Rethinking the Accessibility of Hearing Assessments for Children with Developmental Disabilities.

We aim to determine the accessibility of gold-standard hearing assessments - audiogram or auditory brainstem response (ABR) - during the first 3 months of hearing health care for children with and without developmental disabilities. Electronic health records were examined from children (0-18 years) who received hearing health care at three hospitals. Children with developmental disabilities had a diagnosis of autism, cerebral palsy, Down syndrome, or intellectual disability.

WPOI-5: Accurately Identified at Intraoperative Consultation and Predictive of Occult Cervical Metastases.

Background: Frozen section analysis of oral cancer specimens is ideal for assessing margin distances and depth of invasion (DOI); the latter impacts intraoperative decisions regarding elective neck dissection (END). Here, we show that intraoperative determination of worst pattern of invasion (WPOI), specifically WPOI-5, has a high level of accuracy. This relates to our demonstration herein that WPOI-5 predicts occult cervical metastases (OCM) for pT1 oral squamous carcinoma (OSC).

Patient Complaints in Orthopedic Surgery: An Analysis Utilizing a Large National Database.

Introduction: Unsolicited patient complaints (UPCs) about surgeons correlate with surgical complications and malpractice claims. Analysis of UPCs in orthopedics is limited.

Methods: Patient complaint reports recorded at 36 medical centers between January 1, 2015 and December 31, 2018 were coded using a previously validated coding algorithm Patient Advocacy Reporting System.

Early postoperative physical activity and function: a descriptive case series study of 53 patients after lumbar spine surgery.

Background: The purpose of this prospective case series study was to compare changes in early postoperative physical activity and physical function between 6 weeks and 3 and 6 months after lumbar spine surgery.

Methods: Fifty-three patients (mean [95% confidence interval; CI] age = 59.2 [56.

Endoscopic Stapes Surgery: Pearls and Pitfalls.

The endoscopic approach to stapes surgery affords unique advantages but is not without its specific challenges. The following reviews the equipment and surgical steps required to perform endoscopic stapes surgery safely and effectively, highlighting tips and potential points of failure through a series of case examples.

Bouncing back after lumbar spine surgery: early postoperative resilience is associated with 12-month physical function, pain interference, social participation, and disability.

Background Context: Positive psychosocial factors early after surgery, such as resilience and self-efficacy, may be important characteristics for informing individualized postoperative care.

Purpose: To examine the association of early postoperative resilience and self-efficacy on 12-month physical function, pain interference, social participation, disability, pain intensity, and physical activity after lumbar spine surgery.

Study Design/setting: Pooled secondary analysis of prospectively collected trial data from two academic medical centers.

Psychosocial Mechanisms of Cognitive-Behavioral-Based Physical Therapy Outcomes After Spine Surgery: Preliminary Findings From Mediation Analyses.

Objective: Changing Behavior through Physical Therapy (CBPT), a cognitive-behavioral-based program, has been shown to improve outcomes after lumbar spine surgery in patients with a high psychosocial risk profile; however, little is known about potential mechanisms associated with CBPT treatment effects. The purpose of this study was to explore potential mediators underlying CBPT efficacy after spine surgery.

Methods: In this secondary analysis, 86 participants were enrolled in a randomized trial comparing a postoperative CBPT (n = 43) and education program (n = 43).

Dart thrower's motion and the injured scapholunate interosseous ligament: A scoping review of studies examining motion, orthoses, and rehabilitation.

Study Design: Scoping review.

Introduction: Dart thrower's motion (DTM) of the wrist primarily arises from the midcarpal joint, and minimizes stress to the scapholunate interosseous ligament (SLIL). After SLIL injury or surgery, early controlled DTM may reduce the effects of prolonged immobilization, while protecting SLIL integrity.

Cumulative incidence of neck recurrence with increasing depth of invasion.

Objective: To determine if there is a critical depth of invasion that predicts micrometastasis in early oral tongue cancer.

Methods: Retrospective series identifying patients undergoing primary surgical resection of T1 or T2 oral tongue cancer who elected against neck treatment between 2000 and 2015. Cox proportional-hazard model compared the relative hazard and cumulative incidence of recurrence to depth of invasion.

Geographic variations in orthopedic trauma billing and reimbursements for hip and pelvis fractures in the Medicare population.

We investigated geographic variations in Medicare spending for DRG 536 (hip and pelvis fracture). We identified 22,728 patients. The median number of charges, discharges, and payments were recorded.

Management principles of osteoporotic fractures.

Osteoporotic fractures are difficult to manage. They pose a number of difficulties to the surgeon arising from the underlying poor bone stock compromising the intention to achieve optimum fixation. Moreover, the frail elderly patients present with a variety of medical co-morbidities increasing the risk of developing perioperative complications.

Is more lordosis associated with improved outcomes in cervical laminectomy and fusion when baseline alignment is lordotic?

Background Context: In cervical spondylotic myelopathy (CSM), cervical sagittal alignment (CSA) is associated with disease severity. Increased kyphosis and C2-C7 sagittal vertical axis (SVA) correlate with worse myelopathy and poor outcomes. However, when alignment is lordotic, it is unknown whether these associations persist.

