Objectives/Hypothesis To characterize the sex distribution and sex data handling in published otolaryngology research. Study Design Published research data analysis. Methods The total number of male and female participants, study characteristics, and sex data handling were abstracted from all original studies containing human participants published in five major otolaryngology journals from January 1, 2016 to December 31, 2016 and January 1, 2006 to December 31, 2006. Results Of the 1,128 studies from 2016 included in the analysis, 88.5% specified the sex of participants. There were 3,605,636 (42.1%) men and 4,515,508 (52.8%) women, with 429,006 (5.0%) participants unspecified. However, the average proportions of male and female participants (wherein studies are weighted the same, regardless of number of participants) were 0.579 and 0.421, respectively. Studies from the United States had a significantly higher proportion of women than studies from outside the United States. Subspecialties varied significantly in proportions. Average sex proportions in 2016 remained similar to those in 2006. For all studies, fewer than 40% of studies used any sex data for reporting of outcomes, for any sex‐related analysis, or for discussion of results. Conclusions There was a higher average proportion of male participants than female. Studies originating in the United States included a greater number of female participants than those originating elsewhere, a possible result of explicit sex‐inclusion policies governing research in the United States. Inclusion of women did not changed from 2006 to 2016, but analysis of sex data improved. Improvement of reporting, analysis, and discussion with regard to sex would benefit otolaryngology research and improve treatment for both sexes. Level of Evidence NA Laryngoscope, 129:E420–E427, 2019
Postoperative salivary fistula is an especially undesirable complication because it can be difficult to address, may delay postoperative radiation, and always delays enteral nutrition. Patients who are malnourished, have already undergone radiotherapy, or are hypothyroid are at higher risk of developing this problem. Conservative measures work in most patients, but a significant percentage of patients require intervention beyond pressure dressings and tincture of time. Medications, hyperbaric oxygen therapy, and surgical intervention may be required when fistulas do not heal in a timely manner. Decisions about the approach and timing of more aggressive interventions are part of the art of medicine since definitive scientific protocols are lacking.
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