Featured Publications
Guideline - Adherence in advanced stage head and neck cancer is associated with improved survival – A National study
Cohen O, Brauer PR, Judson BL, Burtness BA, Earles J, Mehra S. Guideline - Adherence in advanced stage head and neck cancer is associated with improved survival – A National study. Oral Oncology 2021, 125: 105694. PMID: 34971883, DOI: 10.1016/j.oraloncology.2021.105694.Peer-Reviewed Original ResearchMeSH KeywordsBlack PeopleFemaleGuideline AdherenceHead and Neck NeoplasmsHumansProportional Hazards ModelsRetrospective StudiesConceptsOverall survivalNCCN guidelinesGuideline adherenceAdherence ratesNeck cancerAdvanced stage HNCGuideline adherence rateOverall stage IIINational Cancer DatabaseDecreased overall survivalAdvanced-stage headPrevalence of guidelinesComorbidity scoreAdherent patientsAdvanced headClinical stagingImproved survivalGuideline awarenessHNC patientsBlack raceInsurance statusNational cohortCancer DatabaseRisk factorsFemale genderPositive margin rates and predictors in transoral robotic surgery after federal approval: A national quality study
Hanna J, Morse E, Brauer PR, Judson B, Mehra S. Positive margin rates and predictors in transoral robotic surgery after federal approval: A national quality study. Head & Neck 2019, 41: 3064-3072. PMID: 31058417, DOI: 10.1002/hed.25792.Peer-Reviewed Original ResearchConceptsPositive margin rateTransoral robotic surgeryLow positive margin rateLow-volume facilitiesHigh-volume facilitiesPositive marginsT classificationMargin rateHuman papilloma virus (HPV) statusRobotic surgeryLymph-vascular invasionNational Cancer DatabaseMargin statusRetrospective reviewTumor subsiteVirus statusCancer DatabaseMultivariable regressionLinear associationPatientsSurgeryQuality studiesStatusAssociationClinical value of transoral robotic surgery: Nationwide results from the first 5 years of adoption
Li H, Torabi SJ, Park HS, Yarbrough WG, Mehra S, Choi R, Judson BL. Clinical value of transoral robotic surgery: Nationwide results from the first 5 years of adoption. The Laryngoscope 2018, 129: 1844-1855. PMID: 30575965, DOI: 10.1002/lary.27740.Peer-Reviewed Original ResearchMeSH KeywordsCarcinoma, Squamous CellChemoradiotherapy, AdjuvantChi-Square DistributionCombined Modality TherapyDatabases, FactualFemaleHumansKaplan-Meier EstimateMaleMargins of ExcisionMiddle AgedMultivariate AnalysisNatural Orifice Endoscopic SurgeryNeoplasm StagingOropharyngeal NeoplasmsProportional Hazards ModelsRegression AnalysisRetrospective StudiesRobotic Surgical ProceduresTreatment OutcomeUnited StatesConceptsOropharyngeal squamous cell carcinomaTransoral robotic surgeryTransoral laser microsurgeryNonrobotic surgeryTORS patientsPositive marginsTLM patientsLower likelihoodT2 oropharyngeal squamous cell carcinomaEarly stage oropharyngeal squamous cell carcinomaLong-term oncologic outcomesUse of TORSKaplan-Meier log-rank testRobotic surgeryNational Cancer DatabaseMajority of patientsMultivariate Cox analysisSquamous cell carcinomaLog-rank testChi-square testCox multivariateN3 diseaseAdjuvant chemoradiotherapyAdjuvant radiotherapyAdjuvant therapyA Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction
Morse E, Henderson C, Carafeno T, Dibble J, Longley P, Chan E, Judson B, Yarbrough WG, Sasaki C, Mehra S. A Clinical Care Pathway to Reduce ICU Usage in Head and Neck Microvascular Reconstruction. Otolaryngology 2018, 160: 783-790. PMID: 30060705, DOI: 10.1177/0194599818782404.Peer-Reviewed Original ResearchConceptsClinical care pathwayLength of stayReadmission ratesFree flap patientsCare pathwayICU admissionSurgical complicationsFlap patientsIntensive care unit admissionNeck free flap patientsRoutine ICU admissionCare unit admissionNumber of patientsNeck microvascular reconstructionFree tissue transferReconstruction of headPrepathway groupUnit admissionPostoperative complicationsPostoperative lengthVentilatory supportMedical complicationsMedian lengthPatient populationPathway implementation
2022
Prophylactic Intraoperative Antibiotic Dosing in Head and Neck Surgery: Opportunities for Improvement and Future Study
