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Naseem DF, Sheth AH, Cheng AG, Qian ZJ. Is Public Interest Associated with Real-World Management of Ankyloglossia? Otolaryngol Head Neck Surg 2024; 170:1442-1448. [PMID: 38219744 DOI: 10.1002/ohn.643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/14/2023] [Accepted: 12/23/2023] [Indexed: 01/16/2024]
Abstract
OBJECTIVES Assess the relationship between public interest in ankyloglossia as determined by internet search volume and real-world medical claims data. STUDY DESIGN Retrospective Cohort Study. SETTING This retrospective cohort study was conducted using claims data from the Merative™ Marketscan® Research Databases. The internet search data was collected from Google Trends. METHODS Annual Google Trends data were compiled using search terms associated with "ankyloglossia" and "frenotomy" for the years 2011 to 2021. We obtained incidence of ankyloglossia diagnoses and frenotomy procedures in children under 12 months from Marketscan relative to all infants enrolled. We compared associations between search and incidence data among US states and over time. RESULTS Google search correlated with ankyloglossia incidence (r = 0.4104, P = .0031) and with frenotomy incidence (r = 0.4062, P = .0034) per state. Ankyloglossia diagnoses increased with Google search index (coefficient = 0.336, 95% confidence interval [CI] 0.284, 0.388) and year (coefficient = 0.028, 95% CI 0.025, 0.031). Similarly, frenotomy procedures increased with Google search index (coefficient = 0.371, 95% CI 0.313, 0.429) and year (coefficient = 0.027, 95% CI 0.024, 0.030). CONCLUSIONS Associations between online ankyloglossia search trends and both diagnosis and treatment rates, persist across US regions and timeframes. Internet search trends are pivotal in shaping pediatric health care decisions, driving clinical consensus, and disseminating evidence-based information.
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Affiliation(s)
- Danial F Naseem
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Amar H Sheth
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Alan G Cheng
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
| | - Z Jason Qian
- Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA
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Cordray H, Raol N, Mahendran GN, Tey CS, Nemeth J, Sutcliffe A, Ingram J, Sharp WG. Quantitative impact of frenotomy on breastfeeding: a systematic review and meta-analysis. Pediatr Res 2024; 95:34-42. [PMID: 37608056 DOI: 10.1038/s41390-023-02784-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 07/31/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Symptoms related to infant ankyloglossia/tongue-tie may deter mothers from breastfeeding, yet frenotomy is controversial. METHODS Databases included PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Google Scholar from 1961-2023. Controlled trials and cohort studies with validated measures of surgical efficacy for breastfeeding outcomes were eligible. Meta-analyses synthesized data with inverse-variance weighting to determine standardized mean differences (SMD) between pre-/postoperative scores. RESULTS Twenty-one of 1568 screened studies were included. Breastfeeding self-efficacy improved significantly post-frenotomy: medium effect after 5-10 days (SMD 0.60 [95% CI: 0.48, 0.71; P < 0.001]), large effect after 1 month (SMD 0.91 [CI: 0.79, 1.04; P < 0.001]). Nipple pain decreased significantly post-frenotomy: large effect after 5-15 days (SMD -1.10 [CI: -1.49, -0.70; P < 0.001]) and 1 month (SMD -1.23 [CI: -1.79, -0.67; P = 0.002]). Frenotomy had a medium effect on infant gastroesophageal reflux severity at 1-week follow-up (SMD -0.63 [CI: -0.95, -0.31; P = 0.008]), with continued improvement at 1 month (SMD -0.41 [CI: -0.78, -0.05; P = 0.04]). From LATCH scores, breastfeeding quality improved after 5-7 days by a large SMD of 1.28 (CI: 0.56, 2.00; P = 0.01). CONCLUSIONS Providers should offer frenotomy to improve outcomes in dyads with ankyloglossia-associated breastfeeding difficulties. PROTOCOL REGISTRATION PROSPERO identifier CRD42022303838 . IMPACT This systematic review and meta-analysis showed that breastfeeding self-efficacy, maternal pain, infant latch, and infant gastroesophageal reflux significantly improve after frenotomy in mother-infant dyads with breastfeeding difficulties and ankyloglossia. Providers should offer frenotomy to improve breastfeeding outcomes in symptomatic mother-infant dyads who face challenges associated with ankyloglossia.
