Author Interviews, ENT, Pediatrics, University of Pittsburgh / 13.05.2021

MedicalResearch.com Interview with: Alejandro Hoberman, M.D. Vice Chair of Clinical Research, Division Director, General Academic Pediatrics, and Professor of Pediatrics and Clinical and Translational Science Jack L. Paradise, MD Endowed Professor of Pediatric Research, UPMC Children's Hospital of PittsburghPresident, UPMC Children's Community Pediatrics MedicalResearch.com: What is the background for this study? Response: Acute otitis media (AOM) is the most frequently diagnosed illness in children in the United States for which antibiotics are prescribed. Recurrent AOM is the principal indication for tympanostomy-tube placement, the most frequently performed operation in children after the newborn period. Supporting the performance of tympanostomy-tube placement for recurrent acute otitis media has been the commonplace observation, after surgery, of acute otitis media–free periods of varying duration. Counterbalancing this view have been the cost of tympanostomy-tube placement; risks and possible late sequelae of anesthesia in young children; the possible occurrence of refractory tube otorrhea, tube blockage, premature extrusion, or dislocation of the tube into the middle-ear cavity; various structural tympanic membrane sequelae; and the possible development of mild conductive hearing loss. Tempering support for surgery is the progressive reduction in the incidence of acute otitis media that usually accompanies a child’s increasing age. Previous trials of tympanostomy-tube placement for recurrent acute otitis media, all conducted before the introduction of pneumococcal conjugate vaccine, have given mixed results and were limited, variously, by small sample size, uncertain validity of diagnoses of acute otitis media determining trial eligibility, short periods of follow-up, and substantial attrition of participants. Official recommendations regarding tympanostomy-tube placement for children with recurrent acute otitis media differ — an otolaryngologic guideline recommends the procedure for children with recurrent acute otitis media, provided that middle-ear effusion is present in at least one ear; a contemporaneous pediatric guideline discusses tympanostomy-tube placement as an “option [that] clinicians may offer.” Given these uncertainties, we undertook the present trial involving children 6 to 35 months of age who had a history of recurrent acute otitis media to determine whether tympanostomy-tube placement, as compared with medical management (comprising episodic antimicrobial treatment, with the option of tympanostomy-tube placement in the event of treatment failure), would result in a greater reduction in the children’s rate of recurrence of acute otitis media during the ensuing 2-year period. (more…)
Author Interviews, ENT, JAMA / 18.03.2021

MedicalResearch.com Interview with: Chao Cao, MPH PhD student in Movement Science, Program in Physical Therapy, Washington University School of Medicine. Senior author: Lin Yang, PhD Research Scientist/Epidemiologist Department of Cancer Epidemiology and Prevention Research Cancer Care Alberta | Alberta Health Services | Canada MedicalResearch.com: What is the background for this study? dizziness-vertigoResponse: Dizziness and imbalance are common among US adults and increases the risk of serious injuries. However, research related to balance overwhelmingly focuses on functional outcomes among older adults, therefore our understanding on how balance function may affect the long-term health outcomes in adults of different age group is limited. MedicalResearch.com: What are the main findings?  Response: We found that balance disorder affects nearly 2/3 of older Americans (65+ yr) as well as 1/3 of those middle-aged (50-64 yr). Our study, for the first time, found that for middle-aged and older Americans, their overall and sensory-specific balance disorders (visual, proprioceptive, and vestibular) were associated with higher mortality risks driven by cancer and CVD death over 12 years.   (more…)
Allergies, Author Interviews, ENT / 07.10.2020

MedicalResearch.com Interview with: Brent A. Senior, MD, FACS, FARS Professor of Otolaryngology/Neurosurgery Vice Chairman for Clinical Affairs Nathaniel and Sheila Harris Distinguished Professor Chief, Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery Department of Otolaryngology-Head and Neck Surgery University of North Carolina at Chapel Hill Chapel Hill, NC MedicalResearch.com: What is the background for this study? How common is the problem of chronic rhinosinusitis with nasal polyps? Response: Chronic rhinosinusitis (CRS) is a very common illness in the United States and around the world, estimated to impact 2-14% of the US population. Chronic rhinosinusitis with polyps is a particularly challenging form of the disease marked by significant impact on quality of life, and being challenging to treat with significant recurrences of symptoms despite standard medical and surgical treatment. Inhaled intranasal steroids are standard therapy for patients with CRS including those with nasal polyps. However, many patients continue to have significant nasal symptoms despite treatment with these medications. This study was designed to answer the question of whether patients who had been receiving treatment with inhaled intranasal steroids and failed were improved by using EDS-FLU. Results were obtained by pooling data from two previous studies of the use of EDS-FLU in patients with CRS, called Navigate 1 and 2.   (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Sleep Disorders, Surgical Research / 09.09.2020

