bluuebunny/crossref_metadata_2025_split huggingface dataset:
Landmark Randomized Clinical Trials in Otolaryngology
Authors: Brietzke Scott E. , Weinberger Debra G. , Davis Greg , Schwartz Seth R. 
Published: September 2011

Program DescriptionThe randomized clinical trial (RCT) represents the pinnacle of the evidence‐based medicine (EBM) hierarchy. Although they are far from perfect in actual execution, RCTs do offer the highest quality evidence available and are deserving of careful review to determine the validity of the results and to consider how they may be used to improve clinical care. While not as common as would be desired, many RCTs have been published in the field of otolaryngology over the years. The purpose of this miniseminar is to succinctly, but thoroughly review some of the key RCTs that have been published in the realm of otolaryngology in the past 10 to 20 years to inform the audience of the results and how they could positively influence the evidence basis of their practice. In addition, the key elements of an RCT that make it Level 1 evidence and thus less prone to the problems of error and bias will be reviewed. A four member panel composed of a pediatric otolaryngologist, a rhinologist, a neuro‐otologist, and a sleep surgeon will present the miniseminar. The key RCTs that have been published in various areas of otolaryngology including otitis media, tonsillitis, hearing loss, rhinosinusitis, and sleep apnea will be reviewed in brief detail. The strengths and weaknesses of each trial and the potential impact of the results on clinical practice will be discussed. Interactive audience participation technology will be used to reinforce the presented material and stimulate audience interest. The attendee of this miniseminar should walk away having learned about some tangible, key published level 1 evidence which could lead to substantive changes in their clinical practice.Educational Objectives1) Understand the concept of the hierarchy of evidence and the key features of the RCT. 2) Learn about key RCTs that have been published in otolaryngology over the past 10 to 20 years. 3) Apply the findings of key RCTs to improve the evidence basis of one’s practice.
Misdiagnosis of Aging
Authors: Kost Karen M. , Malloy Kelly Michele , Calhoun Karen H. , Sataloff Robert T. , McKinnon Brian J. 
Published: September 2011

Program DescriptionThis miniseminar will illustrate the potential “misdiagnoses” of aging and highlight management of common geriatric symptoms. The presentation format will emphasize key points through illustrative cases. Audience participation will be encouraged through the use of interactive keypads. The population demographics of North America are changing rapidly, with an increasing number of elderly individuals. In otolaryngology, age‐related changes in hearing, vestibular function, smell, and phonation are recognized, as are changes in the soft tissues of the head and neck. Some of these changes are compounded by co‐morbidities in other organ systems. It is tempting to dismiss a geriatric patient’s complaints as part of “normal aging.” In doing so there is a risk of missing the same correctable pathology we see in younger patients. The presentation in elderly patients may be subtle and/or atypical, resulting in failure to order appropriate diagnostic tests. Symptoms commonly misdiagnosed as “normal” aging include dizziness, dysphonia, and rhinorrhea. Such assumptions may “blind” the otolaryngologist to treatable etiologies, such as benign positional vertigo, polypharmacy, or allergic rhinitis. The consequences of these potential misdiagnoses directly impact both the level of functioning and quality of life of the geriatric patient. Complaints should be attributed to aging only through exclusion or positive evidence. When this is the case, it is important to recognize that many of the symptoms may nonetheless be managed successfully. Presbyphonia may improve significantly with voice therapy and possibly vocal fold augmentation. Hearing loss frequently is amenable to rehabilitation with an appropriate hearing aid. Multiple symptoms are the rule rather than the exception, and treatment results in a more highly functioning patient with an improved quality of life. In some cases intervention may mean the difference between an autonomous individual and one who is dependent or living in a home.Educational Objectives1) Describe the problem of misdiagnosis. 2) Identify frequent misdiagnoses and recognize the subtle and atypical presentations of disorders in elderly patients. 3) Identify treatable complaints attributable to “normal” aging.
Outcomes Research: Past, Present, and Future
Authors: Stewart Michael G. , Piccirillo Jay F. , Gliklich Richard E. , Smith Timothy L. , Yueh Bevan , Rosenfeld Richard M. , Chen Amy Y. 
Published: September 2011

