bluuebunny/crossref_metadata_2025_split huggingface dataset:
Innovations in Managing Cleft Lip/Palate: A Multicenter Perspective
Authors: Tollefson Travis T. , Buckmiller Lisa M. , Tatum Sherard A. , Senders Craig W. , Sykes Jonathan M. , Sidman James D. , Wang Tom D. 
Published: September 2011

Program DescriptionCleft and craniofacial teams with both pediatric otolaryngology and facial plastic surgery backgrounds continue to develop. Novel approaches in the management of children with cleft lip and palate have contributed to a variety of treatment paradigms. Each institution and individual surgeon brings a unique perspective of treatment preferences that are worthy of discussion. Beginning in the prenatal period, advances in ultrasound technology now allow parents and surgeons to begin early preparation and education. Presurgical orthopedic devices introduced in the 1960s by the late 1990s have developed into nasoalveolar molding. The appliance is created in conjunction with an orthodontist with adjustments leading to approximation of the alveolar segments, as well as to mold the nasal deformity (columellar lengthening). Recently published modifications of the microform, unilateral, and bilateral cleft lip repair will be presented. Other innovations seeking to improve the aesthetic outcomes such as the subunit approach, suture choice, tissue glue, and scar prevention with silicone gel will be justified. Cleft surgeons from five institutions will present their approach to the cleft lip nasal deformity at the time of cleft lip repair. This can range from delaying repair (no rhinoplasty) to bolstering placement, or even direct lower lateral cartilage repositioning with rhinoplasty. This miniseminar will provide the participant a perspective on how different institutions approach common problems in management of the cleft lip, palate, and nasal deformity. This forum supports the goals of the Specialty Surgery Committee of the AAFPRS in fostering collaboration between those cleft surgeons within pediatric otolaryngology and the facial plastic surgery subspecialties. Secondary speech surgery evaluation and treatment will be presented with fluoroscopic and endoscopic examples and panelist discussion. Lastly, difficult cases will also be presented. Audience touchpad interaction will facilitate discussion. The format will include presentations including intraoperative video and subsequent discussion of the following topics: Presurgical nasoalveolar molding, unilateral cleft lip and nasal deformity repair, bilateral cleft lip and nasal deformity repair, primary cleft rhinoplasty options, and management of the extremely wide cleft lip and nasal deformity.Educational Objectives1) Understand the timing and techniques for cleft lip/palate repair based on evidence‐based guidelines. 2) Learn the panelists’ preferred basic and advanced cleft lip repair designs. 3) Be able to interpret and choose treatment for velopharyngeal dysfunction audibly, on fluoroscopy, and nasopharyngoscopy.
Office‐Based Facial Plastic Procedures for Otolaryngologists
Authors: Carniol Paul J. , Fedok Fred G. , Sykes Jonathan M. , Langsdon Phillip R. 
Published: September 2011

Program DescriptionThe modern otolaryngologist has had residency‐based, and in many cases, advanced fellowship training in a wide spectrum of facial plastic and reconstructive procedures to correct congenital‐, acquired‐, and aging‐related deformities. Due to advances in technologies, there has been an increase in the ability to offer patients a variety of effective and minimally invasive interventions in the office setting. Among these interventions, the use of injected botulinum toxin has become common in the treatment of rhytids, hyperfunctional lines, and facial dystonias. The treatment of skin and subcutaneous contour deformities is also a common challenge for which patients seek consultation. Although previously the materials used for correction were limited in number, there has now been an increasing number of widely used and newly introduced materials made available to the practitioner. The introduction of hyaluronic acid–based agents created a significant increase in acceptance and demand for filler substances by patients. More recently approved and soon to be approved fillers promise to increase the application. Laser and light technologies, including laser hair removal, offer intervention for an increasingly large number of clinical issues including the treatment of wrinkles, hyperpigmentation, cutaneous vascular lesions, rosacea, unwanted hair, and other aging‐related skin conditions. Finally, although not representing new technology, but instead low‐cost effective treatments, the practitioner will find the availability of skin care services, particularly the use of various chemical peeling agents, to be a useful adjunct in the office setting. The purpose of the miniseminar is to present an up‐to‐date review of safe, effective office‐based procedures that the otolaryngologist may have available to patients in their office. The presentations will review the pertinent pharmacology, physics where applicable, and anatomy. Technique, preoperative and post procedure issues will be discussed. The clinical photo‐rich presentations will demonstrate technique and patient selection. The prevention and management of complications will be reviewed. This miniseminar will update the attendees that have previous training in these procedures and serve as an introduction to those that are exploring these procedures.Educational Objectives1) Learn the indications and techniques for cosmetic botulinum toxin injections. 2) Learn the indications and techniques for facial filler injections. 3) Learn the indications and techniques for chemical peels, lasers, and light‐based devices.
Applying PSQI: Metrics and More
Authors: Shah Rahul K. , Eisenberg Lee D. , Nussenbaum Brian , Jalisi Scharukh 
Published: September 2011

