International forum of allergy & rhinology
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Int Forum Allergy Rhinol · Mar 2014
Spontaneous sphenoid lateral recess cerebrospinal fluid leaks arise from intracranial hypertension, not Sternberg's canal.
Spontaneous cerebrospinal fluid (CSF) leaks/encephaloceles are proven to be associated with intracranial hypertension by objective measurements of CSF pressure during or following endoscopic repair. A common area of involvement is a pneumatized lateral recess of the sphenoid (LRS) sinus, where prolonged intracranial pressures lead to arachnoid pits and subsequent development of skull-base defects. Even though the LRS is never present at birth, a "congenital" cause of these leaks due to a persistent Sternberg's (lateral craniopharyngeal) canal continues to be erroneously perpetuated in the literature. The objective of this study was to eliminate the myths defining these leaks as congenital in nature. ⋯ This study provides objective evidence that LRS CSF leaks are secondary to erosions from intracranial hypertension and refutes the myth regarding a congenital origin from Sternberg's canal.
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Our objectives were to evaluate collaboration with medical students and other nondoctoral authors, and assess whether mentoring such students influences the academic productivity of senior authors. ⋯ Collaboration with individuals who do not have doctoral-level degrees, presumably medical students, has a strong association with scholarly impact among researchers publishing in the Laryngoscope and IFAR. Research mentorship of medical students interested in otolaryngology may allow a physician-scientist to evaluate the students' effectiveness and functioning in a team setting, a critical component of success in residency training, and may have beneficial effects on research productivity for the senior author.
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Int Forum Allergy Rhinol · Feb 2014
Allergy education in otolaryngology residency: a survey of program directors and residents.
The purpose of this study was to survey program directors of the accredited otolaryngology residency programs and resident attendees of the 2013 American Academy of Otolaryngic Allergy (AAOA) Basic/MOC Course regarding resident education and participation as well as assessment of competency in otolaryngic allergy and immunotherapy. ⋯ This survey demonstrates a discrepancy between program directors and residents regarding resident involvement and adequacy of training in the allergy practice. Although the majority of otolaryngology residencies report offering otolaryngic allergy services and education, the vast majority of residents report inadequate allergy training and less participation in an allergy practice compared to the majority of program directors.
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Int Forum Allergy Rhinol · Jan 2014
Epistaxis: the factors involved in determining medicolegal liability.
The purpose of this study was to examine litigation involving epistaxis and analyze factors that determine liability. ⋯ Contrary to previous reports analyzing malpractice for varying medical procedures and complications, litigation in epistaxis is more commonly resolved in favor of the plaintiff or resolved through out-of-court settlements. Substantial financial awards and therapeutic complications from blindness to death make epistaxis a candidate for litigation. Of importance from a medicolegal stand is the fact that 30.8% (8) of the patients involved in epistaxis litigation died, either from complications of therapy or from experiencing epistaxis as a complication of another procedure/pathology. Using necessary diagnostic imaging, ensuring proper management techniques, and recognizing complications in a timely manner can serve to limit legal liability and enhance patient safety.
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Int Forum Allergy Rhinol · Jan 2014
Randomized Controlled TrialFive-degree, 10-degree, and 20-degree reverse Trendelenburg position during functional endoscopic sinus surgery: a double-blind randomized controlled trial.
Using the reverse Trendelenburg position (RTP) during functional endoscopic sinus surgery (FESS) is a safe, simple, and cost-free method that has been found to reduce intraoperative blood loss. However, the critical angle of RTP that produces the least amount of bleeding without compromising surgical technique and safety remains unanswered. The objective of this study was to assess the effects of 5-degree, 10-degree, and 20-degree RTP (5-RTP, 10-RTP, and 20-RTP, respectively) on intraoperative bleeding during FESS. ⋯ FESS in 20-RTP produced the best BS and lowest blood loss without compromising surgical technique.