Olson, Brennan

ObjectiveTo examine implementation of virtual reality (VR) and Fitbit wearable activity devices in postoperative recovery.MethodsThis was a prospective, 4‐arm, randomized controlled trial of patients undergoing inpatient head and neck surgery at a tertiary academic center from November 2021 to July 2022. Patients were randomized to Control, VR, Fitbit, or combined VR + Fitbit groups. Patients in the VR groups were brought VR headsets to use throughout each day, and patients in the Fitbit groups wore Fitbit devices and were encouraged to achieve 2,000 daily steps. The primary outcome was average daily opioid use, measured as milligram morphine equivalents (MME).ResultsThere were 80 patients included. The majority of patients were male (68.8%), and mean age was 58.8 ± 14.4 years. Only the combined VR + Fitbit cohort was associated with reduced average daily opioid use (VR + Fitbit: 8.8 [20.6] MME vs. Control: 26.4 [37.4] MME, p = 0.02). Patients in intervention groups also had higher hospital satisfaction (p = 0.02). VR was utilized 26% of the time it was provided, with mean use time of 23.8 ± 7.8 min. Mean post‐VR subjective pain reduction was 1.0 ± 1.3, and there were three mild adverse events of neck or nasal discomfort. Among the Fitbit groups, there were no adverse events and daily step counts ≥2,000 steps were achieved 45% of the time.ConclusionImplementation of VR and wearable activity devices in postoperative recovery appears well tolerated and may facilitate further development of Enhanced Recovery After Surgery (ERAS) protocols, though there are challenges to maximizing device usage.Level of Evidence2 Laryngoscope, 135:2044–2050, 2025

AbstractGynecological malignancies are a significant cause of morbidity and mortality across the globe. Due to delayed presentation, gynecological cancer patients are often referred late in the disease's course, resulting in poor outcomes. A considerable number of patients ultimately succumb to chemotherapy‐resistant disease, which reoccurs at advanced stages despite treatment interventions. Although efforts have been devoted to developing therapies that demonstrate reduced resistance to chemotherapy and enhanced toxicity profiles, current clinical outcomes remain unsatisfactory due to treatment resistance and unfavorable off‐target effects. Consequently, innovative biological and nanotherapeutic approaches are imperative to strengthen and optimize the therapeutic arsenal for gynecological cancers. Advancements in nanotechnology‐based therapies for gynecological malignancies offer significant advantages, including reduced toxicity, expanded drug circulation, and optimized therapeutic dosing, ultimately leading to enhanced treatment effectiveness. Recent advances in nucleic acid therapeutics using microRNA, small interfering RNA, and messenger RNA provide novel approaches for cancer therapeutics. Effective single‐agent and combinatorial nucleic acid therapeutics for gynecological malignancies have the potential to transform cancer treatment by giving safer, more tailored approaches than conventional therapies. This review highlights current preclinical studies that effectively exploit these approaches for the treatment of gynecological malignant tumors and malignant ascites.