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Article ; Online: Management of Newborn Traumatic Nasal Deformity with a Nostril Retainer.

Civantos, Alyssa M / Callander, Jacquelyn / Czechowicz, Josephine / Jacobson, Lia / Rosbe, Kristina W

2023 Volume 134, Issue 3, Page(s) 1469–1471

MeSH term(s)	Infant, Newborn ; Humans ; Nose/surgery ; Nose Diseases ; Rhinoplasty ; Cleft Lip/surgery
Language	English
Publishing date	2023-08-29
Publishing country	United States
Document type	Case Reports
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.30956
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Article ; Online: Factors Influencing Delay in Diagnosis of Head and Neck Cancer in Rwanda.

Nteyumwete, Hirwa / Civantos, Alyssa M / Stanford-Moore, Gaelen B / Yau, Jenny / Tuyishimire, Gratien / Umutoni, Josiane / Nyabyenda, Victor / Ncogoza, Isaie / Shaye, David A

The Laryngoscope

2023 Volume 134, Issue 4, Page(s) 1663–1669

Abstract: Objective: Head and neck cancer is a significant contributor to global otolaryngologic disease burden, with a disproportionate impact on low- and middle-income countries. This study investigates the factors contributing to delays in head and neck cancer ...

Abstract	Objective: Head and neck cancer is a significant contributor to global otolaryngologic disease burden, with a disproportionate impact on low- and middle-income countries. This study investigates the factors contributing to delays in head and neck cancer diagnosis at the University Teaching Hospital of Kigali (CHUK). Methods: Cross-sectional study of all patients with a pathologic diagnosis of head and neck cancer presenting to CHUK between January 2021 and June 2022. Sociodemographic data, tumor characteristics, and reasons for delay were collected. Univariate and multivariable analyses were undertaken to evaluate risk factors for delays. Results: Eighty-one patients met criteria for inclusion. Median duration from patient first reported symptoms to initial medical consultation was 52 weeks, from initial medical consultation to referral to CHUK was 4 weeks, and from referral to final pathologic diagnosis was 6 weeks. The most common reason for delay to referral to CHUK was financial (37.04%). Patients who visited traditional healers had higher odds of delay between symptom onset and medical consultation (OR 3.51, CI 1.05-11.70). Delays in final diagnosis after referral were most commonly due to OR availability for biopsy (37.04%) and time for pathology results after biopsy (35.80%). OR availability had a significant impact on duration to final diagnosis (OR 59.48, CI 7.17-493.67). Stage 4 disease had the shortest time to final diagnosis (OR 0.05, CI 0.01-0.45). Conclusion: Understanding the reasons for delayed diagnosis of head and neck cancer may help guide improvements in care, with the goal of reducing global head and neck burden of disease. Level of evidence: 3; prospective non-random follow-up study Laryngoscope, 134:1663-1669, 2024.
MeSH term(s)	Humans ; Prospective Studies ; Rwanda/epidemiology ; Follow-Up Studies ; Cross-Sectional Studies ; Hospitals, University ; Referral and Consultation ; Head and Neck Neoplasms/diagnosis ; Head and Neck Neoplasms/epidemiology
Language	English
Publishing date	2023-10-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	80180-x
ISSN	1531-4995 ; 0023-852X
ISSN (online)	1531-4995
ISSN	0023-852X
DOI	10.1002/lary.31103
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Article ; Online: Effect of the COVID-19 pandemic on medical student career perceptions: a national survey study.

Byrnes, Yasmeen M / Civantos, Alyssa M / Go, Beatrice C / McWilliams, Tara L / Rajasekaran, Karthik

Medical education online

2020 Volume 25, Issue 1, Page(s) 1798088

Abstract: Background & objective: The COVID-19 pandemic and resulting cancellation of medical student clinical rotations pose unique challenges to students' educations, the impact of which has not yet been explored.: Design: This cross-sectional survey study ... ...

