Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Jun 2013
Comparative StudySupraclavicular artery island flap (SCAIF) vs free fasciocutaneous flaps for head and neck reconstruction.
At our institution, the supraclavicular artery island flap (SCAIF) has become a reliable option for fasciocutaneous coverage of complex head and neck (H&N) defects. We directly compare the outcomes of reconstructions performed with SCAIFs and free fasciocutaneous flaps (FFFs), which have not been reported previously. ⋯ The SCAIF is a technically simpler and equally reliable sensate fasciocutaneous flap for H&N reconstruction with comparable outcomes, shorter operative time, less ICU stay, and no need for postoperative monitoring when compared with using FFFs. It should be considered a first-choice reconstructive option for complex H&N defects.
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Otolaryngol Head Neck Surg · May 2013
Variations in antibiotic prescribing of acute rhinosinusitis in United States ambulatory settings.
To identify variations in antibiotic treatment of acute rhinosinusitis (ARS) on a national level. ⋯ Antibiotics were prescribed frequently despite recent consensus guidelines that discourage antibiotic use in mild cases. Furthermore, antibiotic prescription was more likely for younger patients and in primary care settings. This highlights the need to promote awareness of practice guidelines.
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Otolaryngol Head Neck Surg · May 2013
Comparison of plaintiff and defendant expert witness qualification in malpractice litigation in otolaryngology.
Malpractice litigation contributes to rising health care costs in the United States. The role of expert witness testimony has been controversial in the past, with medical professional societies issuing statements regarding ethical obligations of physicians. Our objectives were to examine the relative qualifications of expert witnesses testifying on behalf of plaintiffs vs defendants. ⋯ Upon comparison of otolaryngologist expert witnesses, practitioners testifying on behalf of plaintiffs had statistically fewer years of experience, had a lower scholarly impact, and were less likely to work in an academic setting. Otolaryngologists who repeatedly served as expert witnesses were more likely to be testifying on behalf of plaintiffs than defendants. Professional societies need to frequently update guidelines on expert witness testimony and address the ethical obligations of practitioners.