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Background: Alcohol‐based skin preparations were first approved for surgical use in 1998 and have since become standard in most surgical fields. The purpose of this report is to examine incidence of surgical fires because of alcohol‐based skin preparation and to understand how approval and regulation of alcohol‐based skin preparations impacted trends in fires over time. Methods: We identified all reported surgical fires resulting in patient or staff harm from 1991 through 2020 reported to the Food and Drug Administration's Manufacturer and User Facility Device Experience (MAUDE) database. We examined incidence of fires because of these preparations, trends after approval and regulation, and common causes. Results: We identified 674 reports of surgical fires resulting in harm to patients and surgical personnel, in which 84 involved an alcohol‐based preparation. The time‐adjusted model shows that from 1996 through 2006, there was a 26.4% increase in fires followed by a 9.7% decrease from 2007 to 2020. The decrease in fires was most rapid for head and neck and upper aerodigestive tract surgeries. Qualitative content analysis revealed improper surgical site preparation as well as close proximity of surgical sites to an oxygen source as the most common causes of fires. Conclusion: Since FDA approval, alcohol‐based preparation solutions have been associated with a significant percentage of surgical fires. Warning label updates from 2006 to 2012 coupled with increased awareness efforts of associated risks of alcohol‐based surgical solutions likely contributed to the decrease in fires. Improper surgical site preparation technique and close proximity of surgical sites to oxygen continue to be risk factors for fires. Level of Evidence: 4 Laryngoscope, 134:607–613, 2024 [ABSTRACT FROM AUTHOR]

Background: Survival outcomes are generally better for human papillomavirus–associated oropharyngeal squamous cell carcinoma (HPV+ OPSCC) than other forms of head and neck cancer. However, less is known about oncologic outcomes, late adverse events, and gastrostomy tube dependence associated with salvage surgery after the failure of definitive chemoradiation in patients with HPV+ OPSCC. Methods: A secondary analysis of the Radiation Therapy Oncology Group 1016 randomized trial, which compared radiotherapy plus cetuximab to radiotherapy plus cisplatin in patients with HPV+ OPSCC, was performed. The oncologic and adverse event outcomes for patients who underwent salvage surgery were examined. Results: Among the 805 patients who were assigned to treatment and were eligible for analysis, 198 developed treatment failure. Salvage surgery was required for 61 patients (7.6%), with 33 patients undergoing salvage surgery after locoregional failure (LRF) and 28 patients undergoing salvage neck dissection within the 20 weeks after treatment. Patients with LRF who underwent salvage surgery experienced improved overall survival in comparison with patients with LRF who did not undergo surgery (45% vs. 17% at 5 years after treatment; hazard ratio, 0.41; 95% confidence interval [CI], 0.23–0.74). Surgical salvage after LRF was associated with similar frequencies of late grade 3/4 dysphagia in comparison with LRF without surgery (24% [95% CI, 13%–41%] vs. 20% [95% CI, 12%–32%]; p =.64) and with similar gastrostomy tube dependence at 2 years (29% [95% CI, 15%–49%] vs. 13% [95% CI, 5%–28%]; p =.12). Conclusions: Salvage surgery in patients with HPV+ OPSCC is associated with favorable survival and adverse event outcomes. Surgical salvage is associated with improved overall survival in patients with locoregionally recurrent, human papillomavirus–associated oropharyngeal cancer. The adverse event outcomes of surgical salvage patients are comparable to those of patients with recurrence who do not undergo surgery. [ABSTRACT FROM AUTHOR]

Importance: In head and neck cancer survivors, lung cancer screening may aid in detecting a second primary lung cancer or metastatic head and neck cancer earlier in the course of disease, which may improve treatment outcomes. However, no randomized data exist to assess the value of lung cancer screening in this population., Objective: To evaluate the incidence of second primary lung cancer in survivors of head and neck cancer survivors with screening low-dose computed tomography (CT) vs chest radiography (CXR)., Design, Setting and Participants: For this ad hoc secondary analysis of a randomized clinical trial, head and neck cancer survivors were identified from the National Lung Screening Trial, which enrolled participants from August 2002 to April 2004. This randomized clinical trial compared screening using low-dose CT chest vs CXR in patients aged 55 to 74 years with at least a 30 pack-year history of cigarette smoking and who were current smokers or had quit within the past 15 years and who were at high risk for lung cancer. The incidences of second primary lung cancer and second primary head and neck cancer were compared with screening using low-dose CT vs CXR. Data were analyzed from December 1, 2020, to June 30, 2021., Interventions: Screening low-dose CT of the chest vs CXR., Main Outcomes and Measures: The primary outcome was the incidence of a second primary lung cancer., Results: Among 53 452 enrolled participants, we identified 171 survivors of head and neck cancer, of whom 82 were screened with low-dose CT of the chest and 89 with CXR. Participants' mean (SD) age was 61 (5) years, and 132 were men (77.2%). The incidence of lung cancer was higher among head and neck cancer survivors compared with participants without head and neck cancer (2080 per 100 000 person-years [2.1%] vs 609 per 100 000 person-years [0.6%]; adjusted rate ratio, 2.54; 95% CI, 1.63-3.95). In head and neck cancer survivors, the incidence of second primary lung cancer was 2610 cases per 100 000 person-years in the low-dose CT group vs 1594 cases per 100 000 person-years in the CXR group (rate ratio, 1.55; 95% CI, 0.59-3.63). In head and neck cancer survivors, overall survival was 7.07 years with low-dose CT vs 6.66 years with CXR (log-rank P = .48)., Conclusions and Relevance: The results of this ad hoc secondary analysis of a randomized clinical trial suggest that head and neck cancer survivors are at especially high risk for a second primary lung cancer. These findings underscore the importance of low-dose CT screening in head and neck cancer survivors with significant cigarette smoking history who are fit to undergo treatment with curative intent.

Sensorineural hearing loss (SNHL) is a common finding in cases of the congenital internal acoustic canal (IAC) stenosis. Previous reports reveal a relationship between IAC stenosis and facial palsy as well as vestibular dysfunction. This case identifies a patient with bilateral profound SNHL, bilateral IAC stenosis, and temporary unilateral facial palsy who went on to receive bilateral cochlear implants (CI). The facial nerve synkinesis that was found in this patient with hypoplastic IACs occurred after a cochlear implant activation. The synkinesis was ipsilateral to prior transient facial palsy after salmonella infection. Patients with IAC stenosis and cochlear nerve hypoplasia may respond well to cochlear implantation, but caution should be used when considering CI with an emphasis on counseling for possible facial nerve complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2019, Grauer et al.)