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1.
JAMA Otolaryngol Head Neck Surg ; 148(4): 293, 2022 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-35420655
2.
J Int Adv Otol ; 18(2): 145-149, 2022 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35418363

RESUMO

BACKGROUND: Packing of the external auditory canal after ear surgery is an established practice in most otologic centers. However, no guidelines exist concerning the management of this process. The aim of the study is to investigate otologists' habits concerning packing of the external ear canal after otologic surgery. A second objective was to collect their opinion concerning the absence of packing. METHODS: This study is a cross-sectional survey. We sent an online questionnaire to the 135 members of the French Otology and Neurotology Association (AFON). It was conducted between March 15, 2020, and May 15, 2020. It consisted of 11 demographic questions and 6 surgical management-related questions concerning 6 major otologic procedures. RESULTS: Fifty-seven members answered the survey. The most frequent packing used was ear wick with silicon sheets (48.6%) among all surgical procedures. Among participants, 62% used the same packing material for all surgical procedures. Of the participants, 96% were reluctant not to pack the external ear canal after otologic surgery. CONCLUSION: This study shows a great variability concerning surgeons' practices. A randomized controlled trial would be helpful to guide surgeons for ear packing after otologic surgery and assess the absence of packing.


Assuntos
Neuro-Otologia , Otolaringologia , Procedimentos Cirúrgicos Otológicos , Estudos Transversais , Meato Acústico Externo/cirurgia , Humanos , Procedimentos Cirúrgicos Otológicos/métodos
3.
Int J Pediatr Otorhinolaryngol ; 156: 111122, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35390579

RESUMO

OBJECTIVES: With an emphasis on patient-centered care and provider transparency, patient satisfaction measures have become a key indicator of healthcare quality. Using the Press Ganey Outpatient Medical Practice Survey (PGOMPS), we sought to determine key factors that impact patient satisfaction. METHODS: We conducted a retrospective review of new pediatric (<18 years old) outpatient otolaryngology visits between January 1, 2014 and December 31, 2018 at a children's hospital clinic and satellite clinics. Univariate and multivariate binary logistic regression analysis were used to determine factors correlated with patient satisfaction for both the PGOMPS Total Score and Provider Sub-Score. RESULTS: A total of 1,050 patient or parent responses were included. The mean patient age was 5.6 ± 5.0 years with 54.7% identified as male. Univariate analysis demonstrated that for each 10-min increase in Total Wait Time, the odds of being satisfied were significantly decreased on both the Total Score (odds ratio [OR] 0.5; P < 0.001) and Provider Sub-Score (OR 0.8; P < 0.001). Furthermore, for each additional 5-year increase in patient age, patients were significantly more likely to report satisfaction on Total Score (OR 1.21; P = 0.011). Multivariate analysis revealed that the odds of achieving satisfaction for each decile increase in Total Wait Time were 0.5 for Total Score (P < 0.001) and 0.8 for Provider Sub-Score (P < 0.001), independent of patient age, sex, insurance category, socioeconomic disadvantage level, and patient community type. CONCLUSIONS: Wait time is a significant factor impacting patients' likelihood of being satisfied with their overall care in a pediatric otolaryngology clinic setting.


Assuntos
Otolaringologia , Satisfação do Paciente , Adolescente , Instituições de Assistência Ambulatorial , Criança , Pré-Escolar , Humanos , Lactente , Masculino , Pacientes Ambulatoriais , Inquéritos e Questionários
4.
J Assoc Res Otolaryngol ; 23(3): 319-349, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35441936

RESUMO

Use of artificial intelligence (AI) is a burgeoning field in otolaryngology and the communication sciences. A virtual symposium on the topic was convened from Duke University on October 26, 2020, and was attended by more than 170 participants worldwide. This review presents summaries of all but one of the talks presented during the symposium; recordings of all the talks, along with the discussions for the talks, are available at https://www.youtube.com/watch?v=ktfewrXvEFg and https://www.youtube.com/watch?v=-gQ5qX2v3rg . Each of the summaries is about 2500 words in length and each summary includes two figures. This level of detail far exceeds the brief summaries presented in traditional reviews and thus provides a more-informed glimpse into the power and diversity of current AI applications in otolaryngology and the communication sciences and how to harness that power for future applications.


