Internet and social media research by parents of pediatric otolaryngologic patients.

PURPOSE: Public access to medical information has increased dramatically with the growth and accessibility of the Internet. The goal of this study is to characterize how parents use the Internet to understand and make decisions about their child's otolaryngologic surgery. MATERIALS AND METHODS: A survey was distributed to parents of pediatric patients undergoing otolaryngologic procedures to assess if and how parents gather information about their child's surgery. RESULTS: 105 parents completed the survey. 59.4% of parents gathered online information about their child's surgery. 86% of these parents used Google, 36% used YouTube, 16% used Wikipedia, and 9% used a hospital website. Most searched for general information about the surgery, followed by risks, pain/recovery, and specifics about the surgery. 69% reported that the information found influenced the healthcare decisions they made for their child. 86% felt the information was trustworthy. 21% discussed the information with their child's surgeon. 17% gathered information about their child's surgeon, of which 73% were interested in the surgeon's experience. 69% reported this influenced their choice of surgeon. CONCLUSIONS: Most parents of pediatric otolaryngologic patients use the Internet to gather information about their child's surgery, view that information as accurate, and use that information to make healthcare decisions. However, less than one quarter of parents discuss the information with their child's surgeon. It is critical to understand how parents use the Internet for healthcare information so otolaryngologists can better direct their patients' parents to appropriate and accurate resources.

Differential diagnosis and management of adult-onset laryngomalacia.

OBJECTIVE: Adult-onset laryngomalacia is a rare clinical entity that has been infrequently reported. This study aims to evaluate the clinical presentation, diagnosis, and management of adult-onset laryngomalacia through literature review and report of a case. METHODS: PubMed and Google Scholar databases were queried for articles published from 1960 to 2019 including only patients aged 18 years and older. Included keywords were: 'laryngomalacia', 'adult laryngomalacia', 'acquired laryngomalacia', 'idiopathic laryngomalacia', 'laryngeal obstruction', 'floppy epiglottis', 'floppy epiglottis', and 'epiglottis prolapse'. Data extracted from literature included clinical presentation, diagnostic workup, surgical management, and follow-up care. SOURCES: PubMed and Google Scholar. RESULTS: A total of 21 articles reported 41 cases of adult-onset laryngomalacia. Within these cases, 5 etiologies were identified: neurologic (n = 14), exercise-induced (n = 9), post-operative (n = 7), idiopathic (n = 7), and age-related (n = 4) laryngomalacia. Anterior prolapse of arytenoids and aryepiglottic folds was the most common laryngoscopic finding (n = 21), followed by posterior epiglottic prolapse (n = 20). Management included supraglottoplasty (n = 14), epiglottidectomy (n = 8) or epiglottopexy (n = 2). Neurologic etiology required tracheotomy more often than the other etiologies (n = 5, 36% vs. 15%). Three patients were managed expectantly without surgical intervention and reported symptom resolution. CONCLUSION: Adult laryngomalacia is a rare diagnosis comprising a spectrum of disease. This diagnosis may be overlooked, but association with neurologic injury or trauma should encourage consideration. In comparison to pediatric laryngomalacia, patients often require surgical intervention. Surgical decision is based on the direction of supraglottic collapse, where supraglottoplasty and partial epiglottidectomy are effective interventions. LEVEL OF EVIDENCE: N/A.

The Use of Race and Socioeconomic Status Variables in Published Otolaryngologic Research.

OBJECTIVE: To characterize the use of race and socioeconomic status (SES) variables in clinical otolarynogologic research. METHODS: Databases were queried for all articles published in 2016 issues of 5 major otolaryngologic journals. One thousand, one hundred and forty of 1593 articles abstracted met inclusion criteria for analysis. RESULTS: In total, 244 (21.4%) studies specified race as a variable. The subspecialty of Head and Neck cancer specified race at statistically higher rates compared to other subspecialties (P = .002). Two hundred nine (34.0%) domestic studies specified race compared to 35 (6.7%) international studies. Of the 244 studies that specified race, 79 (32.4%) defined race using racial and ethnic categories interchangeably. Two hundred twenty-four (91.8%) studies reported data by race, 145 (59.4%) analyzed the data, and 112 (45.9%) discussed race-based results.In total, 94 (8.2%) studies specified SES. All subspecialties specified SES at statistically similar rates. Seventy (11.4%) domestic studies specified SES compared to 24 (4.6%) international studies. Of the 94 studies that specified SES, 42 (44.7%) defined SES using insurance status, 35 (37.2%) used education, and 32 (34.0%) used income. Seventy-eight (83.0%) studies reported data by SES, 71 (75.5%) analyzed the data, and 68 (72.3%) discussed SES-based results. CONCLUSION: In clinical otolaryngologic research, the study of race and SES is limited. To improve quality of research and patient care for all patients, investigators should clearly justify their use of race and SES variables, carefully select their measures of race and SES (if the use of these variables is justified), and study race/SES-based data beyond just a superficial level.

Opioid use in pediatric otolaryngologic surgery: A survey of caregivers' attitudes.

OBJECTIVE: Given the current opioid epidemic and the fact that children continue to be undertreated for pain following surgeries, it is important to understand care-givers' attitudes toward post-operative opioid use. DESIGN: A survey was distributed to caregivers of pediatric patients undergoing otolaryngologic procedures. SETTING: An academic hospital in Boston, Massachusetts. PARTICIPANTS: Sixty-eight caregivers completed the survey. MAIN OUTCOME MEASURE: Caregiver attitudes toward post-operative opioid use. RESULTS: The study results are as follows: 38.1 percent of parents stated they would feel comfortable giving their child opioids post-operatively, 30.2 percent would not feel comfortable, and 31.7 percent were unsure. For every increase in 1 year of age of the child, there was an increase in the odds of a parent being comfortable giving opioids. Caregivers who had taken opioids in the past were more likely to feel comfortable, while those who were employed were less likely to feel comfortable. The most common reason reported for not feeling comfortable was addiction potential. The comfort level did not differ based on the caregivers' education level, income, race, or language. CONCLUSION: The majority of caregivers are unsure about or do not feel comfortable giving their child opioids post-operatively. Most are specifically concerned about the risk of addiction. Understanding caregivers' views on opioids in a diverse patient population is essential, so surgeons can counsel caregivers and provide appropriate post-operative pain management in their patients.

Parental Views on the Role of Social Media in Pediatric Otolaryngology.

OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.