Otolaryngology Applicant Perspectives on In-person and Virtual Residency Interviews.

Objective: The objective of this study was to understand applicant perspectives on in-person and virtual otolaryngology residency interviews.

Study Design: Survey study.

Setting: Otolaryngology residency applicants who were interviewed during 2022-2023.

Side-Firing Intraoperative Ultrasonograhy for Resection of Giant Pituitary Adenomas.

Background: Suprasellar extension, cavernous sinus invasion, and involvement of intracranial vascular structures and cranial nerves are among the challenges faced by surgeons operating on giant pituitary macroadenomas. Intraoperative tissue shifts may render neuronavigation techniques inaccurate. Intraoperative magnetic resonance imaging can solve this problem, but it may be costly and time consuming.

Side-firing intraoperative ultrasound applied to resection of pituitary macroadenomas and giant adenomas: A single-center retrospective case-control study.

Introduction: Multiple intraoperative navigation and imaging modalities are currently available as an adjunct to endoscopic transsphenoidal resection of pituitary adenomas, including intraoperative CT and MRI, fluorescence guidance, and neuronavigation. However, these imaging techniques have several limitations, including intraoperative tissue shift, lack of availability in some centers, and the increased cost and time associated with their use. The side-firing intraoperative ultrasound (IOUS) probe is a relatively new technology in endoscopic endonasal surgery that may help overcome these obstacles.

Secondary overtriage of isolated facial trauma.

Design: Retrospective chart review.

Setting: Academic, tertiary care, level I trauma center in a rural state.

Background: Unnecessary transfer of certain facial trauma patients results in a burden of time, money, and other resources on both the patient and healthcare system; identification and development of outpatient treatment pathways for these patients is a significant opportunity for cost savings.

Feasibility of Implementing Opioid Stewardship Recommendations for Sinonasal Surgery.

Objective: The objective of our study was to review the current literature pertaining to perioperative opioids in sinus surgery and to determine the effects of implementing opioid stewardship recommendations in the setting of endoscopic sinonasal surgery.

Study Design: Single-institution retrospective case-control study.

Setting: Academic medical center outpatient area.

Is weight a predictive risk factor of postoperative tonsillectomy bleed?

Objective: To determine if a correlation exists between weight-for-age percentile and post-tonsillectomy hemorrhage in the pediatric population.

Study Design: Retrospective study.

Methods: 1418 patients under the age of 15 who underwent tonsillectomy with or without adenoidectomy at a tertiary children's hospital between June 2012 and March 2015 were included in this retrospective study.

Cost-effectiveness of sialendoscopy versus medical management for radioiodine-induced sialadenitis.

Objectives/hypothesis: The medical management and radiographic identification of radioiodine-induced sialadenitis (RAIS) is challenging. This study utilizes a cost-effectiveness analysis to compare upfront sialendoscopy as both a diagnostic and therapeutic option versus multiple modalities of diagnostic radiography along with medical management.

Study Design: Literature review and cost-effectiveness analysis.

Are prophylactic systemic antibiotics necessary with nasal packing? A systematic review.

Background: The use of prophylactic systemic antibiotics with nasal packing has been a controversial topic. There are few evidence-based studies to determine the need for prophylactic systemic antibiotics. We performed a systematic literature review to determine the role of prophylactic systemic antibiotics with nasal packing in the prevention of toxic shock syndrome and local nasal infections.

Correlation of frontal sinus recess anatomy with ethnicity, gender, and pathology.

Purpose: Research on frontal sinus cells has been conflicting regarding relationship between frontal sinus cells and frontal sinus disease. There are no published studies regarding gender differences in frontal sinus disease. No comparisons between African Americans and Caucasians and frontal sinus disease have been published.

Clinical Consensus Statement: Septoplasty with or without Inferior Turbinate Reduction.

Objective: To develop a clinical consensus statement on septoplasty with or without inferior turbinate reduction.

Methods: An expert panel of otolaryngologists with no relevant conflicts of interest was assembled to represent general otolaryngology and relevant subspecialty societies. A working definition of septoplasty with or without inferior turbinate reduction and the scope of pertinent otolaryngologic practice were first established.

Strategies for decreasing contamination of homemade nasal saline irrigation solutions.

Background: Saline nasal irrigations (SNI) are an important adjunct in the treatment of rhinosinusitis, and many patients prepare and store these solutions in their homes without an awareness of the potential for contamination. The objectives of this study were to determine if such contamination occurs and the effect of preparation methods on contamination.

Methods: Stock solutions of various tonicities and pHs were prepared using boiled, bottled, and distilled water (n = 57).

Current perioperative practice patterns for minimizing surgical site infection during rhinologic procedures.

