Otorhinolaryngologic Diseases Commons^™

Avoiding Unnecessary Surgery In Acute Longus Colli Calcific Tendinitis: A Clinical Image Of A Retropharyngeal Abscess Mimicker, Brandon M. Nielsen, Oluyemi O. Omotoso

HCA Healthcare Journal of Medicine

Acute calcific tendinitis of the longus colli (LCT) is a rare, benign condition that frequently mimics retropharyngeal abscesses (RPA), a true surgical emergency. We present a 34-year-old woman presenting with 4 days of severe posterior neck pain, stiffness, and odynophagia. Initial evaluation revealed significantly elevated inflammatory markers (erythrocyte sedimentation rate [ESR] 113 mm/hr, C-reactive protein [CRP] 128 mg/L) and leukocytosis, raising immediate concern for deep neck infection. Contrast-enhanced computed tomography (CT) demonstrated a retropharyngeal fluid collection; however, the absence of peripheral ring enhancement and the presence of a pathognomonic calcification anterior to the C1 arch pointed toward LCT. This distinction …

Exploring Pediatric Leprosy In An Endemic Area: Case Series Of Eight Patients In Indonesia, Gitalisa Andayani Adriono, Tri Rahayu, Sri Linuwih Sw Menaldi, Nelfidayani Nelfidayani, Retno Sulistyo Wardani, Kahlil Gibran, Malika Sabrina Yunifananda, Kartika Qonita Putri, Yunia Irawati

Journal of General - Procedural Dermatology and Venereology Indonesia

Background: Leprosy remains a significant public health concern in endemic regions such as Indonesia. Children are particularly vulnerable due to their naive immunity and close familial contacts. This study aims to report cases of pediatric leprosy in Lembata, Indonesia, focusing on clinical characteristics and associated risk factors.

Case Illustration: A case series of eight pediatric patients (<15 >years) diagnosed with leprosy was conducted during a community-based screening program in Lembata, Indonesia, in 2022. Of 140 individuals examined, 8 were children. Most patients were male (6/8) with a mean age of 11.75 years. Multibacillary (MB) leprosy predominated (7/8), and a history …

Objective Oculomotor, Vestibular, Reaction Time, And Cognitive Signatures Of Vestibular Migraine, Claire E. J. Ceriani, Alexandr Braverman, Alexander Kiderman

Department of Neurology Faculty Papers

OBJECTIVE: To evaluate oculomotor, vestibular, reaction time, and cognitive (OVRT-C) function in patients with vestibular migraine (VM) using objective eye-tracking-based metrics and to identify patterns of dysfunction relative to healthy controls.

BACKGROUND: Vestibular migraine is a common yet underdiagnosed cause of vertigo. Diagnosis remains primarily clinical, because objective neurologic and vestibular findings are often absent or inconsistent. Quantitative methods capable of capturing the multisystem manifestations of VM may improve objective characterization of the disorder.

METHODS: Participants with a clinical diagnosis of vestibular migraine were recruited from a tertiary headache center and assessed using a battery of OVRT-C tests administered with …

Sonidegib (Lde225) Reduces Inflammatory Signaling And Preserves Taste Buds In A Sepsis Mouse Model, Ashlyn Mcclelland, Murod Khikmatov, Archana Kumari, Gabrielle Audu, Isaiah Nawaz, Kingsley Yin

Rowan-Virtua Research Day

Background:

Sepsis triggers a complex and widespread inflammatory response that disrupts multiple organ systems, including the taste organ. Loss of taste is a symptom recognized in sepsis survivors and has the potential to contribute to further complications such as anorexia. Prior work from our lab demonstrated that cecal ligation and puncture (CLP) in mice induces immune cell infiltration and alters taste bud morphology in the fungiform papillae located in the anterior tongue. We hypothesize that similar deleterious effects occur in the circumvallate papillae (CVP) of the posterior tongue and that the usage of the smoothened inhibitor, sonidegib, could reduce these …

