JAMA Otolaryngology Head and Neck Surgery 2022-01-01

Clinical and Histologic Features Associated With Malignant Transformation of Oral Cavity Dysplasia

Tang JA, Amadio G, Ridge JA.

Publication date 01-01-2022


This cohort study evaluates risk of malignant transformation of oral dysplastic lesions by investigating its potential associations with demographic, social, clinical, and histologic factors.

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JAMA Otolaryngology–Head & Neck Surgery

Publication date 01-01-2022


Mission Statement: JAMA Otolaryngology–Head & Neck Surgery provides timely information for physicians and scientists concerned with diseases of the head and neck. Given the diversity of structure and function based in this anatomic region, JAMA Otolaryngology–Head & Neck Surgery publishes clinical, translational, and population health research from an array of disciplines. We place a high priority on strong study designs that accurately identify etiologies, evaluate diagnostic strategies, and distinguish among treatment options and outcomes. Our objectives are to (1) publish original contributions that will enhance the clinician’s understanding of otolaryngologic disorders, benefit the care of our patients, and stimulate research in our field; (2) forecast important advances within otolaryngology–head and neck surgery, particularly as they relate to the prevention, diagnosis, and treatment of disease through clinical and translational research, including that of the human genome and novel imaging techniques; (3) address questions of clinical outcomes and cost-effectiveness that result from clinical intervention, which grow in importance as health care providers are increasingly challenged to provide evidence of enhanced survival and quality of life; (4) provide expert reviews of topics that keep our readers current with true advances and also to provide a valuable educational resource for trainees in the several disciplines that treat patients with diseases of the head and neck; (5) serve as a forum for the concerns of otolaryngologists such as socioeconomic, legal, ethical, and medical issues; (6) provide helpful critiques that enable contributing authors to improve their submissions. We encourage a concise presentation of information and employ an abstract format that efficiently assesses validity and relevance from a clinical perspective. This approach promotes succinct yet complete presentation for our readers and electronic information resources. We believe this approach typifies the commitment of JAMA Otolaryngology–Head & Neck Surgery to providing important information that is easily interpreted by its diverse readership.

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The Role of HPV in Cancer Prognosis

Schmitt NC.

Publication date 01-01-2022


In recent decades, it has become clear that most oropharyngeal squamous cell carcinomas (OPSCCs) are associated with human papillomavirus (HPV), with a distinct biology and favorable prognosis vs head and neck squamous cell carcinomas (HNSCCs) that originate in other anatomic subsites. The reasons for the superior survival outcomes and treatment responses seen in HPV-related OPSCC are not entirely well understood. However, it is known that viral oncoproteins within tumor cells can serve as a source of antigenic stimulation for immune cells within the tumor microenvironment. Radiation and chemotherapy release these viral antigens from dying tumor cells, effectively turning the tumor into an in situ vaccine. These concepts are supported by the superior responses of HPV-related OPSCC to radiation, chemotherapy, and immune checkpoint inhibitors. However, the role of HPV in the prognosis of HNSCC outside the oropharynx is less clear. Fewer oral, laryngeal, and hypopharyngeal tumors are positive for HPV, although tumors at these sites are not routinely tested. Adding to the mystery, studies investigating whether these nonoropharyngeal, HPV-positive tumors are associated with improved prognosis vs their HPV-negative counterparts have shown mixed results. Tumors from other anatomic subsites of the head and neck often contain transcriptionally active virus and a nonkeratinizing, endophytic growth pattern similar to HPV-positive OPSCC, suggesting that the oncogenesis of these tumors is driven by the virus. However, collectively, these studies suggest that the association between HPV status and prognosis is not nearly as strong outside the oropharynx. In the case of cervical cancer, the effects of HPV on prognosis are also controversial, but this has been challenging to investigate because most cervical cancer cases are associated with HPV.

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Growing Public Health Concern of COVID-19 Chronic Olfactory Dysfunction

Khan AM, Kallogjeri D, Piccirillo JF.

Publication date 01-01-2022


This meta-analysis examines the scale of the public health concern of COVID-19–related chronic olfactory dysfunction.

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National Trends in Gender Diversity Among OHNS Trainees and Physicians in Canada

Grose E, Chen T, Siu J, et al.

Publication date 01-01-2022


This cross-sectional study provides a quantitative and descriptive analysis of the evolution of female representation among Canadian otolaryngology–head and neck surgery residents, faculty, and practicing physicians.

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Tumor Site and the Prognosis and Immunogenomics of HPV-Related Cancers

Zhu G, Amin N, Herberg ME, et al.

Publication date 01-01-2022


This cohort study categorizes tumors of the head and neck and the cervix by human papillomavirus (HPV) positivity status and compares their immunogenomic landscapes and associations with survival.

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Long-term Outcomes of Hypoglossal Nerve Stimulation for Obstructive Sleep Apnea

Pascoe M, Wang L, Aylor J, et al.

Publication date 01-01-2022


This cohort study investigates the association between long-term use of hypoglossal nerve stimulation for obstructive sleep apnea and improved patient-reported outcomes, particularly insomnia and depression indices, and compares these outcomes with those for positive airway pressure therapy.

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Head and Neck Cancer Posttreatment Surveillance Questions

Huang AT, Sturgis EM.

