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1.
J Otolaryngol Head Neck Surg ; 52(1): 39, 2023 May 23.
Article in English | MEDLINE | ID: mdl-37221615

ABSTRACT

BACKGROUND: Previous literature demonstrates that female surgeons face difficulties in family planning, meeting breastfeeding goals, leadership and advancement opportunities. These issues have received limited attention in Canadian surgeons despite different maternity leave patterns compared to the general Canadian population. We sought to describe the experience of otolaryngologist-head and neck surgeons in family planning, fertility, and lactation and to identify the role of gender and career stage in these experiences. METHODS: A RedCAP® survey was disseminated to Canadian otolaryngology-head and neck surgeons and residents from March to May of 2021 through social media and the national listserv. This survey examined fertility, pregnancy losses, and infant feeding. Major independent variables include gender and career stage (faculty and resident). Dependent variables include respondent experiences with fertility, number of children, and length of parental leave. Responses were tabulated and presented descriptively to communicate the experience of Canadian otolaryngologists. Further, statistical comparisons such as chi-square and t-tests were employed to identify relationships between these variables. Thematic analysis was conducted for narrative comments. RESULTS: We received 183 completed surveys (22% response rate). 54% of females versus 13% of males agreed that career influenced their ability to have children (p = 0.002). 74% of female respondents without children have concerns about future fertility compared to 4% of men (p < 0.001). Furthermore, 80% of women versus 20% of men have concerns about future family planning (p < 0.001). The average maternity leave was 11.5 weeks for residents, and 22.2 weeks for staff. Additionally, significantly more women than men stated that maternity leave impacted advancement opportunities (32% vs. 7%) and salary/remuneration (71% vs. 24%) (p < 0.001). Over 60% of those choosing to pump breastmilk at work reported having inadequate time, space, and breastmilk storage. In total, 62% of breastfed infants were receiving breastmilk at 1 year. CONCLUSION: Canadian female otolaryngologists-head and neck surgeons face challenges in family planning, ability to conceive, and breastfeeding. Focused effort is required to provide an inclusive environment that helps all otolaryngologists-head and neck surgeons achieve both their career and family goals, regardless of gender or career stage.


Subject(s)
Family Planning Services , Otolaryngology , Pregnancy , Child , Infant , Male , Female , Humans , Breast Feeding , Canada , Fertility , Lactation
2.
J Otolaryngol Head Neck Surg ; 52(1): 31, 2023 Apr 24.
Article in English | MEDLINE | ID: mdl-37095567

ABSTRACT

INTRODUCTION: Women in surgical specialties face different challenges than their male peers. However, there is a paucity of literature exploring these challenges and their effects on a Canadian surgeon's career. METHODS: A REDCap® survey was distributed to Canadian Otolaryngology-Head and Neck Surgery (OHNS) staff and residents in March 2021 using the national society listserv and social media. Questions examined practice patterns, leadership positions, advancement, and experiences of harassment. Gender differences in survey responses were explored. RESULTS: 183 completed surveys were obtained, representing 21.8% of the Canadian society membership [838 members with 205 (24.4%) women]. 83 respondents self-identified as female (40% response rate) and 100 as male (16% response rate). Female respondents reported significantly fewer residency peers and colleagues identifying as their gender (p < .001). Female respondents were significantly less likely to agree with the statement "My department had the same expectations of residents regardless of gender" (p < .001). Similar results were observed in questions about fair evaluation, equal treatment, and leadership opportunities (all p < .001). Male respondents held the majority of department chair (p = .028), site chief (p = .011), and division chief positions (p = .005). Women reported experiencing significantly more verbal sexual harassment during residency (p < .001), and more verbal non-sexual harassment as staff (p = .03) than their male colleagues. In both female residents and staff, this was more likely to originate from patients or family members (p < .03). DISCUSSION: There is a gender difference in the experience and treatment of OHNS residents and staff. By shedding light on this topic, as a specialty we can and must move towards greater diversity and equality.


Subject(s)
Internship and Residency , Medicine , Otolaryngology , Sexual Harassment , Humans , Male , Female , Gender Identity , Canada , Otolaryngology/education , Surveys and Questionnaires
4.
Laryngoscope ; 130(1): 242-246, 2020 01.
Article in English | MEDLINE | ID: mdl-30720207

ABSTRACT

OBJECTIVES: Minor pediatric surgeries performed in the minor procedure room (MPR) may be more time efficient and less costly compared to those performed in the operating room (OR). STUDY DESIGN: Retrospective review. METHODS: This was a retrospective study on cost and efficiency differences of bilateral myringotomy with tube insertions performed in the MPR versus the OR. Charts were reviewed from June 2015 to May 2017. Cost data was based on supply cost and case costing of medical personnel including nurses, aides, and anesthesia assistants. RESULTS: Two hundred eighteen patients were included in the study. The median age was 2.7 years (range: 0.8-16.7), and there were no differences in gender between locations. One hundred twenty-three patients had surgery in the MPR (56.4%), and 95 had surgery in the OR (43.6%). The median length of time in the procedure room was 11 minutes shorter for patients who underwent surgery in the MPR (12.0 minutes, range: 3.0-33.0) compared to patients in the OR (23.0 minutes, range: 11.0-52.0; P < .0001). Median hospital stay (2.0 hours vs. 4.3 hours; P < 0.0001) and median patient turnover time (6.0 minutes vs. 14.0 minutes; P < .0001) was shorter in the MPR compared to OR. The total overall cost of a myringotomy with tube insertion, including labor and supply cost, was $189.41 in the MPR compared to $468.56 in the OR, a difference of $279.15 per case. CONCLUSION: Bilateral myringotomy with tube insertions are more time and cost-efficient when performed in the MPR. This study supports the need for increased availability of MPR time for appropriate surgeries. LEVEL OF EVIDENCE: 3 Laryngoscope, 130:242-246, 2020.


