Otolaryngology- Head and Neck Surgery最新文献

{"title":"Stroke Risk in Head and Neck Cancer: A Meta-analysis of Reconstructed Individual Patient Survival Data.","authors":"Eda Liew, Jing Xuan Tan, Chen Ee Low, Doreen Shu Lin Goh, Esther Yanxin Gao, Yao Hao Teo, Emilie C M de Groot, Jasper Senff, Ching-Hui Sia, Leonard Leong Litt Yeo, Anna See, Benjamin Kye Jyn Tan, Benjamin Yong-Qiang Tan","doi":"10.1002/ohn.1249","DOIUrl":"10.1002/ohn.1249","url":null,"abstract":"<p><strong>Objective: </strong>Although previous studies suggest an increased stroke risk in head and neck cancer (HNC) survivors, the risk with various treatment modalities, including radiotherapy, is less certain. This study investigates stroke incidence and risk in HNC patients, including how different treatments influence stroke risk.</p><p><strong>Data sources: </strong>A literature search of PubMed, Scopus, and Embase was conducted.</p><p><strong>Review methods: </strong>We included all primary studies assessing stroke as an outcome in HNC patients aged 18 and older, regardless of cancer subtype or treatment modality. Incidence rates were pooled by reconstructing individual patient time-to-event data from survival curves. Random-effects meta-analyses were employed to compare stroke risk between HNC patients, healthy controls, and treatment groups.</p><p><strong>Results: </strong>In total, 15 studies (N = 2,295,447 patients) were included in the analyses. Among surviving HNC patients, stroke occurred at a rate of 1% per year (10% at 10 years and 15% at 15 years cumulatively). Meta-analyses showed that HNC patients had a significantly higher stroke risk compared to healthy controls (hazard ratio [HR] = 1.45; 95% CI: 1.27-1.65; I²: 20%). Among HNC patients, radiotherapy alone increased stroke risk compared to surgery alone (HR = 1.66; 95% CI: 1.35-2.03; I²: 0%). Patients who received any form of radiotherapy had higher stroke risk compared to those without (HR = 1.47; 95% CI: 1.29-1.68; I²: 60%). Patients with definitive chemoradiotherapy had heightened stroke risk compared to patients who received definitive surgery (HR = 1.28; 95% CI: 1.09-1.49; I²: 86%).</p><p><strong>Conclusion: </strong>Patients with HNC face an elevated stroke incidence and risk, especially those treated with radiotherapy. This underscores the need for surveillance and tailored preventive strategies to reduce stroke risk in this vulnerable population.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"17-26"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin Use and Reduced Risk of Sudden Sensorineural Hearing Loss in Type 2 Diabetes.","authors":"Tse-Hsi Li, Jr-Shiang Shiu, Wan-Ming Chen, Ben-Chang Shia, Szu-Yuan Wu, Hsuan-Chih Lin","doi":"10.1002/ohn.1214","DOIUrl":"10.1002/ohn.1214","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between statin use and the risk of sudden sensorineural hearing loss (SSNHL) in patients with type 2 diabetes (T2D), focusing on statin type, dosage, and treatment duration.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Taiwan National Health Insurance Research Database.</p><p><strong>Methods: </strong>We analyzed T2D patients diagnosed between 2008 and 2019, stratified into statin users and nonusers of lipid-lowering therapy. Propensity score matching was used to balance baseline characteristics. Multivariable Cox regression, adjusted for competing risks, assessed the association between statin use and SSNHL risk, as well as all-cause mortality. Statin exposure was analyzed based on cumulative and daily doses.</p><p><strong>Results: </strong>The study cohort included 66,120 statin users and 66,120 nonusers. Statin use was associated with a significantly lower SSNHL risk (adjusted hazard ratio [aHR], 0.83; 95% CI, 0.74-0.92; P = .0008) and reduced all-cause mortality (aHR, 0.55; 95% CI, 0.52-0.57; P < .0001). A dose-response relationship was observed, with higher cumulative defined daily doses (cDDDs) linked to progressively lower SSNHL risk. Hydrophilic statins, particularly rosuvastatin, showed stronger protective effects compared to lipophilic statins.</p><p><strong>Conclusion: </strong>Statin use in T2D patients is associated with reduced SSNHL risk and all-cause mortality, with dose-dependent effects. These findings suggest the potential otoprotective benefits of statins and emphasize the importance of personalized therapy for managing both hearing and cardiovascular health in this high-risk population.