623516
tolaryngology–Head and Neck SurgeryKrouse 2015© The Author(s) 2010
OTOXXX10.1177/0194599815623516O
Reprints and permission: sagepub.com/journalsPermissions.nav
Highlights
Highlights from the Current Issue: February 2016 John H. Krouse, MD, PhD, MBA1
I
am pleased to offer our February 2016 issue for your review and enjoyment! I am sure that you will find many papers that will inform your practices and provide ample fodder for professional discussion. In the first paper this month, Bowe reports on a survey of otolaryngology residency program directors examining the extent of resident and faculty participation in quality improvement (QI) education during otolaryngology training.1 In her study, the author surveyed program directors of all 106 otolaryngology residencies using a 15-item instrument and received a 39% return rate for the survey. Among responders, only 23% of programs offered a specific QI curriculum, and only 33% monitored individual residents’ performance in QI activities. Barriers identified included insufficient training of faculty in QI and competing educational demands within the curriculum. Bowe discusses the implications of her research for otolaryngology education and stresses the need to generate a comprehensive approach to QI for faculty development and resident instruction. Patient safety and QI will continue to be of increasing importance in health care, and this journal will provide both a forum for and resources in these important areas. In the second manuscript, Shi and colleagues evaluate the relationship between preoperative levels of thyroid-stimulating hormone (TSH) and differentiated thyroid microcarcinoma (DTMC).2 The authors performed a systematic review of the literature, examining studies that explored the relationship between TSH and DTMC. They identified 9 eligible studies containing an aggregate pool of 6523 patients. Meta-analysis of these 9 papers demonstrated a significant association between high TSH levels and the presence of DTMC. Based on these data, Shi and associates note that DTMC incidence increases in parallel with TSH concentration, and they explore the possible role of TSH in the pathogenesis of well-differentiated thyroid cancer. In the third paper, Pool and colleagues examine infection rates in major head and neck reconstruction as a function of antibiotic used for prophylaxis.3 For this manuscript, the authors examined 266 patients undergoing free tissue transfer involving the oral cavity or pharynx at a major academic medical center between 2009 and 2014. Using multivariate analysis of collected data, the authors demonstrated that the use of clindamycin for prophylaxis was associated with a 4-fold increased risk of surgical site infection (P = .010) within 30 days following the surgical procedure. This study supports the recent report of Langerman et al,4 as well as other current
Otolaryngology– Head and Neck Surgery 2016, Vol. 154(2) 197–198 © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599815623516 http://otojournal.org
studies suggesting that the use of clindamycin in head and neck prophylaxis is accompanied with higher rates of surgical site infection among postoperative patients. The authors discuss the implications of their paper and recommend broader gram-negative coverage using alternative antibiotics for major reconstructive procedures of the head and neck. In the next article, Kaplan and colleagues discuss the intriguing concept of “amblyaudia,” a recently proposed term used to describe persistent hearing difficulty experienced by individuals with a history of asymmetric hearing loss (AHL) during a critical period of brain development.5 The authors defined this concept of amblyaudia, which has not been extensively discussed in the medical literature, and performed a systematic review of research related to its proposed pathophysiology. Based on this review, the authors concluded that during critical periods of infant brain development, imbalanced auditory input due to AHL may lead to abnormalities in binaural processing, resulting in long-term deficits in auditory perception. Kaplan and colleagues discuss the importance of early identification of and intervention with infants with AHL to decrease the deficits associated with asymmetric hearing in infancy. In our final paper this month, Mascarella and colleagues discuss seasonal differences in the incidence of postoperative hypocalcemia among patients undergoing thyroidectomy in Montreal.6 In their paper, the authors examined a consecutive sample of 823 patients who underwent thyroidectomy for suspected or confirmed malignancy and assessed the rate of hypocalcemia as a function of the season in which the surgery was completed. Among their population, the authors noted a 5.6-fold increase in hypocalcemia following thyroidectomy conducted in the summer months when compared with the same surgery done in winter months. This increase was sustained in a multiple regression analysis as well. Mascarella and associates discuss this observation and argue for the need of additional research to explore this relationship and the role of vitamin D in contributing to this increased incidence.
