JAMA Otolaryngology Head and Neck Surgery 2024-11-01

JAMA Otolaryngology–Head & Neck Surgery

Publication date 01-11-2024


Mission Statement: To advance the patient-centered, evidence-based practice of otolaryngology–head and neck surgery by publishing scientifically rigorous and innovative research, reviews, and commentary. Our journal serves as a vital resource for clinicians, researchers, educators, and trainees by providing high-quality, peer-reviewed content focused on improving the understanding and treatment of ear, nose, and throat conditions. We are dedicated to fostering dialogue and action on critical issues in otolaryngology, including the education and training of health care professionals, quality improvement, and the ethics and economics of equitable health care delivery.

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Patient With Painful and Destructive Nasal Mass

BN Delikkaya,SM Gargano

Publication date 01-11-2024


A patient in their mid-30s presented with pain and swelling involving the bridge of their nose. What is your diagnosis?

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Lower Thyroid Cancer Incidence During COVID-19—Should We Be Concerned?

LM Sarkis,A Eskander

Publication date 01-11-2024


The recent and unprecedented COVID-19 pandemic decreased surgical health care utilization at both the local and global levels and prioritized aggressive malignant disease. In an analysis of longitudinal trends in thyroid cancer incidence using data extrapolated from the Surveillance, Epidemiology, and End Results database, Bell et al have demonstrated a decreased incidence (up to 14%) of papillary thyroid carcinoma, follicular carcinoma, and medullary carcinoma, with an estimated 10 000 thyroid cancer cases missing during the 21 months after the pandemic was declared. Furthermore, there was evidence of underdiagnosis of anaplastic carcinoma approximately 12 months after the pandemic onset. In particular, the sharpest declines occurred during defined waves of the COVID-19 pandemic, coinciding with the emergence of new variants and underpinning the recurring effects of disease resurgence and its downstream effects. The findings of this study have several implications for treating clinicians regarding the delivery of health care during an infectious disease outbreak and subsequent presentation of disease stage, and have provided the results of a natural experiment to gain insight into future resource distribution paradigms. These findings also raise the simple question, “Should we be concerned about these missing thyroid cancer cases?”

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Thyroid Cancer Incidence During 2020 to 2021 COVID-19 Variant Waves

R Bell,DM Weinberger,M Venkatesh,S Fernandes-Taylor,DO Francis,L Davies

Publication date 01-11-2024


This longitudinal study estimates the number of undiagnosed thyroid cancer cases from 2020 to 2021 by comparing observed to expected thyroid cancer incidence in US adults.

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Transoral Laser or Robotic Surgery Outcomes for Oropharyngeal Carcinoma

JT O'Hara,CN Hurt,K Ingarfield,JM Patterson,K Hutcheson,JE Canham,LS Nixon,CD Heiberg,S Johson,M Evans,TM Jones

Publication date 01-11-2024


This cohort study explores whether the different energy sources used and differing surgical philosophy of transoral robotic surgery and laser microsurgery are associated with postoperative early swallowing function, feeding tube use, and specific factors related to quality of life among patients with human papillovirus–positive oropharyngeal squamous cell carcinoma.

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Frozen Section Analysis of Sentinel Nodes in Patients With Oral Squamous Cell Carcinoma

M Abukhder,A Sahovaler,P Vrakas,M McGurk,S Thavaraj,C Schilling

Publication date 01-11-2024


This meta-analysis reviews pooled data from studies of frozen section analysis used to evaluate sentinel nodes in patients with cT1-T2 N0 oral squamous cell cancer.

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Should Mouth Taping and Obstructive Sleep Apnea Therapies Be Regulated?

JW Chadwick,AT Huang

Publication date 01-11-2024


A deluge of coverage regarding the benefits of mouth taping on sleep quality has recently flooded social media. Within the US, more than 7000 posts garnering 7 million views on Tik Tok with the hashtag #mouthtape are available for public consumption. Individuals featured on these platforms tout a myriad of benefits including improved respiratory health, reduced risk for obstructive sleep apnea (OSA) development, and enhanced oral health using this seemingly benign and low-cost intervention. As national news outlets and nearly every academic sleep medicine program have scrambled to release communications and opinion pieces on this trend, a spotlight has been cast on the limited objective data available on forced mouth closure during sleep, and worse, on the lack of protocols and regulations to ensure its appropriate implementation.

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F18-Choline PET/CT for Primary Hyperparathyroidism

TL Chow

Publication date 01-11-2024


To the Editor My attention was captured by the article written by Quak et al, describing the results of an important randomized clinical trial. The findings suggest that F18-choline positron emission tomographic/computed tomographic scan (FCH PET/CT) is more accurate than conventional Tc99m-sestaMIBI single photon-emission (SPE) CT/CT (MIBI SPECT/CT), and can supplant the latter as the first-line investigation. Although there is little doubt that FCH PET/CT is sensitive, I humbly comment on the methodology, results, and conclusion.

