Otolaryngology Commons^™

Case Report: Haemophilus Influenzae Meningitis In A 65 Year Old Female, Kaywan Saed, Russell Mordecai

Rowan-Virtua Research Day

We report a case of a 65-year-old female who presented with fever, altered mental status, and neck stiffness. Cerebrospinal fluid (CSF) analysis confirmed Haemophilus influenzae meningitis. The differential diagnosis of bacterial meningitis in older adults is broad and includes Streptococcus pneumoniae, Neisseria meningitidis, Listeria monocytogenes, and Haemophilus influenzae. However, in the post-Hib vaccine era, non-typeable H. influenzae has emerged as a significant cause of invasive disease in older adults, particularly in those with underlying comorbidities.

Older patients often present with atypical symptoms, which may delay diagnosis and treatment. In this case, early recognition and prompt administration of empiric antibiotic therapy …

The Relevance Of Age, Bmi, And Right Versus Left Ear Surgery To The Incidence Of Taste Disturbance After Stapes Surgery, Jonathan Ong, Dennis Bojrab Ii

Posters

• Many factors such as age and body mass index (BMI) have been shown to influence post-operative outcomes in patients undergoing stapedectomy/stapedotomy.

• This study examines these factors to see if they have any impact on the incidence of taste disturbance, a commonly reported complication of stapes surgery.1

• Our study predicts that BMI and age are correlated with the incidence of taste disturbance post-operatively following stapes surgery.

Multidisciplinary Team Care In Plastic Surgery: Vascular Anomalies, Josephine L Schmidt, Vamsi C Mohan, Richard Appel, Tara L Rosenberg, Jessica A Ching

Faculty, Staff and Students Publications

Vascular anomalies consist of a wide range of diagnoses relating to abnormal vasculature. These lesions can affect a variety of anatomical structures, requiring the expertise of numerous specialists. Over the past few decades, the formation of multidisciplinary vascular anomalies clinics has allowed patients to meet multiple providers within the same clinic visit, leading to improved communication between patients and providers. Furthermore, diagnostic and treatment plans are discussed in multidisciplinary conferences allowing for enhanced diagnostic accuracy and more comprehensive management plans. The purpose of this article is to provide an overview of the multidisciplinary management of vascular anomalies, including descriptions of …

The Impact Of Biomaterial Characteristics On Macrophage Phenotypes In Tissue Engineering: A Review, Julian Jackson, Hani Samarah, William Palmer, Zachary Kaplan, Marianna Nicodem, Parvesh Kumar, Spenser Short, Kelly Bridgham, Larry Harshyne, Joseph Curry

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Macrophages are highly plastic cells central to pathogen removal, tissue regeneration, and inflammation, making them key targets in biomaterial design for improved clinical outcomes. Foreign body responses (FBRs) to implanted biomaterials often involve excessive macrophage-mediated inflammation, leading to fibrotic encapsulation, infection, and implant failure. Advances in tissue engineering demonstrate that macrophage polarization - the transition from pro-inflammatory M1 to anti-inflammatory M2 phenotypes - can be influenced by biomaterial properties to mitigate these responses and enhance regeneration. This review synthesizes the relationship between biomaterial properties, such as surface chemistry, structure, and stiffness, and their ability to modulate macrophage behavior. Key innovations, …

Editorial: Women In Science: Allergy Research, Gemma Carreras-Badosa, Vanesa Esteban, Vivian Hernandez-Trujillo, Elina Toskala, Manali Mukherjee, Saba Al Heialy, Karin Fieten

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

No abstract provided.

Characterizing Radiation-Related Laryngotracheal Stenosis, Natalia Queenan, Jay Trivedi, Dylan Bertoni, Sana Siddiqui, Austin Yap, Kathleen Tibbetts

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: Radiation-related laryngotracheal stenosis (RLTS) develops due to fibrosis of the airway after radiotherapy. We aim to characterize the presentation, management, and outcomes of patients with RLTS and compare these to patients with iatrogenic laryngotracheal stenosis (ILTS).

METHODS: In a single-center retrospective cohort study, patients diagnosed with RLTS between 2017 and 2022 were identified. Demographic data, risk factors, cancer history and treatment, presentation of stenosis, primary stenosis intervention, and outcomes were extracted. Patients were compared to a cohort of patients with ILTS and no history of radiation therapy. Data were analyzed using Fisher's Exact Tests and paired t-tests.

