ENTtoday: March 2011


Everyday Ethics, Practice Management, Viewpoint

Letters: Taking the Lead on Safety

I read with great interest the article published in the December 2010 issue of ENT Today, “Safety Net: With violence on the rise, otolaryngologists implement prevention strategies”. Physician safety in the workplace is still largely ignored and your article serves to further awareness of the problem. I thank you for providing this forum.

Career Development, Legal Matters, Practice Management

Purchase Options: Review these ownership provisions before signing your employment agreement

Physicians who join a medical practice often have the opportunity to purchase an equity interest in the practice after some period of employment with the group, an issue that is usually addressed in the physician’s employment agreement. If you think you may be interested in such a partnership, you should carefully review your employment agreement before signing it. The amount of detail in the employment agreement regarding potential ownership will vary depending on the practice and the negotiating power of the individual physician. Clearly, the more specificity found in the contract, the better you will be served.

Literature Reviews

Case Report: Robotic-Assisted Transoral Removal of Submandibular Megalith

What is the feasibility of utilizing the daVinci Surgical System in the management of large stones of the submandibular gland? Background: At one time, complete removal of the submandibular gland was standard for large salivary stones. Recent studies have shown that a combined approach involving transoral or external removal guided by salivary endoscope can permit stone […]

Literature Reviews

A Look at Transoral Robotic Surgery with Synchronous Neck Dissection

What is the incidence of pharyngocutaneous fistula associated with transoral robotic oropharyngectomy with concurrent neck dissection, and how can pharyngocutaneous fistula be prevented and treated? Background: Transoral resection is emerging as a valuable modality to treat oropharyngeal squamous cell carcinoma. The surgical treatment frequently involves neck dissection, but many surgeons have been reluctant to perform the […]

Literature Reviews

Experience with Robotic Thyroid Surgery in North American Patients

What is the feasibility of robotic thyroid surgery in North American patients? Background: Less invasive thyroid surgery approaches, such as video-assisted thyroidectomy, may be technically difficult and still result in a neck incision. The daVinci Surgical System has been applied to a transaxillary endoscopic approach to the thyroid, allowing increased precision, tremor filtration and more degrees […]

Literature Reviews

Treatment Success Poor for Age-Related Vocal Fold Atrophy

What is the perceived treatment success for patients with vocal fold atrophy? Background: Estimates for the number of elderly people with voice problems range from 4 percent to 30 percent. There are only a few published studies on voice therapy for age-related vocal fold atrophy and treatment outcomes of voice therapy and injection augmentation intervention. Additionally, […]

Literature Reviews

Study Raises Questions about Angioedema Management

What are the criteria for airway intervention in patients with angioedema? Background: Angioedema is painless edema of the mucosal and cutaneous surfaces. The more common type is hereditary and is caused by defects in C1 esterase inhibitor, accumulation of bradykinin and mast cell degranulation. The goals were to determine trends in presentation, management and factors associated […]

Literature Reviews

Larygnopharyngeal Reflux Changes Laryngeal Mucosa

How does reflux affect laryngeal tissue quality? Background: Laryngopharyngeal reflux has deleterious effects on the larynx. Due to the poor intrinsic protective mechanisms in this tissue, damage occurs at a higher pH and leads to the commonly known throat symptoms. The authors in this study have used endogenous acid and pepsin to study the mucosal changes […]