Assuntos
Inteligência Artificial , Otolaringologia , Comunicação , Humanos
6.
J Otolaryngol Head Neck Surg ; 51(1): 14, 2022 Apr 06.
Artigo em Inglês | MEDLINE | ID: mdl-35387688

RESUMO

BACKGROUND: Tonsillectomy is a commonly performed procedure in Canada. The rate of occult malignancy is rare in adult and pediatric populations. At present, no guidelines exist surrounding the need for routine histopathological evaluation of tonsil specimens when no malignancy is suspected. METHODS: We sent a confidential online survey to active members of the Canadian Society of Otolaryngology - Head and Neck Surgery (CSO-HNS) about their current tonsillectomy practice and beliefs surrounding the need for routine histopathological evaluation of tonsillectomy specimens when no malignancy is suspected. We used Opinio survey software for data collection and descriptive statistics. RESULTS: 95 participants completed our survey (response rate 19.3%). Most participants reported performing both adult and pediatric tonsillectomies. When no malignancy is suspected, participant responses were split between whether they send tonsil specimens in pediatrics only (4.2%), in adults only (31.6%), or not sending specimens (29.5%). Half of the participants reported that routinely sending specimens to rule out occult malignancy is an institutional policy. Approximately 75% of participants were in favour of removing this practice in both the pediatric and adult populations. CONCLUSION: Eliminating the practice of automatically sending tonsil specimens for histopathological evaluation when no malignancy is suspected was supported by the majority of study participants. This is in keeping with Choosing Wisely, a campaign designed to facilitate conversations about unnecessary medical tests and procedures. Institutional change is likely required in order to alter this practice.


Assuntos
Neoplasias Primárias Desconhecidas , Otolaringologia , Cirurgiões , Tonsilectomia , Adulto , Canadá , Criança , Estudos Transversais , Humanos , Neoplasias Primárias Desconhecidas/patologia , Tonsila Palatina/patologia , Tonsila Palatina/cirurgia , Tonsilectomia/métodos
7.
BMJ Open ; 12(2): e055516, 2022 03 21.
Artigo em Inglês | MEDLINE | ID: mdl-35314455

RESUMO

OBJECTIVES: To compare gender diversity between UK surgical specialties, assess trends over time, and estimate when gender parity might be achieved. DESIGN: Observational study. SETTING: National Health Service, UK. PARTICIPANTS: NHS Hospital & Community Health Service workforce statistics for 2011 to 2020 MAIN OUTCOME MEASURES: Logistic regression was used to compare female representation in 2020 between surgical specialties, and to examine for any significant trends between 2011 and 2020. The method of least squares was used to estimate when female representation of specialty registrars would reach 50% ('gender parity') for specialties with <40% female representation. RESULTS: In 2020, female consultant and specialty registrar representation was significantly different between surgical specialties (both p<0.001). Female representation for each specialty were as follows (from highest to lowest): Specialty Registrars-Ophthalmology 49.7%, Otolaryngology 48.2%, Paediatric Surgery 45.5%, Plastic Surgery 42.2%, General Surgery 39.8%, Urology 31.6%, Vascular Surgery 25.0%, Neurosurgery 24.7%, Cardiothoracic Surgery 21.3%, and Trauma and Orthopaedics 20.6%; Consultants-Ophthalmology 32.4%, Paediatric Surgery 31.7%, Plastic Surgery 20.9%, General Surgery 17.5%, Otolaryngology 17%, Vascular Surgery 13.7%, Urology 11.7%, Cardiothoracic Surgery 10.8%, Neurosurgery 8.2%, and Trauma and Orthopaedics 7.3%. There was a significant positive trend in female representation of specialty registrars between 2011 and 2020 for all specialties except for Paediatric Surgery (representation consistently >45%) and Vascular Surgery (representation consistently <30%). General Surgery was estimated to achieve gender parity of their specialty registrars by 2028, Urology by 2033, Neurosurgery by 2064, Trauma and Orthopaedics by 2070, and Cardiothoracic Surgery by 2082. CONCLUSIONS: Despite improvements over the last decade, gender disparity persists in the UK surgical workforce and there are significant differences between surgical specialties. Further work is necessary to establish the reasons for these observed differences with a specific focus on Vascular Surgery, Cardiothoracic Surgery, Neurosurgery, and Trauma and Orthopaedics.