MedicalResearch.com Interview with:   Prof Stuart MacKay BSc (Med) MB BS (Hons) FRACS Honorary Clinical Professor Otolaryngology Head and Neck Surgery Clinical Professor at University of Wollongong Graduate School of Medicine Adjunct Professor Faculty of Health Sciences   MedicalResearch.com: What is the background for this study?
  1. Sleep Apnea is common and impairs daytime function and carries health risk.
  2. Many patients have difficulty with CPAP, the main treatment.
  3. Surgery offers an alternative, and we tested this at a very high level in this clinical study.
MedicalResearch.com: What are the main findings? 
  1. Surgery creates marked improvement in stoppages (apnea) and droppages (hypopnea) in airflow.
  2. Surgery significantly improves patient reports of daytime sleepiness.
  3. Many other outcomes related to quality of life, snoring and general well being improve with surgery.
(more…)
Author Interviews, COVID -19 Coronavirus, ENT / 15.04.2020

MedicalResearch.com Interview with: Ahmad R. Sedaghat, MD, PhD, FACS Associate Professor Department of Otolaryngology - Head and Neck Surgery University of Cincinnati College of Medicine Cincinnati, OH, USA   MedicalResearch.com: What is the background for this study? Response: The novel coronavirus, SARS-CoV-2, which causes COVID-19 infects the respiratory tract.  As a rhinologist, I am an expert in diseases of the nose and paranasal sinuses, and as the nose and paranasal sinuses (sinonasal cavities) are a major component of the upper airway, we decided to do a systematic review of the scientific literature on the role of the sinonasal cavities in COVID-19. (more…)
Allergies, Asthma, Author Interviews, ENT / 23.03.2020

MedicalResearch.com Interview with: Joseph Han, MD FARS, FAAOA FAAAAI Medical Director for the Division of Allergy Eastern Virginia Medical School  MedicalResearch.com: What is the background for this study? Response: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease of the nasal passages and sinuses associated with a high symptom burden due to the chronic, relapsing nature of the disease. If you ask CRSwNP patients about the most important disease symptoms, they would say nasal congestion and decrease in smell. However, many CRSwNP patients would say that losing their sense of smell is particularly troublesome. This study was conducted to better understand the effect of dupilumab, which is approved in the U.S. for adults with uncontrolled CRSwNP, on sense of smell.   (more…)
Author Interviews, ENT, JAMA, Obstructive Sleep Apnea, Pediatrics / 03.02.2020

MedicalResearch.com Interview with: Dr. Jonathan R. Skirko, MD , MHPA, MPH Assistant professor Division of Pediatric Otolaryngology University of Utah Health  MedicalResearch.com: What is the background for this study? Response: Obstructive sleep apnea is a common problem that that impacts the lives of many people. Understanding treatment effectiveness is important and Health-State Utility is a standardized way of assessing quality of life.  Before this study, we didn't have a way of measuring quality of life in this population in this important way. You have to accurately measure something before you can improve it. (more…)
Accidents & Violence, Author Interviews, ENT, JAMA / 09.12.2019

MedicalResearch.com Interview with: Roman Povolotskiy MD Candidate '20 Rutgers University New Jersey Medical School MedicalResearch.com: What is the background for this study? Response: The idea for the study came from seeing a few patients with stories of their injuries related to cellphones. Aside from the now ubiquitous texting while driving, we also had patients who were dropping cellphones on their faces while texting in bed. We wanted to see how many head and neck injuries are related to these devices that we can’t seem to take out hands or eyes off of. The main findings were that the incidence of cell phone related injuries has seen a dramatic rise in the recent decade, starting around the time that smart phones really started to take off. We also found that this problem is most prevalent in the adolescent and young adult age groups. (more…)
Author Interviews, Education, ENT, Hearing Loss, JAMA, Pediatrics / 30.11.2019