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Affiliation(s)
- Holly Cordray
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - Nikhila Raol
- Children's Healthcare of Atlanta, Atlanta, GA, USA.
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA.
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
| | - Geethanjeli N Mahendran
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA, USA
| | - Ching Siong Tey
- Children's Healthcare of Atlanta, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - John Nemeth
- Emory University Woodruff Health Sciences Center Library, Atlanta, GA, USA
| | - Alastair Sutcliffe
- Population, Policy, and Practice Department, Institute of Child Health, University College London, London, UK
| | | | - William G Sharp
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Marcus Autism Center, Atlanta, GA, USA
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Huang AE, Chan EP, Stave CM, Patel ZM, Hwang PH, Chang MT. Social Media Utilization in Otolaryngology: A Scoping Review. Laryngoscope 2023; 133:2447-2456. [PMID: 36807152 DOI: 10.1002/lary.30619] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 01/05/2023] [Accepted: 01/30/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Social media (SM) is an increasingly popular medium for the medical community to engage with patients, trainees, and colleagues. This review aimed to identify reported uses of SM in otolaryngology-head and neck surgery (OHNS), assess the quality of evidence supporting these uses, and identify gaps in the literature. With the relative lack of regulatory guidelines for the development of SM content, we hypothesized that the quality of content available on SM would be highly variable. DATA SOURCES AND METHODS A scoping review was performed of English-language peer-reviewed studies published to date discussing SM use in any form within OHNS. Three reviewers independently screened all abstracts. Two reviewers independently extracted data of interest from the full text of articles identified from the preliminary abstract screen. RESULTS 171 studies were included, with 94 (54.9%) studies published between 2020 and 2022. 104 (60.8%) studies were conducted in the US. 135 (78.9%) used cross-sectional or survey-based methodology; only 7 (4.1%) were controlled studies. SM was most commonly employed for professional networking (n = 37 [21%]), and within subspecialties of otology (n = 38 [22%]) and rhinology/allergy (n = 25 [15%]). Facebook was most frequently used for study recruitment (n = 23 [13.5%]), YouTube for patient education (n = 15 [14.6%]), and Twitter for professional networking (n = 16 [9.4%]). CONCLUSION SM use within OHNS is increasing rapidly, with applications including patient education, professional networking, and study recruitment. Despite myriad articles, there remains a paucity of well-controlled studies. As SM becomes integrated into healthcare, particularly for applications directly impacting patient care, higher levels of evidence are needed to understand its true impact. Laryngoscope, 133:2447-2456, 2023.
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Affiliation(s)
- Alice E Huang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Erik P Chan
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Christopher M Stave
- Lane Medical Library, Stanford University School of Medicine, Stanford, California, USA
| | - Zara M Patel
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Peter H Hwang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
| | - Michael T Chang
- Department of Otolaryngology-Head and Neck Surgery, Stanford University, Stanford, California, USA
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McAllister J, Wexelblatt S, Ward L. Controversies and Conundrums in Newborn Feeding. Clin Perinatol 2023; 50:729-742. [PMID: 37536775 DOI: 10.1016/j.clp.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023]
Abstract
Breastfeeding is the biologic norm for newborn feeding, and exclusive breastfeeding for the first 6 months of life is universally endorsed by leading global and national organizations. Despite these recommendations, many people do not meet their breastfeeding goals and controversies surrounding breastfeeding problems exist. Medical issues can present challenges for the clinician and parents to successfully meet desired feeding outcomes. There are studies evaluating these common controversies and medical conundrums, and clinicians should provide evidence-based recommendations when counseling families about newborn feeding.
