bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cricopharyngeal Dysphagia: An Evidence‐Based Approach to Diagnosis and Management
Authors: Stachler Robert J. , Merati Albert L. , Amin Milan R. , Franco Ramon A. , Song Phillip 
Published: September 2011

Program DescriptionFor the past decade, the management of a cricopharyngeal dysphagia including a Zenker’s Diverticulum has predominantly been endoscopic. Recent literature has suggested that long‐term outcomes may not be as successful with the endoscopic technique as once believed. The purpose of this miniseminar is to thoroughly review the literature on this topic and present the most up to date, evidence‐based court room style debate on this topic. This 90‐min miniseminar will review: 1) the normal anatomy of the cricopharyngeus and the upper esophagus. 2) Methods of assessing this area, ie, radiographic, endoscopic, manometry, pH probe. 3) Medical management and its role in this disease process. 4) Surgical techniques: Open techniques: Diverticulectomy with stapled or hand‐sewn closure, diverticuloplasty, +/‐ cricopharyngeal myotomy. Closed (endoscopic) technique: diverticulotomy utilizing stapled, laser, bovie. 5) What is the appropriate management of the patient with a When to botox? When to dilate? What are the long‐term results of this management? This miniseminar will be interactive. At numerous times during the discussion questions will be asked of the audience to keep them involved and entertained. The open vs closed surgical debate will be a court‐room style debate with the Moderator acting as the judge or arbitrator. Each presenter will have 8 mins to define their side of the argument and to present the data. Four minutes will be allowed for cross examination or rebuttal, 2 mins for the closing argument if needed. The audience will give the verdict at the end. A series of questions will be asked of the jury (audience) at the end. Events/Schedule: Normal anatomy of the cricopharyngeus and its assessment: 10 min (Robert Stachler, MD). Medical and surgical management of cricopharyngeal dysfunction: 20 min (Milan Amin, MD). Introduction of the debate of surgical management: 7 mins (Milan Amin, MD). Presiding Arbitrator: Robert J. Stachler, MD. Courtroom: 30 mins total. Pro‐open diverticulectomy: Al Meroti, MD; Pro‐endoscopic diverticulectomy: Phil Song, MD, Ramon Franco, MD. Questions and Answers (Case presentation if time allows): 20 mins. Miniseminar Evaluation for the Audience: This should be an interactive presentation with questions for the audience to answer and an opportunity for the audience to give a verdict on which technique seems to have the best evidence. This is not a question of right or wrong. It is a question of best evidence. The jury will be prompted on this very point. Decisions are rendered based on the best evidence only.Educational Objectives1) Appreciate the newest techniques available to manage cricopharyngeal dysphagia. 2) Evaluate and treat cricopharyngeal dysphagia. 3) Become facile with the medical management currently available to treat CP dysphagia.
Reducing Complications from Tracheotomy
Authors: Merati Albert L. , Halum Stacey L. , Postma Gregory N. , Arora Asit 
Published: September 2011

Program DescriptionWhile tracheotomies are regularly performed by otolaryngologists nationwide and abroad, technique and perioperative management vary widely between surgeons. Recently, the Academy Airway and Swallowing Committee performed a multi‐institutional study reviewing the technique, management, and outcomes from a large series of consecutive tracheotomies. We have used our study, as well as national and international databases to construct tracheotomy evidence‐based guidelines for the otolaryngologist. We will discuss incorporation of tracheostomy care teams for the merging of quality care, medical economics, and patient safety. Guidelines will be presented in an interactive format (surveying the audience on their current practices) with the goal of optimizing intraoperative patient safety and minimizing early and late postoperative complications.Educational Objectives1) Understand the management factors associated with tracheotomy complications. 2) Understand how tracheostomy care teams can optimize patient management. 3) Information will be presented in an interactive format with audience participation.
The Otolaryngologist’s Role in Management of Aspiration: A Practical Review
Authors: Khosla Sid , Merati Albert L. , Pitman Michael J. , Kelchner Lisa , Postma Gregory N. 
Published: September 2011

