J Otolaryngol Head N
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J Otolaryngol Head N · Jun 2019
Oncological and functional outcomes following transoral laser microsurgery in patients with T2a vs T2b glottic squamous cell carcinoma.
There is a paucity of evidence comparing oncological and voice outcomes between T2a and T2b glottic squamous cell carcinoma (SCC) patients treated with transoral laser microsurgery (TLM). This study identified functional and oncological outcomes in this cohort. ⋯ This study highlights positive functional outcomes for T2a glottic SCC. Patients with T2b disease appear to have significantly worse oncological and functional outcomes, including worse voice quality following surgery and higher rates of salvage laryngectomy.
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J Otolaryngol Head N · May 2019
Fellowship training in microvascular surgery and post-fellowship practice patterns: a cross sectional survey of microvascular surgeons from facial plastic and reconstructive surgery programs.
There is a lack of published literature on the training in microvascular reconstructive techniques in facial plastic and reconstructive surgery (FPRS) fellowships or of the extent these techniques are continued in practice. This cross-sectional web-based survey study was conducted to describe the volume, variety, and intended extent of practice of free tissue transfers during fellowship and the post-fellowship pattern of microsurgical practice among FPRS surgeons in various private and academic practice settings across the United States. ⋯ These results provide the first formal description of the training and practice patterns of FPRS-trained microvascular surgeons. They describe a diverse fellowship training experience that often results in robust microvascular practice. The maintenance of substantial microsurgical caseloads after fellowship runs counter to the perception of high levels of burnout from free tissue transfers among microvascular surgeons.
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J Otolaryngol Head N · Feb 2019
Managing the airway catastrophe: longitudinal simulation-based curriculum to teach airway management.
A longitudinal curriculum was developed in conjunction with anesthesiologists, otolaryngologists, emergency physicians and experts in medical simulation and education. ⋯ A longitudinal simulation-based medical curriculum can be an effective method to teach airway management and teamwork skills to otolaryngology residents.
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J Otolaryngol Head N · Jan 2019
Teaching communication skills to OTL-HNS residents: multisource feedback and simulated scenarios.
Effective communication has been linked to a reduction in adverse events and improved patient compliance. Currently in Otolaryngology - Head and Neck Surgery (OTL-HNS) residency programs, there is limited explicit teaching of communication skills. Our objective was to implement an educational program on communication skills for residents using multisource assessment in several simulation-based contexts throughout residency. ⋯ Implementing an educational program focused on communication skills using a multisource assessment in various contexts has shown to be potentially effective at our institution, and resulted for yearly improvement and consolidation of performance of OTL-HNS residents as judged by faculty and residents. The inclusion of a multisource assessment in the simulation curriculum is key to allow for the representation of different perspectives on communication skills, for both the assessment and the debriefing process. Future studies are needed to explore the possibility of fully integrating this educational program into residence training in order to support deliberate communication skills teaching.
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J Otolaryngol Head N · Jan 2019
Perioperative Teaching and Feedback: How are we doing in Canadian OTL-HNS programs?
Discrepancies between resident and faculty perceptions regarding optimal teaching and feedback during surgery are well known but these differences have not yet been described in Otolaryngology - Head and Neck Surgery (OTL-HNS). The objectives were thus to compare faculty and resident perceptions of perioperative teaching and feedback in OTL-HNS residency programs across Canada with the aim of highlighting potential areas for improvement. ⋯ Faculty and residents in OTL-HNS residency programs disagree on the frequency and optimal timing of peri-operative teaching and feedback. This difference in perception emphasizes the need for a more structured approach to feedback delivery including explicitly stating when feedback is being given, and the overall need for better communication between residents and staff.