As competitiveness to obtain a residency position in the field of Otolaryngology–Head and Neck Surgery (Oto‐HNS) has continued to rise, applicants have endeavored to set themselves apart. One increasingly popular strategy is maximizing research output. Over the past 6 years, applicant metrics such as board scores and volunteer and work experiences have risen incrementally, while research production has more than doubled, from 8.4 mean number of abstracts, presentations, and publications in 2016 to 17.2 in 2022. This coincides with the exponential surge of new research fellowships among Oto‐HNS departments over a similar period, which is now up to at least 68 advertised positions. With a significant difference between the research production of matched and unmatched applicants, programs may be signaling a positive bias towards research‐heavy applicants. Whether this is intended and/or preferable should be examined more closely.

The abbreviated injury score (AIS) is commonly used as a grading system for inhalation injuries. While inhalation injury grades have inconsistently been shown to correlate positively with the time mechanical ventilation is needed, grading is subjective and relies heavily on the clinicians’ experience and expertise. Additionally, no correlation has been shown between these patients’ inhalation injury grades and outcomes. In this paper, we propose a novel inhalation injury grading method which uses deep learning algorithms in bronchoscopy images to determine the injury grade from the carbonaceous deposits, blistering, and fibrin casts in the bronchoscopy images. The proposed method adopts transfer learning and data augmentation concepts to enhance the accuracy performance to avoid overfitting. We tested our proposed model on the bronchoscopy images acquired from eighteen patients who had suffered inhalation injuries, with the degree of severity 1, 2, 3, 4, 5, or 6. As performance metrics, we consider accuracy, sensitivity, specificity, F-1 score, and precision. Experimental results show that our proposed method, with both transfer learning and data augmentation components, provides an overall 86.11% accuracy. Moreover, the experimental results also show that the performance of the proposed method outperforms the method without transfer learning or data augmentation.

Since its 2006 FDA approval, the Human Papillomavirus (HPV) vaccine has transformed the prevention of cervical, oropharyngeal, and other HPV-associated cancers in the United States. Despite notable progress, with 78.2% of adolescents initiating and 62.9% completing vaccination, support for the vaccine is at a critical point. Because the Department of Health and Human Services (HHS) mainly provides recommendations, state-level action is crucial. Only five states and territories have adopted school-entry HPV vaccination requirements, but with varying enforcement policies. Uptake varies across the U.S., from Massachusetts' 79.8% completion to Mississippi's 39.1%. Evidence shows that school-entry requirements can significantly improve vaccination rates. As we approach the vaccine's twentieth anniversary, maintaining the current gains and achieving the 80% Healthy People 2030 target for series completion demands a multipronged approach. State policies must become more robust, especially if federal support wanes. Preventing HPV-related cancers for future generations depends on continued progress. By prioritizing policy that strengthens prevention and access, states can safeguard this progress.

Objectives/Hypothesis: Socioeconomics and demographics have been shown to be determinates of healthcare in specialty clinics, in which thorough research is lacking in the setting of the United States clinical sphere. We set out to determine the impact of socioeconomic and demographic factors on patient preparedness in an otolaryngologic clinic as to highlight the need for awareness in this aspect of disparate and delayed clinical care.Study Design: Retrospective chart review.Methods: A chart review was conducted of 482 patients who visited our otolaryngology clinic between June 1, 2020 and June 1, 2023. Demographic data including marital status, gender, age, zip code, and race was collected.Results: Our study found several interesting points of significance. Marital status was a significant determinant of whether patients had missing labs and/or imaging (p = .001). Age was a significant determinant of patients having their imaging (p < .0001). Patients were more likely to have all their labs and imaging at a follow‐up appointment compared to an initial appointment (p < .0001). Finally, a patient's zip code was found to be a significant determinant of whether a patient no‐showed an appointment or arrived with all their needed imaging and labs (p = .004).Conclusions: Having the needed labs and imaging for a clinical visit is vital to providing timely and well‐informed care for all patients. This study highlighted several potential determinates of missing labs and imaging. Elderly patients were less likely to have imaging, which may be attributed to transportation issues and a weaker support system. Individuals who were married were more likely to have their imaging. Married individuals may have a stronger support system, where their spouses can provide transportation and reminders for appointments. Finally, the significance of zip code highlights the role transportation distance and living in an underserved area may have on patients being able to go to their appointments or obtain their needed imaging.Level of Evidence: 4

Background: Disparities in access to otolaryngology and cancer care exist across the United States. However, little is known about the geographic distribution of fellowship‐trained head and neck cancer (HNC) surgeons. Methods: A cross‐sectional study of American Head and Neck Society (AHNS) fellowship graduates from July 1, 1997 to June 30, 2022 was conducted. Geospatial and statistical analysis was conducted to assess current practice location and correlations with training regions. Results: Among 688 graduates, 622 practice in the US or Canada. Most graduates remained in the region of their training. Geospatial analysis showed concentration of graduates in urban areas, with 152 of 3142 US counties having higher‐than‐expected density. Underserved regions were identified in the southeastern US, southern border, and western states. Conclusions: Head and neck surgical fellowship graduates predominantly practice in large urban areas, leaving rural and underserved regions with limited access to complex HNC care. Strategic interventions are needed to address these gaps.

Background: Inflammation has long been a key tenet in the diagnosis and management of malignancies, likely contributing to cancer incidence, staging, and progression. Systemic inflammation, in particular, is often elevated prior to and during cancer development. Systemic inflammation in the context of cancer diagnosis and monitoring is measured by various inflammatory indexes such as the systemic inflammatory response index (SIRI), plasma-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and neutrophil-to-lymphocyte ratio (NLR). We set out to determine the relationship between pre- and post-treatment levels of these inflammatory indexes and the prognosis and outcomes of oropharyngeal cancer (OPC). Methods: A retrospective chart review was performed of 172 patients with OPC who underwent treatment for oropharyngeal cancer at University Medical Center in Lubbock, TX between May 2013 to May 2023. Sites of primary cancer were obtained through chart review. HPV infection status and differentiation of the tumor were noted for each patient. Treatment modalities were classified as surgery, radiation, chemotherapy, or concurrent chemotherapy and radiation. Treatment outcomes were classified based on recurrence and death secondary to disease. The relationships between treatment outcome and the described inflammatory indexes were evaluated. Appropriate parametric tests were selected based on the large number of variables. Results: Pre-treatment SIRI and Albumin levels were positively predictive in determining locoregional recurrence (p = 0.031 and p = 0.039). NLR, SII, and SIRI levels taken at three months post-treatment were also found to be positively predictive of locoregional recurrence (p = 0.005, p < 0.0005, and p = 0.007). SIRI taken at six months post-treatment was also found to be positively predictive of locoregional recurrence (p = 0.008). SII at six months post-treatment was found to be positively predictive of survival (p = 0.027). Conclusion: This study suggested that post-treatment levels of several inflammatory indexes, particularly SIRI, NLR, and SII, may be useful in determining the long-term outlook and recurrence of head and neck cancer following treatment.