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Affiliation(s)
- Jennifer McAllister
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center Perinatal Institute, 3333 Burnet Avenue, ML 7009, Cincinnati, OH 45229, USA.
| | - Scott Wexelblatt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center Perinatal Institute, 3333 Burnet Avenue, ML 7009, Cincinnati, OH 45229, USA
| | - Laura Ward
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center Perinatal Institute, 3333 Burnet Avenue, ML 7009, Cincinnati, OH 45229, USA
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Laccourreye O, Juvanon JM. To tweet or not to tweet in otorhinolaryngology, that is the question. Eur Ann Otorhinolaryngol Head Neck Dis 2023; 140:227-230. [PMID: 35717532 DOI: 10.1016/j.anorl.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To describe the scientific medical literature devoted to the various interactions between otorhinolaryngology (ORL) and social networks. MATERIAL AND METHODS A literature search, conducted on December 15, 2021, using the search engine of the United States National Library of Medicine (PubMed) and the key-words "otorhinolaryngology", "social network", and "Twitter", retrieved 321 articles for which Abstracts were read for selection of articles with qualitative and quantitative data regarding the various relationships between ORL and social media. RESULTS Forty-four articles were selected and analyzed. Thirty-nine originated from the USA and none from France or French-speaking countries. Only 1 article was a prospective randomized study. Schematically, two main types of publication were identified. The first dealt with user interactions, topics discussed, teaching of the ORL specialty and publicizing research. The second dealt with the limits and dangers of this new means of publicizing scientific thinking in our specialty. Reading these articles highlighted the role of social media in publicizing ORL research, and suggested distinct options to improve interactions between otorhinolaryngologists, patients and society as a whole. CONCLUSION At a time when society is demanding rapid access to medical research findings, just as it is mandatory to master and adhere to the rules for medical writing in research, it is also now necessary to learn how to communicate via social media and send a tweet if one wishes to publicize its research and/or exchange with patients.
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Affiliation(s)
- O Laccourreye
- Université de Paris Cité, Service d'Otorhinolaryngologie et de Chirurgie Cervico-faciale, HEGP, AP-HP, 20-40, rue Leblanc, 75015 Paris, France; European Annals of Otorhinolaryngology Head & Neck Diseases, Elsevier, 165, rue Camille Desmoulins, 92130 Issy les Moulineaux, France.
| | - J-M Juvanon
- ORL-Mag, Société Française d'Otorhinolaryngologie, 26, rue Lalo, 75016 Paris, France
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Bacon BR, Carr MM. Maxillary Frenulum and "Lip Tie": What Parents Understand. OTO Open 2023; 7:e71. [PMID: 37674624 PMCID: PMC10478164 DOI: 10.1002/oto2.71] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 07/29/2023] [Indexed: 09/08/2023] Open
Abstract
Objective To determine the proportion of parents that have some knowledge of abnormal maxillary frenulum, or "lip tie," and their sources of this information. Study Design Cross-sectional study. Setting Otolaryngology clinic. Methods Consecutive parents of children ≤12 years of age presenting at a pediatric otolaryngology clinic were surveyed to discover their understanding of "lip tie" in children. The survey included questions on the effects of "lip tie," where they learned about "lip tie," whether they thought their child had "lip tie," whether they had a child undergo "lip tie" division, and how concerned they would be if they thought their child had "lip tie." Information on participant demographics and social media was collected. Results Overall, 59.8% (193) of the 323 parents surveyed had heard of "lip tie"; of those, 17.1% (33) had a child that had undergone "lip tie" surgery. Most parents (91.2%, 176) thought "lip tie" caused breastfeeding problems. Roughly one-quarter of parents (51 of 197 responses) rated their concern about "lip tie" as >8 of 10 on a Likert scale (mean, 5.7). The reported sources of "lip tie" information included lactation consultants (36.8%, 71), nurses (22.8%, 44), and pediatricians (31.6%, 61) as well as nonmedical sources, such as social media, family, and friends (68.4%, 132). Overall, 87% (282) of the 323 participants reported daily use of social media. Conclusion Although many parents are concerned about "lip tie," much of their information on this condition comes from nonmedical sources. Social media would be a valuable platform to provide accurate information on "lip tie."
