JAMA Otolaryngology Head and Neck Surgery 2021-02-01

JAMA Otolaryngology–Head & Neck Surgery

Publication date 01-02-2021


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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Physician Confidence in Neck Ultrasonography for Thyroid Cancer Surveillance

Kovatch KJ, Reyes-Gastelum D, Sipos JA, et al.

Publication date 01-02-2021


This cross-sectional study assesses physician confidence in using neck ultrasonography to detect recurrence of differentiated thyroid cancer in patients under long-term surveillance.

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Increasing Confidence in Detecting Metastatic Thyroid Cancer With Neck Ultrasonography

Azadi JR, Hoang JK.

Publication date 01-02-2021


Ultrasonography is the modality of choice for neck nodal surveillance after thyroidectomy for patients with differentiated thyroid cancer (DTC), according to the American Thyroid Association and the European Thyroid Association. In a cross-sectional survey study published in this issue of JAMA Otolaryngology–Head & Neck Surgery, Kovatch and colleagues draw attention to low confidence in ultrasonography among a cohort of 320 endocrinologists, general surgeons, and otolaryngologists. The authors found that only 1 in 5 physicians reported having high confidence in their own ability to use ultrasonography to detect lymph nodes suggestive of recurrence; 3 in 5 reported having high confidence in a radiologists ability to detect recurrence; and 1 in 3 did not have high confidence in either their own or a radiologist’s ability to detect recurrence.

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Hearing Loss Prediction Tool for Cisplatin Chemotherapy and Radiation in Head and Neck Cancer

Deutsch BC, Collopy C, Kallogjeri D, et al.

Publication date 01-02-2021


This cohort study uses data from a cancer treatment facility and clinical audiometric database to assess the validity of a previously created dynamic nomogram and model for hearing loss to be used after treatment with chemoradiation for head and neck cancer.

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Evaluation of Smoking as a Modifying Factor in Chronic Rhinosinusitis

Hutson K, Clark A, Hopkins C, et al.

Publication date 01-02-2021


This case-control study analyzes whether active smoking is a risk factor for chronic rhinosinusitis and its association with disease-specific quality of life.

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Problematic Reporting of Gender Differences in Clinical Productivity Among Otolaryngologists—Reply

Miller AL, Bergmark RW, Gray ST.

Publication date 01-02-2021


In Reply We sincerely thank Patel and colleagues and Gourin and colleagues for their interest in our study “Assessment of Gender Differences in Clinical Productivity and Medicare Payment Among Otolaryngologists in 2017” and for bringing further attention to this extremely important and complex topic. We wholeheartedly agree that gender disparities indisputably exist in the medical profession and that historically, women have faced considerable challenges and outright discrimination in surgical fields. The continued struggle to achieve parity in salary, promotion, and leadership is well documented and deserves constant scrutiny. To understand and address these inequities, assessment and analysis of available data are necessary.

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Problematic Reporting of Gender Differences in Clinical Productivity Among Otolaryngologists

Patel R, Kejner A, McMullen C.

Publication date 01-02-2021


To the Editor We appreciate the effort of Miller et al to evaluate practice disparities in otolaryngology in their study. This information adds to the discourse on gender bias in otolaryngology; however, several issues arise with using these data to make conclusions about gender-based practice patterns.

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Problematic Reporting of Gender Differences in Clinical Productivity Among Otolaryngologists

Gourin CG, Sebelik ME, McCammon SD.

Publication date 01-02-2021


To the Editor We read with great disappointment the article “Assessment of Gender Differences in Clinical Productivity and Medicare Payments Among Otolaryngologists in 2017” by Miller et al. The authors compare Medicare data for otolaryngology payments in 2017 and conclude that women provide fewer services, bill fewer unique codes, and receive fewer Medicare payments than men. The authors conclude that female otolaryngologists are less clinically productive and less clinically diverse than their male counterparts.

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Comparison of Surgical Treatments for Zenker Diverticulum

Bhatt NK, Mendoza J, Kallogjeri D, et al.

