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OBJECTIVE: The purpose of this paper is to define the microbiome of the head and neck by characterizing and distinguishing the commensal bacteria from pathogenic species. STUDY DESIGN: Literature review. METHODS: Pubmed and Google scholar databases were queried for relevant articles. Keywords such as "middle ear microbiome", "outer ear microbiome", "sinonasal microbiome", "tonsil microbiome", and "laryngeal microbiome" were utilized separately to identify articles pertaining to each topic of study. All applicable abstracts were chosen for initial review and relevant abstracts were then selected for review of the full texts. Articles that did not study the human microbiome, those not written primarily in English, those that were not readily available for full review, and case reports were excluded from the study. RESULTS: Limited studies that investigate the microbial environments of isolated anatomic subsites in the head and neck exist, however the comprehensive microbiome of the head and neck has yet to be completely defined. Based on this review, various studies of the ears, larynx, tonsils and sinus microbiomes exist and yield valuable information, however they are limited in scope and anatomic subsite. In this literature review, these studies are compiled in order to create a comprehensive text inclusive of the known microbial elements of the major anatomic subsites of the head and neck, namely the tonsils, larynx, sinus, outer ear and middle ear. CONCLUSIONS: The significance of the human microbiome in identifying and preventing disease has been established in various physiologic systems, however there is limited research on the microbiome of the head and neck. Understanding the microbiome of the head and neck can help differentiate disease-prone patients from normal patients and guide treatment regimens and antibiotic usage, to aid in resistance control and limit adverse effects of antibiotic overuse. Understanding the elements that lead to dysbiosis can help treat and even prevent common conditions as tonsillitis and rhinosinusitis. In this review, we provide a comprehensive review to serve as an initial background for future studies to define the head and neck microbiome distinguished by all relevant subsites.
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Oído/microbiología , Cabeza/microbiología , Microbiota , Cuello/microbiología , Antibacterianos/uso terapéutico , Disbiosis/microbiología , HumanosRESUMEN
OBJECTIVE: The purpose of this paper is to review the literature and compile key clinically relevant applications of telemedicine for use in otolaryngology relevant to the post-COVID-19 era. STUDY DESIGN: Systematic Literature Review. DATA SOURCES: Pubmed and Google Scholar. REVIEW METHODS: Pubmed and Google Scholar were queried using combined key words such as "telemedicine," "covid" and "otolaryngology." The searches were completed in March-August 2020. Additional queries were made with particular subspecialty phrases such as "rhinology" or "otology" to maximize yield of relevant titles. Relevant articles were selected for abstract review. Applicable abstracts were then selected for review of the full text. RESULTS: Initial search identified 279 results. These were screened for relevance and 100 abstracts were selected for review. Abstracts were excluded if they were not in English, not related to otolaryngology, or if the full text was unavailable for access. Of these, 37 articles were selected for complete review of the full text. CONCLUSION: The sudden healthcare closures during the COVID-19 pandemic resulted in a sharp increase in the use of telemedicine, particularly in subspecialty fields. Otolaryngologists are at a unique risk of infection resulting from the examination of the head and neck and aerosol-generating procedures due to the predilection of viral particles for the nasal cavities and pharynx. The COVID-19 pandemic may have served as a catalyst to implement telemedicine into clinical practice, however identifying ways to integrate telemedicine long term is key for a sustainable and viable practice in the post-COVID-19 era. Although many states are now finding themselves on the down-sloping side of their infection rate curve, many others remain at the apex. Additionally, the risk of future waves of this pandemic, or the onset of another pandemic, should not be overlooked. Practice modification guidelines that mitigate infection risk by utilizing telemedicine would be useful in these instances. Telemedicine can help to reduce infection spread by limiting unnecessary in-person interactions and help conserve personal protective equipment (PPE) by facilitating remote care with the added benefits of expanding care to broad geographic areas, limiting cost, time, and travel burden on patients and families, and enabling consistent follow up.