Program Description“Outcomes research” in medicine is now about 23 years old, and in otolaryngology almost 20 years old. In this miniseminar, some of the otolaryngologists who were involved in outcomes research from its inception will discuss the history, progress, and future opportunities for outcomes research, both in otolaryngology‐head and neck surgery, as well as medicine at large. We will also discuss needed next steps—and barriers—to gather the appropriate data to answer important questions for the future. Outcomes assessment will also become increasingly important at the licensure and regulatory level, and we will address those issues as well. The miniseminar will be organized as follows. First, a couple of speakers will give brief presentations on the history, current status, and potential future impacts of outcomes research in otolaryngology. We will discuss outcomes tool development, diseases studied, and the results from several large outcomes‐based studies. Next, there will be a panel discussion moderated by Dr Stewart which will cover the following topics: Which outcomes assessment tools are currently used in clinical practice? Which outcomes instruments should we be using in practice? In which diseases have the findings from outcomes research changed clinical practice? What other diseases/areas are most in need of outcomes assessment, and also the related question of where might outcomes assessment actually change practice significantly? What have we learned about co‐morbidity and severity staging? The panel will also discuss the role of outcomes assessment in Maintenance of Certification from the perspective of a state licensing board, and the American Board of Otolaryngology. One of the panelists has experience designing outcomes databases for other organizations, and he will relate his unique experience in this area. In addition, we will discuss the role of the Academy, the Board, and other central organizations in outcomes measurements, as well as how to select the best outcome tool, and how to create a database for outcomes assessment. Finally we will discuss the future of outcomes research. Are we teaching our residents and fellows the principles of outcomes assessment? Are we training enough faculty and non‐faculty otolaryngologists on how to do good outcomes research? What opportunities do new training grants offer? What is the funding status for outcomes research overall, and in otolaryngology? What is the potential future of outcomes research in otolaryngology? We will also take questions from the audience.Educational Objectives1) Learn the history of outcomes research in medicine and in otolaryngology. 2) Understand the results from outcomes studies in otolaryngology and their impact on patient care. 3) Be able to select outcomes tools for research, practice assessment, and maintenance of certification.
Professionalism Tune‐up: New Standards for Otolaryngology, 2011
Authors: Stachler Robert J. , Zacharek Mark A. , Medina Jesus E. , Calhoun Karen H. , McCammon Susan D. 
Published: September 2011

Program DescriptionThis miniseminar will be a general review of professionalism and its importance for practitioners, residents, students, and nurses. It is vitally important and practical for clinicians to have a regular review of appropriate etiquette and behavior at meetings and in interactions with others, students, bosses, and pharmaceutical companies. This miniseminar will equip the attendee with tools for lifelong learning. Speaker and Topic: Jesus Medina, MD: Professionalism in 2011, Definition of professionalism: 20 min. Karen Calhoun, MD: Professionalism in the work place: 15 min. Mark Zacharek, MD: Professionalism in a Residency Program: Core Curriculum: 15 min. Robert J. Stachler, MD: Academic Professionalism, Proper Meeting Etiquette: 15 min. Susan McCammon, MD: Appropriate Vendor, Drug Representative, Pharmaceutical Relationships: 15 min. Question and Answers: 10 min.Educational Objectives1) Define professionalism: in the work place, in an academic environment, and at home. 2) Identify appropriate styles of behavior to be effective role models for residents, students, and colleagues. 3) Demonstrate proper etiquette at social functions and meetings to be an effective leader in your field. 4) Define appropriate relationships with vendors, drug representatives, and pharmaceutical companies. 5) Review appropriate behavioral constructs and skills in core curricula during residency training for lifelong learning and reassessment during your career. 6) To learn how to play appropriately in the sandbox.
Head and Neck Surgery
Authors: Marchal Francis , Eisele David W. , Pua Kin‐Choo , Cernea Claudio R. , Arndal Helge , Morton Randall P. , Faure Frederic 
Published: September 2011

