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Otolaryngology—Head and Neck Surgery

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https://www.readbyqxmd.com/read/28419813/do-clinical-practice-guidelines-improve-quality
#1
Cristina M Baldassari
Controversy exists surrounding how to best define and assess quality in the health care setting. Clinical practice guidelines (CPGs) have been developed to improve the quality of medical care by highlighting key clinical recommendations based on recent evidence. However, data linking CPGs to improvements in outcomes in otolaryngology are lacking. Numerous barriers contribute to difficulties in translating CPGs to improvements in quality. Future initiatives are needed to improve CPG adherence and define the impact of CPG recommendations on the quality of otolaryngologic care provided to our patients...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28419812/defining-quality-in-head-and-neck-reconstruction
#2
Peter M Vila, Jason T Rich, Shaun C Desai
Microvascular free flap reconstruction has now become the standard of care in the reconstruction of selected head and neck defects. Although uncommon, flap failure is a catastrophic event that results in significant patient morbidity, extended length of hospitalization, and increased cost. However, there is currently no gold standard for measuring the quality of a reconstructive center. Structure and process outcomes have recently been developed, but outcome measures are still lacking. Areas for future research include preoperative nutrition, preoperative flap planning, intraoperative fluid management, appropriate thromboembolism prophylaxis, consistent perioperative antibiotic regimens, skilled ancillary staff, and clear outcome measures for performance measurement...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28419807/otolaryngology-residency-program-research-resources-and-scholarly-productivity
#3
Jennifer A Villwock, Chelsea S Hamill, Brian D Nicholas, Jesse T Ryan
Objective To delineate research resources available to otolaryngology residents and their impact on scholarly productivity. Study Design Survey of current otolaryngology program directors. Setting Otolaryngology residency programs. Subjects and Methods An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. Results Thirty-nine percent (n = 38) of queried programs responded...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28419806/tracheal-t-tubes-for-long-term-management-of-the-unreconstructable-trachea-in-adults
#4
Mark A Varvares
Management of tracheostenosis in adult patients who are either medically unreconstructable due to significant comorbidities or surgically unreconstructable remains a challenge. The tracheal T-tube offers an excellent permanent solution to the problem of the unreconstructable trachea. This article reviews 3 patients who underwent tracheofissure and placement of a tracheal T-tube after failed prior attempts at repair of tracheal stenosis. The tracheal T-tubes have been maintained for 13, 15, and 36 years, and these patients have enjoyed adequate phonatory and respiratory functions with the T-tube plugged and functioning as an airway stent...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28419805/hypoglossal-nerve-upper-airway-stimulator-implantation-after-radiotherapy-for-head-and-neck-malignancy
#5
Zhong Zheng, Shirley Hu, Boris Chernobilsky
No abstract text is available yet for this article.
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418817/virtual-mapping-of-the-frontal-recess-guiding-safe-and-efficient-frontal-sinus-surgery
#6
Neil S Patel, Amy C Dearking, Erin K O'Brien, John F Pallanch
Objective To define relationships between the frontal sinus opening, ostia of other frontal recess cells, and endoscopic landmarks and to develop a clinically useful framework to guide frontal sinus surgery. Study Design Retrospective review. Setting Tertiary care academic referral center. Methods Adult patients with computed tomography (CT) without sinonasal pathology were included. Virtual endoscopy (using OsiriX) and corresponding CT reconstructions were used to identify all visible ostia in the frontal recess and characterize their positions in spaces between the uncinate/agger nasi (U), bulla ethmoidalis (EB), and middle turbinate (MT)...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418791/superior-semicircular-canal-dehiscence-symptoms-unmasked-by-ossicular-chain-reconstruction
#7
Omid Moshtaghi, Hossein Mahboubi, Hamid R Djalilian, Harrison W Lin
No abstract text is available yet for this article.