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COVID-19/epidemiología , Otolaringología , Pautas de la Práctica en Medicina/estadística & datos numéricos , Telemedicina/métodos , Humanos , Pandemias , SARS-CoV-2RESUMEN
Objective The goal of this study is to analyze the quality, credibility, and readability of videos on TikTok related to tracheostomy in order to assess the adequacy of the information for patient and parental education purposes. Study design This was a cross-sectional analysis of online content. Methods The social media platform TikTok was explored for videos related to tracheostomy. The search function was utilized with multiple hashtags related to tracheostomy and videos were reviewed and scored for quality, credibility, and readability. Each of the videos was assessed using the DISCERN criteria, JAMA benchmark, and readability score based on text either presented in the video or written in the caption. Pearson's correlation coefficient was calculated for each of the studied parameters. Results The TikTok search bar was queried using multiple hashtags, including "#trach," "#tracheostomy," "#trachea," and "#tracheotomy" for relevant videos from October 14 to October 15, 2021. Overall, 60 videos were selected for complete review and analysis. The total views for all related videos analyzed was 17,712,281. The total likes were 693,812. The videos were primarily posted by non-healthcare professionals making up approximately 72% of all videos. Videos created by physicians generated 63% of all views. The average DISCERN score for each video was 24.83 out of 75. The average Flesch Reading Ease score was 70.59 and the average Flesch-Kincaid Grade level was 5.5. There was a positive DISCERN score and views with R = 0.255 (p = 0.049), positive correlation between DISCERN and likes R = 0.334 (p = 0.009), positive correlation between DISCERN and JAMA R = 0.56 (p=<0.0001), positive correlation between DISCERN and Flesch-Kincaid Grade Level R = 0.330 (p=0.010) and a negative correlation between DISCERN and Flesch Reading Ease Score R = -0.337 (p=0.009). There was also a statistically significant positive correlation between JAMA and Flesch-Kincaid Grade Level R = 0.260 (p=0.045). Conclusion Overall, the quality of the videos on TikTok regarding tracheostomy rated poorly on the DISCERN quality index but included text that was fairly easy to read. Currently, medical videos on TikTok do not meet the quality metrics needed to properly educate the public and should not be used as a primary resource.
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Avicenna authored The Canon of Medicine, a principal medical textbook for over 600 years. Our primary goal is to systematically review and translate relevant portions of The Canon in its original Arabic and correlate to Sardo's 2014 translation, focusing on otolaryngology, to present an accurate representation of Avicenna's impact and highlight notable discrepancies. Secondarily, we aim to review the literature for citations discussing Avicenna's contributions to otolaryngology and identify misinterpretations. Notably, Avicenna may have described the shape of the cochlea 500 years before its believed discovery in humans by Eustachius (1552) and Falloppius (1561). There are also obscurities in Avicenna's descriptions of the etiology of epistaxis and airway management. It is essential to remain critical of historical texts and safeguard the accurate propagation of information to preserve the integrity of historical context and timelines of scientific advancement.
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Manuscritos como Asunto , Otolaringología , Humanos , Otolaringología/historia , Historia MedievalRESUMEN
OBJECTIVE: The purpose of this article is to review the literature and compile promising and clinically relevant biomarkers in autoimmune disease related to otolaryngology-head and neck surgery. STUDY DESIGN: Narrative review. METHODS: Pubmed and Google Scholar were queried using combined key words such as "biomarkers" and "otolaryngology." Additional queries were made with combined key words such as "biomarkers" and a particular subspecialty such as "autoimmune" or "Meniere's" to maximize yield of relevant titles. Subsequently, specific biomarkers identified, such as "anti-TPO-antibodies," were used as key words. Relevant titles were reviewed and selected for abstract review. Applicable abstracts were then selected for review of the full text. RESULTS: Biomarkers that are currently in clinical use for the management of autoimmune diseases within the field of otolaryngology were included in this review. The compiled biomarkers were then detailed individually regarding their molecular characteristics, function, and clinical significance. CONCLUSIONS: Based on this literature review, there are several biomarkers currently in clinical use within the field of otolaryngology relating to autoimmune diseases. The majority of these biomarkers are in the form of proteins such as Cogan peptide and c-ANCA. This survey may serve as a comprehensive resource on biomarkers for autoimmune diseases in clinical otolaryngology.
