Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P154

P154
Otolaryngology-Head and Neck Surgery 163(1S)
Presentation schedule is subject to change. The Official Program Abstracts supplement does not reflect changes made after August 10, 2020.

Comprehensive Otolaryngology
Assessing the Utility of a Novel Nonhuman
Parotid Model as an Educational Tool for
Determining Pathology via Ultrasound
Kevin Calamari (Presenter); Stephen Politano; Ryan Ivancic;
Sean Michael McDermott, MD; David Bahner, MD

Comprehensive

Objectives: Ultrasound is a noninvasive means of assessing
head and neck pathology, but education on its use is lacking in
medical education. The objective of this study was to determine whether a novel nonhuman parotid gland ultrasound
model increases comfort with the use of ultrasound in otolaryngology (ENT) and the identification of pathology for medical students.
Methods: Twenty-five first-year medical students were
recruited in December 2019 for (1) a lecture on parotid anatomy, (2) a pretest assessing their comfort with ENT ultrasound
and ability to describe pathology, (3) 5 ultrasound scans of a
pathologic parotid model, and (4) a posttest repeating the pretest questions. Answers were on a 1 to 5 scale ranging from
not at all able to completely able. The model comprised the
finger of a nitrile glove filled with water with spackle putty
molded into nodules inside. The models were covered with
ultrasound gel and plastic wrap. The total cost to produce
1 model was 25 cents.
Results: Question 1 assessed the student's ability to obtain
an image of the model, and pretest and posttest averages
were 1.32 and 3.44, respectively (P < .01). Question 2 had
the students rate their ability to measure the pathology, and
pretest and posttest averages were 1.12 and 3.48, respectively (P < .01). Question 3 had the students rate their ability
to characterize the pathology, and the pretest and posttest
averages were 1.24 and 3.2, respectively (P < .01).
Conclusions: The use of a nonhuman parotid model in ultrasound education improves students' self-reported skill in
detecting and characterizing pathology. Implementation of
cost-effective nonhuman models can increase exposure to
clinical ultrasound earlier in medical education with the ultimate goal of improving provider ENT ultrasound skills.
Bilateral Sublingual Gland Involvement as
the Initial Manifestation of Granulomatosis
With Polyangiitis
Scott R. Hall, MD (Presenter); David G. Lott, MD
Objectives: Granulomatosis with polyangiitis (GPA) is a
systemic vasculitis with frequent head and neck manifestations. Major salivary gland involvement is reported in 4% of
patients with GPA. The sublingual glands are least frequently
affected, with only 1 case report currently in the literature.
Here, we present the case of a patient presenting with symmetric, bilateral sublingual gland enlargement as her primary
manifestation of GPA.
Methods: The authors report the rare case of sublingual
gland enlargement secondary to GPA and review the literature

of GPA affecting the major salivary glands as the initial
presentation.
Results: A 39-year-old woman was seen in the emergency
department with 2 months of progressive floor of mouth
swelling despite multiple courses of antibiotics and steroids.
Computed tomography (CT) of the neck was performed that
showed symmetric, bilateral enlargement of the sublingual
glands without other signs of infection. In addition, the CT of
the neck showed the presence of multiple pulmonary nodules.
Fine-needle aspiration of the sublingual glands, minor salivary gland biopsy, and review of an outside breast biopsy
from 1 month prior were all consistent with GPA. Laboratory
workup demonstrated elevated antineutrophil cytoplasmic
autoantibody titers. The patient had good response to rituximab therapy and was eventually weaned off steroid therapy.
Conclusions: Sublingual gland enlargement is a rare presentation of granulomatosis with polyangiitis but should be considered, particularly in the setting of chronic, multifocal
salivary gland swelling. The clinician should maintain a high
level of suspicion because early treatment may prevent the
development of serious systemic complications.
A Community-Based Head and Neck Cancer
Screening in an Underserved Hispanic
Population
Erik Bjorn Vanstrum (Presenter); Franklin Mengyuan Wu;
Khush Kharidia; Jonathan West; Margaret C. Nurimba;
Mark Swanson, MD; Edie R. Hapner, PhD
Objectives: There are racial disparities in the presentation of
human papillomavirus (HPV)+ head and neck cancers
(HNCs). Hispanic populations present with more advanced
HNCs and have a worse prognosis and survival rate compared
with other racial/ethnic groups. However, HPV risk behaviors
have not been described in this population. The goals of this
study were to document (1) the incidence of findings needing
further head and neck follow-up and (2) the prevalence of
HPV risk behaviors from a community-based HNC screening
involving a largely Hispanic population.
Methods: This retrospective cohort study was part of a cancer screening event in January 2020 in a collaborative effort
between a nonprofit organization and medical students from
the Keck School of Medicine. Participants were recruited from
a community health center of 25,000 enrolled patients; 60%
lacked medical insurance, and 70% were monolingual Spanish
speakers. The primary outcome was the incidence of concerning physical exam findings requiring follow-up. A head and
neck screening was conducted by students and faculty.
Demographic information and a risk behavior profile were
gathered. All materials were provided in English or Spanish.
Results: Risk behaviors for HNC and demographic data
were analyzed using descriptive statistics. Multivariate analysis was performed to identify significant predictors of abnormal findings. Analysis is ongoing.
Conclusions: Community-based screening is an effective
method for targeting vulnerable populations. The HPV risk

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

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