bluuebunny/crossref_metadata_2025 huggingface dataset:
Ethnic Considerations in the International Rhinoplasty Patient
Authors: Cobo‐Sefair Roxana , Pham Tuan V. , Nolsttrenite Gilbert , Palma Pietro , Kim David W. , Montes Jose J.
Published: September 2011

Program Description

Cosmetic rhinoplasty has grown in demand over the years. Because of migration patterns around the world, specialists who perform rhinoplasties will frequently be performing surgery on patients coming from different ethnic groups. Characteristic ethnic features can be hard to define and it can be very difficult to try and “fit” a patient in a specific geographical group. Rhinoplasty in ethnic patients, no matter where they come from, will involve most of the usual techniques that are employed in rhinoplasty. However, how the patient is evaluated, what problems are encountered, and what possible solutions are offered make it a challenging operation. The goal in rhinoplasty today is to achieve a natural non‐operated looking nose that will blend in with the patient’s face preserving its main ethnic features. Radical changes in appearance have been replaced by techniques that offer refinement and will provide stable long term results. This panel of experts coming from different countries around the world will be showing the audience how they approach the different types of ethnic patients. The discussion will focus on specific problems encountered and how they are approached surgically. Demonstrative cases showing pre‐ and postsurgical results with intraoperative photographs and videos on the different surgical techniques used will be shown. At the end of each presentation panelists will be showing the attendees how they try to prevent complications on their specific patients. Some final controversies regarding patient satisfaction and revision cases will be discussed at the end of the session.

Educational Objectives

1) Identify the main anatomic and aesthetic differences encountered in ethnic groups around the world. 2) Be able to identify problems encountered in ethnic noses and establish possible surgical solutions. 3) Acquire a general overview on the prevention and management of possible complications.
Repairing the Externally Crooked Nose: Are There Any Straight Answers?
Authors: Chang C. W. David , Tollefson Travis T. , Marcus Benjamin C. , Wayne Ivan , Chang Edward W.
Published: September 2011

Program Description

The crooked nose—and its aesthetic and functional issues—is a challenge frequently encountered by practicing otolaryngologists. Repair is not always straightforward and residual deformities can be distressing for the patient as well as the surgeon. With the prominence of the nose as a central defining feature of the face, any deviation is easily recognized since it detracts from overall facial symmetry. The purpose of this miniseminar, created by the Facial Plastic and Reconstructive Surgery Education Committee, is to shed light on the diagnostic and technical challenges of repairing the crooked nose. Panelists will focus on careful analysis of the anatomic factors responsible and highlight a repertoire of corrective surgical techniques. Discussion of the topic will be divided into the various thirds of the nose: the bony nasal vault, the cartilaginous mid‐vault, and the nasal tip and caudal septum. Management strategies to be discussed include new osteotomy techniques, suture techniques, cartilage grafting, extracorporeal septoplasty, and tip‐plasty. In contrast to the external rhinoplasty approach, the endonasal approach provides an alternative strategy—and perhaps a different philosophy—to addressing asymmetries of the nose. The role of endonasal rhinoplasty techniques will be presented. Whenever possible, literature will be referenced to support the discussion. The crooked nose is often caused by a complex interplay between bony and cartilaginous deformities, as well as scarring forces especially in traumatic and revision cases. Surgical strategies combine anatomic restoration with camouflage. A surgical plan requires not only an understanding of operative technique but also an understanding of the surgical expectations of the patient. Therefore, cases and patient scenarios will be presented by the moderator to the panelists (and the audience) for discussion. This miniseminar hopes to provide a nuanced understanding of rhinoplasty concepts and techniques that would be appreciated by seasoned surgeons and provide insight to the novice.

Educational Objectives

1) Recognize the various deformities and anatomic factors responsible for the crooked nose. 2) Learn to correct the bony nasal vault, cartilaginous mid‐vault, and nasal tip and caudal septum. 3) Appreciate benefits and limitations of the external versus endonasal rhinoplasty approach to straighten the nose.
Alternative Treatments to Common Otolaryngology Problems: Help or Harm?
Authors: Pribitkin Edmund A. , Mann Eric A. , Nguyen Chau T. , Artz Gregory J. , Seidman Michael D. , Wang Marilene B. , Shah Udayan K.
Published: September 2011

Program Description

Each speaker will review the evidence‐based rationale for integrative therapy of common but difficult to treat ENT ailments. Topics will include: Ear wax: Dangers of ear candling—Eric Mann, MD; Tinnitus: What’s the evidence for gingko biloba, bioflavanoid and antioxidant therapies?—Michael Seidman, MD; Meniere’s Disease & vertigo: Should the FDA approve Betahistamine for Meniere’s Disease in the United States? Can acupuncture and cervical manipulation prevent symptoms? What are the best diet‐based regimens?—Gregory Artz, MD; Allergic rhinosinusitis: Do clinical trials support the use of Quercetin, Sinupret, Butterbur, and other herbal remedies? Should patients irrigate their nasal passages and, if so, what should they use?—Marilyn B. Wang, MD; Atypical Facial Pain: Does Acupuncture provide superior analgesia?—Chao T. Nguyen, MD; Perioperative Considerations: Can arnica and bromelain really lessen bruising and speed healing? What herbals and supplements must be avoided before and after surgery?—Edmund Pribitkin, MD; Medicolegal risks and opportunities related to integrative therapies—Udayan Shah, MD

