The Annals of otology, rhinology, and laryngology最新文献

{"title":"Parental Views on the Role of Social Media in Pediatric Otolaryngology.","authors":"Libby M Ward,&nbsp;Chelsea A Sykora,&nbsp;Yash Prakash,&nbsp;Michael B Cohen,&nbsp;Jessica R Levi","doi":"10.1177/00034894211037413","DOIUrl":"https://doi.org/10.1177/00034894211037413","url":null,"abstract":"<p><strong>Objective: </strong>Social media is playing an increasingly important role in medicine as a tool for patients and their families to find information and connect with others. The goal of this study is to understand parental views on if and how social media should be incorporated into pediatric otolaryngology by physicians and hospitals.</p><p><strong>Methods: </strong>A survey was distributed to parents of pediatric otolaryngologic patients to assess views on professional social media use by physicians and hospitals. The proportion of parents who answered with specific responses in the survey was computed using the SPSS frequency analysis function.</p><p><strong>Results: </strong>One hundred five parents completed the survey. Ninety-six percent of respondents use social media, of which 92% use social media at least once a day (n = 93). Eighty-five percent of respondents said they definitely or probably would visit their physician's professional social media page (n = 90). Seventy-four percent would be interested in obtaining more information about the physician (n = 76). Forty-one percent would be interested in patient stories (n = 76). Twenty-eight percent would visit out of curiosity (n = 76). Twenty-six percent would want to gather more information about the hospital (n = 76). Seventeen percent would want to connect with other patients and their family members (n = 76). Sixty-seven percent of respondents believe it is important for physicians to have a professional social media page, and 79% of respondents believe it is important for hospitals to have a public social media page (n = 93).</p><p><strong>Conclusion: </strong>The vast majority of parents of pediatric otolaryngologic patients use social media regularly and would want to gather information about their physician and hospital through social media. Therefore, physicians and hospitals should consider using social media as a valuable tool to connect with and relay information to patients and their family members.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"640-646"},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39292313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recovery of Vocal Cord Motion Among Pediatric Patients.","authors":"Courtney Ann Prestwood,&nbsp;Ashley F Brown,&nbsp;Romaine F Johnson","doi":"10.1177/00034894211033366","DOIUrl":"https://doi.org/10.1177/00034894211033366","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with vocal cord paralysis can experience feeding, respiratory, and vocal problems leading to disability and decreased quality of life. Current evidence suggests waiting a period of 12 months for spontaneous recovery before permanent interventions. This study aims to determine the time to recover spontaneously and vocal cord movement in a pediatric population and create a model for evidence-based patient counseling.</p><p><strong>Study design: </strong>Retrospective longitudinal cohort study.</p><p><strong>Methods: </strong>The report is a single institution longitudinal study on vocal cord paralysis recovery. Patients were categorized based on spontaneous recovery with vocal cord movement or no recovery. Recovery rates were determined using the Kaplan-Meier method.</p><p><strong>Results: </strong>Of 158 cases of vocal cord paralysis over a 4-year period, 36 had spontaneous recovery with symptom improvement and motion return. The average recovery was 8.8 months for those who recovered, and 78% recovered within 9 months. Two groups emerged from the data: an early recovery group with spontaneous recovery before 12 months and a late recovery group after 12 months. Children with dysphonia and paralysis due to cardiac surgery were less likely to recover, and children with aspiration were more likely to recover. Children with gastrointestinal comorbidities were less likely to recover; however, those who did recover were more likely to have recovered after 12 months. Based on our model, there is about a 3% chance of recovery between 9 and 12 months.</p><p><strong>Conclusions: </strong>Patients should be counseled about earlier interventions. Waiting the conventional 12 months for only a 3% chance of spontaneous recovery without intervention or laryngeal EMG may not be the preferred option for some patients and their families.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"587-594"},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211033366","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39201179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flipping the Classroom: An Evaluation of Teaching and Learning Strategies in the Operating Room.","authors":"Jared Johnson,&nbsp;Emily Misch,&nbsp;Michael T Chung,&nbsp;Jeffrey Hotaling,&nbsp;Adam Folbe,&nbsp;Peter F Svider,&nbsp;Cristina Cabrera-Muffly,&nbsp;Andrew P Johnson","doi":"10.1177/00034894211036859","DOIUrl":"https://doi.org/10.1177/00034894211036859","url":null,"abstract":"<p><strong>Objectives: </strong>With increasing restraints on resident's experiences in the operating room, with causes ranging from decreased time available to increasing operating room costs, focus has been placed on how to improve resident's education. The objectives of our study are to (1) determine barriers in education in the operating room, (2) identify effective learning and teaching strategies for residents in the operating room with a focus on the tonsillectomy procedure.