The Annals of otology, rhinology, and laryngology
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Ann. Otol. Rhinol. Laryngol. · Jan 2020
Attitudes of Clinicians about Screening Head and Neck Cancer Survivors for Lung Cancer Using Low-Dose Computed Tomography.
National guidelines recommend lung cancer screening (LCS) using low-dose computed tomography (LDCT) for high-risk patients, including survivors of other tobacco-related cancers like head and neck cancer (HNC). This qualitative study investigated clinicians' practices and attitudes toward LCS with LDCT with patients who have survived HNC, in the context of mandated requirements for shared decision making (SDM) using decision aids. ⋯ While clinicians feel that LDCT LCS may benefit some HNC survivors, there are barriers both to implementing LCS SDM for these patients in primary care as currently recommended and to integrating it into cancer clinics. Challenges for SDM across settings include a lack of decision aids tailored to patients with cancer histories. Given recommendations to broaden LCS eligibility criteria, more research may be required before refinement of current guidelines.
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Ann. Otol. Rhinol. Laryngol. · Dec 2019
Review Case ReportsOpen Airway Surgery in a Paraplegic: The Importance of an Adequate Cough.
To describe a case of open airway surgery with postoperative respiratory complications in a paraplegic woman and to review the unique respiratory physiology seen in patients with a history of cervical or thoracic spinal cord injury (SCI). ⋯ This first report of cricotracheal resection in a patient with paraplegia following SCI highlights the importance of an adequate cough and demonstrates the unique respiratory management necessary for patients with SCI.
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Ann. Otol. Rhinol. Laryngol. · Oct 2019
Observational StudyPerceived Preparedness of Facial Plastic Surgery Fellows Over Time: A Survey of AAFPRS Fellowship Directors.
Assess the effects of American Council for Graduate Medical Education (ACGME) resident work hour restrictions on the preparedness of incoming facial plastic surgery fellows as assessed by American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS) fellowship directors. ⋯ The study results appear to show no significant perceived trend over time on the effect of duty hour reform on fellows for AAFPRS fellowships among fellowship directors. However, there are some apparent opinion differences between fellowship directors separated by years of service, with more negative perceptions noted in 2 clinical areas by those with more than 10 years of service. This study is in line with the more recent literature that suggests a trend toward a less negative perception of the duty hour change. This may suggest resident education is adapting to the ACGME duty hour regulations.
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Ann. Otol. Rhinol. Laryngol. · Aug 2019
Predictors of Penetration-Aspiration in Parkinson's Disease Patients With Dysphagia: A Retrospective Analysis.
Penetration-aspiration is considered the most severe sign of dysphagia, with aspiration pneumonia as one of its consequences. More than half of Parkinson's disease (PD) patients suffer from dysphagia, and aspiration pneumonia is among the primary causes of mortality in PD patients. However, the identification of predictors of penetration-aspiration in PD patients remains an understudied topic. The purpose of this study was to identify predictors of penetration-aspiration in patients with PD. ⋯ Results of the present study allow for a better understanding of penetration-aspiration risk in PD patients. They are useful for treatment planning in order to improve safe oral intake and adequate nutrition.
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Ann. Otol. Rhinol. Laryngol. · Jul 2019
Case ReportsIntraoperative Ultrasound for Localization and Removal of an Oropharyngeal Wire Grill-Brush Bristle.
This paper reports the utilization of intraoperative ultrasound in the removal of an accidentally ingested wire grill-brush bristle from the pharyngeal space of a child. ⋯ Intraoperative ultrasound serves as a useful tool to guide surgical removal of aerodigestive foreign bodies and may offer an opportunity to reduce the need for CT imaging.