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Objectives: The current study aims to quantify the growth rate of p16-negative oral cavity squamous cell carcinoma, characterize causative relationships between demographic risk factors and tumor growth, and examine pathologic findings associated with the tumor growth rate at a tertiary care institution. It is hypothesized that causative relationships will be drawn between the individual sociodemographic and pathologic factors and oral cavity p16-negative squamous cell carcinoma growth rate., Methods: Prospectively recruited participants, receiving surgical intervention only, were followed from initial staging CT scan to surgical resection. Interval growth was calculated in cm 3 /week. Demographic information including age, sex, smoking history, alcohol consumption history, previous all-type malignancy, previous chemotherapy treatment, previous head or neck radiation exposure, and time interval elapsed between diagnosis and surgery was collected from each participant, and regression analysis was applied to determine causality., Results: Summary statistics revealed a mean growth rate for the study sample of 1.385cm 3 /week. Statistically significant regression correlations were detected between tumor growth and alcohol consumption, origination at the retromolar trigone, and clinical nodal stage., Conclusions: Through a small prospective cohort sample, the current study suggests clinical associations between alcohol consumption, origination at the retromolar trigone, and clinical nodal stage with rate of tumor growth. Future work will validate these relationships in a larger patient cohort, and against stronger modeling techniques., Level of Evidence: Prospective non-random cohort design., Competing Interests: The authors of this paper have no competing interests nor conflicts of interest to disclose., (© 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society.)

Objectives: This article reports on a unique cohort of patients with idiopathic subglottic stenosis spilt fairly equally between endoscopic and open surgical approaches. Patients' sequence of operations and reinterventions over time are outlined, offering insight to improve surgical counseling and allow for informative, autonomous patient decision making., Study Design: Retrospective cohort study., Setting: Tertiary care academic center., Methods: Cases of consecutive adults with idiopathic subglottic stenosis managed surgically over a 12-year period (January 2006-December 2017) were retrospectively reviewed. Surgical workflow, complications, and outcomes, including reinterventions and tracheotomy dependence, are reported., Results: Seventy-two patients (71 women; mean age, 50.4 years) with idiopathic subglottic stenosis requiring surgical airway intervention were identified. Six patients underwent tracheotomy prior to attempt at airway stenosis surgery. Initial surgical approach thereafter included endoscopic (73.5%, n = 53) and open (26.4%, n = 19) procedures. Thirty-one patients underwent cricotracheal resection; the reintervention rate was 22.5%. Sixty patients underwent 147 endoscopic procedures; the reintervention rate was 75.5%, and the mean time between dilations was 83 weeks (range, 5-402). Two (2.8%) patients remain tracheotomy dependent. Adverse events were significantly higher in the cricotracheal group, especially with respect to dysphonia and temporary gastrostomy tube placement ( P < .01)., Conclusions: Endoscopic and open surgical airway intervention can be employed successfully to avoid tracheotomy dependence and maintain airway patency; however, multiple procedures are usually required, regardless of surgical approach. Cricotracheal reintervention rates are lower than endoscopic dilation but with increased morbidity. Quality-of-life outcomes should be clearly discussed with patients before deciding on a surgical management strategy.

Objective: To create and assess a novel high-fidelity peritonsillar abscess simulation task trainer with junior otolaryngology-head and neck surgery residents., Study Design: Prospective cohort study., Setting: Third annual Emergencies in Otolaryngology Head & Neck Surgery Bootcamp course at the Canadian Surgical Technologies & Advanced Robotics in London, Canada., Subjects and Methods: Fresh cadaveric material was obtained consisting of a head and neck. Abscess pockets were simulated with a finger of a latex glove containing vanilla pudding to represent pus, tied off with a silk suture. These abscess pockets were inserted into the peritonsillar space from the transected neck inferiorly, passing medial to the great vessels into the parapharyngeal space. Faculty members evaluated the models to test content validity. The primary outcome measure was a postbootcamp survey evaluation assessing specific domains: learning objectives, effectiveness of faculty, and the quality and realism of models., Results: When working with this model, learners were able to locate, visualize, and manipulate the abscess. The materials and positioning of the pockets created high-fidelity models that were realistic in appearance and haptics feedback., Conclusions: A novel high-fidelity task trainer has been successfully developed to teach the technique of peritonsillar abscess incision and drainage. This task trainer is currently the highest-fidelity model reported in the literature. This model allows learners to practice a high-stakes emergency skill in a controlled environment, affording the opportunity to practice localization, visualization, and drainage of the abscess with a high level of realism., (© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.)

