ENTtoday: November 2010


Career Development

Career Shift: Mid-career mentors can help you change course

Like many physicians, otolaryngologists at mid-career may experience some form of burnout and be looking to make a professional shift. Indeed, a study published in the Annals of Surgery last year found that otolaryngologists had high rates of career burnout that paralleled those of trauma and vascular surgeons.

Medical Education

Lingering Issues: Challenges remain in repairing CSF leaks

Once the province of neurosurgeons, cerebrospinal fluid (CSF) leak repair is now handled mostly by otolaryngologists. This change has occurred over the past couple of decades, during which time the evolution of endoscopic tools and techniques has made possible extracranial rather than intracranial repair. The success rate for repairing these leaks from below has reached about 90 percent, particularly for small leaks.


Literature Reviews

Intraoral Removal Has Advantages over Submandibular Gland Resection

Are surgical outcomes better for intraoral removal of proximal submandibular stones or traditional submandibular gland (SMG) resection? Background: Salivary stones, the most common cause of salivary ductal obstruction, usually occur in the SMG and its ductal system. About 40 percent are located distally in Wharton’s duct and can be easily removed through an intraoral procedure. Proximal […]

Literature Reviews

Injection Laryngoplasty Helps in Recovery of Vocal Fold Motion

What are the long-term outcomes of patients with unilateral vocal fold paralysis (UVFP) who are treated with injection laryngoplasty (IL)? Background: IL, a temporary intervention for UVFP, is often performed in patients with a potentially recoverable recurrent laryngeal nerve insult while they await spontaneous recovery, compensation or definitive intervention. The decision to treat UVFP is historically […]

Literature Reviews

Diagnosis of Supraglottitis in the Post-Immunization Era

What are the demographics, presentation, interventions and outcomes of acute supraglottitis in the era following widespread immunization against Haemophilus influenza type b? Background: The overall incidence of acute supraglottitis has decreased significantly since the introduction of the conjugated Haemophilus influenza type b (Hib) vaccine in 1988 and its widespread use by 1995. While there has been a marked […]

Literature Reviews

Mandible Vascularized Bone Graft Reconstruction Successful in BRONJ

Does vascularized bone reconstruction provide optimum reconstruction among patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ)? Background: Bisphosphonates, a commonly prescribed class of medications used in the treatment of multiple myeloma and metabolic and metastatic bone disease, decrease bone resorption via inhibition of enzyme activity within osteoclasts. Remaining in the bone for several years, bisphosphonates can […]

Literature Reviews

Dysphagia May Lengthen Hospital Stay

Does the presence of dysphagia in hospitalized patients result in prolonged hospital stay and increased morbidity? Background: Dysphagia is a symptom that may be an indication of swallowing dysfunction. Swallowing dysfunction can result in aspiration, dehydration, malnutrition, pneumonia, pulmonary abscess and death. The implication of swallowing dysfunction on a patient’s hospital stay is uncertain. The authors […]

Literature Reviews

Scoring System for Esophageal Cancer Requires Other Considerations

Can a simple scoring system identify individuals at high risk of esophageal cancer?1 Background: The prevalence of esophageal cancer is rapidly expanding. The prognosis for late stage esophageal cancer is dismal, and survival depends on early diagnosis and treatment. Limitations in health care resources preclude screening all individuals with dysphagia. Study design: Retrospective cohort study Setting: University Hospital […]