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Journal of Otolaryngology - Head and Neck Surgery     [SJR: 0.564]   [H-I: 11]
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  This is an Open Access Journal Open Access journal
   ISSN (Print) 1916-0216
   Published by Biomed Central Ltd. Homepage  [273 journals]
  • Erratum: Validation of 1-hour post-thyroidectomy parathyroid hormone level
           in predicting hypocalcemia

    • Authors: Trung Le, Paul Kerr, Donna Sutherland, Pascal Lambert
      First page: 42
      Abstract: No abstract
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:42
      PubDate: 2014-11-20T12:00:00Z
      DOI: 10.1186/s40463-014-0042-6
      Issue No: Vol. ${item.volume} (2014)
  • Erratum: Is fluorine-18 fluorodeoxyglucose positron emission tomography
           useful for the thyroid nodules with indeterminate fine needle aspiration
           biopsy' a meta-analysis of the literature

    • Authors: Ningjian Wang, Hualing Zhai, Yingli Lu
      First page: 43
      Abstract: No abstract
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:43
      PubDate: 2014-11-14T12:00:00Z
      DOI: 10.1186/s40463-014-0043-5
      Issue No: Vol. ${item.volume} (2014)
  • Surgical management of primary hyperparathyroidism in Canada

    • Authors: Blair Williams, Jonathan Trites, S Taylor, Martin Bullock, Robert Hart
      First page: 44
      Abstract: Primary hyperparathyroisim is a relatively common condition, for which the standard treatment is surgical excision of one or more of the parathyroid glands. Primary hyperparathyroidism can be due to a single adenoma or multiple gland hyperplasia. In recent decades localizing imaging has improved and there has been a shift away from multiple gland exploration toward a single gland excision. There are, however, no practice guidelines regarding an optimal approach to this condition. This study shows that there is a high degree of variation in practices across Canada and a large amount of uncertainty in the approach to primary hyperparathyroidism.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:44
      PubDate: 2014-11-01T00:00:00Z
      DOI: 10.1186/s40463-014-0044-4
      Issue No: Vol. ${item.volume} (2014)
  • Reducing otolaryngology surgical inefficiency via assessment of tray

    • Authors: Christopher Chin, Leigh Sowerby, Ava John-Baptiste, Brian Rotenberg
      First page: 46
      Abstract: Background: Health care costs in Canada continue to rise. As a result of this relentless increase in healthcare spending, ways to increase efficiency and decrease cost are constantly being sought. Surgical treatment is the mainstay of therapy for many conditions in the field of Otolaryngology- Head and Neck Surgery. The evidence suggests that room exists to optimize tray efficiency as a novel means of improving operating room throughput. Methods: We conducted a review of instruments on surgical trays for 5 commonly performed procedures between July 5th, 2013 and September 20th, 2013 at St Joseph's Hospital. The Instrument Utilization Rate was calculated; we then designed new `optimized' trays based on which instruments were used at least 20% of the time. We obtained tray building times from Central Processing Department, then calculated an overall mean time per instrument (to pack the freshly washed instruments). We then determined the time that could be saved by using our new optimized trays. Results: In total, 226 instrument trays were observed (Table 1). The average Instrument Utilization Rate was 27.8% (+/' 13.1). Our optimized trays, on average, reduced tray size by 57%. The average time to pack one instrument was 17.7'seconds. Conclusions: By selectively reducing our trays, we plan to reduce tray content by an average of 57%. It is important to remember that this number looks at only 5 procedures in the Department of Otolaryngology- Head and Neck Surgery. If this was expanded city-wide to the rest of the departments, the improved efficiency could potentially be quite substantial.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:46
      PubDate: 2014-12-03T12:00:00Z
      DOI: 10.1186/s40463-014-0046-2
      Issue No: Vol. ${item.volume} (2014)
  • The Canadian contribution to the otolaryngology literature: a five year
           bibliometric analysis

    • Authors: Joshua Gurberg, June Lin, Elaheh Akbari, Paul White, Desmond Nunez
      First page: 47
      Abstract: ObjectivesTo assess the 2008–2012 Canadian contribution to the Otolaryngology literature. Methods: All articles published from January 2008 - December 2012 in 5 Otolaryngology journals were reviewed. Nationality, number of authors, and study type were extracted. The output, number of authors, and study type of Canadian papers were compared to International papers using Mantel-Haenszel Common Odds Ratio Estimate, Pearson’s Chi-Squared or Fishers exact tests. Results: 4519 papers were analyzed. There was a statistically significant decrease in Canadian authored papers from 12.8% in 2008–9 to 10.2% in 2011–12 (Fishers exact, p = .01). Multi-authorship increased in Canadian papers (χ2, p = .01). The types of studies published by Canadian Otolaryngologists did not change over the study period. Conclusions: Canadian authored papers in a sample of Otolaryngology journals decreased from 2008 to 2012. The increase in multiauthorship, whilst indicating increasing collaboration, suggests reduced per capita publication productivity. These findings warrant further study.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:47
      PubDate: 2014-11-22T12:00:00Z
      DOI: 10.1186/s40463-014-0047-1
      Issue No: Vol. ${item.volume} (2014)
  • Predictors of non-diagnostic cytology in surgeon-performed ultrasound
           guided fine needle aspiration of thyroid nodules