Educational Objectives

1) Be able to identify harmful and helpful alternative therapies and counsel patients accordingly. 2) Integrate alternative therapies into their treatment regimens for common ENT ailments. 3) Understand medicolegal ramifications of introducing alternative therapies into their practice.
Avoiding the “Deadly Sins” of Humanitarian Missions: How to “Do Good” Better
Authors: McMains Kevin C. , Boston Mark E. , Holt G. Richard , Discolo Christopher , Cordes Susan R. , Westerberg Brian D.
Published: September 2011

Program Description

Over the past several decades, the numbers of North American physicians and surgeons engaged in international humanitarian missions has increased dramatically. Such trips often provide an opportunity for needy individuals and communities to receive care that would otherwise be unavailable to them. They also provide the opportunity for participants to “give back” through providing direct patient care and teaching in an environment of extreme need. Personal motivations, level of ability of the individual practitioner, sophistication of the mission organization, as well as level of connectedness to “in country” providers varies dramatically among mission groups. This variability has contributed to some unfortunate patient outcomes. Accusations that “surgical safaris” represent a “form of Neo‐colonialism” have cast doubt on the motivations of participants and brought significant scrutiny to the true benefits arising from these efforts. This interactive miniseminar will explore “deadly sins” which are common to medical humanitarian efforts as well as issues which are unique to surgical humanitarian missions. Panelists will discuss available data and areas in which there is a lack of data concerning humanitarian efforts. Finally, “best practices” for humanitarian missions will be discussed. Issues to be discussed include appropriate standard of care, duration, follow‐up, conduct of research, resident trainee participation in surgical procedures, role of the media, and integration with local care systems.

Educational Objectives

1) Identify common problems encountered during medical and surgical humanitarian mission trips. 2) Understand ethical concerns arising during international humanitarian efforts. 3) Apply best practices for conduct of humanitarian mission trips in which they are involved.
Getting Published: How to Write Case Series and Case Reports
Authors: Rosenfeld Richard M. , Har‐El Gady , Cavanagh Eileen , Pugh Courtney
Published: September 2011

Program Description

This miniseminar, taught by editors, staff, and the publisher of the journal Otolaryngology–Head and Neck Surgery, will help attendees maximize their success in getting case reports and case series published. Tips and pointers will be presented on writing and organizing the manuscript, dealing with ethics review and patient privacy concerns, using the right terminology for the right message, and avoiding pitfalls that might delay or prevent manuscript acceptance. The best case reports describe a unique or nearly unique case, an important variation (outlier case), unexpected outcome or adverse event, or unexpected association between diseases or disorders. Manuscripts are most likely to be accepted if they state why the case is worth reading, describe the case and all relevant data, discuss why the case is unique or unexpected, provide alternative explanations for case features, and offer clinical implications. The best case series include a consecutive well‐defined sample of subjects, report interventions with enough detail for reproduction, account for all patients initially assessed and enrolled, and provide adequate follow‐up with descriptions of dropouts and losses. Manuscripts are most likely to be accepted it they include statistical analysis and reach justifiable conclusions devoid of efficacy claims. The goal of the session is to help attendees publish meaningful and valid research that can help journal readers provide enhanced patient care. Time is allotted at the end of the session for audience questions to the expert panel.

Educational Objectives

1) Learn strategies to maximize success in publishing case reports and case series. 2) Understand the role of ethics review and informed consent in observational research. 3) Avoid pitfalls that might delay or prevent acceptance of a manuscript for publication.
Innovations in Thyroid and Parathyroid Surgery
Authors: Kuppersmith Ronald B. , Pellitteri Phillip K. , Randolph Gregory W. , Steward David L. , Terris David J.
Published: September 2011

Program Description

Over the past several years new technologies, potentially offering safer or less invasive techniques, have been applied to surgery of the thyroid and parathyroid glands. While these technologies may offer benefits to surgeons and patients, each has an associated learning curve and incremental costs compared to the standard techniques. The purpose of this miniseminar is to examine some of these “advances” (in‐office ultrasound, laryngeal nerve monitoring, intra‐operative parathyroid hormone measurement, minimally invasive and alternate surgical approaches) and to evaluate the benefits and costs and provide guidance for when these technologies should properly be used. Additionally, guidance for how general otolaryngologists can learn these techniques and how these technologies relate to the concept of “standard‐of‐care” will be addressed. Audience participation will be used to solicit information about usage of these technologies among the membership and to obtain audience opinion to help facilitate discussion.

