JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Jul 2018
Comparative StudyAssessment of a Patient-Specific, 3-Dimensionally Printed Endoscopic Sinus and Skull Base Surgical Model.
Three-dimensional (3D) printing is an emerging tool in the creation of anatomical models for simulation and preoperative planning. Its use in sinus and skull base surgery has been limited because of difficulty in replicating the details of sinus anatomy. ⋯ This study shows that high-resolution, 3D-printed sinus and skull base models can be generated with anatomical and haptic accuracy. This technology has the potential to be useful in surgical training and preoperative planning and as a supplemental or alternative simulation or training platform to cadaveric dissection.
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JAMA Otolaryngol Head Neck Surg · Jun 2018
Association Between Hearing Aid Use and Health Care Use and Cost Among Older Adults With Hearing Loss.
Hearing loss (HL) is common among older adults and is associated with poorer health and impeded communication. Hearing aids (HAs), while helpful in addressing some of the outcomes of HL, are not covered by Medicare. ⋯ This study demonstrates the beneficial outcomes of use of HAs in reducing the probability of any ED visits and any hospitalizations and in reducing the number of nights in the hospital. Although use of HAs reduced total Medicare costs, it significantly increased total and out-of-pocket health care spending. This information may have implications for Medicare regarding covering HAs for patients with HL.
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JAMA Otolaryngol Head Neck Surg · Apr 2018
Observational StudyNonsurgical Treatment for Posttraumatic Complete Facial Nerve Paralysis.
Current recommendations envisage early surgical exploration for complete facial nerve paralysis associated with temporal bone fracture and unfavorable electrophysiologic features (response to electroneuronography, <5%). However, the evidence base for such a practice is weak, with the potential for spontaneous improvement being unknown, and the expected results from alternative nonsurgical treatment also undefined. ⋯ For undisplaced temporal bone fractures, nonsurgical treatment leads to near-universal recovery to House-Brackmann grade I/II and is superior to reported surgical results. Recovery is delayed and usually first manifests at 8 to 12 weeks after the fracture. In the current era of high-resolution computed tomography, surgical exploration should not be first-line treatment for undisplaced longitudingal temporal bone fractures associated with complete facial nerve paralysis and unfavorable electrophysiologic features.
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JAMA Otolaryngol Head Neck Surg · Mar 2018
Current Status of Radiology Training in Otolaryngology Residency Programs.
Otolaryngologists use head and neck imaging on a daily basis. However, little is known about the training residents receive on the subject. Understanding the current training environment is important to identify areas of improvement for resident education. ⋯ Despite no standardized requirements from the Accreditation Council for Graduate Medical Education (ACGME), 71% of US otolaryngology residency program directors who responded to our survey have a radiology curriculum. Most run didactics sessions at the desired frequency, setting, and format preferred by responding program directors. More than half of programs provide a dedicated radiology rotation, mostly during PGY-1, while identifying PGY-2 and PGY-3 as the optimal time for such an experience. These results highlight the need for a more thorough review of radiology education requirements from the ACGME to improve the training of otolaryngology residents across the country.