Michael Brenner

University of Michigan School of Medicine

Objective To investigate perspectives of patients, family members, caregivers (PFC), and healthcare professionals (HCP) on tracheostomy care during the COVID-19 pandemic. Methods The cross-sectional survey investigating barriers and facilitators to tracheostomy care was collaboratively developed by patients, family members, nurses, speech-language...

Objectives The management of sepsis in critically ill patients varies globally based on the availability of resources resulting in increased sepsis-related mortality rates in resource-restricted countries. We aimed to summarise evidence regarding components of sepsis protocols, compliance with implementing sepsis protocol, effects on lengths of sta...

Objective. To offer pragmatic, evidence-informed guidance on the use of systemic corticosteroids (SCS) for common oto-laryngologic disorders. Data Sources. PubMed, Cochrane Library, and American Academy of Otolaryngology-Head and Neck Surgery Foundation clinical practice guidelines. Review Methods. A comprehensive search of published literature thr...

Background Olfactory training is the only evidence-based treatment for post viral olfactory dysfunction. Smell disorders after SARS-CoV-2 infection have been attributed to neuroinflammatory events within the olfactory bulb and the central nervous system. Therefore, targeting neuroinflammation is one potential strategy for promoting recovery from po...

BACKGROUND: Olfactory training is the only evidence-based treatment for post viral olfactory dysfunction. Smell disorders after SARS-CoV-2 infection have been attributed to neuroinflammatory events within the olfactory bulb and the central nervous system. Therefore, targeting neuroinflammation is one potential strategy for promoting recovery from p...

BACKGROUND: Olfactory training is the only evidence-based treatment for post viral olfactory dysfunction. Smell disorders after SARS-CoV-2 infection have been attributed to neuroinflammatory events within the olfactory bulb and the central nervous system. Therefore, targeting neuroinflammation is one potential strategy for promoting recovery from p...

Academic medical centers striving to implement diversity, equity, and inclusion (DEI) and antiracism initiatives often ask faculty to volunteer substantial time to committee work, recruitment, mentoring, community, and administrative responsibilities. These requests are not in lieu of current workload and seldom count toward scholarship; the servic...

Objective To offer pragmatic, evidence-informed guidance on the use of systemic corticosteroids (SCS) for common otolaryngologic disorders. Data Sources PubMed, Cochrane Library, and American Academy of Otolaryngology–Head and Neck Surgery Foundation clinical practice guidelines. Review Methods A comprehensive search of published literature throu...

Objective To provide a contemporary resource for clinicians and researchers on health equity research and implementation strategies to mitigate or eliminate disparities in health care. Data Sources Published studies and literature on health disparities, applicable research methodologies, and social determinants of health in otolaryngology. Review...

When patients are harmed by health care, concerns fan out in all directions. Patients and families confront a sea of uncertainty, contending with injuries that drain them physically, emotionally, and financially. Health care professionals experience a powerful mix of emotions, but are seldom afforded the time to process what happened or the resourc...

The hidden epidemic of burnout exacts a staggering toll on professionals and patients, reflected in increased risk of medical errors, complications, and staff turnover. For surgeons, nurses, and other team members working at the sharp end of care, adverse events can amplify work exhaustion, interpersonal disengagement, and risk of moral adversity....

At the foundation of clinical medicine is the relationship among patients, families, and health care professionals. Implicit to that social contract, professionals pledge to bring clinical excellence to advance their patients' wellness and healing-and to prevent harm. Patients trust that those privileged to deliver care will do so unwaveringly in s...

Objective: COVID-19 has been associated with a wide range of quantitative and qualitative disorders of smell, including hyposmia/anosmia, parosmia, and phantosmia; however, no reports to date have reported hyperosmia as a sequela of SARS-CoV-2 infection. Patients and methods: We present two cases of subjective hyperosmia in a South Tyrolean Alps...

Background: Smell alteration and cognitive impairment are common features of the Long-COVID Syndrome. Mental clouding, often described as brain fog might affect smell by al-tering recollection of odors or through a share mechanism of neuroinflammation. We investigated mental clouding, headache, and cognitive function in adult patients with persiste...

