olaryngology–Head and Neck SurgeryEditorial 2014© The Author(s) 2010


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Highlights Otolaryngology– Head and Neck Surgery 2015, V   ol. 152(2) 195­–196 © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599814562760 http://otojournal.org

Highlights from the Current Issue:  February 2015


ere in my hometown of Philadelphia, Pennsylvania, winter is upon us, and temperatures are low. In the spirit of this time of year, I would like to recommend to you some of the excellent papers we feature in this month’s issue of Otolaryngology–Head and Neck Surgery that will keep you warm and cozy around the fireplace (and appeal to readers in warmer climes, as well!). In the first article, Chung and colleagues1 examine the relationship between the use of statin medications and the incidence of sudden sensorineural hearing loss (SSNHL). The authors reviewed a database in Taiwan in which more than 1200 subjects with SSNHL were compared with more than 6300 disease-matched controls in a case-control study. After the investigators controlled for factors such as sex, age, and the presence of hypertension or cardiovascular disease, there was a significantly more common use of statin medications among patients with SSNHL than among matched controls (27.2% vs 21.3%, P < .001). The odds ratio (OR) of statin use before the onset of SSNHL versus controls was 1.36 (CI, 1.181.57). These findings support an association between the use of statin medications and the onset of an episode of SSNHL. While this study does not prove a causal relationship, it proposes a question about the nature of this observed risk and suggests additional research to further explore this interesting relationship. In another paper, Park and colleagues2 describe a case series of patients with either external auditory canal cholesteatoma (EACC) or keratosis obturans (KO). The authors noted that while these 2 disorders are similar, they have features that characterize them each in a distinct manner, often making a correct diagnosis more challenging. The authors presented data from 14 ears with EACC and 9 ears with KO. In their patient group, individuals with EACC were significantly older than those with KO. In addition, while EACC occurred unilaterally in all patients, 4 of 9 patients with KO had bilateral disease. Furthermore, KO lesions were all circumferential in the external auditory canal, while no EACC lesions invaded the superior portion of the canal. While symptoms were similar in the 2 groups, conductive hearing loss was about 10 dB greater in patients with KO than in those with EACC. The authors discuss these 2 uncommon conditions in greater detail and offer suggestions for management for patients with each of these 2 disorders. In a very interesting paper that highlights the growing influence of the Internet, Willson and colleagues3 present data demonstrating that Google search activity for terms common

to allergic rhinitis and its symptoms was strongly correlated with pollen counts for aeroallergens currently present in the environment during that time frame. In this study, Google trend data (www.google.com/trends) were obtained for search times related to inhalant allergies and their symptoms, and daily pollen and mold spore counts were simultaneously obtained for the corresponding geographic region. The authors demonstrated strong positive correlations between the search terms “allergies” (r = 0.798), “allergy” (r = 0.781), and “pollen” (r = 0.849) and concurrent pollen counts. Search terms on allergy symptoms were less strongly associated with pollen counts. The authors describe how the use of trending Google search data can model disease burden in the population. They also discuss the processes that individuals use to seek information that helps them better understand and define their current illness. This paper is important in showing the potential growing use of Google search trends as surrogates for disease burden in the population. Smith and colleagues4 discuss the role and effectiveness of targeted therapy for lymphedema among patients treated for head and neck cancer at the MD Anderson Cancer Center. In their study, the authors evaluated 733 patients who underwent complete decongestive therapy for soft, pitting edema of the head and neck. Smith and colleagues demonstrated that 60% of patients demonstrated improvement in lymphedema after completing a course of treatment. The authors further demonstrated that adherence to treatment predicted a complete response among patients. The authors finally describe the implications of their findings, including the observation that head and neck lymphedema differs from that at other sites and requires adaptations of traditional methods of treatment and assessment. Finally, Kong and Hu5 assess the readability of patient materials used for tracheotomy care and discuss the implications of Corresponding Author: John H. Krouse, MD, PhD, Temple University, Otolaryngology/HNS, 3440 N. Broad St., Kresge West #300, Philadelphia, PA 19140, USA. Email: [email protected]

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Otolaryngology–Head and Neck Surgery 152(2)

their interesting findings. It is commonly recognized that health information for patients should be presented at a fourth- to sixth-grade reading level. Unfortunately, observations in many areas have shown that materials designed for patients are frequently written at higher levels, which can prevent patients and families from using these resources effectively. In their paper, the authors noted that based on several validity indices of readability, online resources for tracheotomy were generally written at a level more difficult than the recommended fourth- to sixthgrade level for health information. Kong and Hu discuss the implications of these observations for otolaryngologists and their patients undergoing tracheotomy and for future development of patient education materials. I invite you to dive further into these excellent papers to examine their findings and implications, as well as to explore the many other outstanding papers featured in this February issue of Otolaryngology–Head and Neck Surgery.

References 1. Chung SD, Chen CH, Hung SH, et al. A population-based study on the association between statin use and sudden sensorineural hearing loss. Otolaryngol Head Neck Surg. 2015;152:319-325. 2. Park SY, Jung YH, Oh JH. Clinical characteristics of keratosis obturans and external auditory canal cholesteatoma. Otolaryngol Head Neck Surg. 2015;152:326-330. 3. Willson TJ, Lospinoso J, Weitzel E, et al. Correlating regional aeroallergen effects on Internet search activity. Otolaryngol Head Neck Surg. 2015;152:228-232. 4. Smith BG, Hutcheson KA, Little LG, et al. Lymphedema outcomes in patients with head and neck cancer. Otolaryngol Head Neck Surg. 2015;152:284-291. 5. Kong KA, Hu AC. Readability assessment of online tracheostomy care resources. Otolaryngol Head Neck Surg. 2015;152:272-278.

John H. Krouse, MD, PhD Editor in Chief Department of Otolaryngology/Head and Neck Surgery, Temple University, Philadelphia, PA, USA

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Highlights from the current issue: February 2015.

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