    • Authors: Andre Isaac, Caroline Jeffery, Hadi Seikaly, Hani Al-Marzouki, Jeffery Harris, Daniel O¿Connell
      First page: 48
      Abstract: Background: Fine needle aspiration (FNA) is the standard of care for the diagnostic work-up of thyroid nodules but despite its proven utility, the non-diagnostic rate for thyroid FNA ranges from 6-36%. A non-diagnostic FNA is problematic for the clinician and patient because it can result in repeated procedures, multiple physician visits, and a delay in definitive treatment. Surgeon-performed FNA has been shown to be safe, cost-effective, as accurate as those performed by other clinicians, and has the added benefit of decreasing wait times to surgery. Several studies have examined rates and factors that may be predictive of a non-diagnostic cytology in non-surgeon FNA, but none have evaluated this in surgeon-performed thyroid FNA. If these factors are unique in surgeon-performed vs. non-surgeon performed thyroid FNA, then patients may be more appropriately triaged to FNA by alternate clinicians.ObjectivesThe purpose of this study was to determine the rate and factors predictive of a non-diagnostic FNA in surgeon performed ultrasound-guided FNA of thyroid nodules. Methods: We conducted a retrospective review of all adult patients who underwent thyroid FNA by a staff, fellow, or resident Otolaryngologist at the University of Alberta between January 2011 and June 2013. Factors analyzed included patient factors, thyroid characteristics, nodule characteristics, and surgeon level of training and experience. Univariate and multivariate binary logistic regression analysis were performed. Results: 131 patients (180 nodules) were reviewed. The non-diagnostic rate was 23%. Nodules with predominant cystic component, those less than 1cm, and resident-performed FNA were associated with non-diagnostic cytology (p'='0.001, p'='0.02, p'='0.04 respectively). A cystic nodule was the only independent predictor of non-diagnostic FNA on multivariate analysis OR'='4.441, 95% CI [1.785-11.045], p'='0.001). Conclusions: The rate of non-diagnostic thyroid FNA performed by a surgeon with ultrasound guidance is similar to other clinicians. A cystic nodule is a strong independent predictor of non-diagnostic cytology. Non-cystic nodules may particularly benefit from surgeon-performed thyroid FNA due to the high diagnostic rate and potential for earlier definitive management.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:48
      PubDate: 2014-12-03T12:00:00Z
      DOI: 10.1186/s40463-014-0048-0
      Issue No: Vol. ${item.volume} (2014)
  • Patients reported outcome post-cochlear implantation: how severe is their

    • Authors: Faisal Zawawi, Faisal Alobaid, Tony Leroux, Anthony Zeitouni
      First page: 49
      Abstract: ObjectivesThe reported prevalence of vestibular dysfunction after cochlear implantation (CI) is varies between different scientific papers. The aim of this study is to determine the reported post-implantation outcome in terms of dizziness, and to measure its impact on quality of life using the Dizziness handicap inventory (DHI). Methods: This was a prospective questionnaire based study of postoperative cochlear implant patients. The questionnaire assessed the type and onset of dizziness in addition to the DHI. Results: 122 patients were recruited in this study, which is the largest sample size in the literature reported so far. Dizziness was evident in 45.9% of the population post-CI and in 27% pre-CI. The commonest subtype of the dizziness was unsteadiness followed by lightheadedness. The dizziness was mild in most of the patients. Conclusion: Although mild, dizziness is a common complaint post-cochlear implantation. An understanding of symptoms helps counsel patients preoperatively.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:49
      PubDate: 2014-12-10T12:00:00Z
      DOI: 10.1186/s40463-014-0049-z
      Issue No: Vol. ${item.volume} (2014)
  • Overview of major salivary gland cancer surgery in Ontario

