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Objective: Partial superficial parotidectomy (PSP) is the surgical option of choice for treating benign tumors in the superficial lobe of the parotid gland. The less invasive extracapsular parotidectomy (ECP) technique was previously described. Our goal was to review our PSP and ECP cases and compare the outcomes and complications between the surgeries.

Study design: Retrospective cohort review.

Setting: Tertiary care hospital.

Methods: We reviewed the medical records of 98 consecutive with benign parotid tumors restricted to the superficial lobe who underwent parotid surgery. The cohort was divided into 2 groups-ECP (41 patients) and PSP (57 patients). The demographics, tumor size and pathology, operative time, postoperative complications and recurrence rates were compared.

Results: No significant differences were found between the groups regarding age, gender, body mass index (BMI), and final tumor pathology. Moreover, no significant association was found between the tumor-specific pathology and the surgery type performed. The mean tumor diameter was significantly smaller in the ECP group compared to the PSP group. The operative time was significantly shorter in the ECP group than in the PSP group.

Conclusion: ECP is a safe alternative to PSP in properly selective benign parotid tumors. ECP has a significantly shorter operative time. ECP does not increase the risk of complications related to parotid surgery, including facial nerve paralysis.

Objective: The association, if any, between gene mutations, pathologic features of squamous cell carcinoma of the head and neck, and patient prognosis is unknown. This study investigates the association between common gene mutations in oral cavity squamous cell carcinoma, pathologic features of malignancy, and patient survival.

Study design: Retrospective database review.

Setting: US hospitals.

Methods: The cBioPortal for Cancer Genomics database was queried for oral cavity squamous cell carcinoma patient data. Statistical analyses were conducted using IBM SPSS v29.

Results: Of the 423 patients included, the majority were male (66.6%), white (89.3%), and current/former smokers (74.1%). Tumor protein p53 (TP53), titin (TTN), and FAT atypical cadherin 1 (FAT1) mutations were present in 72.3%, 31.2%, and 22.0% of patients, respectively. Mutant TP53 was associated with positive extranodal extension compared to wild-type (WT) TP53 (31.0% vs 18.8%) (P = .038) and perineural invasion (59.4% vs 44.3%, P = .021). High tumor mutational burden was present in 5.4% of cases. Gene mutations were not associated with differences in median overall survival or disease-free survival. Multivariable analysis revealed an association between mutant TP53 and the presence of extranodal extension (odds ratio [OR] 2.61, 95% CI 1.05-6.52, P = .039) and perineural invasion (OR 2.14, 95% CI 1.04-4.42, P = .039).

Conclusion: Mutant TP53 was associated with high-risk pathologic features, including extranodal extension and perineural invasion, but not with inferior survival. A high tumor mutational burden (>10) is rare in oral cavity squamous cell carcinoma. Further research into the interplay between genetic mutations and patient outcomes is needed.

[This corrects the article DOI: 10.1002/oto2.70173.].

Objective: Recurrent acute rhinosinusitis (RARS) significantly decreases quality of life. Transplant recipients (TR) are particularly vulnerable to rhinologic conditions. There is a lack of guidelines for managing RARS in this population. Our study aims to determine the prevalence of and risk factors for RARS among TR and assess the need for sinus surgery within this group.

Study design: Retrospective cohort.

Setting: Mayo Clinic between 2017 and 2022.

Methods: A total of 1116 patients met the inclusion criteria and were divided based on the presence or absence of a new incident RARS diagnosis during the posttransplant period and frequency of sinus surgery. Logistic regression (LR) analysis was performed to identify the odds ratio.

Results: In total, 111/1116 (9.95%) had RARS. Patients with RARS had an increased history of asthma, viral infection, and rheumatoid arthritis (RA) (P = .003) in the pretransplant period. According to the LR analysis, patients with neutropenia, RA, and mantle cell lymphoma were 1.91, 2.71, and 4.02 times more likely to develop RARS (95% CI: 1.19-3.05, P = .01), (95% CI: 0.90-8.14, P = .07), and (95% CI: 1.16-13.89, P = .02) during the posttransplant period, respectively. In those that developed RARS, only 5.5% failed medical therapy and required surgery.

Conclusion: This is the first cohort to investigate the incidence of RARS in TR and the predictive factors associated with its development posttransplant. We found that patients with pretransplant comorbidities such as RA, viral infections, hematologic deficiencies, and malignancies were at an increased risk for developing RARS, though this is not linked to an increased necessity for sinus surgery.

Objective: To identify clinical and polysomnographic factors predicting poor long-term positive airway pressure (PAP) compliance in patients with obstructive sleep apnea (OSA) in a Southeast Asian population and to develop a simple risk model applicable in routine practice.

Study design: Retrospective cohort study.

Setting: Songklanagarind Hospital, Thailand, from January 2012 to December 2022.

Methods: Adult OSA patients aged 18 to 65 years prescribed PAP therapy were included. Adherence was objectively recorded from device downloads. Good adherence was defined as ≥4 hours per night on ≥70% of nights at 12 months. Logistic regression identified predictors of poor long-term adherence.

Results: A total of 343 patients were enrolled; 253 had follow-up data at 12 months. Good adherence was observed in 47.8% of patients. In multivariate analysis, age < 50 years (odds ratio [OR] 1.92; 95% CI 1.01-3.67; P = .046) and poor short-term adherence (OR 4.47; 95% CI 2.33-8.72; P < .001) independently predicted poor long-term adherence. The resulting "AP" model (Age and Poor early adherence) achieved an area under the curve of 0.73 (95% CI 0.66-0.79), with a high specificity of 94%.

