Impact of the COVID-19 pandemic on the otolaryngology residency training program in a university-based hospital in Bangkok, Thailand.

Objective: This study aimed to evaluate the impact of the COVID-19 pandemic on the otolaryngology residency training program in Vajira Hospital, Navamindradhiraj University. Methods: Conducted from October 2021 to January 2022, this cross-sectional survey included all residents, residents who graduated in 2021, and the attending staff. One form was sent to both resident groups for self-assessment and another form to the attending staff for resident assessment. The survey questions were about attitude toward COVID-19 service, knowledge, outpatient department service, surgical skills, and burnout assessment using the Maslach Burnout Inventory. Results: This study included 17 residents and 9 attending staff members. COVID-19 indeed had affected the clinical and surgical training. Regarding the attitude toward COVID-19 services, the residents were moderately satisfied. They were concerned about work suspension resulting from infection and also death from COVID-19. N95 masks and other protective gears were scarce. Compared with those during the prepandemic era, residents had fewer academic activities, and they preferred hybrid teaching. The inpatient department, outpatient department, and surgical training opportunities, as well as elective and urgent surgeries, were also reduced. The attending staff considered 1-year extension of the training program, but the residents disapproved. The residents became less confident both in outpatient department service and surgical skill, and they felt emotional exhaustion, depersonalization, and decreased sense of personal accomplishment. Conclusion: COVID-19 pandemic had significant impact on otolaryngology residency training programs. It did not only affect burnout among residents but also caused a perception of skill and knowledge reduction.

Acoustic rhinometry evaluation in allergic rhinitis patients before and after turbinate radiofrequency ablation.

OBJECTIVE: To evaluate the outcome of turbinate radiofrequency ablation (RFA) by acoustic rhinometry. MATEIAL AND METHOD: Thirty allergic rhinitis (AR) patients aged 19-62 years old were recruited for this cross sectional prospective study. They all underwent radiofrequency turbinate ablation for chronic nasal obstruction. The acoustic rhinometry evaluation, total nasal symptom score, and nasal obstruction score before and after surgery were analyzed at second, fourth, and eighth week. RESULTS: The mean age of the 30 AR patients was 39.5 years old and two patients required a second operation. After surgery, the total nasal symptom score (TSS) and the difference mean of cross-section area (CSA) I were improved in 2-4 weeks and 4-8 weeks respectively but total nasal volume was not changed. CONCLUSION: The authors can use acoustic rhinometry to evaluate short-term result of turbinate radiofrequency ablation. The subjective symptoms were prominently seen in 2-4 weeks after surgery and before the objective result by acoustic rhinometry shown at 4-8 weeks.

Acoustic rhinometry evaluation of radiofrequency ablation of the turbinates.

OBJECTIVES: The objective of this study is to determine if acoustic rhinometry (AR) can predict the outcome of radiofrequency ablation (RFA) of the inferior turbinates. PATIENTS AND METHODS: Preoperative AR measurements of 19 subjects undergoing inferior turbinate RFA were analyzed before and after decongestant. The average total percentage change in cross sectional area (CSA) 1 and in total volume was calculated for each. Both the physician and patient assessed treatment success subjectively. If available, postoperative data was analyzed. RESULTS: The congestion factor of CSA1 was 72.76+/-75.58 before surgery and 42.32+/-27.79 after surgery (p>0.05). There were no significant differences in CSA1, CSA2, CSA3 and total volume after the radiofrequency ablation surgery. All patients were satisfied with the results of the surgery. Physician assessment was 'satisfactory' for 18 patients and 'partially satisfactory' for one. CONCLUSION: Nineteen patients had AR and RFA of the turbinate. Since all patients were satisfied with the operation, no conclusion can be drawn regarding the predictive value of AR. Although there was a trend to a larger volume postoperatively, none of the measured parameters were significantly different.

Physiological change in nasal patency in response to changes in posture, temperature, and humidity measured by acoustic rhinometry.

BACKGROUND: Acoustic rhinometry has been used to assess nasal patency and to calculate nasal cavity volume. This study used acoustic rhinometry to assess changes in nasal patency after alterations in posture, unilateral mechanical obstruction, temperature, and humidity. METHODS: Eight healthy adult volunteer subjects underwent acoustic rhinometry during the following conditions: (1) sitting position (control), (2) supine position, (3) left lateral recumbent position, (4) nostril unilaterally mechanically blocked, (5) ice pack on neck, (6) drinking cold water, (7) drinking hot water, (8) nasal nebulizer, and (9) oxymetazoline decongestant. RESULTS: Two distinct patterns emerged based on the total nasal cavity volumes in response to the decongestant. Subjects with initial unilateral nasal cavity volumes near the mean had an expected increase in total volume after the topical decongestant administration. There were two subjects with initial volumes of 1 SD above the mean that had a paradoxical decrease in total volume in response to the decongestant. In all subjects, there was a significant decrease in the volume of each of the nasal cavities in response to ingestion of hot water at 1 minute. There was a significant decrease in the volume of the smaller of the two nasal cavities in response to nebulizer treatment and hot water ingestion at 5 minutes. Total nasal cavity volume changes were not significant for any of the variables. CONCLUSION: Changes in nasal cavity volumes were detected by acoustic rhinometry after alterations in posture, unilateral mechanical obstruction, temperature, and humidity. Nebulizer treatment and hot water ingestion caused a significant decrease in nasal volume. The nose of a healthy patient was able to adapt to environmental and physiological changes to maintain a consistent total nasal volume within 15 minutes.