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Objective: To investigate the association of social determinants of health (SDoH) in squamous cell carcinoma of the tongue in the United States and to evaluate the real‐world contribution of specific disparities. Study Design: Retrospective cohort study. Setting: United States. Methods: The Centers for Disease Control and Prevention‐Social Vulnerability Index (SVI) and National Cancer Institute‐Surveillance, Epidemiology, and End Results Program database were used to study 62,103 adult tongue squamous cell carcinoma patients from 1975 to 2017. Regression analysis assessed trends in months of follow‐up and survival across social vulnerability and 4 subcategories of social vulnerability. Results: As overall SVI score increases (increased social vulnerability), there is a significant decrease in the average length of follow‐up (22.95% decrease from 63.99 to 49.31 months; P <.001) across patients from the lowest and highest social vulnerability groups. As overall SVI score increases, there is a significant decrease in the average months of survival (28.00% decrease from 49.20 to 35.43 months; P <.001). There is also a significantly greater odds ratio (OR = 1.05; P <.001) of advanced cancer staging upon presentation at higher SVI scores. Patients with higher SVI scores have a lower OR (0.93; P <.001) of receiving surgery as their primary treatment when compared to patients with lower SVI scores. Patients with higher SVI scores also have a significantly greater OR (OR = 1.05; P <.001) of receiving chemotherapy as their primary treatment when compared to patients with lower SVI scores. Conclusion: Increased social vulnerability is shown to have a detrimental impact on the treatment and prognosis of patients with squamous cell carcinoma of the tongue. [ABSTRACT FROM AUTHOR]

Objective: To compare head and neck squamous cell carcinoma stage at presentation and survival in Medicaid‐expanded states versus nonexpanded states. Study Design: Retrospective cohort. Setting: Northwestern University Feinberg School of Medicine. Methods: The Head and Neck with human papillomavirus Status Database within the Surveillance, Epidemiology, and End Results (SEER) Program was queried for cases of head and neck squamous cell carcinoma (HNSCC) diagnosed in the years 2010 to 2016. Cases were grouped according to their respective state Medicaid expansion status. Multivariable logistic regressions and multivariable Cox proportional hazards models were used to evaluate associations with stage IV disease and survival. Results: Compared to nonexpanded states, Medicaid‐expanded states had a significantly larger proportion of Medicaid patients (20.3% vs 16.7%, P =.0009) and a significantly smaller proportion of uninsured patients (1.7% vs 10.1%, P <.0001). The case selection process resulted in 2215 patients meeting inclusion criteria. In multivariable analysis, cases under Medicaid expansion were 31% less likely to present with stage IV disease compared to cases in nonexpanded states (odds ratio: 0.69, 95% confidence interval [CI]: 0.51‐0.93). In the multivariable Cox proportional hazards model, cases under Medicaid expansion had significantly better mortality outcomes and were 32% less likely to die compared to cases in nonexpanded states (hazard ratio: 0.68, 95% CI: 0.55‐0.84). Conclusion: Medicaid expansion is associated with fewer stage IV cases and improved survival of HNSCC cases. These findings support continued efforts to expand Medicaid coverage. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the clinical features of first branchial cleft anomalies (BCAs) and their relationship to pre‐operative imaging, pathologic data, and post‐operative surveillance outcomes. Additional aims were to assess the validity of the Work classification and describe features of recurrent cysts. Methods: Records for 56 children (34 females, 22 males; age at surgery of 5.6 ± 4.4 years) collected over a 12‐year period (2009–2021) were reviewed. Imaging and pathologic slides were re‐reviewed in a blinded fashion by experts in those respective areas. Parents were contacted via telephone to obtain extended follow‐up. An alternate classification method based on the presence (type II) or absence (type I) of parotid involvement is provided. Results: Only 55% of first BCAs could be successfully classified using Work's method. First BCAs within the parotid were more likely to present with recurrent infections, involve scarred tissue planes and lymphadenopathy, and demonstrate enlarged lymphoid follicles on pathology. The overall recurrence rate was 16%, and recurrence was 5.3 times more likely when external auditory canal cartilage was not resected. Preoperative imaging was useful for predicting the extent of surgery required and the presence of scarred tissue planes. Conclusion: First BCAs within the parotid gland involve more difficult and extensive surgical resection and the potential for morbidity related to facial nerve dissection. Appropriately aggressive surgical resection, which may include the resection of involved ear cartilage, is necessary to prevent morbidity related to recurrence. Level of Evidence: 4 Laryngoscope, 134:459–465, 2024 [ABSTRACT FROM AUTHOR]

