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Objective: Mohs micrographic surgery (MMS) and subsequent reconstructive procedures for the treatment of facial nonmelanoma skin cancers (NMSCs) significantly impact quality of life (QoL). A validated patient-reported outcome measure (PROM) for patients who undergo Mohs reconstruction is not yet established. This study aims to systematically assess the quality of existing PROMs to determine their effectiveness in capturing the challenges faced after Mohs reconstruction for facial NMSC.

Data sources: A systematic review following established Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines was performed. Medline, PubMed, Scopus, and Cochrane databases were searched using keywords relevant to MMS, NMSC, facial reconstruction, QoL, and PROMs.

Review methods: Inclusion and exclusion criteria were used to compile eligible PROMs. Methodological quality and psychometric properties of PROMs were evaluated using COnsensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria.

Results: Of 2997 articles, 78 met the inclusion criteria. Of these, 45 studies utilized a PROM as an outcome measure, and 33 reported PROM development or validation. COSMIN assessment demonstrated that the FACE-Q Skin Cancer Module and Facial Skin Cancer Index have the strongest validation. The Mohs Reconstruction Questionnaire-12 (MRQ-12) was the only PROM specific to this population of interest; however, it has not undergone psychometric property assessment.

Conclusion: Various PROMs have been utilized to assess QoL for patients undergoing facial reconstructive surgery after MMS. A clinically validated PROM specific to this patient population is required to gain deeper insight into these emotional impacts. Further validation and psychometric testing of the MRQ-12 may be beneficial.

Objective: Nasal surgery can improve patient-reported obstructive sleep apnea (OSA) outcomes as well as adherence with medical device treatments. The aim of this study was to examine whether previous nasal surgery was associated with hypoglossal nerve stimulation (HNS) therapy outcomes.

Study design: Retrospective observational cohort study was performed utilizing the multicenter international HNS registry (ADHERE).

Methods: Propensity score matching generated a cohort of HNS patients with prior nasal surgery (NS) and a comparable cohort without prior nasal surgery (WNS). Data included demographics and therapy outcome measures including apnea-hypopnea index (AHI), Epworth Sleepiness Scale (ESS), therapy use, and responder rate. Student's t-test was used to compare normally-distributed numeric data, Fisher's exact test to compare categorical data, and 1-sided t-tests to determine noninferiority.

Results: From the ADHERE dataset, 169 HNS patients were identified and matched from each cohort. AHI reduction was 21.01 ± 17.94 in the WNS cohort and 18.39 ± 16.4 in the NS cohort (P = .162). ESS reduction in the WNS cohort was 4.85 ± 4.98 and 4.48 ± 5.83 in the NS cohort (P = .528). Therapy use was similar, 5.67 ± 1.95 in WNS and 5.97 ± 2.06 in NS (P = .181). Responder rate was also similar in WNS (64.5%) and NS (62.1%) groups (P = .735).

Conclusion: Prior nasal surgery was not a predictor of HNS therapy response or adherence. Future prospective studies of HNS candidates with nasal airway obstruction may better determine the role of adjunctive nasal surgery in this population.

Objective: To characterize neighborhood-level area deprivation's association with oropharyngeal carcinoma clinicodemographics, tumor staging, recurrence, and overall survival.

Study design: Retrospective study.

Setting: Single institution academic medical center.

Methods: Patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC) between 2007 and 2022 at our institution were included in this study. The Area Deprivation Index (ADI) was used to quantify neighborhood-level disadvantage based on patients' primary residence at the time of their diagnosis. Continuous variables were compared between groups using the Wilcoxon rank sum test. For categorical variables, proportions were compared using Fisher's exact test. Overall survival (OS) and recurrence-free survival (RFS) distributions were estimated using the Kaplan-Meier method and log-rank test. OS and RFS were further assessed by univariable and multivariable analyses performed using the Cox proportional hazards model.

Results: The higher ADI (more disadvantaged) group consisted of a significantly greater proportion of Black race (P < .001), 10+ pack-year smoking history (P = .003), and Medicare patients (P = .018). On logistic regression analysis, neither ADI nor other social factors were significantly associated with increased likelihood of advanced clinical staging in the p16 positive OPSCC population. Furthermore, while ADI did not correspond with significant differences in survival, multivariate cox regression model demonstrated that "Other" insurance type (Medicaid and uninsured) (hazard ratio [HR] = 10.1, P = .008), age at diagnosis (1.10, P < .001), and advanced clinical staging (HR = 3.25, P = .004) were all significantly associated with increased HR of death.

