{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T21:30:15Z","timestamp":1771018215929,"version":"3.50.1"},"reference-count":23,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Harry Barberian Scholarship"},{"name":"Head and Neck Cancer Alliance\/American Head and Neck Society International Outreach Cancer Prevention Award"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Homeless individuals frequently experience poor access to healthcare, delayed clinical presentation, and higher disease burden. Providing subspecialty otolaryngology care to this population can be challenging. We previously reported on the prevalence of hearing impairment in Toronto's homeless community. As a secondary objective of this study, we sought to define otolaryngology specific need for this population. <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> One hundred adult homeless individuals were recruited across ten homeless shelters in Toronto, Canada using a stratified random sampling technique. An audiometric evaluation and head and neck physical examination were performed by an audiologist and otolaryngology resident, respectively. Basic demographic and clinical information was captured through verbal administration of a survey. Descriptive statistics were used to estimate frequency of otolaryngology specific diseases for this population. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Of the 132 individuals who were initially approached to participant, 100 (76%) agreed. There were 64 males, with median age of 46\u2009years (IQR 37\u201358\u2009years). The median life duration of homelessness was 24\u2009months (IQR 6\u201372\u2009months). Participants had a wide range of medical comorbidities, with the most common being current tobacco smoking (67%), depression (36%), alcohol abuse (32%), and other substance abuse (32%). There were 22 patients with otolaryngology needs as demonstrated by one or more abnormal findings on head and neck examination. The most common finding was nasal fracture with significant nasal obstruction (6%). Eleven patients required referral to a staff otolaryngologist based on concerning or suspicious findings, including two head and neck masses, 6 were later seen in follow-up. <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p> There were substantial otolaryngology needs amongst a homeless population within a universal healthcare system. Future research should focus on further elucidating head and neck related issues in this population and expanding the role of the otolaryngologist in providing care to homeless individuals. <\/jats:p><\/jats:sec>","DOI":"10.1186\/s40463-020-00445-2","type":"journal-article","created":{"date-parts":[[2020,7,9]],"date-time":"2020-07-09T08:08:50Z","timestamp":1594282130000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Otolaryngology needs among an adult homeless population: A prospective study"],"prefix":"10.1177","volume":"49","author":[{"given":"Vincent","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher W.","family":"Noel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Forner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, Dalhousie University, Halifax, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Florence","family":"Mok","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Molly","family":"Zirkle","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"},{"name":"Li Ka Shing Knowledge Institute, Toronto, Canada"},{"name":"Department of Otolaryngology, Head & Neck Surgery, St. Michael's Hospital, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoine","family":"Eskander","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"},{"name":"Department of Otolaryngology, Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"},{"name":"Department of Otolaryngology, Head & Neck Surgery, Sunnybrook Health Sciences Centre, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John M.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Canada"},{"name":"Li Ka Shing Knowledge Institute, Toronto, Canada"},{"name":"Department of Otolaryngology, Head & Neck Surgery, St. Michael's Hospital, Toronto, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,1,1]]},"reference":[{"key":"bibr1-s40463-020-00445-2","author":"City of Toronto Shelter Support and Housing Administration","year":"2010","journal-title":"Per Diem Rates for the Purchase of Service Shelter System and Results of the Review of the Per Diem Funding Model"},{"key":"bibr2-s40463-020-00445-2","author":"City of Toronto Shelter Support and Housing Administration","year":"2006","journal-title":"Street Needs Assessment results. 2006 TCoT"},{"issue":"2","key":"bibr3-s40463-020-00445-2","first-page":"229","volume":"164","author":"Hwang SW","year":"2001","journal-title":"CMAJ."},{"issue":"2","key":"bibr4-s40463-020-00445-2","first-page":"161","volume":"163","author":"Hwang SW","year":"2000","journal-title":"CMAJ."},{"key":"bibr5-s40463-020-00445-2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1989.03430140091031"},{"key":"bibr6-s40463-020-00445-2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.2.200"},{"key":"bibr7-s40463-020-00445-2","doi-asserted-by":"crossref","unstructured":"Jiang S, Mikhail M, Slomovic J, et al. Prevalence and impact of eye disease in an urban homeless and marginally housed population. 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