Visualization of ex vivo rabbit olfactory mucosa and foramina with three-dimensional optical coherence tomography.

There is increasing interest in developing a minimally invasive imaging modality to safely evaluate dynamic microscopic changes of the olfactory mucosa and cribriform foramina. Herein, we utilized three-dimensional (3D) optical coherence tomography (OCT) to characterize the ex vivo stratified substructure of olfactory mucosa in rabbits and create 3D reconstructed images of olfactory foramina. Olfactory mucosa and cribriform plates from four New Zealand White rabbits were dissected and imaged using two swept-source OCT systems: (1) 1.3-µm (µm) center wavelength, 100-nm bandwidth, 200-kHz sweep rate, and (2) 1.7-µm center wavelength, 120-nm bandwidth, 90-kHz sweep rate. Volumetric OCT images were compiled to create a 3D reconstruction of the cribriform plate. The ability of OCT to distinguish the olfactory mucosa substructure and foramina was compared to histology. To estimate imaging penetration depth of each system, the first-order exponential decays of depth-resolved intensity were calculated and compared using a paired t-test. Three-dimensional OCT depicted the stratified layered structures within the olfactory mucosa correlating with histology. The epithelium and lamina propria were measured to be 32 µm and 107 µm in 1.3-µm OCT compared to 30 µm and 105 µm in histology. Olfactory foramina were visualized via 3D reconstruction. The 1.7-µm system provided greater depth penetration compared to the 1.3-µm system, allowing for improved foramina visualization. We have shown that OCT can be used to image non-pathologic olfactory mucosa and foramina. Implications for this work include diagnostic and therapeutic potentials for neurorhinological and neurodegenerative diseases.

Development and Assessment of a Video-Based Intervention to Improve Rhinoplasty Informed Consent.

There has been a growing interest in improving the informed consent process to ensure patients truly understand the benefits, risks, and alternatives of their procedures. Herein, we sought to describe the production of an educational video to supplement the traditional rhinoplasty informed consent process. Additionally, we evaluate satisfaction and risk recall among prospective rhinoplasty patients who participated in the video-assisted informed consent process. One author attended 30 rhinoplasty consultations where informed consent was performed and generated 65 questions related to the benefits, risks, alternatives, and general knowledge of rhinoplasty operations. A video of the senior author answering these questions was filmed and edited to 25 minutes. Prospective rhinoplasty patients watched the video before their initial consultation and were asked to complete two surveys assessing their satisfaction with the video-assisted process as well as their ability to recall risks discussed in the video. Understandability and actionability of the video was assessed by three independent reviewers using the Patient Education Materials Assessment Tool. Postvideo surveys were completed by 40 patients. Patients strongly agreed that the video informed them about rhinoplasty risks and benefits (4.90/5.00), effectively answered their questions and/or concerns (4.78/5.00), and provided adequate information before surgery (4.85/5.00). Participants strongly recommended that all prospective patients watch the video prior to surgery (4.97/5.00). Participants on average correctly answered 4.00 ± 0.877 out of five risk recall questions. There was no statistically significant difference in risk recall performance between college graduates (4.19 ± 0.602) and those who did not graduate college (3.79 ± 1.08), p = 0.076. No significant correlation was found between patient age and recall performance (r = -0.011), p = 0.943. The overall mean understandability and actionability scores for the video were 100%. Video-assisted informed consent for rhinoplasty may enhance and overcome limitations to the traditional verbal consent process by ensuring comprehensive, standardized, and readily understandable information.

Optimizing the Virtual Otolaryngology Residency Information Sessions: A Survey of Applicants.

The 2020-2021 otolaryngology residency application cycle has been immensely distorted by travel restrictions mandated in response to coronavirus disease 2019, limiting opportunities for applicants to meet and rotate with programs of interest. The purpose of this study was to evaluate otolaryngology applicants' preferences toward the content and format of virtual residency information sessions. An anonymous online survey was developed to gauge applicants' virtual exposure to otolaryngology programs and investigate their preferences during virtual sessions. Almost all respondents attended at least 1 virtual information session (89%). Respondents felt that the most important aspects of these sessions were meeting residents, learning about operative volume, and meeting faculty. The majority (85%) preferred these sessions last no longer than 2 hours. Participants preferred virtual sessions to include breakout sessions with participant video/microphone on. These findings have implications for future virtual resident recruitment strategies.