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418784/a-fresh-cadaver-model-for-the-instruction-of-ultrasound-guided-fine-needle-aspiration-of-thyroid-nodules
#8
Hilary C McCrary, Erynne A Faucett, Audriana N Hurbon, Tijana Milinic, Jose A Cervantes, Sean L Kent, William J Adamas-Rappaport
Objective The aim of our study is to determine if a fresh cadaver model (FCM) for the instruction of ultrasound (US)-guided fine-needle aspiration (FNA) of thyroid nodules is a practical method for instruction. Study Design Pre- and postinstruction assessment of medical students' ability to perform US-guided FNA of artificially created thyroid nodules placed adjacent to the thyroid gland of a fresh cadaver. Setting University-based fresh cadaver laboratory. Subjects and Methods Study participants included a total of 17 first- and second-year medical students with minimal US training...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418783/locoregional-flaps-for-oral-cavity-reconstruction-a-review-of-modern-options
#9
Urjeet A Patel, Gregory K Hartig, Matthew M Hanasono, Derrick T Lin, Jeremy D Richmon
Objective To review state-of-the-art modifications and advances in soft tissue local and regional flap reconstruction of the oral cavity and to determine the role these techniques play in current practice. Data Sources Review of the literature regarding oral cavity reconstruction. Review Methods The authors describe advances in locoregional reconstructive options and assimilate data from the literature that compare recent advances to the historic standards. Conclusions Modern advances in regional reconstruction of the oral cavity offer outstanding results and demonstrate potential advance over free tissue transfer...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418781/induction-chemotherapy-plus-concurrent-chemoradiotherapy-vs-concurrent-chemoradiotherapy-in-elderly-patients-with-advanced-nasopharyngeal-carcinoma
#10
Chunlin Wang, Xi Tang, Jiaojian Wang, Jian Song, Yanhua Xu
Objective This study aimed to compare survival and toxicity between induction chemotherapy followed by concurrent chemoradiotherapy (IC + CCRT) and concurrent chemoradiotherapy (CCRT) alone in elderly patients with advanced nasopharyngeal carcinoma (NPC). Study Design Propensity-matched analysis of survival and toxicity in a retrospective elderly cohort. Setting Department of Medical Oncology, Jingzhou Hospital, Tongji Medical College, Huazhong University of Science and Technology, China. Subjects and Methods In total, 193 patients with stage III to IVb NPC who were treated with IC + CCRT or CCRT alone were enrolled...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418779/determining-a-successful-nasal-airway-surgery-calculation-of-the-patient-centered-minimum-important-difference
#11
Hedyeh Ziai, James P Bonaparte
Objective Determine whether the patient-identified minimum important difference (MID) in Nasal Obstruction Symptom Evaluation (NOSE) score differs from a statistically calculated estimate of MID in patients with septal deviation undergoing nasal airway surgery. Study Design Prospective cohort. Setting Tertiary academic referral center. Subjects Patients with nasal obstruction due to septal deviation. Methods Patients completed the NOSE questionnaire preoperatively and indicated the change from their baseline score that they would consider the minimum improvement required to define the septoplasty with turbinate reduction as successful...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418775/research-101-an-initiative-to-encourage-and-facilitate-quality-resident-research-in-a-military-setting
#12
Kathryn E Marshall, Tanisha L Hammill
Objective Describe and evaluate a structured research program initiated at a tertiary Department of Defense (DOD) Medical Training Facility (MTF) to encourage and facilitate the conduct of research investigations, specifically among residents and junior or inexperienced investigators, but applicable for all DOD otolaryngology (ENT) and audiology providers. Methods A new comprehensive program was deployed in the ENT clinic at Madigan Army Medical Center (MAMC) to help improve the research program. Identified gaps in research methods and regulatory training were incorporated into the existing graduate medical education program along with structured mentorship between residents and senior staff...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418754/evaluating-the-effect-of-virtual-reality-temporal-bone-simulation-on-mastoidectomy-performance-a-meta-analysis
#13
Justin T Lui, Monica Y Hoy
Background The increasing prevalence of virtual reality simulation in temporal bone surgery warrants an investigation to assess training effectiveness. Objectives To determine if temporal bone simulator use improves mastoidectomy performance. Data Sources Ovid Medline, Embase, and PubMed databases were systematically searched per the PRISMA guidelines. Review Methods Inclusion criteria were peer-reviewed publications that utilized quantitative data of mastoidectomy performance following the use of a temporal bone simulator...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418275/factors-influencing-cochlear-patency-after-translabyrinthine-surgery