Subject(s)
Cost-Benefit Analysis , Middle Ear Ventilation/economics , Operating Rooms/economics , Adolescent , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Ear Ventilation/methods , Minor Surgical Procedures/economics , Retrospective Studies , Treatment Outcome
5.
A A Pract ; 13(3): 88-90, 2019 Aug 01.
Article in English | MEDLINE | ID: mdl-30920427

ABSTRACT

Video laryngoscopes are commonly used to manage difficult airways, among other devices. However, they present a challenge when inserting the blade in patients with a limited mouth opening, and an adequate visualization of the glottis does not always translate into successful intubation. The C-MAC Video-Stylet-with its small diameter and flexible tip-offers an effective alternative. We describe the successful use of the novel C-MAC Video-Stylet to secure the airway in a patient with minimal mouth opening due to the side effects of previous neck surgery and radiation therapy.


Subject(s)
Intubation, Intratracheal/instrumentation , Laryngoscopy/instrumentation , Video-Assisted Surgery/instrumentation , Female , Humans , Middle Aged , Video Recording
6.
Allergy Rhinol (Providence) ; 9: 2152656718764142, 2018.
Article in English | MEDLINE | ID: mdl-29977651

ABSTRACT

BACKGROUND: This report presented the case of a difficult-to-remove needle foreign body. The patient had a dental procedure in which a 30-gauge needle was lost in the gingival buccal sulcus. Several attempts at removal were unsuccessful. The patient presented to the otolaryngology clinic with trismus, pain with mastication, intermittent right otalgia, and numbness of the right cheek. METHODS: The needle was finally localized in the infratemporal fossa and removed by using image guidance technology. RESULTS: This case demonstrated an approach to a difficult-to-locate foreign body removal and the importance of intraoperative imaging in foreign body localization. CONCLUSION: Foreign bodies of the infratemporal fossa and posterior orbit are better removed via endoscopic than open technique.

7.
Medicine (Baltimore) ; 96(43): e6927, 2017 Oct.
Article in English | MEDLINE | ID: mdl-29068974

ABSTRACT

RATIONALE: Giant fibrovascular polyps (GFVPs) found in the hypopharynx are exceedingly rare. These are benign tumors which are identified by CT or MRI and usually treated based on symptoms. Even more rarely, pathology may identify one of these masses as an atypical lipomatous tumor (ALT). This paper will present a case of an ALT of the hypopharynx that was originally classified as a GFVP, highlighting the difficulty in distinguishing between them and the importance of making the correct diagnosis. PATIENT CONCERNS: An 84-year-old man presented to the emergency department with a 6-month history of a pedunculated hypopharyngeal growth, dysphagia, and intermittent dyspnea. DIAGNOSES: The mass was characterized as a GFVP by barium swallow and MRI. INTERVENTIONS: The hypopharyngeal mass was resected for obstructive symptoms and to confirm the diagnosis. Final pathology found the mass to be more consistent with an atypical lipomatous tumor (ALT). OUTCOMES: The patient's dysphagia and dyspnea resolved. He was free of recurrence at 22 months postoperative. LESSONS: Both GFVPs and ALTs are very rarely found in the hypopharynx but can be easily misclassified as one another. Imaging is useful to initially characterize the mass, but to definitively differentiate between them, pathological analysis is necessary. Although they are rare, it is important to consider both possibilities on the differential for hypopharyngeal masses. Further, accurate analysis is essential to distinguish between them because their definitive management and follow-up is different.


Subject(s)
Hypopharyngeal Neoplasms/pathology , Lipoma/pathology , Polyps/pathology , Aged, 80 and over , Deglutition Disorders/etiology , Diagnosis, Differential , Dyspnea/etiology , Humans , Hypopharyngeal Neoplasms/classification , Hypopharyngeal Neoplasms/complications , Hypopharyngeal Neoplasms/surgery , Lipoma/classification , Lipoma/complications , Lipoma/surgery , Magnetic Resonance Imaging , Male
8.
Am J Rhinol Allergy ; 30(5): 356-9, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27657901

ABSTRACT

BACKGROUND: The problem of postoperative management after frontal sinus surgery remains a challenge. The bilateral opening created in the Draf III procedure does not fit any currently available stent, and patients find rinsing the frontal sinus difficult, which thus decreases compliance. The objective of this study was to demonstrate the successful use of a novel frontal sinus catheter fashioned from a biliary T tube by addressing these issues in patients with complicated sinus disease. METHODS: This was a review of 30 patients who underwent a Draf III procedure between January and October 2014, and who had a T-tube stent inserted at the end of the procedure. Patient charts were analyzed for complications such as bleeding, infection, and restenosis as well as indications of ease of rinsing ability after surgery. RESULTS: From the chart data, there was only one intraoperative bleed and only one postoperative bleed that required packing. Four patients had infections that required antibiotics after surgery. At the time of data collection, only one patient had signs of restenosis as judged by the operating surgeon. Patients reported an ease of rinsing ability with the T-tube stent. CONCLUSIONS: The novel biliary T-tube stent use presented in this article is a promising future direction for postoperative care after extended frontal sinus surgery.


Subject(s)
Catheters/statistics & numerical data , Endoscopy , Frontal Sinus/surgery , Paranasal Sinus Diseases/surgery , Postoperative Complications/prevention & control , Female , Humans , Male , Middle Aged , Retrospective Studies , Therapeutic Irrigation , Treatment Outcome
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