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tube placement. Unfortunately, the pectoralis flap became nonviable. Subsequently, he underwent anterolateral thigh free tissue transfer, wound vac, and hyperbaric oxygen therapy to help
with healing. He had a persistent pharyngocutaneous fistula
and was brought to the operating room to assess the wound.
The healing pharyngeal mucosa was too tenuous to hold a
suture, so we came up with a way to plug the defect. We used
Integra and parachuted it through the cutaneous defect into the
pharyngeal defect. We then kept it in place with Evicel.
Results: After 3 weeks, a swallow study was performed, and
there was no leak. He was allowed a diet per speech language
pathology. The cutaneous defect closed on its own after this
intervention without packing.
Conclusions: There are many ways to try to prevent a fistula,
including using vascularized tissue, ensuring euthyroid state,
good nutrition, specialized surgical closure techniques for
pharyngeal closure, and avoiding infection using perioperative antibiotics. We present an innovative way to attempt closure when all else has failed and the tissue cannot hold a suture
for usual closure techniques.
Comparison of Long-term Outcomes Between
Lip-Split and Mandibular Lingual Releasing
Approach in Advanced Gum Cancers
Howyun Ko (Presenter); Leong Perng Chan
Objectives: The aim of this study was to compare esthetic,
functional, and oncologic outcomes between the 2 access
procedures.
Methods: A retrospective cohort study was performed on
42 patients with T3/T4 gum cancers from 2014 to 2019. The
mandibular lingual releasing approach was used when the
mouth opening was ≥15 mm; otherwise, the lip-split was used.
Subjective outcomes of their speech, lip competence, and
postoperative facial appearance were accessed.
Results: Twenty patients received the mandibular lingual
releasing approach and 22 underwent lip-splits. There was no
significant difference in surgical margin, locoregional recurrence, operation time, and 5-year survival between the
2 groups. The mandibular lingual releasing approach had
lower rates of osteoradionecrosis, lip incompetence, and better facial appearance.
Conclusions: In advanced gum cancer, our data suggest that
the mandibular lingual releasing approach provides adequate
access to the lesion and does not compromise disease control
rate and is superior to the lip-split approach in terms of postoperative complications and facial appearance.
Cystic Lateral Neck Lymphadenopathy as
Initial Presentation of Papillary Thyroid
Carcinoma
Madelyn Stevens, MD (Presenter); Shaunak N. Amin;
James L. Netterville, MD; Sarah L. Rohde, MD
Objectives: Although the presence of cystic cervical lymph
nodes (LNs) is associated with metastatic head and neck

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carcinoma, the primary presentation of cystic LNs as indicative
for a new diagnosis of papillary thyroid carcinoma (PTC) has
not been well explored. Here we present an analysis of patients
with large cystic cervical LNs as the initial presenting sign of
PTC and explore the effect on treatment course.
Methods: A retrospective chart review from a single tertiary
care center was conducted of patients with lateral neck cystic
LN(s) who underwent surgical management of PTC from
2001 to 2019. Patient demographics, presentation, treatment
course, and radiologic and pathologic characteristics were
reviewed.
Results: Of 224 patients who underwent definitive surgical
treatment for PTC, 29 patients (12.9%) aged 8 to 78 years
(mean 43, SD 14.8) had 1 or more cystic LNs in levels 2, 3, 4,
or 5 at initial presentation. Time from initial identification to
definitive surgical treatment ranged from 22 to 212 days (mean
83.2, SD 49.8). Initial interventions included fine-needle aspiration (FNA) with diagnosis of PTC (16 patients), FNA without diagnosis (3 patients), excisional LN biopsy (10 patients),
modified neck dissections (3 patients), and monitoring (1
patient). Initial thyroid imaging was read as normal in 16 of 29
(55%) patients. Pathology was significant for primary tumor
size <2 cm (mean 1.47, SD 1.12) in 23 patients and involved an
average of 10.76 (SD 10.13) LNs.
Conclusions: Providers should maintain a high suspicion for
metastatic PTC in patients who present with cystic lymph
nodes in levels 3 to 5. Additional imaging or thyroglobulin
testing of FNA specimens to investigate thyroid origin of disease could potentially avoid additional procedures or a delay
in definitive surgical treatment.
Delayed Presentation of Migratory Fish Bone
Foreign Body Requiring Hemithyroidectomy
for Removal
Michael W. Randall, MD (Presenter); Sepehr Shabani, MD;
Krupal Patel, MD
Objectives: A pharyngeal or esophageal foreign body such
as a fish bone is commonly encountered and treated emergently by an otolaryngologist, usually by extraction via endoscopy. Fish bones located outside the aerodigestive tract are
relatively unusual, and it is even rarer that they can migrate to
the thyroid gland.
Methods: We present a rare case of a fish bone migrating into
the thyroid gland 4 days after the onset of symptoms. The
patient's initial symptoms included foreign-body sensation and
a sharp pain during swallowing after eating fish. The symptoms
progressed, which prompted evaluation in the emergency room.
Results: The fish bone location was confirmed on computerized tomographic (CT) scan. Because of the location of the
fish bone in the thyroid gland, it required a hemithyroidectomy for removal. It was removed successfully, and the small
esophageal defect was repaired primarily. The patient developed no subsequent complications postoperatively.
Conclusions: Fish bones are one of the most common aerodigestive foreign bodies encountered in an emergent setting by

Head and Neck

Poster Presentations	



Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

Table of Contents for the Digital Edition of Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Contents
Accreditation Information
2020 President Duane J. Taylor, MD
2020 Annual Meeting Program Committee
2020 Star Reviewers
2020 Distinguished Service Award Recipients
2020 Honor Award Recipients
Honorary Guest Lecturers 2020
Panel Presentations
Oral Presentations
Poster Presentations
Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Intro
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A1
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Contents
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A5
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A6
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Accreditation Information
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 President Duane J. Taylor, MD
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Annual Meeting Program Committee
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P4
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Star Reviewers
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Honor Award Recipients
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P7
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Honorary Guest Lecturers 2020
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P9
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Panel Presentations
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P12
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Oral Presentations
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Poster Presentations
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P276
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P277
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P278
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P279
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P280
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P281
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P282
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P283
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P284
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P285
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P286
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P287
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P288
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P289
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P290
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P291
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P292
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P293
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P294
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P295
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P296
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P297
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P298
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P299
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P300
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P301
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P302
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P303
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P304
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P305
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P306
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P307
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P308
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P309
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P310
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P311
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P312
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P316
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P317
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P318
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P319
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P320
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P321
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P322
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P323
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P324
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P325
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P326
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P327
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P328
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P329
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P330
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P331
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P332
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover4
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