Objectives: To study the current selection of mobile applications (apps) relating to otolaryngology-head and neck surgery (OtoHNS). To conduct a review of the apps available in OtoHNS., Data Sources: App Store, Google Play, BlackBerry World, Windows Store., Methods: The Apple, Google, Windows, and Blackberry mobile app stores were searched for apps relating to OtoHNS. App information was analyzed based on in-store descriptions, and apps were downloaded and reviewed., Conclusions and Implications for Practice: There is a rapidly expanding collection of apps with a wide variety of functions available in OtoHNS. There are several high-quality apps for education and clinical use, which have been highlighted in our review. Mobile apps have the potential to become widely incorporated into OtoHNS, although there is a need for appropriate guidance from the specialty to ensure app quality and accuracy of content., (© American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.)

Objective: Patients considering surgery face many uncertainties and concerns. This investigation sought to develop an objective assessment tool for characterizing the areas of greatest concern among those considering thyroidectomy., Study Design: Prospective cohort design., Setting: Tertiary-care otolaryngology practice., Subjects: Participants included individuals presenting with a thyroid nodule found to be of intermediate risk (15%-20%) of cancer based on fine-needle aspiration (FNA) biopsy and amendable to hemithyroidectomy., Methods: As part of validating a clinical measure concerning perioperative concerns, patients presenting with thyroid nodules amendable to hemithyroidectomy were voluntarily recruited. Thirty individuals (6 men, 24 women) completed a novel 18-item questionnaire during their initial clinical visit and again 3 days later. Outcome measures included descriptive statistics and test-retest reliability., Results: Individual patients have both general and specific preoperative concerns. A wide range of responses was obtained across the entire spectrum of the survey. The questionnaire demonstrated fair-to-excellent test-retest reliability, with correlation values from 0.467 to 0.954. Between-rater reliability was consistent with intraclass correlation coefficient values of 0.52 to 0.86. No relationship between question order and patient response was identified. Women were found to be more concerned about scar appearance (P = .028), and men were conversely more concerned about resuming daily activities (P = .026)., Conclusions: Patients considering thyroidectomy have concerns that remain stable in the early preoperative period. This is the first study to evaluate preoperative patient concerns and preliminarily establishes the Western Surgical Concern Inventory-Thyroid as a means of ensuring adequate patient counseling and a method of evaluating preoperative patient education.

Objectives: To determine the feasibility and effectiveness of virtual-patient computer-assisted instruction (CAI) in pre-clerkship undergraduate otolaryngology education., Study Design: Prospective, randomized, controlled trial., Subjects and Methods: Second-year medical students at the University of Western Ontario, Canada, were randomized into two groups: group A was given a CAI module and group B was presented with two Internet review articles, both covered specific learning objectives for pediatric stridor. Students completed randomized pre- and post-tests and a questionnaire one week later., Results: Fifty-five students completed the study with 28 in group A and 27 in group B. Mean pretest scores were 59.1% in group A and 59.8% in group B (95% CI = -7.9% to 10.4%). Mean post-test scores were significantly elevated in group A (84.6%, P < 0.001) and group B (74.3%, P = 0.008). Group A had a significantly higher (P = 0.02) mean post-test score than group B (mean difference of 10.2%). Students spent significantly more time (P < 0.001) reading text articles (25.5 minutes) than completing the CAI (9.06 minutes). Forty-one (66%) students completed the survey. Thirty-six (88%) respondents indicated that they preferred CAI to online articles., Conclusion: CAI is a feasible, effective, and efficient means of enhancing self-directed learning as supplementation to the pre-clerkship undergraduate otolaryngology curriculum.