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OBJECTIVE: The purpose of this paper is to review the literature and compile promising and clinically relevant biomarkers in otolaryngology-head & neck surgery not related to autoimmune disorders. STUDY DESIGN: Narrative review. METHODS: PubMed and Google Scholar were queried using combined key words such as "biomarkers" and "otolaryngology." Additional queries were made with combined key words such as "biomarkers" and a particular subspecialty such as "rhinology" or "otology" to maximize yield of relevant titles. Subsequently, specific biomarkers identified, such as "beta-2 transferrin," were used as key words. Relevant titles were reviewed and selected for abstract review. Applicable abstracts were then selected for review of the full text. RESULTS: Biomarkers currently in clinical use within the field of otolaryngology were included in this review. The compiled biomarkers were then detailed individually regarding their molecular characteristics, function, and clinical significance. CONCLUSIONS: The number of biomarkers in use in otolaryngology is rapidly expanding representing a new diagnostic modality for our field. This review defines the key biomarkers that are currently or likely to be soon translated into clinical use within the field of otolaryngology. The majority of these biomarkers are in the form of proteins such as beta-2 transferrin, thyroglobulin, and P16. Given their growing impact on diagnosis, management and surveillance of otolaryngologic disorders periodic surveys are needed for education and to guide further advances and applications of otolaryngologic biomarkers.
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OBJECTIVE: To determine the incidence and survival of sinonasal adenocarcinoma (SNAC) by subsite and histologic subtype. STUDY DESIGN: Retrospective database review. METHODS: Using the SEER database, we performed a retrospective analysis, identified cases of SNAC diagnosed between 1973 and 2013 and analyzed demographic, histopathology, clinicopathology, and determinants of disease specific survival (DSS). RESULTS: A total of 746 patients with SNAC were identified. Median age at diagnosis was 64 years. Overall incidence was 0.44 per million, and was higher among blacks (O.R.:1.10-2.07:1) and males (O.R.:1.38-2.06:1). Nasal cavity (41.5%) was the most common site, followed by maxillary (26.5%), and ethmoid (17.4%) sinuses. Intestinal-type adenocarcinoma was less likely than Adenocarcinoma not otherwise specified (ANOS) to be found in the maxillary sinus (8.8% vs. 30.6%, p < .05). Surgery alone (48.56%) was the most common treatment modality, followed by surgery and radiotherapy (RT) (32.5%), and RT alone (11.6%). DSS at 5, 10, and 20 years were 63.8%, 57.6%, and 47.0%, respectively. DSS was higher for nasal cavity SNAC, lower grade, lower stage, and those receiving surgery only. CONCLUSIONS: SNAC is more common among men and blacks. Incidence has not changed significantly in the past 40 years. Survival varies with grade, stage, histology, subsite, and treatment.
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Adenocarcinoma/mortalidad , Neoplasias Nasales/mortalidad , Senos Paranasales/patología , Adenocarcinoma/patología , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Neoplasias Nasales/patología , Estudios Retrospectivos , Programa de VERF , Estados Unidos/epidemiología , Adulto JovenRESUMEN
OBJECTIVES/HYPOTHESIS: The head and neck are two of the most common locations for cutaneous melanoma. We present the first population-based analysis of geographic differences in anatomic subsite, clinicopathologic and demographical traits, histopathologic subtype, treatment modality, and disease-specific survival (DSS) of cutaneous head and neck melanoma (CHNM). STUDY DESIGN: Retrospective database analysis. METHODS: The Surveillance, Epidemiology, and End Results database was queried for cases of CHNM reported between 2000 and 2013. Patients were grouped into East, Midwest, South, and West regions of the United States. Overall incidence, demographic traits, primary tumor site, clinicopathologic traits, histopathologic subtype, treatment modality, and DSS were compared among regions. RESULTS: There were 49,365 patients with CHNM identified. The West (4.60) and the South (4.42) had significantly higher incidence (per 100,000) than the East (3.84) and Midwest (3.65) (P < .05). DSS was significantly different among regions (P < .0066). The East (5 years: 89.4%, 10 years: 84.1%) had the highest DSS rate, and the South (5 years: 87.0%, 10 years: 81.8%) had the lowest DSS rate. The Midwest (5 years: 88.4%, 10 years: 84.3%) and West (5 years: 88.3%, 10 years: 83.5%) had intermediate DSS. On multivariate analysis, the South had an elevated hazard ratio (1.17, 95% confidence interval: 1.05-1.30) when compared to the West. CONCLUSIONS: Geographic region may play a significant role in CHNM. Incidence is higher in the South and the West. Incidence, histologic subtype, treatment modality, and DSS vary among regions. DSS is lower in the South than the West, even after accounting for other major prognostic factors. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:2763-2769, 2017.