Assuntos
Internato e Residência , Ortopedia , Otolaringologia , Especialidades Cirúrgicas , Criança , Feminino , Humanos , Masculino , Especialidades Cirúrgicas/educação , Medicina Estatal , Reino Unido
8.
Laryngorhinootologie ; 101(4): 272-273, 2022 04.
Artigo em Alemão | MEDLINE | ID: mdl-35320853
10.
Artigo em Inglês | MEDLINE | ID: mdl-35329354

RESUMO

Background: Nowadays, head and neck surgical approaches need an increased level of anatomical knowledge and practical skills; therefore, the related learning curve is both flat and long. On such procedures, surgeons must decrease operating time as much as possible to reduce the time of general anesthesia and related stress factors for patients. Consequently, little time can be dedicated for training skills of students and young residents in the operating theater. Fresh human cadavers offer the most obvious surrogate for living patients, but they have several limitations, such as cost, availability, and local regulations. Recently, the feasibility of using ex vivo animal models, in particular ovine ones, have been considered as high-fidelity alternatives to cadaveric specimens. Methods: This comprehensive review explores all of head and neck otolaryngology applications with this sample. We analyzed studies about ear surgery, orbital procedures, parotid gland and facial nerve reanimation, open laryngeal and tracheal surgery, microlaryngoscopy procedures, laryngotracheal stenosis treatment, and diagnostic/operative pediatric endoscopy. For each different procedure, we underline the main applications, similarities, and limitations to human procedures so as to improve the knowledge of this model as a useful tool for surgical training. Results: An ovine model is easily available and relatively inexpensive, it has no limitations associated with religious or animal ethical issues, and it is reliable for head and neck surgery due to similar consistencies tissues and neurovascular structures with respect to humans. However, some other issues should be considered, such as differences about some anatomical features, the risk of zoonotic diseases, and the absence of bleeding during training. Conclusion: This comprehensive review highlights the potentials of an ex vivo ovine model and aims to stimulate the scientific and academic community to further develop it for other applications in surgical education.


Assuntos
Otolaringologia , Cirurgiões , Animais , Criança , Cabeça/cirurgia , Humanos , Modelos Animais , Pescoço/cirurgia , Ovinos
11.
Pediatr Clin North Am ; 69(2): xvii-xviii, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35337548
13.
Otolaryngol Head Neck Surg ; 166(5): 793-794, 2022 05.
Artigo em Inglês | MEDLINE | ID: mdl-35259032

RESUMO

Given the high prevalence of otolaryngology infections such as tonsillitis, otitis, and pharyngitis in low and middle income countries, the field of global otolaryngology continues to grow to accommodate patients around the world. This commentary focuses on best practices in transcultural communications between US doctors and foreign patients with an emphasis on cultural competency. We use alternative medicine as an exemplar for how to collaborate with patients to develop treatment plans that respect their cultural beliefs and lifestyles. Rather than assigning value to the patient's alternative medicine practices, we believe that instructing and counseling a patient on how to incorporate follow-up visits and rehabilitation after allopathic medical procedures such as surgical tonsillectomy should be done in a way that respects the patient's preexisting health regimen. By doing so, these new aspects of their health care will take a discrete place in their wellness practices and engender more trust and better health outcomes.


Assuntos
Otolaringologia , Tonsilectomia , Tonsilite , Competência Cultural , Tomada de Decisões , Humanos , Tonsilectomia/métodos , Tonsilite/cirurgia
14.
Int J Pediatr Otorhinolaryngol ; 156: 111097, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35259634

RESUMO

OBJECTIVES: 1) Evaluate the caregiver-perceived benefits and barriers of a tertiary pediatric otolaryngology telemedicine service using the validated Telemedicine Satisfaction Questionnaire (TSQ); 2) Explore the provider's perception and experience on the current telemedicine platform using a modified Physician Satisfaction Questionnaire (PSQ). METHODS: Caregivers of patients ≤18 years of age who received telemedicine services from May 4 to June 18, 2020 (duration of telemedicine use) were eligible for this study. Caregivers were contacted via telephone and given the option to answer the TSQ over the phone, receive a link via email, or decline participation. Providers were administered the modified PSQ as an anonymous, self-report online instrument on the 2 nd week of telemedicine implementation. The study authors were excluded from the PSQ. RESULTS: 58/148 caregivers completed the TSQ. The TSQ questions were grouped into three categories: quality of care, similarity to in-person care, and perception of the interaction. Caregivers felt the most satisfied with the perception of the interaction (mean response 4.84, SD 0.08, p < 0.05). With the PSQ, providers had less favorable responses when compared to the TSQ across all categories (p < 0.05 for all categories) but did report satisfaction for the perception of the interaction (mean response 3.37, SD 0.85). CONCLUSION: Our study demonstrates further evidence that the telemedicine may provide positive benefits. Caregivers were supportive of this service due to its convenience. Providers felt confident using this service, but they also felt the care provided was different from that in the clinic. Improvement in the telemedicine platforms and associated technology for physical exams may help improve the quality of telemedicine care, and similarity to in-person care.


