JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Sep 2013
Comparative StudyAccreditation Council for Graduate Medical Education accreditation and influence on perceptions of pediatric otolaryngology fellowship training experience.
The American Society of Pediatric Otolaryngology (ASPO) has set a goal of universal accreditation of fellowship programs by the Accreditation Council for Graduate Medical Education (ACGME) by 2014. This study offers data comparing trainee experience at accredited vs nonaccredited programs. ⋯ Most respondents were in agreement with universal ACGME accreditation. Those having trained in accredited programs cite increased allowance for research, academic and vacation time, more formal opportunities to evaluate their faculty, and decreased primary call burden.
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JAMA Otolaryngol Head Neck Surg · Sep 2013
Comparative StudyDepression among long-term survivors of head and neck cancer treated with radiation therapy.
The diagnosis and subsequent treatment of head and neck cancer can have a potentially devastating impact on psychosocial functioning. Although the long-term physical adverse effects of radiation therapy (RT) for head and neck cancer have been well described, relatively few studies have evaluated psychosocial functioning after treatment. ⋯ Despite a relatively high rate of depression among patients with head and neck cancer in the post-RT setting, mental health services are severely underutilized.
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JAMA Otolaryngol Head Neck Surg · Aug 2013
Comparative StudyFrailty as a predictor of morbidity and mortality in inpatient head and neck surgery.
The increasing number of elderly and comorbid patients undergoing surgical procedures raises interest in better identifying patients at increased risk of morbidity and mortality, independent of age. Frailty has been identified as a predictor of surgical complications. ⋯ The mFI is significantly associated with morbidity and mortality in this retrospective survey. Additional study with prospective analysis and external validation is needed. The mFI may provide an improved understanding of preoperative risk, which would facilitate perioperative optimization, risk stratification, and counseling related to outcomes.
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JAMA Otolaryngol Head Neck Surg · Aug 2013
Sentinel node biopsy in lieu of neck dissection for staging oral cancer.
Neck dissection is the standard staging procedure to ascertain the pathologic status of cervical lymph nodes in patients with oral cavity squamous cell carcinoma (OSCC), but it results in multiple morbidities. ⋯ The majority of patients with positive results on SNB had additional positive nodes on neck dissection. A low rate of isolated neck recurrence was found in patients with negative results on SNB. Individuals with negative results on SNB exhibited better overall and disease-specific survival than those with positive results.
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JAMA Otolaryngol Head Neck Surg · Jul 2013
Randomized Controlled Trial Comparative StudyComparison of voice and swallowing parameters after endoscopic total and partial arytenoidectomy for bilateral abductor vocal fold paralysis: a randomized trial.
Total arytenoidectomy is claimed to increase risk of aspiration and cause more voice loss than other operations performed for bilateral abductor vocal fold paralysis (BVFP). However, objective evidence for such a conclusion is lacking. There is no study comparing swallowing and voice after total and partial arytenoidectomy. ⋯ Endoscopic total and partial arytenoidectomy are very successful static surgical options for BVFP. Partial takes longer than total arytenoidectomy. They both provide a comfortable airway, acceptable voice, and acceptable deglutition. It may be a sound practice to perform partial arytenoidectomy initially for primary BVFP cases and reserve total arytenoidectomy for revision cases.