RESULTS: Seven …

Unmet Supportive Care Needs In Patients With Advanced Cancer And Its Impact On Distress, Kayla W Miranda, Benjamin L Musher, Hoda J Badr

Faculty, Staff and Students Publications

Purpose: Patients with advanced cancer endure considerable physical and emotional distress without sufficient supportive care. This cross-sectional study examined the relationship between cancer-related symptoms, supportive care needs, and distress levels in patients with advanced lung, head and neck, or gastrointestinal cancers.

Methods: 158 patients were assessed for symptom burden and distress levels using the M.D. Anderson Symptom Inventory (MDASI) and unmet needs using the Supportive Care Needs Survey (SCNS-34) within one month of treatment initiation. Pearson correlations and multiple regression analyses were used to explore associations between supportive care needs and distress.

Results: Distress levels were moderate across the study …

Dysphagia And Covid-19 In Adults: A Prospective Clinical Trial With Fiberoptic Endoscopic Evaluation Of Swallowing, Gökhan Can Törpü, Müberra Tanrıverdi, Nahide Öztoprak, Ömer Faruk Çalım, Orhan Özturan

Internet Journal of Allied Health Sciences and Practice

Purpose: Coronavirus disease 2019 (COVID-19) is distinguished by its impact on various tissues and organs across the body. It is known that COVID-19-related conditions are associated with swallowing function. This prospective study aimed to investigate the correlation between COVID-19 and dysphagia in adults. Methods: Adults who applied to the swallowing disorders outpatient clinic participated in this study. According to polymerase chain reaction (PCR) testing, participants were divided into two groups: COVID-19 and non-COVID-19 group. Swallowing disorders were evaluated using fiberoptic endoscopic evaluation of swallowing and scored with the Penetration-Aspiration Scale (PAS). PAS score > 1 was considered as dysphagia. Oral …

Disc Edema Secondary To Sleep Apnea: A Case Report, Jeannette A. Wong-Powell Od

Optometric Clinical Practice

Background: Bilateral optic disc edema is associated with multiple systemic conditions of potentially dire consequences. Idiopathic intracranial hypertension (IIH) is a common culprit and diagnosis of exclusion, which has been observed in multiple patients with obstructive sleep apnea (OSA) and raised questions of a pathophysiological link between the two.

Case Report: A 28-year-old Caucasian male with history of transient ischemic attack-like symptoms presented with bilateral disc edema prompting a multi-disciplinary work up that included imaging, lumbar puncture, laboratory analysis, neuroophthalmological, cardiological, and pulmonary evaluations that ultimately led to a diagnosis of OSA. The case is unique in that it followed …

The Impact Of Digital Inequities On Oropharyngeal Cancer Disparities In The United States, David J. Fei-Zhang, Achilles A. Kanaris, Camaren M. Cuenca, Sydney A. Fleishman, Jill N. D'Souza, Anthony M. Sheyn, Daniel C. Chelius, Jeffrey C. Rastatter

School of Medicine Faculty Publications

Objective: To assess associations of digital inequity with oropharyngeal cancer (OPC) prognostic and care outcomes in the United States while adjusting for traditional social determinants/drivers of health (SDoH). Study Design: Retrospective cohort study. Setting: United States. Methods: In total, 70,604 patients from 2008 to 2017 were assessed for regression trends in long-term follow-up period, survival, prognosis, and treatment across increasing overall digital inequity, as measured by the Digital Inequity Index (DII). DII is based on 17 census-tract level variables derived from the American Community Survey and Federal Communications Commission. Variables were categorized as infrastructure-access (ie, digital-related variables) or sociodemographic (ie, …

Ototoxicity Monitoring: The Evolution Of A Protocol For Head And Neck Cancer Patients, Jena Patel, Jacob Beiriger, Kalena Liu, Zachary Urdang, Julia Croce, Molly Wolfson, Jacob Hulswit, Olivia Giglio, Jacob B. Hunter, Irina L. Middleton

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: We evaluated an ototoxicity monitoring program (OMP) for improving audiologic follow-up in head and neck cancer (HNC) patients.

STUDY DESIGN: Retrospective cohort study.

SETTING: Tertiary academic center.

METHODS: Two hundred and forty patients were recommended for chemotherapy between January 2017 and June 2022. An OMP was implemented in March 2021; every patient received an audiology referral and was contacted to schedule a pretreatment audiogram. Patients were divided into pre-OMP and post-OMP cohorts. Main outcome measures included rates of pretreatment audiograms, posttreatment audiograms, posttreatment otologic symptoms, and hearing aid utilization.