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Effect of Olfactory Enrichment For Older Adults

M Leon

Publication date 01-11-2024


To the Editor Di Stadio et al wrote in response to Vohra et al that olfactory training, also called olfactory enrichment, has been shown to improve olfactory ability in young adults, but not in older adults. In fact, there are now 3 reports demonstrating improved olfaction, cognition, and relief from depression symptoms in older adults, even older adults with dementia, following olfactory enrichment. Birte-Antina et al showed significant improvement of olfactory ability in older adults following olfactory training, along with improvements in verbal ability, subjective well-being, and depression symptoms. Woo et al showed that following olfactory enrichment, there was a large improvement in memory relative to controls in older adults. Cha et al gave intensive olfactory enrichment to older adults with dementia (40 odors 2 times per day) and found large improvements on standard memory assessments along with moderate improvements in their attention, language, and depression symptoms. These outcomes are far better than any previous clinical trial for the treatment of dementia. Olfactory enrichment therefore is an effective, safe, affordable, and convenient treatment for olfactory loss, memory loss, and depression.

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F18-Choline PET/CT for Primary Hyperparathyroidism—Reply

E Quak,A Lasne-Cardon,B Clarisse

Publication date 01-11-2024


In Reply We thank Chow for their comments on our APACH2 trial, a 2-arm diagnostic intervention randomized phase 3 trial comparing first-line fluorocholine positron emission tomography-computed tomography (FCH PET/CT FCH1) vs multiplexed ion beam imaging single-photon emission computed tomography (MIBI SPECT/CT MIBI1) in patients with primary hyperparathyroidism (PHPT) needing parathyroidectomy. The primary end point of our study was to compare the proportions of patients in whom the first-line imaging modality resulted in successful minimally invasive parathyroidectomy (MIP) and normocalcemia 1 month after surgery.

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Covered Stent Graft for Treatment of Carotid Blowout Syndrome

V Plaforet,L Tournier,F Deschamps,B Bonnet,A Moya-Plana,A Gaudin,A Levy,C Even,J Cortese,N Leymarie,S Suria,A Hakimé,S Temam,P Blanchard,T de Baere,L Tselikas

Publication date 01-11-2024


This case series study evaluates the safety and outcomes of stent-graft placement for treatment of carotid blowout syndrome in patients with head and neck cancer.

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Mouth Closure and Airflow in Patients With Obstructive Sleep Apnea

H Yang,P Huyett,TY Wang,J Sumner,A Azarbarzin,GPT Labarca,L Messineo,LK Gell,A Aishah,WH Hu,DP White,SA Sands,A Wellman,D Vena

Publication date 01-11-2024


This nonrandomized clinical trial evaluates the overall association of mouth closure with inspiratory airflow and the change in inspiratory airflow with mouth closure across 3 oral-breathing quantiles.

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Everolimus Following Dilation in Idiopathic Subglottic Stenosis

RJ So,SL Collins,S Collins,L Mafla,Y Chan-Li,I Lina,A Gelbard,KM Motz,AT Hillel

Publication date 01-11-2024


This interventional trial evaluates the effect of oral everolimus on postoperative recurrence of stenosis and peak expiratory flow in participants with idiopathic subglottic stenosis.

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Suprazygomatic Maxillary Nerve Block and Postoperative Opioid Use in Children Undergoing Adenotonsillectomy

JP Dahl,DK Low,LD Martin

Publication date 01-11-2024


To the Editor We would like to commend Lin et al on their well-conducted clinical trial focusing on the efficacy of a suprazygomatic maxillary nerve block on postoperative opioid use in children undergoing adenotonsillectomy. This innovative, opioid-sparing approach to perioperative analgesia is part of the current move to identify multimodal analgesic approaches for children undergoing this relatively painful procedure. The authors demonstrate, in a very limited study sample (26 in the regional group, 27 in the control group), that mean opioid morphine equivalent consumption during the postanesthesia care unit (PACU) phase of care was reduced with the regional anesthesia arm having a higher incidence of opioid-free PACU care and lower Face, Legs, Activity, Cry, and Consolability scale scores.

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Cutaneous Squamous Cell Carcinoma in Transketolase Deficiency

N Loranger,A Vishnevetsky,M Spencer-Manzon,E Karn,WK Chung,A Roche,ES Ruiz

Publication date 01-11-2024


This case report describes a patient in their late 30s with a history of transketolase deficiency who presented with a new diagnosis of squamous cell carcinoma.

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Suprazygomatic Maxillary Nerve Block and Postoperative Opioid Use in Children Undergoing Adenotonsillectomy—Reply

BCH Tsui,S Abboud,C Lin

Publication date 01-11-2024


In Reply We appreciate the comments of Dahl and colleagues regarding our suprazygomatic maxillary nerve block (SZMNB) for postoperative analgesia in adenotonsillectomy patients. They contend that using SZMNB may result in increased risk, duration, and cost compared with medical intervention.