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Affiliation(s)
- Beatrice R. Bacon
- Jacobs School of Medicine and Biomedical SciencesUniversity at BuffaloBuffaloNew YorkUSA
| | - Michele M. Carr
- Department of Otolaryngology, Jacobs School of Medicine and Biomedical SciencesUniversity at BuffaloBuffaloNew YorkUSA
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Bharat N, Sandelski M, Cerasiello S, Hurtuk A. TikTok Influence on Rates of Tonsillectomies for Tonsil Stones. Cureus 2023; 15:e37957. [PMID: 37223167 PMCID: PMC10200686 DOI: 10.7759/cureus.37957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Tonsillectomy is one of the most common otolaryngologic surgeries and is increasingly being performed for the management of tonsil stones or tonsilloliths. Incidentally, over the years, tonsilloliths have become a popular topic on the social media platform TikTok (ByteDance, Beijing, China) and we propose that this may be influencing the trends of tonsillectomies for tonsil stones. Objectives: We aim to assess rates of outpatient visits and tonsillectomies for tonsil stones at our institution as well as analyze videos on TikTok regarding tonsil stones. METHODS A retrospective chart query was performed. Data including the number of patient encounters per month with a diagnosis code of tonsilloliths were collected from July 2016 to December 2021. The number of TikTok videos under the search result "tonsil stones" and the content of these videos were reviewed. RESULTS There were 126 patients seeking evaluation for tonsil stones with an average age of 33.4 years, and 76% were females. The number of patients who underwent a tonsillectomy for tonsil stones increased from two in the first full year of collection in 2017 to 13 in 2021. Similarly, the average number of patients presenting for tonsil stone evaluation per month increased steadily from 1.0 in 2017 to 3.3 in 2021. TikTok video content under the search result "tonsil stones" varied and the number of videos on this topic has increased in recent years. CONCLUSION Rates of patients seeking tonsillectomy for tonsil stones increased from 2016 to 2021 in conjunction with the rising popularity of TikTok. Given the numerous TikTok videos featuring tonsil stones, we believe that this social media platform may be influencing the number of patients seeking evaluation for tonsil stones. This data may be used to understand future influence patterns of social media posts on healthcare consumer behavior and patient care practices.
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Affiliation(s)
- Nisha Bharat
- Otolaryngology, Loyola University Chicago Stritch School of Medicine, Maywood, USA
| | | | | | - Agnes Hurtuk
- Otolaryngology - Head and Neck Surgery, Loyola University Medical Center, Maywood, USA
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Winkel T, Wilson J, Spence M, Colby S, Springer C, Hedrick M, Kavanagh K. Tethered Oral Tissue Release Among Breastfed Infants: Maternal Sources of Information and Treatment. J Hum Lact 2023:8903344231159378. [PMID: 36945736 DOI: 10.1177/08903344231159378] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
BACKGROUND Despite limited clinical consensus regarding surgery for tethered oral tissues ("tongue-tie") for resolving breastfeeding-related issues, the procedure has been increasing in the United States. Greater understanding of maternal experiences with obtaining surgical release may help to improve breastfeeding outcomes. RESEARCH AIM To explore experiences of breastfeeding mothers with infants having undergone "tongue-tie" surgery. METHOD This online, cross-sectional, observational survey occurred between August and September 2020. Eligibility included being ≥ 18 years of age and previously or currently breastfeeding an infant with ≥ 1 tissue surgically released. Of 463 screens, 318 mothers were eligible and 115 consented. The final sample was 90. RESULTS The sample was predominantly white (n = 86; 95%), non-Hispanic (n = 84; 93%), married/cohabitating (n = 85; 94%), and currently providing their own milk (n = 81; 89%).Difficult latch was the primary reason for seeking help. Participants reported lingual (n = 84; 93%), labial (n = 79; 88%), and buccal (n = 16; 17%) tissue-release, with 80% (n = 73) reporting > 1 released. For each tissue released, > 80% (n = 72) of participants felt "very confident" in their ability to correctly identify it and 97% (n = 87) felt "very involved" and "strongly agreed" with surgical release. International Board Certified Lactation Consultants® were the most frequently identified source of information (n = 45; 50%) and referrals (n = 38; 42%), while pediatric dentists most frequently performed interventions (n = 60; 67%). CONCLUSIONS Participants reported being confident, involved, and in agreement with surgical release and lactation support professionals were frequent information and referral sources.
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Affiliation(s)
- Taylor Winkel
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Jennifer Wilson
- Department of Audiology and Speech Pathology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Marsha Spence
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Sarah Colby
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Cary Springer
- Office of Information Technology, Research Computing Support, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Mark Hedrick
- Department of Audiology and Speech Pathology, University of Tennessee Knoxville, Knoxville, TN, USA
| | - Katherine Kavanagh
- Department of Nutrition, University of Tennessee Knoxville, Knoxville, TN, USA
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