The aim of this pilot study was to assess: (1) the feasibility and acceptability of a Mindfulness-Based Virtual Reality (MBVR) intervention among children and young adults with Inflammatory Bowel Disease (IBD), and (2) the preliminary efficacy of MBVR on key psychological (anxiety) and physical (pain) outcomes. Participants were 62 children to young adults with IBD (M = 15.6 years; 69.4% Crohn’s disease; 58% male) recruited from an outpatient pediatric IBD clinic. Participants completed a baseline assessment, underwent the 6-min MBVR intervention, completed a post-intervention assessment and study satisfaction survey, and provided qualitative feedback. Results suggest strong feasibility and acceptability. Participants reported high levels of satisfaction with MBVR including high levels of enjoyment (M = 4.38; range 1–5) and relaxation (M = 4.35; range 1–5). Qualitative data revealed several key themes including participants interest in using MBVR in IBD medical settings (e.g., hospitalizations, IBD procedures, IBD treatments), as well as in their daily lives to support stress and symptom management. Preliminary analyses demonstrated improvements in anxiety (t = 4.79, p = 0.001) and pain (t = 3.72, p < 0.001) following MBVR. These findings provide initial support for the feasibility and acceptability of MBVR among children and young adults with IBD. Results also suggest MBVR may improve key IBD outcomes (e.g., anxiety, pain) and highlight the importance of conducting a randomized controlled trial and more rigorous research to determine intervention efficacy.

Objectives Mobile applications (apps) are multiplying in laryngology, with little standardization of content, functionality, or accessibility. The purpose of this study is to evaluate the quality, functionality, health literacy, readability, accessibility, and inclusivity of laryngology mobile applications. Methods Of the 3230 apps identified from the Apple and Google Play stores, 28 patient‐facing apps met inclusion criteria. Apps were evaluated using validated scales assessing quality and functionality: the Mobile App Rating Scale (MARS) and the Institute for Healthcare Informatics App Functionality Scale. The Clear Communication Index (CDC) Institute of Medicine Strategies for Creating Health Literate Mobile Applications, and Patient Education Materials Assessment Tool (PEMAT) were used to evaluate apps health literacy level. Readability was assessed using established readability formulas. Apps were evaluated for language, accessibility features, and representation of a diverse population. Results Twenty‐six apps (92%) had adequate quality (MARS score > 3). The mean PEMAT score was 89% for actionability and 86% for understandability. On average, apps utilized 25/33 health literate strategies. Twenty‐two apps (79%) did not pass the CDC index threshold of 90% for health literacy. Twenty‐four app descriptions (86%) were above an 8th grade reading level. Only 4 apps (14%) showed diverse representation, 3 (11%) had non‐English language functions, and 2 (7%) offered subtitles. Inter‐rater reliability for MARS was adequate (CA‐ICC = 0.715). Conclusion While most apps scored well in quality and functionality, many laryngology apps did not meet standards for health literacy. Most apps were written at a reading level above the national average, lacked accessibility features, and did not represent diverse populations. Laryngoscope, 133:1540–1549, 2023

IntroductionAlthough microlaryngoscopy has been recognized to be effective in addressing lesions in vocal performers, no detailed information regarding return to performance (RTP) following surgery exists. We describe our experience and offer proposals to establish standardized criteria for RTP among vocal performers.MethodsRecords for adult vocalists who underwent microlaryngoscopy for benign vocal fold (VF) lesions and had a clearly documented RTP date between 2006 and 2022 were reviewed. Patient demographics, diagnoses, interventions, and postsurgical care before and after RTP were described. The need for medical and procedural interventions and rate of reinjury were used to determine the success of RTP.ResultsSixty‐nine vocal performers (average age: 32.8 years, 41 [59.4%] female, 61 [88.4%] musical theater) underwent surgery for 37 (53.6%) pseudocysts, 25 (36.2%) polyps, 5 (7.2%) cysts, 1 (1.4%) varix, and 1 (1.4%) mucosal bridge. Fifty‐seven (82.6%) underwent voice therapy. The average time to RTP was 65.0 ± 29.8 days. Prior to RTP, six (8.7%) experienced VF edema requiring oral steroids and one (1.4%) underwent a VF steroid injection. Within 6 months following RTP, eight (11.6%) received oral steroids for edema and three underwent procedural interventions (two steroid injections for edema/stiffness, one injection augmentation for paresis). One patient experienced pseudocyst recurrence.ConclusionsReturn to vocal performance at an average of 2 months following microlaryngoscopy for benign lesions appears overwhelmingly successful, with low rates of need for additional intervention. There is a need for validated instruments to better measure performance fitness to refine and possibly accelerate RTP.Level of EvidenceIV Laryngoscope, 2023

Background Living with Inflammatory Bowel Disease (IBD) has been associated with increased psychosocial stress among pediatric IBD populations. Elevated psychological stress can exacerbate disease activity and IBD symptoms like abdominal pain, which in turn can negatively impact children’s mental health. There is an increasing need for mind-body interventions that can improve biopsychosocial processes among youth with IBD. Mindfulness-based interventions (MBIs) have been shown to be efficacious in improving emotional distress, pain, and inflammation in a range of pediatric and adult chronic illness/pain populations. Few studies have explored MBIs in pediatric IBD. Using virtual reality (VR) as the medium for an MBI in pediatric IBD has great potential given the increasing prevalence of VR in children’s hospitals, the immersive nature of the technology, and the high acceptability of VR among youth. Aims 1) Assess the feasibility and acceptability of mindfulness-based virtual reality (MBVR) among youth with IBD; 2) Assess the preliminary efficacy of MBVR on anxiety and pain. Methods Youth at an outpatient IBD clinic were offered MBVR. Our team developed a 6-minute MBVR experience, “MediMindfulness-Transitions” (Stanford University & Weightless Studios), that focused participants’ awareness on a natural environment (e.g., waterfall in meadow, northern lights) and their breath. Participants rated their level of anxiety and pain on VAS scales (0-100mm) immediately before and after the MBVR experience. Paired t-tests were used to assess changes in patient reported outcomes (SPSS 26). Patients also completed a satisfaction survey and provided qualitative feedback. Results The sample included 52 participants with IBD (M=15 yrs; 69% Crohn’s disease; 58% Male; 62% White). MBVR was easily integrated into clinic flow (offered before or after MD visit) and there was 100% treatment compliance. There were high levels of enjoyment (M=4.4, range 1–5) and relaxation (M=4.3, range 1–5) post-intervention; 50% of the sample reported MBVR was an ideal length and were extremely interested in using MBRV at home. Qualitative data revealed areas of enjoyment and suggestions for future use (Table 1). Exploratory efficacy analyses revealed MBVR decreased anxiety (16.54 ± 20.56 vs 7.10 ± 13.27, p &lt; 0.001) and pain (9.5 ± 16.19 vs 3.04 ± 6.22, p &lt; 0.01). One patient experienced worsening of their anxiety symptoms. Conclusion MBVR was shown to be feasible and have high acceptability among youth with IBD. The results demonstrated preliminary support for MBVR reducing acute anxiety and pain. This study suggests MBVR could be a promising mind-body therapy for youth with IBD. Future studies should explore the efficacy of MBVR during IBD procedures and treatments (e.g., blood draws, MRIs, infusions) and whether longer-term use of MBVR improves biopsychosocial outcomes.