Evidence in Rhinology Care
American Rhinologic Society
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May 2013Panelists at the American Rhinologic Society Meeting talked about evidence in the literature, both published and not yet published, that has helped them, and how they incorporate it into their practice.
Michael Stewart, MD, MPH, chairman of the department of otolaryngology-head and neck surgery at Weill Cornell Medical College in New York and editor in chief of The Laryngoscope, emphasized that there is “good evidence out there, which unfortunately takes a long time to get disseminated.”
John Krouse, MD, PhD, chair of otolaryngology-head and neck surgery at Temple University in Philadelphia, said he recalled a 2005 study that showed that the topical intranasal antihistamine azelastine performed better than oral antihistamines, which he said was a “paradigm shift” for him and led him to greatly reduce his use of oral antihistamines.
David Poetker, MD, MA, of the Medical College of Wisconsin in Milwaukee, acknowledged that he often looks to the literature “to justify what I’ve been doing” rather than to seek out best practices, which he cautioned against. Literature can also be helpful to communicate to patients the “rationale” of treatment in order to encourage better compliance.
Dr. Stewart cautioned that it can be easy to “fall into the trap” of relying on one well-done study and not taking into account all of the other evidence.
Bionic Approaches to Facial Reanimation
American Academy of Facial Plastic and Reconstructive Surgery
At the Spring Meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Alice Frigerio, MD, PhD, of the Carolyn and Peter Lynch Center for Laser and Reconstructive Surgery at Harvard Medical School in Boston, discussed her group’s efforts to refine the use of infrared light beams as a technology for eye-blink detection this biosignal serves as a trigger for facial pacing. The focus, at this point, is to elicit biomimetic eye blinks on the paralyzed side of a face using a close-looped device that can record
movement of the healthy side of the face and pace-assisted movements on the contralateral side, in case of unilateral facial nerve injury. Using infrared light beams, her group tested a prototype of goggles and obtained perfect results, defined as no false positives or false negatives, in 25 percent of the trials. Eighty-seven percent had true positives, while 11 percent had false positives, half of which were due to the software mistaking a twitch for a blink.