American journal of otolaryngology
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Describe current practices and challenges in personal protective equipment (PPE) use among US otolaryngologists during the COVID-19 pandemic. ⋯ The majority of participants reported routine access to full PPE for AGPs and pAGPs in all patients, regardless of COVID status. There was a high perception of security, as well as adequate N95 fitting and PPE training. Areas for improvement include: optimizing PPE availability for AGPs in patients without confirmed COVID and wider recognition of otolaryngologic procedures as high risk for aerosolization.
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An important challenge of big data is using complex information networks to provide useful clinical information. Recently, machine learning, and particularly deep learning, has enabled rapid advances in clinical practice. The application of artificial intelligence (AI) and machine learning (ML) in rhinology is an increasingly relevant topic. ⋯ AI is especially useful when there is no conclusive evidence to aid decision making. ML can help doctors make clinical decisions, but it does not entirely replace doctors. However, when critically evaluating studies using this technique, rhinologists must take into account the limitations of its applications and use.
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During patient transport from operating room to post-operative recovery area, anesthesia staff are at increased risk of particle aerosolization from patients despite wearing face shields. Current single-use face shields do not provide anesthesia staff from adequate protection from bioaerosolized particles expired during a patient's cough, particularly during transfer from the operating room to the post-anesthesia recovery unit. In this study, we compare the efficacy of single-use face shield currently available at our institution to a newly designed face shield that provides better protection while still maintaining cost-effectiveness and the ease-of-use of a disposable device. ⋯ Transfer from the operating room to the post-operative recovery unit is a hands-on process and involves managing multiple aspects of patient care physically. Current single-use face shields are convenient and cost-effective, but do not provide adequate protection from droplet aerosolization by patients during transfer. Other masks that provide adequate coverage are costly and are not designed to be single-use. A single-use disposable face shield that offers improved coverage of the lower face provides improved protection for anesthesia staff while maintaining cost-effectiveness, ease-of-use, and infection control.
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Lumbar drains are frequently used in patients with otolaryngologic concerns. These can be used therapeutically or prophylactically with the primary purpose being to modulate CSF pressure. Within otolaryngology, lumbar drains are most frequently used for cerebrospinal fluid leaks - either due to cerebrospinal fluid fistulas or in skull base surgery as these allow for potential healing of the defect. While not typically placed by otolaryngologists, a basic understanding of lumbar drains is beneficial in the context of patient management. ⋯ Lumbar drains are important tools used in patients with otolaryngologic pathologies. Otolaryngologists and otolaryngology residents should be familiar with these catheters to determine if they are working correctly and to identify adverse effects as early as possible.
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Olfactory dysfunction in coronavirus disease-2019 (COVID-19) is poorly understood. Thus, mechanistic data are needed to elucidate the pathophysiological drivers of anosmia of COVID-19. ⋯ We did not find significant mucosal changes or olfactory cleft abnormality on CT imaging in patients with anosmia of COVID-19. Conductive causes of anosmia (i.e., mucosal disease) do not seem play a significant role in anosmia of COVID-19.