Objective: To identify variables that are associated with poor compliance to thyroid hormone replacement therapy in children after total thyroidectomy. Method: A retrospective cohort study of children who underwent total thyroidectomy by high‐volume pediatric otolaryngologists between 1/2014 and 9/2021. Postoperative poor compliance was characterized by at least three separate measurements of high TSH levels not associated with radioactive iodine treatment. Results: There were 100 patients, ages 3–20 years old who met inclusion criteria; 44 patients underwent thyroidectomy for cancer diagnosis, and 56 for Graves' disease. The mean follow‐up time was 36.5 months (range 3.0–95.6 months). Overall, 42 patients (42%) were found to have at least three measurements of high TSH during follow‐up, and 29 patients (29%) were diagnosed with clinical hypothyroidism. Sex, race, income, insurance type, and benign versus malignant etiology for thyroidectomy were not associated with adherence to therapy. Multivariate regression analysis identified patients with Graves' disease and hyperthyroidism at the time of surgery and Hispanic ethnicity to be associated with postoperative clinical hypothyroidism (OR 9.38, 95% CI 2.16–49.2, p = 0.004 and OR 6.15, 95% CI 1.21–36.0, p = 0.033, respectively). Conclusions: Preoperative hyperthyroidism in patients with Graves' disease and Hispanic ethnicity were predictors of postoperative TSH abnormalities. Preoperative counseling for patients and their families on the implications of total thyroidectomy and the need for life‐long medications postoperatively is necessary. Efforts should be made to evaluate and improve adherence to therapy pre‐and postoperatively in patients with Graves' disease. Level of Evidence: 4 Laryngoscope, 133:2402–2406, 2023 [ABSTRACT FROM AUTHOR]

Objective: To evaluate weight gain in children post‐thyroidectomy and identify predictors. Methods: Charts from patients at a tertiary health care facility who underwent total thyroidectomy from 2014 to 2020 were reviewed for Body Mass Index z‐scores (BMIz) at the time of thyroidectomy and at 1 and 2‐year post‐operation intervals. Patient demographic information, comorbidities, pre‐ and postoperative thyroid stimulating hormone, and postoperative free T4 levels were also extracted. Patients with other known endocrine abnormalities, chronic kidney disease, or without sufficient follow‐up were excluded. Results: A total of 56 patients (ages 3–17 years old) met the inclusion criteria (n = 17 Graves' disease; n = 39 presumed cancer). Over the first year, average BMIz significantly increased in patients with Graves' disease (∆BMIz = 0.45 ± 0.77, p = 0.03), Hispanic ethnicity (∆BMIz = 0.43 ± 0.68, p = 0.004), Medicaid/no insurance coverage (∆BMIz = 0.33 ± 0.74, p = 0.038), age <13 years at thyroidectomy (∆BMIz = 0.35 ± 0.68, p = 0.016), and persistent postoperative hypothyroidism (∆BMIz = 0.41 ± 0.41, p = 0.012). These changes remained significant after the second year. Age at thyroidectomy correlated negatively with ∆BMIz only after the first year (r = −0.40, p = 0.002). Regression analysis, controlling for Graves' status, persistent postoperative hypothyroidism, and insurance coverage, identified age at thyroidectomy as a significant predictor of ∆BMIz after the first year (b = −0.06, p = 0.004) and Hispanic ethnicity as a significant predictor after the second year (b = 0.60, p = 0.003). Conclusion: A small increase in BMIz post‐thyroidectomy was observed across several patient subgroups. Younger age at thyroidectomy and Hispanic ethnicity were associated with increased BMIz in the first 2 years post‐thyroidectomy. Level of Evidence: Level 4 ‐ Historically controlled cohort Laryngoscope, 133:1518–1523, 2023 [ABSTRACT FROM AUTHOR]

Objectives: To investigate long‐term outcomes, imaging, and pathologic findings in pediatric patients who underwent superficial parotidectomy for recalcitrant juvenile recurrent parotitis (JRP). Methods: Records for 20 children (23 parotidectomies; 9 females, 11 males; age at surgery of 8.6 ± 3.7 years) collected over a 10‐year period (2012–2021) were reviewed. Parents were contacted via telephone to obtain extended follow‐up. A simplified scoring system was used to assess imaging findings and an additional pathologic review was conducted to further clarify the underlying disease process. Results: All but one patient experienced resolution of their recurrent symptoms after superficial parotidectomy. Three of the patients studied required surgery on the contralateral side, and this could be predicted based on their imaging at the time of the initial surgery. Pathologic findings included ductal fibrosis, metaplasia, and dilatation as well as parenchymal atrophy and fatty deposition. There were no major surgical complications, however, the incidence of Frey's syndrome in this sample was 43.5% of surgical sites. Conclusion: For patients with frequent recalcitrant symptoms or significant quality of life impairment related to JRP, superficial parotidectomy represents a potential treatment option with the noted reduction in symptom burden following surgery. Further longitudinal studies are needed. Level of Evidence: 4 Laryngoscope, 133:1495–1500, 2023 [ABSTRACT FROM AUTHOR]