</p><p><strong>Methods: </strong>An online survey was sent to all otolaryngology residents and residency programs for which contact information was available from January 2016 to March 2016 with 139 respondents. The 12-question survey focused on information regarding limitations to learning how to perform tonsillectomies as well as difficulties with teaching the same procedure. Resident responses were separated based on PGY level, and analysis was performed using <i>t</i>-tests and Chi squared analysis.</p><p><strong>Results: </strong>Common themes emerged from responses for both teaching and learning how to perform tonsillectomies. A significant limitation in learning the procedure was lack of visualization during the surgery (57% learning vs 60% teaching). For both learners and teachers, the monopolar cautery instrument was found to be the most preferred instrument to use during tonsillectomy (80% each). The majority of resident respondents (93%) felt that an instructional video would be beneficial for both learning and teaching the procedure.</p><p><strong>Conclusions: </strong>Significant limitations for learning and teaching in the operating room were identified for performing tonsillectomies. Future endeavors will focus on resolving these limitations to improve surgical education.</p><p><strong>Evidence level: </strong>Level IV.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"573-578"},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211036859","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39277250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining Medical Urgency of Voice Disorders Using Auditory-Perceptual Voice Assessments Performed by Speech-Language Pathologists.","authors":"Robert Brinton Fujiki,&nbsp;Peter W Sanders,&nbsp;M Preeti Sivasankar,&nbsp;Stacey Halum","doi":"10.1177/00034894211032779","DOIUrl":"https://doi.org/10.1177/00034894211032779","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether speech-language pathologist auditory-perceptual voice assessments can predict the medical urgency of voice disorders.</p><p><strong>Methods: </strong>Twenty speech-language pathologists (SLPs) evaluated 25 voice samples recorded during initial voice evaluations. Voice samples represented a range of dysphonia severity (mild-severe) balanced across patient diagnoses. Diagnoses included: benign lesions, laryngeal cancer, non-organic voice disorders, laryngeal edema (associated with LPR), and laryngeal paralysis or paresis. Laryngeal cancer and severe unilateral laryngeal paralysis were considered urgent disorders. While blinded to patient information, SLPs rated severity of voice quality, predicted patient diagnosis, and determined whether the patient should be seen urgently by a laryngologist. SLPs were then given basic medical history information and rated medical urgency of voice disorder a second time.</p><p><strong>Results: </strong>On average, SLPs correctly identified 65% of urgent voices and 87% of nonurgent voices when blinded to patient information. Accuracy improved significantly to 86% for urgent voices with medical history information (<i>P</i> < .001) and decreased to 77% for nonurgent voices. Accuracy was better when severity of voice quality was severe for urgent voices and mild for nonurgent voices (<i>P</i> < .001). SLPs indicated that patient smoking history and severity of dysphonia were most influential in their decision making. Diagnostic accuracy of auditory-perceptual assessments was poor.</p><p><strong>Conclusions: </strong>SLPs identified 86% of medically urgent voice disorders when auditory perceptual assessments were combined with medical history information. Further work is needed to determine what medical history information is most crucial to rating accuracy and what speech tasks might best separate urgent and nonurgent patients.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"579-586"},"PeriodicalIF":1.4,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211032779","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multi-Disciplinary Skull Base Conference and its Effects on Patient Management.","authors":"Nathan Kemper,&nbsp;Scott B Shapiro,&nbsp;Allie Mains,&nbsp;Noga Lipschitz,&nbsp;Joseph Breen,&nbsp;John Michael Hazenfield,&nbsp;Mario Zuccarello,&nbsp;Jonathan Forbes,&nbsp;Ravi N Samy","doi":"10.1177/00034894211021251","DOIUrl":"https://doi.org/10.1177/00034894211021251","url":null,"abstract":"<p><strong>Objective: </strong>Examine the effects of a multi-disciplinary skull base conference (MDSBC) on the management of patients seen for skull base pathology in a neurotology clinic.</p><p><strong>Methods: </strong>Retrospective case review of patients who were seen in a neurotology clinic at a tertiary academic medical center for pathology of the lateral skull base and were discussed at an MDSBC between July 2019 and February 2020. Patient characteristics, nature of the skull base pathology, and pre- and post-MDSBC plan of care was categorized.</p><p><strong>Results: </strong>A total of 82 patients with pathology of the lateral skull base were discussed at a MDSBC during an 8-month study period. About 54 (65.9%) had a mass in the internal auditory canal and/or cerebellopontine angle while 28 (34.1%) had other pathology of the lateral skull base. Forty-nine (59.8%) were new patients and 33 (40.2%) were established. The management plan changed in 11 (13.4%, 7.4-22.6 95% CI) patients as a result of the skull base conference discussion. The planned management changed from some form of treatment to observation in 4 patients, and changed from observation to some form of treatment in 4 patients. For 3 patients who underwent surgery, the planned approach was altered.