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Gender analysis of the top classic papers in otolaryngology head and neck surgery

World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第2期9卷 160-167页

作者： Beatrice Go Neeraj Suresh Cammille Go kevin chorath Natasha Mirza Erica Thaler Alvaro Moreira Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Perelman School of Medicine University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics Division of NeonatologyThe University of Texas Health Science Center at San AntonioSan AntonioTexasUSA

Objective:The aim of this study was to identify and analyze the gender breakdown of first authorship contributing to the most-cited papers in the field of otolaryngology,with a goal of identifying trends in gender representation in ***:The top 150 most-cited papers were identified using the Science Citation Index of the Institute for Scientific *** the first authors,gender,h-index,percentage of first,last,and corresponding authorship positions,total publications,and citations were ***:The majority of papers were in the English language,from the United States,of clinical nature,and on otologic ***-one percent of papers(n=122)had men who were first authors,although there was no difference inh-index score,authorship position,number of publications,citations,and average citations/year between men and women first *** subgroup analysis by decade(1950s-2010s),there was no difference in the number of articles by women first authors(P=0.11);however,there was a statistically significant increase in the percentage of women authors(P=0.001)in papers published later compared to those published ***:While a promising number of women otolaryngologists are publishing high-powered articles,future initiatives to promote academic inclusivity of women should be considered.

关键词： authorship bibliometrics citations gender otolaryngology publications

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Nonopioid perioperative analgesia in head and neck cancer surgery:A systematic review

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 107-117页

作者： Beatrice C.Go Cammille C.Go kevin chorath Alvaro Moreira Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Perelman School of Medicine University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics Division of NeonatologyUniversity of Texas Health-San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:Management of postoperative pain after head and neck cancer surgery is a complex issue,requiring a careful balance of analgesic properties and side *** objective of this review is to discuss the efficacy and safety of multimodal analgesia(MMA)for these ***:Pubmed,Cochrane,Embase,Scopus,and *** were systematically searched for all comparative studies of patients receiving MMA(nonsteroidal anti-inflammatory drugs(NSAIDs),acetaminophen,anticonvulsants,local anesthetics,and corticosteroids)for head and neck cancer *** primary outcome was additional postoperative opioid usage,and secondary outcomes included subjective pain scores,complications,adverse effects,and 30-day ***:A total of five studies representing 592 patients(MMA,n=275;non-MMA,n=317)met inclusion *** most commonly used agents were gabapentin,NSAIDs,and acetaminophen(n=221),NSAIDs(n=221),followed by corticosteroids(n=35),dextromethorphan(n=40),and local nerve block(n=19).Four studies described a significant decrease in overall postoperative narcotic usage with two studies reporting a significant decrease in hospital *** pain scores widely varied with two studies reporting reduced pain at postoperative day *** were no differences in surgical outcomes,medical complications,adverse effects,or 30-day mortality and readmission ***:MMA is an increasingly popular strategy that may reduce dependence on opioids for the treatment of postoperative pain.A variety of regimens and protocols are available for providers to utilize in the appropriate head and neck cancer patient.

关键词： analgesia head and neck neoplasm NSAID opioids pain management

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Enhanced recovery after surgery protocols for outpatient operations in otolaryngology:Review of literature

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 96-106页

作者： kevin chorath Sara Hobday Neeraj V.Suresh Beatrice Go Alvaro Moreira Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics University of Texas Health-San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Objective:Enhanced recovery after surgery(ERAS)protocols are patient-centered,evidence-based pathways designed to reduce complications,promote recovery,and improve outcomes following *** protocols have been successfully applied for the management of head and neck cancer,but relatively few studies have investigated the applicability of these pathways for other outpatient procedures in *** goal was to perform a systematic review of available evidence reporting the utility of ERAS protocols for the management of patients undergoing outpatient otolaryngology ***:A systematic literature review was conducted using MEDLINE,EMBASE,SCOPUS,and gray *** identified studies that evaluated ERAS protocols among patients undergoing otologic,laryngeal,nasal/sinus,pediatric,and general otolaryngology *** assessed the outcomes and ERAS components across protocols as well as the study design and ***:A total of eight studies fulfilled the inclusion criteria and were included in the *** of procedures evaluated with ERAS protocols included tonsillectomy and adenoidectomy,functional endoscopic sinus surgery,tympanoplasty and mastoidectomy,and septoplasty.A reduction in postoperative length of stay and hospital costs was reported in two and three studies,*** studies between ERAS and control groups showed persistent improvement in pre-and postoperative anxiety and pain levels,without an increase in postoperative complications and readmission ***:A limited number of studies discuss implementation of ERAS protocols for outpatient operations in *** clinical pathways appear promising for these procedures as they may reduce length of stay,decrease costs,and improve pain and anxiety postoperatively.