Abstract	Background & objective: The COVID-19 pandemic and resulting cancellation of medical student clinical rotations pose unique challenges to students' educations, the impact of which has not yet been explored. Design: This cross-sectional survey study collected responses from 13 April 2020 until 30 April 2020. Students at US allopathic medical schools completed the survey online. Results: 1,668 responses were analyzed. A total of 337 (20.2%) respondents thought the pandemic would affect their choice of specialty, with differences across class years: 15.2% (53) of first-years (MS1s), 26.4% (92) of second-years (MS2s), 23.7% (162) of third-years (MS3s), and 9.7% (22) of fourth-years (MS4s) (p < 0.0001). Among all classes, the most common reason chosen was inability to explore specialties of interest (244, 72.4%), and the second was inability to bolster their residency application (162, 48.1%). Out of the MS3s who chose the latter, the majority were concerned about recommendation letters (68, 81.0%) and away rotations (62, 73.8%). As high as 17.4% (119) of MS3s said they were more likely to take an extra year during medical school as a result of the pandemic. Region of the US, number of local COVID cases, and number of local COVID deaths had no effect on whether respondents thought the pandemic would affect their specialty choice. Conclusions: Our study found that about one-fifth of surveyed medical students currently believe that the COVID-19 pandemic will affect their choice of specialty, with many of these citing concerns that they cannot explore specialties or obtain recommendation letters. With prolonged suspension of clinical rotations, targeted efforts by medical schools to address these concerns through enhanced virtual curriculum development and advising strategies will become increasingly important. Further study is needed to explore whether these cross-sectional student perspectives will manifest as changes in upcoming National Residency Matching Program data.
MeSH term(s)	Betacoronavirus ; COVID-19 ; Career Choice ; Coronavirus Infections/epidemiology ; Cross-Sectional Studies ; Humans ; Internship and Residency/statistics & numerical data ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Students, Medical/psychology ; Students, Medical/statistics & numerical data ; United States
Keywords	covid19
Language	English
Publishing date	2020-07-24
Publishing country	United States
Document type	Journal Article
ISSN	1087-2981
ISSN (online)	1087-2981
DOI	10.1080/10872981.2020.1798088
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Article ; Online: Effect of the COVID-19 pandemic on medical student career perceptions

Byrnes, Yasmeen M. / Civantos, Alyssa M. / Go, Beatrice C. / McWilliams, Tara L. / Rajasekaran, Karthik

Medical Education Online

a national survey study

2020 Volume 25, Issue 1, Page(s) 1798088

Keywords	Education ; General Medicine ; covid19
Language	English
Publisher	Informa UK Limited
Publishing country	uk
Document type	Article ; Online
ISSN	1087-2981
DOI	10.1080/10872981.2020.1798088
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Conference proceedings: Chondrosarcoma of the Skull Base: A Single-Institution 15-Year Review

Civantos, Alyssa M. / Prasad, Aman / Cretney, Evan J. / Newman, Jason G. / O'Malley, Bert W. / Brody, Robert M.

Journal of Neurological Surgery Part B: Skull Base

2021 Volume 82, Issue S 02

Event/congress	Special Virtual Symposium of the North American Skull Base Society, Online, 2021-02-13
Language	English
Publishing date	2021-02-01
Publisher	Georg Thieme Verlag KG
Publishing place	Stuttgart ; New York
Document type	Article ; Conference proceedings
ZDB-ID	2654269-9
ISSN	2193-634X ; 2193-6331
ISSN (online)	2193-634X
ISSN	2193-6331
DOI	10.1055/s-0041-1725296
Database	Thieme publisher's database

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Article ; Online: Management of chronic rhinosinusitis with steroid nasal irrigations: A viable nonsurgical alternative in the COVID-19 era.

Sweis, Auddie M / Locke, Tran B / Douglas, Jennifer E / Lin, Theodore C / Sweis, Brian M / Civantos, Alyssa M / Kennedy, David W

International forum of allergy & rhinology

2020 Volume 10, Issue 9, Page(s) 1108–1109

MeSH term(s)	Adult ; Aged ; Anti-Inflammatory Agents/administration & dosage ; Anti-Inflammatory Agents/therapeutic use ; Betacoronavirus ; Budesonide/administration & dosage ; Budesonide/therapeutic use ; COVID-19 ; Chronic Disease ; Coronavirus Infections/prevention & control ; Drug Administration Schedule ; Female ; Humans ; Male ; Middle Aged ; Mometasone Furoate/administration & dosage ; Mometasone Furoate/therapeutic use ; Nasal Lavage/methods ; Pandemics/prevention & control ; Pilot Projects ; Pneumonia, Viral/prevention & control ; Pregnanes/administration & dosage ; Pregnanes/therapeutic use ; Retrospective Studies ; Rhinitis/drug therapy ; SARS-CoV-2 ; Sinusitis/drug therapy ; Treatment Outcome
Chemical Substances	Anti-Inflammatory Agents ; Pregnanes ; Mometasone Furoate (04201GDN4R) ; Budesonide (51333-22-3)
Keywords	covid19
Language	English
Publishing date	2020-07-16
Publishing country	United States
Document type	Letter
ZDB-ID	2625826-2
ISSN	2042-6984 ; 2042-6976
ISSN (online)	2042-6984
ISSN	2042-6976
DOI	10.1002/alr.22646
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Article ; Online: Care of immunocompromised patients with head and neck cancer during the COVID-19 pandemic: Two challenging and informative clinical cases.