Case Report: Pott’S Puffy Tumor, A Rare Complication Of Sinusitis, Je Seong Lee, Esai A. Hernandez, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of an 11-year-old female who presented with lethargy and new left upper extremity weakness after a recent Emergency Department visit for fever, rhinorrhea, and head fullness, and was subsequently diagnosed with Pott’s Puffy Tumor(PPT). Pott’s Puffy Tumor is a frontal bone osteomyelitis with an frontal  subperiosteal abscess and represents a rare but potentially life-threatening complication of sinusitis. Prompt imaging and timely clinical intervention are critical, though variable presentations can make diagnosis challenging. This case highlights the importance of early recognition, appropriate imaging, and prompt surgical and antibiotic management given the PPT’s  strong association with intracranial complications. …

Impact Of Mips Measure 66 On The Incidence Of Pta's, Sydney Finch, Christopher Houston

North Texas GME Research Forum 2026

INTRO

A number of randomized controlled trials indicate that using point-of-care group A strep (POC GAS) testing decreases antibiotic utilization without compromising health outcomes. In 2018, the Merit-based Incentive Payment System (MIPS) measure 66 went into effect requiring the testing for GAS when treating pharyngitis. The intent was to decrease the unnecessary use of antibiotics in the treatment of pharyngitis, given that most cases are viral. Anecdotally, some physicians have noticed the increased incidence of peritonsillar abscesses (PTA). Our research group aims to investigate if there has been a significant increase in incidence of PTAs after the implementation of MIPS …

A Rare Case Of Severe Disseminated Pyoderma Gangrenosum Of The Upper Body With Concurrent Nasopharyngeal And Inferior Orbital Wall Necrosis, Robert M. Branstetter, Isabel E. Baird, Mohammed S. Rais, Danielle N. Ledet, Megan N. Terrebonne

School of Medicine Faculty Publications

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis usually linked to autoimmune or inflammatory bowel disease and typically affects the lower extremities. This case is notable for extensive upper-body, oropharyngeal, and nasal involvement in a patient without an underlying autoimmune disorder. A 56-year-old man with chronic cocaine use and stage IV renal cell carcinoma presented with rapidly progressive ulcerations of the face, neck, shoulders, and back, along with nasal septal collapse and oropharyngeal destruction. Prior biopsy demonstrated sterile neutrophilic inflammation without vasculitis, infection, or malignant infiltration, supporting PG as a diagnosis of exclusion. Imaging showed erosive sinonasal disease. He was …

Increasing Pediatric Hpv Vaccination Rates, Brooke A. Nicholas

Dissertations

Increasing Pediatric HPV Vaccination Rates

Abstract

Problem: The human papillomavirus (HPV) is a sexually transmitted infection that affects more than 80% of the population within the United States (Eisenhauer et al., 2020). HPV can develop into cervical, anogenital, and oropharyngeal cancers (Eisenhauer et al., 2020). About 4,000 individuals die from cervical cancer alone each year (O’Leary, 2022). The HPV vaccine, though recommended by the ACIP and AAP, is below national vaccination rates in comparison to other vaccines (O’Leary, 2022).

Methods: This quality improvement project is a non-randomized controlled trial that observed HPV vaccine dose completion rates for patients aged 9-14 …

Designing An Electronic Patient-Reported Outcomes Information Infrastructure Supported By The Re-Aim Implementation Framework, Amy C. Moreno, Angela Peek, Toshiko S. Stein, Kevin R. Shook, Sara M. Ali, Laia Humbert-Vidan, Aileen Chen, Miriam Lango, Anna Lee, Michael Spiotto, William H. Morrison, Adam S. Garden, Jack Phan, Steven J. Frank, Katherine Hutcheson, David I. Rosenthal, Clifton D. Fuller, G Brandon Gunn

Advances in Cancer Education and Quality Improvement

Objective: Patient-reported outcomes (PROs) contain valuable information that can be leveraged by providers to perform timely interventions and improve quality of life and survival. However, the implementation of electronic PROs (ePROs) remains a challenge from technical and evaluation perspectives. Our objective was to construct a robust electronic health record (EHR)-integrated ePRO information infrastructure founded on RE-AIM (reach-effectiveness-adoption-implementation-maintenance) principles.