1
Department of Otolaryngology/Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania, USA Corresponding Author: John H. Krouse, MD, PhD, MBA, Temple University, Otolaryngology/HNS, 3440 N Broad St, Kresge West #300, Philadelphia, PA 19140, USA. Email: [email protected]
Downloaded from oto.sagepub.com at Middle East Technical Univ on February 16, 2016
198
Otolaryngology–Head and Neck Surgery 154(2)
Please enjoy reading these papers as well as the other important manuscripts published in this February issue of Otolaryngology–Head and Neck Surgery. John H. Krouse, MD, PhD, MBA Editor in Chief, Otolaryngology–Head and Neck Surgery Department of Otolaryngology/Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania, USA References 1. Bowe SN. Quality improvement in otolaryngology residency: survey of program directors. Otolaryngol Head Neck Surg. 2016;154:349-354.
2. Shi RL, Liao T, Qu N, Liang F, Chen JY, Ji QH. The usefulness of preoperative thyroid-stimulating hormone for predicting differentiated thyroid mecrocarcinoma. Otolaryngol Head Neck Surg. 2016;154:256-262. 3. Pool C, Kass J, Spivack J, et al. Increased surgical site infection rates following clindamycin use in head and neck free tissue transfer. Otolaryngol Head Neck Surg. 2016;154:272-278. 4. Langerman A, Ham SA, Pisano J, Pariser J, Hohmann SF, Meltzer DO. Laryngectomy complications are associated with perioperative antibiotic choice. Otolaryngol Head Neck Surg. 2015;153:60-68. 5. Kaplan AB, Kozin ED, Remenschneider A, et al. Amblyaudia: review of pathophysiology, clinical presentation, and treatment of a new diagnosis. Otolaryngol Head Neck Surg. 2016;154:247-255. 6. Mascarella MA, Forest VI, Nhan C, et al. Seasonal difference in postthyroidectomy hypocalcemia: a Montreal-based study. Otolaryngol Head Neck Surg. 2016;154:263-267.
Downloaded from oto.sagepub.com at Middle East Technical Univ on February 16, 2016
tolaryngology–Head and Neck SurgeryKrouse 2015© The Author(s) 2010
OTOXXX10.1177/0194599815623516O
Reprints and permission: sagepub.com/journalsPermissions.nav
Highlights
Highlights from the Current Issue: February 2016 John H. Krouse, MD, PhD, MBA1
I
am pleased to offer our February 2016 issue for your review and enjoyment! I am sure that you will find many papers that will inform your practices and provide ample fodder for professional discussion. In the first paper this month, Bowe reports on a survey of otolaryngology residency program directors examining the extent of resident and faculty participation in quality improvement (QI) education during otolaryngology training.1 In her study, the author surveyed program directors of all 106 otolaryngology residencies using a 15-item instrument and received a 39% return rate for the survey. Among responders, only 23% of programs offered a specific QI curriculum, and only 33% monitored individual residents’ performance in QI activities. Barriers identified included insufficient training of faculty in QI and competing educational demands within the curriculum. Bowe discusses the implications of her research for otolaryngology education and stresses the need to generate a comprehensive approach to QI for faculty development and resident instruction. Patient safety and QI will continue to be of increasing importance in health care, and this journal will provide both a forum for and resources in these important areas. In the second manuscript, Shi and colleagues evaluate the relationship between preoperative levels of thyroid-stimulating hormone (TSH) and differentiated thyroid microcarcinoma (DTMC).2 The authors performed a systematic review of the literature, examining studies that explored the relationship between TSH and DTMC. They identified 9 eligible studies containing an aggregate pool of 6523 patients. Meta-analysis of these 9 papers demonstrated a significant association between high TSH levels and the presence of DTMC. Based on these data, Shi and associates note that DTMC incidence increases in parallel with TSH concentration, and they explore the possible role of TSH in the pathogenesis of well-differentiated thyroid cancer. In the third paper, Pool and colleagues examine infection rates in major head and neck reconstruction as a function of antibiotic used for prophylaxis.3 For this manuscript, the authors examined 266 patients undergoing free tissue transfer involving the oral cavity or pharynx at a major academic medical center between 2009 and 2014. Using multivariate analysis of collected data, the authors demonstrated that the use of clindamycin for prophylaxis was associated with a 4-fold increased risk of surgical site infection (P = .010) within 30 days following the surgical procedure. This study supports the recent report of Langerman et al,4 as well as other current