Publication date 01-02-2021


This systematic review and network meta-analysis compares the 3 most common surgical techniques—endoscopic laser-assisted diverticulotomy, endoscopic stapler-assisted diverticulotomy, and transcervical diverticulectomy with cricopharyngeal myotomy—in adults with Zenker diverticulum.

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Drug-Induced Sleep Endoscopy Findings in Children With OSA With vs Without Obesity or Down Syndrome

Hyzer JM, Milczuk HA, Macarthur CJ, et al.

Publication date 01-02-2021


This cohort study examines drug-induced sleep endoscopy findings in surgically naive children with obesity and children with Down syndrome.

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A Broader View of Video Head Impulse Tests—Reframing Windows

Wong EC, Pasquesi L, Steenerson KK, et al.

Publication date 01-02-2021


This case report describes 2 patients who had normal findings on video head impulse testing despite having vestibulo-ocular reflex abnormalities on clinical head impulse test results.

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Olfactory Disorder With No Menarche in a Teenager

Sakurai R, Mori E, Kojima H.

Publication date 01-02-2021


A 16-year-old female presents with a history of olfactory disorder, laryngeal tracheoesophageal fissure, intestinal hernia, and hearing loss because of an ossicular malformation. What is your diagnosis?

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Contemporary Management of Vascular Anomalies of the Head and Neck

Gallant SC, Chewning RH, Orbach DB, et al.

Publication date 01-02-2021


This review provides an up-to-date overview of the diagnostic and therapeutic management options for congenital vascular malformations of the head and neck.

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Exploratory Factor Analysis of the Vestibular Activities Avoidance Instrument

Dunlap PM, Marchetti GF, Sparto PJ, et al.

Publication date 01-02-2021


This cohort study applies exploratory factor analysis to the 81-item Vestibular Activities Avoidance Instrument to assess whether it can be shortened for practical clinical application to identify fear avoidance beliefs in individuals with dizziness.

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Moving Toward Equitable Telemedicine in Otolaryngology–Head and Neck Surgery—Reply

Miller LE, Gray ST, Rathi VK.

Publication date 01-02-2021


In Reply We appreciate the interest Kidane and colleagues have expressed in our work. We wholeheartedly agree that marginalized groups experience considerable and unacceptable inequities in otolaryngologic care. These individuals undoubtedly deserve special consideration as telemedicine becomes an increasingly important part of practice in our field.

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Nasal Saline Irrigations in the COVID-19 Pandemic—Reply

Farrell N, Klatt-Cromwell C, Schneider J.

Publication date 01-02-2021


In Reply We thank Radulesco et al for their interest in our article and their letter in response. We agree that it would be beneficial to explore the utility of other topical additives in prevention and treatment of respiratory viruses, such as severe acute respiratory syndrome coronavirus 2. Regarding the potential use of copper, it is certainly encouraging to note its antiviral efficacy. The literature is particularly supportive of its use as an antimicrobial coating for surfaces. However, there is not yet strong evidence regarding the safety of copper as an additive for nasal saline irrigations. As the authors address, 1 preliminary study performed by Huang et al does note the safety of a nasal solution enriched with copper, among other additives. However, the product evaluated in that study reports only that it is enriched with copper and does not further specify the concentration or form of copper used. Though the aforementioned study notes safety of a nasal solution enriched with copper, animal studies of nasally applied copper salts and nanoparticles have demonstrated the potential toxic effects of copper, resulting in direct olfactory neuron damage or intracranial translocation, resulting in neurologic damage. These concerns were further described in a recent review of copper toxicology, which notes concern for copper-induced cell damage through the release of reactive oxygen species.

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Moving Toward Equitable Telemedicine in Otolaryngology–Head and Neck Surgery

Kidane J, Kim EK, Sharon JD.