Materials and Methods: We used Epic Systems as our EHR platform to build the MD Anderson Symptom Index Head and Neck Module (MDASI-HN) for release to all patients undergoing evaluation and/or treatment in our HN Radiation Oncology clinics. RE-AIM metrics were …

Validation Of A Prognostic Nomogram For Locally Advanced Oropharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy With/Without Systemic Therapy, P. Bossi, R. Gili, S. Calza, L. Licitra, M. Maddalo, A. Bacigalupo, L. Belgioia, J. Cacicedo, N. Facchinetti, A. Garcia Castano, M. Oliva, P. Bonomo, G. Sanguineti, P. Franco, A. Argiris, A. Psyrri, E. Orlandi

Kimmel Cancer Center Faculty Papers

BACKGROUND: Head and neck squamous-cell carcinoma (HNSCC), particularly oropharyngeal cancer (OPC), exhibits diverse prognostic factors influenced by demographic and lifestyle variables. Prognostic nomograms, such as the one developed by Fakhry et al., incorporate clinical and biological markers to predict overall survival (OS) and progression-free survival (PFS) in OPC patients. However, their applicability to European populations remains unverified. This study aimed to externally validate Fakhry's prognostic nomogram in a large European cohort of locally advanced OPC patients treated with definitive intensity-modulated radiotherapy (IMRT) with or without systemic therapy.

METHODS: This is a retrospective external validation study conducted on 805 OPC patients …

Agenda (Pdf), Lsu Health Sciences Center - New Orleans

Usher Syndrome in Louisiana

Agenda, promotional flyer and resources list for the Usher Syndrome in Louisiana 5th Symposium held September 19, 2025.

Artificial Intelligence In Head And Neck Cancer: Towards Precision Medicine., Jacob Hagen, Logan Hornung, William Barham, Supratik Mukhopadhyay, Ada Bess, Kevin Contrera, Kevin Contrera, Devraj Basu, Vlad Sandulache, Guillaume Spielmann, Sagar Kansara

School of Medicine Faculty Publications

Simple Summary: This review was conducted to highlight current and potential applications of artificial intelligence (AI) in the care of patients with head and neck cancer, the barriers to its clinical implementation, and the relative scarcity of research in this field. While AI has demonstrated success in other areas of oncology, its role in head and neck cancer remains limited, with progress slowed by technical, ethical, and logistical challenges. Nevertheless, integrating AI with multiomics approaches presents a promising opportunity to advance precision medicine in this patient population. The findings presented in this manuscript may encourage further multi-institutional studies aimed at …

Are Orthopaedic Trauma Surgeons At Risk Of Occupational Noise-Induced Hearing Loss?, Vincent W. Lau, Stephanie A. Kwan, Jack Graham, Gregory K. Deirmengian

Rothman Institute Papers

OBJECTIVES: Orthopaedic surgeons are at risk of occupational, noise-induced hearing loss due to exposure to instruments in the operating room. The primary objective of this study was to determine whether orthopaedic trauma procedures exceed recommended decibel (dB) limits. The secondary objective was to demonstrate which actions during a case create the highest sound levels.

METHODS: Intraoperative recordings were taken during orthopaedic trauma surgeries and classified into open reduction internal fixation (ORIF), intramedullary nailing, closed reduction percutaneous pinning, external fixation, soft tissue procedures, or a combination thereof. Recordings were taken of drilling, screw insertion, suctioning, saw use, and mallet striking. Decibel …

Silvestrol Inhibits Nasopharyngeal Carcinoma Cells And Synergizes With Cx‑5461: Insights From A Proteomics Study, Maelinda Daker, Munirah Ahmad, Alan Khoo, Lu Ping Tan, Siok-Fong Chin, Siaw San Hwang, Paul Neilsen