    • Authors: Antoine Eskander, Jonathan Irish, Jeremy Freeman, Patrick Gullane, Ralph Gilbert, Patti Groome, Stephen Hall, David Urbach, David Goldstein
      First page: 50
      Abstract: Background: The primary objective of this study is to describe variations in incidence rates, resection rates, and types of surgical ablations performed on patients diagnosed with major salivary gland cancers in Ontario. Methods: All major salivary gland cancer cases in Ontario (2003'2010) were identified from the Ontario Cancer Registry (n'='1,241). Variations in incidence rates, resection rates, and type of surgical therapy were compared by sex, age group, neighbourhood income, community population, health region, and physician specialty. Results: Eight-year incidence rates per 100,000 vary significantly by sex (male: 15.5, female: 9.7), age (18'54 years: 6.7, 75+ years: 53.4), neighborhood income (lowest quintile: 11.8, highest quintile: 13.7), and community size (cities with a population greater than 1.5 million: 10.6, cities with a population of less than 100,000: 14.7). There was a significant correlation between the likelihood to receive a resection and age with the elderly (75+ years) being the least likely to receive resection (69%). Large differences in incidence and resection rates were observed by health region. Otolaryngology-Head & Neck surgeons provide the majority of total/radical resections (95%). Conclusions: Major salivary gland cancer incidence rates vary by sex, age, neighborhood income, community size, and health region. Resection rates vary by age and health region. These disparities warrant further evaluation. Otolaryngology-Head & Neck Surgeons provide the majority of major salivary gland cancer surgical care.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:50
      PubDate: 2014-12-10T12:00:00Z
      DOI: 10.1186/s40463-014-0050-6
      Issue No: Vol. ${item.volume} (2014)
  • Publication rate of abstracts presented at the Canadian society of
           otolaryngology- head and neck surgery annual meetings: a five year study

    • Authors: Lauren Ogilvie, Julie Pauwels, Neil Chadha, Frederick Kozak
      First page: 51
      Abstract: Background: To determine the rate of publication in a peer-reviewed journal for all oral presentations made at the Canadian Society for Otolaryngology- Head and Neck Surgery's Annual Meetings from 2006'2010. Methods: All abstracts were searched by keywords and authors' names in Medline via PubMed and Google Scholar.
      Authors of presented abstracts not found to be published were contacted directly for further information. Results: 50.5% of presented abstracts (n'='198) were subsequently published with an average time to publication of 21'months. For those abstracts found not to be published 74.6% (n'='167) of authors responded with further information about their research, 66% (n'='89) of abstracts with author response that were not published were never submitted for publication.
      Authors ' main reasons for not publishing were that the research was still in process (34%, n'='21) or that a resident or fellow working on the project 'had moved on' (26%, n'='16). Conclusion: The publication rate for the Canadian Society for Otolaryngology- Head and Neck Surgery's Annual Meetings from 2006'2010 is within the range reported by other conferences and specifically other Canadian conferences in different specialties; however, roughly half of presentations went on to be published. The main barrier to publication was bringing projects to the submission stage and not rejection by journals. Resources such as more time for research or personnel to coordinate projects may result in a greater rate of project completion.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:51
      PubDate: 2014-12-17T12:00:00Z
      DOI: 10.1186/s40463-014-0051-5
      Issue No: Vol. ${item.volume} (2014)
  • Preliminary report: neural firing patterns specific for Meniere¿s

    • Authors: Brian Blakley, Zeinab Dastgheib, Brian Lithgow, Zahra Moussavi
      First page: 52
      Abstract: ObjectiveTo describe the application of a new, objective diagnostic test for Meniere's disease.IntroductionElectrovestibulography (EVestG) is a complex, newly-developed test paradigm that searches for neural firing patterns that may be diagnostic for particular neural disorders. EVestG system was previously 'trained' to distinguish Meniere's disease from other patients on a set of training data. In this paper we illustrate its diagnostic application in a new group of unknown subjects.SettingCollaborative Academic Bioengineering Research Centre.Study designProspective, blinded human Clinical Trial. Methods: In an attempt to understand the specific neural firing patterns that may objectively characterize latent Meniere's disease, two hundred fifty-six consecutive patients who presented for electronystagmography testing were asked to undergo EVestG testing. Ten subjects actually completed testing but data were too noisy to permit analysis for one patient. Complete data were available for nine patients with either a clinical diagnosis of either Meniere's disease (4 patients) or some other vestibular disorder (2 vestibular neuritis, 2 benign positional vertigo and 1 non-specific dizziness). None of the patients were experiencing attacks of vertigo within a week of EVestG testing. Ten normal control subjects with no history or symptoms of ear disease were also tested. EVestG was performed in a separate engineering research facility by investigators who were unaware of their clinical diagnosis. If EVestG suggested that the probability of Meniere's disease was 0.5 or greater Meniere's disease was considered present by the objective testing. The objective and clinical diagnoses were compared. Results: EVestG testing correctly identified three of four Meniere's disease patients and rejected the diagnosis in 9 of the 10 controls. Two of the 5 dizzy, non-Meniere's patients were incorrectly identified as Meniere's disease. The sensitivity and specificity of EvestG testing were 75% and 80%, respectively. EVestG results were statistically significantly different for Meniere's patients versus the other dizzy patients and controls (Univariate ANOVA difference contrasts p'='0.0340) even in this small sample. Conclusion: The EVestG protocol appeared to show promise as an objective, diagnostic test for Meniere's disease, but our sample size is too small to generalize widely.Level of evidenceN.A. Prospective Human clinical trial.
      Citation: Journal of Otolaryngology - Head & Neck Surgery 2014, null:52
      PubDate: 2014-12-20T00:00:00Z
      DOI: 10.1186/s40463-014-0052-4
      Issue No: Vol. ${item.volume} (2014)
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
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