Conclusion: While ADI may not be significantly associated with outcomes in HPV-related OPSCC patients, this study revealed significant sociodemographic and risk factor differences across ADIs, as well as individual factors influencing prognosis. These findings emphasize the need for a comprehensive approach to understanding factors influencing HPV-related OPSCC incidence and prognosis.

Objective: Assessing the quality of human papillomavirus (HPV) vaccination-related content on TikTok is crucial due to its popularity among adolescents. We assessed these videos while comparing the content and quality of videos with and without physician involvement.

Study design: Cross-sectional cohort analysis.

Setting: HPV vaccination-related TikTok videos.

Methods: The TikTok library was queried using the search terms #HPVvaccine, #HPVvaccination, #Gardasil, #Gardasilvaccine, and #Gardasilvaccination. Video quality was evaluated using the DISCERN scale, assessing treatment-related information quality. Descriptive statistics were used to characterize our cohort. t Test and Fischer's exact test were used to assess for differences in video content and quality based on physician involvement. Significance was set at P < .05.

Results: Our search yielded 131 videos, averaging 68,503.12 views, 2314.27 likes, and 89.28 comments per video. Videos frequently involved physicians (48.09%), focused on education (54.96%) or advocacy (22.90%), and were US-made (68.90%). Otolaryngologists were rarely featured (3.17%). While most videos mentioned the HPV vaccine protected against cancer generally (86.26%), and cervical cancer specifically (67.94%), few discussed its protective effect against head and neck cancer (26.72%). Videos infrequently discussed updated eligibility among all adults ≤45 years of age (26.72%) or that men can also receive the vaccine (28.24%). Physician-involved videos were more focused on education (P < .001) and focused less on patient experiences (P < .001) and advocacy (P = .036). Overall DISCERN scores were low among physician (mean = 2.46, SD = 1.13) and nonphysician (mean = 2.09, SD = 1.02) content.

Conclusion: TikTok HPV vaccination content is poor in quality, even with physician involvement. Enhancing content quality and increasing otolaryngologist participation can boost HPV awareness and vaccination rates.

We present O-T advancement reconstruction (OTAR) in lateral tongue defects, describing technique, indications, outcomes, and limitations. 11 patients with lateral tongue defects who underwent OTAR after earlystage cancer removal. Demographics, staging, functional oral intake scale (FOIS), dysphagia outcome severity scale (DOSS), defect size, and complications were included. Functional outcomes assessed through telephone encounters. Preoperative FOIS and DOSS were 6.9 and 6.8, postoperatively were 4.8 and 5. Mean defect of 4.7 cm × 3.4 cm. Nine patients required nasogastric tubes postoperatively. Site complications included 2 minor dehiscence. By telephone, tongue-biting was reported in 3, mild dysarthria in 3, and food impaction in 2. FOIS and DOSS were 6.7 and 6.5. Reconstruction of tongue defects may be achieved with OTAR as a reliable alternative to primary closure or even more complex microvascular techniques. Utilization may preserve functional swallowing and speech outcomes, most probably due to lateral sulcus sparing features.

Objective: This study investigates ChatGPT's accuracy, readability, understandability, and actionability in responding to patient queries on sudden sensorineural hearing loss (SSNHL) in English and Spanish, when compared to Google responses. The objective is to address concerns regarding its proficiency in addressing medical inquiries when presented in a language divergent from its primary programming.

Study design: Observational.

Setting: Virtual environment.

Methods: Using ChatGPT 3.5 and Google, questions from the AAO-HNSF guidelines were presented in English and Spanish. Responses were graded by 2 otolaryngologists proficient in both languages using a 4-point Likert scale and the PEMAT-P tool. To ensure uniform application of the Likert scale, a third independent evaluator reviewed the consistency in grading. Readability was evaluated using 3 different tools specific to each language. IBM SPSS Version 29 was used for statistical analysis using one-way analysis of variance.

Results: Across both languages, the responses displayed a native-level language proficiency. Accuracy was comparable between sources and languages. Google's Spanish responses had better readability (effect size 0.35, P < .001), while Google's English responses were more understandable (effect size 0.67, P = .018). ChatGPT's English responses demonstrated the highest level of actionability (60%), though not significantly different when compared to other sources (effect size 0.47, P = .14).