Background: There is a paucity of information in the literature regarding the best practices to reduce surgical site infections associated with rhinologic surgery.

Methods: We surveyed the American Rhinologic Society (ARS) membership to assess current perioperative infection control measures performed for rhinologic procedures, with the goal of establishing a baseline of current practice.

Results: Results revealed that for most rhinologic procedures performed in the operating room (OR) setting, the majority of physicians gown and drape in a sterile fashion and perform a complete surgical scrub of their hands and forearms but do not prep the facial skin with an antimicrobial agent.

Diagnostic criteria for a curable form of chronic rhinosinusitis: the mucous recirculation syndrome.

In clinical practice, nonallergic rhinosinusitis (rhinopathy) is a common diagnosis of exclusion. The mucous recirculation syndrome is one incompletely defined condition that masquerades as nonallergic rhinopathy. Mucous recirculation syndrome, a curable condition, should be differentiated from nonallergic rhinopathy.

Clival chordoma of the nasal septum secondary to surgical pathway seeding.

Educational Objective: At the conclusion of this presentation, the participants should be able to recognize seeding as a form of treatment failure in transseptal resection of clival chordomas.

Objectives: The purpose is to present a case of implanted metastases in the nasal septum after a transseptal approach for resection of clival chordoma and to compare it with other reported cases in the literature.

Study Design: Case report and literature review.

Effective use of physician extenders in an outpatient otolaryngology setting.

Physician extenders may be a valuable asset to an outpatient otolaryngology practice. The adjunctive care provided by physician extenders appears to be cost effective and has the advantages of increasing patient education, promoting physician productivity, and improving management of chronic conditions. Practice types that may benefit from advanced practice providers include group or solo practices with high demand or who need improved efficiency.

Characteristics of nasal injuries incurred during sports activities: analysis of 91 patients.

Nasal injuries are among the most common sports injuries. We conducted a prospective, observational study of 91 patients, aged 7 to 60 years (mean: 18.3), who had sustained a nasal injury while engaging in a sport, exercise, or other recreational physical activity.

Complications of allergic fungal sinusitis.

Purpose: Allergic fungal sinusitis is a syndrome of chronic noninvasive fungal sinusitis that results in the accumulation of eosinophil-rich allergic mucin within the paranasal sinuses. This mucin may become an expansile mass leading to complications that have not been well characterized or classified.

Methods: Inclusion criteria for this study required meeting previously published diagnostic criteria and complications greater than nasal polyps or sinusitis itself.

Atrophic rhinosinusitis: progress toward explanation of an unsolved medical mystery.

Purpose Of Review: Atrophic rhinosinusitis is a chronic condition associated with considerable morbidity and decreased quality of life. This review describes progress in the characterization of primary and secondary atrophic rhinosinusitis and the development of diagnostic criteria for both syndromes.

Recent Findings: Primary atrophic rhinitis usually develops as a consequence of an acute febrile illness in members of lower socioeconomic groups in developing areas of the world.

Clinical features of sarcoid rhinosinusitis.

Objective: We asked if certain clinical features were useful predictors of sarcoid rhinosinusitis in general populations of patients with chronic rhinosinusitis.

Methods: Our patients with sarcoid rhinosinusitis and those from the literature formed the study group. A group of 21 randomly selected patients from The University of Mississippi Medical Center Allergy Clinic with chronic rhinosinusitis composed the control group.

Going to the next level: health care's evolving expectations for evidence.

Rhinologic literature has historically relied on lower levels of evidence to make prescriptive recommendations for use of new technology and procedures. However, as the medical profession has moved to embrace the principles of evidence-based medicine, expectations for minimum standards of evidence have risen. The resulting high-quality efficacy outcomes data have become the linchpin of informed decision making by physicians, payers, and health care systems.

Diagnostic criteria for atrophic rhinosinusitis.

Background: Patients with atrophic rhinosinusitis have intractable upper airway symptoms that result from loss of the normal nasal epithelium. There is no consensus on how to diagnose this condition, and diagnostic criteria are not available to perform multicenter treatment trials. We sought to establish diagnostic criteria for atrophic rhinosinusitis.

Diagnostic evaluation of inhalant allergies: a cost-effectiveness analysis.

Background: The purpose of this study was to compare the cost-effectiveness of modified quantitative testing (MQT), intradermal dilutional testing (IDT), and in vitro allergy testing as diagnostic methods used in the management of patients with suspected IgE-mediated inhalant allergies.

Methods: A systematic review was conducted to determine key statistics for analysis, such as prevalence of disease, and sensitivity and specificity of each diagnostic modality. Costs were calculated based on charges from distribution companies to providers.