Heterotopic calcification in a child presenting as acute on chronic myelopathy.

Purpose: Heterotopic calcification (HC) is a rarely reported pathology of aberrant bone deposition in extraskeletal tissue, most commonly outside of the central nervous system. While some of these findings may be incidental and asymptomatic, patients with symptomatic cord compression due to HC require consideration for expedited surgical intervention. We present the first described pediatric case of HC of the cervical spine causing spinal cord compression in a patient presenting with acute weakness and paresthesias following a minor trauma.

Domain-Specific Customization for Language Models in Otolaryngology: The ENT GPT Assistant.

Objective: To develop and evaluate the effectiveness of domain-specific customization in large language models (LLMs) by assessing the performance of the ENT GPT Assistant (E-GPT-A), a model specifically tailored for otolaryngology.

Study Design: Comparative analysis using multiple-choice questions (MCQs) from established otolaryngology resources.

Setting: Tertiary care academic hospital.

Comparing the Outcomes of Osteocutaneous Radial Forearm and Fibula Free Flaps in the Reconstruction of Mandibular Osteoradionecrosis.

Background: This study compares the outcomes of osteocutaneous radial forearm free flap (OC-RFFF) and fibula free flap (FFF) reconstruction of mandibular osteoradionecrosis (ORN).

Methods: Retrospective review of patients undergoing OC-RFFF/FFF reconstruction for mandible ORN between 2005 and 2020 at a tertiary center. Patient characteristics, postoperative complications, and functional outcomes were evaluated using chi-squared and logistic regression analysis.

Preanalytical Phase Tumor Contaminants in Intraoperative Margins From Transoral Robotic Surgeries.

Context.—: Tumor contaminants were incidentally noted in frozen section margins of oropharyngeal squamous cell carcinoma.

Objective.

Interim Phase II Results Using Panitumumab-IRDye800CW during Transoral Robotic Surgery in Patients with Oropharyngeal Cancer.

Purpose: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has continually increased during the past several decades. Using transoral robotic surgery (TORS) significantly improves functional outcomes relative to open surgery for OPSCC. However, TORS limits tactile feedback, which is often the most important element of cancer surgery.

Effect of Perioperative Antithrombotics on Postoperative Transfusion and Hematoma in Head and Neck Free Flaps.

Objective: To explore if antiplatelet or anticoagulant therapy increases the risk of transfusion requirement or postoperative hematoma formation in patients undergoing microvascular reconstruction for head and neck defects.

Study Design: Retrospective cohort study.

Setting: Departments of Otolaryngology-Head and Neck Surgery at the University of Alabama at Birmingham, the University of Colorado, and the University of California Irvine.

A Survey of Otolaryngology Residency Programs on Adapting to the United States Medical Licensing Examination (USMLE) Step 1 Transitioning to Pass/Fail.

Objectives In February 2020, the National Board of Medical Examiners (NBME) announced that the United States Medical Licensing Examination (USMLE) Step 1 licensing examination would change from a numerical score to Pass/Fail (P/F). After implementation, many believe that USMLE-Step 2-Clinical Knowledge (CK) will become an important metric for students applying to otolaryngology (ENT). The purpose of this study is to determine factors important to resident selection after these changes.

A multi-model approach to predict efficacious clinical dose for an anti-TGF-β antibody (GC2008) in the treatment of osteogenesis imperfecta.

Osteogenesis imperfecta (OI) is a heterogeneous group of inherited bone dysplasias characterized by reduced skeletal mass and bone fragility. Although the primary manifestation of the disease involves the skeleton, OI is a generalized connective tissue disorder that requires a multidisciplinary treatment approach. Recent studies indicate that application of a transforming growth factor beta (TGF-β) neutralizing antibody increased bone volume fraction (BVF) and strength in an OI mouse model and improved bone mineral density (BMD) in a small cohort of patients with OI.

Complications in oncologic mandible reconstruction: A comparative study between the osteocutaneous radial forearm and fibula free flap.

Background: The osteocutaneous radial forearm free flap (OC-RFFF) has been proposed as a safe and reliable free flap for head and neck reconstruction with low donor site morbidity. The purpose of this study is to compare the late complications (>30 days) associated with using the OC-RFFF versus the free fibula flap (FFF) for mandibular reconstruction following oncologic segmental resection.

Methods: We conducted a single-institution, retrospective study composed of patients who underwent oncologic microvascular composite mandibular reconstruction with either the OC-RFFF or FFF.

Moving to a more restrictive transfusion protocol: Outcomes in head and neck free flap surgery.

