ImportancePatients undergoing tracheal resection commonly experience dysphagia postoperatively, and the patient factors that predict severity and duration of symptoms are currently unclear.ObjectiveTo determine the association of patient and surgical factors on postoperative dysphagia in adult patients undergoing tracheal resection.Design, Setting, and ParticipantsThis was a retrospective cohort study of patients undergoing tracheal resection at 2 tertiary academic centers from February 2014 to May 2021. The centers included LAC+USC (Los Angeles County + University of Southern California) Medical Center and Keck Hospital of USC, both tertiary care academic institutions. Patients involved in the study underwent a tracheal or cricotracheal resection.ExposuresTracheal or cricotracheal resection.Main Outcomes and MeasuresThe main outcome was dysphagia symptoms as measured by the functional oral intake scale (FOIS) on postoperative days (PODs) 3, 5, and 7, on the day of discharge, and at the 1-month follow-up visit. Demographics, medical comorbidities, and surgical factors were evaluated for association with FOIS scores at each time period using Kendall rank correlation and Cliff delta.ResultsThe study cohort consisted of 54 patients, with a mean (SD) age of 47 (15.7) years old, of whom 34 (63%) were male. Length of resection segment ranged from 2 to 6 cm, with a mean (SD) length of 3.8 (1.2) cm. The median (range) FOIS score was 4 (1-7) on PODs 3, 5, 7. On the day of discharge and at 1-month postoperative follow-up, the median (range) FOIS score was 5 (1-7) and 7 (1-7), respectively. Increasing patient age was moderately associated with decreasing FOIS scores at all measured time points (τ = −0.33; 95% CI, −0.51 to −0.15 on POD 3; τ = −0.38; 95% CI, −0.55 to −0.21 on POD 5; τ = −0.33; 95% CI, −0.58 to −0.08 on POD 7; τ = −0.22; 95% CI, −0.42 to −0.01 on day of discharge; and τ = −0.31; 95% CI, −0.53 to −0.09 at 1-month follow-up visit). History of neurological disease, including traumatic brain injury and intraoperative hyoid release, was not associated with FOIS score at any of the measured time points (δ = 0.03; 95% CI, −0.31 to 0.36 on POD 3; δ = 0.11; 95% CI, −0.28 to 0.47 on POD 5, δ = 0.3; 95% CI, −0.25 to 0.70 on POD 7; δ = 0.15; 95% CI, −0.24 to 0.51 on the day of discharge, and δ = 0.27; 95% CI, −0.05 to 0.53 at follow-up). Resection length was also not correlated with FOIS score with τ ranging from −0.04 to −0.23.Conclusions and RelevanceIn this retrospective cohort study, most patients undergoing tracheal or cricotracheal resection experienced full resolution of dysphagia symptoms within the initial follow-up period. During preoperative patient selection and counseling, physicians should consider that older adult patients will experience greater severity of dysphagia throughout their postoperative course and delayed resolution of symptoms.

Hearing loss (HL) is the most common sensory disorder worldwide and arises from a heterogeneous set of genetic and environmental etiologies. Currently, therapy for sensorineural HL is non-specific and limited to amplification devices and implanted neuroprosthetics. Recent advances in the burgeoning field of precision medicine focused on individualizing disease diagnosis and tailoring treatment to each patient’s own biology hold great promise to provide tailored care for hearing loss patients. In this review, we discuss the current diagnostic algorithm and treatment options for hearing loss, the advances in using precision medicine tools to identify specific genetic variants that predispose to or result in hearing loss, the role of genetics in determining surgical outcomes following cochlear implantation, recent advances in gene and stem cell therapies for treating hearing loss, and patient-specific disease modeling using induced pluripotent stem cells. All of these precision medicine techniques will result in improved care for patients based on the precise etiology of their hearing loss.