Department of Medical Oncology Faculty Papers

Nasopharyngeal carcinoma (NPC) is a cancer arising from the epithelial cells of the nasopharynx, which is rare in Western countries but extremely prevalent in Borneo and the Southern China region. Present-day hurdles in NPC treatment that lead to poor quality of life and poor survival include distant metastasis and resistance to chemoradiotherapy. Silvestrol and its 5'''-epimer, episilvestrol, are compounds isolated from the plant Aglaia stellatopilosa, which is endemic to Borneo. Silvestrol, a protein synthesis inhibitor, preferentially inhibits the translation of cancer-associated mRNAs. CX-5461 is an inhibitor of RNA polymerase I that catalyzes rRNA synthesis. The present study sought to …

Computed Tomography Radiomics-Based Cross-Sectional Detection Of Mandibular Osteoradionecrosis In Head And Neck Cancer Survivors, Serageldin Kamel, Laia Humbert-Vidan, Zaphanlene Kaffey, Sarah Mirbahaeddin, Abdulrahman Abusaif, David T A Fuentes, Kareem Wahid, Cem Dede, Mohamed A Naser, Renjie He, Ahmed W Moawad, Khaled M Elsayes, Melissa M Chen, Adegbenga O Otun, Jillian Rigert, Mark S Chambers, Andrew Hope, Erin Watson, Kristy K Brock, Katherine Hutcheson, Lisanne Van Dijk, Amy C Moreno, Stephen Y Lai, Clifton D Fuller, Abdallah S R Mohamed, Md Anderson Head And Neck Cancer Symptom Working Group

Faculty, Staff and Student Publications

Purpose: This study aims to identify radiomic features from contrast-enhanced CT (CECT) scans that differentiate osteoradionecrosis (ORN) from normal mandibular bone in head and neck cancer (HNC) patients treated with radiotherapy (RT).

Materials and methods: CECT images from 150 patients with confirmed ORN diagnosis (2008-2018) at MD Anderson Cancer Center (MDACC) were analyzed (80 % train, 20 % test). Radiomic features were extracted using PyRadiomics from manually segmented ORN regions and automated contralateral healthy mandible regions. Correlation analysis (r > 0.95) reduced features for model training. A random Forest (RF) classifier with Recursive Feature Elimination identified discriminative features. Explainability was assessed …

Uncharted Territory: The First Case Of Cardiac Myxoma In A Patient With Nf2, Muhammad Sabri, Zinya Talukder, Naila Ijaz, Joseph Neri

Rothman Institute Papers

BACKGROUND: Cardiac myxoma is a benign tumor, typically originating in the left atrium, and is often linked to Carney complex. In our literature review, there are no case reports of cardiac myxoma in patients with neurofibromatosis type 2 (NF2).

CASE SUMMARY: A 60-year-old man presented with dizziness and was found to have meningioma and vestibular schwannoma, consistent with NF2. Cardiac myxoma was incidentally diagnosed through echocardiography and confirmed by cardiac magnetic resonance imaging and tissue pathology. The mass was surgically resected. The patient was offered genetic testing; however, he decided to not undergo further testing.

DISCUSSION: NF2 is an inherited …

Urgent Implementation Of Point-Of-Care Testing For Group A Streptococcal Infection In A Uk Children’S Emergency Department, Ruth Shorrocks, Philip J. Turner, Thomas Fanshawe, Umasha Ukwatte, Jim Gray, James Taylor, Liliana Graveto, Gail Hayward, Chris Bird

Journal of Pediatric Infectious Diseases

Objective: In late 2022, Western Europe and the United States experienced increased incidences of scarlet fever and life-threatening invasive group A strepto- coccal (iGAS) infections, especially among children. The outbreak was widely reported in the media in the United Kingdom, leading to increased emergency department (ED) attendances and threatened supplies of antibiotics. Our ED rapidly introduced point-of-care testing for GAS pharyngitis with the aim of rationalizing antibiotic prescribing.

