The Laryngoscope
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To determine what characteristics and comorbidities are associated with a higher rate of complications in patients undergoing nasal reconstruction with a forehead flap. ⋯ Smokers with full-thickness defects are shown to be at greater odds for developing a postoperative complication. Laryngoscope, 2009.
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To assess the level of functioning in patients with head and neck cancer (HNC) using the the International Classification of Functioning, Disability, and Health (ICF). ⋯ The ICF identifies problems in functioning in patients with HNC comprehensively. The results emphasize the importance of contextual environmental factors. In particular, environmental factors referring to interpersonal support should be more strongly included in rehabilitation plans for HNC.
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To report and analyze the soft tissue complications of 462 consecutive cochlear implants using a minimal access approach at a single institution. ⋯ An overall soft tissue complication rate of 1.51% (7/462) at our institution supports the use of a small incision technique combined with device fixation as a safe method of cochlear implantation. We believe that good fixation is especially important in pediatric implantation, because of the thinner soft tissue envelope and increased frequency of minor head trauma.
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Studies of medical error demonstrate that errors and adverse events (AEs) are common in hospitals. There are little data of errors on pediatric surgical services. ⋯ Multiple errors occurred in every inpatient pediatric otolaryngology admission; however, only 26 minor and eight moderate AEs were identified. The rate of errors per 1,000 hospital days (6,356 per 1,000 days) is higher than previously reported in voluntary reporting studies, possibly due to our methodology of physician review with a "zero-defect" standard. Trends in the data suggest that the presence of small errors may be associated with the risk of adverse events. Although labor-intensive, physician chart review is a valuable tool for identifying areas for improvement. Although small errors were common, there were few harms and no major morbidity.
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Measure compliance with the Accreditation Council of Graduate Medical Education (ACGME) residents' work hour regulations and evaluate their impact on patient care and residents' performance on the Otolaryngology Training Examination (OTE). ⋯ Institution of the ACGME duty hour regulations did not improve patient care as measured by the 30-day readmission rate, inhospital mortality, and patient's length of stay. Residents' performance on the OTE did not change after implementation of the ACGME rules. Further studies are warranted to assess the impact of the ACGME work hour regulations on patient care and resident-physicians' training.