Program DescriptionAspiration pneumonia is a major problem in the geriatric population, in patients who are hospitalized long term, and for people with head and neck cancer. It is the second most common type of nosocomial infection, resulting in massive mortality and morbidity; in the elderly, the mortality rates range from 20% to 50%, with a rate as high as 80% in some studies. The health care costs associated with aspiration pneumonia are staggering. While aspiration pneumonia is often due to oropharyngeal or laryngeal disorders, the role of the otolaryngologist in diagnosing and managing aspiration can vary significantly; this purely clinical miniseminar will focus on how the general otolaryngologist can maximally contribute to the care of patients with aspiration. The panelists will discuss the following: 1) The practical value of multiple diagnostic modalities will be reviewed, including fiberoptic laryngoscopy, transnasal esophagoscopy (TNE), modified barium swallow and other radiological imaging, functional endoscopic evaluation of swallowing (FEES), sensory testing, pH and impedance probes, and high resolution manometry; 2) in‐office evaluation for surgical decision making; 3) when to perform a tracheotomy or refer for a gastrostomy tube; 4) nonsurgical treatment including swallowing therapy, stents, salivary control, injection of botulism toxin, and electrical stimulation; 5) surgical treatment including laryngeal framework surgery, cricopharyngeal myotomy, laryngeal suspension, laryngeal closure procedures, and sensory reinnervation. Illustrative cases will also be presented to highlight common dilemmas and challenges.Educational Objectives1) Describe how in‐office evaluation and procedures are useful for decision making in medical and surgical treatment. 2) Understand the value of different diagnostic modalities. 3) Describe medical and surgical treatments for aspiration.
Otology/Neurotology
Authors: Lalwani Anil K. , Buchman Craig A. , El‐Kashlan Hussam K. , Lustig Lawrence R. , McGrew Benjamin M. , Megerian Cliff A. 
Published: September 2011

Program DescriptionThe temporal bone is the home to and neighbor of a variety of critical neural and vascular structures that are at risk for injury during otologic surgery involving the middle ear and mastoid cavity. Their injury can have devastating consequences including hearing loss, facial nerve injury, central nervous system injury, or stroke. The challenge to the otologic surgeon is to eradicate disease, to preserve structure and function, and to avoid injury. Being prepared to handle expected and unexpected situations is the key to success for otologic or any other surgery. In this miniseminar, a panel of experts will specifically review: 1) How to avoid cholesteatoma recurrence; 2) strategies to prevent facial nerve injury; 3) what to do when the brain is injured; 4) avoiding and managing vascular injury; 5) what to do when the unexpected occurs during routine stapes surgery. The goal of the panel is to provide the tools necessary to become a more effective otologic surgeon and guidance for how to handle a variety of potential complications that may be encountered during routine ear surgery.Educational Objectives1) Understand surgical principles and techniques to avoid FN, vascular, and CNS injury during otologic surgery. 2) Understand strategies to effect total removal of cholesteatoma and minimize its recurrence. 3) Understand the state‐of‐the‐art approaches to minimizing and addressing complications of stapes surgery.
Challenging Problems in Clinical Otology
Authors: Micco Alan G. , Leonetti John P. , Derebery Jennifer , Haynes David S. , Angeli Simon L. 
Published: September 2011

Program DescriptionApproximately 35% of office visits in a general otolaryngologic practice are otologic in nature. Simple diagnosis such as cerumen impaction, presbycusis, or acute otitis media are very straight forward and rather easily treated. Other ear‐related issues can be more challenging and may require additional office time and resources to manage. This miniseminar will discuss the otologic evaluation and management of progressive SNHL, pulsatile tinnitus, referred otalgia, unilateral middle ear effusion, and osteoradionecrosis of the EAC. While the presentation of these issues may appear benign, they may represent a more serious underlying illness. Emphasis will be placed on a detailed differential diagnosis, and appropriate testing that should be considered by the general otolaryngologist. Audience participation will be encouraged through case presentations.Educational Objectives1) Recognize common patient presenting complaints that can be harbingers of a more serious problem. 2) Understand the basic workup that should be performed prior to referring the patient to a subspecialist. 3) Understand the essential treatment protocol that should be instituted prior to a referral.
Health Care for All? Economics, Politics, and Delivery Systems
Authors: Kokoska Mimi S. , Trimmer Joy L. , Eisenberg Lee D. , Stack Brendan C. , Burton Martin J. , Taylor Mark 
Published: September 2011