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"58-68"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Sternothyroid Muscle Division on Patient-Reported Swallowing Outcomes Following Thyroid Surgery: A Prospective Study.","authors":"Joshua Barlow, Benjamin M Laitman, Juan Nogues, Susmita Chennareddy, Christine Barron, Raymond L Chai","doi":"10.1002/ohn.1253","DOIUrl":"10.1002/ohn.1253","url":null,"abstract":"<p><strong>Objective: </strong>Division of the sternothyroid muscle during thyroidectomy is a widely accepted surgical technique to provide improved exposure of the thyroid gland, superior pole vessels, and the external branch of the superior laryngeal nerve (EBSLN). Our group had previously shown no decrement in postoperative voice outcomes with this technique. However, given the known role of the strap muscles in swallowing function, this study aims to assess the impact of sternothyroid muscle division on patient-reported dysphagia.</p><p><strong>Study design: </strong>Prospective, consecutive cohort study.</p><p><strong>Setting: </strong>Single institution urban tertiary health care system.</p><p><strong>Methods: </strong>Adult patients who underwent total thyroidectomy or lobectomy with a single surgeon between November 2022 and July 2023 were enrolled. Patients with clinical evidence of significant preoperative dysphagia were excluded. Complete sternothyroid muscle division was performed in all cases. The integrity of the recurrent laryngeal nerve and EBSLN (when visualized) was confirmed through intraoperative nerve monitoring and postoperative flexible laryngoscopy. Differences between preoperative and postoperative patient-reported swallowing outcomes were assessed using the Eating Assessment Tool-10 (EAT-10).</p><p><strong>Results: </strong>A total of 114 patients were included in the study. No statistically significant difference was found between mean preoperative and postoperative EAT-10 scores (0.63 vs 0.75, P = .677). These results remained consistent regardless of sex, history of reflux, unilateral or bilateral sternothyroid muscle division, performance of substernal resection of goiter, or final histologic diagnosis.</p><p><strong>Conclusion: </strong>Division of the sternothyroid muscle during thyroidectomy can be useful in the exposure of the thyroid gland without impact on patient-perceived swallowing disturbance.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"178-184"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Toxicity Across the Thyroid Cancer Care Continuum: A Systematic Review.","authors":"Maria Armache, Rachel Stemme, Wassim Najjar, Nadia L Samaha, Madison Hearn, Stefany Lazieh, Emily Joseph, Kaitlyn Frazier, Douglas Ball, Jonathon O Russell, Carole Fakhry, Laila A Gharzai, Leila J Mady","doi":"10.1002/ohn.1241","DOIUrl":"10.1002/ohn.1241","url":null,"abstract":"<p><strong>Objective: </strong>To describe the financial toxicity (FT) associated with thyroid cancer (TC) across the care continuum and elucidate factors contributing to FT in this patient population.</p><p><strong>Data sources: </strong>PubMed, Embase, Cochrane, Web of Science, and Scopus.</p><p><strong>Review methods: </strong>A systematic review was conducted of peer-reviewed studies on FT in patients with a history of TC, between 1995 and 2024, using search terms \"thyroid cancer,\" \"financial toxicity,\" and their relevant synonyms. Full-text, English-language studies reporting subjective (self-reported FT) and objective (out-of-pocket [OOP], employment changes, and bankruptcy) FT outcomes were included.</p><p><strong>Results: </strong>A total of 927 studies were identified, with 13 meeting the inclusion criteria. Nine studies addressed subjective FT, with prevalence rates ranging from 16% to 47%. Younger age, lack of health insurance, belonging to a racial minority, and having a lower annual household income were significantly associated with increased FT. Patients with TC had higher OOP costs and bankruptcy rates compared to other cancer types or matched controls.</p><p><strong>Conclusion: </strong>Despite a generally favorable prognosis, patients with TC experience significant FT, particularly among vulnerable groups such as younger individuals, the uninsured, and racial/ethnic minorities. In the setting of the rising incidence of TC, it is essential to identify and address FT in this population. Addressing FT requires a multifaceted approach, which includes incorporating financial counseling and cost discussions in routine care, ensuring comprehensive insurance coverage, and implementing employer-level protections to mitigate income and insurance loss. Further research is needed to understand the potential financial implications of different care pathways in the treatment of TC.