MedicalResearch.com Interview with: Dr. Carlijn M. P. le Clercq, MD Speech and Language Pathology, Pediatrics, Otolaryngology Erasmus MC, Rotterdam MedicalResearch.com: What is the background for this study? Response: Recently, more reports have been publishes about the prevalence of slight to mild hearing loss among children in the general population. These studies showed that slight hearing loss is common, also within our population-based cohort in the Netherlands. Slight hearing loss is often scored as “not relevant”. We wanted to examine if we could find associations of hearing thresholds in children with performance scores in everyday life. (more…)
Author Interviews, ENT, Genetic Research, Pediatrics / 02.10.2019

MedicalResearch.com Interview with: Manvendra K Singh PhD Program in Cardiovascular and Metabolic Disorders, Duke-NUS Medical School National Heart Research Institute, National Heart Center Singapore, Singapore MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Craniofacial and cardiovascular abnormalities are the most common defects, contributing to more than one-third of the congenital diseases. Proper formation of these structures involves intricate processes such as proliferation, migration, and differentiation of neural crest cells (NCCs). Functional defects in NCCs result in craniofacial malformations, including cleft lip and/or cleft palate. Many transcription factors, chromatin remodelling factors, non-coding RNA and signalling molecules have been implicated in impaired neural crest development that result in cardio-craniofacial syndromes. However, the cell-autonomous role of splicing regulators in neural crest biology remains unclear and warrants further investigation. (more…)
Author Interviews, Brigham & Women's - Harvard, Cost of Health Care, ENT, Surgical Research / 25.07.2019

MedicalResearch.com Interview with: Vinay K. Rathi, MD Otolaryngology Resident | Massachusetts Eye and Ear Project Manager | Partners Ambulatory Care MBA Candidate | Harvard Business School  MedicalResearch.com: What is the background for this study?  Response: This study is a secondary subgroup analysis that follows on the heels of a recently published study in The New England Journal of Medicine (NEJM) examining physician reimbursement for surgical procedures in the Medicare Physician Fee Schedule (PFS), which both public and private insurers use to determine payment rates for clinician services. Although it is widely understood that physician time (i.e., the amount of physician time required to perform a procedure) is perhaps the most important factor used to determine payment rates, the Centers for Medicare and Medicaid Services (CMS) has historically relied upon limited and potentially biased survey data to estimate physician time. Leveraging time data from American College of Surgeons National Quality Improvement Program, the authors of the recent NEJM study demonstrated that CMS does not appear to systematically misestimate intraoperative times, but there are substantial discrepancies that may result in over- or undercompensation for certain procedures and specialties. (more…)
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 18.07.2019

MedicalResearch.com Interview with: Megan Rist Haymart MD Associate Professor Metabolism, Endocrinology and Diabetes Clinic Michigan Medicine MedicalResearch.com: What is the background for this study? What are the main findings?  Response: Thyroid cancer is a common malignancy with surgery considered one of the primary treatments. Complications from thyroid surgery can lead to long-term voice problems. However, few studies have used validated scales to quantify the impact of thyroid surgery on patient voice. Prior work has largely focused on single institution studies with high volume surgeons or claims data with reports of specific nerve injury. We surveyed a diverse cohort of patients affiliated with SEER sites Georgia and Los Angeles to identify the prevalence, severity and correlates of poor voice outcomes following surgery for differentiated thyroid cancer. We found that out of 2,325 patients 25.8% reported voice changes lasting greater than 3 months after surgery, 12.7% had abnormal voice per a validated voice scale (Voice Handicap Index- 10), and 4.7% reported a diagnosis of vocal fold motion impairment. We also identified patient factors associated with abnormal voice 2-4 years post op. (more…)
Accidents & Violence, Author Interviews, Brain Injury, ENT, Pediatrics / 12.06.2019