Purpose: To determine if a more restrictive transfusion protocol results in increased rates of adverse flap outcomes in patients undergoing free tissue transfer.

Materials And Methods: Mixed retrospective and prospective cohort study. Patients who underwent surgery before the protocol change were collected retrospectively.

Inhibition of TGF-β Increases Bone Volume and Strength in a Mouse Model of Osteogenesis Imperfecta.

Osteogenesis imperfecta (OI), is a genetic disorder of bone fragility caused by mutations in collagen I or proteins involved in collagen processing. Previous studies in mice and human OI bones have shown that excessive activation of TGF-β signaling plays an important role in dominant and recessive OI disease progression. Inhibition of TGF-β signaling with a murine pan-specific TGF-β neutralizing antibody (1D11) was shown to significantly increase trabecular bone volume and long bone strength in mouse models of OI.

#ENT: Otolaryngology Residency Programs Create Social Media Platforms to Connect With Applicants During COVID-19 Pandemic.

Objective: To determine which otolaryngology residency programs have social media platforms and to review which programs are utilizing platforms to advertise virtual open houses and virtual subinternships for residency applicants.

Study Design: Cross-sectional study.

Setting: The study was conducted online by reviewing all accredited otolaryngology residency programs in the United States participating in the Electronic Residency Application Service.

Safety of fibula free flap in patients following total knee replacement.

Background: Fibula free flap (FFF) is the preferred osteocutaneous flap for reconstruction of large head and neck composite defects. There is a paucity of data whether FFF can be performed safely in patients with knee replacement (total knee arthroplasty [TKA]).

Methods: Multi-institutional review of outcomes following FFF in patients who had prior TKA.

Impact of COVID-19 on Away Rotations in Surgical Fields.

The COVID-19 pandemic has presented a variety of challenges in the medical education curriculum, one of which is the possible loss of summer and fall away rotations for fourth year students applying into surgical subspecialties. Subsequently, a lack of in-person evaluations may have a major impact on an applicant's perception of the residency and the program's ability to assess the individual applicant. This is especially crucial for applicants without a home program in their specialty of interest, as away rotations are an important opportunity to confirm interest in pursuit of a subspecialty, obtain letters of recommendation, and make positive impressions at programs of interest.

Tracheotomy in the SARS-CoV-2 pandemic.

The severe acute respiratory syndrome (SARS)-CoV-2 pandemic continues to produce a large number of patients with chronic respiratory failure and ventilator dependence. As such, surgeons will be called upon to perform tracheotomy for a subset of these chronically intubated patients. As seen during the SARS and the SARS-CoV-2 outbreaks, aerosol-generating procedures (AGP) have been associated with higher rates of infection of medical personnel and potential acceleration of viral dissemination throughout the medical center.

Shift in the timing of microvascular free tissue transfer failures in head and neck reconstruction.

Objective: Analyze the cause and significance of a shift in the timing of free flap failures in head and neck reconstruction.

Study Design: Retrospective multi-institutional review of prospectively collected databases at tertiary care centers.

Methods: Included consecutive patients undergoing free flap reconstructions of head and neck defects between 2007 and 2017.

Outcomes and cost implications of microvascular reconstructions of the head and neck.

Background: Critical review of current head and neck reconstructive practices as related to free flap donor sites and their impact on clinical outcomes and cost.

Methods: Retrospective multicenter review of free tissue transfer reconstruction of head and neck defects (n = 1315). Variables reviewed: defect, indication, T classification, operative duration, and complications.

Evaluation of optical imaging agents in a fluorescence-guided surgical model of head and neck cancer.

Background: Tumor proliferation often occurs from pathologic receptor upregulation. These receptors provide unique targets for near-infrared (NIR) probes that have fluorescence-guided surgery (FGS) applications. We demonstrate the use of three smart-targeted probes in a model of head and neck squamous cell carcinoma.

Utility of the Surgical Apgar Score in Head and Neck Squamous Cell Carcinoma.

Objectives To recognize the utility of the surgical Apgar score (SAS) in a noncutaneous head and neck squamous cell carcinoma (HNSCC) population. Study Design Retrospective case series with chart review. Setting Academic tertiary medical center.

Utility of the Modified Surgical Apgar Score in a Head and Neck Cancer Population.

Objective The Surgical Apgar Score (SAS) is a validated postoperative complication prediction model. The purpose of this study was to investigate the utility of the SAS in a diverse head and neck cancer population and to compare it with a recently developed modified SAS (mSAS) that accounts for intraoperative transfusion. Study Design Case series with chart review.