Faculty Bibliography

OBJECTIVES/OBJECTIVE:) and PRO scores; (3) explore how changes across individual PROs align with changes in DIGEST pre- to six weeks post- surgery. METHODS:) pharyngeal total score and the DIGEST. PROs included the Bazaz Dysphagia Scale, the Eating Assessment Tool (EAT-10), the Swallowing Quality of Life Questionnaire (SWAL-QoL), and the Hospital for Special Surgery Dysphagia Index (HSS-DDI). RESULTS:Statistical models for all outcome measures revealed a significant effect of operative timepoint, indicating worse outcomes postoperatively. There were greater postoperative increases in point prevalence and incidence rates using PROs compared with DIGEST. Rates of clinically meaningful change were similar across PROs and DIGEST, but not consistently across the same individual cases. CONCLUSION/CONCLUSIONS:This study highlights the difference between physical function and patient experience, suggesting the presence or absence of dysphagia symptoms may not correspond with observed physical impairments after ACDF. LEVEL OF EVIDENCE/METHODS:Level III.

INTRODUCTION/UNASSIGNED:for head and neck cancer (HNC), a patient-reported symptom measure available only in English. METHODS/UNASSIGNED: = 4) diagnosed with HNC. RESULTS/UNASSIGNED:The translation was acceptable in cultural relevance (average CVI score = 0.95) and equivalence (average CVI score = 0.84). Cognitive interviews revealed 9 problematic items that differed in words and meaning, primarily addressing pain and swallowing symptoms. These items were refined and included in the final translation of the Spanish ePVA. CONCLUSION/UNASSIGNED:These study findings underscore the need for survey instrument translations that account for variations in shared languages spoken across countries.

BACKGROUND AND PURPOSE/OBJECTIVE:Skeletal-related events (SRE) are a major source of morbidity and mortality across cancer types. Identification of risk factors for SRE and association with survival would facilitate more targeted preventive treatment. MATERIALS AND METHODS/METHODS:This retrospective cohort study included patients with bone metastases from solid tumors undergoing systemic imaging from February-March 2022 who had not received radiation within one year. Survival was analyzed using Cox models, and multi-state models assessed factors linked to SRE with death as a competing risk. Outcomes were SRE (including radiation for pain) and all-cause death. Variables included tumor type, metastasis site, and trial eligibility. RESULTS:Among 410 patients (median age 67 years; 48 % male), 162 (40 %) experienced SRE over a median follow-up of 26.8 months. Seventy-five (18.3 %) received radiation for pain alone. Experiencing any type of SRE (HR 1.98, 95 % CI 1.47-2.67, p < 0.001) or radiation for pain alone (HR 2.14, 95 % CI 1.57-2.92, p < 0.001) were both associated with increased mortality. Patients eligible for a trial of early radiation were more likely to develop SRE (HR 1.67, 95 % CI 1.18-2.37, p = 0.004). Prostate cancer histology (HR 1.70, p = 0.02) and metastases to the hip/acetabulum (HR 2.55, p = 0.02) were associated with SRE. CONCLUSION/CONCLUSIONS:Patients treated with radiation for pain alone demonstrated similar risk of death as those experiencing any type of SRE, supporting the inclusion of radiation in endpoint definitions. Prostate cancer type and hip/acetabulum metastasis location may help identify patients and lesions at elevated SRE risk, informing future preventive strategies.