Autoimmune inner ear disease (AIED) encompassed a diverse group of disorders in which immune-mediated damage to vestibulocochlear apparatus results in hearing loss, tinnitus, or vestibular impairment. The underlying pathogenesis involves inflammatory responses with self-reactive antibodies and T-cell-mediated injuries. These insults induce electroc...

The Centralized Otolaryngology Research Efforts (CORE) grant program coordinates research funding initiatives across the subspecialties of otolaryngology–head and neck surgery. Modeled after National Institutes of Health study sections, CORE grant review processes provide comprehensive reviews of scientific proposals. The organizational structure a...

Objective To offer pragmatic, evidence-informed advice on administering corticosteroids in otolaryngology during the coronavirus disease 2019 (COVID-19) pandemic, considering therapeutic efficacy, potential adverse effects, susceptibility to COVID-19, and potential effects on efficacy of vaccination against SARS-CoV-2, which causes COVID-19. Data...

Objective Investigate healthcare providers, caregivers, and patient perspectives on tracheostomy care barriers during COVID-19. Study design Cross-sectional anonymous survey Setting Global Tracheostomy Collaborative Learning Community Methods A 17-item questionnaire was electronically distributed, assessing demographic and occupational data; cha...

It is currently known that anosmia is a sign of SARS-CoV2 infection, as well as the symptom is caused by the neuroinflammation of the olfactory bulbs. To date, it is unknown why some patients suffer from persistent anosmia. The suspect is that genetic of the host can be responsible of this persistent symptom. Moreover, also spike variants can have...

Parosmia can arise as sequela of post-COVID-19 anosmia. Some authors described this symptom as good prognostic factor of the olfactory recovery; however several patients suffer from persistent parosmia that tends to worsening by the time. In this paper we discussed the causes of parosmia and suggested some therapeutic options to avoid its onset dur...

Purpose: Investigate parental perceptions of children's sleep disturbance and psychological distress associated with an inpatient stay in a low-resource hospital setting. Design and methods: Demographic and validated survey instruments were adapted for administration to parents of children in the medical wards of a tertiary hospital in India. Pa...

Objectives To evaluate new drugs and devices relevant to otolaryngology–head and neck surgery that were approved by the US Food and Drug Administration (FDA) in 2020. Data Sources Publicly available device and therapeutic approvals from ENT (ear, nose, and throat), anesthesia, neurology (neurosurgery), and plastic and general surgery FDA committee...

Objective Invasively ventilated patients with acute respiratory failure related to coronavirus disease 2019 (COVID–19) potentially benefit from tracheostomy. The aim of this study was to determine the practice of tracheostomy during the first wave of the pandemic in 2020 in the Netherlands, to ascertain whether timing of tracheostomy had an associa...

Between March 2016 and July 2018, 23 states implemented legislation limiting the duration of initial opioid prescriptions to a maximum of 7 days (17 states [74%] limited to 7 days or less, 2 [9%] to 5 days or less, and 4 [17%] to 3 days or less),¹ yet the effect of these policies on opioid prescribing remain poorly understood.² A previous analysis...

Many patients receive their first opioid prescription from a surgeon. While surgery is a large concern for most patients, receiving an opioid prescription may seem more incidental. Yet 1 of every 17 patients who uses an opioid after otolaryngologic surgery continues to require opioids long after postoperative care has been completed.¹ Overall, 1 of...

Importance: During respiratory disease outbreaks such as the COVID-19 pandemic, aerosol-generating procedures, including tracheostomy, are associated with the risk of viral transmission to health care workers. Objective: To quantify particle aerosolization during tracheostomy surgery and tracheostomy care and to evaluate interventions that minim...

The perioperative care of adult patients undergoing free tissue transfer during head and neck surgical (microvascular) reconstruction is inconsistent across practitioners and institutions. The executive board of the Society for Head and Neck Anesthesia (SHANA) nominated specialized anesthesiologists and head and neck surgeons to an expert group, to...