Civantos, Alyssa M / Carey, Ryan M / Lichtenstein, Gary R / Lukens, John N / Cohen, Roger B / Rassekh, Christopher H

Head & neck

2020 Volume 42, Issue 6, Page(s) 1131–1136

Abstract: Background and methods: There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks ...

Abstract	Background and methods: There is an added level of complexity in the management of head and neck cancer patients with underlying immunosuppressive disorders during the COVID-19 pandemic. Head and neck oncologists are tasked with balancing the dual risks of cancer progression in the setting of impaired tumor immunity and increased susceptibility to life-threatening complications from exposure to viral infection for patients and providers. Through two cases of immunocompromised patients with newly diagnosed head and neck malignancies, we aim to provide guidance to clinicians struggling with how to best counsel and manage this unique subset of patients under these difficult circumstances. Results: After careful consideration of the options, we took different approaches in the care of these two patients. Conclusions: Ultimately, there is no uniform set of rules to apply to this heterogeneous group of immunocompromised patients. We provide some general principles to help guide patient management during the current pandemic.
MeSH term(s)	Adult ; COVID-19 ; Clinical Decision-Making ; Communicable Disease Control/methods ; Conservative Treatment/methods ; Coronavirus Infections/epidemiology ; Disease Management ; Female ; Follow-Up Studies ; Head and Neck Neoplasms/pathology ; Head and Neck Neoplasms/therapy ; Humans ; Immunocompromised Host ; Interdisciplinary Communication ; Laryngeal Neoplasms/pathology ; Laryngeal Neoplasms/surgery ; Male ; Middle Aged ; Mouth Neoplasms/pathology ; Mouth Neoplasms/surgery ; Pandemics/prevention & control ; Patient Safety ; Pneumonia, Viral/epidemiology ; Risk Assessment ; Sampling Studies ; Time Factors ; Time-to-Treatment/organization & administration ; United States ; Vocal Cords/pathology ; Vocal Cords/surgery
Keywords	covid19
Language	English
Publishing date	2020-04-22
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.26165
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Article ; Online: False-positive reverse transcriptase polymerase chain reaction screening for SARS-CoV-2 in the setting of urgent head and neck surgery and otolaryngologic emergencies during the pandemic: Clinical implications.

Katz, Andrew P / Civantos, Francisco J / Sargi, Zoukaa / Leibowitz, Jason M / Nicolli, Elizabeth A / Weed, Donald / Moskovitz, Alexander E / Civantos, Alyssa M / Andrews, David M / Martinez, Octavio / Thomas, Giovana R

Head & neck

2020 Volume 42, Issue 7, Page(s) 1621–1628

Abstract: Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT-PCR) for novel coronavirus in preoperative screening.: Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk ...

Abstract	Background: No reports describe falsepositive reverse transcriptase polymerase chain reaction (RT-PCR) for novel coronavirus in preoperative screening. Methods: Preoperative patients had one or two nasopharyngeal swabs, depending on low or high risk of viral transmission. Positive tests were repeated. Results: Forty-three of 52 patients required two or more preoperative tests. Four (9.3%) had discrepant results (positive/negative). One of these left the coronavirus disease (COVID) unit against medical advice despite an orbital abscess, with unknown true disease status. The remaining 3 of 42 (7.1%) had negative repeat RT-PCR. Although ultimately considered falsepositives, one was sent to a COVID unit postoperatively and two had urgent surgery delayed. Assuming negative repeat RT-PCR, clear chest imaging, and lack of subsequent symptoms represent the "gold standard," RT-PCR specificity was 0.97. Conclusions: If false positives are suspected, we recommend computed tomography (CT) of the chest and repeat RT-PCR. Validated serum immunoglobulin testing may ultimately prove useful.
MeSH term(s)	Aged, 80 and over ; Betacoronavirus/genetics ; COVID-19 ; Coronavirus Infections/diagnosis ; Coronavirus Infections/epidemiology ; Emergencies ; False Positive Reactions ; Female ; Florida/epidemiology ; Humans ; Lung/diagnostic imaging ; Male ; Middle Aged ; Nasopharynx/virology ; Otorhinolaryngologic Surgical Procedures ; Pandemics ; Pneumonia, Viral/diagnosis ; Pneumonia, Viral/epidemiology ; Preoperative Care ; RNA, Viral ; Reverse Transcriptase Polymerase Chain Reaction ; SARS-CoV-2 ; Tomography, X-Ray Computed ; Young Adult
Chemical Substances	RNA, Viral
Keywords	covid19
Language	English
Publishing date	2020-06-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.26317
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Article ; Online: Mental health among head and neck surgeons in Brazil during the COVID-19 pandemic: A national study.

