April 27, 2026, Alexandria, Virginia—A new retrospective study published in OTO Open, the open-access journal of the American Academy of Otolaryngology–Head and Neck Surgery Foundation (AAO-HNSF), demonstrates that the Clinical Practice Guideline (CPG) Opioid Prescribing for Analgesia After Common Otolaryngology Operations has had a measurable and sustained impact on prescribing practices following parotidectomy, which a surgical procedure to remove the parotid gland.
The study analyzed deidentified data from more than 25,000 patients across 80 U.S. healthcare organizations using the TriNetX database, spanning January 2013 through December 2023. Researchers found that following the publication of the CPG in April 2021, opioid prescribing in the postoperative period dropped immediately and significantly, and that the trend continued over time.
"This study highlights the importance of clinical practice guidelines and the impact they can have on practice patterns," said senior author Viran J. Ranasinghe, MD, with the Department of Otolaryngology-Head and Neck Surgery, University of Texas Medical Branch.
The research, which was first presented at the AAO-HNSF 2025 Annual Meeting & OTO EXPO, held October 11–14, 2025, in Indianapolis, Indiana, represents a meaningful shift toward the multimodal, non-opioid-first approach to postoperative pain management championed by the CPG.
This CPG was developed to reduce the variation in postoperative pain management across the specialty and curb the risks associated with opioid overprescribing, including opioid use disorder (OUD), diversion, and overdose. Among its key action statements, the guideline issued strong recommendations that clinicians:
- Advocate for non-opioid medications as first-line management of pain following otolaryngologic surgery
- Screen patients for OUD risk factors before surgery when opioids are anticipated
- Counsel patients on secure storage and disposal of any unused opioids.
The guideline also emphasizes shared decision-making, multimodal analgesia strategies, and patient education, providing a comprehensive framework aimed at reducing opioid dependence risk while maintaining effective pain control.
Study Citation: Africa, R.E., Mason, B., Ali, S.R., McKinnon, B.J., Coblens, O.M., Maldonado-Chapa, F. and Ranasinghe, V.J. (2026), Evaluation of Opioid Prescribing Guidelines on Opioid Prescription Trends for Parotidectomy. OTO Open, 10: e70221. https://doi.org/10.1002/oto2.70221
OTO Open is the official open-access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation. Its mission is to publish clinically relevant, contemporary, and ethical research in otolaryngology--head and neck surgery that advances patient care and supports the global medical community through free and unrestricted access to peer-reviewed science.
About the AAO-HNS/F
The AAO-HNS/F is one of the world's largest organizations representing specialists who treat the ears, nose, throat, and related structures of the head and neck. Otolaryngologist-head and neck surgeons diagnose and treat medical disorders that are among the most common affecting patients of all ages in the United States and around the world. Those medical conditions include chronic ear disease, hearing and balance disorders, hearing loss, sinusitis, snoring and sleep apnea, allergies, swallowing disorders, nosebleeds, hoarseness, dizziness, and tumors of the head and neck as well as aesthetic and reconstructive surgery and intricate micro-surgical procedures of the head and neck. The Academy has approximately 13,000 members. The AAO-HNS Foundation works to advance the art, science, and ethical practice of otolaryngology-head and neck surgery through education, research, and quality measurement.
