American Academy of Otolaryngology-Head and Neck Surgery, Oct. 3-6

The annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery was held in Los Angeles from Oct. 3 to 6 and attracted approximately 5,000 participants from around the world, including otolaryngologists, medical experts, allied health professionals, and administrators. The conference highlighted the latest advances in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck.

In one study, Clemens Heiser, M.D., Ph.D., of Klinikum Rechts der Isar der Technischen Universität München in Germany, and colleagues found that bilateral stimulation of the hypoglossal nerve appears to have similar clinical outcomes as unilateral stimulation for patients with moderate-to-severe obstructive sleep apnea.

The authors compared the outcomes for the first 10 patients with moderate-to-severe obstructive sleep apnea who underwent unilateral stimulation in 2014 to the first 10 patients who underwent bilateral stimulation in 2020. The researchers found that bilateral stimulation of the hypoglossal nerve with the Genio System (Nyxoah) seems to be as safe and effective as unilateral stimulation of the hypoglossal nerve with the Inspire II (Inspire Medical Systems).

"Patients with obstructive sleep apnea, who are noncompliant or nonadherent to their continuous positive airway pressure therapy and decide to go for hypoglossal nerve stimulation, can distinguish between these two systems. Both of them are comparable to each other," Heiser said. "A new system demonstrated to be as effective as the old system, which is really great news for the large cohort of obstructive sleep apnea patients."

Abstract: Bilateral vs Unilateral Hypoglossal Nerve Stimulation in OSA Patients

In another study, Nicole L. Molin, M.D., of Temple University Hospital in Philadelphia, and colleagues found that tracheostomy placement in COVID-19 patients does not decrease length of stay in the hospital or intensive care unit, but the number of deaths was significantly lower for patients with tracheostomy compared with those who did not undergo tracheostomy.

In this prospective cohort study, the authors evaluated the outcomes for ventilated COVID-19 patients who underwent tracheostomy compared to those who did not. Data were obtained using the review of medical records of patients older than the age of 18 years who had a diagnosis of COVID-19 and required invasive positive pressure ventilation. Outcome assessment included mortality, hospital length of stay, intensive care unit length of stay, and time on mechanical ventilation. The researchers found that tracheostomy placement in COVID-19 patients did not decrease hospital length of stay, intensive care unit length of stay, or time on mechanical ventilation.

"The need for a tracheostomy in the setting of COVID-19 is not a poor prognostic factor, as tracheostomy patients in our study had a higher survival rate than those in the nontracheostomy cohort," Molin said. "The decision to proceed with tracheostomy placement should be based on individual patient factors and patient prognosis similar to a non-COVID-19 setting."

Abstract: COVID-19 Tracheostomy Outcomes

Ariel Omiunu, M.D., of Rutgers New Jersey Medical School in Newark, and colleagues found that gender is an important perioperative risk stratification measure and may be useful for surgeons in clinical decision-making and management.

The authors utilized the American Cancer Society-National Surgical Quality Improvement Program database to determine the influence of gender on 30-day postoperative outcomes in patients with thyroid cancer undergoing thyroidectomy. Potential differences in demographics and comorbid conditions were identified among men and women within the selected patient population. The researchers found that men undergoing thyroidectomy for thyroid cancer were older with a higher comorbid disease burden prior to surgical intervention. Men also experienced higher odds of postoperative complications compared with women.

"To our knowledge, dedicated multi-institutional, population-based analyses exploring the association of gender and outcomes following thyroidectomy have yet to be performed," Omiunu said. "Providers should carefully evaluate male thyroid cancer patients to optimize modifiable medical risk factors prior to undergoing thyroidectomy."

Abstract: Gender and Outcomes in Patients With Thyroid Cancer Undergoing Thyroidectomy