MedicalResearch.com Interview with: Amishav Bresler MD Department of Otolaryngology - Head and Neck Surgery Rutgers - New Jersey Medical School  MedicalResearch.com: What is the background for this study? Response: This study was inspired by a personal experience with the rental scooters. The most recent American Academy of Otolaryngology-Head and Neck Surgery annual conference was in Atlanta this year. At the time of the conference, the scooter rental industry had recently entered the region. A friend of mine, another ENT resident, was encouraging others to use these scooters for transportation for both the novelty and convenience. However, he didn't even have a helmet! Here was a well-educated doctor who takes call for craniofacial injuries, who was about to get on a scooter without a helmet. This experience made me wonder if scooters were dangerous scooters and their overall impact on public health. In terms of the backgroud, the personal transportation industry is undergoing a revolution. The search for efficient and environmentally-friendly urban transportation ignited an ongoing debate in the United States regarding the role of motorized scooters. Although known to be a popular method of transportation in Europe and Asia, motorized scooters have only recently begun to make inroads in the United States. The gradual rise in popularity has been attributed to their convenience, affordability, and status as a “green” alternative to vehicles with combustion engines. These advantages combined with the fact electric scooters enable users to travel longer distances than conventional scooters present an attractive method of transportation to school, work, and leisure. (more…)
Accidents & Violence, Author Interviews, ENT, Pediatrics / 06.06.2019

MedicalResearch.com Interview with: Dr. Garth Essig, MD Otolaryngologist The Ohio State University Wexner Medical Center.  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Dog bites are a significant yet modifiable public health concern, but the true magnitude is difficult to estimate with such wide ranges in reporting, severity of injury and varieties of breeds that bite.  We reviewed bites from reports in the literature and from two regionally distinct medical centers. We concluded that bite frequency and severity could be attributed to certain breeds in this sample, if the breed is known. Our study also acknowledged the significant risk of biting with the mixed breed population, which creates a dilemma with identification. (more…)
Author Interviews, ENT / 03.06.2019

MedicalResearch.com Interview with: Edward McCoul, MD, MPH, FACS Associate Professor Director, Rhinology and Sinus Surgery Department of Otorhinolaryngology Ochsner Clinic New Orleans, Louisiana  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Although the potential for doctors and patients to misunderstand each other has been noted in other areas of medicine, the meaning of the word "congestion" had not previously been the subject of study.  This paper calls attention to the relevance of potential communication gap in otolaryngology.  This is particularly important since congestion is a major diagnostic criteria of sinusitis, which ranks nationwide in the top 5 reasons for clinical encounters year after year.  If a communication gap is evident around this particular term, which is integral to establishing a diagnosis of sinusitis, then the likelihood increases that patients who present with "sinusitis" will be incorrectly diagnosed. The process of congestion refers to the microscopic accumulation of blood and/or fluid within cells or the spaces between cells in a particular tissue or body part.  When this occurs in the nose, the result is swelling inside the nose, which narrows the space for air to flow.  A patient would perceive this as blockage or obstruction of airflow.  This can be treated with anti-inflammatory medication that reduces swelling.  Medications that clear up mucus generally are not great at reducing swelling.  Many over-the-counter products are available that combine both types of medications, but using those products runs the risk of overmedication, which can have adverse consequences. (more…)
Author Interviews, ENT, JAMA, Pain Research, Pediatrics, Surgical Research / 05.04.2019

MedicalResearch.com Interview with: Gillian R. Diercks, MD, MPH Instructor in Otolaryngology, Harvard Medical School Department of Otolaryngology Massachusetts Eye and Ear Infirmary Boston, Massachusetts  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Pediatric tonsillectomy is a commonly performed procedure, representing the second most common ambulatory surgery performed on children in the United States, with over half a million children undergoing the surgery annually.  A major concern for surgeons, patients, and their families is the issue of postoperative pain control as pain can last up to 10-14 days after surgery, be quite severe, and result in readmission to the hospital or ED visits for medications and dehydration. In young children and children with sleep apnea we cannot safely administer narcotic pain medications at home.  This leaves limited options for pain control, including acetaminophen and ibuprofen.  However, there are concerns that ibuprofen could potentially increase bleeding risk after surgery because of its effects on platelet function in the blood.  At baseline, the risk of postoperative hemorrhage within the first two weeks after tonsillectomy is around 4.5%, with about 1-1.5% of children requiring a return to the operating room to control severe bleeding.  Our study set out to show that the risk of severe postoperative bleeding when ibuprofen is given for 9 days after tonsillectomy was not increased compared with the bleeding risk when acetaminophen was administered instead. Our study could not conclude that the risk of bleeding is no different when ibuprofen is used, and was suggestive that the bleeding risk may actually be higher. (more…)
Author Interviews, Cancer Research, ENT, JAMA, Surgical Research / 06.11.2018