Background: Whereas data from the pre-pandemic era have demonstrated that tracheostomy can accelerate liberation from the ventilator, reduce need for sedation, and facilitate rehabilitation, concerns for healthcare worker safety have led to disagreement on tracheostomy placement in COVID-19 patients. Data on COVID-19 patients undergoing tracheosto...

Objective: To investigate prevalence, radiological characteristics, and functional correlates of arachnoid cysts (AC) of the internal auditory canal (IAC) region, including associations of nerve compression with auditory/vestibular symptoms and asymmetrical audiogram or vestibular testing. Methods: T2-weighted MRI studies of IACs were retrospectiv...

The perioperative care of adult patients undergoing free tissue transfer during head and neck surgical (microvascular) reconstruction is inconsistent across practitioners and institutions. The executive board of the Society for Head and Neck Anesthesia (SHANA) nominated specialized anesthesiologists and head and neck surgeons to an expert group, to...

Objective: Surgical procedures that render patients acutely aphonic can cause them to experience significant anxiety and distress. We queried patient perceptions after tracheostomy or laryngectomy and investigated whether introducing augmentative technology was associated with improvement in patient-reported outcomes. Methods: Participants inclu...

Hypothesis: Moringa extract, a naturally occurring anti-oxidant, protects against aminoglycoside-induced hair cell death and hearing loss within the organ of Corti. Background: Reactive oxygen species (ROS) arise primarily in the mitochondria and have been implicated in aminoglycoside-induced ototoxicity. Mitochondrial dysfunction results in los...

Objective: To assess the outcomes of tracheostomy in patients with COVID-19 respiratory failure. Summary background data: Tracheostomy has an essential role in managing COVID-19 patients with respiratory failure who require prolonged mechanical ventilation. However, limited data are available on how tracheostomy affects COVID19 outcomes, and unc...

The perioperative care of adult patients undergoing free tissue transfer during head and neck surgical (microvascular) reconstruction is inconsistent across practitioners and institutions. The executive board of the Society for Head and Neck Anesthesia (SHANA) nominated specialized anesthesiologists and head and neck surgeons to an expert group, to...

Objectives: Approximately 30% of patients with confirmed COVID-19 report persistent smell or taste disorders as long-term sequalae of infection. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with inflammatory changes to the olfactory bulb, and treatments with anti-inflammatory properties are hypothesized to at...

Public health crises palpably demonstrate how social determinants of health have led to disparate health outcomes. The staggering mortality rates among African Americans, Native Americans, and Latinx Americans during the COVID-19 pandemic have revealed how recalcitrant structural inequities can exacerbate disparities and render not just individuals...

Objective To offer practical, evidence-informed knowledge on clinical decision support systems (CDSSs) and their utility in improving care and reducing costs in otolaryngology–head and neck surgery. This primer on CDSSs introduces clinicians to both the capabilities and the limitations of this technology, reviews the literature on current state, an...

Objective Opioid use disorder (OUD), which includes the morbidity of dependence and mortality of overdose, has reached epidemic proportions in the United States. Overprescription of opioids can lead to chronic use and misuse, and unused narcotics after surgery can lead to their diversion. Research supports that most patients do not take all the pre...

Objective: Opioid use disorder (OUD), which includes the morbidity of dependence and mortality of overdose, has reached epidemic proportions in the United States. Overprescription of opioids can lead to chronic use and misuse, and unused narcotics after surgery can lead to their diversion. Research supports that most patients do not take all the p...

Background: Several techniques have been proposed to modify tip shape and projection, both in congenital and acquired nasal tip deformities. We describe a novel technique, the Y-columellar strut graft (“Y-strut”), which uses auricular cartilage to increase tip projection and restore contour in primary or revision rhinoplasty. Methods: Thirty-seven...

Rationale: Feasibility of a large, multi-center, randomized controlled trial (RCT) comparing the risks and benefits of early use speaking valve following tracheostomy is not clear. Objective: To investigate the feasibility of accelerated (≤ 24 hours) versus standard (≥ 48 hours) one-way speaking valve ("speaking valve") placement after percutane...