Program DescriptionThere is significant external pressure on physicians and healthcare organizations to measure physician outcomes (metrics). However, metrics are quite complicated to develop, validate, and implement. Unfortunately, agencies such as The Joint Commission via hospital medical staffs are requiring evaluations of ongoing professional practice (OPPE) and focused professional practice evaluations (FPPE). As a group, surgeons are not very well versed on this topic. It has come to the attention of the Patient Safety and Quality Improvement Committee of the Academy that many members seek education on creation of metrics and to ensure their non‐punitive applications. This miniseminar will begin with an overview of the pertinent definitions and organizations involved in the quality landscape. This brief overview will attempt to be a primer for otolaryngologists such that they can understand the priorities of the quality movement and how to prepare for such in their practices. The primer will also help lay the foundation for the discussion on metrics and how they relate back to the mandates of OPPE. The miniseminar will then discuss how to create and implement metrics from three varying perspectives. We will demonstrate this for a large, multi‐specialty practice group, an academic department, and an academic hospital. Participants will learn what constitutes an appropriate metric and how these should ideally be designed for implementation in their practices.Educational Objectives1) Understand the priorities of the quality movement and how to meet the requirements of various constituencies. 2) Learn how to create and implement quality improvement metrics within the practice setting (multi‐specialty group practice, academic department, and academic hospital).
General Otolaryngology
Authors: Osguthorpe J. David , Wax Mark K. 
Published: September 2011

Program DescriptionThe Academic Bowl pits four of the top otolaryngology residency programs in the country (Loyola University Medical Center; University of Mississippi Medical Center; Tulane University School of Medicine; and University of Texas Southwest) in a clinically oriented test of knowledge. While the programs compete, the audience can participate with the residents through the audience response system. Audience members can also earn CME/CE credit and review for MOC.Educational Objectives1) Test knowledge of current diagnosis and management of diseases of the head and neck. 2) Identify areas meriting further study before the Maintenance of Certification or Board Certification examinations. 3) Gain familiarity with the question format utilized by Annual Inservice and American Board of Otolaryngology exams.
Avoiding Disaster at the Skull Base: Case Studies in 3D
Authors: Snyderman Carl H. , Friedman Rick A. , Fernandez‐Miranda Juan M. 
Published: September 2011

Program DescriptionDisaster awaits unprepared surgeons at the skull base. Multiple routine surgeries in otolaryngology are in close proximity to the skull base. Potential risks of endoscopic sinus surgery include cerebrospinal fluid leak, loss of olfaction, penetrating brain injury, visual loss, hemorrhage from the internal carotid artery, and loss of trigeminal sensory and motor function. Potential risks of temporal bone and lateral approaches include vascular injuries of the sigmoid sinus, jugular bulb, and internal carotid artery; injury to cranial nerves 7‐12; cerebrospinal fluid leak, intra‐ and extradural hemorrhage; and brain trauma. A thorough understanding of skull base anatomy is essential for avoiding such complications during routine surgical procedures. In this miniseminar, case studies will be used to demonstrate potential risks of standard surgical procedures relative to the skull base. Important anatomical landmarks and relationships will be presented in 3D using cadaveric dissections and intraoperative photographs. Strategies to avoid skull base complications will be discussed with an emphasis on everyday surgical procedures.Educational Objectives1) Understand key anatomical relationships at the skull base. 2) Relate skull base anatomy to anterior and lateral skull base approaches. 3) Apply anatomical knowledge to avoid surgical complications.
Challenging Cough Cases: A New Frontier in Otolaryngology
Authors: Altman Kenneth W. , Krouse John H. , Johns Michael M. E. , Carroll Linda M. , Murry Thomas 
Published: September 2011

