NIH Funding within Otolaryngology: 2005-2014.

Objective Analyze grants awarded between 2005 and 2014 to otolaryngology departments that appear in the National Institutes of Health (NIH) RePORTER database, summarize characteristics of grant recipients associated with otolaryngology departments as listed in the RePORTER between 2005 and 2014, and identify trends in otolaryngology NIH funding between 2005 and 2014 by topic. Study Design Case series. Setting NIH database inquiry. Subjects Grant recipients. Methods The RePORTER was queried for all grants awarded to otolaryngology departments between 2005 and 2014. All grants classified as new, renewal, or revision were included while duplicates were excluded. Results In total, 475 grants to 51 institutions were categorized by topic and subtopic. Internet searches were conducted for characteristics of 352 principal investigators. Sixty-seven percent of awardees had a PhD, 22% had an MD, and 11% had an MD/PhD. Sex ratios varied by degrees held. Although 31% of all grant recipients were women, this ratio was not seen when recipients were classified by degree type, with 78% of women holding a PhD compared with 55% of men ( P = .0013). Of the award types, 39% were R01s, 15% were R21s, and 10% were R03s. The top 3 represented topics were otology/neurotology (52%), audiology (25%), and head and neck surgery (14%). The mean annual award amount, after adjusting for inflation to 2014 dollars, was $226,495.76, with 72.8% awarded by the National Institute of Deafness and Communication Disorders. Twenty percent of awardees received multiple grants. Conclusion NIH funding in otolaryngology tends to be awarded to those with PhDs studying the hearing sciences, with 1 in 5 having multiple awards. As in other areas of NIH funding, women are underrepresented overall.

Dysphagia Following Airway Reconstruction in Adults.

IMPORTANCE: Patients who undergo open airway reconstruction procedures are likely to experience some degree of postoperative dysphagia symptoms and delayed return to oral intake. OBJECTIVE: To review the duration of postoperative dysphagia symptoms and outcomes in a group of adult patients. DESIGN, SETTING, AND PARTICIPANTS: Retrospective review of the medical records of adult patients undergoing laryngotracheoplasty, posterior cricoid split laryngoplasty, tracheal resection, and cricotracheal resection in a tertiary hospital between July 2009 and September 2014. EXPOSURES: Laryngotracheoplasty, posterior cricoid split laryngoplasty, tracheal resection, and cricotracheal resection. MAIN OUTCOMES AND MEASURES: Demographic characteristics, etiology of airway stenosis, surgical procedure, stent type, and duration of dysphagia symptoms. RESULTS: Thirty-eight patients (14 men, 24 women; mean [SD; range] age, 48 [14.4; 20-80] years) fitting the inclusion criteria were identified. Twenty-four (63%) patients had laryngotracheal stenosis secondary to prolonged intubation, with 3 (8%), 5 (13%), and 6 (16%) cases being due to autoimmune, idiopathic, or other etiology, respectively. Twenty-five (66%) patients underwent tracheal or cricotracheal resection, and 13 (34%) underwent laryngotracheoplasty or posterior cricoid split laryngoplasty. Of the 17 patients with stents placed, 6 (35%) patients had a suprastomal stent sewn at the top with a polypropylene suture using a horizontal mattress technique, 6 (35%) patients had a suprastomal stent capped with an extended Silastic thoracic T-tube segment, and 5 (29%) patients had either a T-tube or hood bronchial stent. Eight of 17 patients used a nasogastric feeding tube while the stent was in place (up to 5 weeks). All patients returned to their preoperative diet. The mean (SD) duration of dysphagia symptoms in all patients (both those without a stent and following stent removal) was 8 (27.2) days (median, 1.5 days). The mean (SD) duration of dysphagia symptoms in patients who did not have a stent placed was 4.8 (5.3) days (median, 4 days). CONCLUSIONS AND RELEVANCE: In this study of adults who underwent open airway reconstruction, all returned to their preoperative diet, but those without stents had a shorter duration of dysphagia symptoms than those with stents. Approximately half as many patients with a stent had a prolonged course with dysphagia symptoms compared with those without a stent.