JAMA Otolaryngology–Head & Neck Surgery
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.
November Issue Highlights
Error in Data Reporting
In the Original Article titled “Frequent Association of Cochlear Nerve Canal Stenosis With Pediatric Sensorineural Hearing Loss,” published online April 16, 2012, and in the April 2012 print issue of Archives of Otolaryngology–Head & Neck Surgery, there was an error in the data reporting in the Methods section. According to referenced studies, a cochlear nerve canal measurement of 1.5 to 1.8 mm was considered to be in the lower limit of normal. This article was corrected online.
Head and Neck Melanoma Incidence Trends in Children and Young Adults in the United States and Canada
01-11-2019 – Bray HN, Simpson MC, Zahirsha ZS, et al.
This population-based study examines changes over 20 years in the incidence of head and neck melanoma in children, adolescents, and young adults residing in North America.
Between Current Implications and Future Perspectives—Reply
01-11-2019 – Lieu JC, Gantz J.
In Reply We appreciate the response from Ropers and colleagues to our commentary, and welcome the news that they do not dismiss imaging for children with unilateral sensorineural hearing loss. We agree that there is insufficient strong evidence to help guide the use of imaging for prognosis at this time, and we support the strong recommendation that future studies should address the research questions of prognostic value, comorbid conditions, and effective interventions in this population of children. Furthermore, we share the concern that most of the imaging currently performed is not easily accessible for research studies that we posit will derive benefit for this population.
Skull Base and Orbital Solitary Plasmacytoma Mimicking a Meningioma
01-11-2019 – Dang S, Manzoor NF, Harmsen H, et al.
This case report describes a patient in their 30s who presented with sudden onset of 3 generalized tonic-clonic seizures, double vision, and several days of headache, and was diagnosed with a skull base and orbital solitary plasmacytoma.
Between Current Implications and Future Perspectives
01-11-2019 – Ropers FG, Rotteveel LC, Dekkers OM.
To the Editor We would like to respond to the invited commentary to our meta-analysis and literature review on the benefit of imaging in children with unilateral sensorineural hearing loss (USNHL). The authors suggest that our review (1) dismisses imaging for USNHL as useless in most children, and (2) frames imaging in a way that discourages patients and parents from imaging. However, we would like to emphasize that this is neither our message nor what we practice.
Reducing Head and Neck UV Exposure in Younger Persons
01-11-2019 – Hall ET, Paulson KG.
In this issue of JAMA Otolaryngology–Head & Neck Surgery, Bray and colleagues shine a light on the increasing incidence of head and neck melanoma among pediatric and young adult patients (defined as ages 0-39 years). By using a large North American cancer epidemiological database that included 26 US states and 6 Canadian provinces, the authors found that the incidence of head and neck melanoma among pediatric and young adult patients increased by 51% over the 20-year period between 1995 and 2014.
Neck Mass in a Newborn With 22q11.2 Deletion Syndrome
01-11-2019 – Hamberis AO, Pecha PP, Discolo CM.
A newborn with 22q11.2 deletion syndrome, tetralogy of Fallot, and unilateral renal agenesis presented at birth with a right neck mass and intermittent inspiratory stridor. What is your diagnosis?
Dysphagia After Primary TORS With Neck Dissection in Patients With Oropharyngeal Cancer
01-11-2019 – Hutcheson KA, Warneke CL, Yao CL, et al.
This case series study examines the rates of acute dysphagia and recovery after transoral robotic surgery (TORS) vs radiotherapy and compares swallowing outcomes by primary treatment modality in patients with oropharyngeal cancer.
Evaluation of Hypoglossal Nerve Stimulation Treatment in Obstructive Sleep Apnea
01-11-2019 – Kent DT, Carden KA, Wang L, et al.
This cohort study examines data from trials on the use of hypoglossal nerve stimulation for treatment of patients with obstructive sleep apnea.
Imaging for Pediatric Unilateral Sensorineural Hearing Loss—Reply
01-11-2019 – Ropers FG, Dekkers OM, Rotteveel LC.
In Reply We thank Dr Pross for his reply to our article. The first point raised considers imaging in children with congenital unilateral sensorineural hearing loss (USNHL) without neurological symptoms to rule out retrocochlear malignant abnormalities. We addressed this issue in the discussion section of our review. One glioma was found on magnetic resonance imaging (MRI) but missed on computed tomographic (CT) scan results, in a total of 1504 included patients. A precise estimate of risk of malignant abnormality is unfortunately not possible, owing to lack of systematic inclusion of patients with congenital USNHL without neurological symptoms, and publication of inner ear imaging findings according to scientific standards. However, the risk appears to be very low.
What Does Head Impulse Testing Really Test?—Reply
01-11-2019 – Walther L, Löhler J, Schmucker C.
In Reply We thank Drs Curthoys and Halmagyi for their interest in our recently published scoping review. Both have raised some concerns on the validity of our review, which we address herein.
Traumatic Vidian Nerve Injury
01-11-2019 – Chee J, Ng C.
This case report describes a patient who presented with mild epistaxis and dryness of bilateral nasal cavities and eyes after a traumatic workplace injury and was diagnosed with a vidian nerve injury.
Imaging for Pediatric Unilateral Sensorineural Hearing Loss
01-11-2019 – Pross SE.