Shah R, Cohen O, Panth N, Dibble J, Paolillo D, Cook A, Mehra S. Prophylactic Intraoperative Antibiotic Dosing in Head and Neck Surgery: Opportunities for Improvement and Future Study. Otolaryngology 2022, 169: 482-488. PMID: 36113029, DOI: 10.1177/01945998221126144.Peer-Reviewed Original ResearchMeSH KeywordsAnti-Bacterial AgentsAntibiotic ProphylaxisCefazolinClindamycinHumansMetronidazoleRetrospective StudiesSurgical Wound InfectionConceptsIntraoperative antibiotic prophylaxisFree tissue transferAntibiotic prophylaxisAmpicillin-sulbactamNeck surgeryTissue transferAdherence ratesGuideline adherence rateProphylactic antibiotic regimenNeck oncologic surgeryRetrospective case seriesSingle academic centerSecondary exploratory analysisFrequency of administrationAntibiotic typeAntibiotic regimenGuideline adherencePostoperative infectionAntibiotic dosingCase seriesDosing recommendationsFuture studiesOncologic surgeryDose 2Dose 3
2021
Major Salivary Gland Cancer With Distant Metastasis Upon Presentation: Patterns, Outcomes, and Imaging Implications
Benchetrit L, Mehra S, Mahajan A, Rahmati RW, Judson BL, Edwards HA. Major Salivary Gland Cancer With Distant Metastasis Upon Presentation: Patterns, Outcomes, and Imaging Implications. Otolaryngology 2021, 167: 305-315. PMID: 34784258, DOI: 10.1177/01945998211058354.Peer-Reviewed Original ResearchMeSH KeywordsCarcinomaHumansNeoplasm MetastasisNeoplasm StagingPrognosisRetrospective StudiesSalivary Gland NeoplasmsTomography, X-Ray ComputedConceptsDistant metastasisMajor salivary gland cancerPredictors of DMRate of DMSite of DMHigh-grade mucoepidermoid carcinomaCancer-accredited hospitalsComputed tomography neckNational Cancer DatabaseCommon metastatic siteKaplan-Meier methodCox regression analysisLog-rank testSalivary duct carcinomaSalivary gland cancerRegression analysisMultivariate regression analysisHigh rateCancer presentationRetrospective cohortBone metastasesHistologic subtypeMetastatic sitesTumor histologyDuct carcinomaExtranodal Head and Neck Mantle Cell Lymphoma: Characteristics, Treatment, and Survival
Breen CT, Chao J, Mehra S, Kohli N. Extranodal Head and Neck Mantle Cell Lymphoma: Characteristics, Treatment, and Survival. Annals Of Otology Rhinology & Laryngology 2021, 131: 412-419. PMID: 34137303, DOI: 10.1177/00034894211025171.Peer-Reviewed Original ResearchConceptsMantle cell lymphomaExtranodal mantle cell lymphomaCumulative incidenceOverall survivalCell lymphomaEnd Results 18 registriesStage IV diseaseEarly-stage diseaseCause-specific hazards modelLate-stage diseaseProportion of casesSignificant differencesExtranodal headChemoradiation therapyCommon subsiteDisease characteristicsCommon siteAnatomic sitesPrimary headRadiation therapyCommon treatmentOral cavityHazards modelStage IIIStage I
2020
Revisiting the Radiation Therapy Oncology Group 1221 Hypothesis: Treatment for Stage III/IV HPV-Negative Oropharyngeal Cancer
Jacobs D, Torabi SJ, Park HS, Rahmati R, Young MR, Mehra S, Judson BL. Revisiting the Radiation Therapy Oncology Group 1221 Hypothesis: Treatment for Stage III/IV HPV-Negative Oropharyngeal Cancer. Otolaryngology 2020, 164: 1240-1248. PMID: 33198564, DOI: 10.1177/0194599820969613.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseHPV-negative oropharyngeal cancersChemoradiation therapyOverall survivalCancer DatabaseOropharyngeal cancerHPV-negative oropharyngeal squamous cell carcinomaLarge national cancer databaseNeck cancer-specific survivalOropharyngeal squamous cell carcinomaCox proportional hazards regressionKaplan-Meier survival analysisCancer-specific survivalImproved overall survivalMultivariable Cox regressionRetrospective cohort studyAdjuvant chemoradiation therapyUse of surgeryEnd Results ProgramProportional hazards regressionSquamous cell carcinomaSEER cohortAdjuvant therapyCohort studySEER databaseThe epidemiology, surgical management, and impact of margins in skull and mandibular osseous‐site tumors
Torabi SJ, Bourdillon A, Salehi PP, Kafle S, Mehra S, Rahmati R, Judson BL. The epidemiology, surgical management, and impact of margins in skull and mandibular osseous‐site tumors. Head & Neck 2020, 42: 3352-3363. PMID: 32743892, DOI: 10.1002/hed.26389.Peer-Reviewed Original ResearchConceptsOverall survivalPositive marginsImproved overall survivalNational Cancer DatabaseEffect of surgeryInherent selection biasSurgical managementCox regressionCancer DatabaseTreatment outcomesCartilage tumorsMultivariate analysisSurgeryTumorsOsteosarcomaEpidemiologySelection biasImpact of marginsTreatmentDescriptive analysisCohortAn Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank
