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https://www.readbyqxmd.com/read/29726623/contemporary-analysis-of-practicing-otolaryngologists
#1
Willard C Harrill, David E Melon, Merritt J Seshul, Marc S Katz, Adam M Zanation
OBJECTIVES/HYPOTHESIS: To investigate contemporary issues facing practicing otolaryngologists including workforce dynamics, ancillary service modeling, otolaryngic allergy integration, ambulatory surgery center utilization, and relevant certificate of need legislation. STUDY DESIGN: A cross-sectional survey analysis of academic and private practicing otolaryngologists in North and South Carolina in 2016. METHODS: A cross-sectional survey was e-mailed to 510 practicing otolaryngologists in North and South Carolina...
May 4, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29710318/a-3-dimensional-printed-short-segment-template-prototype-for-mandibular-fracture-repair
#2
Parul Sinha, Gary Skolnick, Kamlesh B Patel, Gregory H Branham, John J Chi
Importance: After reduction of complex mandibular fractures, contouring of the fracture plates to fixate the reduced mandibular segments can be time-consuming. Objective: To explore the potential application of a 3-dimensional (3-D)-printed short-segment mandibular template in the management of complex mandibular fractures. Design, Setting, and Participants: A feasibility study was performed at a tertiary academic center using maxillofacial computed tomography data of 3 patients with comminuted mandibular fractures who required preoperative planning with a perfected complete mandible model...
April 26, 2018: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/29710075/effect-of-perioperative-gabapentin-use-on-postsurgical-pain-in-patients-undergoing-head-and-neck-mucosal-surgery-a-randomized-clinical-trial
#3
Melanie Townsend, Tina Liou, Dorina Kallogjeri, Morgan Schoer, Nicholas Scott-Wittenborn, Miranda Lindburg, Michael Bottros, Ryan S Jackson, Brian Nussenbaum, Jay F Piccirillo
Importance: Effective postoperative pain management increases patient satisfaction, reduces cost, reduces morbidity, and shortens hospitalizations. Previous studies investigating multimodal pain therapy in otolaryngology patients focused on homogenous patient groups with short postoperative follow-up times. Objective: To investigate the effect of perioperative gabapentin treatment on postsurgical pain in patients undergoing head and neck mucosal surgery. Design, Setting, and Participants: Adults undergoing head and neck mucosal surgery from July 25, 2016, through June 19, 2017, were included in this double-blinded, placebo-controlled randomized clinical trial and randomized to receive gabapentin, 300 mg twice daily, or placebo before surgery and up to 72 hours after surgery...
April 19, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29650421/financial-outcomes-of-transoral-robotic-surgery-a-narrative-review
#4
REVIEW
Sammy Othman, Brian J McKinnon
OBJECTIVE: To determine the current cost impact and financial outcomes of transoral robotic surgery in Otolaryngology. DATA SOURCES: A narrative review of the literature with a defined search strategy using Pubmed, MEDLINE, CINAHL, and Web of Science. REVIEW METHODS: Using keywords ENT or otolaryngology, cost or economic, transoral robotic surgery or TORs, searches were performed in Pubmed, MEDLINE, CINAHL, and Web of Science and reviewed by the authors for inclusion and analysis...
April 3, 2018: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/29533322/maximizing-operational-efficiency-using-an-in-house-ambulatory-surgery-model-at-an-academic-medical-center
#5
Samantha Tayne, Christian A Merrill, Rajeev C Saxena, Caitlin King, Karthik Devarajan, Stefan Ianchulev, Jon Chilingerian
Given the rising costs of healthcare delivery and reimbursement constraints, large academic medical centers (AMCs) must improve efficiency while delivering high-quality care. With standardized cases and high volumes, ambulatory surgery is a high-value target for efficiency improvement. Mining a data set of more than 7,500 cases consisting of the three highest-volume ambulatory procedures in orthopedics, otolaryngology-head and neck surgery, and urology, we analyzed process times and wait times involved in patient flow...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/29446458/clinical-criteria-for-ct-scan-evaluation-of-upper-digestive-tract-fishbone
#6
Forsan Jahshan, Eyal Sela, Eli Layous, Einat Levy, Niddal Assadi, Etgar Shilo, Nour Ibrahim, Dor Maayan, Ohad Ronen
OBJECTIVES: To establish clinical criteria for performing computed tomography scan for suspected upper digestive tract fishbone. METHODS: This is a prospective study of all adult patients referred to the otolaryngology emergency department at our medical center for suspected fishbone in the upper digestive tract after no fishbone was seen on physical examination. The patients were divided into two groups: 1) The first was a high clinical suspicion group, which included patients with at least one of the following criteria: drooling, accumulation of saliva in the sinus piriformis, fever, referral 24 hours after the ingestion with worsening/continuing symptoms, and readmission...
