ENTtoday: May 2011

Targeting Headaches: Trigger release surgery an option for patients with chronic migraine

Surgically releasing specific “trigger sites” may provide long-term relief for some sufferers of chronic migraine. According to a recent study published in Plastic and Reconstructive Surgery, 88 percent of patients who underwent surgical deactivation of targeted trigger sites reported at least a 50 percent reduction in the frequency, severity and duration of their migraine headaches five years later.

National Drug Shortage Hits ENT Surgeries: Succinylcholine, propofol and tetracaine in limited supply

When performing certain procedures, many otolaryngologists use succinylcholine, a neuromuscular blocking agent, to help them monitor the facial nerve.

Letter: Another ENT-Hospitalist

Regarding the article, “Otolaryngologist Pioneers New Practice Model: Dr. Russell heralds hospitalist role as others ponder the concept’s staying power”…

Middle Ear Implants Offer Potential: New breed of devices may stimulate compliance, experts say

For decades, otolaryngologists have been frustrated by the refusal of some patients with hearing loss to use hearing aids. Statistics on noncompliance vary, but there is general agreement that only about 20 percent to 25 percent of Americans with treatable hearing loss use hearing aids. The problem seems to be more acute for people with mild hearing loss: A consumer survey conducted by the nonprofit Better Hearing Institute in 2009 found that fewer than 10 percent of people with mild hearing loss use amplification and that even among people with moderate-to-severe hearing loss, only four in 10 use amplification.

Social Media-cine: Get your practice on board with an Internet policy

An increasing number of physicians are venturing onto the web, and, in particular, into social media. Recently, my client Dr. M was advised by a consultant to update his practice’s website, create a Facebook page for his practice and join Twitter. The marketing consultant cautioned Dr. M that there are legal concerns for health care providers associated with the Internet and social media. While social media can be a beneficial marketing tool, it is important for physicians to have in place a specific media policy that addresses the proper ways to use this outreach both in and outside the workplace.

Increasing Evidence that PDE-5 Inhibitors Can Cause Hearing Loss

While recent reports show that phosphodiesterase-5 (PDE-5) inhibitors can cause sudden sensorineural hearing loss (SSHL), what is the global experience of this phenomenon? Background: SSHL has been reported after the ingestion of a PDE-5 inhibitor such as Viagra. SSHL has been defined as hearing loss of at least 30 dB in three or more continuous frequencies […]

The Importance of Timing in Mandible Fracture Repair

Is fixation of mandible fractures urgent? Background: There are conflicting reports on the urgency of fixing mandible fractures. While some recommend fixation within the first 72 hours, others claim that repairs that are made as late as five days post-injury do just as well. Although delayed repair can be associated with compromised nutrition, poor hygiene, inflammation, […]

Acute Mastoiditis Admissions Up, Despite Vaccination

Have the characteristics of acute mastoiditis in children changed in the post-heptavalent pneumococcal conjugate vaccine (PCV7) era? Background: With the advent of antibiotics, the incidence of acute mastoiditis, a complication of acute otitis media (AOM), has decreased. In recent years, however, there have been reports of an increase in the frequency of acute mastoiditis, which remains […]

Recurrent Laryngeal Nerve Monitoring No Better Than ID Alone

Is intraoperative neuromonitoring (IONM) of the recurrent laryngeal nerve (RLN) during thyroidectomy better than identification alone at reducing the risk of true vocal fold palsy (TVFP)? Background: TVFP is one of the most feared complications of thyroidectomy and is, along with hypoparathyroidism, one of the leading causes for litigation after thyroidectomy. Additionally, some individuals with unilateral […]

Reducing Hospital Costs for Patients Undergoing TL/BND

What factors influence intraoperative and postoperative costs associated with total laryngectomy (TL) and bilateral neck dissection (BND)? Background: Given the current environment of health care reform, the ability to respond to the financial challenges ahead requires an understanding of the drivers of cost variation for surgical procedures. Only by examining both the costs associated with specific […]

Factors to Consider in Preventing Laryngeal Injury Following Intubation

Does the duration of intubation, size of endotracheal tube or type of endotracheal tube impact the degree of laryngeal injury following intubation? Background: The incidence of laryngeal injury following intubation remains surprisingly high and has been attributed to duration of intubation and size of the endotracheal tube (ETT). Conflicting studies suggest the factors leading to laryngeal […]