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1-16"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structure From Motion Reconstruction of the Pediatric Larynx: A Clinical Case Series.","authors":"Michael C Barbour, Shaunak N Amin, Hannah F Case, Seth D Friedman, Francisco A Perez, Randall A Bly, Kaalan E Johnson, Sanjay R Parikh, Clare M Richardson, John P Dahl, Alberto Aliseda","doi":"10.1002/ohn.1247","DOIUrl":"10.1002/ohn.1247","url":null,"abstract":"<p><strong>Objective: </strong>Endoscopy is the gold-standard diagnostic modality for many pediatric airway disorders but does not enable quantitative assessment of airway morphology. In a series of pediatric patients, we aim to demonstrate that structure from motion (SfM) photogrammetry, a computer-vision algorithm, can accurately reconstruct three-dimensional (3D) models of laryngeal anatomy directly from bronchoscopy videos.</p><p><strong>Study design: </strong>Prospective case series.</p><p><strong>Setting: </strong>Tertiary academic pediatric hospital.</p><p><strong>Methods: </strong>Pediatric patients undergoing direct laryngoscopy/bronchoscopy and same-day neck and chest computed tomography (CT) as a part of clinical care were recruited. Optical calibration of the imaging system occurred after each bronchoscopy. SfM was used to reconstruct 3D surfaces from bronchoscopy videos. SfM-reconstructed surfaces were compared against CT-derived geometries to determine reconstruction accuracy at glottic and subglottic levels.</p><p><strong>Results: </strong>SfM reconstruction was successfully completed for all four patients. Circular equivalent diameter (D_CE) of cross-sectional area slices measured from SfM-reconstructed airways was highly accurate compared to D_CE measured from the gold-standard CT scans, with root mean squared error of 0.1, 0.375, and 0.225 mm at the glottis, proximal subglottis, and distal subglottis subsites, respectively. This represents average percent errors of 2%, 4%, and 4%, for each site, respectively.</p><p><strong>Conclusion: </strong>We demonstrate the feasibility of reconstructing laryngeal anatomy with high fidelity from SfM photogrammetry in a clinical series of pediatric patients. This reproducible method provides highly accurate anatomic models directly from endoscopy, enabling quantitative assessment without CT scanning and radiation exposure. This approach has the potential to impact many areas of otolaryngology, including virtual surgical planning, simulation, and family counseling.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"260-267"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to Reduce Health Care Utilization for Non-English Language Preference Patients After Tonsillectomy.","authors":"Meredith Lind, Kristyn Moss, Thomas Javens, Kris Jatana","doi":"10.1002/ohn.1240","DOIUrl":"10.1002/ohn.1240","url":null,"abstract":"<p><strong>Objective: </strong>Compared with those of English language preference (ELP), patients of non-English language preference (NELP) are at increased risk of postoperative complications and health care utilization. A series of interventions were initiated to reduce utilization and improve post-tonsillectomy outcomes for NELP patients.</p><p><strong>Methods: </strong>This quality improvement (QI) study was performed at a tertiary pediatric hospital. Data collection began in 2019 and interventions, including improving translated postoperative education materials, pain medication tracking charts, direct access to interpreters, consistent tonsillectomy technique, and routine postoperative nurse phone call for education, were initiated by December 2020. Postintervention data were collected through July 2024. The primary outcome measured was return to the emergency department (ED) or urgent care (UC) with same-day discharge within 30 days post-tonsillectomy. Additional data collected included demographics, language spoken, reason for surgery, and reason for return.</p><p><strong>Results: </strong>Between January 2019 and July 2024, a total of 14,007 patients underwent tonsillectomy: 12,830 (91.6%) ELP and 1177 (8.4%) NELP. After interventions, there was a 70.2% reduction (7.73% in 2019 to 2.30% in 2024) in NELP patients who were seen and discharged same day. In 2019, NELP patients were seen significantly more often (P = .016). In 2023, there was not a statistically significant difference between the two groups (ELP = 1.28%; NELP = 2.30%, P = .55).</p><p><strong>Discussion: </strong>In our patient population, a set of thoughtful interventions for NELP patients/caregivers reduced minor, potentially unnecessary, nonoperative returns to the ED/UC.</p><p><strong>Implications for practice: </strong>Implementation may reduce complications, improve the postoperative experience for NELP patients, and reduce overall health care costs.