ENTtoday: January 2011

Another Option for Allergic Rhinitis?: Study examines long-term safety, efficacy of RF turbinoplasty

When patients with allergic rhinitis don’t respond to medical therapy, an otolaryngologist’s arsenal of treatment includes surgical options. Among these is radiofrequency (RF) turbinate reduction, also known as RF turbinate ablation or turbinoplasty, an office procedure that advocates say is cost-effective and minimally invasive, with fewer complications than other surgical remedies. Some otolaryngologists, however, are still hesitant to use this relatively new therapy.

Patient with Conductive Hearing Loss

A 71-year-old male presented with an approximately 10-year history of a gradually progressive right-sided hearing loss.

Physician Groups Set 2011 Agenda: Medicare payment reform tops the list

Physician groups representing otolaryngologists have ambitious 2011 policy and legislative agendas that include pushing for replacement of the Medicare physician payment formula and helping to shape health reform’s implementation.

A Seller’s Market: How to prepare your practice for sale to a hospital

It’s 2011 and the pendulum is once again moving toward private practices selling to hospitals or affiliated foundations. Several years ago, the same phenomenon drove the medical market. Management companies and hospitals went on an acquisition frenzy, purchasing practices at breakneck speed. Soon, hospitals were dissatisfied, management companies went broke and physician practices went private again. Physicians simply proved to be less motivated and productive when employed by hospitals or affiliated with management companies.

Falling on Deaf Ears: Hearing loss in older adults may be an undertreated condition

Most people will experience some degree of hearing loss as they age. Statistics from the National Institute on Deafness and Other Communication Disorders at the National institutes of Health (NIH) indicate that 30 percent of adults ages 65 to 74, and 47 percent of adults 75 years or older, have hearing loss.

New Frontiers: Medical tourism brings potential for big business but poses big questions

More patients every year are traveling outside of the U.S. in search of lower health bills and treatments that might be unavailable to them at home.

Goiter Size Associated with Increasing Symptoms

In the preoperative evaluation of goiter, is there a correlation between goiter size and symptoms, between preoperative neck imaging abnormalities and symptoms and predictors for goiter recurrence? Background: Substernal goiter affects up to one in 5,000 patients, with progressive growth potentially resulting in progressive dyspnea, dysphagia and untoward cosmetic changes. Thyromegaly is a common problem that […]

Laryngeal EMG Is Best Technique to Differentiate Arytenoid Dislocation from Unilateral Vocal Fold Paralysis

What are the incidence, diagnosis, laryngeal findings and management of arytenoid dislocation as a separate entity from vocal fold paralysis? Background: A rare clinical entity, arytenoid dislocation commonly presents with hoarseness, breathy voice and dysphagia. The etiology is usually intubation, direct laryngoscopy or blunt laryngeal trauma. Early diagnosis is important, but laryngoscopic findings are similar to […]

Hearing Conservation Program Helps Elementary School Children

What is the efficacy of a hearing conservation program in changing acoustic risk taking and hearing conservation behaviors in elementary school children? Background: Approximately 30 million North Americans have speech-frequency hearing loss, and its prevalence among young adults is growing. In early years, hearing loss can affect a child’s ability to differentiate between consonant sounds, adversely […]

Cost Analysis of Transoral Surgery versus XRT for Early-Stage Glottic Cancer

Which treatment for Tis/T1 glottic carcinoma among adult patients, transoral CO2 laser excision (TOL) or external beam radiation (XRT), is superior in terms of cost utility? Background: Cancer of the larynx is the most common head and neck cancer, with 75 percent of cases confined to the level of the glottis. The goal of treatment for […]

Link Between Mortality and Post-Surgery Complications Unclear

Is there a correlation between rates of complications after inpatient surgery and mortality? Background: Hospital mortality associated with inpatient surgery varies widely. Hospitals, regulatory agencies and payers have focused on reducing the rates of postoperative complications to reduce rates of mortality. Early recognition and effective management of postoperative complications once they have occurred may be equally […]

Purpura Formation a Poor Clinical Endpoint for Laser Treatment

How effective are subjective clinical endpoints in determining the effectiveness of laser therapy in the treatment of capillary malformations, also commonly referred to as port wine stains (PWS)? Background: PWS arise from ectatic blood vessels in the dermis. Various lasers are used to selectively photocoagulate these aberrant blood vessels. Purpura formation is commonly used to assess […]