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Objective: Limited investigation of factors potentially contributing to treatment choice in early‐stage glottic carcinoma (EGC) has been performed with large‐scale data. The National Cancer Database (NCDB) represents >72% of all new cancer cases in the United States. We hypothesized that NCDB variables may lend insight into treatment decisions between surgery and radiation for EGC. Methods: The NCDB was queried for all cases of T1‐2 N0 M0 glottic carcinoma from 2004 to 2016. We used multivariable logistic regression analysis to examine factors associated with first‐line treatment modality: radiation therapy (RT) versus surgery. All reported odds ratios (OR) were adjusted for age, gender, race, insurance, residence in a metropolitan area, region, and facility volume. Results: 34,991 EGC patients received treatment: 6,687 (19%) surgery; 20,289 (58%) RT; and 8,015 (23%) surgery and RT. OR for receiving RT (vs. surgery alone) were >2 for: more advanced T stage cancers (OR 2.5 [95%CI: 2.3, 2.7]), treatment at non‐academic facilities (OR 2.8, [95%CI: 2.6, 3.0]), and shorter travel distances to treatment centers (OR 2.2, [95%CI: 2.0, 2.4]). Surgery was more likely with treatment in the western US, higher income, private insurance, living in a metropolitan (vs. non‐metropolitan) area, female gender, older age, and low facility volume. Hispanic ethnicity, education level, and race were not associated with treatment type in the multivariable model. Conclusion: Most patients in the NCDB receive first‐line treatment with radiation for EGC, and this decision is associated with various tumor, patient, and treatment facility characteristics. Level of Evidence: 4 Laryngoscope, 133:901–907, 2023 [ABSTRACT FROM AUTHOR]

Background: Pathophysiology-targeting treatments exist for aspirin-exacerbated respiratory disease (AERD) through aspirin desensitization and biologics, such as dupilumab. With increasing attention paid to these treatments, which may be associated with significant side effects and/or cost, there is little description of chronic rhinosinusitis with nasal polyps (CRSwNP) response to treatment with intranasal corticosteroids and saline irrigations in AERD. Objective: To determine the effect of intranasal budesonide irrigations for the treatment of CRSwNP in AERD. Methods: This is an observational study of 14 AERD patients presenting to a rhinology clinic for CRS who were treated with twice daily high volume, low pressure irrigations with 240 mL of saline to which a 0.5 mg/2 mL respule of budesonide was added. All participants completed a 22-item Sinonasal Outcome Test (SNOT-22) at enrollment and at follow up 1 to 6 months later. Polyp scores were also calculated at each time point. Results: SNOT-22 scores ranged from 26 to 98 (median: 40.5) at enrollment and 3 to 85 (median: 38.5) at follow-up. Polyp scores ranged from 2 to 6 (median: 4) at enrollment at 0 to 6 (median: 2) at follow-up. Over the treatment period, change in SNOT-22 score ranged from −38 to 16 (median: −18) and change in polyp score ranged from −2 to 0 (median: −0.5). Approximately 57% of participants experienced at least 1 minimal clinically important difference in SNOT-22 score and 21% of participants had a SNOT-22 score <20 at follow-up. Conclusion: Medical management with intranasal corticosteroids and saline irrigations alone leads to significant improvement in sinonasal symptomatology in a subset of AERD. [ABSTRACT FROM AUTHOR]

Objectives/Hypothesis: As a cardinal symptom of chronic rhinosinusitis (CRS), hyposmia has been recommended to be assessed as a component of CRS disease control. Herein we determine the significance of hyposmia in CRS in the context of nasal obstruction and drainage symptoms. Study Design: Prospective, cross‐sectional Methods: Cross‐sectional study of 308 CRS patients (102 CRSwNP, 206 CRSsNP) without prior endoscopic sinus surgery. The burden of nasal obstruction and hyposmia were assessed using the corresponding item scores on the 22‐item Sinonasal Outcome Test (SNOT‐22). Burden of nasal discharge was assessed using the mean of "thick nasal discharge" and "thick post‐nasal discharge" SNOT‐22 item scores. Patients were all asked to rate their CRS symptom control as "not at all," "a little," "somewhat," "very," or "completely." Results: In CRSwNP, only 4.9% had a hyposmia score > 1 with nasal obstruction and drainage scores less than or equal to 1. In CRSsNP, only 1.9% had a hyposmia score > 1 with nasal obstruction and drainage scores less than or equal to 1. On univariate association, CRS symptom control was significantly associated with nasal obstruction, hyposmia, and drainage in both CRSwNP and CRSsNP (P <.05 in all cases). Using multivariable regression to account for all nasal symptoms, only nasal obstruction and nasal discharge scores (but not hyposmia) were significantly associated with CRS symptom control. Conclusions: Hyposmia rarely occurs without nasal obstruction or nasal drainage, and may therefore be redundant to assess for CRS disease control. Moreover, hyposmia was not associated with patient‐reported CRS symptom control when accounting for the burden of nasal obstruction and drainage. Level of Evidence: 3 Laryngoscope, 131:E2116–E2120, 2021 [ABSTRACT FROM AUTHOR]

Objective: Report a unique case of absent posterior belly of digastric muscle, with a literature review and discussion of its clinical importance. Methods: Present a case report and review the current literature including PUBMED search terms; "absent posterior digastric", "digastric muscle", "posterior belly". Results: While there were multiple reports of accessory anterior and posterior bellies and absence of anterior belly, there is a paucity of literature on absence of posterior belly of digastric muscle. Conclusion: To our knowledge, this is the first report of an absent posterior belly of the digastric muscle. The posterior belly of the digastric muscle is an important landmark in neck dissection, and its absence makes knowledge of other anatomic landmarks critically important. Laryngoscope, 131:1501–1502, 2021 [ABSTRACT FROM AUTHOR]