RESULTS: There were 131 patients evaluated pre-OMP and 109 evaluated …

Tobacco Smoke Exposure Is A Driver Of Altered Oxidative Stress Response And Immunity In Head And Neck Cancer, Yang Li, Pedram Yadollahi, Fonma N Essien, Vasanta Putluri, Chandra Shekar R Ambati, Karthik Reddy Kami Reddy, Abu Hena Mostafa Kamal, Nagireddy Putluri, Lama M Abdurrahman, Maria E Ruiz Echartea, Keenan J Ernste, Akshar J Trivedi, Jonathan Vazquez-Perez, William H Hudson, William K Decker, Rutulkumar Patel, Abdullah A Osman, Farrah Kheradmand, Stephen Y Lai, Jeffrey N Myers, Heath D Skinner, Cristian Coarfa, Kwangwon Lee, Antrix Jain, Anna Malovannaya, Mitchell J Frederick, Vlad C Sandulache

Faculty, Staff and Student Publications

Background: Exposomes are critical drivers of carcinogenesis. However, how they modulate tumor behavior remains unclear. Extensive clinical data show cigarette smoke to be a key exposome that promotes aggressive tumors, higher rates of metastasis, reduced response to chemoradiotherapy, and suppressed anti-tumor immunity. We sought to determine whether smoke itself can modulate aggressive tumor behavior in head and neck squamous cell carcinoma (HNSCC) through reprogramming of the cellular reductive state.

Methods: Using established human and murine HNSCC cell lines and syngeneic mouse models, we utilized conventional western blotting, steady state and flux metabolomics, RNA sequencing, quantitative proteomics and flow cytometry to …

International Multispecialty Expert Physician Preoperative Identification Of Extranodal Extension In Patients With Oropharyngeal Cancer Using Computed Tomography: Prospective Blinded Human Inter-Observer Performance Evaluation, Onur Sahin, Serageldin Kamel, Kareem A Wahid, Cem Dede, Nicolette Taku, Renjie He, Mohamed A Naser, Christina S Sharafi, Antti Mäkitie, Benjamin H Kann, Kimmo Kaski, Jaakko Sahlsten, Joel Jaskari, Moran Amit, Gregory M Chronowski, Eduardo M Diaz, Adam S Garden, Ryan P Goepfert, Jeffrey P Guenette, G Brandon Gunn, Jussi Hirvonen, Frank Hoebers, Katherine A Hutcheson, Nandita Guha-Thakurta, Jason Johnson, Diana Kaya, Shekhar D Khanpara, Kristofer Nyman, Stephen Y Lai, Miriam Lango, Kim O Learned, Anna Lee, Carol M Lewis, Anastasios Maniakas, Amy C Moreno, Jeffrey N Myers, Jack Phan, Kristen B Pytynia, David I Rosenthal, Vlad C Sandulache, Dawid Schellingerhout, Shalin J Shah, Andrew G Sikora, Abdallah S R Mohamed, Melissa M Chen, Clifton D Fuller, Multidisciplinary Oropharyngeal Cancer Extra‐Nodal Extension (Opc Ene) Assessment Working Group

Faculty, Staff and Students Publications

Background: Pathologic extranodal extension (pENE) is a crucial prognostic factor in oropharyngeal cancer (OPC), but determining pENE from imaging has high inter-observer variability. The role of clinician specialty in the accuracy of imaging-detected extranodal extension (iENE) remains unclear. The purpose of this study is to assess the influence of clinician specialty on the accuracy of preoperative iENE detection in human papillomavirus (HPV)-positive OPC using computed tomography (CT) imaging.

Methods: This prospective observational study evaluated pretherapy CT images from 24 HPV-positive OPC patients (30 scans, including duplicates). Thirty-four expert observers (11 radiologists, 12 surgeons, 11 radiation oncologists) assessed iENE and reported …

Fruits Of The Professional Educator Appreciation And Recognition (Pear) Awards: Learning What Students Value In Their Medical Educators, Madeline Tomlinson, Kristiana Nasto, Kevin Gosselin, Ellen M Friedman, Anne Gill, Stacey Rose

Faculty, Staff and Students Publications

Purpose: The Professional Educator Appreciation and Recognition (PEAR) awards program was created by students at Baylor College of Medicine (BCM) in 2020 to recognize exemplary educators. We reviewed our 3-year experience of this initiative to identify characteristics of award-winning educators, and to assess the award's impact.

