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Article ; Online: Online Searches Related to Total Laryngectomy.

Wu, Michael P / Miller, Lauren E / Meyer, Charles D / Feng, Allen L / Richmon, Jeremy D

2023 Volume 133, Issue 11, Page(s) 2971–2976

Abstract: Objective: To identify the most frequently asked questions regarding "laryngectomy" through an assessment of online search data.: Methods: Google Search data based on the search term "laryngectomy" were analyzed using Google Trends and Search ... ...

Abstract	Objective: To identify the most frequently asked questions regarding "laryngectomy" through an assessment of online search data. Methods: Google Search data based on the search term "laryngectomy" were analyzed using Google Trends and Search Response. The most common People Also Ask (PAA) questions were identified and classified by the concept. Each website linked to its respective PAA question was rated for understandability, ease of reading, and reading grade level. Results: Search popularity for the term "laryngectomy" remained stable between 2017 and 2022. The most popular PAA themes were post-laryngectomy speech, laryngectomy comparison to tracheostomy, stoma and stoma care, survival/recurrence, and post-laryngectomy eating. Of the 32 websites linked to the top 50 PAA's, eleven (34%) were at or below an 8 Conclusion: Post-laryngectomy speech, eating, survival, the stoma, and the difference between laryngectomy and tracheostomy are the most common topics searched online in relation to "laryngectomy." These are important areas for both patient and healthcare provider education. Level of evidence: N/A Laryngoscope, 133:2971-2976, 2023.
MeSH term(s)	Humans ; Laryngectomy ; Comprehension ; Tracheostomy ; Speech ; Internet
Language	English
Publishing date	2023-03-08
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.30643
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Article ; Online: Laryngeal Force Sensor: Quantifying Extralaryngeal Complications after Suspension Microlaryngoscopy.

Feng, Allen L / Song, Phillip C

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

2018 Volume 159, Issue 2, Page(s) 328–334

Abstract: Objectives To develop a novel sensor capable of dynamically analyzing the force exerted during suspension microlaryngoscopy and to examine the relationship between force and postoperative tongue complications. Study Design Prospective observational study. ...

Abstract	Objectives To develop a novel sensor capable of dynamically analyzing the force exerted during suspension microlaryngoscopy and to examine the relationship between force and postoperative tongue complications. Study Design Prospective observational study. Setting Academic tertiary care center. Methods The laryngeal force sensor is a designed for use during microphonosurgery. Prospectively enrolled patients completed pre- and postoperative surveys to assess the development of tongue-related symptoms (dysgeusia, pain, paresthesia, and paresis) or dysphagia (10-item Eating Assessment Tool [EAT-10]). To prevent operator bias, surgeons were blinded to the force recordings during surgery. Results Fifty-six patients completed the study. Of these, 20 (36%) developed postoperative tongue symptoms, and 12 (21%) had abnormal EAT-10 scores. The mean maximum force across all procedures was 164.7 N (95% CI, 141.0-188.4; range, 48.5-402.6), while the mean suspension time was 34.3 minutes (95% CI, 27.4-41.2; range, 7.1-108.1). Multiple logistic regression showed maximum force (odds ratio, 1.15; 95% CI, 1.02-1.29; P = .019) and female sex (30.1%; 95% CI, 22.7%-37.5%; P < .001) as significant predictors for the development of tongue-related symptoms. The only significant predictor of an abnormal postoperative EAT-10 score was an increased maximum force (odds ratio, 1.03; 95% CI, 1.00-1.06; P = .045). Conclusions The laryngeal force sensor is capable of providing dynamic force measurements throughout suspension microlaryngoscopy. An increase in maximum force during surgery may be a significant predictor for the development of tongue-related symptoms and an abnormal EAT-10 score. Female patients may also be at greater risk for developing postoperative tongue symptoms.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; Equipment Design ; Humans ; Laryngoscopes ; Laryngoscopy/methods ; Middle Aged ; Monitoring, Intraoperative/instrumentation ; Outcome Assessment (Health Care) ; Postoperative Complications/physiopathology ; Pressure ; Prospective Studies ; Stress, Mechanical
Language	English
Publishing date	2018-04-03
Publishing country	England
Document type	Journal Article ; Observational Study
ZDB-ID	392085-9
ISSN	1097-6817 ; 0161-6439 ; 0194-5998
ISSN (online)	1097-6817
ISSN	0161-6439 ; 0194-5998
DOI	10.1177/0194599818768482
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Article ; Online: Management of the Embedded Tracheoesophageal Prosthesis: Retrograde Removal and Replacement.