Program DescriptionThis miniseminar on sialendoscopy will provide the audience with the latest developments of sialendoscopy, starting from the basics to advanced cases of sialadenitis. A complete description of the actual indications, how best to investigate those patients, how to treat them—under local or general anesthesia, and how to avoid complications will be detailed. All treatment modalities will be explained and videos shown, with the picture in picture system, allowing easy comprehension of both operative and endoscopic field. Results from around 100 centers linked to the European Sialendoscopy Training Center (ESTC) will be presented, allowing the participants to have objective evidence of the success of this technique.Educational Objectives1) Understand the role of sialendoscopy as a new treatment modality, not only for salivary stones, but also for juvenile recurrent parotitis, adult recurrent parotitis, radio‐iodine‐induced parotitis, or other inflammatory conditions leading to ductal strictures. 2) Appreciate the paradigm shift that is occurring in the whole world for using interventional sialendoscopy instead of removing salivary glands. 3) Consider the results of multicentric studies analyzing the benefits of the technique but also its limitations.
EHR/EMR and “Meaningful Use”: Efficient Strategies to Comply with Current and Future Mandates
Authors: Lee K. J. , Ermini Edward B. , Eisenberg Lee D. , Das Subinoy , Nielsen David R. 
Published: September 2011

Program DescriptionThis miniseminar will analyze and help academic as well as private practice doctors to comply with the current and future criteria of “Meaningful Use” efficiently without interrupting the “patient‐doctor encounter.” Features of electronic health record that will help the doctor and the staff as well as pitfalls will be discussed. Time will be allocated for Q&A.Educational Objectives1) Understand “Meaningful Use” criteria. 2) Be able to select and use an EHR/EMR to receive “stimulus money.” 3) Understand Pay for Performance.
HPV‐Associated Oropharyngeal Cancer Tumor Board
Authors: Nussenbaum Brian , Weinstein Gregory S. , Girod Douglas A. , Bradford Carol R. , Hinni Michael L. , Colevas Dimitri , Yom Sue 
Published: September 2011

Program DescriptionThe incidence of Human Papilloma Virus (HPV)–related oropharyngeal cancer is increasing at a near‐epidemic proportion. As such, otolaryngologists are diagnosing and treating greater numbers of patients, especially younger patients, with this distinct disease. There have been significant strides in our knowledge about the pathophysiology of this disease. Yet despite our increased knowledge, there are still several unanswered questions about the ideal management. The educational objective of this miniseminar is to provide otolaryngologists with up‐to‐date clinically relevant information about making treatment decisions for patients with oropharyngeal cancer. This will be done using a case‐based format in the style of a multidisciplinary tumor board with incorporating audience participation. The cases discussed will incorporate basic concepts and controversial topics within the discussion. These topics will include 1) initial management with surgical techniques versus non‐surgical modalities, 2) incorporating biomarkers (HPV, p16, others) and patient‐related factors into initial treatment decision making, 3) optimal management of the neck, 4) management of patients with persistent/recurrent primary site disease after completion of initial therapy, and 5) management of patients with an unknown primary site when the neck metastasis is HPV positive. Panel members will provide support for their responses based on the best evidence‐based medicine available. Standard available therapies, currently available and upcoming clinical trials, and future research directions will be emphasized. At the conclusion of this miniseminar, the participant will be able to describe the current “state‐of‐the‐art” for evaluation and management of oropharynx cancer and discuss the underlying principles for how treatment decisions are made.Educational Objectives1) Describe the current “state‐of‐the‐art” for evaluation and management of HPV‐associated oropharynx cancer. 2) Discuss the underlying principles for making treatment decisions for patients with oropharynx cancer. 3) Describe current standard treatment options, available clinical trials, and future research directions.
Managing the Neck in Papillary Thyroid Cancer: Exploring the Evidence
Authors: Terris David J. , Kraus Dennis H. , Orloff Lisa A. , Randolph Gregory W. , Chen Amy Y. , Tufano Ralph P. , Singer Michael C. 
Published: September 2011