Conclusion: ChatGPT offers patients comprehensive and guideline-conforming answers to SSNHL patient medical queries in the 2 most spoken languages in the United States. However, improvements in its readability and understandability are warranted for more accessible patient education.

Objective: Online patient portals are important tools for patient engagement, and their use has increased particularly since the COVID-19 pandemic and the 21st Century Cures Act. However, prior work across various specialties has demonstrated disparities in patient portal usage with respect to age, gender, race, and insurance status. However, this has not been studied in the field of otolaryngology, and not since the onset of the COVID-19 pandemic.

Study design: Retrospective study.

Setting: Single tertiary care outpatient otolaryngology practice over a 3-year period (December 2019-December 2022).

Methods: We used univariate and multivariate analyses to measure how patient portal use for appointment scheduling varied before and after the COVID-19 pandemic and across demographic groups including gender, race, age, primary language, insurance type, and primary care physician (PCP) status (Loyola vs non-Loyola).

Results: From December 2019 to December 2022, 49,462 unique patients scheduled 221,611 otolaryngology clinic visits. Significantly more online scheduling occurred after the onset of the COVID-19 pandemic (10.7% vs 1.9%, P < .01). In multivariate analysis, male gender, age <18 or >65 years, non-English primary language, and outside PCP were all associated with a lower likelihood of online appointment scheduling (P < .01 for each). Patients with Medicare had higher odds of portal use than commercially insured patients when controlling for other demographic variables (P = .034).

Conclusion: Patient portal use in otolaryngology has markedly increased over the last 3 years, but utilization varies across demographic groups. This provides an opportunity to improve patient portal content and outreach, and ultimately make portals more accessible to diverse patient populations.

Objective: The development of health applications (apps) includes those for testing hearing, although most of them are available only in English. This study investigates whether poor English language proficiency creates a barrier for Polish users in the accuracy of such an app in measuring self-determined hearing thresholds.

Study design: The study compared hearing thresholds measured by an English-language app and a professionally conducted reference test, with attention to participants' English proficiency and age.

Setting: The English-language app "Hearing test, Audiogram," was used to determine hearing thresholds. A reference test was performed by an audiologist using specialized equipment.

Methods: Participants were 87 nonnative English language speakers aged 16 to 88. They were divided into 3 groups based on their proficiency in English: no knowledge (Group 1), basic (Group 2), and advanced (Group 3). The mean differences between hearing thresholds determined using the app and the reference tests were measured for each group.

Results: The accuracy of the results varied according to the level of English proficiency. A statistically significant difference was found between Group 1 (no knowledge) and Group 3 (advanced), with mean differences of 13.6, 9.3, and 6.7 dB for Groups 1, 2, and 3, respectively, meaning that discrepancies were larger in the less proficient groups. However, when participant age was considered, language proficiency was less important and was no longer a significant factor.

Conclusion: This study revealed that English language proficiency does affect the accuracy of mobile app-based hearing tests, but age of the user is also important.

Objective: Patients undergoing surgery commonly experience anxiety during their procedure which can negatively affect surgical outcomes. Music therapy has emerged as a promising noninvasive approach to reducing anxiety particularly in patients undergoing otolaryngology procedures.The objective of this study is to evaluate the effectiveness of music therapy on anxiety and pain during these procedures.

Data sources: PubMed and Embase.

Review methods: A systematic search was conducted using the PRISMA approach to retrieve articles published between 1980 and March 2024. The search terms were applied to PubMed and Embase databases. The search term yielded a total of 669 articles on PubMed and 1027 articles on Embase, 5 of which met the inclusion criteria.

Results: Five studies consisting of 4 randomized controlled trials and one case-control studies were included in our study, resulting in a total of 381 patients undergoing various otolaryngology procedures. Music therapy was found to reduce preoperative, perioperative, and postoperative anxiety and pain levels compared to control groups. Furthermore, patients who received music therapy experienced improvements in physiological parameters such as heart rate and blood pressure, indicating a positive impact on stress.

Conclusion: Music therapy offers a potentially cost-effective and noninvasive method of reducing anxiety and pain in otolaryngological surgery patients. Our study indicates that music therapy can serve as a valuable addition to traditional pharmacological approaches in managing surgery-related anxiety and pain. However, more research is needed to standardize music therapy protocols and compare its effect in comparison to other nonpharmacologic and pharmacologic modalities to optimize care for patients.