Educational Objectives

1) Describe the indications for using new technology in thyroid and parathyroid surgery. 2) Understand the costs and benefits related to using new technology in thyroid and parathyroid surgery. 3) Determine further training necessary to incorporate new technology into practice.
Lifelong Learning as Part of the Quality Improvement Process
Authors: Wax Mark K. , Miller Robert H. , Nielsen David R.
Published: September 2011

Program Description

Lifelong learning is a process that begins when one enters medical school. It continues throughout residency and practice. With a constantly evolving and changing knowledge base, it provides tools for a continual educational process for the clinician. Lifelong learning has been mandated as a core essential element of both professional training, as well as maintenance of professional standing. The field of continuing medical education has evolved to meet this demand. The tools and methodologies available to the practicing clinician in today’s environment are constantly changing. In the past decade or so we have seen a change from education products being enduring materials, such as textbooks and journals to online on demand materials. This evolution has been brought about by not only improved technology but by advances in the understanding of how we learn. This miniseminar will initiate with a concept of how lifelong learning fits into residency training. The role of this competency and how it is managed in residency will be discussed. The evolution of the ability to measure and the different measurement tools available will be presented. It will then move into CME materials that are currently available on the market. The commonest materials will be demonstrated and an understanding of how online educational activities can contribute to online learning will be shown. A discussion of the new rules of CME that are on the horizon and how they impact physician interaction with pharmaceutical manufacturing and the requirements for measurement of outcomes will be presented. Each of us is soon going to be required to identify practice gaps and then demonstrate how we have addressed them. Finally we will have to demonstrate how we have changed our practice with this knowledge. The miniseminar will end with a discussion on how lifelong learning fits into the maintenance of the Certification Program of the American Board of Otolaryngology. The role of online education and certification of competence will be demonstrated.

Educational Objectives

1) Learn how to better able relate to the historical and evolutionary change in lifelong learning. 2) Understand online learning materials and how to integrate this teaching into identifying practice gaps and then modifying those gaps to provide the best possible care.
Advances in Head and Neck Ultrasound and Their Clinical Applications
Authors: Sofferman Robert A. , Ahuja Anil , Orloff Lisa A. , McIver Brian
Published: September 2011

Program Description

Office‐based ultrasound of the thyroid and neck is now a standard imaging tool for otolaryngologists, endocrinologists, and surgical clinicians. Training courses in the use of ultrasound are now well‐structured and available to clinicians in their related disciplines. Yet, as with all standard technology, new applications and refinements have expanded both the resolution of image quality and uses of ultrasound beyond what was initially envisioned. Through the use of both short didactic presentations and directed questions with clinical case examples from the moderator, this panel of experts will discuss several new frontiers of ultrasound. Techniques that optimize cytologic aspiration, indications and use of core biopsy, alcohol ablation of thyroid cysts, and selection of cases of lymph node ablation with papillary carcinoma, elastography, and the evolving use of radiofrequency ablation and contrast enhanced ultrasound are some of the topics that will be covered. An emphasis on how best to improve the standard use of head and neck ultrasound will make this a practical seminar for the otolaryngologist as well as an important glimpse into the near future.

Educational Objectives

1) The seminar attendee should learn new advances in obtaining cytologic samples with ultrasound. 2) The seminar attendee will understand new advances in destroying malignant lymph nodes and cysts of the thyroid gland including advantages and disadvantages of the technology compared with conventional surgery. 3) The seminar attendee will learn new adjunctive technologies to ultrasound such as elastography and contrast imaging.
Management of the Neck in HNSCC: Controversies and Guidelines in 2011
Authors: Wang Marilene B. , Gosselin Benoit J. , Deschler Daniel G. , Lai Stephen Y. , Robbins K. Thomas
Published: September 2011

Program Description

Neck dissection continues to be an integral part of surgical treatment of head and neck squamous cell carcinoma (HNSCC). The operation has evolved significantly since first described by Crile and others more than 100 years ago. With the development of more precise imaging modalities, chemoradiation treatment protocols, and transoral laser (TLM) and robotic (TORS) surgery, it is important to reexamine guidelines for management of the neck. This miniseminar will focus on several relevant topics pertaining to treatment of the neck in HNSCC: 1) The role of imaging in planning treatment of the neck will be discussed. Pre‐treatment imaging with PET, CT, and MRI can yield valuable information regarding subclinical neck metastases and may help in treatment planning, particularly for T1 and T2 primary tumors. The timing and optimal modality for post‐chemoradiation imaging remains controversial. 2) The advantages and disadvantages for upfront neck dissection for small and unknown primary HNSCC will be addressed. Elective neck dissection vs radiation vs observation for clinically negative necks will be discussed. 3) Management of the neck in conjunction with TLM/TORS will be examined. With increasing use of TLM/TORS for surgical management of HNSCC, it is essential that the neck is treated appropriately. Guidelines for neck dissection in conjunction with TLM/TORS will be outlined. 4) Paradigms for management of the neck following chemoradiation continue to evolve. Chemoradiation protocols for HNSCC are effective in eradicating advanced nodal disease as well as the primary tumor. Thus, the use of planned neck dissection for N2 and N3 disease following completion of chemoradiation is giving way to the use of salvage neck dissection. Also, concepts have changed toward the use of more limited neck dissections. Finally, challenging cases involving management of neck disease will be presented to the panel of experts, for discussion and audience participation.