Methods: We rapidly implemented the use of a molecular-based (polymerase chain reaction) point-of-care test for all children scoring 3 or higher on the McIsaac clinical prediction rule for GAS pharyngitis in children …

Three-Dimensional Printed Models To Accelerate Resident Surgical Learning Curve For Standard Endoscopic Sinus Surgery Techniques, Jumah G Ahmad, Alexander J Citardi, Amber U Luong, William C Yao

Faculty, Staff and Student Publications

Background: Endoscopic sinus surgery presents significant visuospatial challenges to surgical trainees. We tested the utility of novel 3D printed models to simulate sinus surgery tasks to improve endoscopic skillsets in resident trainees.

Methods: This was a prospective quality improvement study of 10 ENT residents (PGY1-5). Participants rotated through 4 stations with different 3D simulation training modules designed to enhance endoscopic skillsets in the axial, sagittal and coronal planes (e.g., straight forceps to grasp a bead from a ledge, angled instruments to cannulate openings). Participants completed a self-assessment survey on the subjective sinus surgical skills using a visual analog …

Fracture Patterns In Craniofacial Gunshot Wounds: A Seven-Year Experience, Gabriela G Cruz, Sameer H Siddiqui, David Z Allen, Kunal R Shetty, Sean P Mckee, Brady J Anderson, Mark Knackstedt, W Katherine Kao, Tang Ho

Faculty, Staff and Student Publications

Objective: To characterize facial fracture patterns and understand predictors of surgical repair and LOS with the objective of assisting providers in managing and understanding these complex injuries.

Study design: This is a retrospective cohort chart review study.

Methods: A retrospective review was conducted for patients admitted with gunshot wounds (GSWs) to the head, neck, or face between January 2013 and March 2020 at a level one trauma tertiary care hospital. Univariate and multivariate analysis were performed to identify associations with surgical repair and LOS.

Results: Of the 578 patients with head, neck, or facial GSWs, 204 survived and sustained facial …

Reducing Surgery For Pediatric Posttonsillectomy Hemorrhage Using Tranexamic Acid: A Quality Improvement Initiative, Laura A. Petrauskas, Janavi Sethurathnam, Ansley J. Kunnath, Rahul K. Sharma, John Ceremsak, Ryan H. Belcher, James D. Phillips, Jay A. Werkhaven, Amy S. Whigham, Lyndy J. Wilcox, Christopher T. Wootten, Frank W. Virgin, Jason S. Park

School of Medicine Faculty Publications

Objective: Evaluate the use of tranexamic acid (TXA) and observation as a management option for pediatric patients presenting with posttonsillectomy hemorrhage (PTH). Study Design: Retrospective analysis of a prospectively implemented quality improvement initiative with a historical control comparison group. Setting: Tertiary children's hospital. Methods: Patients < 18 years of age who underwent adenotonsillectomy (AT) and returned to the Emergency Department for PTH were included. Patients who were stable without large volume or active bleeding were given intravenous TXA and admitted for overnight observation. Data were compared in a before-and-after analysis: preprotocol (April 2022 to March 2023) versus postprotocol (April 2023 to March 2024). For cost-effectiveness analysis, we analyzed aggregated claims data from a commercial claims database. Results: Preprotocol 1800 adenotonsillectomies were performed, and 40 procedures were performed for control of hemorrhage (2.2 per 100 AT). Postprotocol 2356 adenotonsillectomies were performed, and 30 procedures were performed to control hemorrhage (1.3 per 100 AT) showing a significant reduction in return to the operating room (relative risk [RR] = 0.59, 95% confidence interval [CI] [0.358, 0.916], P-value.020). There were no reported adverse events attributable to TXA. An estimated 21 surgeries were avoided, and 26 additional patients were observed in the hospital during the postprotocol period, for an estimated net cost savings of $174,970. Conclusion: The implementation of a standardized TXA protocol significantly reduced the need for return to the operating room for PTH in pediatric patients, without complications and with net cost savings to the health care system.