Program DescriptionDiscussions regarding health care (HC) legislation, reform, and costs continue to be in the public conscience. The media in large part have presented little facts and the enacted health care law has been met with mixed responses from the public, HC sector, and politicians. A central philosophical and public health question is should everyone have covered HC? The panel will suppose the answer is yes and present evidence for what systems could succeed in the US. This program presents facts from national and worldwide experiences that have been essentially absent in media discussion forums. It will also provide participants with an analysis of the political environment surrounding the HC debate in the US. The potential implications of a universal health HC system versus a nationalized HC system on otolaryngologists in private and academic practices will be discussed. Health information technology (HIT) beyond the electronic health record is just beginning to become widely implemented. There is evidence of rapid shifts in how HIT and exchanges will change the current models of clinical practice with socioeconomic implications. The various ways HIT has been and will be used to improve quality of care, shift revenues, and impact access to information will be presented. This set of presenters collectively has experience in a wide breadth of health care systems including private, academic, US government, as well as the Canadian and United Kingdom HC systems. They will provide their perspectives on the current challenges and successes associated with their systems. In conclusion, the panelists will have a moderated question and answer session covering questions such as, what is the preferred model for delivering health care for all in the US and how would you fund it? What is the scope of practice considerations in Canada, UK and US? The audience will also be able to provide and view their answers using the interactive audience response system.Educational Objectives1) Understand various government healthcare systems, politics of healthcare, and the impact on otolaryngologists. 2) Understand the current and future status of health information technology and exchanges beyond medical records. 3) Learn about global models of health care delivery from panelists with experience in varied healthcare systems.
Emerging Technologies in Implantable Auditory Prostheses
Authors: Fishman Andrew J. , Richter Claus‐Peter , Roland J. Thomas , Svirsky Mario A. , Rubinstein Jay T. , Micco Alan G. 
Published: September 2011

Program DescriptionCurrent prosthetic auditory implants have achieved a high level of success, however, it would be fair to say that performance gains over the past decade have reached a stable plateau. The latest phase of development has centered primarily on increasing stimulus resolution, preserving residual auditory ultrastructure and function, and implanting higher order neural pathways. To serve these objectives, electrodes have been designed to more closely approximate the spiral ganglion and be inserted virtually atraumatically. Implantation of the higher order pathways has already been performed with combinations of penetrating needles or electrode paddles at the brainstem. Prototypes even exist for stimulation as high up as the auditory cortex. We are now also witnessing the development of highly focused fiberoptic delivery systems for infrared laser energy as the stimulus source. A panel of surgeons and scientists, all of whom have been involved in both clinical and basic science of auditory implants, will debate the strategies being developed to foster the next leap in performance gains. The seminar will begin with a candid appraisal of the successes of currently marketed achievements including modiolar hugging electrodes, hearing preservation hybrid implants, compressed and split arrays for severely malformed and obstructed cochleae, and bilateral implantation. Minimally invasive surgical techniques will be examined with the questions posed: What truly constitutes a minimally invasive procedure? What technical features need to be retained in order to maintain necessary safeguards and precautions? The variable successes of auditory brainstem implantation will be reviewed with an eye toward future improvement. The panelists will then present their collective experience with emerging technologies aiming to push the envelope of performance higher into the future. The constant gains in microprocessor speeds will offer opportunities for development of novel processing strategies including current steering. The emerging concept of integrated drug delivery systems will require a careful re‐exploration of the well‐known design problems of hermeticity, durability, and ultrastructural trauma induction. Changes in stimulus energy source (eg, infrared laser) will undoubtedly require radical changes in device designs and coding strategies. It is the hope of the organizers that this miniseminar will benefit both the attendees and the panelists through the process of evaluative debate and exploration of new ideas.Educational Objectives1) Understand the current status and future direction of hybrid “hearing preservation” cochlear implantation. 2) Understand the newest device and coding strategies including infrared laser optical based devices. 3) Be familiar with the current systems under development including vestibular prostheses, DACS and ABI.
The Use of Implants in the Management of Tinnitus
Authors: Hoffer Michael E. , Seidman Michael D. , Rubinstein Jay T. , Van de Heyning Paul , Shulman Abraham 
Published: September 2011