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"278-287"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal and Geographic Trends in HPV Testing for Oropharyngeal Cancer in the United States.","authors":"Andrea Costantino, J Scott Magnuson, Evan M Graboyes, Uthman Alamoudi, Bruce H Haughey","doi":"10.1002/ohn.1259","DOIUrl":"10.1002/ohn.1259","url":null,"abstract":"<p><strong>Objective: </strong>Although human papillomavirus (HPV) testing is fundamental to staging, accurate prognosis, patient management, and clinical trial eligibility in oropharyngeal squamous cell carcinoma (OPSCC), national testing patterns remain unclear. This study investigates temporal and geographic trends in HPV DNA-RNA and/or p16 immunohistochemistry testing for OPSCC in the United States.</p><p><strong>Study design: </strong>Retrospective cohort study including patients with OPSCC between 2010 and 2021.</p><p><strong>Setting: </strong>National Cancer Database (NCDB).</p><p><strong>Methods: </strong>Logistic regression analyses were performed to characterize the association of temporal, demographic, and clinical factors with HPV testing rates.</p><p><strong>Results: </strong>Among the 146,176 patients with OPSCC and known HPV testing included in the study, the overall HPV testing rate was 88.4% (N = 129,240/146,176). Testing for HPV mediation significantly increased during the study period from 56.0% to 93.6% (adjusted odds ratio [OR]: 1.23, 95% CI: 1.22-1.24, P < .001). Significant differences were measured between geographic regions within the United States (range: 85.6%-91.2%; P < .001). Additionally, demographic, socioeconomic, and hospital-related factors were significantly associated with variations in testing rates.</p><p><strong>Conclusion: </strong>Despite significant disparities across categories, this study highlights a significant increase in HPV testing rates for OPSCC since 2010, indicating an expanded awareness of its importance in the diagnosis and management of OPSCC. Further research is warranted to address geographic and other disparities to optimize testing for refined patient outcomes.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"134-143"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144009097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who Is Diagnosing Pediatric Thyroid Nodules? A Tertiary Children's Hospital Review.","authors":"Joy M Justice, Janavi Sethurathnam, Nanda Nayak, Heidi Chen, Kalpnaben Patel, Sara Bartz, Christopher Baron, Barron Patterson, Ryan H Belcher","doi":"10.1002/ohn.1232","DOIUrl":"10.1002/ohn.1232","url":null,"abstract":"<p><strong>Objective: </strong>The incidence of pediatric thyroid cancer has increased. Little is documented about which providers are diagnosing pediatric thyroid nodules and how this impacts care. Our objective was to analyze how nodules are identified and how diagnosing provider type impacts nodule size and management.</p><p><strong>Study design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Tertiary care children's hospital.</p><p><strong>Methods: </strong>Pediatric patients (aged 0-17) with at least one thyroid nodule diagnosed between 2006 and 2023 were reviewed. Diagnosing provider type, diagnostic method, nodule size, clinical management, and final diagnosis were analyzed.</p><p><strong>Results: </strong>The study included 351 patients. Primary care providers diagnosed the largest proportion of nodules (43.0%), followed by incidental nodules by radiologists (24.2%). The proportion diagnosed by radiologists increased from 12% to 31% after 2017 (P < .001). Primary care providers were more likely to use physical exam than pediatric endocrinologists (65% vs 42%, P = .004), who more often used ultrasound (56% vs 37%, P = .02). Primary care providers diagnosed nodules with a median diameter of 1.50 cm, larger than that of pediatric endocrinologists and radiologists, both 0.8 cm (P = .01, P < .001). Compared to patients diagnosed by radiologists, patients diagnosed by primary care providers more often underwent biopsy (P = .02) or surgery (P < .001) and received a malignant diagnosis (P = .001).</p><p><strong>Conclusion: </strong>Primary care providers play a key role in detecting pediatric thyroid nodules, and a physical exam is vital in identifying significant pathology. Radiologic incidental nodules increased in frequency over our study timespan. Future research should consider the impact of socioeconomic status or geographic location on nodule size and management.