Materials and methods: We reviewed the title, department, and clinical affiliation of award winners. Using ChatGPT, we qualitatively analyzed de-identified nomination narratives to identify themes of educator characteristics most valued by students. Following refinement by the study team, each award was then assigned one or more themes. Unsolicited thank-you emails were reviewed to consider …

Key Decision-Making Factors In Pediatric Microtia Repair, Maya Guhan, Grace Anand, Yi-Chun Liu

Faculty, Staff and Students Publications

No abstract provided.

Evaluation Of A Comprehensive Set Of Normal Tissue Complication Probability Models For Patients With Head And Neck Cancer In An International Cohort, Suzanne P M De Vette, Maria I Van Rijn-Dekker, Lisa Van Den Bosch, Kylie Keijzer, Hendrike Neh, Hung Chu, Yan Li, Mark L Frederiks, Hans Paul Van Der Laan, Jolien Heukelom, Peter Van Luijk, Arjen Van Der Schaaf, Roel J H M Steenbakkers, Nanna M Sijtsema, Katherine A Hutcheson, Clifton D Fuller, Johannes A Langendijk, Amy C Moreno, Lisanne V Van Dijk

Faculty, Staff and Student Publications

Background/purpose: Normal tissue complication probability (NTCP) models can be used to guide radiation therapy (RT) decisions by estimating side-effect risks pretreatment to minimize (late) side-effects. Recently, a comprehensive individual toxicity risk (CITOR) profile of NTCP models addressing common side-effects in head and neck cancer (HNC) patients was developed. This study investigates the generalizability of these models in an international setting, with different treatment approaches and side-effect assessments, promoting their integration into more widespread clinical practice.

Materials/methods: From a prospective registry study, 407 HNC patients were included who were treated with definitive RT with or without systemic therapy between 2015 and …

Effect Of Eye Position On Variability Of The Vestibulo-Ocular Reflex, Kathryn Mozzochi, Amsal Madhani, Michael D. Balkwill, Divya Chari, Faisal Karmali

Tower Health Research Day

No abstract provided.

Stop The Bleed! Acute Epistaxis Management, Christopher R. Cannell

Lynchburg Journal of Medical Science

Epistaxis, the most common Otolaryngology-related emergency, is responsible for one in 200 emergency department (ED) visits in the United States (US) and one-third of otolaryngology visits.^1,11 Up to 60% of the population will experience epistaxis during their lifetime, and 6% -10 % will require medical intervention.^2,3 Epistaxis occurs in children and adults and has a seasonal variation. Although 85% of nosebleeds are idiopathic, they are more frequent in those on supplemental oxygen, anticoagulation, antiplatelet therapy, and in those with other conditions that may predispose them to bleeding. Most clinicians will encounter patients with acute epistaxis; therefore, it is …

Laryngeal Tuberculosis Mimicking Laryngeal Candidiasis, Claire Walters, Maranda Saigh, Eytan Keidar

Posters

Tuberculosis (TB) from the bacterium Mycobacterium tuberculosisand candidiasis from the fungus Candida albicansare both opportunistic pathogens with the ability to instigate infections within the larynx with similar clinical features, yet vastly different diagnostic parameters and treatment regimens.

Here, we highlight a case of an Indian woman on immune-modulating drugs who presented with severe laryngeal symptoms initially presumed to be laryngeal candidiasis but was later discovered to be laryngeal tuberculosis.

Outcomes Of Double Free Flap Reconstruction For Advanced Head And Neck Tumors In A Safety-Net Hospital Population, Yossef Alsabawi, John M. Gaddis, Angela D. Haskins, Jonathan Shum, David J. Hernandez

Research Symposium

Background: Double-free flap reconstruction has emerged as a viable option for addressing more complicated defects after oncologic resection. We aim to report the feasibility of this approach at a single-institutional safety net hospital.

Methods: A retrospective chart review was performed between November 2020 and October 2023 for adult patients who underwent multiple, simultaneous free tissue transfers for head and neck defects following tumor resection. This study occurs at Ben Taub Hospital, a safety net hospital in Houston, Texas. Data collected included demographics, risk factors, oncologic and operative details, complications, and functional and disease outcomes. Socioeconomic status was assessed …