Program DescriptionTinnitus is one of the most common health problems in the United States and recent figures show that tinnitus is increasing in frequency. As otolaryngologists we are the primary specialty responsible for the diagnosis and management of tinnitus. Despite a great deal of work in this area definitive treatment options for tinnitus are lacking in many cases. Recognizing the importance of this issue the AAO‐HNSF and the Martha Entenmann Tinnitus Foundation have endowed a series of miniseminars to address tinnitus. This year’s panel will once again be comprised of national and international experts who will discuss advances in tinnitus treatment using implantable devices. The panel will discuss the use of cochlear implants, implantable hearing aids, and other, more novel, implantable devices. In particular the presenters will focus on the physiologic basis for tinnitus response to electrical or mechanical stimulation, cases series and outcomes, and patient selection for various treatments. The panel will finish by discussing several cases and will provide time for audience questions.Educational Objectives1) Better understand treatment options for tinnitus. 2) Better understand the principals that support the use of electrical stimulation in tinnitus. 3) Provide a more clear understanding of the impact of cochlear implants on tinnitus.
Tympanoplasty: Best Method of Grafting, Medial, Lateral, Medio‐Lateral, or Cartilage
Authors: Jung Timothy T. K. , Brackmann Derald E. , Chole Richard A. , Dornhoffer John L. , McKenna Michael J. 
Published: September 2011

Program DescriptionAlthough there are well‐established surgical techniques for tympanoplasty to repair chronic tympanic membrane perforation, surgical methods remain varied, often based more on local traditions than on scientific research. Successful tympanoplasty continues to pose a significant challenge to the otolaryngologist. The goal of this miniseminar is to present the best surgical technique of this common procedure. Toward these ends, we have assembled a panel of respected and experienced otologists from the East coast, Midwest, South, and West coast of the US. Following a brief introduction, each panelist will present his preferred surgical technique of tympanoplasty for tympanic membrane perforation that works best whether media, lateral, medio‐lateral, or cartilage graft method. The remaining time will be devoted to case presentations to discuss on best graft method for particular cases. This miniseminar will provide information that should improve the ability of each participant to perform successful tympanoplasty for chronic tympanic membrane perforation in different clinical situations.Educational Objectives1) Learn best grafting method in tympanoplasty for reconstruction of chronic tympanic membrane perforation. 2) Understand to use different method grafting depending on the location of tympanic membrane perforation. 3) Be able to perform better tympanoplasty in different clinical situations.
Pediatric Otolaryngology
Authors: White David R. , Buchman Craig A. , Choo Daniel , Preciado Diego A. , Froehlich Patrick 
Published: September 2011