Program DescriptionBoth acute and chronic cough are responsible for a significant portion of all ambulatory medical visits annually (about 3%), over‐the‐counter self‐medication expenses in excess of $3.6 billion in the United States, and impaired quality of life. According to 2007 data, there were more than 27 million visits to all physicians for cough, but that same year otolaryngologists saw a total of only 17 million visits for all diagnoses. This suggests a large unmet need for otolaryngologists to participate in the care of these patients. The diagnosis of cough can be simple or profoundly challenging, and it may be a sentinel indicator of severe underlying disease. The list of diseases that may induce cough is growing, along with an appreciation of their interrelations. For example, the Unified Airway concept supports our long‐held observation that the upper and lower airway diseases are closely related. There is also a spectrum of overlapping asthmatic, non‐asthmatic, and suppurative pulmonary disease. Gastroesophageal reflux (both distal and proximal LaryngoPharyngeal Reflux), along with neurologic reflexes and aspiration are similarly important. And the complex interplay of neurologic reflexes for cough in the brainstem may result in paradoxical vocal fold motion and disordered breathing. Otolaryngologists are playing an increasingly important role in the multidisciplinary evaluation of these challenging patients, and mastering many procedures associated with cough patients. The spectrum of medical specialists also includes pulmonology and chest physicians, allergy and immunology, gastroenterology, neurology, cardiology, infectious disease, speech and swallowing pathologists, as well as psychiatry. This miniseminar will involve the use of case presentations, panel discussion and audience participation to emphasize evidence‐based practice and “state‐of‐the‐art.” Controversial areas will include the inter‐relatedness of the disease, the role of speech therapy in disordered breathing, and the importance of early diagnosis in value‐based healthcare.Educational Objectives1) Learn the spectrum of common and uncommon causes of chronic cough. 2) Understand evidence‐based treatment guidelines in the evaluation and treatment of these patients. 3) Be prepared to participate in interdisciplinary discussion of these patients at their home institution.
Cochrane Reviews and Evidence‐Based Healthcare
Authors: Rosenfeld Richard M. , Burton Martin J. , Rhee John S. , Shin Jennifer J. 
Published: September 2011

Program DescriptionThis miniseminar, taught by leadership from the AAO‐HNS and the Cochrane Collaboration, will empower attendees to use Cochrane reviews of interventions as a platform for evidence‐based healthcare. Cochrane Reviews are systematic reviews of primary healthcare research on prevention, treatment, rehabilitation, and diagnostic test accuracy. Each review addresses a clearly formulated question; for example: Do perioperative antibiotics improve recovery after tonsillectomy? All the existing primary research on a topic that meets certain criteria is searched for and collated, and then assessed using stringent guidelines, to judge the level of evidence for, or against, a specific intervention. Evidence‐based healthcare is the conscientious use of current best evidence, derived ideally from systematic review, in making decisions about the care of individual patients or the delivery of health services. Recognizing the increasing role of evidence‐based health care in otolaryngology, the AAO‐HNS has partnered with the Cochrane ENT Disorders Group since 2006. This miniseminar is one product of that partnership, along with other efforts to enhance the AAO‐HNS journal, annual meeting, research agenda, and quality initiatives. Attendees will learn of these efforts including ways to obtain Academy‐sponsored travel grants to the annual meeting of the Cochrane Collaboration. Time is allotted at the end of the session for audience questions to the expert panel.Educational Objectives1) Appreciate how systematic review of interventions facilitates evidence‐based healthcare. 2) Understand why Cochrane reviews are important to otolaryngologists and their patients. 3) Learn how to read a systematic review, interpret results, and apply findings to patient care.
Corticosteroid Use in Otolarynogology: What Does the Recent Evidence Tell Us?
Authors: Parnes Lorne S. , Stewart Michael G. , Hartnick Christopher J. , Piccirillo Jay F. 
Published: September 2011