Burks, Ciersten A / Feng, Allen L / Deschler, Daniel G

The Annals of otology, rhinology, and laryngology

2020 Volume 130, Issue 7, Page(s) 840–842

Abstract: Objective: To describe the retrograde removal of a tracheoesophageal (TE) prosthesis embedded in the common wall between the trachea and esophagus with preservation of the original tracheoesophageal puncture (TEP) tract with subsequent placement of new ... ...

Abstract	Objective: To describe the retrograde removal of a tracheoesophageal (TE) prosthesis embedded in the common wall between the trachea and esophagus with preservation of the original tracheoesophageal puncture (TEP) tract with subsequent placement of new tracheoesophageal prosthesis for voice restoration. Methods: The Blom-Singer TEP Set (InHealth Technologies, Carpinteria, CA) was used to facilitate this procedure. The coated wire leader cable was threaded through the small opening in the posterior tracheal wall and into the lumen of the old TE prosthesis. The wire was pulled through the mouth in retrograde fashion - bringing the old TE prosthesis out with it and dilating the existing TEP tract. A new prosthesis was then placed over the end of the wire and returned through the stoma, delivering the prosthesis through the TE tract and into the stoma. Results: Safe, voice restoration with avoidance of need for multiple procedures. Conclusion: Removal of an embedded prosthesis and simultaneous replacement of a new prosthesis was safely and efficiently achieved using a retrograde technique which maintained the patency of the prior TE tract and restored voice.
MeSH term(s)	Aged, 80 and over ; Device Removal/methods ; Esophagus/surgery ; Humans ; Male ; Prostheses and Implants ; Prosthesis Failure ; Trachea/surgery
Language	English
Publishing date	2020-10-23
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	120642-4
ISSN	1943-572X ; 0003-4894
ISSN (online)	1943-572X
ISSN	0003-4894
DOI	10.1177/0003489420967700
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Article ; Online: Partial parotidectomy via periauricular incision: Retrospective cohort study and comparative analysis to alternative incisional approaches.

Colaianni, C Alessandra / Feng, Allen L / Richmon, Jeremy D

Head & neck

2020 Volume 43, Issue 3, Page(s) 825–832

Abstract: Background: We investigated a periauricular approach to the parotid and compared outcomes to alternative parotidectomy incisions.: Methods: Retrospective chart review of patients (n = 97) undergoing partial parotidectomy for benign or malignant ... ...

Abstract	Background: We investigated a periauricular approach to the parotid and compared outcomes to alternative parotidectomy incisions. Methods: Retrospective chart review of patients (n = 97) undergoing partial parotidectomy for benign or malignant pathology by a single surgeon. After October 2017, most patients were approached via a periauricular incision (n = 59). Results: There was no significant difference in patient age, tumor location, length of hospital stay, postoperative complication, or pathology. Mean tumor diameter was significantly smaller in the periauricular group (2.1 cm) than in the traditional incision group (2.6 cm). No permanent injuries to facial nerve branches occurred in either group. Patients were followed for a median of 44 days after surgery. Conclusions: This is the largest study to date that demonstrates the periauricular incision is a safe and feasible approach for most parotid neoplasms. The cosmetic advantage of this approach is that the resulting scar is smaller and does not extend into the neck.
MeSH term(s)	Cicatrix ; Humans ; Parotid Gland/surgery ; Parotid Neoplasms/surgery ; Postoperative Complications/epidemiology ; Retrospective Studies
Language	English
Publishing date	2020-11-15
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.26542
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Article ; Online: Novel voice prosthesis after total laryngectomy with laryngoplasty reconstruction.