Breen CT, Mehra S. An Analysis of Otolaryngology Medical Malpractice Payments From the National Practitioner Data Bank. Otolaryngology 2020, 164: 589-594. PMID: 32691675, DOI: 10.1177/0194599820942498.Peer-Reviewed Original ResearchConceptsPatient ageNational Practitioner Data BankMalpractice paymentsRetrospective cross-sectional analysisMean paymentCross-sectional analysisInsignificant injuryBrain damageLifelong careMedian paymentPatientsNumber of otolaryngologistsMedical malpractice paymentsOtolaryngologistsInjurySeveritySignificant decreaseAgeAnnual numberDescriptive statisticsPayment amountAssociationYearsLinear regressionAssessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States
Jacobs D, Torabi SJ, Gibson C, Rahmati R, Mehra S, Judson BL. Assessing National Utilization Trends and Outcomes of Robotic and Endoscopic Thyroidectomy in the United States. Otolaryngology 2020, 163: 947-955. PMID: 32539533, DOI: 10.1177/0194599820927699.Peer-Reviewed Original ResearchConceptsNational Cancer DatabaseEndoscopic thyroid surgeryRobotic thyroid surgeryThyroid surgeryOpen surgeryRobotic approachNational utilization trendsUnplanned hospital readmissionMultivariable logistic regressionOutcomes of roboticsPostoperative mortalityWorse morbidityComplication rateHospital readmissionEndoscopic thyroidectomyMortality outcomesPositive marginsSurgical approachNational cohortCancer DatabasePatient outcomesEndoscopic approachRetrospective analysisSurgeryOpen approachAdjuvant external beam radiotherapy for surgically resected, nonmetastatic anaplastic thyroid cancer
Saeed NA, Kelly JR, Deshpande HA, Bhatia AK, Burtness BA, Judson BL, Mehra S, Edwards HA, Yarbrough WG, Peter PR, Holt EH, Decker RH, Husain ZA, Park HS. Adjuvant external beam radiotherapy for surgically resected, nonmetastatic anaplastic thyroid cancer. Head & Neck 2020, 42: 1031-1044. PMID: 32011055, DOI: 10.1002/hed.26086.Peer-Reviewed Original ResearchMeSH KeywordsAgedChemotherapy, AdjuvantHumansRadiotherapy, AdjuvantRetrospective StudiesThyroid Carcinoma, AnaplasticThyroid NeoplasmsConceptsAnaplastic thyroid cancerLonger OSAdjuvant EBRTThyroid cancerAdjuvant external beam radiotherapyNational Cancer DatabaseExternal beam radiotherapyConcurrent chemoradiationConcurrent chemotherapyImproved survivalMedian ageCancer DatabaseRetrospective analysisBeam radiotherapyEBRTChemotherapyPatientsCancerUVAChemoradiationResectionRadiotherapy
2019
The Association between Industry Payments and Brand‐Name Prescriptions in Otolaryngologists
Morse E, Hanna J, Mehra S. The Association between Industry Payments and Brand‐Name Prescriptions in Otolaryngologists. Otolaryngology 2019, 161: 605-612. PMID: 31547772, DOI: 10.1177/0194599819852321.Peer-Reviewed Original ResearchClinical Outcomes of Head and Neck Cancer Patients Who Undergo Resection, But Forgo Adjuvant Therapy
LOGANADANE G, KANN BH, PARK HS, JOHNSON SB, MEHRA S, JUDSON BL, BHATIA A, BELKACEMI Y, YARBROUGH WG, BURTNESS B, HUSAIN ZA. Clinical Outcomes of Head and Neck Cancer Patients Who Undergo Resection, But Forgo Adjuvant Therapy. Anticancer Research 2019, 39: 4885-4890. PMID: 31519591, DOI: 10.21873/anticanres.13674.Peer-Reviewed Original ResearchConceptsLocoregional recurrence-free survivalAdjuvant therapyNeck squamous cell carcinomaOutcomes of patientsRecurrence-free survivalSquamous cell carcinomaNeck cancer patientsHNSCC patientsClinical outcomesRecurrence rateCell carcinomaMean TTPCancer patientsPatientsTherapyResectionMonthsOutcomesHNSCCSurgeryCarcinomaHeadIncidenceProgressionMargins in Laryngeal Squamous Cell Carcinoma Treated with Transoral Laser Microsurgery: A National Database Study
