JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Sep 2014
A chief of service rotation as an alternative approach to pediatric otolaryngology inpatient care.
Maintaining an outpatient practice and providing high-quality inpatient care pose significant challenges to the traditional call team approach. ⋯ The COS program was created to meet the clinical, educational, and organizational demands of a high-volume and high-acuity inpatient service. It is a financially sustainable model with unique advantages, particularly for the staff who maintain their outpatient practices without disruption and for the trainees who have the opportunity to work closely with the entire faculty. Patients are provided supervised evaluations and continuity of care. This rotating hospitalist program is a viable alternative to the full-time hospitalist staff model.
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JAMA Otolaryngol Head Neck Surg · Sep 2014
Case ReportsCricothyroid onabotulinum toxin A injection to avert tracheostomy in bilateral vocal fold paralysis.
More than half of children with bilateral vocal fold paralysis require a tracheostomy for airway management. We report an innovative, minimally invasive approach consisting of onabotulinum toxin A injection into the cricothyroid muscles. ⋯ Onabotulinum toxin A injection into the cricothyroid muscles leads to an increase in the glottic space, providing an adequate airway. Onabotulinum toxin A injection in the cricothyroid muscles could be offered as a safe, effective, noninvasive first-line option for patients with bilateral vocal fold paralysis.