JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · May 2013
Review Historical ArticleThe early history of the cochlear implant: a retrospective.
Histories of cochlear implant (CI) technology have often been inaccurate owing to the confusion of terms and anatomical situations or to biased reporting. This retrospective, published shortly after the death of inventor William F. House-and more than 50 years after placement of the first CI-offers a precise account of the early experimental period. ⋯ Inspired by French experiments with electrode implantation at the VIII nerve, the initial practical development of the CI is nonetheless a Californian story, divided between the House group at Los Angeles and teams at Stanford University and UCSF.
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JAMA Otolaryngol Head Neck Surg · Jul 2016
Domestic Travel and Regional Migration for Parathyroid Surgery Among Patients Receiving Care at Academic Medical Centers in the United States, 2012-2014.
To improve outcomes after parathyroidectomy, several organizations advocate for selective referral of patients to high-volume academic medical centers with dedicated endocrine surgery programs. The major factors that influence whether patients travel away from their local community and support system for perceived better care remain elusive. ⋯ Centralization of parathyroid surgery is a reality in the United States. Significant disparities based on race and insurance coverage exist and may hamper access to the highest-volume surgeons and hospitals. Academic medical centers with dedicated endocrine surgery programs should consider strategic initiatives to reduce disparities within their respective regions.
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JAMA Otolaryngol Head Neck Surg · Mar 2017
Decision-Making Quality in Parents Considering Adenotonsillectomy or Tympanostomy Tube Insertion for Their Children.
Shared decision making is a process in which clinicians and patients make health care decisions in a collaborative manner using the most up-to-date evidence, while considering patient values and preferences. Shared decision making is thought to have a positive influence on the decision-making process in medicine. ⋯ Many parents experienced significant decisional conflict when making decisions about their child's elective surgical treatment. Parents who perceived themselves as being more involved in the decision-making process reported less decisional conflict and decisional regret. Future research should explore the influence of decision quality on health outcomes and develop methods to improve shared decision making.
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JAMA Otolaryngol Head Neck Surg · Feb 2019
Randomized Controlled Trial Comparative StudyEffect of Total Intravenous Anesthesia vs Volatile Induction With Maintenance Anesthesia on Emergence Agitation After Nasal Surgery: A Randomized Clinical Trial.
Emergence agitation is common after nasal surgery under general anesthesia and may lead to serious consequences for the patient, including an increased risk of injury, pain, hemorrhage, and self-extubation. Despite decades of research, studies on the incidence, risk factors, and prevention of emergence agitation in adult patients are ongoing, and opinions differ on the different effects of inhalation and intravenous anesthesia. ⋯ The occurrence of emergence agitation after nasal surgery under general anesthesia can be significantly reduced by using TIVA rather than VIMA.