Educational Objectives

1) Understand the role of imaging in planning treatment of the neck. 2) Understand how to manage the neck in conjunction with TLM/TORS. 3) Understand how paradigms for management of the neck following chemoradiation have evolved.
Robotic Head and Neck Surgery: Lessons Learned and Future Opportunities
Authors: Terris David J. , Weinstein Gregory S. , Singer Michael C. , Magnuson J. Scott , Holsinger F. Christopher
Published: September 2011

Program Description

Robotic technology has penetrated most surgical disciplines in the past 5 years, and has now been embraced for a number of head and neck applications including transoral resection of aerodigestive tumors and thyroidectomy. Undoubtedly, further expansion of robotic procedures can be anticipated, and it is prudent to learn from challenges encountered during the development process. Experts in the field of robotic surgery will describe the development of this technology as it relates to specific procedures, and the following questions will be addressed by each discussant: 1) What was the compelling motivation to explore robotic application to the specific procedure? 2) What were the principal challenges encountered in refining and exporting the techniques learned? 3) If you had to do it over again, what would you have done differently in either development, training, or early application of the technique? 4) How do the costs compare with the patient benefit? The topics that will be addressed are transoral resection of supraglottic and oropharyngeal tumors, transoral surgery for benign conditions, remote access thyroidectomy, and novel applications under development (including neck dissection and skull base surgery). This will be an interactive session and audience participation will be actively encouraged. The difficult questions regarding this new technology will be asked, including cost‐benefit ratios and responsible implementation among general practices.

Educational Objectives

1) Recognize the transoral application of robotic technology for benign and malignant supraglottic and oropharyngeal conditions. 2) Understand the current state‐of‐the‐art robotic approach to remote access thyroidectomy. 3) Become familiar with novel applications under development (including neck dissection and skull base surgery).
The American Thyroid Association Guidelines: Do We All Agree?
Authors: Witt Robert L. , Komisar Arnold , Coltrera Marc D. , Shaha Ashok R. , Wang Robert C. , Pribitkin Edmund A. , Holsinger F. Christopher
Published: September 2011

Program Description

The theme of this audience interactive miniseminar is to incorporate what is new and controversial in the management of differentiated thyroid cancer as well as to examine the level that molecular biology is incorporated into the management of thyroid neoplasms. The American Thyroid Guidelines for differentiated thyroid cancer are a widely quoted document. The level of evidence on which these recommendations are made varies extensively leaving considerable room for debate. Some aspects of surgical management such as laryngoscopy, bronchoscopy, and neuro‐monitoring are left out of the document. The moderator will provide a brief background power‐point presentation on the pertinent ATA guideline as a template. Expert panelists will debate case presentations germane to the given guideline and determine the level of agreement. Audience interactive opinion will be sought. The specific guidelines (where applicable) and case presentations will include: 1) Ultrasound indications for fine needle aspiration and the use of molecular markers from the FNA; 2) Laryngoscopy and neuro‐monitoring; 3) Extent of initial surgical therapy for low‐risk differentiated thyroid neoplasms and the potential role for molecular markers; 4) Bronchoscopy, preparation for airway management and extent of surgery for high risk patients with extra‐thyroidal spread; and 5) Surgery for recurrent differentiated thyroid cancer and the role of molecular targeted therapy. Panelists and the interactive audience will give opinions on the relevance of the ATA guidelines to their thyroid surgical practice.

Educational Objectives

1) Learn the benefits and limitations of the American Thyroid Association Guidelines. 2) Learn about molecular markers for diagnosis, prognostication, and molecular‐targeted therapy. 3) Learn about ultrasound‐guided FNA, management of low‐ and high‐risk patients, and recurrence.
Laryngology/Broncho‐Esophagology
Authors: Soliman Ahmed M. , Lintzenich Catherine J. , Merati Albert L. , Leahy Kevin
Published: September 2011

Program Description

Adult laryngotracheal stenosis (LTS) is a very old problem which continues to represent a diagnostic and treatment challenge for the otolaryngologist. It is distinct in many ways from similar disease seen in the pediatric population. The goal of this miniseminar is to outline the evaluation and management of this disorder. Presenters will discuss the diagnosis and treatment of this condition including airway management, as well as office‐based, endoscopic and open procedures. In addition, recent information on the molecular basis of LTS will be presented. Challenging cases will be presented for discussion.

Educational Objectives

1) Be able to list the most common etiologies of laryngotracheal stenosis in adults. 2) Understand the various treatment options available for the treatment of laryngotracheal stenosis. 3) Understand the molecular basis of laryngotracheal stenosis.
Finding Balance in a Surgical Career
Authors: Simon Lawrence M. , Wynn Rhoda , Derebery Jennifer , Smith Richard J. H. , Magit Anthony E. , Clarke Beth
Published: September 2011

Program Description

One of the most common problems many physicians struggle with is maintaining work‐life balance. As physicians, we all face extraordinary demands on our time and need to learn how to balance the demands of our careers and family, while also allowing time to cultivate personal interests. Dealing with all of these demands creates stress for both physicians and their families. During this interactive miniseminar, practical techniques and pearls regarding time management and work‐life balance will be shared by fellow otolaryngologists. The panel will include both private and academic otolaryngologists who manage busy practices and make substantial contributions to their institutions and specialty societies, while maintaining strong relationships with their friends and families and pursuing interests outside of medicine.

