ENTtoday: October 2010

Old Problem, New Focus: Otolaryngologists tailor allergy treatments to geriatric patients

Allergic rhinitis among the elderly poses a particularly difficult diagnostic challenge for the otolaryngologist. As people age, they undergo immunosenescence. The thymus, which produces T cells against new invaders, atrophies markedly after adolescence, and this decline results in a less robust immune response to bacteria, viruses and presumably allergens (J Pathol. 2007;211(2):144-156). Consequently, physicians have assumed that allergies should decline as people age.

ENT Today Welcomes New Committee

One of the features weíve added to ENT Today since our new publishing partnership with Wiley-Blackwell has been concise, to-the-point reviews of some of the most important articles in the literature. Our editorial board members have been responsible for the most recent reviews in our ìLiterature Reviewî department, but the Triological Society has established a new committee of outstanding individuals who will scan the literature and write the summaries you read in ENT Today.

New Quality Indicator: MOC promotes better care, ABOto director says

With greater scrutiny of doctors and easier access to information about doctors’ education, the American Board of Otolaryngology’s Maintenance of Certification (MOC) program is more important than ever, said Robert Miller, MD, executive director of the American Board of Otolaryngology (ABOto).

A Tailored Approach to Dizziness: Take extra caution and care in the elderly, panelists say

Dizziness is a particular danger among the elderly, but extra care taken by physicians can help ease their problems and help keep older patients functioning, panelists said at the 2010 Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, held here Sept. 26-29.

Room for Improvement: Pediatric ambulatory centers could benefit from guidelines, panelists say

Pediatric ambulatory surgery centers are fast-paced, high-volume places with many of the ingredients that can contribute to safety concerns, a patient safety expert from Children’s National Medical Center (CNMC) said at the 2010 Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), held here Sept. 26-29.

EHR Contracts Done Right: Get the most out of the government’s new adoption incentives

Need an incentive to implement an electronic health records (EHR) system in your practice? How about $44,000? That’s the amount the federal government is making available to eligible physicians as part of its effort to speed up the adoption of health information technology throughout the U.S. In fact, under the Health Information Technology for Economic and Clinical Health Act (HITECH Act), part of the American Recovery and Reinvestment Act of 2009, billions of federal stimulus dollars are flowing to medical practices throughout the U.S. to help physicians set up EHR systems.

New Study Presents Education Opportunity: Nasal zinc side effects spark discussions about alternative treatments

Arecent study in Archives of Otolaryngology-Head and Neck Surgery on the potential side effects of nasal zinc therapies is the newest staging ground in the debate over how otolaryngologists can advise patients on the benefits of homeopathic treatments in the context of the common cold.

Experts Push EHR Adoption: Expect to commit your time and finances, panelists say

The time for otolaryngologists to adopt electronic health records (EHRs) is now, practice management and information technology experts said at a session at the 2010 Annual Meeting of the American Academy of Otolaryngology-Head and Neck Surgery, held here Sept. 26-29.

The End of the Food Challenge Test?: Researchers seek new ways of diagnosing food allergy

New ways of diagnosing food allergies are on the horizon, with allergy experts hoping that it might be possible one day for many patients to avoid the traditional food challenge test (FCT).

Voice Prosthesis Seals Small Pharyngocutaneous Fistulas After Total Laryngectomy

What management is possible for small pharyngocutaneous fistulas (PCFs) in patients with limited survival chance who are not candidates for surgery?  Background: Some of the most common complications following total laryngectomy are PCFs. While a standard protocol for PCF management does not exist, the first approach is conservative management with wound care and tube feeding. When […]

Systemic and Otic Administration of Ofloxacin Are Comparable

Does topical application of ofloxacin to the intact tympanic membrane (TM) compare to systemic administration? Background: Acute otitis media (AOM) is routinely treated with systemic antibiotics, which have been linked to antibiotic-resistant strains of bacteria. Generally, topical therapy is considered appropriate if the TM is nonintact and permits solutions placed in the external auditory canal to […]

Balloon Dilation Useful for Revision Frontal Sinusotomy

Is the balloon a useful tool for revision frontal sinusotomy to efficiently and safely allow subsequent instrumentation of the frontal outflow tract using larger, more aggressive instruments? Background: Reports of drill-out frontal sinusotomy outcomes have emphasized the importance of mucosal preservation and the avoidance of circumferential mucosal disruption in maximizing long-term success. The frontal sinus outlflow […]

Large Fiberoptic Endoscopes May Be More Durable than Small Endoscopes

What is the durability of endoscopes to continued use and automated high-level disinfection, and how many duty cycles can a flexible endoscope withstand before repairs should be anticipated?  Background: High-level disinfection (HLD) for semi-critical instruments such as flexible endoscopes is recommended by the Association of Operating Room Nurses and the Association for Professionals in Infection Control […]

Chemotherapy Alone Not Recommended for Advanced Laryngeal or Hypopharyngeal Cancer

Is treatment with chemotherapy alone feasible for advanced laryngeal or hypopharyngeal squamous cell carcinoma? Background: A favorable response to induction chemotherapy has been shown to be predictive of response to chemoradiation in patients with advanced laryngeal squamous cell cancer. Because of the adverse long-term sequelae of radiation therapy, including fibrosis and dysphagia, this study sought to […]

Survival Rates Comparable in Children and Adults with Oral Tongue Squamous Cell Cancer

Does young age adversely affect prognosis for oral squamous cell carcinoma? Background: Squamous cell carcinoma in young patients (<40 years of age) is believed to have an etiology that is distinct from squamous cell cancer in older patients because these patients have had less exposure to risk factors such as tobacco and alcohol use. Younger patients […]