Sleep in disease: inflammation and chronic rhinosinusitis.

Chronic rhinosinusitis (CRS) is a common inflammatory disorder that is associated with significant quality of life (QOL) impairment, including sleep dysfunction. There are multiple factors that have been independently associated with poor sleep among this population including alterations in inflammatory mediators, rhinologic symptom interference such as nasal discharge, obstruction, and facial pain, and co-morbid conditions including asthma. While there is a high prevalence of sleep dysfunction among this population, treatment with both medical and surgical options may lead to sustained improvements in sleep.

Current Trends in the Management of Recurrent Nasopharyngeal Carcinoma.

Background: Recurrent nasopharyngeal carcinoma (NPC) is associated with challenges in treatment due to the complex anatomic location and impact of prior treatment modalities such as radiation therapy. The purpose of this review is to discuss modern treatment strategies for recurrent NPC, potential challenges, and outcomes.

Methods: A narrative review was performed, evaluating management strategies of recurrent NPC, survival measures, and advancements in treatment considerations.

Travel Costs and Carbon Savings Associated With Telemedicine in a Tertiary Care Rhinology Center.

Objective: Healthcare-associated costs as well as carbon dioxide (CO) emissions are rising, and identifying means to mitigate these may provide direct benefits to patients as well as overall population health, especially among patients with chronic sinonasal disease. This study aimed to assess potential personal travel costs and CO emissions saved due to telemedicine visits.

Methods: This was a retrospective review of patients within Oregon presenting for telemedicine visits at a tertiary rhinology center from July 2022 to July 2023.

Outcomes of Immunotherapy Treatment in Sinonasal Mucosal Melanoma.

Background: Sinonasal mucosal melanoma has poor survival despite multimodality treatment. While the impact of immunotherapy (IT) on metastatic cutaneous melanoma is well-defined, there are relatively little data on sinonasal mucosal melanoma.

Objective: We sought to define immunotherapy outcomes in patients with sinonasal mucosal melanoma.

Postoperative Implementation of Virtual Reality and Wearable Devices: Opportunities and Challenges.

Objective: To examine implementation of virtual reality (VR) and Fitbit wearable activity devices in postoperative recovery.

Methods: This was a prospective, 4-arm, randomized controlled trial of patients undergoing inpatient head and neck surgery at a tertiary academic center from November 2021 to July 2022. Patients were randomized to Control, VR, Fitbit, or combined VR + Fitbit groups.

Patterns of virtual reality and Fitbit wearable activity device use after skull base surgery.

Virtual reality (VR) and Fitbit devices are well tolerated by patients after skull base surgery. Postoperative recovery protocols may benefit from incorporation of these devices. However, challenges including patient compliance may impact optimal device utilization.

Health care disparities and chronic rhinosinusitis: Does neighborhood disadvantage impact outcomes in sinonasal disease?

Objective: Socioeconomic status (SES) is linked to health outcomes but has not been well studied in patients with chronic rhinosinusitis (CRS). The area deprivation index (ADI) is a comprehensive measure of geographic SES that ranks neighborhood disadvantage. This investigation used ADI to understand the impact of neighborhood disadvantage on CRS treatment outcomes.

Use of Perioperative Virtual Reality Experiences on Anxiety and Pain: A Randomized Comparative Trial.

Objective: To evaluate the effect of different virtual reality (VR) experiences on perioperative anxiety and pain among patients undergoing head and neck surgery.

Methods: Prospective, randomized, comparative trial among patients undergoing outpatient head and neck surgery from December 2021 to April 2022 at a single academic institution. Group 1 utilized a preoperative VR gaming experience and a postoperative VR mindfulness experience, while Group 2 utilized the same interventions in the reverse order.

Monitoring postoperative ambulation and sleep after head and neck surgery: Feasibility and utility study using wearable devices.

Background: To evaluate use of wearable activity devices to monitor trends in ambulation and sleep after head and neck surgery.

Methods: Patients utilized Fitbit devices after surgery. Daily activity and sleep scores, step counts, and total sleep time (TST) were obtained.

Work productivity and activity impairment in patients with chronic rhinosinusitis undergoing endoscopic sinus surgery-A prospective, multi-institutional study.

Background: Productivity loss and activity limitations due to chronic rhinosinusitis (CRS) are known to contribute to the significant economic and personal burden of disease. The purpose of this study was to assess productivity and activity impairment before and after endoscopic sinus surgery (ESS) for medically refractory CRS.

Methods: This investigation was a prospective, multi-institutional, observational cohort study.

Effect of Virtual Reality on Pain Management and Opioid Use Among Hospitalized Patients After Head and Neck Surgery: A Randomized Clinical Trial.

Importance: Optimal postoperative pain management is challenging. Virtual reality (VR) provides immersive, 3-dimensional experiences that may improve pain control and reduce reliance on pharmacologic pain management.

Objective: To evaluate use of VR on postoperative pain management after head and neck surgery.

Financial Hardship Impacts Depression and Anxiety Among U.S. Patients with Sinusitis.

Background: Mental health conditions are common in the United States, and recent efforts have examined the development of mental health conditions among patients with sinusitis.

Objectives: The purpose of this study was to investigate the association between depression, anxiety, and financial hardship among patients with sinusitis.

Methods: Cross-sectional study using the 2018 National Health Interview Survey (NHIS).

Pain and Opioid Consumption Following Endoscopic Sinus Surgery: A Prospective Cohort Study.

Objectives/hypothesis: Surgeons have a critical role in the current opioid epidemic, and there is a need to prospectively understand patterns of pain and opioid use among patients undergoing endoscopic sinus surgery (ESS).

Study Design: Prospective observational cohort.

Methods: This was a prospective, observational cohort study that included patients undergoing ESS from November 2019 to March 2020.

Perceived Financial Insecurity Impacts Healthcare Decision-Making Among Patients With Sinusitis.

Objectives/hypothesis: The economic burden of sinusitis is significant, and socioeconomic factors can impact patient decision-making. The purpose of this study was to examine the impact of perceived financial insecurity on healthcare decision-making and treatment compliance among sinusitis patients.

Study Design: Cross-sectional study using the 2018 National Health Interview Survey.

An Update on Epidemiology and Management Trends of Vestibular Schwannomas.

Objective: To determine the current epidemiology and management trends for patients with vestibular schwannomas (VS).

Study Design: Retrospective cohort study.

Setting: The Surveillance, Epidemiology, and End Results (SEER) tumor registry.

The Application of Virtual Reality in Patient Education.

Background: Virtual reality (VR) provides an immersive image-viewing experience that has recently been expanding in use in clinical medicine. We developed a three-dimensional (3D) model of an abdominal aortic aneurysm (AAA) for patients with a diagnosis of an AAA to view in VR to assess the use of VR in patient education.

Methods: This was a cross-sectional study using an educational intervention.