Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P183

Poster Presentations	

P183

documentation of FAS after oral cavity surgery. This case
series highlights the rare development of FAS from the structural effects of oral cavity surgery in combination with significant psychological stress of cancer treatment.

Conclusions: Significant racial differences exist in head and
neck squamous cell carcinomas. Many of these differences are
reversible and can be eliminated by education, setting up
screening programs, and expanding health care coverage.

The Dynamic Tracheoesophageal Prosthesis
Length
Sara Yang, MD (Presenter); Corinne Bunn, MD;
Brian Chou, MD; Sarah Kramer; Eric Thorpe, MD

Effect of Insurance Status and Residential
Distance on Delays in Accessing Medical
Care in Patients With Oropharyngeal
Cancer
Raisa Tikhtman, MD (Presenter); Forest W. Weir, MD;
David Leo Choi, MD; Brian Cervenka, MD; Yash J.
Patil, MD; Chad A. Zender, MD; Alice Tang, MD

Effect of Health Care Disparity on Squamous
Cell Carcinomas of Head and Neck
Sepehr Shabani, MD (Presenter); Krupal Patel, MD
Objectives: Head and neck squamous cell carcinomas are
aggressive cancers with significant morbidity and mortality
that can be confounded by health care disparities, particularly
race. The purpose of this study is to educate and provide evidence on the status of health care disparities, especially race,
in head and neck squamous cell carcinomas.
Methods: A review of the English literature was performed
using PubMed and MEDLINE.
Results: African American patients are diagnosed at younger
age, present with higher tumor burden, are less likely to
receive definitive cancer treatment, and have increased mortality compared with white patients.

Objectives: In the present study, we examined factors potentially contributing to delays in patient medical care-seeking
after becoming symptomatic in oropharyngeal squamous cell
carcinoma (OPSCC).
Methods: A retrospective chart review in a single academic
institution was performed for patients diagnosed with OPSCC
between January 1, 2017, and December 31, 2018. Data regarding patient demographics, cancer subsite, and subjective reporting of symptom onset were collected. Specific determinants
evaluated included insurance status and residential distance
from academic center. Data analysis was performed using the
chi-square test and univariate regression analysis.
Results: In sum, there were 61 patients (55 men, 6 women),
which included 89% (n = 54) Caucasian, 8.2% (n = 5), African
American, and 3.3% (n = 2) not specified. Most (74%, n = 45)
presented to a provider within 0 to 6 months of symptom
onset, whereas 11.5% (n = 7) presented between 6 and
12 months and 9.8% (n = 6) presented after 1 year. Primary
cancer subsites included tonsil (49%, n = 30), base of tongue
(38%, n = 23), soft palate (7%, n = 4), and pharyngeal wall
(4.9%, n = 3). There was no difference between laterpresenting patients and insurance status (P = .09) nor was
there a significant difference in earlier presentation by cancer
subsite (P = .1). We also did not observe a difference in
patients seeking earlier care and age at presentation (P = .17)
or sex (P = .65). Residential distance from the academic medical center also did not affect delays in care seeking (P = .9).
Conclusions: Patient-reported delays in seeking care at our
institution do not appear to be related to demographic factors
or vary by OPSCC subsite. More studies are needed to identify risk factors predisposing patients to delays in seeking care
for OPSCC.
Effects of Free Flap Reconstruction on
Functional Outcomes After Primary Total
Laryngectomy
Maxwell Y. Lee (Presenter); Mario Belfiglio; Shlomo
Koyfman, MD; Nikhil Joshi, MD; David J. Adelstein, MD;
Christopher W. Fleming; Brian B. Burkey, MD;
Jamie A. Ku, MD
Objectives: Most patients receiving primary total laryngectomy (TL) receive primary closure (PC) of the pharynx,

Head and Neck

Objectives: In a postlaryngectomy patient, tracheoesophageal (TE) speech is considered to be the preferred method of
communication. Previous clinical research has demonstrated
that despite an appropriately sized prosthesis placement at the
time of puncture, there is a significant portion that require
resizing postoperatively. The purpose of this project is to report
on the variability of the tracheoesophageal prosthesis length.
Methods: This was a retrospective chart review of
62 patients who underwent secondary tracheoesophageal
puncture (TEP) at a tertiary cancer center from January 2008
to November 2019. Patient demographics, history of smoking
or alcoholism, history of radiation therapy, primary vs salvage
surgery, free flap reconstruction, average change in prosthesis
length, and timing of prosthesis change were collected.
Results: Sixty-two patients met the criteria for study inclusion. The mean age was 61.96 years; 49 were male (79%), and
13 were female (21%). Twenty-three patients (37.1%) underwent primary laryngectomy, whereas 39 (62.9%) were salvage
laryngectomy. Free flap reconstruction was used in 23 patients
(37.1%). Fifty-two patients (83.9%) had radiation therapy prior
to tracheoesophageal puncture. Overall change in prosthesis
length was -3.85 ± 3.58 mm. Time to first prosthesis change
was 2.29 months. Despite the general trend for decreasing prosthesis length, 26 patients (41.9%) had increases in their prosthesis length. In 15 patients (24.2%), the increase occurred
>6 months after surgery.
Conclusions: In general, tracheoesophageal puncture length
decreases with time. However, there is a clinically significantly
portion that has fluctuating changes in prosthesis length.
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
