Browsing by Author "Orloff, Lisa A."

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    African Head and Neck Society Clinical Practice guidelines for thyroid nodules and cancer in developing countries and limited resource settings
    (Wiley, 2020-08) Zafereo, Mark; Yu, Justin; Onakoya, Paul A.; Aswani, Joyce; Baidoo, Kenneth; Bogale, Mesele; Cairncross, Lydia; Cordes, Susan; Daniel, Adekunle; Diom, Evelyne; Maurice, Mpessa E.; Mohammed, Garba M.; Biadgelign, Melesse G.; Koné, Fatogoma I.; Itiere, Arnaud; Koch, Wayne; Konney, Anna; Kundiona, Innocent; Macharia, Chege; Mashamba, Victor; Moore, Michael G.; Mugabo, Rajab M.; Noah, Patrick; Omutsani, Mary; Orloff, Lisa A.; Otiti, Jeffrey; Randolph, Gregory W.; Sebelik, Merry; Todsen, Tobias; Twier, Khaled; Fagan, Johannes J.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background International thyroid nodule and cancer management guidelines generally fail to take into account potential limitations in diagnostic and treatment resources. Methods Thyroid cancer specialists from the African Head and Neck Society and American Head & Neck Society Endocrine Section developed guidelines for diagnosis and management of thyroid nodules and cancer in low resource settings. Recommendations were based on literature review and expert opinion, with level of evidence defined. Results Using the ADAPTE process, diagnostic and treatment algorithms were adapted from the National Comprehensive Cancer Network (NCCN). Low resource settings were simulated by systematically removing elements such as availability of laboratory testing, hormone replacement, imaging, and cytopathology from NCCN guidelines. Conclusions Successful management of thyroid nodules and cancer in low resource settings requires adaptation of treatment methodologies. These guidelines define specific scenarios where either more or less aggressive intervention for thyroid pathology may be advisable based on limited available resources.
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    Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic
    (AMA, 2020-03) Givi, Babak; Schiff, Bradley A.; Chinn, Steven B.; Clayburgh, Daniel; Iyer, N. Gopalakrishna; Jalisi, Scharukh; Moore, Michael G.; Nathan, Cherie-Ann; Orloff, Lisa A.; O'Neill, James P.; Parker, Noah; Zender, Chad; Morris, Luc G. T.; Davies, Louise; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Importance The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists–head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19.