There is accumulating anecdotal evidence that anosmia and dysgeusia are associated with the COVID-19 pandemic. To investigate their relationship to SARS-CoV2 infection, the American Academy of Otolaryngology–Head and Neck Surgery developed the COVID-19 Anosmia Reporting Tool for Clinicians for the basis of this pilot study. This tool allows health care providers to confidentially submit cases of anosmia and dysgeusia related to COVID-19. We analyzed the first 237 entries, which revealed that anosmia was noted in 73% of patients prior to COVID-19 diagnosis and was the initial symptom in 26.6%. Some improvement was noted in 27% of patients, with a mean time to improvement of 7.2 days in this group (85% of this group improved within 10 days). Our findings suggest that anomia can be a presenting symptom of COVID-19, consistent with other emerging international reports. Anosmia may be critical in timely identification of individuals infected with SARS-CoV2 who may be unwittingly transmitting the virus.

Problem In the 2021 residency application cycle, the average otolaryngology applicant applied to more than half of programs. Increasing application numbers make it difficult for applicants to stand out to programs of interest and for programs to identify applicants with sincere interest. Approach As part of the 2021 Match, otolaryngology applicants could participate in a preference signaling process, signaling up to 5 programs of particular interest at the time of application submission. Programs received a list of applicants who submitted signals to consider during interview offer deliberations. Applicants and program directors completed surveys to evaluate the signaling process and assess the impact of signals on interview offers. Outcomes All otolaryngology residency programs participated in the signaling process. In total, 611 students submitted applications for otolaryngology residency programs, 559 applicants submitted a Match list including an otolaryngology program, and 558 applicants participated in the signaling process. The survey response rate was 42% for applicants (n = 233) and 52% for program directors (n = 62). The rate of receiving an interview offer was significantly higher from signaled programs (58%) than from both nonsignaled programs (14%; P < .001) and the comparative nonsignal program (23%; P < .001) (i.e., the program an applicant would have signaled given a sixth signal). This impact was consistent across the spectrum of applicant competitiveness. Applicants (178, 77%) and program directors (53, 91%) strongly favored continuing the program. Next Steps Many specialties face high residency application numbers. Programs have difficulty identifying applicants with sincere interest, and applicants face limited opportunities to identify programs of particular interest. Applicants to these specialties may benefit from a preference signaling process like that in otolaryngology. Additional evaluation is needed to determine the impact of signals across racial and demographic lines and to validate these early outcomes.

Laser endoscopic management is a reasonable and safe method for surgical treatment of Zenker's diverticulum in comparison with the open technique. Employment of the endoscopic approach reduces operative time and the complexity of postoperative care. Practitioners should be aware that the endoscopic approach may result in a higher failure rate.

Cheilitis granulomatosa (CG) is a cosmetically disturbing and persistent idiopathic lip swelling. It is one manifestation of orofacial granulomatosis (OFG), which is a clinical entity describing facial and oral swelling in the setting of non-caseating granulomatous inflammation and in the absence of systemic disease such as Crohn's disease and sarcoidosis. CG can occur by itself or as part of the Melkersson-Rosenthal syndrome, which includes facial palsy and a plicated tongue. Other proposed causes of OFG include dietary allergens such as cinnamon and benzoates. Similar orofacial swelling may be an early manifestation of Crohn's disease or sarcoidosis, and so clinical history is important in diagnosis. The cause of CG has not been wholly elucidated, but a current hypothesis holds that a random influx of inflammatory cells is responsible. Other granulomatous and edematous causes of lip swelling must be investigated prior to diagnosis. Options for treatment include dietary modifications, antibiotics, systemic or intralesional corticosteroids, and surgery, although treatment is not always necessary. CG should be considered in the differential of persistent lip swelling.

After implementation of a point-based reward system, resident research activity increased. The data suggest that this system may encourage resident research, although further refinement may be required to promote higher-quality research endeavors.

Aims:  To characterize the efficacy of widely accepted heat and chlorination on culturable and non‐culturable Legionella pneumophila in starved and warm water. Methods and Results:  For L. pneumophila starved for 1 day (S1), heating at 60°C or more for 30 min or chlorination at 0·5–20 mg l−1 for 60 min, a loss of 6–8 log culturability was observed, whereas only 17–47% of cells had membrane damage. Non‐culturability was also observed after heating or chlorinating the cells starved for 14 days (S14). The effect of heating on membrane deterioration was reduced for S14 cells while the chlorination effect remained. Legionella pneumophila entered a non‐culturable phase after being starved for 33–40 days. The disinfection effects of both heating and chlorination on non‐culturable N4 and N35 cells (which were collected on the fourth and the 35th days of the non‐culturability phase respectively) decreased, indicating the development of disinfection resistance among non‐culturable cells that had been subjected to starvation for 1–2 months. Conclusions:  Heating and chlorination significantly reduce the culturability of starved L. pneumophila, and damage cell membrane to a much less extent. Significance and Impact of the Study:  This study shows the ability of long‐term starved L. pneumophila to resist against disinfection treatments, which has implications in terms of public health.

Otolaryngology is viewed as a competitive residency program, and as a result, a high number of applications are submitted by each applicant. A look at the data quantifies the cost and the challenges.

The field of otolaryngology has historically enjoyed extreme interest among residency applicants. However, in the past few years, the number of applicants has precipitously dropped, so that there is no longer a significant excess of applications. It remains important for academic programs to promote student interest in otolaryngology, to break down barriers that may dissuade excellent candidates, and to widen the welcome.