Climate change and environmental sustainability in otolaryngology: A state-of-the-art review.

Background: Climate change has been identified by the World Health Organization (WHO) as the greatest existing threat to human health. Given the direct exposure of the upper aerodigestive system to pollutants, patients in otolaryngology are at high risk for increased disease burden in the setting of climate change and worsening air quality. Given this and the environmental impact of surgical care, it is essential for surgeons to understand their role in addressing climate health through quality-driven clinical initiatives, education, advocacy, and research.

Addressing Climate Health: A Practical Guide to Quantifying and Reducing Health Care-Associated Emissions.

Objective: The objective was to quantify annual greenhouse gas emissions from a surgical specialty hospital and identify high-yield areas to reduce emissions associated with patient care.

Study Design: Pre-post study, greenhouse gas inventory.

Setting: Specialty hospital.

Environmental sustainability in otolaryngologic surgery.

Purpose Of Review: Climate change is an urgent public health crisis that significantly impacts disease development, health outcomes, and access to care. The major approaches to climate change are mitigation and adaptation. The purpose of this review is to discuss the effects of climate change on health and health disparities, review the carbon footprint of surgical care and discuss strategies for surgeons to reduce emissions and advocate for sustainability.

Unhappy Patients Can Turn into Angry Patients: How to Deal with Both.

Patient satisfaction is the ultimate measure of success in cosmetic facial plastic surgery. A successful outcome depends on patient selection, technical performance, and postoperative care. Patient perception can be influenced by physician-patient interactions.

Surgical Facial Esthetics for Gender Affirmation.

The sexual identity of an individual is obvious to most observers with a glance or when only noticing a portion of the face. The overall appearance of the male face is quite different from the female face. Differences in facial structures-such as brow bone, chin, nose, or lips-can be quite small.

Procalcitonin as a Biomarker in Rhinosinusitis: A Systematic Review.

Objectives: (1) To describe the existing literature on procalcitonin (PCT) as a biomarker in patients with acute rhinosinusitis (ARS), (2) to analyze outcomes in ARS patients who were treated with PCT-guided therapy versus traditional management, and (3) to compare PCT to other biomarkers used in diagnosis of bacterial ARS. Data Sources: PubMed and Embase. Review Methods: A systematic search in the PubMed and Embase databases was performed to identify studies related to PCT as a biomarker in ARS.

Risk of Venous Thromboembolism Among Otolaryngology Patients vs General Surgery and Plastic Surgery Patients.

Importance: Venous thromboembolism (VTE), which includes deep venous thrombosis or pulmonary embolism, is the number 1 cause of preventable death in surgical patients. Current guidelines from the American College of Chest Physicians provide VTE prevention recommendations that are specific to individual surgical subspecialties; however, no guidelines exist for otolaryngology.

Objective: To examine the rate of VTE for various otolaryngology procedures compared with an established average-risk field (general surgery) and low-risk field (plastic surgery).

Auditory brainstem implantation in a 16-month-old boy with cochlear hypoplasia.

Objective: To determine the safety and feasibility of auditory brainstem implantation in children younger than 5 years.

Patient(s): Patients younger than 5 years who were not candidates for cochlear implantation because of anatomic considerations were included in the analyses.

Intervention(s): Auditory brainstem implantation via retrosigmoid craniotomy.

The predictive value of single-photon emission computed tomography/computed tomography for sentinel lymph node localization in head and neck cutaneous malignancy.

Objectives/hypothesis: Preoperative localization of sentinel lymph nodes in head and neck cutaneous malignancies can be aided by single-photon emission computed tomography/computed tomography (SPECT/CT); however, its true predictive value for identifying lymph nodes intraoperatively remains unquantified. This study aims to understand the sensitivity, specificity, and positive and negative predictive values of SPECT/CT in sentinel lymph node biopsy for cutaneous malignancies of the head and neck.

Study Design: Blinded retrospective imaging review with comparison to intraoperative gamma probe confirmed sentinel lymph nodes.

Cochlear implant outcomes in patients with superior canal dehiscence.

Objective: To determine whether adult cochlear implant (CI) users with superior canal dehiscence syndrome (SCDS) or asymptomatic superior semicircular canal dehiscence (SCD) have different surgical, vestibular, and audiologic outcomes when compared to CI users with normal temporal bone anatomy.

Methods: A retrospective single institution review of CI users with either superior semicircular canal dehiscence syndrome or asymptomatic superior semicircular canal dehiscence identified eight post-lingually deafened adults with unilateral or bilateral cochlear implantation between 2006 and 2010. Preoperative and postoperative speech perception scores as well as medical and epidemiological data were recorded and analyzed.