ENT & OMF Source Type: research

Diffuse Palatal Swelling
A healthy woman in her 60s was referred for evaluation of a palatal swelling of unknown duration. She denied any pain or discomfort from the site and stated that the increasing size of the mass was what first alerted her to its presence. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 2, 2020 Category: ENT & OMF Source Type: research

JAMA Otolaryngology –Head & amp; Neck Surgery —Best of 2019
The Best of 2019 editorial represents a new addition to JAMA Otolaryngology –Head and Neck Surgery. This Editorial is written by members of the editorial board and highlights select articles published in the journal over the past year. The selected articles represent the main specialty domains covered by the journal. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 2, 2020 Category: ENT & OMF Source Type: research

Prescribing Time to Temporize Burnout
Burnout is harming our medical students, residents, fellows, and colleagues. What is at stake is not only our professional well-being but also the safety of our patients. A 1-point increase in a surgeon ’s self-reported emotional exhaustion score is associated with a 5-point increase in errors; this negative association is doubled for a 1-point increase in depersonalization scores. Burnout exacts a staggering toll in safety and quality of care, lost productivity, diminished patient satisfaction, and turnover. This cost is compounded by the mental and physical fatigue experienced by clinicians and their families. We a...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 2, 2020 Category: ENT & OMF Source Type: research

Mantle Cell Lymphoma Involving Major and Minor Salivary Glands With Parotid Sparing
This case report describes a man in his 70s who presented with painless bilateral neck swelling of 1 year ’s duration that had gradually grown to affect his speech, and was diagnosed with mantle cell lymphoma. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 2, 2020 Category: ENT & OMF Source Type: research

Association of Weekly Protected Nonclinical Time With Resident Physician Burnout and Well-being
This nonrandomized crossover study describes the design of a departmental-level burnout intervention, evaluates the intervention ’s association with otolaryngology residents’ burnout and well-being, and describes how residents used and perceived the intervention. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 2, 2020 Category: ENT & OMF Source Type: research

Safety of Intralesional Cidofovir for Adjuvant Treatment of Recurrent Respiratory Papillomatosis
This case series examines the safety of adjuvant intralesional cidofovir injections in patients with recurrent respiratory papillomatosis. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - January 2, 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 that w...
Source: JAMA Otolaryngology - Head and Neck Surgery - January 1, 2020 Category: ENT & OMF Source Type: research

Nasal Polyps, Laryngeal Masses, and Subglottic Stenosis in a Middle-aged Man
A 52-year-old man with a history of asthma presented with exacerbation of long-standing dyspnea along with progressively worsening nasal congestion and dysphonia over the past 2 years. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 26, 2019 Category: ENT & OMF Source Type: research

Association Between Microvascular Retinal Signs and Age-Related Hearing Loss in the ARIC-NCS
This cohort study investigates whether microvascular retinal signs are associated with age-related hearing loss among patients in the Artherosclerosis Risk in Communities Neurocognitive Study (ARIC-NCS). (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 26, 2019 Category: ENT & OMF Source Type: research

Discontinuation and Nonpublication of Head and Neck Cancer Randomized Clinical Trials
This systematic review assesses the rate of discontinuation or nonpublication of phase 3 and 4 randomized clinical trials involving patients with head and neck cancer. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 26, 2019 Category: ENT & OMF Source Type: research

An Enlarging Right Neck Mass in a 25-Year-Old Woman
A 25-year-old woman with a history of polycystic ovarian syndrome and a migraine disorder presented with a right neck mass that had enlarged over the course of 6 months. What is your diagnosis? (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 19, 2019 Category: ENT & OMF Source Type: research

Geographic Variation in the Use of Audiovestibular Testing —Too Much or Too Little?
Clinical epidemiology aims to better understand health care delivery. It can identify potential problems with underutilization or overutilization of services and can be used to establish priorities for future studies or interventional trials. Defining geographic variation of utilization is an important part of clinical epidemiology. Theoretically, the care delivered to patients should be similar in different regions. However, regions can also have important differences in population characteristics that justify variation. Differences in supply may also contribute to variation, ie, supply sensitive variation. Services with ...
Source: JAMA Otolaryngology - Head and Neck Surgery - December 19, 2019 Category: ENT & OMF Source Type: research

Permanent Facial Paralysis and Hearing Loss After Aural Irrigation
This case report describes a woman in her 70s who presented with impacted cerumen in the right ear and underwent bilateral irrigation, which resulted in tympanic membrane perforation and infection, with subsequent permanent facial palsy and mixed hearing loss. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 19, 2019 Category: ENT & OMF Source Type: research

Clinician Use and Payments for Audiometric and Vestibular Testing Among US Medicare Beneficiaries
This cross-sectional study evaluates the variation in clinician use and payments for audiograms and vestibular tests across all regions of the United States and by specialty practice. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 19, 2019 Category: ENT & OMF Source Type: research

Unilateral Vocal Fold Immobility After Prolonged Endotracheal Intubation
This subgroup analysis of a cohort study examines the incidence of and risk factors for unilateral vocal fold immobility after more than 12 hours of mechanical ventilation in a medical intensive care unit. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 19, 2019 Category: ENT & OMF Source Type: research

An Unusual Nasal Septal Lesion in an Adult Patient
This Clinical Challenge describes an exceedingly rare cause for pain in the right nostril of a 31-year-old woman. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 12, 2019 Category: ENT & OMF Source Type: research

Clinical Implications of Scleroderma in the Decision for Radiotherapy-Based Larynx Preservation
This case report describes 2 patients who presented with laryngeal complications after undergoing radiation therapy. (Source: JAMA Otolaryngology - Head and Neck Surgery)
Source: JAMA Otolaryngology - Head and Neck Surgery - December 12, 2019 Category: ENT & OMF Source Type: research