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Typical audiometric screening criteria should be modified in the veteran population to improve cost efficiency of diagnosis. Observation is the primary management strategy in the veteran population because of age.

Objectives Assess current frenotomy practice patterns of pediatric otolaryngologists via a cross‐sectional survey. Study Design Survey study. Methods A 31‐question electronic survey assessing frenotomy practice patterns was distributed to all American Society of Pediatric Otolaryngology (ASPO) members. Descriptive statistics were used to summarize responses and demographics of respondents. Results Of all ASPO members, 41% (240/588) completed the survey. Most respondents, 185 (77%), reported increased frenotomy referrals over the last 5 years and 144 (60%) described the current number of referrals as “too many.” The two primary lingual frenotomy indications identified in infants were: breastfeeding/nipple pain (92%) and inability to latch (83%). For older children, speech difficulty (87%) was the primary indication. Maxillary frenotomy indications in infants varied amongst respondents. For analgesia during in‐office frenotomy procedures, respondents used glucose/sucrose drops (48%), topical lidocaine (29%), or no pain control measure (27%). For post‐procedure care, respondents recommended continuing lactation support (45%), massaging/stretching the wound (38%), or none (40%). Most respondents, 143 (60%), reported having seen a complication from frenotomy, and the most reported frenotomy complications were frenulum re‐attachment and excessive bleeding. Conclusions In the last 5 years, otolaryngologists have seen an increase in referrals for frenotomy. Pediatric otolaryngologists have varying practice patterns with regards to ankyloglossia diagnosis and treatment. The reported indications for frenotomy varied amongst pediatric otolaryngologists especially with respect to maxillary frenotomy. Practice patterns also varied with respect to procedural pain control and frenotomy aftercare recommendations. More frenotomy research is needed to establish a standard of care for patients with ankyloglossia. Level of Evidence 4 Laryngoscope, 132:2505–2512, 2022

The endoscopic approach is an alternative treatment to direct excision of benign forehead tumors. Prior publications describe the technique and outcomes. Our study assumes a quality improvement perspective, focusing on patient satisfaction with decision making and scar outcomes. This is a retrospective case series study of adult patients who underwent endoscopic removal of benign forehead tumors at Kaiser Permanente Oakland from 2006 to 2016. Data were collected pertaining to surgical outcomes, patient satisfaction using validated instruments. Thirty adult patients were included. Mean operating time was 60 minutes. Forehead tumors included osteomas and a variety of soft tissue lesions. Transient complications included hypoesthesia, seroma, and frontalis weakness. A recurrence of an epidermal inclusion cyst occurred. Patients reported nearly complete satisfaction with decision making and scar outcomes. Endoscopic removal of benign forehead tumors is a safe and effective treatment. Patient satisfaction with decision making and the scar is excellent. Further studies are needed to compare the endoscopic approach to direct excision. The surgeon should offer the endoscopic approach and appropriate counseling to the patient with a benign forehead tumor.