Beyond Morbidity and Mortality Conference: How Do We Learn From Special Cases?

Objective: Physicians experience scary cases in the course of usual medical practice. Cases of near misses, legal and ethical dilemmas, or unique clinical challenges are great sources of education. However, there is no format for presentation and dissemination of cases that do not meet criteria for morbidity and mortality (M&M) conferences.

Evaluation and Management of Tinnitus: Are There Opportunities for Improvement?

Objective: To review current information about diagnosis and management of tinnitus aiming to identify opportunities for achieving a cost-effective, efficient, evidence-based approach that meets the needs of tinnitus sufferers.

Data Sources: PubMed/MEDLINE.

Review Methods: In total, 249 relevant published reports were reviewed.

Making a Major Change: Changing Your Practice Setting, Retirement, and Locums.

The goal of this article is to discuss factors associated with career change and give data and recommendations of how to prepare for a career change in regards to early, mid, and late career.

Bilateral congenital cholesteatoma: A case report and review of the literature.

Objectives: Congenital cholesteatoma (CC) occurs less commonly than acquired cholesteatoma (AC), and bilateral CC (BCC) is even more rare with only 38 such cases having been reported in the past 42 years. Because of the rarity of this condition, providers confronted with cases of BCC may find it difficult to treat while balancing complete removal of disease, optimal hearing outcomes, and minimized surgical burden in the pediatric patient. This review alerts physicians that BCC occurs, highlights past presentations and management strategies, describes the considerations in treatment and offers an algorithm helpful in the management of BCC.

Are validated patient-reported outcomes used on children in pediatric otolaryngology? A systematic review.

Objectives: Review the pediatric otolaryngology literature to 1) identify studies in which children completed patient-reported outcome (PRO) measures and 2) appraise the psychometric quality and validity of these PROs as they apply to pediatrics.

Methods: In October 2016, a systematic review was performed by two reviewers on PubMed/MEDLINE and EMBASE for all otolaryngology-related studies that utilized PROs in children. Inclusion criteria included articles that required children (age<18) to complete PROs.

The Interactive Candidate Assessment Tool: A New Way to Interview Residents.

The purpose of the residency interview is to determine the extent to which a well-qualified applicant is a good fit with a residency program. However, questions asked during residency interviews tend to be standard and repetitive, and they may not elicit information that best differentiates one applicant from another. The iCAT (interactive Candidate Assessment Tool) is a novel interview instrument that allows both interviewers and interviewees to learn about each other in a meaningful way.

Assessing work-related musculoskeletal symptoms among otolaryngology residents.

Purpose: Previous studies have suggested that musculoskeletal symptoms are common among practicing otolaryngologists. Early training can be the ideal time to foster knowledge of ergonomics and develop safe work habits, however, little data exists regarding musculoskeletal symptoms in residents. The purpose of this study was to identify and characterize musculoskeletal symptoms in a preliminary sample of otolaryngology residents.

Increasing Competitiveness for an Otolaryngology Residency: Where We Are and Concerns about the Future.

For graduating medical students, securing a residency in otolaryngology-head and neck surgery has become exceedingly difficult. This commentary explores the ways that applicants and residency programs are reacting to the increasing competitiveness in applying to, interviewing for, and matching to an otolaryngology residency. The commonly held perceptions of applicants are compared to perspectives held by residency program directors and resident selection committees.

Minocycline-induced hyperpigmentation of tympanic membrane, sclera, teeth, and pinna.

A 40-year-old woman was referred by her primary care physician for evaluation after a routine physical exam revealed bilateral brownish pigmentation of the tympanic membrane. Head and neck examination in the otolaryngology clinic revealed bluish hue of both sclera, teeth, and portions of her pinnae. A hearing test revealed bilateral mild sensorineural hearing loss.

Otologic outcomes after blast injury: the Boston Marathon experience.

Objective: Otologic trauma was the most common physical injury sustained after the April 15, 2013, Boston Marathon bombings. The goal of this study is to describe the resultant otologic morbidity and to report on early outcomes.

Study Design: Multi-institutional prospective cohort study.

What an otolaryngologist should know about evaluation of a child referred for delay in speech development.

Importance: Otolaryngologists are asked to evaluate children who a parent, physician, or someone else believes is slow in developing speech. Therefore, an otolaryngologist should be familiar with milestones for normal speech development, the causes of delay in speech development, and the best ways to help assure that children develop the ability to speak in a normal way.