</p><p><strong>Conclusions: </strong>For a significant proportion of patients with pathology of the lateral skull base, the management plan changed as a result of discussion at an MDSBC. Although participants of a MDSBC would agree of its importance, it is unclear how an MDSBC affects patient outcomes.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"277-280"},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211021251","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39029210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Approach for the Treatment of Sialolithiasis that Preserves Salivary Duct Anatomy.","authors":"Gani Atilla Şengör,&nbsp;Ahmet Mert Bilgili","doi":"10.1177/00034894211018926","DOIUrl":"https://doi.org/10.1177/00034894211018926","url":null,"abstract":"<p><strong>Objective: </strong>The sialendoscopy era in the treatment of salivary gland stones has reduced the use of classical surgical methods. However, the miniature ducts and tools may cause difficulties in removing large sialoliths. Therefore, invasive combined oral surgeries or gland resection may be considered. We searched for the most suitable method in order to stay in line with the minimally invasive approach that preserves the ductus anatomy, and that can reduce the surgical fears of patients.</p><p><strong>Materials and methods: </strong>The study included 84 cases (23 parotid and 61 submandibular) in whom stones were fragmented by pneumatic lithotripsy and removed between January 2015 and January 2020. The parotid cases comprised 7 females and 16 males, and the submandibular cases comprised 25 females and 36 males. Intraductal lithotripsy was performed using pneumatic lithotripter. This study has fourth level of evidence.</p><p><strong>Results: </strong>Based on total number of cases (n = 84), success rate was 67/84 (79.7%) immediately after sialendoscopy, and overall success rate was 77/84 (91.6%). Based on number of stones treated (n = 111), our immediate success rate was 94/111 (84.6%), and overall success rate was 104/111 (93.7%). The success criteria were complete removal of the stone and fragments in a single sialendoscopy procedure and resolution of symptoms.</p><p><strong>Conclusions: </strong>We successfully treated salivary gland stones, including L3b stones, in our patient cohort with sialendoscopy combined with pneumatic lithotripsy. The lithotripsy method that we have adapted seems to be more useful and cost-effective compared to its alternatives. We were also able to preserve the ductus anatomy and relieve patients' concerns.<b>Level of Evidence:</b> Level IV.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"268-276"},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211018926","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38948689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Use of the Buccal Fat Pad for Sinocutaneous Fistulae Closure and a Review of Reconstructive Options.","authors":"Christopher Pool,&nbsp;Neerav Goyal,&nbsp;Jessyka G Lighthall","doi":"10.1177/00034894211014299","DOIUrl":"https://doi.org/10.1177/00034894211014299","url":null,"abstract":"<p><strong>Background: </strong>Sinocutaneous fistulae (SCF) are abnormal communications between the paranasal sinuses and the overlying skin. They may be difficult to manage due to facial geometry, scar contraction, and poor tissue vascularity. We describe a novel use of the buccal flap and review the literature to examine management options for this disease process.</p><p><strong>Methods: </strong>A PubMed/MEDLINE literature search was performed for studies published between January 1, 1950 and April 29, 2020 that describe management strategies for SCF. The clinical record, imaging, and operative reports were reviewed of the case in which the buccal fat flap was used in reconstruction.</p><p><strong>Results: </strong>A total of 359 articles were retrieved. After removing duplicate articles, non-English studies, animal studies, duplicate articles and studies that mentioned SCF without specific mention of management strategies, 51 articles were reviewed. Management paradigms throughout the articles include (1) removal of infection, (2) ensuring patency of sinus outflow tracts, (3) tensionless multilayered closure using well vascularized tissue, and (4) prevention or minimization of future risk factors for fistula formation.</p><p><strong>Conclusion: </strong>This article informs surgeons on reconstructive options for sinocutaneous fistulae including a novel description of the buccal fat flap.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"295-302"},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211014299","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39016258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Operative Dysphagia in Anterior Cervical Discectomy and Fusion.","authors":"Leonard Haller,&nbsp;Khush Mehul Kharidia,&nbsp;Caitlin Bertelsen,&nbsp;Jeffrey Wang,&nbsp;Karla O'Dell","doi":"10.1177/00034894211015582","DOIUrl":"https://doi.org/10.1177/00034894211015582","url":null,"abstract":"<p><strong>Objective: </strong>We sought to identify risk factors associated with long-term dysphagia, characterize changes in dysphagia over time, and evaluate the incidence of otolaryngology referrals for patients with long-term dysphagia following anterior cervical discectomy with fusion (ACDF).