Program DescriptionBoth oral and topical corticosteroids are used frequently in the practice of otolaryngology. Their use is often based on historical evidence rather than clinical research. First, we will overview corticosteroids’ mechanisms of action and their adverse effects. We will then present a brief overview on evidence‐based medicine and grade the evidence to help the audience understand how the studies which we are discussing fit into the overall scheme of “best evidence.” We will then present short case examples in each of the subspecialty areas of otology/neurotology, rhinology, laryngology/head and neck surgery, and pediatric otolaryngology. We will poll the audience if, and how, they might use corticosteroids in these case examples. We will then have clinician scientists who have expertise in each of these areas review the recent evidence in the literature to see if there is any scientific support for their use. Where possible, we will reference clinical practice guidelines. Representative acute cases might include Bell’s palsy, sudden deafness, nasal polyposis, acute laryngotracheobronchitis, and deep neck space infections. We will then re‐poll the audience for any changes of opinions. We will also discuss the general perioperative use of corticosteroids in ear surgery, sinus surgery, laryngeal surgery, and tonsillectomy. We feel that this mini‐seminar will be of great importance to the general otolaryngologist, providing them with the knowledge of when and when not to use corticosteroids in both their office and surgical practices.Educational Objectives1) Learn the evidence behind using corticosteroids in various otolaryngological disorders. 2) Understand the different oral and topical corticosteroid regimes. 3) Learn the proper use of corticosteroids in several common disorders.
Device Complications: What Does the Surgeon Do?
Authors: Park Albert H. , D’Eredita Riccardo , Smith Gina A. Maisto 
Published: September 2011

Program DescriptionMedical device failures are commonly associated with surgical complications. In late 1997, the US FDA (Food and Drug Administration) reported that it receives approximately 100,000 medical device reports a year, and the agency considers this number just the tip of the medical device problem iceberg. Any surgeon is very likely to experience this complication in his or her operative career. The Pediatric Otolaryngology and the Medical Devices and Drugs Committee decided to organize a miniseminar to provide guidelines to surgeons experiencing this complication and for surgeons wishing to be informed to device failures. The symposium will be divided into two major parts. In the first part, clinical cases associated with medical device failures will be presented. The impact of one of these cases based on a national survey of pediatric otolaryngologists will be highlighted. The second part will then include the medicolegal ramifications, disclosure to patients and families, and resources available for the surgeon to report and receive updates on device failures.Educational Objectives1) Learn the role of the surgeon in disclosing device complications to patients and national reporting agencies. 2) Learn the medicolegal ramifications of a device failure to the surgeon. 3) Learn how an otolaryngologist can keep him or herself informed of device recalls or complications.
Failure on the Newborn Infant Hearing Screen: What’s Next?
Authors: Buchman Craig A. , Greinwald John H. , Papsin Blake C. , Roush Patricia A. , Niparko John K. 
Published: September 2011

