Head and neck tumor organoid grown under simplified media conditions model tumor biology and chemoradiation responses.

Head and neck squamous cell carcinoma (HNSCC) is a prevalent and often fatal malignancy associated with significant treatment-related toxicity. There is an urgent need for a preclinical model to assess therapeutic options and guide clinical decision-making. To define conditions for establishing patient-derived organoid (PDO) models that faithfully recapitulate morphological, histopathological, and genomic characteristics of HNSCC patients and can predict radiation and chemotherapy responses in patients, PDOs were generated from a group of HNSCC patients.

Oral Herpes Simplex Virus Mimicking Tongue Squamous cell Carcinoma in Von Hippel-Lindau Patient: A Case Image.

We present the case of a 51-year-old man with Von Hippel-Lindau disease and a history of renal transplantation who developed a persistent, painful tongue lesion with episodes of significant swelling. Given his history of prolonged immunosuppression and elevated cancer risk, oral squamous cell carcinoma was a major concern. However, histopathological evaluation confirmed recrudescent herpes simplex virus (HSV) infection rather than malignancy.

Simulation training with haptic feedback of instrument vibrations reduces resident workload during live robot-assisted sleeve gastrectomy.

Background: New surgeons experience heavy workload during robot-assisted surgery partially because they must use vision to compensate for the lack of haptic feedback. We hypothesize that providing realistic haptic feedback during dry-lab simulation training may accelerate learning and reduce workload during subsequent surgery on patients.

Methods: We conducted a single-blinded study with 12 general surgery residents (third and seventh post-graduate year, PGY) randomized into haptic and control groups.

Comparing outcomes of radial forearm free flaps and anterolateral thigh free flaps in oral cavity reconstruction: A systematic review and meta-analysis.

Objectives: To compare surgical morbidity, functional and aesthetic restoration, and health-related quality of life among patients receiving anterolateral thigh (ALT) or radial forearm (RFF) free flaps for intra-oral reconstruction.

Materials And Methods: PubMed, Medline, EMBASE, CINAHL, and CDSR databases were searched from 2000 to 2022. Primary outcomes included flap survival, recipient site complications, donor site morbidity, recovery of oral function, and quality of life among patients after oncologic resection and reconstruction of oral cavity defects with ALT or RFF.

Design of interactive augmented reality functions for robotic surgery and evaluation in dry-lab lymphadenectomy.

Background: Augmented reality (AR) has been widely researched for use in healthcare. Prior AR for robot-assisted minimally invasive surgery has mainly focussed on superimposing preoperative three-dimensional (3D) images onto patient anatomy. This article presents alternative interactive AR tools for robotic surgery.

A Novel Cough Simulation Device for Education of Risk Mitigation Techniques During Aerosol-Generating Medical Procedures.

The COVID-19 pandemic has drawn attention to aerosol-generating medical procedures (AGMPs) in health care environments as a potential mode of transmission. Many organizations and institutions have published AGMP safety guidelines, and several mention the use of simulation in informing their recommendations; however, current methods used to simulate aerosol generation are heterogenous. Creation of a high-fidelity, easily producible aerosol-generating cough simulator would meet a high-priority educational need across all medical specialties.

A Review of Otolaryngology Malpractice Cases with Associated Court Proceedings from 2010 to 2019.

Objectives/hypothesis: To report key characteristics of the landscape of malpractice litigation with associated court proceedings in otolaryngology over the previous decade.

Study Design: Retrospective database review.

Methods: The LexisNexis database was queried to identify otolaryngology-related malpractices cases that yielded court opinions, jury verdicts, and settlements from federal and state courts across the United States from 2010 to 2019.

Impact of Lymph Node Yield on Survival in Surgically Treated Oropharyngeal Squamous Cell Carcinoma.

Objectives: (1) To estimate the association between neck dissection lymph node yield (LNY) and survival among patients with surgically treated human papilloma virus (HPV)-associated oropharyngeal squamous cell carcinoma (OPSCC). (2) To identify a clinically relevant quality metric for surgical treatment of HPV-related OPSCC.

Study Design: Retrospective cohort study.

National Database Research in Head and Neck Reconstructive Surgery: A Call for Increased Transparency and Reproducibility.