MedicalResearch.com Interview with: Dr. Evan M. Graboyes MD Otolaryngologist: Head and Neck Surgeon Medical University of South Carolina MedicalResearch.com: What is the background for this study? Response: Unfortunately, there is no screening test for head and neck cancer like there is for colorectal, prostate, breast, lung, or cervical cancers. As a result, two-thirds of patients with head and neck cancer (HNC) present with loco-regionally advanced disease, making other aspects of timely treatment that much more critically important. We therefore sought to understand the association between treatment delay at different points along the cancer care continuum and oncologic outcomes for patients with head and neck cancer. (more…)
Author Interviews, Cancer Research, Cost of Health Care, ENT, HPV, JAMA, Surgical Research / 18.09.2018

MedicalResearch.com Interview with: Richard B. Cannon, MD Division of Otolaryngology–Head and Neck Surgery School of Medicine University of Utah, Salt Lake City  MedicalResearch.com: What is the background for this study? What are the main findings?  Response: The Patient Protection and Affordable Care Act (ACA) is a nationwide effort to reduce the number of uninsured individuals in the United States and increase access to health care. This legislation is commonly debated and objective data is needed to evaluate its impact.  As a head and neck cancer surgeon, I sought to evaluate how the ACA had specifically influenced my patients.  Main findings below:     MedicalResearch.com: What should readers take away from your report? Response: This population-based study found an increase in the percentage of patients enrolled in Medicaid and private insurance and a large decrease in the rates of uninsured patients after implementation of the Patient Protection and Affordable Care Act (ACA).  This change was only seen in states that adopted the Medicaid expansion in 2014. The decrease in the rate of uninsured patients was significant, 6.2% before versus 3.0% after. Patients who were uninsured prior to the Patient Protection and Affordable Care Act had poorer survival outcomes. (more…)
Author Interviews, ENT, Environmental Risks, Occupational Health / 06.09.2018

MedicalResearch.com Interview with: Beatrice Golomb, MD, PhD Director of the Golomb Research Group Professor of Medicine University of California, San DiegoResponse: MedicalResearch.com: What is the background for this study? How was the radiation emitted? Response: Possibilities include surveillance devices (or things to jam them), electronic weapons, or, less likely, “innocent” communications devices. MedicalResearch.com: What are the main findings? Response: That all key features of diplomats’ experiences comport with pulsed radiofrequency/ microwave (RF/MW) radiation.
  1. The nature of the “sounds” heard – chirping, clicking, ringing, grinding/buzzing – are known “sounds” produced via the “microwave auditory effect” aka Frey effect.  Different sounds are heard by different people, because the character of the sound heard depends on head dimensions (as well as pulse characteristics). Sounds were primarily heard at night: consistent with the microwave auditory effect, which requires low ambient noise. Some diplomats reported that sounds were spatially localized with “laserlike” specificity – said to defy known physics. This defies the physics of sound, but not radiation. The “sound” was reported to follow a diplomat as he walked, within the territory in which it was heard. Sound from a fixed source does not seem to follow people – but the microwave auditory affect does, often perceived as being located just behind (or in some cases just above, or inside) the head of the person, irrespective of the person’s orientation relative to the radiation source.
  2. The symptoms reported following these experiences also fit. Rates of reported symptoms in diplomats – headache, cognitive and sleep problems dominating, then dizziness, tinnitus, anxiety, nausea at lesser but still high rates – match closely with rates of the same symptoms reported in a 2012 Japanese study of people who report health effects from radiation, typically including pulsed RF/MW. Hearing loss is a relatively distinctive and prominent symptom in both diplomats, and RF/MW affected civilians. In both groups, some reportedly experience speech problems, balance problems, nosebleed, and strange sensations of vibration and pressure.
Reports of symptoms with RF/MW exposures date at least to the 1920s, affecting radio amateurs and shipboard radio operators as well as others working with radar or microwaves in occupational settings. By 1971/72, a Naval report with over 2300 citations (many from Russia and Eastern Europe), assessing effects of low intensity RF radiation, had whole sections devoted to each of a number of the symptoms diplomats report.
  1. Hundreds (if not thousands) of studies have illuminated mechanisms by which these effects may arise, centered on oxidative stress (the kind of injury that antioxidants help to defend against) – and many downstream effects of oxidative stress (membrane damage, blood brain barrier impairment with potential for brain swelling, inflammation, voltage gated calcium (and other) channel effects (which can also lead to oxidative stress), mitochondrial impairment, autoimmune activation, etc.)
Affected persons are a minority (in both settings), and in the nondiplomat setting, vulnerability has been tied to genetic variants less adept at defending against oxidative stress; and low concentrations of a critical antioxidant. In both groups, brain imaging studies resemble traumatic brain injury; and in both, at least some of those affected had prior head injury. Head injury may be a predisposing factor, as well as possible consequence. Reprising findings also shown for research on other lucrative products with potential to cause harm in some, there is a powerful tie between study results and financial conflict of interest (e.g. source of study funding or conflicts by authors).
  1. There is precedent for use of microwaves in the diplomat setting. It is known that the US embassy in Moscow was microwaved for several decades beginning in the early 1950s (with some embassy staff citing – disputed - health problems). A 1976 NY Times story (“Moscow rays linked to U.S. bugging”) referenced speculation these were for surveillance; the Soviets claimed their purpose was to thwart U.S. listening devices on the roof of the embassy.
(more…)
Anesthesiology, Author Interviews, ENT, Heart Disease, JAMA / 03.09.2018