Hanna J, Brauer PR, Morse E, Mehra S. Margins in Laryngeal Squamous Cell Carcinoma Treated with Transoral Laser Microsurgery: A National Database Study. Otolaryngology 2019, 161: 986-992. PMID: 31476984, DOI: 10.1177/0194599819874315.Peer-Reviewed Original ResearchConceptsPositive margin rateLaryngeal squamous cell carcinomaPercent of patientsSquamous cell carcinomaPositive marginsTransoral laser microsurgeryMargin rateMargin statusT stageCell carcinomaNational Cancer DatabaseNational database studyMultivariable logistic regressionProper patient selectionEquivalent survival benefitLaser microsurgeryLaryngeal laser surgeryMicrosurgery resectionT3 tumorsNonacademic centersSurvival benefitGlottic tumorsMultivariable analysisPatient selectionRetrospective reviewPreoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins
Benchetrit L, Torabi SJ, Morse E, Mehra S, Rahmati R, Osborn HA, Judson BL. Preoperative biopsy in parotid malignancies: Variation in use and impact on surgical margins. The Laryngoscope 2019, 130: 1450-1458. PMID: 31411749, DOI: 10.1002/lary.28224.Peer-Reviewed Original ResearchConceptsPreoperative biopsyParotid malignanciesSurgical marginsPositive marginsClinical T1 stageNational Cancer DatabaseClinical T stageClinical N stageHigh-volume centersSubgroup of patientsMultivariable logistic regressionEarly clinical stageChi-square testAdjuvant therapyRetrospective cohortYounger patientsT stageClinical stageSurgical outcomesVolume centersBiopsy useCancer DatabaseN stageBiopsyPatientsEpidemiological analysis of croup in the emergency department using two national datasets
Hanna J, Brauer PR, Morse E, Berson E, Mehra S. Epidemiological analysis of croup in the emergency department using two national datasets. International Journal Of Pediatric Otorhinolaryngology 2019, 126: 109641. PMID: 31442871, DOI: 10.1016/j.ijporl.2019.109641.Peer-Reviewed Original ResearchConceptsEmergency Department SampleEmergency departmentReadmission ratesNational Hospital Ambulatory Medical Care SurveyAmbulatory Medical Care SurveyNational Emergency Department SampleNationwide Emergency Department SampleCases of croupHospital admission ratesInappropriate antibiotic useIncidence of croupMajority of casesRepeat admissionsSteroid usageHospital admissionAirway proceduresAnnual incidenceRetrospective reviewMean agePeak incidenceCare SurveyAdmission ratesAntibiotic useAntibiotic usageAverage ageIs robotic surgery an option for early T‐stage laryngeal cancer? Early nationwide results
Hanna J, Brauer PR, Morse E, Judson B, Mehra S. Is robotic surgery an option for early T‐stage laryngeal cancer? Early nationwide results. The Laryngoscope 2019, 130: 1195-1201. PMID: 31233223, DOI: 10.1002/lary.28144.Peer-Reviewed Original ResearchConceptsTransoral robotic surgeryTransoral laser microsurgeryAdjuvant radiationOpen surgerySupraglottic patientsOverall survivalCox regressionMargin statusMultivariable analysisSurgical approachLaryngeal cancerLaryngeal squamous cell carcinoma patientsSquamous cell carcinoma patientsEarly-stage laryngeal cancerRobotic surgeryMultivariable Cox regressionNational Cancer DatabaseCell carcinoma patientsRetrospective database analysisViable treatment optionTORS patientsPartial surgeryMultivariable logisticCarcinoma patientsNegative marginsPositive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation
Benchetrit L, Morse E, Judson BL, Mehra S. Positive Surgical Margins in Submandibular Malignancies: Facility and Practice Variation. Otolaryngology 2019, 161: 620-628. PMID: 31159649, DOI: 10.1177/0194599819852094.Peer-Reviewed Original ResearchConceptsPositive margin ratePositive surgical marginsPositive marginsOverall survivalMargin rateSurgical resectionSurgical marginsSubmandibular carcinomaCox proportional hazards regressionMultivariable logistic regression analysisCancer-accredited hospitalsPreoperative diagnostic biopsiesNational Cancer DatabasePrimary surgical resectionAdvanced T stageKaplan-Meier curvesProportional hazards regressionLogistic regression analysisQuality of careCarcinoma histologyRetrospective cohortMargin statusPreoperative biopsyT stageHazards regressionIndustry Payments for Otolaryngology Research: A Four‐Year Analysis of the Open Payments Database
Brauer PR, Morse E, Mehra S. Industry Payments for Otolaryngology Research: A Four‐Year Analysis of the Open Payments Database. The Laryngoscope 2019, 130: 314-320. PMID: 31059584, DOI: 10.1002/lary.27896.Peer-Reviewed Original ResearchMeSH KeywordsBiomedical ResearchCross-Sectional StudiesDatabases, FactualHumansIndustryOtolaryngologyRetrospective StudiesSpecialties, SurgicalUnited States