Program DescriptionHearing screening for newborn infants has become commonplace. The Joint Commission on Infant Hearing (JCIH) in its position statements has created goals and guidelines for managing these children in a timely manner. The early hearing detection and intervention (EHDI) process is designed to maximize linguistic and communicative competence and literacy development for children who are deaf or hard of hearing. Without appropriate opportunities to learn language, these children will fall behind their hearing peers in language, cognition, and social‐emotional development. Such delays may result in lower educational and employment levels in adulthood. Early diagnosis and treatment of hearing impaired infants in the first year of life has been shown to avoid the detrimental effects of delayed action. Despite this fact and a high screening rate among programs (>95%), almost half of those infants who do not pass the initial screening fail to have appropriate and timely follow‐up including audiological and medical assessment by an individual with training in pediatric hearing disorders. Rather, families are often times reassured or misinformed by well‐intentioned professionals about this process and the consequences of delayed intervention. This miniseminar will provide the fundamental framework for obtaining timely and accurate audiological and medical diagnosis and hearing instrument fitting (hearing aids or cochlear implants). Recognized professionals in the field will cover topics such as electrophysiological hearing testing, practical application and results of amplification, medical assessment including radiological and genetic evaluation, and the criteria and results of cochlear implantation. Issues relevant to delayed diagnosis and intervention such as organizational structure, awareness, funding, and necessary political activity will be addressed.Educational Objectives1) Understand the significance of a failure result on the newborn infant hearing screening examination. 2) Learn the fundamental, multidisciplinary evaluation, and management paradigm for infants that fail the newborn screen. 3) Understand the cause and consequences of inappropriate or delayed intervention in hearing impaired children.
Economic Aspects of Head and Neck Oncologic Surgery: Implications for the Head and Neck Surgeon Now and in the Future
Authors: Jalisi Scharukh , Koch Wayne M. , Burkey Brian B. , Couch Marion E. 
Published: September 2011

Program DescriptionAlthough head and neck oncologic surgery (HNOS) is time consuming, requires an effective team, and needs allotment of precious resources, financial compensation for the surgeon is relatively low so that financial inducements for a surgeon to do HNOS are diminishing. However, HNOS can generate significant revenue for a hospital. This miniseminar provides information about costs, revenue, profit/ loss analysis of many aspects of HNOS. Parameters pertaining to HNOS that will be defined and discussed include the following: relative value units (RVU’s) contribution margins, case mix index, allocated expenses, opportunity costs, comparative profitability of various different treatment modalities, and the impact of diminishing reimbursements. In addition we will explain the ways that an otolaryngology department can utilize hospital financial data to justify the commitment of the varied resources that are needed to do major HNOS cases and to safely take care of the patients following surgery. In addition, we will discuss the mandate from the Residency Review Committee that requires residency programs to provide experience for residents with HNOS index cases. We will discuss how to prepare financial data, economic projections, and a business plan in a way that is both comprehensible to hospital financial planners and sufficiently compelling to warrant the commitment of resources that is likely to enable a HNOS program to become vibrant and grow. Examples of successful efforts to garner hospital resources for HNOS will be provided. Risk management will be considered in an analysis of safety issues inherent in doing HNOS and providing postoperative care for patients with advanced disease. We will discuss the need to report outcome data to such external data repositories and agencies such as University Healthsystems Consortium (UHC), Consumer Assessment of Healthcare Providers and Systems (CAHPS), and the US Department of Health and Human Services. Finally, we will discuss how imminent health care reform measures are likely to impact financial aspects of doing HNOS within the next few years including Accountable Care organizations and Health Innovation Zones.Educational Objectives1) Understand how to obtain and interpret hospital financial data that is pertinent for HNOS. 2) Discuss how imminent health care reform measures may impact financial aspects of doing HNOS. 3) Understand the constraints for academic success for a head and neck oncologic surgeon.
Global Health 2011: Our Academy Around the World
Authors: Randolph Gregory W. , Thomas J. Regan , Bebear Jean‐Pierre , Carcamo Carla M. , Grandison Barbara , Gomez Juan‐Manuel Garcia , Ibekwe Titus , Lund Valerie J. , Profant Milan , Sichel Jean‐Yves , Tong Michael , Uzun Cem 
Published: September 2011

Program DescriptionThis international symposium will showcase Academy relationships and activities in seven regions of the world. President J. Regan Thomas, MD, will describe his vision for enhanced international collaboration. Academy Regional Advisors who are on the International Steering Committee will introduce our eminent and wide‐ranging visiting speakers.Educational Objectives1) Understand the myriad ways the academy interacts with otolaryngology communities in different regions. 2) Appreciate the opportunities for collaboration in scientific exchange, research, fellowships, and observerships. 3) Learn the Academy’s resources available to members, subscribers, meeting attendees, and web visitors.