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Near-Infrared Autofluorescence Signature of Parathyroid Glands

E Akgun,E Berber

Publication date 01-11-2024


This diagnostic study analyzes the difference in near-infrared autofluorescence signatures of parathyroid glands in single adenomas vs double adenomas and hyperplastic disease.

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Determinants of Prognosis in Head and Neck Cutaneous Squamous Cell Carcinoma With Nodal Metastases

A Ebrahimi,R Gupta,L McDowell,MJR Magarey,PN Smith,KM Schulte,DM Perriman,M Veness,S Porceddu,TH Low,A Fowler,JR Clark

Publication date 01-11-2024


This cohort study examines key determinants of prognosis in patients with nodal metastatic head and neck cutaneous squamous cell carcinoma.

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Decisional Conflicts in Patients With Low-Risk Papillary Thyroid Microcarcinomas

Q Zhang,X Gu,S Liu,R Fu,Y Wang,J Hegarty,P Zhu,J Ge

Publication date 01-11-2024


This qualitative survey study examines patients’ experience of decisional conflict when considering active surveillance as an alternative to surgery for low-risk papillary thyroid microcarcinomas.

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Medical Device Reprocessing

ML Lalakea,A Dilger,DA Meiklejohn

Publication date 01-11-2024


This Viewpoint discusses the benefits and challenges to implementation of medical device reprocessing in otolaryngology.

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Chronic Facial Pain in an Adolescent

JW Lewis,TT Palmer,JD Carron

Publication date 01-11-2024


A 13-year-old female individual presented with chronic facial pain and abnormal computed tomography findings and a history of developmental delay, atrial septal defect, cerebral palsy, and pulmonary artery sling. What is your diagnosis?

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Peripartum and Pregnancy-Related Considerations in Residency

NI Ibrahim,RA Kupfer,JL Farlow

Publication date 01-11-2024


To the Editor We read with great interest the article by Noij et al and appreciate their description of concurrent trainee pregnancies and parental leaves; we strongly agree with their conclusions. Paralleling the authors’ experience and national trends of increasing female surgical trainees, we have had extensive experience in our institution, with 8 pregnancies among otolaryngology head and neck surgery residents in the past 5 years with concurrent pregnancies. In addition to the authors’ conclusions, we have found that lactation and peripartum complications are additional salient factors that must be anticipated by the trainee and training program because there can be significant implications for clinical service and education.

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Peripartum and Pregnancy-Related Considerations in Residency

DR Larrow,PK Yu,ST Gray

Publication date 01-11-2024


To the Editor We are writing to commend the recent Viewpoint by Noij et al. This Viewpoint addresses the issue of accommodating parental leave during otolaryngology residency training, an important and timely topic given the Accreditation Council for Graduate Medical Education (ACGME) gender-neutral paid parental leave policy.

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Peripartum and Pregnancy-Related Considerations in Residency—Reply

KS Noij,A Hillel,CM Jenks

Publication date 01-11-2024


In Reply We greatly appreciate the interest generated by our Viewpoint on concurrent pregnancies and parental leaves among trainees in a residency program. We appreciate the acknowledgment from colleagues at other institutions about the importance of this conversation and the need for policies to both protect resident physicians and help programs navigate these issues. Ibrahim et al and Larrow et al confirm the timeliness and importance of this topic, and we agree with their statements.

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Chronic Rhinosinusitis and Mental Health

NS Khan,M Gajula,L Goehring,M Takashima,A Dhanda,TA Syed,ED McCoul,JT Vrabec,M Ramanathan,R Hu,OG Ahmed

Publication date 01-11-2024


This cohort study examines the bidirectional risk of anxiety and depression for patients with chronic rhinosinusitis.

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Tonotopic and Default Frequency Fitting for Music Perception in Cochlear Implant Recipients

G Creff,N Bernard-Le Liboux,P Coudert,H Bourdon,V Pean,N Wallaert,C Lambert,B Godey

Publication date 01-11-2024


This randomized, double-blind, crossover clinical trial examines the use of a tonotopic map on music perception in new cochlear implant users.

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Enlarged Lymph Nodes

NA Stoler,DC Chelius

Publication date 01-11-2024


This JAMA Otolaryngology–Head & Neck Surgery Patient Page describes lymph nodes and how they can be treated if they become enlarged.

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Efficacy of a Serotonin-Norepinephrine Reuptake Inhibitor as a Treatment for Meniere Disease

H Rizk,NP Monaghan,S Shah,Y Liu,BA Keith,S Jeong,SA Nguyen

Publication date 01-11-2024


This randomized clinical trial analyzes the efficacy of a serotonin-norepinephrine reuptake inhibitor, venlafaxine, compared to placebo in treating adults with Meniere disease.

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