Circulating Tumor DNA in the Surgical Management of Cancer: A Review of Clinical Trials to Understand Future Impact on Multidisciplinary Practice.

BackgroundCirculating tumor DNA (ctDNA) has been proposed as a surrogate for solid tumor tissue biopsies. Our study evaluated trends of clinical trials that assess the role of ctDNA in surgical oncology.MethodsThe ClinicalTrials.

Socioeconomic disparities in treatment and survival in patients with hypopharyngeal malignancy.

Background: This retrospective study utilizes The Surveillance, Epidemiology, and End Results database to investigate socioeconomic factors leading to treatment disparities in hypopharyngeal malignancy.

Methods: Treatment was compared to National Cancer Care Network guidelines. Novel analyses, including logistic modeling, allowed survival analysis and identification of socioeconomic variables not previously considered in staging and management guidelines.

Automated Exposure Notification for COVID-19.

In the current COVID-19 pandemic, various Automated Exposure Notification (AEN) systems have been proposed to help quickly identify potential contacts of infected individuals. All these systems try to leverage the current understanding of the following factors: transmission risk, technology to address risk modeling, system policies and privacy considerations. While AEN holds promise for mitigating the spread of COVID-19, using short-range communication channels (Bluetooth) in smartphones to detect close individual contacts may be inaccurate for modeling and informing transmission risk.

Pituitary Adenomas as a Barometer for Health Care Access.

 Expanding access to care has been shown to impact patient care and disease epidemiology for different disease states, but has not been studied in pituitary adenoma. We hypothesize that increasing access to care-which includes diagnostics-through the Affordable Care Act (ACA) and Medicaid expansion has increased identification of pituitary adenomas.  The National Cancer Institute's Surveillance, Epidemiology, and End Results database was utilized to identify patients with pituitary adenomas from 2007-to 2016 yielding 39,120 cases.

Management of Acute Complicated Mastoiditis: A Systematic Review and Meta-analysis.

Background: The objective of our study was to evaluate the efficacy of treatment options for the most frequently reported complications of acute mastoiditis in the English literature. PubMed, EMBASE, and The Cochrane Library were searched from database inception through March 29, 2019.

Methods: Two independent reviewers (M.

Soft Robotic Deployable Origami Actuators for Neurosurgical Brain Retraction.

Metallic tools such as graspers, forceps, spatulas, and clamps have been used in proximity to delicate neurological tissue and the risk of damage to this tissue is a primary concern for neurosurgeons. Novel soft robotic technologies have the opportunity to shift the design paradigm for these tools towards safer and more compliant, minimally invasive methods. Here, we present a pneumatically actuated, origami-inspired deployable brain retractor aimed at atraumatic surgical workspace generation inside the cranial cavity.

Social determinants of health and treatment decisions in head and neck cancer.

Background: This study compares select social determinants of health (SDOH) with treatment modality selection and treatment completion in head and neck cancer (HNC) patients, to better understand disparities in health outcomes.

Methods: A retrospective cohort study of HNC (n = 1428) patients was conducted. Demographic and disease-specific variables were recorded, including treatment modality selection and completion.

Geographic Barriers Affect Follow-Up Care in Head and Neck Cancer.

Objectives/hypothesis: Follow-up care in head and neck cancers (HNC) is critical in managing patient health. However, social determinants of health (SDOH) can create difficulties in maintaining follow-up care. The study goal is to explore how SDOH impacts maintenance of HNC follow-up care appointments.

Long-Term Opioid Use in Post-Surgical Management of Patients With Head and Neck Cancer.

Objective: This study aims to identify clinical and socioeconomic factors associated with long-term, post-surgical opioid use in the head and neck cancer population.

Methods: A single center retrospective study was conducted including patients diagnosed with head and neck cancer between January 1, 2014 and July 1, 2019 who underwent primary surgical management. The primary outcome measure was continued opioid use 6 months after treatment completion.

Ergonomics in Endoscopic Transsphenoidal Surgery: A Survey of the North American Skull Base Society.

 Different surgical set-ups for endoscopic transsphenoidal surgery (ETS) have been described, but studies on their ergonomics are limited. The aim of this article is to describe present trends in the ergonomics of ETS.  A 33-question, web-based survey was sent to North American Skull Base Society members in 2018 and 116 responded to it (16% of all members).

Predicting Anticoagulation Need for Otogenic Intracranial Sinus Thrombosis: A Machine Learning Approach.

 The role of anticoagulation (AC) in the management of otogenic cerebral venous sinus thrombosis (OCVST) remains controversial. Our study aims to better define when AC is used in OCVST.  MEDLINE, EMBASE, and The Cochrane Library were searched from inception to February 14, 2019 for English and English-translated articles.

Multimodal Microvascular Mapping for Head and Neck, Skull Base Research and Education: An Anatomical Donor Study.

 This study was aimed to develop a method combining computed tomography (CT) and fluorescence imaging, allowing identification of microvasculature in anatomical donors and facilitating translational research and education.  We investigated homogeneity and radiopacity of 30 different mixtures including radiopaque substances povidone-iodine (Betadine), barium sulfate (BaSO ), and bismuth subsalicylate (Pepto-Bismol) varying in suspension and dilution with agar, latex, or gelatin. Three candidate mixtures were selected for testing the extent of perfusion in renal vasculature to establish methodology.

