Stereotactic radiosurgery for vestibular schwannomas: a survey of current practice patterns of neurotologists.

OBJECTIVE: To evaluate the use of radiation by neurotologists practicing in the United States as a treatment modality for vestibular schwannomas (VSs). STUDY DESIGN: Cross-sectional survey. METHODS: We surveyed 302 members of the American Neurotology Society to assess the number of VS seen, the frequency with which radiation is used as a treatment modality, radiation training and experience, the impact of tumor size and patient age on treatment decisions, and radiation dose ultimately used by neurotologists. RESULTS: Responses were received from 43% (132/302) of surveyed neurotologists; of the respondents, 42% (54/132) perform stereotactic radiation. Approximately 58% (30/54) of those use gamma knife, and 44% (24/54) use Cyberknife; 36.7% of VS patients seen by neurotologists received radiation. On average, 6 additional neurotologists per year begin treating VS with stereotactic radiation. Academic and private neurotologists showed significant differences (p < 0.05) between new VS patients per year, years in practice, and maximum tumor size recommended for radiation. The most common barrier to using radiation was prevention by a neurosurgical or radiation oncology service. Neurotologists use radiation to treat other cranial base tumors as well, most commonly glomus tumors or meningiomas, and 64% of respondents irradiate neurofibromatosis Type 2. Total radiation dose and fractionation were variable. CONCLUSION: Neurotologists are increasingly choosing to treat VS with stereotactic radiation. There seem to be significant differences between academic and private neurotologists' practice characteristics. Not all neurotologists strictly adhere to the consensus statement by the International RadioSurgery Association with regard to radiation dosing and tumor size limits.

Personality types of otolaryngology resident applicants as described by the Myers-Briggs Type Indicator.

OBJECTIVE: To assess the personality types of applicants to a single otolaryngology residency program using the Myers- Briggs Type Indicator. The personality types were compared with those of the general population and with physicians in other medical specialties. STUDY DESIGN: Cross-sectional survey. SETTING: University hospital. SUBJECTS AND METHODS: A personality survey was emailed to 327 resident physician applicants over 2 consecutive years (2008- 2009). Analysis was accomplished by calculating prevalence estimates. RESULTS: Of the 327 anonymous surveys, 137 were completed (response rate = 42%). The Introverted/Sensing/Thinking/ Judging personality type was the most prevalent (14.6%), representing 13% of the general population. Prospective applicants displayed mostly Extroverted (E; 58%), Sensing (S; 54%), Thinking (T; 62%), and Judging (J; 61%) personality traits. Of the 16 personality types, statistically significant differences were found between otolaryngology resident applicants and the general population only for the Extroverted/Sensing/Thinking/ Perceiving (P = .002) personality type after correcting for multiple comparisons. The Intuitive (N; 46%) and Feeling (F; 38%) types correlated closely with the reported personality types of those individuals in non­primary care specialties, 47% and 28%, respectively. Extroverted (E) and Thinking (T) individuals appeared to prefer surgical specialties, which occurred in 58% and 62% of the applicants, respectively. There were no significant differences between male and female applicants. CONCLUSION: This study examines the personality types of medical students applying to an otolaryngology residency. The results support a highly structured, data-driven teaching preference among applicants. These results may allow for a better understanding of the personalities of medical students who are interested in otolaryngology.