MedicalResearch.com Interview with: Henry E. Wang, MD, MS Professor and Vice Chair for Research University of Texas Health Science Center at Houston Department of Emergency Medicine Houston, Texas MedicalResearch.com: What is the background for this study? What are the main findings? Response: For over three decades, paramedics have performed endotracheal intubation (ETI) as the standard advanced airway management strategy in cardiac arrest. However, intubation is a difficult and error-prone intervention. Newer supraglottic airways such as the laryngeal tube (LT) offer easier insertion technique with comparable ventilation. However, intubation and laryngeal tubes have not been tested head-to-head in a randomized trial. Our study - the Pragmatic Airway Resuscitation Trial (PART) - tested intubation vs laryngeal tube for airway management in adult out-of-hospital cardiac arrests. The trial included 27 EMS agencies from the Birmingham, Dallas-Fort Worth, Milwaukee, Portland and Pittsburgh communities. The trial randomized a total of 3,004 adult cardiac arrests to airway management with ETI or LT. We found that compared with traditional ETI, LT was associated with almost 3% better survival. Out-of-hospital cardiac arrest survival in the US is less than 10%, so the observed difference is important.  (more…)
Author Interviews, ENT, JAMA, NIH / 17.08.2018

MedicalResearch.com Interview with: “Bad smell” by Brian Fitzgerald is licensed under CC BY 2.0Kathleen Bainbridge, PhD Epidemiology and Biostatistics Program NIDCD MedicalResearch.com: What is the background for this study? What are the main findings? Response: The causes of phantom odor perception are not understood. This study looked for the prevalence and risk factors for this disorder. We found that that 1 in 15 Americans (or 6.5 percent) over the age of 40 experiences phantom odors. This study, is the first in the U.S. to use nationally representative data to examine the prevalence of and risk factors for phantom odor perception. The study included about 7,400 adults who participated in the National Health and Nutrition Examination Survey, a continuous survey conducted by the National Center for Health Statistics which is part of the Centers for Disease Control and Prevention. The study could inform future research aiming to unlock the mysteries of phantom odors. We identified risk factors that may be related to the perception of phantom odors. People are more likely to experience this condition if they are female, and are relatively young—we found a higher prevalence in 40-60 year-olds compared to 60+ year-olds. Other risk factors include head injury, dry mouth, poor overall health, and low socio-economic status. People with lower socio-economic status may have health conditions that contribute to phantom odors, either directly or because of medications needed to treat their health conditions. (more…)
Author Interviews, Cancer Research, ENT, HPV / 25.07.2018