#14
Brian Rodgers, Emily Stucken, Aaron Metrailer, Eric Sargent
Objective To determine predictive factors for cochlear obliteration after translabyrinthine surgery for vestibular schwannoma. Study Design Case series with chart review. Setting Neurotology referral center. Subjects and Methods In total, 345 charts were reviewed, resulting in 103 patients who underwent translabyrinthine surgery between January 2010 and July 2015 and had postoperative magnetic resonance imaging (MRI) for review. Surveillance MRI performed after translabyrinthine resection of vestibular schwannomas was reviewed...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418273/thalidomide-for-epistaxis-in-patients-with-hereditary-hemorrhagic-telangiectasia-a-preliminary-study
#15
Jia Fang, Xiaomeng Chen, Bijun Zhu, Haibo Ye, Weitian Zhang, Jian Guan, Kaiming Su
To evaluate the effectiveness of thalidomide for epistaxis in hereditary hemorrhagic telangiectasia (HHT), 7 HHT patients with recurrent epistaxis were treated with thalidomide at an initial dose of 50 mg/d, gradually increasing to 100 mg/d if needed. The Epistaxis Severity Score (ESS) was used to evaluate the treatment effects. Patients reported that epistaxis improved 1 to 3 weeks after starting thalidomide. The mean ESS before treatment, at the end of treatment, and 3 months after stopping treatment was 5...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418271/use-of-a-novel-airway-kit-and-simulation-in-resident-training-on-emergent-pediatric-airways
#16
Jonathan M Melzer, Erin R S Hamersley, Thomas Q Gallagher
Objective Development of a novel pediatric airway kit and implementation with simulation to improve resident response to emergencies with the goal of improving patient safety. Methods Prospective study with 9 otolaryngology residents (postgraduate years 1-5) from our tertiary care institution. Nine simulated pediatric emergency airway drills were carried out with the existing system and a novel portable airway kit. Response times and time to successful airway control were noted with both the extant airway system and the new handheld kit...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28418270/usmle-and-otolaryngology-predicting-board-performance
#17
Liana Puscas, David Chang, Hui-Jie Lee, Rodney Diaz, Robert Miller
Objective To ascertain what relationship exists between the United States Medical Licensing Examination (USMLE) and the American Board of Otolaryngology Written Qualifying Examination (WQE). Study Design Retrospective, longitudinal study. Setting De-identified database. Subjects Residents entering otolaryngology-head and neck surgery (OHNS) residency between 2007 and 2009 and taking the WQE for the first time between 2012 and 2014. Methods Regression models were used to determine if the USMLE score predicts passage of the WQE on the first attempt, which step score was a better predictor, and whether an increase in the Step 2 score increased the chances of WQE passage...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28417704/effects-of-silver-nitrate-cauterization-on-middle-turbinate-synechia-after-endoscopic-sinus-surgery
#18
Sinan Uluyol
Objective This study aimed to examine the efficacy of silver nitrate cauterization of the middle turbinate (MT) for hindering postoperative middle meatal synechia formation after endoscopic sinus surgery (ESS). Study Design Prospective, controlled, and single-blinded. Settings Tertiary referral center. Subjects and Methods For this study, 38 patients undergoing bilateral ESS due to nasal polyposis were recruited. Following ESS, silver nitrate cauterization of the lateral side of the left MT was performed in all cases...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28417691/telangiectasias-in-osler-weber-rendu-syndrome
#19
Jason E Cohn, Joshua Scharf
No abstract text is available yet for this article.
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28417683/tracheostomy-for-severe-pediatric-obstructive-sleep-apnea-indications-and-outcomes
#20
Christopher J Rizzi, Julian D Amin, Amal Isaiah, Tulio A Valdez, Anita Jeyakumar, Suzanne E Smart, Kevin D Pereira
Objectives (1) To describe characteristics of pediatric patients undergoing tracheostomy for obstructive sleep apnea (OSA). (2) To highlight perioperative events and outcomes of the procedure. Study Design Case series with chart review. Setting Four tertiary care academic children's hospitals. Subjects and Methods Twenty-nine children aged <18 years from January 1, 2010, to December 31, 2015, who underwent tracheostomy for severe OSA, defined as an apnea-hypopnea index (AHI) >10, were included in the study...
April 1, 2017: Otolaryngology—Head and Neck Surgery
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