Program DescriptionA tremendous amount of debate has occurred since the 2006 and 2009 ATA guidelines made recommendation regarding the indications for central and lateral neck lymph node surgery in patients with well‐differentiated thyroid cancer. While consensus has yet to be reached, several pivotal issues have been defined and are the target of prospective randomized trials. The panelists will identify these key issues and answer the following questions: 1) What is the prevailing clinical approach in 2011? 2) What is the best evidence available that governs this approach? 3) What are the future opportunities for refining our understanding? Specific issues that will be explored include: 1) Lateral neck surgery ‐ when and how much? Which levels should be addressed? 2) Has there been a change in the epidemiology of well‐differentiated thyroid cancer? How has this impacted neck disease and survival? What is the appropriate threshold for nodal surgery after prior thyroidectomy? 3) What is the evidence for elective central neck dissection (pro and con)? 4) How do we best determine where the disease is located? What is the optimal way to define the extent of surgery? 5) Putting it all together, how do I approach the neck in a patient with early and advanced well‐differentiated thyroid cancer? This will be an interactive panel with plentiful discussion and questions from the audience and case‐based analysis. The panelists will move toward consensus when possible regarding each of these issues and help provide a framework for investigation and validation of proposed management algorithms.Educational Objectives1) Understand which levels should be addressed in undertaking lateral neck surgery for thyroid cancer. 2) Recognize changes in epidemiology of thyroid cancer and impact on neck disease and survival. 3) Become familiar with optimal determination of the location of disease and therefore extent of surgery.
State‐of‐the‐Art Endoscopic Management of Larynx and Pharynx Cancer
Authors: Burns James A. , Zeitels Steven M. , Haughey Bruce H. , Weinstein Gregory S. 
Published: September 2011

Program DescriptionTransoral treatment of larynx and pharynx cancer has been done for over a century. Despite substantial technical innovations such as enhanced imaging, innovative laser technologies, and robotics guidance systems, radiotherapy and/or chemotherapy dominate the treatment strategy at many institutions. In part, this is due to limited familiarity with recent novel endoscopic surgical approaches. Outcomes data on transoral microsurgical management for advanced oropharynx and larynx cancer will be presented to illustrate the efficacy of surgical management of these diseases. Robotics and laser photoangiolysis of laryngeal cancer are two emerging technologies that can enhance endoscopic surgery. These novel and innovative treatment technologies can potentially be combined in the future to expand the indications for endoscopic surgery. This miniseminar will highlight advantages and disadvantages of endoscopic techniques and update the attendees on state‐of‐the‐art procedural innovations.Educational Objectives1) Understand outcomes data on transoral laser microsurgery for advanced oropharyngeal and laryngeal cancer. 2) Understand the emerging role of robotics in endoscopic surgical management of larynx and pharynx cancer. 3) Understand concepts of photoangiolysis in treatment of aerodigestive tract malignancy.
Transoral Robotic Surgery: A New Paradigm in the Treatment of Head and Neck Cancer and Reconstructive Surgery
Authors: Lin Derrick T. , Genden Eric M. , Magnuson J. Scott , Selber Jesse 
Published: September 2011