Educational Objectives

1) Identify obstacles to work‐life balance and achieving personal and professional goals. 2) Develop time management and efficient communication skills at work such as how to organize your schedule, control the pace of patient encounters, and trim work flow. 3) Streamline personal errands and chores to maximize time spent with family and interests.
Current Management of Adult HPV: From Papilloma to Cancer
Authors: Meyer Tanya K. , Sewell Duane , Inglis Andrew F. , Burns James A. , Leiserowitz Gary
Published: September 2011

Program Description

Human papilloma virus (HPV) infection is a major cause of disease. It is causal in respiratory papillomatosis and cervical cancer and is etiologically associated with cancers of the oropharynx as well as additional anogenital sites. Our knowledge of the role of HPV in these diseases is evolving and there are yet many unanswered questions. Furthermore, the epidemiology of these diseases may change with trends in increasing promiscuity and the advent of widespread HPV vaccination. Patients have often read extensively about their diagnosis on the internet and may present with incomplete/incorrect knowledge and difficult questions about disease transmission, progression, treatment and transformation. This miniseminar brings together experts that specialize in different manifestations of HPV disease: adult and pediatric clinicians that treat recurrent respiratory papilloma (RRP), a head and neck surgeon that treats oropharyngeal carcinoma and actively researches vaccines targeting HPV related malignancy, and a guest clinician from gynecology to give insights on the treatment of HPV from a different perspective. The format will focus on case presentations to highlight the specific topics selected for discussion to include: basic biology of HPV infection and oncogenesis, treatment strategies for RRP, adjuvant treatments for RRP, counseling regarding contacts of patients with HPV related disease, HPV vaccine indications, and current concepts regarding the role of HPV in oropharyngeal cancer. There will be opportunity for the audience to ask questions throughout the presentation.

Educational Objectives

1) Understand current RRP management strategies including surgical techniques, adjuvant medications and nutritional supplements. 2) Be able to counsel patients on etiology of RRP, transmission, cancer risk, and vaccination. 3) Understand how RRP fits in the spectrum of HPV‐related disease.
Laryngopharyngeal Reflux (LPR)
Authors: Marple Bradley F. , Fried Marvin P. , Krouse John H. , Postma Gregory N. , Altman Kenneth W. , DelGaudio John
Published: September 2011

Program Description

Objective: Develop a working algorithm that effectively eliminates dangerous conditions while efficiently provides reasonable alternatives to address LPR symptoms. Methods: use an audience response system in combination with a structured set of questions directed to the audience. End result: a real world proposed treatment algorithm. White paper. Possible basis for outcomes assessment study. The overall goal of this session is to define current practice trends on the management of laryngopharyngeal reflux (LPR) based on actual audience participation/input, and the consideration of appropriate management for a typical patient. Using an interactive panel format, the moderator will prompt panelists to present a quick review of epidemiology, symptomatology, and co‐morbid conditions impacting laryngopharyngeal reflux (LPR); diagnosis/differential diagnosis; current evidence on diagnostic and therapeutic management; and future research and management implications. After laying out background, the moderator/panel will consider real world patient management algorithms.

Educational Objectives

1) Who is the typical patient presenting with laryngopharyngeal reflux (LPR) in an otolaryngology practice? 2) What diagnostic testing options are or should be employed? What are the common treatment pathways? 3) What differential data should be considered? What health care costs impact diagnosis/treatment? When is referral recommended?
Updates and Innovations in Pediatric Laryngology
Authors: Rickert Scott M. , Merati Albert L. , Hartnick Christopher J. , Zur Karen B. , Statham Melissa M.
Published: September 2011

Program Description

The field of pediatric laryngology has experienced tremendous growth in the past few years; the increased focus on voice‐related quality of life issues in pediatric airway is a prime example of this. Much in the development of pediatric laryngology reflects the complementary efforts of laryngologists and pediatric otolaryngologists supported by key technological advancements. This miniseminar incorporates the viewpoints of several clinicians experienced in the management of pediatric laryngeal disorders, particularly those related to voice. The presenters will focus on clinically relevant matters for both general and specialty otolaryngologists, including diagnosis, common pathologies, as well as both operative and non‐operative approaches and techniques. The anatomical and physiological basis for pediatric laryngology care will be reviewed. Specific components of the interactive session will include addressing these questions: What is the role of videostroboscopy in children? What is the role of FEES and FEESST testing in children? What is the role of in‐office tracheobronchoscopy? Who should be referred for these tests? Fundamental pathologies impacting pediatric laryngology will be reviewed, including benign vocal lesions, RRP, laryngeal webs, subglottic stenosis, and hemangioma. Non‐operative innovations will be discussed including propanolol, mitomycin, steroids, Botulinum toxin, and fillers. Operative innovations will include the use of cold versus laser technique for benign lesions, a brief discussion of open techniques, and recent augmentations to standard open techniques. Differing practical approaches for operative and non‐operative techniques will be discussed in a panel format with presentations of challenging cases after the initial diagnostic, pathological, and interventional options have been discussed in a lecture format.