</p><p><strong>Methods: </strong>About 56 patients who underwent ACDF between May 2017 to February 2019 were included in the study. All patients were assessed for dysphagia using the Eating Assessment Tool (EAT-10) survey preoperatively and late postoperatively (≥1 year). Additionally, 28 patients were assessed for dysphagia early postoperatively (2 weeks-3 months). Demographic data, medical comorbidities, intraoperative details, and post-operative otolaryngology referral rates were collected from electronic medical records.</p><p><strong>Results: </strong>Of the 56 patients enrolled, 21 patients (38%) had EAT-10 scores of 3 or more at long-term follow-up. None of the demographics, comorbidities, or surgical factors assessed were associated with long-term dysphagia. Patients who reported no long-term dysphagia had a mean EAT-10 score of 6.9 early postoperatively, while patients with long-term symptoms had a mean score of 18.1 (<i>P</i> = .006). Of the 21 patients who reported persistent dysphagia symptoms, 3 (14%) received dysphagia testing or otolaryngology referrals post-operatively.</p><p><strong>Conclusion: </strong>Dysphagia is a notable side effect of ACDF surgery, but there are no significant demographics, comorbidities, or surgical risk factors that predict long-term dysphagia. Early postoperative characterization of dysphagia using the EAT-10 questionnaire can help predict long-term symptoms. There is inadequate screening and otolaryngology follow-up for patients with post-ACDF dysphagia.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"289-294"},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211015582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38983829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pembrolizumab Induced Acute Persistent Airway Disease in a Patient with Recurrent Respiratory Papillomatosis (RRP).","authors":"Kathryn Marcus,&nbsp;Daniel J Lee,&nbsp;Jeffrey S Wilson,&nbsp;Richard J H Smith,&nbsp;Michael Puricelli","doi":"10.1177/00034894211021276","DOIUrl":"https://doi.org/10.1177/00034894211021276","url":null,"abstract":"<p><strong>Objective: </strong>To present an uncommon but serious, recently identified complication of checkpoint inhibitor therapy in a patient treated with pembrolizumab infusion for disseminated recurrent respiratory papillomatosis (RRP).</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A 43-year-old woman with underlying asthma developed acute hypoxic respiratory failure within 24 hours of her third infusion of pembrolizumab for treatment of intractable, disseminated recurrent respiratory papillomatosis. Pulmonary function testing revealed a severe intra-thoracic obstructive ventilatory defect. Discontinuation of pembrolizumab, ventilatory support, and treatment with systemic and inhaled corticosteroids resulted in resolution of respiratory failure; however, her underlying asthma remains poorly controlled.</p><p><strong>Conclusion: </strong>To our knowledge, this case is the first report of pembrolizumab-induced obstructive respiratory failure in a patient being treated for RRP.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"331-336"},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211021276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38955197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oropharyngeal Carcinoma Treated with Surgery Alone: Outcomes and Predictors of Failure.","authors":"Joshua D Waltonen,&nbsp;Sydney G Thomas,&nbsp;Gregory B Russell,&nbsp;Christopher A Sullivan","doi":"10.1177/00034894211021287","DOIUrl":"https://doi.org/10.1177/00034894211021287","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the oncologic outcomes and risk factors for recurrence in patients who underwent surgery for oropharyngeal squamous cell carcinoma (OPSCC), and in whom adjuvant therapy was not recommended or was declined.</p><p><strong>Methods: </strong>Retrospective cohort study of patients with OPSCC who were treated with transoral surgery only at a tertiary care academic medical center from April 2010 to March 2019.</p><p><strong>Results: </strong>Seventy-four patients met inclusion criteria. In 16, adjuvant therapy was recommended but declined. There were 8 recurrences, of which 6 had been given recommendations for adjuvant therapy. Of the 8 recurrences, 2 died, 2 are alive with disease, and 4 were successfully salvaged. Five patients died of unrelated causes. Lymphovascular invasion (LVI, <i>P</i> = .016) had a significant impact on recurrence, while other pathologic features of the primary tumor such as size, location, human papillomavirus (HPV) status, and margin status did not. Margins were classified as \"positive\" in 4 patients, \"close\" in 54, and \"negative\" in 16. There were 3 local recurrences (4.1%), each of whom had declined adjuvant therapy. Lymph node features such as N-stage (<i>P</i> = .0004), number of positive nodes (<i>P</i> = .0005), and presence of extra-nodal extension (ENE, <i>P</i> = .0042) had a statistically significant impact on relapse. Smoking history and surgical approach showed no significant impact on recurrence.</p><p><strong>Conclusion: </strong>Patients who undergo surgery for HPV-positive OPSCC with negative margins, no PNI, no LVI, and ≤1 positive lymph node without ENE have low risk for recurrence. These patients can likely be safely treated with surgery alone. Patients with these risk factors who decline adjuvant therapy are at risk for recurrence, and should be monitored.</p>","PeriodicalId":520787,"journal":{"name":"The Annals of otology, rhinology, and laryngology","volume":" ","pages":"281-288"},"PeriodicalIF":1.4,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/00034894211021287","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38955200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}