Pituitary Carcinoma Diagnosis and Survival Improvement, with Affordable Care Act Correlation: A SEER Database Study.

 Pituitary carcinomas are challenging tumors to diagnose and treat due to their rarity and limited data surrounding their etiology. Traditionally, these patients have exhibited poor survival. Over the last several decades, our understanding of pituitary carcinomas has dramatically increased, and there have been recent initiatives to improve patient access to health care, including the Affordable Care Act (ACA).

Review of Pediatric Otolaryngology Clinical Trials: Past Trends and Future Opportunities.

Objectives/hypothesis: Pediatric otolaryngologic conditions are highly prevalent in the United States. Although data gathered from clinical trials drive therapeutic strategies, the trends of research in pediatric otolaryngology remain unclear. The objective of this study was to characterize recent trials in pediatric otolaryngology to better understand current directions of study and to identify opportunities for future research.

Social Determinants of Health and Oral Cavity Cancer Treatment and Survival: A Competing Risk Analysis.

Objective: Competing risk analysis is a powerful assessment for cancer risk factors and covariates. This method can better elucidate insurance status and other social determinants of health covariates in oral cavity cancer treatment, survival, and disparities.

Study Design: Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database.

Investigating Patient Preferences in Medical Student Attire in the Outpatient Otolaryngology Setting.

Background: The authors sought to investigate patient preferences on physician and medical student attire in the outpatient otolaryngology setting.

Methods: A prospective sample of 50 (23 males, 27 females) patients presenting to an otolaryngology clinic in a North American teaching hospital, Boston, MA, were included. Patients were seen by a researcher wearing a white coat and either (1) a shirt and tie or (2) surgical scrubs, then completed a Likert-style survey evaluating feelings of trust, comfort, and professionalism.

Neural Crest Cell Failure as Embryogenesis for Fusiform Aneurysm of the Anterior Communicating Artery: Case Report and Review of the Literature.

Background: Pure fusiform aneurysms of the anterior communicating artery (AcomA) are rare. We report a unique case of a patient with an AComA fusiform aneurysm in the setting of several unusual cranial neurocristopathies, including a hypoplastic internal carotid artery (ICA), persistent craniopharyngeal canal, transsphenoidal encephalocele, and ectopic, duplicated pituitary gland. We also review the literature on cranial base neurocristopathies and AComA fusiform aneurysms.

Education and insurance status: Impact on treatment and survival of sinonasal cancer patients.

Objectives/hypothesis: To understand the impact of education and insurance as social determinants of health on sinonasal cancer treatment and outcomes.

Study Design: Retrospective cohort study using the Surveillance, Epidemiology, and End Results (SEER) database.

Methods: Demographics, tumor characteristics, location, stage at diagnosis, treatment, and survival data for 1,365 patients diagnosed with sinonasal cancers were extracted from the SEER database.

Thyroid cancer clinical trials in the United States: Understanding trends to maximize impact.

Background: We sought to understand thyroid cancer study modalities, publications, and grants. This provides scope, resources, and dissemination patterns to inform future directions for research and policy.

Methods: A retrospective study of thyroid cancer trials using ClinicalTrials.

Plasma circulating tumor DNA as a potential tool for disease monitoring in head and neck cancer.

Background: Recommendations for perioperative therapy in head and neck cancer are not explicit and recurrence occurs frequently. Circulating tumor DNA is an emerging cancer biomarker, but has not been extensively explored for detection of recurrence in head and neck cancer.

Methods: Patients diagnosed with head and neck squamous cell carcinoma were recruited into the study protocol.

A Cross-sectional Survey of the North American Skull Base Society: Current Practice Patterns of Vestibular Schwannoma Evaluation and Management in North America.

 Very few studies have examined vestibular schwannoma (VS) management trends across centers and between providers. The objective of this study is to examine current practice trends, variance in treatment philosophies, and nuanced or controversial aspects of VS care across North America.  This is a cross-sectional survey of North American Skull Base Society (NASBS) members who report regular involvement in VS care.

Erratum: A Review of Skull Base Tumor Clinical Trials: Past Trends and Future Opportunities.

[This corrects the article DOI: 10.1055/s-0036-1586759.].

A Review of Skull Base Tumor Clinical Trials: Past Trends and Future Opportunities.

 Tumors of the anterior and lateral skull base (TALSB) are relatively rare but can be devastating to patients. By examining trials focused on TALSB, we can characterize the studies that predominate and better understand current directions of study. This gives us a better understanding of future studies to pursue.

Association of oral flora with orbital complications of acute sinusitis.

Background: Acute and chronic sinusitis in children and adults can spread to the orbit. Oral flora has been seen in orbital infections, but the extent of synergy between pathogens in such infections remains unknown.

Methods: A retrospective case series of patients with complicated sinusitis that involved the orbit from acute sinusitis who were admitted to a tertiary care hospital from January 2000 to December 2014 and who had surgical cultures obtained.

Characteristics of NIH- and industry-sponsored head and neck cancer clinical trials.

Objectives/hypothesis: Compare U.S. clinical trials sponsored by the National Institutes of Health (NIH) and industry, especially with regard to trial design, interventions studied, and results reporting rates.