Educational Objectives

1) Understand the clinical role of specific diagnostic tests in pediatric laryngology. 2) Approach clinical issues in pediatric laryngology and address them with practical non‐operative and operative solutions. 3) Understand the clinical advantages and disadvantages of individual non‐operative and operative solutions.
Clinical Practice Guideline: Sudden Hearing Loss
Authors: Stachler Robert J. , Chandrasekhar Sujana S. , Archer Sanford M. , Rosenfeld Richard M. , Schwartz Seth R.
Published: September 2011

Program Description

The miniseminar will consist of a lively panel discussion on the evidence‐based recommendations for the diagnosis and treatment of sudden hearing loss. The panel will discuss the newly developed AAO‐HNS clinical practice guideline. The primary purpose of the guideline is to improve the diagnosis and management of sudden hearing loss in adults aged 18 years and older. In creating this guideline the AAO‐HNSF selected a panel representing the fields of otolaryngology‐head and neck surgery, audiology, otology, neurology, neurotology, family medicine, emergency medicine, and consumers.

Educational Objectives

1) Learn diagnostic criteria for sudden sensorineural hearing loss. 2) Plan treatment based on current best evidence from randomized, controlled trials. 3) Identify management and counseling strategies that improve quality of care.
Endoscopic Middle Ear Surgery: Tips and Pearls
Authors: Nogueira Joao‐Flavio , Tarabichi Muaaz , Marchioni Daniele
Published: September 2011

Program Description

Middle ear surgery can generally be performed with the aid of an operating microscope. However, under a potentially minimally invasive trans‐canal approach, it is very difficult to operate on several sites using a microscope alone unless the surrounding bone is removed and retro‐auricular approaches are performed. Such sites may include the epitympanum as well as the inferior and posterior parts of the mesotympanum. Although it has been more than 15 years since the introduction of operative endoscopy to middle ear surgery there is still a very limited role for the endoscope in the surgical management of middle ear disease across the globe. There are several possible reasons for that, such as the current idea of a limited and marginal role for endoscopes in middle ear surgery, a potentially long learning curve through the hassles and tribulations of adapting newer techniques and newer instrumentation, and some resistance, especially with otologists who are very comfortable with the use of microscopes. The operating microscope provides a very good quality magnified image in a straight line, however, the surgeon’s field of view is limited to the narrowest segment of the ear canal when using a transcanal approach. On the other hand, endoscopes also provide a magnified vision that enables the ability to change rapidly from a close‐up to a wide angle view, just by going closer or by withdrawing the instrument. Further, it provides an all‐round vision to the surgeon who can rotate angled endoscopes to visualize the deep and hidden structures. In this miniseminar, we are going to discuss, with the help of very nice quality surgical movies, endoscopic anatomic dissection images and videos, virtual reality objects and also augmented reality capability the current techniques for endoscopic middle ear dissection, and surgical management of several middle ear diseases, such as tympanic membrane perforations, cholesteatomas, ossicular chain reconstruction and also stapedotomies, all performed with endoscopes discussing and commenting the equipment needed, surgical indications, also showing the potential advantages and disadvantages of the procedures, postoperative care and results and some interesting tips and pearls regarding this new way to surgically manage middle ear diseases.

Educational Objectives

1) Learn and review the endoscopic anatomy of the middle ear, discussing anatomic landmarks. 2) Identify the actual indications and limitations of this minimally invasive approach. 3) Describe and demonstrate step‐wise endoscopic middle ear approaches for several diseases of this area.
Managing Cochlear Implant Complications
Authors: Pollak Natasha , Roland J. Thomas , Roland Peter S. , Meyer Ted A. , Chen Douglas A.
Published: September 2011

Program Description

This miniseminar is designed for otolaryngologists who include cochlear implants in the scope of their practice and would like to learn more about managing various intraoperative and postoperative complications, and special considerations as they inevitably arise. Particularly useful for otologic surgeons who have small to moderate cochlear implant case volumes, this seminar will address common as well as less common complications and provide a framework for systematically and effectively managing them. A panel of experts consists of four otologists who run busy, mature cochlear implant programs and have extensive experience in managing various implant‐related issues. During the first hour, each panelist will give a brief presentation. Topics include: analyzing suspected device failures, evaluation and revision of inappropriate electrode placement, management of CSF gushers and leaks, management of skin ulceration, skin breakdown and device exposure, management of wound infection and device infection. The following half hour will be reserved for discussion of individual case scenarios. The moderator will present cases to the expert panel for discussion. Members of the audience are encouraged to participate in the discussion, ask questions, and present their own cases to the panel. Attendees will learn how to avoid common intraoperative complications and how to better manage complications when they do occur. The aim of this miniseminar is to allow the attendees to benefit from the experience of our panelists and provide them with “tried and true” techniques that can be implemented in their own cochlear implant programs, ultimately improving the scope and quality of cochlear implant services available nationally and internationally.