BACKGROUND:Fistulous and cystic neck lesions that cannot be categorized into traditional classification schemes at presentation are challenging to manage and often manifest as recurrently draining fistulas after primary surgery. Work up with traditional cross-sectional imaging techniques with computed tomography (CT) or magnetic resonance imaging (MRI) may not provide adequate fine details of small channels. Characterization of fistula tracts is necessary for identification and definitive management of atypical or recurrent congenital neck anomalies. METHODS:A retrospective review of the electronic medical record from 2 institutions between 2016 and 2023 identifying cases of atypical or recurrent congenital neck anomalies for which CT and MR fistulogram, a novel interventional imaging technique, identified and characterized atypical fistula tracts. Imaging protocol, fistulogram technique, imaging-anatomic correlation, and follow up are reported. RESULTS:We identified 5 patients aged 8-14 years who presented with a draining pit in the head and neck who underwent CT or MRI fistulograms. Diagnoses include first branchial cleft anomalies (n = 3), deep branchial cleft fistula containing ectopic salivary tissue (n = 1), and a recurrent thyroglossal duct cyst (n = 1). Three patients had prior surgery to address these anomalies with recurrences, and one patient had an associated Kabuki syndrome. Complete resection was performed in all cases, with no recurrence to date. CONCLUSION/CONCLUSIONS:CT and MRI fistulograms are minimally invasive, safe, efficacious, and feasible techniques that can be performed before surgery and facilitated on the same day in a single anesthesia encounter. The technique allows for complete visualization of atypical and/or recurrent cystic and fistulous neck anomalies. It facilitates preoperative planning and aids in the characterization of the lesion so that a complete surgical excision can be executed.

Developed by the Center for Robust Speech Systems at the University of Texas at Dallas, in collaboration with New York University and the University of Wisconsin-Madison, CCi-MOBILE addresses a critical challenge in optimizing cochlear implant (CI) fitting and enhancing sound coding strategies. Existing clinical CI processors and research tools often lack either the necessary computational power and flexibility or the portability required for real-world testing. CCi-MOBILE bridges this gap by enabling the implementation and evaluation of diverse real-time sound coding algorithms in both laboratory and real-world settings, including those requiring synchronized bilateral stimulation. Building upon previous publications, this paper provides new detailed discussion on parameter setting for stimulus generation with CCi-MOBILE and serves as a comprehensive resource for scientists and engineers developing novel real-time sound coding and signal processing strategies with this platform. As part of an ongoing development effort, future generations of CCi-MOBILE may offer additional functionalities beyond those described here.

Nasal bone and nasal septal fractures are common facial traumas. The proper management of these injuries and their associated complications can both functionally improve nasal breathing and also lead to improved cosmetic outcomes. Closed reduction of these fractures can often be performed at bedside if within the appropriate time window; regardless of whether reduction is performed under local anesthesia, these patients can follow-up in clinic to discuss further management, which might include delayed septorhinoplasty in the operating room.

We present a case highlighting innominate vein reconstruction for resection of Hurthle cell carcinoma with complex vascular invasion. A 69-year-old man presented with a rapidly enlarging neck mass, dysphagia and dysphonia. Workup demonstrated a 11.2 × 7.0 × 6.5 cm Hurthle cell carcinoma invading the oropharynx and superior mediastinum. We proceeded with left thyroid lobectomy and modified left radical neck dissection. Median sternotomy, resection of the left clavicular head, and partial resection of the left manubrium were performed to circumferentially expose the innominate vein. Tumor thrombus was extruded from the innominate vein followed by patch angioplasty, which remains patent 14 months postoperatively.

Diagnostic adjuncts for oral potentially malignant disorders such as leukoplakia or erythroplakia can aid the clinician in triaging abnormal lesions and facilitate both biopsy site selection and surgical management. No adjuncts replace gold standard biopsy and histopathological examination, and their optimal use requires training and experience. This article covers the potential applications, both in primary and expert settings, of adjuncts, such as tissue autofluorescence, toluidine blues staining, and cytopathology. It covers new and emerging adjuncts such as confocal microscopy, liquid biopsy, oral microbiome testing, and the role of artificial intelligence. Incisional biopsy site selection and techniques will also be discussed.

Congenital cholesteatomas are defined as a collection of epithelium in the absence of prior surgery or pathologic retraction. They are most commonly found in the middle ear and are thought to arise from a residual epithelial rest present since birth; however, a small number of cases present with disease isolated to the mastoid bone. One such case and a review of prior reports are presented. A 29-year-old male with a 2-year history of headaches and no otologic surgery was found to have a destructive mass centered in the right mastoid bone, invading the jugular foramen and posterior fossa without middle ear disease. He underwent a mastoidectomy with complete resection of the cholesteatoma. A literature review identified 21 prior cases of isolated mastoid congenital cholesteatoma. Congenital cholesteatoma should be considered in the differential diagnosis when patients present with postauricular pain or headaches. Mastoidectomy is considered the treatment of choice.