MedicalResearch.com Interview with: Eric Adjei PhD, MA Saint Louis University Center for Health Outcomes Research (SLUCOR) St. Louis, Missouri  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Survivors of head and neck cancer (HNC) develop second primary cancers (SPCs) at a higher rate than most common cancers. This is concerning because the number of HNC survivors are increasing due to advancements in treatment and technology. Patients whose head and neck cancer was caused by smoking and alcohol are different than those whose HNC were caused by human papillomavirus (HPV). We therefore used data from 2000-2014 National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) 18 database to examine if the incidence and the type of SPC that patients with smoking-related HNC develop were different from those from HPV-related head and neck cancer. First, independent of group of HNC (HPV-related or not), we found that SPCs among survivors of head and neck cancer were high, with about 1-in-8 patients developing an SPC. Additionally, irrespective of whether the index . head and neck cancer was from smoking-related or HPV-related, the majority of SPCs were second malignancies in head and neck region (e.g. tongue, gum, mouth floor etc), lung and esophagus. However, we observed different incidence rates between the two groups. Patients with smoking-related head and neck cancer developed SPCs at a higher rate (14%) than those with HPV-related HNC (10%). (more…)
Annals Internal Medicine, Author Interviews, ENT, Environmental Risks, Hearing Loss / 19.04.2018

Christine Marie Durand, M.D. Assistant Professor of Medicine Johns Hopkins Medicine MedicalResearch.com Interview with: Dr. Véronique J. C. Kraaijenga MD Department of Otorhinolaryngology–Head and Neck Surgery Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, the Netherlands MedicalResearch.com: What is the background for this study? Response: During the past two decades, the frequency of hearing loss among young people has increased and going to music concerts, clubs and festivals may part of the reason. Noise-induced hearing loss because of recreational noise exposure is reduced by using earplugs. Our study evaluated 51 adults who attended an outdoor music festival in Amsterdam, the Netherlands, in September 2015. The study measured music festival visit for 4.5 hours (intervention); temporary hearing loss (outcome). (more…)
Author Interviews, ENT, JAMA, Surgical Research / 02.03.2018

MedicalResearch.com Interview with: Boris Paskhover, MD Rutgers New Jersey Medical School Adjunct Instructor,Department of Otolaryngology-Head and Neck Surgery NYU Langone Medical Center MedicalResearch.com: What is the background for this study? Response: Patient's and the general public routinely mention that their nose appears large, especially when they look at photos taken with their phone. I realized that patients in general are taking selfies more often nowadays. In my training, we routinely would tell patient’s not to use selfies as a marker of how they look, and we instead would take a 5ft distance photograph since we knew that is more realistic. I looked through the medical literature, and it appeared to me that no one had thoroughly discussed why selfies are a bad when evaluating the nose. I contacted a colleague at Stanford who has a PhD with interest in computer graphics and we developed a model for the face/nose. (more…)
Accidents & Violence, Author Interviews, Emergency Care, ENT, JAMA / 21.12.2017

“Qtip” by Rafael Castillo is licensed under CC BY 2.0MedicalResearch.com Interview with: Eric T. Carniol, MD, MBA Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology–Head and Neck Surgery, University of Toronto Toronto, Ontario, Canada MedicalResearch.com: What is the background for this study? What are the main findings? Response: Tympanic membrane perforations (aka "popped" or "burst" ear drum) is a common complaint of patients presenting to the emergency room, primary care offices, and otolaryngologist (ENT doctors) offices. These may be caused by trauma, infections, or other causes. As well, many patients will use qtips (cotton-tipped applicators) to clean ears and remove ear wax and are unaware of the potential harms of doing so. This study was designed to examine the cause of ear drum perforations as diagnosed in emergency departments in the United States. Foreign body instrumentation of the ear (qtips, hair combs, hair pins, needles, etc) were the cause of 61.2% of perforations. Cotton tip applicators are the single leading cause of traumatic tympanic membrane perforation in all age groups except young adults (13-18) and 19-36 year olds, in which it is the second largest cause (behind water trauma). Children less than 18 years old constitute nearly 2/3 of all ear drum perforations in the emergency department. (more…)
Abuse and Neglect, Author Interviews, Cancer Research, ENT, JAMA, Smoking, Social Issues / 10.11.2017

