bluuebunny/crossref_metadata_2025_split huggingface dataset:
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 DescriptionThe 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 Objectives1) 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 DescriptionThe 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 Objectives1) 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 DescriptionMiddle 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 Objectives1) 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 DescriptionThis 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 Objectives1) 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 DescriptionClinical 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 Objectives1) 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 DescriptionPediatric 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 Objectives1) 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 DescriptionThe 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 Objectives1) 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 DescriptionOver 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 Objectives1) 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 DescriptionThis 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 Objectives1) 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 DescriptionBackground: 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 Objectives1) 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.
Food Allergy 2011: State of the Science
Authors: Reisacher William R. , Calhoun Karen H. , Veling Maria C. , Damask Cecelia 
Published: September 2011

Program DescriptionFood allergies are difficult for the patient to understand and challenging for the clinician to treat. The CDC has recently reported that the prevalence of reported food allergies increased 18% over the past 10 years in children under 18. In addition, children with food allergies are 2 to 4 times more likely to suffer from asthma and other allergies. Allergic reactions to foods can produce life‐threatening anaphylaxis, but have also been associated with other head and neck problems such as Meniere’s disease, migraine headache, chronic rhinitis, and chronic serous otitis media. There is a wide range of symptoms attributed to food allergies, such as nausea, cramping, diarrhea, dermatitis, urticaria, asthma, and joint pain. However, despite the fact that otolaryngologists see a large number of patients with food allergies, diagnosis and treatment strategies still remain controversial. The first part of the miniseminar will focus on the scientific basis of food allergies by taking a critical look at the latest scientific evidence available in the literature. A basic review of the relevant immunology will be provided along with a comparison of IgE‐mediated food reactions versus non‐IgE‐mediated food reactions. The impact that food preparation and food spoiling has on allergic pathways will also be examined. In the second part of the miniseminar, the manifestations of food allergies will be discussed. The recent literature concerning the rise in prevalence of food allergies will be analyzed and the impact of food allergies on the head and neck and airway will be reviewed. We will examine the role of oral tolerance in human evolution and the relationship of failure to achieve oral tolerance on the health of the individual. The next section will be devoted to the current diagnostic modalities available for the diagnosis of food allergies. The use of structured patient‐completed surveys to maximize thoroughness and efficiency will be discussed. We will compare the performance and accuracy of the different methods of food allergy testing, including skin and in vitro methods vs. the traditional gold standard of double‐blind, placebo‐controlled food challenge. The final part of the presentation will be devoted to treatment strategies for food allergies. Traditional methods, such as elimination diets and recognizing emergencies will be reviewed, as well as more cutting‐edge techniques, such as oral and sublingual desensitization and genetically modified foods, will also be discussed. Audio‐visual materials will be used to help present this information to the audience.Educational Objectives1) Analyze the literature comparing different methods for diagnosing food allergy. 2) Evaluate the scientific basis of IgE and non‐IgE mediated food allergy. 3) Understand the currently available treatments for food allergy as well as future directions.