February 15, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29420775/algorithm-for-management-of-the-refractive-aerosinusitis-patient
#7
Andrew G Boston, K Christopher McMains, Philip G Chen, Erik K Weitzel
Introduction: For some career military aviators, their ability to continue on flight status is limited by the pressure and pain of aerosinusitis, which is present only while in the flying environment. Failure to treat their disease process can mean the end of their flying careers and the loss of valuable assets trained with taxpayer dollars. Because some medications commonly used in treatment of sinus diseases are not allowed in aviation, this presents a unique problem for their medical management...
February 6, 2018: Military Medicine
https://www.readbyqxmd.com/read/29417586/office-based-esophageal-dilation-in-head-and-neck-cancer-safety-feasibility-and-cost-analysis
#8
Rebecca J Howell, Melissa A Schopper, John Paul Giliberto, Ryan M Collar, Sid M Khosla
OBJECTIVE: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA). METHODS: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Next, a transnasal esophagoscopy (TNE) was performed. If the patient tolerated TNE, we proceeded with esophageal dilation using Seldinger technique with the CRE™ Boston Scientific (Boston Scientific Corp...
February 8, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29392282/primary-palate-trauma-in-patients-presenting-to-us-emergency-departments-2006-2010
#9
Aaron Smith, Meredith Ray, Scott Chaiet
Importance: The sequelae of palate trauma vary from minimal discomfort to major neurovascular injury. Infrequency of palate trauma and clinician unfamiliarity with the disease process may lead to variation in evaluation, treatment, and disposition in the emergency department (ED). Objectives: To measure the incidence of primary palate trauma visits to US emergency departments with analysis of demographics, disposition, and repair and to determine frequency and factors associated with head and neck imaging...
March 1, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29389252/risk-factors-and-predictive-model-development-of-thirty-day-post-operative-surgical-site-infection-in-the-veterans-administration-surgical-population
#10
Xinli Li, William Nylander, Tracy Smith, Soonhee Han, William Gunnar
BACKGROUND: Surgical site infection (SSI) complicates approximately 2% of surgeries in the Veterans Affairs (VA) hospitals. Surgical site infections are responsible for increased morbidity, length of hospital stay, cost, and mortality. Surgical site infection can be minimized by modifying risk factors. In this study, we identified risk factors and developed accurate predictive surgical specialty-specific SSI risk prediction models for the Veterans Health Administration (VHA) surgery population...
April 2018: Surgical Infections
https://www.readbyqxmd.com/read/29383077/development-of-a-novel-ultrasound-guided-peritonsillar-abscess-model-for-simulation-training
#11
Vivienne Ng, Jennifer Plitt, David Biffar
Introduction: Peritonsillar abscess (PTA) is the most common deep space infection of the head and neck presenting to emergency departments.1 No commercial PTA task trainer exists for simulation training. Thus, resident physicians often perform their first PTA needle aspiration in the clinical setting, knowing that carotid artery puncture and hemorrhage are serious and devastating complications. While several low-fidelity PTA task trainers have been previously described, none allow for ultrasound image acquisition...
January 2018: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29335042/training-and-assessment-in-functional-endoscopic-sinus-surgery
#12
M Chan, S Carrie
BACKGROUND: Functional endoscopic sinus surgery is a common procedure performed within otolaryngology, but it carries potential for significant life-changing complications. It is therefore essential that trainees undergo adequate training. The European Working Time Directive has led to reduced operating time for the trainee surgeon. With variable access and the cost implications associated with cadaveric specimens, simulation can be an invaluable educational resource in surgical training...
February 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29324861/cost-of-treatment-for-head-and-neck-cancer-in-india
#13
Akashdeep Singh Chauhan, Shankar Prinja, Sushmita Ghoshal, Roshan Verma, Arun S Oinam
There are no published data on the cost of cancer treatment for guiding reimbursement decisions in India. The present study was designed to estimate the cost of treating head and neck cancer (HNC) with the aim of determining package rates. The present study was undertaken in the Departments of Radiotherapy and Otolaryngology of a large tertiary care hospital in North India. Economic health system costs incurred were assessed using a bottom-up methodology. Data on all resources-capital or recurrent, incurred on the delivery of HNC treatment were collected from April 2014 to March 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29323794/skills-transfer-to-sinus-surgery-via-a-low-cost-simulation-based-curriculum
#14
R Alex Harbison, Jennifer Dunlap, Ian M Humphreys, Greg E Davis
BACKGROUND: Surgical skill development outside the operating room aims to improve technique and subsequent patient safety. The purpose of this study was to evaluate the correlation between technical and cognitive skills with cadaveric endoscopic sinus surgery (ESS) performance and change in ESS performance before and after implementation of a dedicated ESS simulation-based and knowledge-based curriculum. METHODS: A before-after study design was implemented among 10 medical students and 10 junior otolaryngology residents...