Otolaryngology– Head and Neck Surgery 2016, Vol. 154(2) 197–198 © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599815623516 http://otojournal.org
studies suggesting that the use of clindamycin in head and neck prophylaxis is accompanied with higher rates of surgical site infection among postoperative patients. The authors discuss the implications of their paper and recommend broader gram-negative coverage using alternative antibiotics for major reconstructive procedures of the head and neck. In the next article, Kaplan and colleagues discuss the intriguing concept of “amblyaudia,” a recently proposed term used to describe persistent hearing difficulty experienced by individuals with a history of asymmetric hearing loss (AHL) during a critical period of brain development.5 The authors defined this concept of amblyaudia, which has not been extensively discussed in the medical literature, and performed a systematic review of research related to its proposed pathophysiology. Based on this review, the authors concluded that during critical periods of infant brain development, imbalanced auditory input due to AHL may lead to abnormalities in binaural processing, resulting in long-term deficits in auditory perception. Kaplan and colleagues discuss the importance of early identification of and intervention with infants with AHL to decrease the deficits associated with asymmetric hearing in infancy. In our final paper this month, Mascarella and colleagues discuss seasonal differences in the incidence of postoperative hypocalcemia among patients undergoing thyroidectomy in Montreal.6 In their paper, the authors examined a consecutive sample of 823 patients who underwent thyroidectomy for suspected or confirmed malignancy and assessed the rate of hypocalcemia as a function of the season in which the surgery was completed. Among their population, the authors noted a 5.6-fold increase in hypocalcemia following thyroidectomy conducted in the summer months when compared with the same surgery done in winter months. This increase was sustained in a multiple regression analysis as well. Mascarella and associates discuss this observation and argue for the need of additional research to explore this relationship and the role of vitamin D in contributing to this increased incidence.
1
Department of Otolaryngology/Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania, USA Corresponding Author: John H. Krouse, MD, PhD, MBA, Temple University, Otolaryngology/HNS, 3440 N Broad St, Kresge West #300, Philadelphia, PA 19140, USA. Email: [email protected]
Downloaded from oto.sagepub.com at Middle East Technical Univ on February 16, 2016
198
Otolaryngology–Head and Neck Surgery 154(2)
Please enjoy reading these papers as well as the other important manuscripts published in this February issue of Otolaryngology–Head and Neck Surgery. John H. Krouse, MD, PhD, MBA Editor in Chief, Otolaryngology–Head and Neck Surgery Department of Otolaryngology/Head and Neck Surgery, Temple University, Philadelphia, Pennsylvania, USA References 1. Bowe SN. Quality improvement in otolaryngology residency: survey of program directors. Otolaryngol Head Neck Surg. 2016;154:349-354.
2. Shi RL, Liao T, Qu N, Liang F, Chen JY, Ji QH. The usefulness of preoperative thyroid-stimulating hormone for predicting differentiated thyroid mecrocarcinoma. Otolaryngol Head Neck Surg. 2016;154:256-262. 3. Pool C, Kass J, Spivack J, et al. Increased surgical site infection rates following clindamycin use in head and neck free tissue transfer. Otolaryngol Head Neck Surg. 2016;154:272-278. 4. Langerman A, Ham SA, Pisano J, Pariser J, Hohmann SF, Meltzer DO. Laryngectomy complications are associated with perioperative antibiotic choice. Otolaryngol Head Neck Surg. 2015;153:60-68. 5. Kaplan AB, Kozin ED, Remenschneider A, et al. Amblyaudia: review of pathophysiology, clinical presentation, and treatment of a new diagnosis. Otolaryngol Head Neck Surg. 2016;154:247-255. 6. Mascarella MA, Forest VI, Nhan C, et al. Seasonal difference in postthyroidectomy hypocalcemia: a Montreal-based study. Otolaryngol Head Neck Surg. 2016;154:263-267.
Downloaded from oto.sagepub.com at Middle East Technical Univ on February 16, 2016