关键词： enhanced recovery after surgery otolaryngology outpatient surgery patient safety PSQI

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Implementation of an enhanced recovery after surgery protocol for head and neck cancer patients:Considerations and best practices

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第2期8卷 91-95页

作者： Aman Prasad kevin chorath Louis-Xavier Barrette Beatrice Go Jie Deng Alvaro Moreira Karthik Rajasekaran Perelman School of Medicine University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Otorhinolaryngology-Head and Neck Surgery University of PennsylvaniaPhiladelphiaPennsylvaniaUSA School of Nursing Laboratory of Innovative&Translational Nursing ResearchUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Pediatrics University of Texas Health San AntonioSan AntonioTexasUSA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Enhanced recovery after surgery(ERAS)protocols have been developed in numerous surgical specialties as a means of systematically improving patient recovery,functional outcomes,cost savings,and resource *** multidisciplinary initiatives seek to minimize variability in several aspects of perioperative patient care,helping to reduce inpatient length of hospital stay,complications,and the overall resource and financial burden of surgical *** and neck oncology patients stand to benefit from the implementation of comprehensive ERAS protocols,as these patients have complex medical needs that may dramatically impact multiple aspects of their recovery,including breathing,eating,nutrition,pain,speech,swallowing,and *** ERAS protocols for head and neck cancer patients may present unique challenges,and require significant interdisciplinary coordination and *** therefore sought to provide a comprehensive guide to the planning and institution of such ERAS systems at institutions undertaking care of head and neck cancer *** elements to consider in the implementation of successful ERAS protocols for this population include organizing a team consisting of frontline leaders such as nursing staff,medical specialists,and associated health professionals;designing interventions based on systematically evaluated,high-quality literature;and instituting a clear methodology for regularly updating protocols and auditing the success or potential limitations of a given *** obstacles to the success of ERAS interventions for head and neck cancer patients include challenges in systematically tracking progress of the protocol,as well as resource limitations in a given health system.

关键词： enhanced recovery after surgery ERAS head and neck oncology quality improvement

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A quiet place:The impact of the word"quiet"on clinical workload

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第1期9卷 91-96页

作者： Beatrice C.Go kevin chorath Amy Schettino Vincent Anagnos Ivy Maina Laura Henry Lukas Dumberger Neel Sangal Vasiliki Triantafillou Solomon Husain Chad Sudoko Evan Cretney Karthik Rajasekaran Department of Otorhinolaryngology University of PennsylvaniaPhiladelphiaPennsylvaniaUSA Department of Otorhinolaryngology Leonard Davis Institute of Health EconomicsUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA

Purpose:This study aimed to determine the impact of uttering the word"quiet"on clinical workload during the overnight otolaryngology call shift and understand the factors contributing to resident *** and Methods:A multicenter,single-blind,randomized-controlled trial was conducted.A total of 80 overnight call shifts covered by a pool of 10 residents were randomized to the quiet or to the control *** the start of shift,residents were asked to state aloud,"Today will be a quiet night"(quiet group)or"Today will be a good night"(control group).Clinical workload,as measured by number of consults,was the primary *** measures included number of sign-out tasks,unplanned inpatient and operating room visits,number of phone calls and hours of sleep,and self-perceived ***:There was no difference in the number of total(P=0.23),nonurgent(P=0.18),and urgent(P=0.18)*** at signout,total phone calls,unplanned inpatient visits,and unplanned operating room visits did not differ between the control and quiet *** there were more unplanned operating room visits in the quiet group(29,80.6%)compared to the control group(34,94.4%),this was not found to be significant(P=0.07).The majority of residents reported feeling"not busy"during control nights(18,50.0%)compared to feeling"somewhat busy"during quiet nights(17,47.2%;P=0.42).Conclusion:Contrary to popular belief,there is no clear evidence that uttering the word"quiet"significantly increases clinical workload.

关键词： burnout call schedule quiet resident workload wellness

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Use of the O-Z flap as an alternative to free tissue transfer for reconstruction of large scalp defects

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 355-360页

作者： Austin C.Cao Ryan M.Carey Mitali Shah kevin chorath Robert M.Brody Steven B.Cannady Jason G.Newman Rabie M.Shanti Karthik Rajasekaran Perelman School of Medicine University of PennsylvaniaPhiladelphia19104PA Department of Otorhinolaryngology-Head and Neck Surgery University of PennsylvaniaPhiladelphia19104PA Drexel University College of Medicine Drexel UniversityPhiladelphia19102PA Department of Oral and Maxillofacial Surgery University of PennsylvaniaPhiladelphia19104PA Leonard Davis Institute of Health Economics University of PennsylvaniaPhiladelphiaPA

Objective:The reconstruction of large scalp defects poses both functional and cosmetic *** free tissue transfer remains the standard for defects larger than 30 cm^(2),prolonged anesthesia and postoperative complications remain significant *** purpose of this study is to evaluate the use of O-Z flaps for the reconstruction of large scalp defects and to describe the techniques ***:This is a retrospective analysis of ten patients who underwent reconstructive surgery using an O-Z flap approach for large scalp defects between July 2017 and June *** parameters included in this study were patient demographics,tumor characteristics,and postoperative management,collected for at least a year after ***:In this cohort,the mean age was 76.1 years and 90%were *** patients were treated for neoplastic skin lesions,with 70%located on the vertex and 30%located on the temporoparietal *** mean size of defect was 52.0 cm^(2)(range:38.6 to 63.8 cm^(2)).The maximum hospital stay was two days,and no patients were readmitted within 30 days of *** were no cases of wound infection or flap *** patients reported pain control with acetaminophen and *** patients received adjuvant radiation,and there was no delay to receiving treatment following ***:The O-Z flap is a reliable alternative for the reconstruction of non-irradiated scalp defects in the vertex and temporoparietal regions up to 63 cm^(2).This technique provides advantages for patients,including hairline preservation,shorter hospital stays,and decreased postoperative complications.

关键词： Scalp reconstruction Local flaps Free flap reconstruction Facial plastics Microvascular surgery Head and neck cancer

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