The Home Program Advantage in the Otolaryngology Residency Match.

OBJECTIVE: To evaluate the effect of home residency programs on outcomes in the otolaryngology residency match DESIGN: A retrospective online survey study during the 2015, 2018, 2019, 2020, and 2021 match cycles was conducted. All available otolaryngology residency positions listed by the National Resident Matching Program were compared with publicly available spreadsheets containing the following information: matriculated applicant name, medical school, whether the final match institution was the matriculated applicant's home program (HP), whether the matriculated applicant had completed an away rotation at their final matched institution (designated away institution, AI), or neither (designated Other Institution, OI). SETTING: Nonclinical survey study using publicly available spreadsheets containing The Match data from 2015 to 2021 located online at Otomatch.com. PARTICIPANTS: Newly matched United States otolaryngology-head and neck surgery residents completing the Otomatch.com survey RESULTS: A total of 1771 matched OHNS applicants were identified. Fifty-one percent of students were affiliated with their matched institution, with 25% of students matching at HPs, and 26% matching at AIs. Students with home programs had an increased likelihood of remaining in the same geographic region compared to students without home programs (OR 1.742 95% CI [1.21-2.506], p = 0.003). Applicants with HPs matched at significantly larger residency programs (p < 0.001). CONCLUSIONS: This study found that a majority of residents match at an institution with which they were affiliated, either their home program or away institution. Applicants with HPs are more likely to remain in the same geographic region as their medical school, and to match into larger residency programs compared to applicants without HPs.

An evaluation of otolaryngology resources at United States medical schools.

OBJECTIVE: Otolaryngology (OTO) is a competitive specialty, and medical school factors outside an applicant's control, such as presence of OTO student resources and an affiliated OTO residency program, can impact the competitiveness of a student's application. This study sought to evaluate the extent of OTO resources United States (U.S.) allopathic medical schools provide to help their students be successful, and to evaluate for medical school factors which may bias toward inequitable distribution of student OTO resources. METHODS: A 48-question cross-sectional survey evaluating the extent of OTO resources was distributed by email to LCME accredited U.S. allopathic medical schools in 2020 and 2021. RESULTS: Schools with residency programs and where faculty were employed through an OTO or surgery department were more likely to have an Otolaryngology Interest Group (OIG), an Otolaryngology Medical Student Education Director (OMSED), and were more likely to provide opportunities for OTO research.

A Cross-Sectional Survey Study Evaluating United States Medical School Curricula in Otolaryngology.

OBJECTIVES: With an ever-expanding medical knowledge base and requirements for clinical training, medical schools struggle to incorporate subspecialty education, such as otolaryngology (OTO), into curricula. This study aims to assess the current state of OTO education, and evaluate factors contributing to the extent of OTO teaching in United States (U.S.) medical schools. METHODS: A 48-question survey evaluated the extent and practices of OTO teaching. The survey was distributed by email to all 155 LCME accredited U.S. allopathic medical schools in 2020 and 2021. RESULTS: Sixty-eight unique responses were received (43.9% of U.S. allopathic medical schools). 36.8% (n = 25) of schools reported having formal expectations of OTO knowledge in their core curriculum. Only 1 school (1.5%) had a required OTO rotation; the majority of schools offered an optional third or fourth year clerkship rotation (76.5% and 95.6%, respectively). Schools with residency programs and who employ their faculty through an OTO or surgery department were more likely to have otolaryngologists teach basic science lectures and the Head & Neck exam, offer an optional third year rotation, and have formal expectations of rotating students. CONCLUSIONS: Medical schools with residency programs and who employ their faculty through an OTO or surgery department have more robust OTO curricula. Despite the ubiquity of OTO presentations across specialties, incorporation of OTO knowledge in U.S. medical school curricula remains variable, and at times limited.

Ghost Cell Odontogenic Carcinoma: A Case Report and Literature Review.

Ghost cell odontogenic carcinoma (GCOC) is an exceptionally rare malignant odontogenic neoplasm with a significant potential for aggressive growth. Although the literature on this tumor is limited, its high recurrence rates suggest that early and multimodal intervention may be beneficial. This study reports a case of GCOC of the mandible that was successfully treated with surgical resection, reconstruction, and radiation. A comprehensive literature review was performed, and the relevant genomic and histopathological characteristics of this malignancy were determined. Laryngoscope, 133:830-833, 2023.

Topical treatments for early-stage mycosis fungoides using Grading Recommendations Assessment, Development and Evaluation (GRADE) criteria: A systematic review.

BACKGROUND: Mycosis fungoides (MF) is a cutaneous lymphoma; most patients present with early, skin-limited disease and are managed by dermatologists. OBJECTIVE: The purpose of this study was to systematically review and assess the evidence on topical treatments for early-stage (IA, IB, IIA) MF. METHODS: We performed a literature search via MEDLINE, Embase, Web of Science, and Cochrane databases. Grading Recommendations Assessment, Development and Evaluation (GRADE) criteria were used to assess the certainty of the data. RESULTS: Two searches yielded 1252 references; 26 met the inclusion criteria and included literature on nitrogen mustard, retinoids, corticosteroids, carmustine, fluorouracil, methotrexate-laurocapram, hexadecylphosphocholine, peldesine, ingenol mebutate, topical methotrexate with oxygen flow-assisted LP3 carrier, and resiquimod. Most studies were single intervention, observational series. Nitrogen mustard, with the most published reports, was effective with 12%-82% early-stage MF patients (total n > 1000) achieving complete remission (CR) (low certainty evidence). Clinical CR was achieved among 10%-60% treated with topical retinoids (low certainty evidence). Two moderate-sized retrospective case series on topical steroids had 18%-63% CR (low certainty evidence). Only single studies were available for the other therapies. CONCLUSIONS: For most outcomes of interest, the GRADE certainty for topical therapies for early-stage MF was low. Further randomized controlled trials and inclusion of quality of life indicators are needed.

Resistance of Neisseria meningitidis to human serum depends on T and B cell stimulating protein B.

The ability of the human bacterial pathogen Neisseria meningitidis to cause invasive disease depends on survival in the bloodstream via mechanisms to suppress complement activation. In this study, we show that prophage genes coding for T and B cell stimulating protein B (TspB), which is an immunoglobulin-binding protein, are essential for survival of N. meningitidis group B strain H44/76 in normal human serum (NHS). H44/76 carries three genes coding for TspB. Mutants having all tspB genes inactivated did not survive in >5% NHS or IgG-depleted NHS. TspB appeared to inhibit IgM-mediated activation of the classical complement pathway, since survival of the tspB triple knockout was the same as that of the parent strain or a complemented mutant when the classical pathway was inactivated by depleting NHS of C1q and was increased in IgM-depleted NHS. A mutant solely carrying tspB gene nmbh4476_0681 was as resistant as the parent strain, while mutants carrying only nmbh4476_0598 or nmbh4476_1698 were killed in ≥5% NHS. The phenotype associated with TspB is formation of a matrix containing TspB, IgG, and DNA that envelopes aggregates of bacteria. Recombinant proteins corresponding to particular subdomains of TspB were found to have human IgG Fcγ- and/or DNA-binding activity, but only TspB derivatives containing both domains formed large, biofilm-like aggregates when combined with purified IgG and DNA. Recognizing the role of TspB in serum resistance may lead to a better understanding of why strains that carry tspB genes are associated with invasive meningococcal disease.