Program DescriptionTransoral robotic head and neck surgery (TORS) has quickly become an accepted alternative approach for treatment of tumors of the upper aerodigestive tract. Specifically, approaches to oropharyngeal tumors have traditionally been through a mandibulotomy or lingual release approach with its associated postoperative morbidity. Because of this potential morbidity and the proven efficacy of chemoradiotherapy, there has been a paradigm shift away from upfront surgical management. With the advent of TORS over the past few years, several reports have documented its safety and improved functional outcomes in the management not only of oropharyngeal tumors but also of hypopharyngeal and laryngeal cancers without sacrificing tumor control or overall survival. As the indications for TORS continue to expand, will there then be an evolving role for robotic‐assisted reconstructive surgery? And what are the indications for reconstructions after TORS? The miniseminar will be composed of four parts: First, the moderator will provide a short introduction. The second speaker will review the current literature and their experience with TORS. They will specifically discuss the current indications and functional results without reconstruction. The third speaker will discuss the rationale for robotic free flap reconstruction, its indications and potential improved function. The last speaker will discuss the current research on robotic assisted reconstruction and its future advantages and challenges ahead.Educational Objectives1) Understand the role of transoral robotic surgery in head and neck cancer. 2) Understand the current use of robotic reconstructive surgery. 3) Understand the indications and future potential for robotic‐assisted reconstructive surgery.
Update on Diagnosis and Management of Primary Hyperparathyroidism
Authors: Shindo Maisie L. , Orloff Lisa A. , Steward David L. , Stack Brendan C. 
Published: September 2011

Program DescriptionThe diagnosis and management of primary hyperparathyroidism is generally straightforward. Cases referred from endocrinologists for surgery will usually have the classic laboratory findings and the correct diagnosis. An adenoma will be localized by imaging in approximately 80% to 85% of these patients. As increasing referrals are being generated from primary care physicians rather than endocrinologists, surgeons will invariably see only partially worked up patients and diagnostic dilemmas. The first part of this panel, which is composed of expert endocrine surgeons with extensive experience in parathyroid surgery, will address some of the diagnostic challenges and their evaluation. The second portion of the panel will focus on treatment. Minimally invasive parathyroidectomy (MIP) has become the preferred surgical approach for treatment of primary hyperparathyroidism. Localization of an adenoma on preoperative imaging is the key to being able to perform a successful MIP. The panel will discuss pearls and pitfalls in the imaging of parathyroid adenomas, including the use of ultrasound, sestamibi parathyroid scan, and CT scans. Thirdly the panel will present state of the art minimally invasive parathyroidectomy techniques, such as radioguided surgery, lateral approach, performing MIP under local/sedation. Cases will also be presented on how to approach failed explorations.Educational Objectives1) Learn pearls and recognize pitfalls of challenging cases of hyperparathyroidism. 2) Understand the principles and techniques of minimally invasive parathyroidectomy. 3) Learn how to improve the yield of preoperative imaging for primary hyperparathyroidism.
Controversies in the Management of Pediatric Aspiration
Authors: Gerber Mark E. , Zur Karen B. , Messner Anna H. , Schroeder James W. 
Published: September 2011

Program DescriptionThis miniseminar is supported by the Airway and Swallowing Committee. It will be an open forum and interactive discussion on the management of dysphagia and aspiration in the pediatric population. The panelists will discuss diagnostic methods as well as medical and surgical treatment options. They will assist the attendee in understanding the pathophysiology and morbidity of chronic aspiration in children. A case presentation format will be used and the audience will be able to help determine the focus of the discussion. Attendees will have the opportunity to submit a case for presentation by emailing to aspirationaao@me.com prior to the meeting. Each case presented will have a set of questions developed regarding differential diagnosis, evaluation, and treatment for the audience to select prior to discussion by the panel. The audience response will be a springboard for more in‐depth discussions. Controversies that will be reviewed include the use of videofluoroscopic swallow studies vs fiber optic endoscopic evaluation of swallowing; sialorrhea management options, including botox, ductal ligation, and salivary gland excision, and surgical management options for persistent aspiration following maximal treatment for sialorrhea and GERD.Educational Objectives1) Understand diagnostic tests available for children with dysphagia and aspiration. 2) Formulate algorithm for investigation of children who present with symptoms of dysphagia and aspiration. 3) Understand treatment options for mild, moderate, and severe dysphagia and aspiration.