Assuntos
COVID-19 , Otolaringologia , Médicos , Telemedicina , Criança , Humanos , Satisfação do Paciente , Satisfação Pessoal
15.
MMW Fortschr Med ; 164(5): 5, 2022 03.
Artigo em Alemão | MEDLINE | ID: mdl-35274234
16.
Int J Mol Sci ; 23(5)2022 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-35269718

RESUMO

For decades, biomaterials have been commonly used in medicine for the replacement of human body tissue, precise drug-delivery systems, or as parts of medical devices that are essential for some treatment methods. Due to rapid progress in the field of new materials, updates on the state of knowledge about biomaterials are frequently needed. This article describes the clinical application of different types of biomaterials in the field of otorhinolaryngology, i.e., head and neck surgery, focusing on their antimicrobial properties. The variety of their applications includes cochlear implants, middle ear prostheses, voice prostheses, materials for osteosynthesis, and nasal packing after nasal/paranasal sinuses surgery. Ceramics, such as as hydroxyapatite, zirconia, or metals and metal alloys, still have applications in the head and neck region. Tissue engineering scaffolds and drug-eluting materials, such as polymers and polymer-based composites, are becoming more common. The restoration of life tissue and the ability to prevent microbial colonization should be taken into consideration when designing the materials to be used for implant production. The authors of this paper have reviewed publications available in PubMed from the last five years about the recent progress in this topic but also establish the state of knowledge of the most common application of biomaterials over the last few decades.


Assuntos
Materiais Biocompatíveis , Otolaringologia , Antibacterianos/farmacologia , Materiais Biocompatíveis/farmacologia , Cerâmica , Humanos , Polímeros , Tecidos Suporte
17.
Dan Med J ; 69(4)2022 Mar 23.
Artigo em Inglês | MEDLINE | ID: mdl-35319453

RESUMO

INTRODUCTION: This study aimed to conduct a targeted needs assessment to identify and prioritise technical skills and procedures suited for simulation-based training (SBT) in private otorhinolaryngology (ORL) practice in Denmark, including mapping the learning environment related to implementation of SBT. METHODS: A panel of trainers and trainees in private ORL practice was recruited. Using the Delphi method, three rounds of surveys were conducted. Round one consisted of a survey of the learning environment and a brainstorming phase. Round two quantified the frequency of procedures, ranked the importance of procedural competency, impact on patient safety and feasibility for SBT. In round three, panelists eliminated and ranked procedures for final prioritisation. RESULTS: A total of 26 of 57 invited trainers and trainees accepted participation. The educational environment was described and 136 skills were suggested in the brainstorming phase. "Non-technical" skills were removed, and the remaining 46 technical skills were grouped for appraisal in round two. In round three, panelists reduced these to eight technical skills and procedures which were maintained for final prioritisation for SBT with myringotomy with ventilation tube insertion ranking highest. Trainees and trainers indicated that close supervision and dedicated time for training were major strengths of the learning environment. CONCLUSIONS: Our findings extend the results obtained in a previous general needs assessment and may inform curricular implementation of SBT in private ORL practice. A structured "package" with SBT and assessment for the identified procedures are desired by trainers. This work is already in progress and implementation is facilitated by a positive attitude towards SBT among trainers and trainees alike. FUNDING: none. TRIAL REGISTRATION: not relevant.


Assuntos
Otolaringologia , Treinamento por Simulação , Currículo , Técnica Delfos , Humanos , Determinação de Necessidades de Cuidados de Saúde , Treinamento por Simulação/métodos
19.
Artigo em Chinês | MEDLINE | ID: mdl-35325946

RESUMO

Objective: To analyze the citation of articles in Chinese Journal of Otorhinolaryngology Head and Neck Surgery, and to explore the strategy for running scientific journals. Methods: Using the Citation Database of Chinese Biomedical Journals, the citations of articles in this journal from 2009 to 2019 were statistically analyzed, and the characteristics of highly cited articles were analyzed. Results: From 2009 to 2019, Chinese Journal of Otorhinolaryngology Head and Neck Surgery published 2 814 papers. Cited papers accounted for 75.69% of all papers, and each paper was cited 7.24 times. The citation rate of published papers was consistent with the variation trend of citation frequency. Non treatises such as guide consensus and original articles for special issues were cited better. There was no obvious correlation between paper funding and citation. Conclusion: Improving the content quality and optimizing the column setting are important measures to enhance the influence of scientific journals.


Assuntos
Otolaringologia , China , Humanos
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