Objective: To reproduce a published study comparing outcomes of patients who underwent microvascular reconstruction by plastic surgeons and otolaryngologists and to examine how case selection and methodology using the National Surgical Quality Improvement Program (NSQIP) data set can affect results and conclusions.

Study Design: Cross-sectional analysis of US national database.

Setting: American College of Surgeons National Surgical Quality Improvement Program (NSQIP) from 2005 to 2017.

Incidence of inadequate perforators and salvage options for the anterior lateral thigh free flap.

Objective: The anterolateral thigh (ALT) free flap is a soft tissue flap used in head and neck reconstruction. Occasionally, its perforators to the skin paddle are absent or too small to support the flap. Salvage options in this scenario have not been well described for head and neck reconstruction.

Techniques for developing and viewing stereoscopic three-dimensional teaching videos for transoral robotic surgery (TORS).

Advances in three-dimensional (3D) video recording and playback have expanded the availability of stereoscopic videos for consumption with specialized televisions, computer monitors, and virtual reality (VR) headsets. The built-in stereoscopic vision of the da vinci surgical system (Intuitive Surgical, Sunnyvale, CA) enables the recording of both camera views. However, medical-grade devices for direct stereoscopic video recording can be cost-prohibitive.

Evaluation of high-fidelity simulation as a training tool in transoral robotic surgery.

Objectives/hypothesis: To develop and evaluate a high-fidelity training simulator for transoral robotic posterior hemiglossectomy.

Study Design: Prospective observational study.

Methods: We constructed a transoral robotic surgery (TORS) simulator using porcine tongue in a modified airway mannequin.

Objective assessment of robotic surgical skill using instrument contact vibrations.

Background: Surgical skill evaluation ordinarily requires tedious video review and survey completion, while new automatic approaches focus on evaluating the quality of the surgeon's movements in free space. Robotic surgical instrument vibrations are simple to measure and physically correspond to how roughly instruments are handled, but they have yet to be studied as a measure of technical surgical skill.

Methods: Thirteen surgeons used a robotic surgery system (da Vinci S by Intuitive Surgical) to perform four trials each of peg transfer (PT), needle pass (NP), and intracorporeal suturing (IS).

A Randomized Controlled Trial to Assess the Effects of Competition on the Development of Laparoscopic Surgical Skills.

Background: Serious games have demonstrated efficacy in improving participation in surgical training activities, but studies have not yet demonstrated the effect of serious gaming on performance. This study investigated whether competitive training (CT) affects laparoscopic surgical performance.

Methods: A total of 20 novices were recruited, and 18 (2 dropouts) were randomized into control or CT groups to perform 10 virtual reality laparoscopic cholecystectomies (LCs).

Deliberate practice enhances quality of laparoscopic surgical performance in a randomized controlled trial: from arrested development to expert performance.

Background: This study investigated whether deliberate practice leads to an increase in surgical quality in virtual reality (VR) laparoscopic cholecystectomies (LC). Previous research has suggested that sustained DP is effective in surgical training.

Methods: Fourteen residents were randomized into deliberate practice (n = 7) or control training (n = 7).

A practical system for recording instrument interactions during live robotic surgery.

We have developed a system for measuring and recording the high-frequency vibrations that characterize instrument interactions during minimally invasive robotic surgery. Consisting of simple circuitry and a DVD recorder, this system is low-cost and easily implementable, requires no sterilization, and enables measurement of a validated, objective technical skill metric in both the simulated setting and the operating room. The vibration recordings of fourteen sleeve gastrectomies were processed by segmenting the operation into seven phases and calculating the root mean square (RMS) vibration within each phase.

Intraoperative resident education for robotic laparoscopic gastric banding surgery: a pilot study on the safety of stepwise education.

Background: Incorporation of robotic surgery into resident education poses questions regarding intraoperative teaching and patient care. This study aimed to evaluate the impact of gradually increasing resident console responsibility on resident competency and patient safety, in the presence of a proctor and bedside surgeon, for robotic laparoscopic-assisted gastric banding (R-LAGB) compared with the classical training model (CTM) of residents as first assistant.

Study Design: Eight clinical year 4 (CY4) residents completed 60 R-LAGB using a one-to-one proctored training model (PTM).