Identifying quality improvement opportunities in a universal newborn hearing screening program.

Background And Objectives: Hospital-based universal newborn hearing screening (UNHS) programs are encouraged to maintain quality assurance protocols, but many hospitals lack the time and resources to initiate this process. We studied a practical approach to measuring baseline quality indicators and identifying improvement opportunities in UNHS programs.

Methods: We determined screening processes and quality indicators for UNHS programs at 4 hospitals through site visits and a 2-year retrospective review of nursery and audiology records.

Endoscopic endonasal hemisphenoidotomy for resection of pituitary lesions confined to the sella: report of 3 cases and technical note.

The authors report use of a minimally invasive endoscopic procedure, unilateral endonasal hemisphenoidotomy, for removal of lesions contained in the sella. The entire procedure was performed through a single nostril with the use of an endoscope. A unilateral endonasal hemisphenoidotomy (1.

Endoscopic resection of pituitary lesions through the nostril.

The endoscope has been used in paranasal sinus surgery for many years. More recently, cooperation between neurosurgeons and ear, nose, and throat (ENT) surgeons has resulted in an extension of use of the endoscope to resection of lesions in the sella turcica region. The procedure described herein involves insertion of the endoscope and surgical instruments through one nostril to provide improved visualization of the pituitary gland and an economy of perioperative trauma.

Improved survival with preoperative chemotherapy followed by resection uncompromised by tumor response for advanced squamous cell carcinoma of the head and neck.

Background: A total of 93 patients were treated with one of two preoperative chemotherapy regimens over a 15-year period. The study supports the importance of strict adherence to guidelines for ablative surgery.

Methods: A single surgeon performed the surgery and evaluated each patient prior to treatment.

Use of intraoperative neuromonitoring to prevent orbital complications in ethmoid sinus surgery.

Orbital injury is one of the most serious complications in sinus surgery. Although these injuries are generally infrequent, there is a considerable increased risk for orbital complications during procedures in which anatomic landmarks are distorted because of the severity of disease or prior surgery. Currently there are no methods to detect early defects in the lamina papyracea or to prevent continued resection until orbital fat or periorbita is seen.

The role of KTP laser in revision stapedectomy.

In recent years, the safety and efficacy of revision stapedectomy has come under scrutiny. Experienced surgeons report that the results of such surgery are often worse than the results after primary surgery and that the risks of sensorineural hearing loss, tinnitus, and vertigo are increased. With the addition of laser technology to revision stapes surgery, the procedure to open the neomembrane over the oval window and gain access to the inner ear can now be performed safely.