Is obesity associated with worse patient-reported outcomes following lumbar surgery for degenerative conditions?

Purpose: To investigate whether obesity is associated with worse patient-reported outcomes following surgery for degenerative lumbar conditions.

Methods: We evaluated consecutive patients undergoing elective lumbar laminectomy or laminectomy with fusion for degenerative lumbar conditions. The Oswestry Disability Index (ODI), EuroQol-5D (EQ-5D), Short-Form 12 (SF-12), and NASS patient satisfaction were utilized.

Prevalence of hearing loss among primary school children in Mbarara, Uganda.

Introduction: Hearing loss in children is a common entity worldwide. We examined the prevalence and etiology of hearing loss among primary school children in Mbarara, Uganda.

Methods: Cross-sectional study in primary school children aged 5-14 was performed to determine the prevalence of hearing loss.

Evaluating Progress in the Global Surgical Crisis: Contrasting Access to Emergency and Essential Surgery and Safe Anesthesia Around the World.

Introduction: Since 2007, observations reveal that low- and middle-income countries (LICs and LMICs) experience similar surgical access and safety issues, though the etiology of these challenges varies by country. The collective voice of surveys completed to date has pushed the agenda for the inclusion of safe surgery and anesthesia within global health discussions. Comparison of four countries across the world shows similar basic progress as well as ongoing surgical and anesthesia needs in resource-challenged countries.

Factors associated with long-term patient-reported outcomes after three-column osteotomies.

Background Context: Studies have demonstrated sustained improvements in patient-reported outcomes (PROs) after three-column osteotomies (three-COs), but no study has evaluated what factors impact long-term outcomes.

Purpose: The aim was to investigate factors associated with PROs in patients who underwent three-CO at minimum 5 years postoperatively.

Study Design/sample: This was a retrospective review of prospective database.

Primary tumors of the facial nerve.

This article describes the pathophysiology, diagnosis, treatment, and outcomes of primary tumors of the facial nerve. These tumors include facial nerve schwannomas, geniculate ganglion hemangiomas, glomus facialis, and granular cell tumors. Although these tumors are rare, collected data help to form a consensus with regard to optimal treatment methods.

Petroclival meningiomas.

Petroclival meningiomas are most commonly found in women around 50 years of age and have the general tendency to grow and affect several cranial nerves. At presentation, many patients complain of headaches, gait disturbances and cranial neuropathies. Treatment options include surgery, with a variety of surgical approaches, and or radiotherapy.

Implantable hearing devices: the Ototronix MAXUM system.

For many hearing-impaired individuals, the benefits of conventional amplification may be limited by acoustic feedback, occlusion effect, and/or ear discomfort. The MAXUM system and other implantable hearing devices have been developed as an option for patients who derive inadequate assistance from traditional HAs, but who are not yet candidates for cochlear implants. The MAXUM system is based on the SOUNDTEC Direct System technology, which has been shown to provide improved functional gain as well as reduced feedback and occlusion effect compared to hearing aids.

Velopharyngeal dysfunction in children with Prader-Willi syndrome after adenotonsillectomy.

Introduction: Prader-Willi syndrome (PWS) is a rare genetic disorder with an incidence rate of 1 in 10,000-30,000. Patients with PWS typically have symptoms related to hypotonia, obesity, and hypothalamic dysfunction. A high rate of obstructive sleep apnea (OSA) is found among this population of patients.

Inpatient management of women with gestational and pregestational diabetes in pregnancy.

For women with type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes (GDM), poor maternal glycemic control can significantly increase maternal and fetal risk for adverse outcomes. Outpatient medical and nutrition therapy is recommended for all women with diabetes in order to facilitate euglycemia during the antepartum period. Despite intensive outpatient therapy, women with diabetes often require inpatient diabetes management prior to delivery as maternal hyperglycemia can significantly increase neonatal risk of hypoglycemia.

Early postoperative fear of movement predicts pain, disability, and physical health six months after spinal surgery for degenerative conditions.

Background Context: The fear-avoidance model offers a promising framework for understanding the development of chronic postoperative pain and disability. However, limited research has examined this model in patients undergoing spinal surgery.

Purpose: To determine whether preoperative and early postoperative fear of movement predicts pain, disability, and physical health at 6 months following spinal surgery for degenerative conditions, after controlling for depressive symptoms and other potential confounding variables.

Cognitive-behavioral-based physical therapy to improve surgical spine outcomes: a case series.

Background And Purpose: Fear of movement is a risk factor for poor postoperative outcomes in patients following spine surgery. The purposes of this case series were: (1) to describe the effects of a cognitive-behavioral-based physical therapy (CBPT) intervention in patients with high fear of movement following lumbar spine surgery and (2) to assess the feasibility of physical therapists delivering cognitive-behavioral techniques over the telephone.

Case Description: Eight patients who underwent surgery for a lumbar degenerative condition completed the 6-session CBPT intervention.