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Cost otolaryngology

Matthew L Bush, Robin Thompson, Catherine Irungu, John Ayugi
OBJECTIVE: The purpose of this study was to assess the feasibility and effectiveness of live telemedicine applications in hearing amplification and cochlear implantation. DATA SOURCES AND STUDY SELECTION: A systematic search was performed in PubMed, MEDLINE, PsychINFO, CINALH, and Web of Science to identify peer-reviewed research. Inclusion criteria were titles containing words from the search terms 1) audiology, otolaryngology, and hearing impairment, 2) rehabilitative methods, and 3) telemedicine...
October 12, 2016: Otology & Neurotology
Katherine R Kavanagh, Valerie Cote, Yvonne Tsui, Simon Kudernatsch, Donald R Peterson, Tulio A Valdez
OBJECTIVE: Simulation to acquire and test technical skills is an essential component of medical education and residency training in both surgical and nonsurgical specialties. High-quality simulation education relies on the availability, accessibility, and reliability of models. The objective of this work was to describe a practical pediatric laryngeal model for use in otolaryngology residency training. Ideally, this model would be low-cost, have tactile properties resembling human tissue, and be reliably reproducible...
October 12, 2016: Laryngoscope
Samuel R Barber, Elliott D Kozin, Matthew Dedmon, Brian M Lin, Kyuwon Lee, Sumi Sinha, Nicole Black, Aaron K Remenschneider, Daniel J Lee
INTRODUCTION: Surgical simulators are designed to improve operative skills and patient safety. Transcanal Endoscopic Ear Surgery (TEES) is a relatively new surgical approach with a slow learning curve due to one-handed dissection. A reusable and customizable 3-dimensional (3D)-printed endoscopic ear surgery simulator may facilitate the development of surgical skills with high fidelity and low cost. Herein, we aim to design, fabricate, and test a low-cost and reusable 3D-printed TEES simulator...
November 2016: International Journal of Pediatric Otorhinolaryngology
Julian Danino, Jameel Muzaffar, Chris Metcalfe, Chris Coulson
Human evaluation and judgement may include errors that can have disastrous results. Within medicine and healthcare there has been slow progress towards major changes in safety. Healthcare lags behind other specialised industries, such as aviation and nuclear power, where there have been significant improvements in overall safety, especially in reducing risk of errors. Following several high profile cases in the USA during the 1990s, a report titled "To Err Is Human: Building a Safer Health System" was published...
September 13, 2016: European Archives of Oto-rhino-laryngology
Samantha Anne, Samuel Trosman, Timothy Haffey, Raj Sindwani, Katie Geelan-Hansen
OBJECTIVE: The best imaging study for evaluation of pediatric hearing loss is debated and it is well known magnetic resonance imaging is more costly than computed tomography. The objective of this study is to evaluate charges of computed tomography temporal bone (CTTB) versus magnetic resonance imaging brain, internal auditory canal/cerebellopontine angle (MRI IAC/CPA), with and without sedation in the pediatric population in order to assess to what extent the charges for the procedure are increased...
October 2016: International Journal of Pediatric Otorhinolaryngology
Matthew R Naunheim, Phillip C Song, Ramon A Franco, Blake C Alkire, Mark G Shrime
OBJECTIVES/HYPOTHESIS: Endoscopic management of bilateral vocal fold paralysis (BVFP) includes cordotomy and arytenoidectomy, and has become a well-accepted alternative to tracheostomy. However, the costs and quality-of-life benefits of endoscopic management have not been examined with formal economic analysis. This study undertakes a cost-effectiveness analysis of tracheostomy versus endoscopic management of BVFP. STUDY DESIGN: Cost-effectiveness analysis. METHODS: A literature review identified a range of costs and outcomes associated with surgical options for BVFP...
August 31, 2016: Laryngoscope
Zahir Mughal, Vijay Thirunavukarasu, Adnan Darr, Mudit Jindal
BACKGROUND: Grommet insertion is a common procedure in children. A lengthy otolaryngology follow-up can have an adverse impact on clinic waiting times, new patient appointment availability, and pecuniary disadvantage for the hospital. OBJECTIVE OF REVIEW: To consolidate research and opinion concerning follow-up care following grommet insertion in a pediatric population. SEARCH STRATEGY: The literature between January 1990 and September 2015 was searched on MEDLINE (Ovid), Google Scholar, PubMed and Web of Science databases...
