JAMA otolaryngology-- head & neck surgery
-
JAMA Otolaryngol Head Neck Surg · Sep 2016
ReviewRecognition and Documentation of Strangulation Crimes: A Review.
Strangulation accounts for 10% of violent deaths in the United States and 15% to 20% of deaths associated with domestic violence. However, strangulation deaths represent only a small fraction of nonfatal strangulation assaults, which occur with daily frequency in medium to large US cities. Careful evaluation and documentation of strangulation injuries may identify life-threatening medical conditions, and may facilitate prosecution of strangulation crimes. ⋯ Otolaryngologists should be knowledgeable of the subtle patterns of injury and potentially life-threatening complications of strangulation and should consider domestic violence in women presenting with throat complaints or bruises on the neck.
-
JAMA Otolaryngol Head Neck Surg · Aug 2016
Upper Airway Computed Tomography Measures and Receipt of Tracheotomy in Infants With Robin Sequence.
Airway management in infants with Robin sequence is challenging. Objective upper airway measures associated with severe airway compromise requiring tracheotomy are needed to guide decision making. ⋯ Computed tomography measures quantifying tongue position and mandibular configuration can identify infants with Robin sequence, and importantly, differentiate those who have severe upper airway compromise requiring tracheotomy. Following validation, these measures can be used for objective upper airway assessment and for expediting clinical decision-making in these challenging cases for which no such tools currently exist.
-
JAMA Otolaryngol Head Neck Surg · Aug 2016
Sinonasal Quality of Life in Children With Cystic Fibrosis.
Sinusitis is the most common otolaryngologic complaint in children with cystic fibrosis (CF). However, basic knowledge about the effect of sinusitis on these children is lacking. ⋯ In this study, the incidence of symptomatic CRS was high, but quality-of-life impact was relatively low among children with CF. Use of standardized assessment scales, including consensus diagnostic criteria and validated quality-of-life surveys, may be helpful to guide referral and management decisions.
-
JAMA Otolaryngol Head Neck Surg · Jul 2016
Domestic Travel and Regional Migration for Parathyroid Surgery Among Patients Receiving Care at Academic Medical Centers in the United States, 2012-2014.
To improve outcomes after parathyroidectomy, several organizations advocate for selective referral of patients to high-volume academic medical centers with dedicated endocrine surgery programs. The major factors that influence whether patients travel away from their local community and support system for perceived better care remain elusive. ⋯ Centralization of parathyroid surgery is a reality in the United States. Significant disparities based on race and insurance coverage exist and may hamper access to the highest-volume surgeons and hospitals. Academic medical centers with dedicated endocrine surgery programs should consider strategic initiatives to reduce disparities within their respective regions.