Publication date 01-02-2021


To the Editor We appreciate Miller et al for detailing the use and trends of telemedicine services provided to Medicare beneficiaries. In this study, they determine that from 2010 to 2018, there was little absolute growth of telemedicine services in Otolaryngology–Head and Neck Surgery (OHNS), particularly in comparison to specialties like dermatology and psychiatry. We concur with the authors’ call for telemedicine adoption, but we wish to highlight the potential effect of telemedicine on marginalized groups, including racial and cultural minorities, rural communities, and low-income populations.

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Nasal Saline Irrigations in the COVID-19 Pandemic

Radulesco T, Lechien JR, Michel J.

Publication date 01-02-2021


To the Editor We read with great interest the article by Farrell et al arguing for benefits of nasal irrigations during the coronavirus disease 2019 (COVID-19) pandemic. We totally agree that the benefit-risk equation is in favor of continuing nasal irrigations, particularly in patients with chronic rhinosinusitis, if respecting specific measures avoiding the risk of spreading the virus. Whereas the antiviral action of sodium chloride has already been established, the question is, to date, which additive could be useful and effective, especially regarding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The use of povidone-iodine carries risk of dilution error, which may cause damage to ciliary function in the case of prolonged or repeated contact, because ready-for-use solutions are not available worldwide.

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Nonmedicated Controls in Randomized Clinical Trials of Patients With Chronic Rhinosinusitis

Caulley L, James J, Hopkins C.

Publication date 01-02-2021


This systematic review and meta-analysis assesses the association of nonmedicated control substances in randomized clinical trials with disease outcomes in patients diagnosed with chronic rhinosinusitis.

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Controls for Clinical Trials of Intranasal Medications for Chronic Rhinosinusitis

Sedaghat AR, Phillips KM.

Publication date 01-02-2021


Clinical trials are designed as uncontrolled or controlled studies. Controlled studies, with the highest quality and level of evidence coming from randomized controlled studies, judge the efficacy of an experimental treatment against an alternative treatment, or control. Controls may be broadly categorized as placebo, active treatment, or best available therapy. A placebo, by definition, has no therapeutic benefit and is intended to provide only a psychological treatment effect. In comparison, active treatment or best available therapy controls have intrinsic therapeutic benefit.

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Incidence of Hearing Impairment and Changes in Pure-Tone Average Across Generations

Paulsen AJ, Fischer ME, Pinto A, et al.

Publication date 01-02-2021


This cohort study examines whether hearing impairment incidence and change in pure-tone average in adults differ by generation and identifies factors underlying these differences.

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Use of Intraoperative Parathyroid Hormone in Minimally Invasive Parathyroidectomy

Quinn A, Ryan ÉJ, Garry S, et al.

Publication date 01-02-2021


This meta-analysis compares surgical outcomes with and without use of intraoperative parathyroid hormone during minimally invasive parathyroidectomy.

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Disparities in the Uptake of Telemedicine During the COVID-19 Surge in a Multidisciplinary Head and Neck Cancer Population

Tam S, Wu VF, Williams AM, et al.

Publication date 01-02-2021


This cohort study examines the association between patient demographic characteristics and socioeconomic status and engagement in telemedicine during the COVID-19 pandemic.

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Use of Vascular Clues to Locate Ectopic Parathyroid Glands and Predict Anatomic Abnormalities

Battista R, Noel JE, Orloff LA.

Publication date 01-02-2021


This case report describes a woman in her 60s who was referred for primary hyperparathyroidism and was subsequently diagnosed with an aberrant right subclavian artery.

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Steroid Shots and the Culture of Instant Gratification

McCoul ED.

Publication date 01-02-2021


This Viewpoint discusses the value of steroid shots as “quick fixes” in the treatment of patients with acute upper respiratory tract infections.

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Chronic Rhinosinusitis With Nasal Polyps In Patients With Aspirin Sensitivity

Kariyawasam HH, Leandro M, Dziadzio M, et al.

Publication date 01-02-2021


This case report describes 4 patients with chronic rhinosinusitis with nasal polyposis who were treated with mycophenolate mofetil.

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