Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Nov 2015
Observational StudyLaryngoscope Illuminance in a Tertiary Care Medical Center: Industry Standards and Implications for Quality Laryngoscopy.
To test the hypothesis that a substantial proportion of laryngoscopes exhibit substandard illuminance by comparing laryngoscope illuminance in a tertiary-level medical center to established standards and identifying features associated with poor illuminance. ⋯ Twenty-eight percent of laryngoscopes in a tertiary care hospital exhibit substandard illuminance; these results corroborate the findings of our inaugural study on this subject. Consequently, our hospital is instituting changes to reduce the likelihood of substandard performance by laryngoscopes in circulation.
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Otolaryngol Head Neck Surg · Nov 2015
Perception of Shame in Otolaryngology-Head and Neck Surgery Training.
This survey was developed to assess the prevalence and effects of the perception of shame in otolaryngology-head and neck surgery residency training in the United States. ⋯ Half of respondents have felt shamed during their residency training, and a majority has witnessed a colleague being shamed. Understanding the negative impact that shaming behaviors have on the learning environment and on the performance of the individual within it is an important first step in creating an environment maximally conducive to learning, professional development, and patient safety.
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Airway stabilization is critical in combat maxillofacial injury as normal anatomical landmarks can be obscured. The study objective was to characterize the epidemiology of airway management in maxillofacial trauma. ⋯ There is a high incidence of airway injury in combat maxillofacial trauma, which may be underestimated. Airway management in this population requires a high degree of suspicion and low threshold for airway stabilization.
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Otolaryngol Head Neck Surg · Oct 2015
Effect of Adenotonsillectomy on Central and Obstructive Sleep Apnea in Children with Down Syndrome.
To determine and quantify changes in both central and obstructive sleep apnea in patients with Down syndrome (DS) after adenotonsillectomy (AT). ⋯ Children with DS who underwent AT demonstrated significant reductions in both obstructive and central apneic indices on PSG. A significant number of patients with central sleep apnea demonstrated resolution postoperatively. Additional analysis demonstrated a significant interaction between CO2 retention, adenoid size, and postoperative CAI reduction.
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Otolaryngol Head Neck Surg · Oct 2015
Development of a Temporal Bone Model for Transcanal Endoscopic Ear Surgery.
Transcanal endoscopic ear surgery (TEES) is being increasingly used in chronic ear disease for cholesteatoma removal and middle ear reconstruction, reducing the need for a postauricular incision and mastoidectomy. However, TEES is a challenging technique even for the most experienced otologist, requiring one-handed dissection using angled instrumentation. We have therefore developed a high-fidelity dissection model incorporating key aspects of TEES and cholesteatoma removal to facilitate the acquisition of these skills. ⋯ A pilot study was conducted whereby surgeons endoscopically elevated a tympanomeatal flap with artificial bleeding and removed artificial cholesteatoma with angled instrumentation. Surgeons were uniformly satisfied with the experience and felt it would translate into improved performance in the operating room. This study suggests that the TEES dissection model could become an integral tool in the training of emerging TEES techniques.