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To determine if perioperative administration of dexmedetomidine affects postoperative fluid intake in tonsillectomy patients. A retrospective chart review was performed at University Medical Center, Texas Tech Health Science Center, Lubbock, Texas. The study identified 534 patients within the last five years who met the criteria. Common indications for the surgeries included recurrent tonsillitis, obstructive sleep apnea, and sleep disordered breathing. Patients with concurrent peritonsillar abscess drainage, microlaryngoscopy, bronchoscopy, supraglottoplasty, and other procedures that may impact fluid intake were excluded. The relationship between dexmedetomidine and fluid intake was evaluated using bivariate analysis as well as multivariable regression to account for possible confounders such as age, concurrent medication, surgery type, and method of surgery using STATA statistical software, version 17.0 (StataCorp LLC, College Station, TX). Administration of dexmedetomidine did not significantly impact the amount of fluid intake, fluid intake per kilogram per hour, or average postoperative pain levels in patients who underwent tonsillectomy or adenotonsillectomy in the bivariate analysis (p = 0.217, 0.489, 0.512 respectively) and multiple regression model (p = 0.156, 0.802, 0.795) Dexmedetomidine does not negatively influence postoperative fluid intake levels in patients and should continue to be utilized in appropriately selected patients experiencing anxiety or agitation prior to surgery. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: Socioeconomics and demographics have been shown to be determinates of healthcare in specialty clinics, in which thorough research is lacking in the setting of the United States clinical sphere. We set out to determine the impact of socioeconomic and demographic factors on patient preparedness in an otolaryngologic clinic as to highlight the need for awareness in this aspect of disparate and delayed clinical care. Study Design: Retrospective chart review. Methods: A chart review was conducted of 482 patients who visited our otolaryngology clinic between June 1, 2020 and June 1, 2023. Demographic data including marital status, gender, age, zip code, and race was collected. Results: Our study found several interesting points of significance. Marital status was a significant determinant of whether patients had missing labs and/or imaging (p =.001). Age was a significant determinant of patients having their imaging (p <.0001). Patients were more likely to have all their labs and imaging at a follow‐up appointment compared to an initial appointment (p <.0001). Finally, a patient's zip code was found to be a significant determinant of whether a patient no‐showed an appointment or arrived with all their needed imaging and labs (p =.004). Conclusions: Having the needed labs and imaging for a clinical visit is vital to providing timely and well‐informed care for all patients. This study highlighted several potential determinates of missing labs and imaging. Elderly patients were less likely to have imaging, which may be attributed to transportation issues and a weaker support system. Individuals who were married were more likely to have their imaging. Married individuals may have a stronger support system, where their spouses can provide transportation and reminders for appointments. Finally, the significance of zip code highlights the role transportation distance and living in an underserved area may have on patients being able to go to their appointments or obtain their needed imaging. Level of Evidence: 4 [ABSTRACT FROM AUTHOR]

Intrathyroidal parathyroid carcinoma (PC) is a rare malignancy that is usually difficult to diagnose. We present a case of a 31-year-old male with a history of hyperparathyroidism who was found to have intrathyroidal PC upon review of immunostains along with a review of the current literature. A systematic review of the literature utilizing the PubMed database identified 24 relevant, full-text articles. 25 cases were analyzed, including our own report. The case of a 31-year-old man with a history of hyperparathyroidism managed with subtotal thyroidectomy and subtotal parathyroidectomy who had persistent hypercalcemia and elevated parathyroid hormone. Abnormal radiotracer uptake was noted in the left thyroid gland. Neck exploration with left parathyroidectomy and revision thyroidectomy was performed. A candidate left inferior parathyroid was found within the left thyroid lobe remnant and identified as parathyroid carcinoma. Immunostains determined an intrathyroidal parathyroid carcinoma. The literature review shows the average presenting age was 50.9 years. 54.17% (CI, 43–82%) of affected patients are female. Right-sided thyroid involvement is seen in 54.17% (CI, 34–74%) of cases. The inferior aspect of the thyroid is involved in 66.67% of cases (CI, 53–89%). Intrathyroidal parathyroid carcinoma is a rare and challenging diagnosis due to similarities with other more common endocrine abnormalities. This review found that the inferior parathyroid is more likely to be located within the thyroid gland. Surgeons may consider aberrant anatomical locations, including intrathyroidal locations, for the inferior parathyroid glands. [ABSTRACT FROM AUTHOR]

Evaluates in vivo desensitization and self-modeling for effectiveness in treating a 29-year-old female with an intense fear of children. Following 19 sessions over a six-month period the subject stopped avoiding situations involving children, heart rate and blood pressure decreased slightly, confidence increased, and multiple fears were reduced. (RJM)

The posterior belly of the digastric muscle, referred to as the "resident's friend," serves as a valuable anatomical landmark because identification of its location during head and neck surgery helps to secure vital structures. A 53-year-old female was referred for an oral cavity mass with a biopsy confirmed squamous cell cancer. A physical exam revealed a 4 cm long and 2 cm wide right ulcerated oral tongue mass. Imaging findings demonstrated no evidence of pathological lymph nodes and distant metastasis. A surgical excision with elective neck dissection was planned along with submental island flap reconstruction. During the neck dissection, the external carotid artery (ECA) was noted to be passing over the posterior belly of the digastric muscle and then descending deeper than the stylohyoid muscle. No other vascular anomaly was identified. The surgery was completed without any complications, and the patient was discharged on post-operative day five. It is necessary to be attentive to a potential course variation of the neurovascular structures underneath that could affect the credibility of the posterior belly of the digastric muscle as a trusted friend. This case report emphasizes the significance of identifying the rare variation where the posterior belly of the digastric muscle exposes the ECA to its lateral side., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Texas Tech University Health Sciences Center School of Medicine issued approval Exempt. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, May et al.)

Intrathyroidal parathyroid carcinoma (PC) is a rare malignancy that is usually difficult to diagnose. We present a case of a 31-year-old male with a history of hyperparathyroidism who was found to have intrathyroidal PC upon review of immunostains along with a review of the current literature. A systematic review of the literature utilizing the PubMed database identified 24 relevant, full-text articles. 25 cases were analyzed, including our own report. The case of a 31-year-old man with a history of hyperparathyroidism managed with subtotal thyroidectomy and subtotal parathyroidectomy who had persistent hypercalcemia and elevated parathyroid hormone. Abnormal radiotracer uptake was noted in the left thyroid gland. Neck exploration with left parathyroidectomy and revision thyroidectomy was performed. A candidate left inferior parathyroid was found within the left thyroid lobe remnant and identified as parathyroid carcinoma. Immunostains determined an intrathyroidal parathyroid carcinoma. The literature review shows the average presenting age was 50.9 years. 54.17% (CI, 43-82%) of affected patients are female. Right-sided thyroid involvement is seen in 54.17% (CI, 34-74%) of cases. The inferior aspect of the thyroid is involved in 66.67% of cases (CI, 53-89%). Intrathyroidal parathyroid carcinoma is a rare and challenging diagnosis due to similarities with other more common endocrine abnormalities. This review found that the inferior parathyroid is more likely to be located within the thyroid gland. Surgeons may consider aberrant anatomical locations, including intrathyroidal locations, for the inferior parathyroid glands., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.