Objective: To provide information for otolaryngologists that is helpful in the evaluation and management of children perceived to be delayed in developing speech.

Early detection of factual knowledge deficiency and remediation in otolaryngology residency education.

Objectives/hypothesis: Within otolaryngology residency training, the annual Otolaryngology Training Examination (OTE) is the primary method used to assess, quantify, and compare the factual knowledge acquired by each resident. The objective of this study was to develop a more frequent method for tracking of factual knowledge to prevent educational delay.

Study Design: Retrospective analysis of educational scores.

A comparison of two methods for preventing cross-contamination when using flexible fiberoptic endoscopes in an otolaryngology clinic: disposable sterile sheaths versus immersion in germicidal liquid.

Objectives/hypothesis: To assess the efficacy of using a sterile sheath to prevent cross-contamination when using a fiberoptic nasopharnygolaryngoscope (FNPL) in an otolaryngology clinic.

Study Design: Prospective controlled trial.

Methods: All FNPLs were disinfected according to applicable current guidelines recommended by the US Center for Disease Control.

Hearing loss.

For physicians treating patients with sensorineural hearing loss, therapy is directed more toward helping the patient cope with the loss of hearing rather than offering various medical or surgical interventions. Accordingly, for the patient with sensorineural hearing loss, the care plan is usually more directed toward palliation than toward cure. This article views hearing loss not only as a physiologic deficit, but as the loss of an important aspect of overall communication skill that can have far reaching emotional and psychologic effects on the patient, the family, and those who surround patients in their daily lives.

Analysis of recurrent angiotensin converting enzyme inhibitor-induced angioedema.

Objective/hypothesis: A known risk for patients taking angiotensin converting enzyme-inhibitors (ACE-Is) is angioedema that can involve the face, lips, oral cavity, and larynx. Such upper airway obstruction may be severe enough to require an emergency department visit or even necessitate prompt airway intervention. Once a patient has had an episode of ACE-inhibitor induced angioedema (AIIA), certainly a thrust of continuing case management would be to avoid the occurrence of subsequent episodes of AIIA that potentially can be life-threatening.

Cervical tuberculosis: a decision tree for protecting healthcare workers.

Objectives/hypothesis: The clinical presentation of cervical tuberculosis (TB) is a unique challenge to the otolaryngologist. To minimize the risk of nosocomial transmission, otolaryngologists must suspect the diagnosis and be familiar with recommendations for TB prevention.

Study Design: Scientific review.

Emerging therapies for the treatment and prevention of otitis media.

Otitis media is one of the most common disorders occurring in children, and there is growing concern that bacteria are quickly becoming resistant to antimicrobials. As a result, global antibiotic treatment is no longer the standard of care and treatment of otitis media has changed dramatically in the last decade. In addition to new antimicrobials currently in development, the effects of the pneumococcal conjugate vaccine are just beginning to be understood.

Hearing loss in Wegener's granulomatosis.

Objective: To describe the frequency, type, and clinical course of hearing loss in Wegener's granulomatosis and assess hearing loss as an indicator of disease activity.

Study Design, Setting, And Patients: Retrospective cohort review of all patients with Wegener's granulomatosis seen in 1 year at an academic medical center.

Main Outcome Measures: Hearing loss documented by pure-tone audiogram.

Clinical practice guideline: Otitis media with effusion.

The clinical practice guideline on otitis media with effusion (OME) provides evidence-based recommendations on diagnosing and managing OME in children. This is an update of the 1994 clinical practice guideline "Otitis Media With Effusion in Young Children," which was developed by the Agency for Healthcare Policy and Research (now the Agency for Healthcare Research and Quality). In contrast to the earlier guideline, which was limited to children aged 1 to 3 years with no craniofacial or neurologic abnormalities or sensory deficits, the updated guideline applies to children aged 2 months through 12 years with or without developmental disabilities or underlying conditions that predispose to OME and its sequelae.

Diagnosis and management of spontaneous cerebrospinal fluid-middle ear effusion and otorrhea.

Objectives/hypothesis: Spontaneous leak of cerebrospinal fluid (CSF) into the middle ear can occur in adults without a history of temporal bone trauma or fracture, meningitis, or any obvious cause. Therefore, clues may be lacking that would alert the otolaryngologist that fluid medial to an intact eardrum, or fluid emanating from an eardrum perforation, is likely to be CSF fluid. A review of relevant medical literature reveals that herniation of the arachnoid membrane through a tegmen defect may be congenital, or CSF leak may occur when dynamic factors (i.