Program DescriptionThe management of cholesteatoma has been a topic frequently filled with controversy regarding surgical technique and different methods of hearing restoration. Cholesteatoma management has always presented the otolaryngologist with a unique set of challenges, especially in the pediatric population. Challenges in management include access to various areas of the middle ear and surrounding structures, identification of recurrence, and restoration of hearing loss caused by the disease. Within the past decade, novel techniques such as removal/replacement of the canal wall, diffusion weighted MRI for diagnosis of recurrence, and advances in understanding of cholesteatoma biology have resulted in evolving clinical algorithms used to treat this difficult disease. This miniseminar will be organized as a panel discussing current care and novel management of pediatric cholesteatoma. The multi‐institutional panel will include experts in cholesteatoma biology, resective surgery for cholesteatoma, hearing restoration, and imaging of cholesteatoma. Each panelist will focus on novel and/or controversial aspects of cholesteatoma management. The miniseminar will use an audience response system to allow interaction between the panel and the audience during the presentations.Educational Objectives1) Identify current theories regarding etiology of pediatric cholesteatoma and biologic factors determining behavior of cholesteatoma. 2) Understand current options for primary and hearing restorative surgery for pediatric cholesteatoma. 3) Learn about current options for identification of recurrent pediatric cholesteatoma.
Biofilms in Otolaryngology: What Does This Mean to the Clinician?
Authors: Derkay Craig S. , Post James C. , Han Joseph , Darrow David H. 
Published: September 2011

Program DescriptionVirtually all microbes live in biofilm communities. Within these communities, the microbes assume differing specialized roles which confer survival advantages on the community. These communities cause chronic and device‐associated infections. The role of biofilms in the persistence of chronic, mucosal‐based ENT‐related infections was first recognized in otitis media. Within the field of pediatric otolaryngology, biofilms have now been shown to play a role in many infections, including: recurrent acute otitis media, otitis media with effusion, cholesteatoma, chronic tonsillitis, chronic rhinosinusitis, and infections of tracheostomies, endotracheal tubes, tympanostomy tubes, and cochlear implants. The recognition that chronic ear, nose, and throat bacterial infections are biofilm‐related has been the impetus for the development of new technologies for the study of biofilms and their prevention and treatment. Understanding that chronic bacterial infections are biofilm‐related is fundamental to developing rationale strategies for treatment and prevention.Educational Objectives1) Appreciate the current state of understanding regarding biofilms in middle ear effusions and recurrent acute otitis media. 2) Understand the contributions that biofilms make toward chronic infections of the tonsils and adenoids. 3) Understand the near and long‐term possibilities in treatment and prevention of pediatric otolaryngology infections associated with biofilms.
From Bench to Bedside: Updates in Pediatric Obstructive Sleep Apnea
Authors: Ishman Stacey L. , Bhattacharjee Rakesh , Garetz Susan L. 
Published: September 2011

Program DescriptionPediatric obstructive sleep apnea (OSA) has been identified in 2% to 4% of children in the United States. While adenotonsillectomy is widely regarded as the primary therapy for pediatric OSA, evidence suggests that anatomy alone is not enough to explain the presence of OSA. With this in mind, evaluation of other factors contributing to OSA has revealed that inflammation, and specifically leukotrienes, may contribute to airway obstruction and that medical treatment of airway inflammation may be effective to treat sleep disordered breathing (SDB). In addition, the evidence regarding accurate diagnosis of sleep‐disordered breathing in children is still subject to debate. While sleep studies are unquestionably the gold standard for diagnosis, the use of criteria adapted from adult studies has led to come controversy regarding the correct parameters to use for diagnosis. Additional investigations have found that respiratory patterns in children differ from those in adults and standard sleep study parameters may not be very specific or sensitive. Therefore, flow‐based respiratory measures have been developed to help determine which children would benefit from treatment and measure response to treatment after surgery. While accurate measurement of SDB is essential, quantification of the consequences of OSA and SDB is also important and the relationship between neurobehavioral measures and SDB has been explored. Understanding the role of inflammation and the potential for flow‐based respiratory measures is critical in advancing the treatment of pediatric OSA. In addition, a better understanding of the relationship between neurocognitive and behavioral measures and SDB is fundamental to developing rationale strategies for treatment.Educational Objectives1) Appreciate the current state of understanding regarding inflammation and biomarkers in pediatric obstructive sleep apnea. 2) Understand how the measurement of airflow in children can best reflect sleep‐disordered breathing. 3) Understand the relationship between neurocognition and sleep disordered breathing in children and changes seen with treatment.