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"251-259"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation Mapping to Identify Strategies to Increase Timely Postoperative Radiotherapy Initiation for Head/Neck Cancer.","authors":"Laila A Gharzai, Jaymie Bromfield, Michelle Kwan, Alexis Larson, Janine A Kingsbury, Adil Akthar, Gaurava Agarwal, Julia H Vermylen, Sara Becker, Kelli Scott, Amelia E Van Pelt, Katelyn O Stepan","doi":"10.1002/ohn.1268","DOIUrl":"10.1002/ohn.1268","url":null,"abstract":"<p><strong>Objective: </strong>Timely initiation of postoperative radiotherapy (PORT) for head and neck squamous cell carcinoma (HNSCC) is associated with improved survival, but rates of timely PORT initiation are low. To support uptake in a tertiary academic center, we aimed to identify implementation determinants (eg, barriers and facilitators) to timely PORT initiation and to design context-specific implementation strategies.</p><p><strong>Methods: </strong>We created an implementation blueprint through a sequential mixed-methods study where we (1) identified determinants by fielding a 15-item survey based on the Theoretical Domains Framework (TDF), (2) prioritized determinants through focus groups with relevant stakeholders, (3) mapped barriers to implementation strategies using the Consolidated Framework for Implementation Research (CFIR)-Expert Recommendations for Implementing Change (ERIC) matching tool, and (4) operationalized strategies using the Action, Actor, Context, Target, Time (AACTT) framework.</p><p><strong>Results: </strong>Twenty-three participants from three departments (61% Radiation Oncology, 35% Otolaryngology, 4% Medical Oncology) in a variety of roles (35% physicians, 39% nurses or advanced practice providers, 22% radiation therapists or dosimetrists, and 4% research coordinators) completed surveys. Participants identified 10 determinants affecting timely PORT initiation. After strategy selection and operationalization by focus group participants (n = 13), three ERIC strategies were selected for clinical implementation: remind clinicians, conduct educational meetings, and facilitate relay of clinical data to providers.</p><p><strong>Discussion: </strong>This work developed a menu of implementation strategies for future deployment to support timely PORT initiation. Codesign centered the voice of frontline workers, increasing the likelihood of successful implementation.</p><p><strong>Implications for practice: </strong>The systematic approaches to development can serve as a model for process improvement in other contexts.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"288-298"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Race, Ethnicity, and Language on Adenotonsillectomy Outcomes in Pediatric Otolaryngology.","authors":"Caleb M Allred, John P Dahl, Sanjay Parikh, Xing Wang, Juliana Bonilla-Velez","doi":"10.1002/ohn.1230","DOIUrl":"10.1002/ohn.1230","url":null,"abstract":"<p><strong>Objective: </strong>Disparities have been described across racial and socioeconomic groups in adenotonsillectomy access and surgical outcomes, but little is known about the impact of language. We studied the effect of race, ethnicity, and language on the frequency of postoperative rates of visits to the emergency department, hospital admissions, and return to the operating room. We hypothesized that non-white, Hispanic, and patients speaking a non-English language would have higher rates of emergency department visits, readmissions, and return to the operating room.</p><p><strong>Study design: </strong>Retrospective cohort analysis.</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Methods: </strong>Demographic and encounter data were abstracted from the hospital's data warehouse for patients who underwent adenotonsillectomy over 12 years (May 2011-June 2023). Continuous variables were compared using the Kruskal-Wallis test or Mann-Whitney U test as indicated. Categorical variables were compared using Fisher's exact test.</p><p><strong>Results: </strong>Our study included 7945 patients. Non-white patients had higher 30-day emergency department visit rates than white patients (8.6% vs 6.8%; P = .003) but comparable 30-day hospital admissions and 30-day return to the operating room rates. Hispanic and other ethnic groups had higher rates of postoperative emergency department visits (8.0%, 8.6%) compared to non-Hispanic white patients (6.8%; P = .026). Patients speaking Spanish or a different non-English language had higher 30-day emergency department visits (8.7%, 10.6%) than English-speaking patients (7.3%; P = .038). Rates of hospital admission and return to the operating room were similar across race and ethnic groups.</p><p><strong>Conclusion: </strong>Higher rates of postoperative emergency department visits were present for our patient population across racial, ethnic, and linguistic cohorts.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"237-242"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}