Feng, Allen L / Zenga, Joseph / Varvares, Mark A

Head & neck

2020 Volume 43, Issue 4, Page(s) 1321–1330

Abstract: Background: Although many patients achieve serviceable speech after total laryngectomy (TL), others are limited by un-naturally low pitch. We describe a cadaveric study to provide proof of concept for a novel voice prosthesis after TL with free tissue ... ...

Abstract	Background: Although many patients achieve serviceable speech after total laryngectomy (TL), others are limited by un-naturally low pitch. We describe a cadaveric study to provide proof of concept for a novel voice prosthesis after TL with free tissue laryngoplasty. Methods: Devices were implanted into fresh frozen cadavers after TL and free tissue laryngoplasty. Phonation pressures were measured using a custom Blom-Singer Manometer (InHealth Technologies, Carpinteria, CA) and acoustic files were analyzed using Praat, a speech analysis software. Results: Two fresh frozen cadavers were implanted with the voice prosthesis. Both prostheses demonstrated appropriate stenting of the laryngoplasty. Successful sound production was achieved after airflow generation at the proximal trachea. An average phonation pressure of 3.5 cmH Conclusions: The novel voice prosthesis described herein offers a feasible voice generation mechanism.
MeSH term(s)	Humans ; Laryngectomy ; Laryngoplasty ; Larynx, Artificial ; Phonation ; Prosthesis Design ; Speech
Language	English
Publishing date	2020-12-29
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.26592
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Article: Design, development, and face validation of an intubation simulation device using real-time force data feedback.

Rao, Gopikrishna M / Rao, Vishwanatha M / Juang, Jeremy / Benoit, Justin / Feng, Allen L / Song, Phillip C

Laryngoscope investigative otolaryngology

2022 Volume 7, Issue 5, Page(s) 1506–1512

Abstract: Objectives: To develop a novel laryngoscope device capable of dynamically measuring force and torque measurements in real-time during intubation and to explore the efficacy of such a device through a face validation simulation.: Methods: The torque ... ...

Abstract	Objectives: To develop a novel laryngoscope device capable of dynamically measuring force and torque measurements in real-time during intubation and to explore the efficacy of such a device through a face validation simulation. Methods: The torque sensor laryngoscope is designed for use during intubation and is modeled after a standard, single-use plastic laryngoscope. After device calibration, a face validation study was performed with intubation experts in the field. Quantitative data (intubation force metrics) and qualitative data (expert feedback on the device) were collected from three intubations using a Mac blade and three intubations with the Miller blade. Results: Three experts (two anesthesiologists and one otolaryngologist) participated in the study. The mean maximum force exerted with the Mac blade was 24.5 N (95% confidence interval [CI], 22.3-26.8). The average force exerted was 13.6 N (95% CI, 11.7-15.5). The average total suspension time was 13.1 s (95% CI, 10.4-15.8). The average total impulse was 164.6 N·s (95% CI, 147.9-181.4). The mean maximum force exerted with the Miller blade was 31.6 N (95% CI, 26.4-36.8). The average force exerted was 15.8 N (95% CI, 13.8-17.9). The average total suspension time was 11.3 s (95% CI, 9.9-12.6). The average total impulse was 216.2 N·s (95% CI, 186.5-245.9). The mean maximum force ( Conclusion: The torque sensor laryngoscope can measure and display real-time intubation force metrics for multiple laryngoscope blades. Initial validation studies showed a significantly lower maximum force and total impulse when intubating with the Mac blade than with the Miller blade. Face validation survey results were positive and suggested the potential for this device as a teaching tool. Level of evidence: Level 5.
Language	English
Publishing date	2022-09-15
Publishing country	United States
Document type	Journal Article
ISSN	2378-8038
ISSN	2378-8038
DOI	10.1002/lio2.916
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Article ; Online: Predictors of multiple dilations and functional outcomes after total laryngectomy and laryngopharyngectomy.

Cortina, Luis E / Wu, Michael P / Meyer, Charles D / Feng, Allen L / Varvares, Mark A / Richmon, Jeremy D / Deschler, Daniel G / Lin, Derrick T

Head & neck

2023 Volume 46, Issue 1, Page(s) 138–144

Abstract: Background: Following total laryngectomy (TL) or laryngopharyngectomy (TLP), patients may develop strictures that require multiple dilations to treat. However, the risk factors associated with dysphagia refractory to a single dilation are unknown.: ... ...