April 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29310703/management-of-persistent-epistaxis-using-floseal-hemostatic-matrix-vs-traditional-nasal-packing-a-prospective-randomized-control-trial
#15
Scott Murray, Adrian Mendez, Alexander Hopkins, Hamdy El-Hakim, Caroline C Jeffery, David W J Côté
BACKGROUND: Epistaxis is the most common emergent consultation to otolaryngology-head & neck surgery (OHNS) and with 60% of the population having experienced an episode and 1.6 in 10,000 requiring hospitalization in their lifetime. In preliminary studies Floseal® (Baxter, USA) Hemostatic Matrix has shown efficacy in up to 80% of persistent anterior epistaxis. We sought to evaluate the clinical efficacy and cost-effectiveness of Floseal® (Baxter, USA) compared to traditional nasal packing for persistent epistaxis...
January 8, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29299520/the-efficacy-of-lavender-aromatherapy-in-reducing-preoperative-anxiety-in-ambulatory-surgery-patients-undergoing-procedures-in-general-otolaryngology
#16
Michael Wotman, Joshua Levinger, Lillian Leung, Aron Kallush, Elizabeth Mauer, Ashutosh Kacker
Background: Preoperative anxiety is a common problem in hospitals and other health care centers. This emotional state has been shown to negatively impact patient satisfaction and outcomes. Aromatherapy, the therapeutic use of essential oils extracted from aromatic plants, may offer a simple, low-risk and cost-effective method of managing preoperative anxiety. The purpose of this study was to evaluate the efficacy of lavender aromatherapy in reducing preoperative anxiety in ambulatory surgery patients undergoing procedures in general otolaryngology...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29117883/admission-criteria-for-children-with-obstructive-sleep-apnea-after-adenotonsillectomy-considerations-for-cost
#17
David F Smith, Charlene P Spiceland, Stacey L Ishman, Branden M Engorn, Christopher Donohue, Paul S Park, James R Benke, Tiffany Frazee, Robert H Brown, Nicholas M Dalesio
STUDY OBJECTIVES: Postoperative respiratory complications (PRCs) are common among children with obstructive sleep apnea (OSA) after adenotonsillectomy. We analyzed postoperative admission guidelines to determine which optimally balanced patient safety and cost. METHODS: Retrospective study of children aged 12 years or younger undergoing adenotonsillectomy for OSA after polysomnography at a tertiary academic care center over 2 years. Demographics, medical History, and hospital course were collected...
December 15, 2017: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
https://www.readbyqxmd.com/read/28972409/endoscope-i-an-innovation-in-mobile-endoscopic-technology-transforming-the-delivery-of-patient-care-in-otolaryngology
#18
N Mistry, C Coulson, A George
Digital and mobile device technology in healthcare is a growing market. The introduction of the endoscope-i, the world's first endoscopic mobile imaging system, allows the acquisition of high definition images of the ear, nose and throat (ENT). The system combines the e-i Pro camera app with a bespoke engineered endoscope-i adaptor which fits securely onto the iPhone or iPod touch. Endoscopic examination forms a salient aspect of the ENT work-up. The endoscope-i therefore provides a mobile and compact alternative to the existing bulky endoscopic systems currently in use which often restrict the clinician to the clinic setting...
October 17, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28915948/the-economics-of-surgical-simulation
#19
REVIEW
Noel Jabbour, Carl H Snyderman
There are massive hidden costs in the current paradigm of surgical training related to increased operative times for procedures with resident involvement and costs of medical errors. Shifting procedural training outside of the operating room through use of simulation has the potential to improve patient safety, minimize learning time to achieve competency, and increase operative efficiency. Investment in surgical simulation has the potential to reduce costs to health care systems through improved operating room efficiency and reduction of medical errors...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28895462/is-hospitalization-necessary-after-ear-surgery-a-national-survey-and-retrospective-review-of-postoperative-events
#20
Tanja Jelicic, Julian Richard Savage, Margaret Aron
Objective First, to survey our national otolaryngology colleagues on their postoperative care habits (hospitalization vs day surgery) after elective middle ear surgery. Second, to evaluate the necessity of hospitalization and safety of day surgery after these procedures. Methods A national survey regarding postoperative habits after elective middle ear surgery was launched. Then, the cases of all patients having undergone these surgical procedures at our center between 2010 and 2016 were reviewed. They were divided into 2 groups: hospitalization and day surgery...
October 2017: Otolaryngology—Head and Neck Surgery
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