Educational Objectives

1) Identify and manage a variety of complications related to cochlear implants with more confidence. 2) Learn to evaluate suspected cochlear implant device failures and need for revisions. 3) Learn an operative technique for managing a CSF gusher.
Otitis Media: Evidence‐Based Reviews to Change Practice
Authors: Burton Martin J. , Rosenfeld Richard M. , Schilder Anne G. M.
Published: September 2011

Program Description

Clinical practice must change and evolve in response to the regular, systematic review of new high quality evidence, considered alongside the existing knowledge base. Clinical effectiveness and cost‐effectiveness must be evaluated and up‐to‐date practice guidance must reflect these evaluations. The three speakers are practicing clinicians with expertise in the critical appraisal and synthesis of clinical research evidence, including formal systematic review and meta‐analysis. They will discuss three important areas of pediatric otolaryngological practice in this session: the use of 1) pneumococcal conjugate vaccination against acute otitis media (AOM) in children, 2) antibiotics for AOM, and 3) ventilation tubes for otitis media with effusion (OME). The session will emphasize the practical implementation of research evidence.

Educational Objectives

1) Appreciate the role of high‐quality systematic reviews in implementing best clinical practice. 2) Understand the advantages and disadvantages of pneumococcal conjugate vaccines in managing children with acute otitis media (AOM). 3) Understand the benefits and harms of anti‐microbial chemotherapy in managing children with AOM and understand the implications and limitations of the evidence‐base for ventilation tubes in children with OME derived from randomized controlled trials.
Pediatric Sinusitis: Drugs and Devices
Authors: Rimell Frank L. , Ramadan Hassan H. , Manning Scott C. , Shah Udayan K.
Published: September 2011

Program Description

Pediatric sinusitis is a major source of patient referrals for the otolaryngologist. The issue of diagnosis and treatment differs from the adult with regard to pathophysiology, management, and patient cooperation. This seminar will focus on the current state of drugs and devices used to diagnose and treat pediatric sinusitis. The seminar will begin with the use of devices in children to diagnose chronic rhinosinusitis or differentiate rhinitis from sinusitis. Discussion will include the use of pediatric office endoscopy, endoscopic‐guided cultures, CT scanning, pH probe testing and other devices. We will also discuss how they should be used in the office on children. The seminar will then progress to the use of drugs and devices in the management and treatment of pediatric sinusitis. This discussion will include adenoidectomy and associated devices, culture techniques, balloon sinus surgery, and associated minimally invasive devices as well as traditional endoscopic surgical techniques. Further discussion will focus on various endoscopic surgical drugs and devices applied to the pediatric patient both intraoperative and postoperative. Drugs discussed for the treatment and management of pediatric sinusitis will include intravenous antibiotics, topical aerosol therapy, mucolytic agents, steroids, and intranasal packing and stents. Presentations will also occur on the pediatric patient with special issues and sinusitis such as immunologic deficiencies and cystic fibrosis. This will be a presentation based on the current literature, extensive clinical experience and case studies. Panel discussions and opinion by pediatric otolaryngologist with extensive experience will be a major part of this seminar.

Educational Objectives

1) Discuss and present drugs and medical devices currently used to diagnose and treat pediatric sinusitis. 2) Present current medical devices and techniques used to treat pediatric sinusitis in the operative setting. 3) Present current drugs and devices used to manage children with sinusitis and related medical disorders.
Practice Guideline: Polysomnography Before Tonsillectomy in Children
Authors: Roland Peter S. , Rosenfeld Richard M. , Mitchell Ron B. , Friedman Norman R.
Published: September 2011

Program Description

The miniseminar will consist of a lively panel discussion on the evidence‐based recommendations for the use of polysomnography in managing patients with sleep‐disordered breathing who are candidates for tonsillectomy, with or without adenoidectomy. The panel will discuss the newly developed AAO‐HNS clinical practice guideline for otolaryngologists. The primary purpose of this guideline is to improve the referral patterns for polysomnography for candidates for tonsillectomy, 2 to 18 years of age, when tonsillectomy is recommended for SDB. In creating this guideline the AAO‐HNSF selected a panel representing the fields of anesthesiology, pulmonology, otolaryngology‐head and neck surgery, pediatrics, and sleep medicine. The committee made recommendations that 1) Before performing tonsillectomy, the clinician should refer children with SDB for PSG if they exhibit any of the following: obesity, Down syndrome, craniofacial abnormalities, neuromuscular disorders, sickle cell disease, or mucopolysaccharidoses; 2) The clinician should advocate for PSG prior to tonsillectomy for SDB in children without any of the comorbid conditions listed in statement No. 1 for whom the need for surgery is uncertain or when there is discordance between tonsillar size on physical examination and the reported severity of SDB; 3) Clinicians should communicate the results of PSG to the anesthesiologist prior to the induction of anesthesia for tonsillectomy in a child with SDB; 4) Clinicians should admit children with OSA documented on PSG for inpatient, overnight monitoring after tonsillectomy if they are under age 3 years or have severe OSA (apnea‐hypopnea index of 10 or more obstructive events/hour, or have an oxygen saturation nadir less than 80%); and 5) In children for whom PSG is indicated to assess SDB prior to tonsillectomy, clinicians should obtain laboratory based PSG, when available, instead of portable monitoring (PM) with a home device. This guideline is intended to assist otolaryngologists‐head and neck surgeons in making evidence‐based decisions regarding PSG in children.

