Browsing by Subject "head and neck surgery"

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    Advanced head and neck surgery training during the COVID-19 pandemic
    (Wiley, 2020) Givi, Babak; Moore, Michael G.; Bewley, Arnaud F.; Coffey, Charles S.; Cohen, Marc A.; Hessel, Amy C.; Jalisi, Scharukh; Kang, Steven; Newman, Jason G.; Puscas, Liana; Shindo, Maisie; Shuman, Andrew; Thakkar, Punam; Weed, Donald T.; Chalian, Ara; Otolaryngology -- Head and Neck Surgery, School of Medicine
    The COVID-19 pandemic has significantly impacted medical training. Here we assess its effect on head and neck surgical education. Methods Surveys were sent to current accredited program directors and trainees to assess the impact of COVID-19 on the fellow's experience and employment search. Current fellows' operative logs were compared with those of the 2018 to 2019 graduates. Results Despite reduction in operative volume, 82% of current American Head and Neck Society fellows have reached the number of major surgical operations to support certification. When surveyed, 86% of program directors deemed their fellow ready to enter practice. The majority of fellows felt prepared to practice ablative (96%), and microvascular surgery (73%), and 57% have secured employment to follow graduation. Five (10%) had a pending job position put on hold due to the pandemic. Conclusions Despite the impact of the COVID-19 pandemic, current accredited trainees remain well-positioned to obtain proficiency and enter the work-force.
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    Advanced head and neck surgery training during the COVID-19 pandemic
    (Wiley, 2020) Givi, Babak; Moore, Michael G.; Bewley, Arnaud F.; Coffey, Charles S.; Cohen, Marc A.; Hessel, Amy C.; Jalisi, Scharukh; Kang, Steven; Newman, Jason G.; Puscas, Liana; Shindo, Maisie; Shuman, Andrew; Thakkar, Punam; Weed, Donald T.; Chalian, Ara; Otolaryngology -- Head and Neck Surgery, School of Medicine
    Background The COVID-19 pandemic has significantly impacted medical training. Here we assess its effect on head and neck surgical education. Methods Surveys were sent to current accredited program directors and trainees to assess the impact of COVID-19 on the fellow's experience and employment search. Current fellows' operative logs were compared with those of the 2018 to 2019 graduates. Results Despite reduction in operative volume, 82% of current American Head and Neck Society fellows have reached the number of major surgical operations to support certification. When surveyed, 86% of program directors deemed their fellow ready to enter practice. The majority of fellows felt prepared to practice ablative (96%), and microvascular surgery (73%), and 57% have secured employment to follow graduation. Five (10%) had a pending job position put on hold due to the pandemic. Conclusions Despite the impact of the COVID-19 pandemic, current accredited trainees remain well-positioned to obtain proficiency and enter the work-force.
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    Centralized Otolaryngology Research Efforts: Stepping‐stones to Innovation and Equity in Otolaryngology–Head and Neck Surgery
    (Wiley, 2022-06) Brenner, Michael J.; Nelson, Rick F.; Valdez, Tulio A.; Moody-Antonio, Stephanie A.; Nathan, Cherie-Anne O.; St John, Maie A.; Francis, Howard W.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    The Centralized Otolaryngology Research Efforts (CORE) grant program coordinates research funding initiatives across the subspecialties of otolaryngology-head and neck surgery. Modeled after National Institutes of Health study sections, CORE grant review processes provide comprehensive reviews of scientific proposals. The organizational structure and grant review process support grant-writing skills, attention to study design, and other components of academic maturation toward securing external grants from the National Institutes of Health or other agencies. As a learning community and a catalyst for scientific advances, CORE evaluates clinical, translational, basic science, and health services research. Amid the societal reckoning around long-standing social injustices and health inequities, an important question is to what extent CORE engenders diversity, equity, and inclusion for the otolaryngology workforce. This commentary explores CORE's track record as a stepping-stone for promoting equity and innovation in the specialty. Such insights can help maximize opportunities for cultivating diverse leaders across the career continuum.
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    An Unusual Retropharyngeal Lesion
    (AMA, 2021) Yang, Christine J.; Novinger, Leah J.; Sim, Michael W.; Otolaryngology -- Head and Neck Surgery, School of Medicine
    A female smoker in her 50s was referred for hyperparathyroidism and a multinodular goiter. The patient reported symptoms of joint and musculoskeletal pain and fatigue but denied fever, sore throat, abdominal pain, and kidney stones. Her medical history was remarkable for congestive heart failure and schizophrenia. Neck examination revealed no meaningful findings except right thyroid enlargement. Results of laboratory evaluation demonstrated normal white blood cell count, borderline hypercalcemia (10.6 mg/dL), and elevated parathyroid hormone level (208 pg/mL). She underwent ultrasonography at an outside facility, and results demonstrated a 2.2-cm dominant right thyroid nodule with additional smaller thyroid nodules. Findings of preoperative technetium-99m (Tc-99m) sestamibi planar and single-photon emission computed tomographic/computed tomographic (SPECT/CT) imaging (Figure, A) were nonlocalizing for a parathyroid adenoma and showed increased uptake in the dominant right thyroid nodule (Figure, B). Results of an ultrasound-guided biopsy of the thyroid nodule demonstrated a benign colloid nodule with cystic changes. Computed tomography with intravenous contrast was obtained, and findings were initially reported as negative except for right multinodular goiter. However, on additional review, a well-circumscribed fat density mass measuring 3.0 × 2.3 × 1.1-cm was identified in the right retropharyngeal space posterior to the hypopharynx (Figure, C).
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    Use of Thromboelastography and Rotational Thromboelastometry in Otolaryngology: A Narrative Review
    (MDPI, 2022-02) Marsee, Mathew K.; Shariff, Faisal S.; Wiarda, Grant; Watson, Patrick J.; Sualeh, Ali H.; Brenner, Toby J.; McCoy, Max L.; Al-Fadhl, Hamid D.; Jones, Alexander J.; Davis, Patrick K.; Zimmer, David; Folsom, Craig; Medicine, School of Medicine
    In the field of otolaryngology—head and neck surgery (ENT), coagulopathies present unique diagnostic and therapeutic challenges. In both hyper- and hypocoagulable patients, management of coagulopathies requires intricate attention to the nature of hemostatic competence. Common coagulation tests (CCTs) offer only a snapshot of hemostatic competence and do not provide a clear insight into the patient’s real-time hemostatic condition. Viscoelastic tests (VETs) offer a holistic and concurrent picture of the coagulation process. Although VETs have found prominent utilization in hepatic transplants, obstetrics, and emergent surgical settings, they have not been fully adopted in the realm of otolaryngology. The objective of this manuscript is to provide an overview of the literature evaluating the current utilization and possible future uses of VETs in the field of otolaryngology. The authors performed a comprehensive literature search of the utilization of VETs in otolaryngology and identified applicable studies that included descriptions of viscoelastic testing. Twenty-five studies were identified in this search, spanning topics from head and neck oncology, microvascular free flap reconstruction, obstructive sleep apnea, adenotonsillectomy, facial trauma, and epistaxis. The applicability of VETs has been demonstrated in head and neck oncology and microvascular free flap management, although their pervasiveness in practice is limited. Underutilization of VETs in the field of otolaryngology may be due to a lack of familiarity of the tests amongst practitioners. Instead, most otolaryngologists continue to rely on CCTs, including PT, PTT, INR, CBC, fibrinogen levels, and thrombin time. Learning to perform, interpret, and skillfully employ VETs in clinical and operative practice can greatly improve the management of coagulopathic patients who are at increased risk of bleeding or thrombosis.