Abstract	Background: Following total laryngectomy (TL) or laryngopharyngectomy (TLP), patients may develop strictures that require multiple dilations to treat. However, the risk factors associated with dysphagia refractory to a single dilation are unknown. Methods: Single-institution retrospective review of patients who underwent at least one stricture dilation after TL/TLP between March 2013 and March 2022. Results: A total of 49 patients underwent stricture dilation after TL/TLP. Thirty-five (71%) underwent multiple dilations. Pharyngocutaneous fistula, primary chemoradiation therapy, and a shorter time interval from TL/TLP to first dilation were independently associated with dysphagia requiring multiple dilations. Patients in the multiple dilations group had a higher rate of limited diet and G-tube dependence compared to patients in the single dilation group. Conclusions: Shorter time interval to stricture formation is a prognostic indicator of the need for multiple dilations following TL/TLP. Patients requiring multiple dilations are at increased risk of persistent dysphagia long-term.
MeSH term(s)	Humans ; Constriction, Pathologic/complications ; Dilatation/adverse effects ; Laryngectomy/adverse effects ; Deglutition Disorders/etiology ; Retrospective Studies ; Treatment Outcome ; Esophageal Stenosis/complications ; Esophageal Stenosis/therapy
Language	English
Publishing date	2023-10-31
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.27545
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Article ; Online: Neck scar perception after neck dissection in HPV-associated oropharyngeal squamous cell carcinoma.

Au, Vivienne H / Miller, Lauren E / Mitchell, Margaret B / Larson, Andrew R / Lin, Derrick T / Feng, Allen L / Richmon, Jeremy D

American journal of otolaryngology

2023 Volume 45, Issue 1, Page(s) 104074

Abstract: Importance: While there has been an increased understanding of the impact of visible neck scars in some patients with certain diseases, this has not yet been explored in the HPV+ OPSCC population.: Objective: To understand patients' perception of ... ...

Abstract	Importance: While there has been an increased understanding of the impact of visible neck scars in some patients with certain diseases, this has not yet been explored in the HPV+ OPSCC population. Objective: To understand patients' perception of their scar and the impact on their quality of life (QOL) at least 6 months after neck dissection (ND) for HPV+ oropharyngeal squamous cell carcinoma (OPSCC). Design, setting, and participants: In this retrospective case-control study, patients who underwent primary transoral robotic surgery (TORS) and ND for HPV+ OPSCC between 2016 and 2021 at a single tertiary care center were identified. Data analysis was performed in January 2022. Main outcomes and measures: Dermatology Life Quality Index was modified (mDLQI) to assess patients' perceptions of their scars. The primary outcome was the mean mDLQI survey score with higher scores corresponding to worse perceptions. Three questions adapted from the Self-Consciousness Scale (SCS) were also included to assess awareness of appearance. All questions were scaled on a 0-3 Likert Scale. Tweedie generalized linear model was used to understand the relationship between mDLQI score and patient- and procedure-specific factors (including the three SCS survey questions). An additional exploratory logistic regression was performed to understand the risk factors for clinically significant mDLQI score change. Results: A total of 67 patients (response rate 57 %) completed the survey with a mean mDLQI survey score of 0.84 (max 30). Although there was a statistically significant negative association between private insurance and mDLQI survey score (95 % Confidence Interval [CI]: -2.72 - -0.38), and a positive association between the SCS score and mDLQI survey score (95 % CI: 0.23-0.81) (p < 0.05), these variables were not found to be risk factors for a clinically significant difference in mDLQI on multivariable analysis. Conclusion: The majority of patients felt their neck scars did not interfere with their daily lives. Patient perceptions of neck scars were consistent despite differing patient characteristics and treatment regimens.
MeSH term(s)	Humans ; Squamous Cell Carcinoma of Head and Neck/surgery ; Squamous Cell Carcinoma of Head and Neck/etiology ; Neck Dissection/adverse effects ; Quality of Life ; Cicatrix/etiology ; Carcinoma, Squamous Cell/pathology ; Retrospective Studies ; Case-Control Studies ; Papillomavirus Infections/complications ; Papillomavirus Infections/surgery ; Oropharyngeal Neoplasms/pathology ; Head and Neck Neoplasms/surgery ; Perception ; Robotic Surgical Procedures/adverse effects
Language	English
Publishing date	2023-10-12
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.2023.104074
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Article ; Online: Depth of resection predicts loss of tongue tip sensation after partial glossectomy in oral tongue cancer: A pilot study.