Civantos, Alyssa M / Bertelli, Antonio / Gonçalves, Antonio / Getzen, Emily / Chang, Changgee / Long, Qi / Rajasekaran, Karthik

American journal of otolaryngology

2020 Volume 41, Issue 6, Page(s) 102694

Abstract: Purpose: Head and neck surgeons are among the highest risk for COVID-19 exposure, which also brings great risk to their mental wellbeing. In this study, we aim to evaluate mental health symptoms among head and neck surgeons in Brazil surrounding the ... ...

Abstract	Purpose: Head and neck surgeons are among the highest risk for COVID-19 exposure, which also brings great risk to their mental wellbeing. In this study, we aim to evaluate mental health symptoms among head and neck surgeons in Brazil surrounding the time it was declared the epicenter of the virus. Materials and methods: A cross-sectional, survey-based study evaluating burnout, anxiety, distress, and depression among head and neck surgeons in Brazil, assessed through the single-item Mini-Z burnout assessment, 7-item Generalized Anxiety Disorder scale, 22-item Impact of Event Scale-Revised, and 2-item Patient Health Questionnaire, respectively. Results: 163 physicians completed the survey (74.2% males). Anxiety, distress, burnout, and depression symptoms were reported in 74 (45.5%), 43 (26.3%), 24 (14.7%), and 26 (16.0%) physicians, respectively. On multivariable analysis, female physicians were more likely to report a positive screening for burnout compared to males (OR 2.88, CI [1.07-7.74]). Physicians 45 years or older were less likely to experience anxiety symptoms than those younger than 45 years (OR 0.40, CI [0.20-0.81]). Physicians with no self-reported prior psychiatric conditions were less likely to have symptoms of distress compared to those with such history (OR 0.11, CI [0.33-0.38]). Conclusion: Head and neck surgeons in Brazil reported symptoms of burnout, anxiety, distress and depression during our study period within the COVID-19 pandemic. Institutions should monitor these symptoms throughout the pandemic. Further study is required to assess the long-term implications for physician wellness.
MeSH term(s)	Adult ; Age Factors ; Aged ; Anxiety/epidemiology ; Betacoronavirus ; Brazil/epidemiology ; Burnout, Professional/epidemiology ; COVID-19 ; Coronavirus Infections/epidemiology ; Cross-Sectional Studies ; Depression/epidemiology ; Female ; Humans ; Male ; Middle Aged ; Occupational Stress/epidemiology ; Otolaryngologists/psychology ; Pandemics ; Pneumonia, Viral/epidemiology ; SARS-CoV-2 ; Sex Factors ; Stress, Psychological/epidemiology ; Surgeons/psychology ; Surveys and Questionnaires
Keywords	covid19
Language	English
Publishing date	2020-08-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	604541-8
ISSN	1532-818X ; 0196-0709
ISSN (online)	1532-818X
ISSN	0196-0709
DOI	10.1016/j.amjoto.2020.102694
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Article ; Online: Palliative care in metastatic head and neck cancer.

Civantos, Alyssa M / Prasad, Aman / Carey, Ryan M / Bur, Andrés M / Mady, Leila J / Brody, Robert M / Rajasekaran, Karthik / Cannady, Steven B / Hartner, Lee / Ibrahim, Said A / Newman, Jason G / Brant, Jason A

Head & neck

2021 Volume 43, Issue 9, Page(s) 2764–2777

Abstract: Background: Due to inherent impact on quality of life, metastatic head and neck cancer patients are well-suited to benefit from palliative care (PC). Our objective was to examine factors that shape PC utilization and implications for overall survival in ...

Abstract	Background: Due to inherent impact on quality of life, metastatic head and neck cancer patients are well-suited to benefit from palliative care (PC). Our objective was to examine factors that shape PC utilization and implications for overall survival in stage IVc head and neck cancer patients. Methods: A retrospective study of patients with stage IVc head and neck cancer in the National Cancer Database from 2004 and 2015 was conducted. Results: 7794 cases met inclusion criteria, of which 19.3% received PC. PC use was associated with more recent years of diagnosis, Northeast facility geography, and non-private insurances (p < 0.05). Compared to no PC, "interventional" PC, defined as palliative surgery, radiation, and/or chemotherapy, and "pain management only" PC were associated with lower overall survival (p < 0.05). Conclusions: PC use increased over time and was associated with demographic and clinical factors. There remains opportunity for improvement in optimal implementation of palliative care.
MeSH term(s)	Databases, Factual ; Head and Neck Neoplasms/therapy ; Humans ; Palliative Care ; Quality of Life ; Retrospective Studies
Language	English
Publishing date	2021-05-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	645165-2
ISSN	1097-0347 ; 0148-6403 ; 1043-3074
ISSN (online)	1097-0347
ISSN	0148-6403 ; 1043-3074
DOI	10.1002/hed.26761
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