To the Editor I read with great interest the report by Ropers et al, “Assessment of the Clinical Benefit of Imaging in Children with Unilateral Sensorineural Hearing Loss: A Systematic Review and Meta-analysis.” The authors present a well-designed review of the literature of obtaining imaging for pediatric patients with unilateral sensorineural hearing loss. The authors reported that they were able to identify a cause of the hearing loss in more than 33% of patients, but concluded that none of these findings had therapeutic consequences and therefore suggest that obtaining imaging in all cases may not have high utility. These findings and recommendations brought up 2 areas of concern for me.
What Does Head Impulse Testing Really Test?
01-11-2019 – Curthoys IS, Halmagyi GM.
To the Editor Walther et al ignore a fundamental rule of neurology: the pattern of the clinical or physiological deficit indicates the site and not the pathology of the lesion. This is the principle of neurological localization—there are textbooks written about it. The head impulse test, just like the caloric test, or the vestibular evoked myogenic potential, or an extensor plantar response can localize a lesion but reveal nothing about its pathology. For that, one needs to consider the history and results of ancillary investigations, say magnetic resonance imaging or spinal fluid test results. Impulsive testing can localize a vestibular deficit to 1 or more of the 6 semicircular canals but can show nothing about the cause of the deficit (Ménière, or vestibular neuritis, or anterior inferior cerebellar artery territory stroke, for example).
A Next-Generation Single-Port Robotic Surgical System for Transoral Robotic Surgery
01-11-2019 – Holsinger F, Magnuson J, Weinstein GS, et al.
This study evaluates a new single-port robotic surgical system for head and neck surgery prospectively through 2 concurrent nonrandomized clinical trials.
Multidisciplinary Care Approach and Quality of Care After Pediatric Tracheostomy
01-11-2019 – McKeon M, Kohn J, Munhall D, et al.
This quality improvement study assesses whether a multidisciplinary tracheostomy program is associated with the quality of care after pediatric tracheostomy by analyzing a cohort of 700 children who received a tracheostomy.
The Multidisciplinary Tracheostomy Team
01-11-2019 – Prager JD, Baker CD.
In their article “Association of a Multidisciplinary Care Approach With the Quality of Care After Pediatric Tracheostomy,” Mc
Keon et al present their single-center experience of implementing a multidisciplinary tracheostomy team (MDT). Having taken the Global Tracheostomy Collaborative’s 5 key drivers for tracheostomy care to heart (standardization of care protocols, broad staff education, patient and family involvement, monitoring of outcomes, and multidisciplinary collaboration), the authors and their institution created an MDT in 2015. This MDT consists of clinicians from 11 disciplines involved in the care of patients with tracheostomies. The group meets regularly, communicating with and seeing patients in both inpatient and outpatient settings. The makeup of the multidisciplinary team and its activities are presented in Table 1 and the Methods section of the article. Patients at Boston Children’s Hospital who were tracheostomy dependent or who underwent tracheostomy placement during the study period were observed by the MDT prospectively. Data presented therein were collected from 2015 to 2018.
Why State Medicaid Programs Should Cover Hearing Aids for Adults
01-11-2019 – Willink A, Hernando M, Steege S.
This Viewpoint discusses why hearing aids and related services should be covered for all US Medicaid enrollees for whom they are medically necessary, regardless of age.
Association of Obstructive Sleep Apnea With the Risk of Affective Disorders
01-11-2019 – Kim J, Ko I, Kim D.
This cohort study uses a Korean nationwide database to investigate whether obstructive sleep apnea is associated with the development of depression and anxiety.
Outcomes Associated With Delayed Treatment of HNSCC in an Underserved Urban Population
01-11-2019 – Liao DZ, Schlecht NF, Rosenblatt G, et al.
This cohort study investigates the association of delayed treatment initiation with overall survival and recurrence among patients with head and neck squamous cell carcinoma among an underserved urban population.
Better Late Than Never, but Never Late Is Better
01-11-2019 – Graboyes EM, Hughes-Halbert C.
Despite aggressive multimodal therapy consisting of combinations of surgery, radiotherapy, and chemotherapy, patients with locally advanced head and neck squamous cell carcinoma (HNSCC) have a poor prognosis, with 5-year survival rates hovering around 50%. This suboptimal survival is even worse for racial/ethnic minorities and underinsured patients with HNSCC, who experience significantly higher rates of mortality relative to their white and well-insured peers. Therefore, HNSCC is a cancer for which strategies to improve survival and equity are desperately needed. In light of this need, it is becoming abundantly clear that the manner in which we deliver cancer care to patients with HNSCC has significant potential as a modifiable target to drive improvements in survival and decrease disparities in outcomes. Delays in cancer care delivery across the continuum contribute to excess mortality for patients with HNSCC, disproportionately burden racial/ethnic minorities and underinsured patients, and are a key contributor to disparities in survival for racial/ethnic minority and underinsured populations.
Prognostic Value of Tumor-Infiltrating Lymphocytes in Head and Neck Squamous Cell Carcinoma
01-11-2019 – Spector ME, Bellile E, Amlani L, et al.
This cohort study examines the prognostic value of specific classes of tumor-infiltrating lymphocytes in head and neck squamous cell carcinoma pretreatment biopsies.