Successful management of lip and perioral trauma requires a nuanced understanding of anatomy and surgical techniques. Surgical correction is particularly challenging in instances of tissue loss, due to a narrow tolerance for aesthetic deformity and highly specialized functions of the perioral region, including facial expression, communication, and...

For individuals aspiring to a career in otolaryngology-head and neck surgery, mentorship can shape destiny. Mentorship helps assure safe passage into the specialty, and it influences the arc of professional development across the career continuum. Even before the novel coronavirus disease 2019 (COVID-19) pandemic, technology and social networking w...

Metastatic lymph nodes of the head and neck are often associated with locoregional spread of mucosal squamous carcinoma, but in rare instances visceral malignancies may bypass Virchow's node. The possibility of distant metastasis should be considered. Metastatic lymph nodes of the head and neck are often associated with locoregional spread of mucos...

Difficult airway protocols are critical for ensuring safety, as a single airway procedure can result in viral transmission to hundreds of health care workers.2 In emergency airway situations, where the patient cannot be intubated and cannot be ventilated, we favor a cricothyroidotomy procedure. In contrast, in urgent instances, with impending risk...

Mortality from COVID-19 has obscured a subtler crisis – the swelling ranks of COVID-19 survivors. After critical illness, patients often suffer post-intensive care syndrome (PICS), which encompasses physical, cognitive, and/or mental health impairments that are often long-lasting barriers to resuming a meaningful life. Some deficits after COVID-19...

The meteoric rise of telemedicine early in the COVID-19 pandemic might easily be mistaken for an ephemeral trend—one reaching its zenith in a moment of crisis. To the contrary, momentum has been mounting for telehealth over decades. The recent increase in telecare reveals its potential to deliver efficient, patient-centered, high-quality care in an...

Purpose Complications in facial plastic surgery can lead to pain, suffering, and permanent harm. Yet, the etiology and outcomes of adverse events are understudied. This study aims to determine the etiology and outcomes of adverse events reported in aesthetic facial plastic surgery and identify quality improvement opportunities. Material and method...

Background: Multiple sclerosis (MS) is associated with otolaryngology-related manifestations including vestibular or auditory symptoms; facial motor or sensory disorders; voice or swallowing impairment; and snoring/sleep apnea. Because these symptoms are nonspecific, their significance in MS is seldom recognized by patients with MS and their physic...

Objective: The coronavirus disease 2019 (COVID-19) pandemic has led to a global surge in critically ill patients requiring invasive mechanical ventilation, some of whom may benefit from tracheostomy. Decisions on if, when, and how to perform tracheostomy in patients with COVID-19 have major implications for patients, clinicians, and hospitals. We...

It is impossible to secure the airway of a patient with “neck-only” breathing transorally or transnasally. Surgical removal of the larynx (laryngectomy) or tracheal rerouting (tracheoesophageal diversion or laryngotracheal separation) creates anatomic discontinuity. Misguided attempts at oral intubation of neck breathers may cause hypoxic brain inj...

Academic centers embody the ideals of otolaryngology and are the specialty’s port of entry. Building a diverse otolaryngology workforce—one that mirrors society—is critical. Otolaryngology continues to have an underrepresentation of racial and ethnic minorities. The specialty must therefore redouble efforts, becoming more purposeful in mentoring, r...

Objective: Tracheostomy tube cuff balloon herniation is a rare event and can determine airway obstruction. Sometimes the obstruction is not very evident but, if it is not correctly solved, can determine a severe hypoxia with patient’s death. Material and Methods: We present a 49-year-old male patient, with cT4aN0M0 squamous cell carcinoma of the o...

Objective: to show that Björk flap tracheotomy is a safe procedure for healthcare and patients during COVID-19 pandemia. Method: An 81-year-old man, who had a known history of thyroid goiter, presented to the ER of our hospital due to the onset of breathing difficulties arisen 10 days before and dramatically increased in last 24-hours. The patient...