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Innovations in otorhinolaryngology in the age of COVID-19: A systematic literature review

World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第3期8卷 224-238页

作者： E.Berryhill McCarty Liuba Soldatova jason A.Brant jason G.newman Perelman School of Medicine at the Universityof Pennsylvania PhiladelphiaPAUSA Department of Otorhinolaryngology-Head and Neck Surgery Universityof Pennsylvania Health SystemPhiladelphiaPennsylvaniaPAUSA

Objective: Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that *** Sources: PubMed, Ovid/Medline, and ScopusMethods: A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were ***: A total of 41 papers met inclusion criteria and were organized into 5 categories ("General Recommendations for Otolaryngologic Surgery’, "Equipment Shortage Solutions’, "Airway Procedures’, "Nasal Endoscopy and Skull Base Procedures’, and "Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 ***: Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically

关键词： COVID-19 Innovations Inventions Literature Review Otolaryngology

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Changes in otolaryngology application requirements and match outcomes:Are we doing any better?

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2023年第2期9卷 144-152页

作者： Emma De Ravin Ariel S.Frost Neal R.Godse Amber D.Shaffer Noel Jabbour Barry M.Schaitkin jason newman Leila J.Mady Department of Otorhinolaryngology-Head and Neck Surgery University of Pennsylvania Health SystemPhiladelphiaPennsylvaniaUSA Head and Neck Institute Cleveland ClinicClevelandOhioUSA Division of Pediatric Otolaryngology Children's Hospital of Pittsburgh of UPMCPittsburghPennsylvaniaUSA Department of Otolaryngology University of Pittsburgh Medical CenterPittsburghPennsylvaniaUSA Department of Otolaryngology-Head and NeckSurgery Medical Universityof South CarolinaCharlestonSouth CarolinaUSA MUSC Hollings Cancer Center CharlestonSouthCarolinaUSA Department of Otolaryngology-Head and Neck Surgery Thomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA Cancer Risk and Control Program of Excellence Sidney Kimmel Cancer CenterPhiladelphiaPennsylvaniaUSA

Objectives:Otolaryngology-specific requirements were piloted to minimize applicant and program *** investigated the impact of introducing and then removing these requirements on Match ***:2014-2021 National Resident Matching Program?data were *** primary outcome was the impact of Otolaryngology Resident Talent Assessment(ORTA;prematch 2017,postmatch 2019)and Program-Specific Paragraph(PSP;implemented 2016,optional 2018)on applicant numbers and match *** survey analysis assessed candidate perceptions of PSP/***:Applicant numbers declined significantly during PSP/ORTA(18.9%;p=0.001).With the optional PSP and postmatch ORTA,applicant numbers increased significantly(39.0%;p=0.002).Examined individually,mandatory PSP was associated with a significant decline in applicants(p=0.007),whereas postmatch ORTA was associated with significant increases in applicants(p=0.010).ORTA and PSP negatively impacted the decision to apply to otolaryngology in 59.8%and 51.3%of applicants,***,match rate success improved significantly from 74.8%to 91.2%during PSP/ORTA(p=0.014),followed by a significant decline to 73.1%after PSP was made optional and ORTA moved to postmatch(p=0.002).Conclusions:ORTA and PSP correlated with decreased applicant numbers and increased match rate *** programs seek ways to remove barriers to applying to otolaryngology,the potential consequences of an increasing pool of unmatched candidates must also be considered.

关键词： academic success internship and residency medical students otolaryngology surveys and questionnaires

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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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Evaluation of an interactive virtual surgical rotation during the COVID-19 pandemic

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 302-307页

作者： Yasmeen M.Byrnes Neil N.Luu Ariel S.Frost Tiffany N.Chao Robert M.Brody Steven B.Cannady Karthik Rajasekaran Rabie M.Shanti jason G.newman Perelman School of Medicine at the University of Pennsylvania Jordan Medical Education Center3400 Civic Center BlvdPhiladelphia19104PAUSA Department of Otorhinolaryngology-Head& Neck SurgeryHospital of the University of Pennsylvania3400 Spruce StreetPhiladelphia19104PAUSA

Objective:To evaluate medical student and attending surgeon experiences with a novel interactive virtual Otolaryngology-Head and Neck Surgery(OHNS)medical student elective during the COVID-19 *** Design:A virtual OHNS elective was created,with three components:(1)interactive virtual operating room(OR)experience using live-stream video-conferencing,(2)telehealth clinic,(3)virtual ***:OHNS Department at the University of Pennsylvania(May 2020 to June 2020).Methods:Six medical students from the University of Pennsylvania;five attending *** surveys were designed and distributed to participating medical students and attending *** included 5-point Likert scale items,with 1 indicating"not at all"and 5 indicating"very much so".Results:Response rate was 100%for both *** on average rated the educational value of the telehealth experience as 4.2±1.2,and the virtual OR experience as 4.0±*** students(n=5,83%)indicated that they had enough exposure to faculty they met on this rotation to ask for a letter of recommendation(LOR)for residency if needed,while attending surgeons had an average response of 3.0±1.0 when asked how comfortable they would feel writing a LOR for a student they met through the rotation.A majority of students(n=4,67%)felt they connected enough with faculty during the rotation to ask for *** the students(n=5,50%)indicated that the rotation allowed them to evaluate the department's culture either"extremely well"or"somewhat well".Conclusions:Overall,participating students described this innovative virtual surgical rotation as an educationally and professionally valuable *** the continued suspension of visiting student rotations due to the COVID-19 pandemic,this virtual model may have continued relevance to medical education.

关键词： Virtual surgical education Otolaryngology Undergraduate medical education Covid-19 Telemedicine Surgical video capture

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Predictors of nodal metastasis in sinonasal squamous cell carcinoma:A national cancer database analysis

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第2期6卷 137-141页

作者： Viran J.Ranasinghe Vanessa C.Stubbs Danielle C.Reny Ramie Fathy jason A.Brant jason G.newman Department of Otorhinolaryngology e Head and Neck Surgery University of PennsylvaniaPhiladelphiaPAUnited States Perelman School of Medicine University of PennsylvaniaPhiladelphiaPAUnited States

Objective:We present the largest population based study of sinonasal squamous cell carcinoma(SCC)to identify risk factors for presentation with nodal ***:The National Cancer Database(NCDB)was used for this *** codes corresponding to the nasal cavity and paranasal sinuses and histology codes representing SCC malignancy were *** regression analysis was performed to identify factors associated with presentation with nodal ***:6448 cases met inclusion *** metastasis at presentation was seen in 13.2%of patients,with the sinus subsite(19.3%)being a significant risk factor for nodal metastasis at presentation when compared to the nasal cavity(7.9%).Logistic regression analysis showed black,uninsured and Medicaid patients were more likely than white and privately insured patients,respectively,to present with nodal ***:In sinonasal SCC,the sinus subsite has a significantly increased risk of nodal metastasis compared to the nasal *** race,uninsured and Medicaid patients are more likely to have nodal metastasis at presentation.

关键词： Squamous cell carcinoma National cancer database Nodal metastasis Maxillary sinus Nasal cavity

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