Conclusion: Although predictors of PAP adherence have been described in Western populations, this study provides the first large data set from Thailand. The AP model, while simple, is pragmatic and easily applied in resource-limited settings. Prospective, multicenter validation across Southeast Asia is warranted to enhance its generalizability and incorporate modifiable predictors.

Objective: Glucagon-like peptide 1 receptor agonists (GLP-1RA) have shown remarkable results in glycemic control for patients with type 2 diabetes (T2DM). While no association has been made, there is a concern for thyroid cancer (TC) from GLP-1RA. We aimed to study the 5-year risk of TC in T2DM patients taking GLP-1RA.

Study design: Retrospective cohort.

Setting: TriNetX database.

Methods: TriNetX was queried to identify T2DM patients between 2017 and 2019. The 5-year risk of TC in patients using GLP-1RA was compared to patients taking sodium-glucose cotransporter 2 inhibitors (SGLT-2I), metformin, and dipeptidyl peptidase 4 inhibitors (DPP-4I) after propensity score matching by demographics and comorbidities.

Results: On analysis of T2DM patients taking GLP-1RA compared to SGLT-2I, 7736 patients were in each cohort after matching. The 5-year rate of TC in patients taking GLP-1RA was 0.30% compared to 0.48% in those taking SGLT-2I (RR 0.62 (95% CI 0.37-1.05); P = .07). Analysis of GLP-1RA versus metformin yielded 5158 patients in each cohort. Patients taking GLP-1RA had similar rates of TC compared to those taking metformin (0.25% vs 0.39%; RR 0.65 (95% CI 0.32-1.31); P = .22). A comparison of GLP-1RA versus DPP-4I yielded 12,570 patients in each cohort. The rate of TC was not increased in those taking GLP-1RA compared to those taking DPP-4I (0.33% vs 0.37%; RR 0.91 (0.60-1.39); P = .67).

Conclusion: T2DM patients taking GLP-1RA may not have an increased 5-year risk of TC compared to those taking metformin, SGLT-2I, or DPP-4I. Conclusions of long-term use are limited as most GLP-1RA were approved within the last decade.

Objective: Signaling was introduced to the otolaryngology match in 2021, with 5 signals allotted to applicants in 2021, 4 in 2022, 7 in 2023, and 25 in 2024. This study investigated the modifying effect of signaling volume on the relationship between away rotations and matching in otolaryngology from 2018 to 2024.

Study design: Cross-sectional.

Setting: National survey of US medical students.

Methods: We used the Texas Seeking Transparency in Application to Residency (STAR) survey responses of otolaryngology applicants from 2018 to 2024. Using multivariate logistic regression, we determined the odds of matching where away rotations were performed and how these odds varied across the pre-volume (2018-2020), low-volume (2021-2023), and high-volume (2024) signaling eras.

Results: In total, 28.3% (n = 855) of otolaryngology applicants from 2018 to 2024 completed the Texas STAR survey. Using multivariate logistic regression, adjusting for applicant characteristics, and including an interaction term between performing away rotations and signaling time period, applicants in the high-volume signaling era were found to be significantly less likely to match at programs where away rotations were performed (odds ratio [OR]: 0.56, 95% CI: 0.33-0.95; P < .05) compared to the pre-signaling era. The same trend was seen in the low-volume signaling era, though not statistically significant (OR: 0.76, 95% CI: 0.47-1.22, P = .24). The most impactful factor on matching across all study years was performing an away rotation (OR: 12.1, 95% CI: 9.0-16.5, P < .001).

Conclusion: The introduction of signaling and the recent increase in signal number are associated with decreased likelihood of matching at a program where an away rotation was performed compared to the pre-signaling era.

Level of evidence: V.

Objective: To analyze the temporal trends and turning points of thyroid cancer burden in China from 1990 to 2021 and project future incidence and mortality to 2035.

Study design: Cross-sectional study.

Setting: Data were sourced from the Global Burden of Disease 2021 database.

Methods: Temporal trends were evaluated using Joinpoint regression, and associations between cancer burden and sociodemographic indices were explored through frontier analysis. A Bayesian Age-Period-Cohort model was applied to project future disease burden through 2035.

Results: In 2021, China reported 48,104 new thyroid cancer cases and 7692 deaths. From 1990 to 2021, the age-standardized incidence rate (ASIR) and prevalence rate (ASPR) increased markedly (average annual percentage change [AAPC]: 2.98% and 2.25%, respectively), whereas the age-standardized mortality rate (ASMR) and disability-adjusted life year rate (ASDR) declined (AAPC: -0.65% and -0.56%). A pivotal shift occurred around 2005: while ASMR and ASDR continued to decrease in both China and globally, China's ASIR and ASPR accelerated further, contrasting with a global deceleration. Projections indicate that China's ASIR for thyroid cancer is expected to increase more rapidly than the global average over the next 15 years.

Conclusion: The thyroid cancer burden in China is characterized by rapidly rising incidence and stagnating mortality decline, a pattern distinct from global trends and likely driven by intensified detection. This escalating burden necessitates public health strategies focused on optimizing screening practices and managing overdiagnosis.