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Background: Complications following head and neck microvascular free tissue transfer (MFTT) are common. Less is known about when they occur. Method: Retrospective study of patients with primary or recurrent head and neck cancer undergoing MFTT reconstruction at a tertiary care institution. MFTT reconstructions with inpatient postoperative complications were included. The Kruskal–Wallis test was used to compare median postoperative day (POD) onset of complication by flap type. Results: Of 1090 patients undergoing MFTT reconstruction, 126 (11.6%) patients experienced inpatient complications including fibula (n = 35), anterolateral thigh (n = 60), or radial forearm (n = 31) MFTTs. POD onset was shortest for surgical site hematoma (median = 1 [IQR 1–5]), and longest for donor site infection (median = 11.5 [IQR 8–15]). There was no significant difference between flap types and POD onset of complications (p > 0.05). Conclusion: Hematoma formation and flap failure occur earliest during hospitalization, while dehiscence, infection, and fistula occur later. There is no difference in complication timing between flap types. [ABSTRACT FROM AUTHOR]

Objectives: Decisional conflict (DC) is high in obstructive sleep apnea (OSA) surgical candidates interested in positive airway pressure (PAP) alternatives. We evaluated the impact of pre‐consultation video decision aids on patient DC and decision readiness. Methods: Prior to consultation for PAP alternatives, adult OSA patients were enrolled and completed a questionnaire querying DC (scored 0 [no conflict]–100 [high conflict]) and decision readiness. Those considering ≥3 treatment options were categorized as "high‐conflict." Patients were randomized to either an intervention group with video review about PAP and surgical options prior to their visit or to a control group that received no video review. Audio recordings of clinic visits were analyzed for patient engagement. Results: Twenty‐five participants (control: n = 12, intervention: n = 13) were found to have comparably high DC (mean score: 40.0). Both groups experienced post‐visit improvements in DC scores (post‐consult: 25.2, p = 0.003) which did not differ between the two groups (intervention: 20.5 ± 15.1 vs. control: 11.7 ± 12.1 points, p = 0.13). The intervention group showed significant improvement in decision‐making stage after the visit, with 72.7% "close to selecting an option" (p = 0.04) versus 41.7% in the control group. Use of videos was not associated with any differences in patient satisfaction, engagement, or decision to pursue surgery (all p > 0.05). High‐conflict patients (n = 5) who reviewed pre‐visit videos (intervention sub‐group) spoke fewer words during the visit (687 ± 139 vs. 1120 ± 389 words, p = 0.047) and had shorter visit times (18.7 ± 2.9 vs. 24.3 ± 3.1 min, p = 0.02) than high‐conflict control patients. Conclusions: Patients have high levels of DC when considering PAP alternatives. Use of video decision aids prior to sleep surgery consultation may improve the treatment decision‐making process. Level of Evidence: 2 Laryngoscope, 134:2958–2963, 2024 [ABSTRACT FROM AUTHOR]

Objective: Human Papillomavirus (HPV) is a well-documented cause of cervical, oropharyngeal, vaginal, vulvar, anal, and penile cancers, largely preventable with the HPV vaccine. We aim to characterize the most popular TikTok videos pertaining to HPV-associated cancers and vaccination with a focus on oropharyngeal cancer., Methods: Observational study of public social media content. The top 200 TikTok videos that appeared when searching for #HPVvaccine and #Gardasil individually were included and analyzed on the basis of creator characteristics, viewer reach, content, and accessibility. Characteristics of each video were counted if mentioned or listed in the caption., Results: Forty-four percent of videos originated from creators self-identifying as health care professionals and had an average of 129,525 (SD: 59,997) views. 72.0% were pro-vaccination, and 17.5% were specifically anti-vaccination. Only 14.0% mentioned all six types of HPV-related cancer (including oropharyngeal). Other mentions included HPV prevention (62.0%), transmission (31.0%), infection risk factors (12.0%), and vaccine side effects (23.0%), while only 7.5% specifically regarded vaccines as safe. 35.5% of creators identified the Gardasil vaccine as appropriate for both men and women., Conclusions: Medical professionals have a strong presence on TikTok and overwhelmingly support HPV vaccination for cancer prevention but miss the mark in associating high-risk HPV with non-cervical cancers, addressing vaccine safety, and clearly defining who is eligible for the HPV vaccine/Gardasil. Despite oropharyngeal cancer eclipsing cervical cancer as the most common HPV-related malignancy, there is still a dearth of online patient education about this disease and the potential treatment/prevention measures available., (© 2025 The American Laryngological, Rhinological and Otological Society, Inc.)