July 31, 2009 Robert T. Sataloff, MD, DMA, FACS, Editor-in-Chief
article
Otolaryngologists practicing in the United States can expect to be involved in medical/legal issues at some time during their careers. Those practicing in “high-risk” areas may have to address medical/legal issues weekly, if not daily.
July 30, 2009
news
U.S. News & World Report has released its 2009-2010 “America’s Best Hospitals” list, which includes hospitals ranked by specific specialties.
May 31, 2009
article
Otolaryngologists have not been as prolific in promulgating practice parameters and technology assessments as some of our colleagues in other specialties. We have more clinical practice guidelines than we do practice parameters, but even these were developed through a relatively informal process until recently.
April 30, 2009 Leonard Yuen, Daniel M. Gore, BSc, MCROphth, and Esther J. Posner, FRCOphth
December 1, 2008 Eileen M. Raynor, MD
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Abstract
Although the American Academy of Otolaryngology-Head and Neck Surgery conducts a workforce survey annually, no study has been conducted to examine practice patterns as they pertain specifically to academic otolaryngology. Therefore, I developed the Academic Otolaryngologist Survey for this purpose. This survey, conducted in 2006, was mailed to 856 practicing otolaryngologists in the United States; 230 responded, for a return rate of 26.9%. Of the 230 respondents, 94% practiced full-time, 97% worked with otolaryngology residents and were board certified, and 67% had fellowship training in one or more subspecialties. The most commonly reported fellowships were in pediatric otolaryngology, facial plastic surgery, head and neck, and otology/neurotology. Respondents answered that they felt practice patterns had changed. Unlike the private-practice sector, academic otolaryngology is seeing a shift from generalists to subspecialists. The subspecialization becoming prevalent in academic otolaryngology may ultimately alter resident training. Therefore, academic programs need a balance of general and subspecialized otolaryngologists in order to train residents for practice.
August 31, 2008 Lynn S. Alvord, PhD, Michael S. Benninger, MD, and Brad A. Stach, PhD
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Abstract
Because the cause of falls is often multifactorial, efforts to identify risk factors and promote prevention would benefit from a multidisciplinary approach in which the contributions of a broad range of body systems are considered. We describe the practices and procedures followed at the otolaryngology-based multidisciplinary Falls Prevention Clinic at Henry Ford Hospital in Detroit. Our team is made up of an otolaryngologist, an audiologist, an internist, and a physical therapist. Our multidisciplinary approach involves evaluations of vestibular and balance function, cardiovascular function, and visual function; lower-extremity strength and sensation; cognition and mood; and medication use. We also assess a number of nonmedical risk factors. Evaluations are made over the course of two clinic visits. To assess the effectiveness of our approach, we conducted a preliminary study based on chart reviews and telephone interviews of 52 patients who had been referred to our clinic for evaluation and counseling. The basis of our study was a comparison of the number of falls that patients had experienced during the 6 months prior to their first visit to our clinic and the number of falls they experienced during the 6 months after their second visit. We found that among “true fallers” (i.e., those who had actually experienced a fall at some point during the study), 64.7% reported that they had experienced fewer falls after their clinic visits than before (p < 0.001). Also, 59.1% of patients who had been “frequent fallers” prior to their clinic evaluation (i.e., ≥3 falls during the previous 6 mo) reported that they had not fallen at all during the 6 months following their last visit. Finally, our evaluations identified a substantial number of risk factors in individual patients that had been missed previously, including many nonvestibular factors that might not have been detected without a multidisciplinary approach. We conclude that the results of this preliminary study demonstrate the potential that a comprehensive falls prevention clinic can have in reducing the number of falls among outpatients at risk, and we believe that further study is warranted.
March 31, 2008 Michael T. Gaslin, MD, Cory Rubin, BA, and Edmund A. Pribitkin, MD
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Abstract
Long-term use of silver-containing products is associated with a permanent bluish-gray discoloration of the skin known as argyria, but they remain widely available despite several measures by the FDA to regulate them. Several recent case reports have described the occurrence of argyria as a result of using these “natural” products. We used the five most common Internet search engines to find Web sites providing information on silver-containing nasal sprays. Of 49 Web sites analyzed, only 2 (4%) mentioned argyria as a possible complication, although 30 (61%) did caution against long-term use. Eight sites (16%) made specific claims about the health benefits of the product. All 49 sites (100%) provided direct or indirect links to buy silver-containing nasal sprays. We conclude that information about silver-containing nasal sprays on the Internet is misleading and inaccurate. Therefore, otolaryngologists should be aware of the misinformation their patients may be receiving about these products.
March 1, 2008 Monica Hollowell, MD, Lester D. R. Thompson, MD, FASCP, and Liron Pantanowitz, MD
February 1, 2008 Thomas V. Paul, MD, James Dinakar, MBBS, Nihal Thomas, MD, FRACP, Suma Susan Mathews, MS, Nylla Shanthly, MBBS, DRM, and Aravindan Nair, MS
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Abstract
Turner syndrome is a hereditary chromosomal anomaly that affects girls and women. A result of gonadal dysgenesis, its primary characteristics are short stature, osteoporosis, neck webbing, and cardiac defects. Turner syndrome may also involve the auditory system and kidneys. We report the case of a woman with Turner syndrome who presented late in adulthood with severe osteoporosis and hypercalcemia. She was subsequently diagnosed with primary hyperparathyroidism secondary to a parathyroid adenoma. After excision of the adenoma, the woman's serum calcium level normalized. To the best of our knowledge, only 4 other cases of Turner syndrome with hyperparathyroidism have been reported in the literature.
January 1, 2008 Steven F. Isenberg, MD
