Ten years have passed since the U.S. was attacked on September 11, 2001 and six since Hurricane Katrina slammed into the Gulf Coast. And, while disasters of that magnitude are rare, hundreds of smaller-scale disasters occur every year, including tornadoes, blizzards, fires, earthquakes, airline crashes and chemical spills.
The biggest gains in the future for surgical and therapeutic treatments of head and neck cancer will likely include the use of imaging techniques, radio-enhancers and drug delivery vehicles that are really, really small.
The science of medicine continues to expand rapidly, and this is obviously good for humanity. The art of medicine, on the other hand, has been largely forgotten. This skill is the basis of the time-honored physician-patient relationship and is an important aspect of good patient care. So why have so many physicians forgotten this basic skill? Why would a caring physician disregard any expertise that would benefit his patient?
I have been working with electronic medical records (EMR) for many years, having first become interested in 1996, when I was looking for a tool to collect data for pediatric sinusitis. As we designed a product to collect this data, our scope expanded into developing a subspecialty-specific EMR. I have since learned a great deal about developing and codifying information and am currently participating in my third and largest implementation of an EMR at Boys Town National Research Hospital in Omaha, Neb. In this column, I would like to discuss what to look for in an EMR and give some initial thoughts on implementation.
Most microvascular and reconstructive free-flap head and neck surgeons experience at least moderate professional burnout, according to a study published in October 2010 in the Archives of Otolaryngology and Head and Neck Surgery.
For patients who undergo septoplasty to repair a crooked septum, reconnecting pieces of cartilage and stabilizing the cartilage during the healing process is critical to achieving straight alignment of the nasal septum. Stabilizing cartilage is particularly challenging for patients who require correction of severe septal deviations or severe post-traumatic deformities that are often both functional and cosmetic.
For otolaryngologists seeing increasing numbers of children with sleep-disordered breathing, whether or not to refer children for a polysomnography (PSG) prior to surgery is not a decision easily made. Currently, only about 10 percent of otolaryngologists request a sleep study in children with sleep-disordered breathing prior to surgery.
In May, Marcelo Antunes, MD, chief resident of otorhinolaryngology-head and neck surgery at the University of Pennsylvania, was able to practice bilobed flaps on pig’s feet at an ORL Rising Chief Boot Camp held at Penn Medicine Clinical Simulation Center in Philadelphia. While he had previously experienced medical simulation during his otolaryngology residency, the boot camp put the methodology in proper context for Dr. Antunes, who is particularly interested in facial plastics.
The most significant danger to children now is obesity, and of the many related comorbidities that affect obese children, obstructive sleep apnea (OSA) will impact a child’s life more than anything else, according to Carole Marcus, MD, an invited lecturer here last month at SLEEP 2011, the 25th Annual Meeting of the Associated Professional Sleep Societies.Dr. Marcus is a professor of pediatrics at the University of Pennsylvania and director of the sleep center at Children’s Hospital of Philadelphia.