Publication date 01-01-2022


The role of close follow-up of patients with head and neck cancer after completion of therapy is unquestionably important, but questionably vague. While National Comprehensive Cancer Network guidelines on the timing of surveillance are published, the lack of high-level evidence on the effectiveness of these protocols and the changing landscape of HPV-associated cancers on survivorship have expectedly raised the collective eyebrow on their suitability in the current era. As more patients with head and neck cancer benefit from a quantity-of-life perspective from more advanced radiation delivery systems, chemoimmunotherapy breakthroughs, and improved surgical techniques, the impending impact this has on resources needed in surveillance, such as costs associated with specialty examinations and anatomic imaging studies, as well as the psychosocial and financial impact on the patients themselves, is becoming more prevalent. In the Original Investigation by Chen et al, the authors seek to identify physician and patient-related barriers to deintensifying surveillance practices and provide suggestions on facilitating change.

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Local Anesthetic Infusion for Improving Pain From Head and Neck Cancer Surgery

Rahman S, Mendelsohn A.

Publication date 01-01-2022


To the Editor With great anticipation we read the recent article titled “Postoperative Pain Treatment with Continuous Local Anesthetic Wound Infusion in Patients with Head and Neck Cancer: A Nonrandomized Clinical Trial.” Of primary importance, the authors should be singularly commended for pursuing treatment alternatives away from standard opioid administration. As we join a number of institutions following the example of Gostian and colleagues, we felt it prudent to specify details that may limit clinical application of the specific technique described to optimize future efforts.

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The Best Option to Protect Health Care Workers From COVID-19 During Tracheostomy Is to Adapt the Procedure

Favier V, Gallet P.

Publication date 01-01-2022


To the Editor We read with great interest the study of Berges et al and congratulate them for quantifying the particles emitted during tracheostomy and tracheostomy care to evaluate the contamination risk for health care workers. This method is probably the most objective to evaluate the particle dissemination and the efficiency of protective measures.

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Local Anesthetic Infusion for Improving Pain From Head and Neck Cancer Surgery—Reply

Gostian M, Loeser J, Gostian A.

Publication date 01-01-2022


In Reply We thank Drs Rahman and Mendelsohn for their interest in our recent study. The performance of a neck dissection has been shown to be associated with great and potentially long-lasting pain and is therefore also listed in the German S3 guideline for acute postoperative pain as a surgical procedure with expected high pain levels. Multimodal pain therapy strategies used in various surgical disciplines incorporate the continuous application of local anesthesia in surgical wound cavities. Therefore, this mechanism seems to be reasonable also in the wound cavity after neck dissection. Furthermore, anesthesia of the superficial branches of the cervical plexus also represents an effective technique of anesthesia of the entire lateral neck as it is also performed during local anesthetic procedures on the cervical vessels. Brown has reported that the anterior rami of the second to fourth cervical nerves may also interconnect with peripheral branches of the trigeminal, facial, glossopharyngeal, and hypoglossal nerves. Thus, effective pain relief by a locally applied anesthetic also seems reasonable and effective in the context of neck dissection involving the cervical plexus and, in our opinion, may achieve more than pure anesthesia of the skin of the neck only.

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The Best Option to Protect Health Care Workers From COVID-19 During Tracheostomy Is to Adapt the Procedure—Reply

Berges AJ, Lina IA, Hillel AT.

Publication date 01-01-2022


In Reply We thank Favier and Gallet for their review of and response to our recent article quantifying aerosolization risk during tracheostomy and tracheostomy care.

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Clinician Attitudes and Beliefs About Deintensifying Head and Neck Cancer Surveillance

Chen MM, Mott NM, Miller J, et al.

Publication date 01-01-2022


This qualitative study surveys otolaryngologists and radiation oncologists regarding their opinions on deintensification of surveillance in patients with diagnosed head and neck cancer.

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Predictive Value of a Genomic Classifier in Indeterminate Thyroid Nodules Based on Nodule Size

Dublin JC, Papazian M, Zan E, et al.

Publication date 01-01-2022


This case series examines the accuracy of a genomic classifier in diagnosis and treatment of patients with indeterminate thyroid nodules.

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Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss

Moody-Antonio SA, Chandrasekhar SS, Derebery M.

Publication date 01-01-2022


The treatment of idiopathic sudden sensorineural hearing loss (SSNHL) continues to be a substantial clinical challenge, in part because of the heterogeneity of the patient population and in part because of the difficulty of studying a disorder with no known causes and no defined, proven, or widely accepted course of clinical intervention. We read with interest the systematic review and meta-analysis by Joshua and colleagues on hyperbaric oxygen therapy (HBOT) for patients with SSNHL. Rhee and colleagues published a review of the same topic in 2019; however, their conclusions were criticized for significant heterogeneity of the pooled studies, which introduced potentially unsurmountable bias.

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Hyperbaric Oxygen Therapy for Sudden Sensorineural Hearing Loss

Joshua TG, Ayub A, Wijesinghe P, et al.

Publication date 01-01-2022


This systematic review and meta-analysis evaluates recent evidence on the effect of hyperbaric oxygen therapy on hearing outcomes in patients with sudden sensorineural hearing loss to determine if this treatment should be part of a combination regimen.

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Association of Performance on Dichotic Auditory Tests With Risk for Incident Dementia and Alzheimer Dementia

Mohammed A, Gibbons LE, Gates G, et al.

Publication date 01-01-2022


This cohort study examines associations between signal sensitivity, central auditory processing, and dementia and Alzheimer dementia risk.

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Association of Bone Conduction Devices for Single-Sided Sensorineural Deafness With QOL

Hampton T, Milinis K, Whitehall E, et al.

Publication date 01-01-2022


This systematic review and meta-analysis assesses quality of life measures among patients with single-sided sensorineural deafness who received a unilateral bone conduction device.

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