MedicalResearch.com Interview with: Nosayaba Osazuwa-Peters, BDS, MPH, CHES Instructor, Department of Otolaryngology-Head and Neck Surgery Saint Louis University School of Medicine Member, Saint Louis University Cancer Center St Louis, Missouri  MedicalResearch.com: What is the background for this study? What are the main findings? Response: Several studies have shown that there is an adverse effect of smoking on head and neck cancer survival; however, there are studies that show no effect between smoking and head and neck cancer. We wanted to investigate this problem using a single institution’s cancer dataset. Additionally, we wanted to understand the role of marital status in the smoking behavior of head and neck cancer patients, and to understand if smoking played any role in head and neck cancer survival. Our study confirmed that head and neck cancer patients who were smokers at the time of diagnosis had lower survival rates than nonsmokers. We also found that married head and neck cancer patients were less likely to be smokers and more likely to survive longer than those unmarried. (more…)
Author Interviews, ENT, JAMA, Stanford, Surgical Research / 12.10.2017

MedicalResearch.com Interview with: David Schoppy, MD PhD Resident, Division of Head and Neck Surgery Department of Otolaryngology Stanford University School of Medicine Stanford, Palo Alto, California MedicalResearch.com: What is the background for this study? What are the main findings? Response: There is a growing focus in healthcare on quality, and one component of this focus is the development of robust measures of quality. Currently, there are relatively few validated metrics of performance in oncologic surgery, and several of these indicators are relatively static metrics (such as hospital case volume and institution type). This study examined the relationship between overall survival (one surrogate of quality cancer surgery) and two modifiable variables in Head and Neck surgery - achieving negative surgical margins around a primary tumor and 18 or more lymph nodes from a concurrent neck dissection. After controlling for multiple other patient variables, data collected from the National Cancer Database (NCDB) showed that treatment at hospitals where a high percentage of patients had a surgery with negative margins and 18 or more lymph nodes removed from their neck was associated with improved survival. Importantly, this survival benefit was independent of the individual, patient-level survival benefit conferred by having either of these surgical process measures reached. This study therefore highlights two modifiable measures of institutional performance in Head and Neck surgery that may serve as targets for quality improvement programs. (more…)
Author Interviews, ENT, Surgical Research / 22.09.2017

MedicalResearch.com Interview with: Brett A. Miles, DDS MD FACS Associate Professor of Otolaryngology Head and Neck Surgery Co-Chief Division Head and Neck Oncology Fellowship Director Head and Neck Oncologic and Microvascular Reconstructive Surgery Department of Otolaryngology Head and Neck Surgery Icahn School of Medicine at Mount Sinai New York, NY 10029  MedicalResearch.com: What is the background for this study? What are the main findings? Response: The ideal core temperature for patients undergoing prolonged major head and neck surgery remains unknown. Previous data indicates the low temperatures may increase the risk of developing postoperative complications such as tissue loss, hematomas, or surgical infections.(1) Other studies have indicated that high temperatures may also influence outcomes and lead to increased complications such as bleeding.(2) This study was a study of 519 patients who underwent major head and neck surgery at the Mount Sinai Hospital, New York, New York. The study looked at the core temperature of the patients during prolonged surgery for head and neck cancer in order to identify the optimal temperature range for these patients to prevent complications. The study found that higher intraoperative temperatures were associated with worse outcomes in terms of tissue loss, wound complications, and infection. Our study suggests an optimal temperature range of 35.3C-37.6C. If patients were above or below that range for a significant period of time, their complications increased. Therefore maintaining this temperature range (mild hypothermia) may improve flap outcomes in this population. (more…)
Author Interviews, Endocrinology, ENT, Surgical Research / 11.09.2017

MedicalResearch.com Interview with: Raymond L. Chai, MD Assistant Professor of Otolaryngology Icahn School of Medicine at Mount Sinai.  MedicalResearch.com: What is the background for this study? Response: Primary hyperparathyroidism is a common endocrine disorder affecting up to 1% of the general population. Surgical intervention is the only known durable cure for the disease. Untreated primary hyperparathyroidism can lead to number of health problems, including progressive osteoporosis and kidney stones. Although parathyroidectomy is a commonly performed surgical procedure by otolaryngologists, limited data exists regarding risk factors and rates of reoperation and readmission following surgery. (more…)