Assessment of Otolaryngology Residency Training Program in Iran: Perspectives of Faculty Members and Recently Graduated Medical Students.

INTRODUCTION: There is limited evidence regarding the quality of otolaryngology residency programs in Iran. Regarding this, the present study aimed to assess some aspects of otolaryngology residency program in the field of otology in Iran based on the perspectives of faculty members and graduates. MATERIALS AND METHODS: This study was conducted on 105 recent graduates and 30 faculty members and/or program directors in otolaryngology using two self-administered questionnaires. RESULTS: While the faculty members believed that a resident should work on at least 5.4 temporal bone surgeries on average, the actual number was 2.49. Tympanoplasty was assigned the highest rate of satisfaction by the recent graduates, whereas the lowest score belonged to middle ear exploration, ossiculoplasty, and stapes surgery. Only 53.6% of the graduates stated that there was an organized training curriculum in temporal laboratory. The recent graduates reported to have more frequent experiences of performing usual otology operations. However, they had fewer experiences of performing more advanced surgeries. The recently graduated subjects had a significantly low level of satisfaction with their competencies in carrying out more complex types of otology surgeries. CONCLUSION: High prevalence of otology surgeries in Iran provides valuable opportunities for training otolaryngology residents to achieve an acceptable level of competency. However, the results of this study strongly suggest the necessity of quality improvement both in teaching-learning and assessment processes in otolaryngology training programs.

Determining compliance of ear CT scan with interaoperative findings in deaf children with cochlear implantation.

INTRODUCTION: Defecated or impaired hair cell function of the cochlea causes deafness. Cochlear implantation allows transmission of sound information through central auditory pathways using direct electric stimulation of auditory nerve dendrites. Using radiologic imaging, including CT scan is very helpful in selection of candidates and evaluation after implantation. The purpose of this study is to determine compliance of CT findings in deaf children undergoing cochlear implantation compared with the intra-operative findings. METHOD: In a periodical-descriptive study, 100 patients (56 male and 44 female), 6 months to 6 years of age, who were candidates for cochlear implantation at Baqiyatallah Hospital in Tehran between January 2010 and October 2011, were studied. After getting informed consent form the parents of patients, demographic data was recorded. CT scan and surgical data were double blindly collected in the designed questionnaire which was approved by three radiologists and three ENT specialists. Finally, surgical and radiological data were compared and t-test and chi-square test was used. RESULTS: Atic status in 89 patients (89%) was statistically significant between radiology and surgery (P=0.06). Positive Predictive Value and Negative Predictive Value were respectively 100 and 92.8. Middle ear space was same in 85 patients (85%) in the two methods (P=0.01) (NVP=63.4). Pyramid status was similar in radiology and surgery results in 67 patients (67%) (P=0.000) and PPV and NPV were 100 and 63.4 respectively. Jugular bulb was similar in 73 patients (73%) (P=0.00). There was no significant difference between other modalities. CONCLUSION: In most cases examined in this study, compliance between the surgical and radiological findings was above 80%. In some cases, CT scan could give confidence to the surgeon, but in atic, middle ear space, pyramid and jugular bulb there might be insufficient reliance to CT findings and there would be need to more accurate observation during surgery.

Huge teratoma of the nasopharynx.

Congenital immature teratoma of the nasopharynx is a very rare form of extragonadal teratoma. In this article, management of a newborn with nasopharyngeal teratoma who underwent tumor resection is reported. The tumor, which originated from the nasopharynx, almost filled the oral cavity and protruded through the mouth, with its external part comparable to the size of the head. She could breath when the head and mass were turned to the left. For safe management of these cases, prenatal evaluation, careful preoperative assessment of the airway, sufficient preparation, and intubation by an expert are mandatory. Perioperative bleeding and obstruction of airway by the tumor or its remnant could render the case difficult.