September 2016: International Journal of Pediatric Otorhinolaryngology
Shelly P Smith, Beth L Elias
The shared medical appointment (SMA) is one model of care that holds promise for achieving the goal of balancing efficiency, cost, and quality. The results of recent studies of SMAs suggest that improved physiologic health, self-efficacy, and patient education and feasibility emerge as positive outcomes. In order to discover the potential applicability of the SMA format to otolaryngology, a pilot nasal symptoms SMA (NSSMA) model was implemented. The NSSMA was piloted in a private otolaryngology practice serving a metropolitan area in the Mid-Atlantic region...
July 2016: American Journal of Managed Care
Vaninder K Dhillon, Lee M Akst
In the otolaryngology practice, there is a rising concern with the current diagnosis and management of laryngopharyngeal reflux (LPR). The implication of LPR in many common head and neck symptoms, along with the rising cost of empiric therapy and no overall improvement in patient symptoms, has established a need to review what are indeed laryngopharyngeal complaints secondary to reflux and what are not. This article reviews the otolaryngologist's approach to LPR, the various ways diagnosis is made, and the guidelines that inform the current trends in otolaryngology management of LPR...
August 2016: Current Gastroenterology Reports
Elizabeth Higgins, Linnie Newman, Katherine Halligan, Margaret Miller, Sally Schwab, Lynn Kosowicz
PURPOSE: The authors sought to determine the value of the audition elective to the overall success of medical students in the match. METHOD: The authors surveyed 1,335 fourth-year medical students at 10 medical schools in 2013. The study took place over a 2-month period immediately following the match. Medical students were emailed a 14-question survey and asked about audition electives, rank order, and cost of 'away' rotations. RESULTS: One hundred percent of students wishing to match in otolaryngology, neurosurgery, plastic surgery, radiation oncology, and urology took the audition electives...
2016: Medical Education Online
Daniel J Meara, Susan Coffey Zern
PURPOSE OF REVIEW: Simulation in healthcare is no longer a novel idea. Simulation continues to rapidly permeate and transform both clinical practice and medical education. Craniomaxillofacial surgery is comprised of multiple surgical disciplines, including neurosurgery, plastic surgery, otolaryngology, ophthalmology, and oral and maxillofacial surgery. All of these specialties are performing surgery in an era of evolving technology, cost containment, reduced resident work hours, and a focus on patient safety...
August 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
Elizabeth A Zambricki, Jennifer L Bergeron, Elizabeth E DiRenzo, C Kwang Sung
OBJECTIVES/HYPOTHESIS: To introduce the use of a new phonomicrosurgical trainer using easily accessible materials, and to establish the effectiveness of the model. STUDY DESIGN: The model uses a grape imbedded in gelatin, a microscope, and microlaryngeal instruments. The study was designed to test baseline differences in training levels, as well as improvement in performance after training with the simulation model. METHODS: Thirty subjects enrolled in the Stanford University School of Medicine otolaryngology training program performed microlaryngeal surgery tasks on a grape...
April 23, 2016: Laryngoscope
Jason J Chen, Bryan T Lemieux, Brian J F Wong
OBJECTIVES: (1) To determine ciliary beat frequency (CBF) using a consumer-grade cellphone camera and MATLAB and (2) to evaluate the effectiveness and accuracy of the proposed method. STUDY DESIGN: Prospective animal study. SETTING: Academic otolaryngology department research laboratory. METHODS: Five ex vivo tracheal samples were extracted from 3 freshly euthanized (<3 hours postmortem) New Zealand white rabbits and incubated for 30 minutes in buffer at 23°C, buffer at 37°C, or 10% formalin at 23°C...
August 2016: Otolaryngology—Head and Neck Surgery
Jason Silvestre, Divyansh Agarwal, David I Lee
OBJECTIVE: To elucidate the current portfolio of National Institutes of Health (NIH) funding to departments of urology at U.S. medical schools. MATERIALS AND METHODS: The NIH Research Portfolio Online Reporting Tools Expenditures and Results was used to generate a comprehensive analysis of NIH research grants awarded to urology departments during 2014. Costs, mechanisms, and institutes were summarized with descriptive statistics. Demographic data were obtained for principal investigators and project abstracts were categorized by research type and area...