Cortina, Luis E / Meyer, Charles D / Feng, Allen L / Lin, Derrick T / Deschler, Daniel G / Richmon, Jeremy D / Varvares, Mark A

Oral oncology

2023 Volume 147, Page(s) 106595

Abstract: Objective(s): To characterize the change in sensory function following partial glossectomy for oral tongue cancer (OTC) and to identify predictors of loss of tongue-tip sensation (LoTTS).: Materials and methods: Patients with at least three months ... ...

Abstract	Objective(s): To characterize the change in sensory function following partial glossectomy for oral tongue cancer (OTC) and to identify predictors of loss of tongue-tip sensation (LoTTS). Materials and methods: Patients with at least three months follow-up after partial glossectomy for primary OTC were included. All patients underwent a qualitative tongue sensation assessment and an objective tongue sensory exam of the native tongue tip. Additional details regarding the oncologic resection, surgical reconstruction, and pathological stage were collected. Multiple linear and logistic regressions were used for statistical analysis. Results: Sixty-four patients were enrolled, including 34 (53%) men with a median age of 65 at enrollment. Ten (15%) patients reported LoTTS. Increased depth of resection (DOR) was an independent predictor of LoTTS on multivariate analysis, with an increased risk at a threshold of 1.3 cm. LoTTS was also associated with worse subjective quality of life and perceptive speech performance in our qualitative tongue assessment. Conclusions: In this pilot study, we found that DOR is a critical prognostic factor in predicting post treatment function. Patients with an increased DOR, particularly above 1.3 cm, are at greatest risk of LoTTS and associated morbidity. These findings may be used to predict post-operative sensory deficits, manage patients' expectations, and optimize the reconstructive approach. Future studies are needed to validate and replicate our results.
MeSH term(s)	Male ; Humans ; Female ; Tongue Neoplasms/etiology ; Glossectomy/methods ; Pilot Projects ; Quality of Life ; Tongue/surgery ; Sensation
Language	English
Publishing date	2023-10-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1120465-5
ISSN	1879-0593 ; 0964-1955 ; 1368-8375
ISSN (online)	1879-0593
ISSN	0964-1955 ; 1368-8375
DOI	10.1016/j.oraloncology.2023.106595
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Article ; Online: Plunging ranula with lingual nerve tether: Case report and literature review.

Suresh, Krish / Feng, Allen L / Varvares, Mark A

American journal of otolaryngology

2019 Volume 40, Issue 4, Page(s) 612–614

Abstract: Plunging ranulas are most often treated surgically; various surgical approaches may be necessary depending on the unique characteristics of each case. Here, we present the case of a plunging ranula noted on imaging to have a cordlike tether, which was ... ...

Abstract	Plunging ranulas are most often treated surgically; various surgical approaches may be necessary depending on the unique characteristics of each case. Here, we present the case of a plunging ranula noted on imaging to have a cordlike tether, which was revealed intraoperatively to be the lingual nerve. This case illustrates the importance of preoperative imaging for surgical planning, and when a transcervical approach may be the best choice for plunging ranulas.
MeSH term(s)	Adult ; Humans ; Lingual Nerve/diagnostic imaging ; Lingual Nerve/pathology ; Oral Surgical Procedures/methods ; Preoperative Period ; Ranula/diagnostic imaging ; Ranula/pathology ; Ranula/surgery ; Treatment Outcome
Language	English
Publishing date	2019-05-15
Publishing country	United States
Document type	Case Reports ; Journal Article ; Review
ZDB-ID	604541-8
ISSN	1532-818X ; 0196-0709
ISSN (online)	1532-818X
ISSN	0196-0709
DOI	10.1016/j.amjoto.2019.05.017
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