Educational Objectives

1) Understand when clinicians should refer children with SDB for PSG. 2) Use PSG results to identify children with SDB admitted for overnight observation following tonsillectomy. 3) Know why PSG performed in sleep laboratory is preferred over home PSG with portable monitoring devices.
Redefining Pediatric Rhinosinusitis
Authors: Parikh Sanjay R. , Lusk Rodney P. , Manning Scott C. , Muntz Harlan R.
Published: September 2011

Program Description

Over a decade has passed since the last comprehensive definition of pediatric rhinosinusitis was developed by an expert panel. In this miniseminar, international leaders in the field of pediatric rhinology will provide the latest evidence and experience regarding the definition of pediatric rhinosinusitis. Specifically, panelists will provide state‐of‐the‐art concepts regarding pediatric rhinosinusitis including contributing factors such as allergy, antigens, fungus, biofilms, and reflux. The panel will discuss the differences between acute and chronic pediatric rhinosinusitis and provide the audience with guidelines for the clinical evaluation of both. Finally, with the use of case presentations, the panel will discuss contemporary medical and surgical interventions for acute and chronic pediatric rhinosinusitis.

Educational Objectives

1) Understand the current definitions of acute and chronic pediatric rhinosinusitis. 2) Understand contributing factors to pediatric rhinosinusitis including allergy, fungus, biofilms, and reflux. 3) Understand contemporary treatment options for acute and chronic pediatric rhinosinusitis.
ICD‐9‐CM to ICD‐10‐CM Transition
Authors: Waguespack Richard W. , Buckholtz Rhonda
Published: September 2011

Program Description

This presentation will assist the ENT physician in determining the impact ICD‐10 will have to their practice and other health care providers and provide a timeline of essential activities for successful implementation. In this session we will delve into what physicians should expect to prepare for during implementation processes. This is the largest change to the healthcare system in our history and careful planning will be necessary in order to successfully implement both ICD‐10 and 5010. We will also explore common implementation hurdles, why it is so important to get started now, and how physicians will be impacted by clinical documentations issues. In addition we will go over the most commonly billed ENT diagnosis codes used now and what they will look like in ICD‐10‐CM.

Educational Objectives

1) Explore the history of ICD‐10‐CM and the impact to physicians. 2) Understand why an implementation timeline is important for successful implementation and how the proper steps can lessen impact of implementation. 3) Review ENT case examples for clinical documentation hurdles and specificity required in ICD‐10‐CM to properly assign codes.
Facts and Fictions about Non‐allergic Rhinitis
Authors: Toskala Elina M. , Krouse John H. , Naclerio Robert M. , Fokkens Wytske J. , Togias Alkis
Published: September 2011

Program Description

Background: AAAAI set up a working group for non‐allergic rhinitis (NAR) 2 years ago to describe established facts about NAR with the purpose of identifying gaps in our knowledge based on a comprehensive review of existing literature. Dr Toskala is a member of this working group and most of the review data is now available. Methods: A literature search spanning the years 1960‐2010 was performed and articles relevant to NAR were assigned into 7 categories. Information from each article was extracted into category‐specific databases. Descriptive analyses were conducted. Results: A total of 2000 articles were reviewed out of which 40% were deemed relevant for data extraction. Reviews were excluded. The majority of articles described prospective, controlled studies. Very few articles offered epidemiologic information. The lack of universal terminology and of NAR phenotyping using objective criteria were the most striking knowledge gaps. Pathophysiology research covered areas of nasal hyperreactivity and autonomic nerve dysfunction, but the evidence was inconclusive. The presence of mucosal inflammation may identify distinct NAR syndromes such as local allergy with local IgE production in the absence of systemic sensitization. Medical management studies suggest that intranasal steroids and topical antihistamines are useful in some patients with NAR, but the responder phenotype is unclear. In patients with excessive rhinorrhea, anticholinergic treatment is effective. The use of capsaicin is supported by one randomized, placebo‐controlled trial. Few combination trials were found. Many surgical procedures were reviewed, but there are no randomized controlled trials comparing medical versus surgical treatments.

Educational Objectives

1) Recognize, diagnosed and treat patients with NAR according to the evidence‐based data. 2) Give a comprehensive review of published data about NAR with classification of the evidence. 3) Identify the gaps in our knowledge about NAR.