May 2016: Urology
Daniel M Beswick, Anita Vashi, Yohan Song, Rosemary Pham, F Chris Holsinger, James D Rayl, Beth Walker, John Chardos, Annie Yuan, Ella Benadam-Lenrow, Dolores Davis, C Kwang Sung, Vasu Divi, Davud B Sirjani
BACKGROUND: The purpose of this study was to evaluate a telemedicine model that utilizes an audiovisual teleconference as a preoperative visit. METHODS: Veterans Health Administration (VHA) patients with head and neck cancer at 2 remote locations were provided access to the Palo Alto Veterans Affairs (PAVA) Health Care System otolaryngology department via the telemedicine protocol: tissue diagnosis and imaging at the patient site; data review at PAVA; and a preoperative teleconference connecting the patient to PAVA...
June 2016: Head & Neck
Helen Moses, David Powers, Jarrod Keeler, Detlev Erdmann, Jeff Marcus, Liana Puscas, Charles Woodard
The provision of trauma care is a financial burden, continually associated with low reimbursement, and shifts the economic burden to major trauma centers and providers. Meanwhile, the volume of craniomaxillofacial (CMF) trauma and the number of surgically managed facial fractures are unchanged. Past financial analyses of cost and reimbursement for facial trauma are limited to mandibular and midface injuries, consistently revealing low reimbursement. The incurred financial burden also coincides with the changing landscape of health insurance...
March 2016: Craniomaxillofacial Trauma & Reconstruction
Jose L Gómez-Urquiza, César Hueso-Montoro, Josefa Urquiza-Olmo, Rocío Ibarrondo-Crespo, Emilio González-Jiménez, Jacqueline Schmidt-Riovalle
AIMS: To determine the effectiveness of photographic display at reducing pre-operative anxiety in an ear, nose and throat surgery unit; alone and in combination with music. BACKGROUND: The waiting time prior to the surgery is often unpleasant and a time of anxiety for patients. Anxiety can affect physical recovery and psychological well-being; lengthening convalescence and hospital stay after the surgery. Improving pre-operative anxiety is a challenge with potential impacts on improving patients' satisfaction and well-being and decreasing the cost of care...
July 2016: Journal of Advanced Nursing
Calum Sinclair Honeyman
Undertaking a microsurgical course is a key adjunct to trainee development in plastic surgery, otololaryngology and oral and maxillofacial surgery. Traditionally, these courses last approximately 5 days and can cost upward of US $2000 (£1500).The North East Microsurgery Training Course and Workshop is a new 2-day course costing just US $760 (£500). This course was set up in 2015 by reconstructive microsurgeon Mr Maniram Ragbir at the Freeman Hospital in Newcastle, England.The aim of the course is provide maximum hands-on experience in microsurgery for surgical trainees interested in relevant specialties under close supervision of experienced consultant faculty...
September 2016: Annals of Plastic Surgery
Joseph M Hoxworth, Devyani Lal
BACKGROUND: Sinus computed tomography (CT) is performed for the diagnosis of paranasal sinus disease and to assess response to medical therapy. In addition, sinus CT is used for intraoperative imaging guidance. Multiple CTs increase cost and radiation exposure. OBJECTIVE: To determine potential cost savings and radiation dose reduction that result from the use of a single universal sinus CT protocol for diagnostic imaging and intraoperative navigation. MATERIALS AND METHODS: For sinus CT at the authors' institution, a single imaging protocol was begun and deemed acceptable by neuroradiologists and surgeons for diagnostic imaging and intraoperative guidance...
January 2015: Allergy & Rhinology
A J Bizaki, J Numminen, R Taulu, M Rautiainen
OBJECTIVES: The aim of the study is to evaluate and compare the clinical outcome of balloon sinuplasty and uncinectomy for patients suffering from isolated chronic rhinosinusitis of the maxillary sinus. DESIGN: A prospective, randomized, non-blinded, controlled trial was conducted. SETTING: The study was carried out at the Department of Otolaryngology, Tampere University Hospital, Finland. PARTICIPANTS: Adult patients with symptomatic isolated chronic or recurrent rhinosinusitis without severe findings in the sinuses, as documented in the sinus' Computer Tomography scan and clinical examination, were randomized into 2 groups: uncinectomy and balloon sinuplasty...
November 9, 2015: Clinical Otolaryngology
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