The Laryngoscope
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Public reporting and transparency of patient experience is an emerging national healthcare priority. The objectives of this report are to describe patient satisfaction scores in ambulatory otolaryngology and examine the association of teaching status across multiple service domains. ⋯ Otolaryngology patients evaluated in the teaching setting report lower patient satisfaction overall, primarily related to access to care and visit-specific processes; however, they are more likely to display loyalty and recommend their practice and care provider. The teaching setting does not influence care provider satisfaction scores. Because practice loyalty is most closely correlated to provider-specific behaviors, otolaryngologists may consider enhancement of provider-patient communication to improve patient satisfaction regardless of the practice setting. Academic otolaryngology practices should consider focusing on access systems and process improvement to enhance the overall patient experience.
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Comparative Study
Validation of an operating room immersive microlaryngoscopy simulator.
To assess the face and construct validity of two assessment tools for a microlaryngoscopy simulator-a Checklist Assessment for Microlaryngeal Surgery and Global Rating Assessment for Microlaryngeal Surgery. ⋯ This study is the first reported study of a high-fidelity microlaryngoscopy simulator with task-specific rating tools. Use of these tools is recommended within otolaryngology training programs, with the global rating assessment for use as a frequently used feedback tool, and the checklist assessment as a confirmatory evaluation of competency at transitions of professional training.
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Comparative Study
Predictors of complications of free flap reconstruction in head and neck surgery: Analysis of 304 free flap reconstruction procedures.
The objectives of this study were to classify and analyze perioperative complications following free flap reconstruction in the head and neck and investigate potential predictors of these complications. ⋯ The rate and grade of complications with free flap reconstruction in the head and neck were found to be low. Higher tumor stage and pharyngoesophageal reconstruction were found to be associated with increased complication grades, whereas preoperative radiation alone and chemoradiation were not. Smoking and alcohol use, age, diabetes mellitus, peripheral vascular disease, and preoperative myocardial infarction as well as preoperative cerebrovascular accident were not found to be associated with increased complications. No statistically significant difference in complication grades was found with different flap types or indications for reconstruction.
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Comparative Study
Safety analysis of percutaneous dilational tracheostomies with bronchoscopy in the obese patient.
Since originally described in 1985 by Ciaglia, percutaneous dilational tracheostomy (PDT) has grown in popularity, and today is widely used for critically ill patients requiring long-term mechanical ventilation. Since the inception of PDT, obesity has been considered a relative contraindication to its use. The purpose of this study is to evaluate the risks of PDT in obese patients. ⋯ PDT can be performed safely in obese patients. There were no statistically significant differences in measured variables found between the two study groups. This study supports the use of intensive care unit bedside PDT in the obese population.
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Comparative Study
Late complications of nickel-titanium alloy stent in tracheal stenosis.
To investigate and treat the late complications of using nickel-titanium alloy stents in laryngotracheal, bronchial, and esophageal stenosis patients who developed severe laryngotracheal stenosis (SLS). ⋯ The nickel-titanium alloy stents should be used with extreme caution in patients with laryngotracheal, bronchial, or esophageal stenosis treatment that can be corrected by surgical therapy.