[Current status of otorhinolaryngology. Concept of otorhinolaryngology. Its history. Otorhinolaryngology in general practice and as a specialty].
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Otolaryngology Head and Neck Surgery have been improved and progressed tremendously in the recent years in China. In this paper, information on the recent advances in these areas was provided and the future perspective of the specialty field was discussed.
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In the United States of America (US), most departments of otorhinolaryngology head and neck surgery have been performing thyroid surgery for many years. In contrast to the US, thyroid surgery is still dominated by general surgeons in most European countries. In numerous university centers, there continues to be friction regarding thyroid surgery. The focus of this editorial is to demonstrate that there is objective data in the literature to suggest that otorhinolaryngologists with appropriate training in head and neck surgery are well suited to perform the entire spectrum of thyroid surgery. The question of who is qualified to perform thyroid surgery is not determined by the basic specialty certification of the surgeon—general or otolaryngology; rather it depends on the training, skill and experience in surgery of the neck, of post-surgical and post-irradiated necks, and of neighboring structures.
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Covid-19 infection is caused by the coronavirus SARS-CoV-2.This has resulted in the present pandemic from which thousands of people have died including many front-line health care workers.Of the surgeons who have died from covid-19 it would appear that otorhinolaryngology surgeons have made the largest sacri ice (Figure 1) [1].The potential explanations for this are discussed.
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A major evolutionary change in the past decade has been to broaden the exposure and enhance the experience of the otolaryngology resident in the field of facial plastic surgery. A strong background in head and neck surgical oncology has been established in most residency programs and subsequent introduction to facial plastic surgery through reconstructive procedures has opened a new horizon to the regional specialist. The increased importance of an aesthetically acceptable surgical result in the face with its strong social and psychologic connotations imposes more pressure on the head and neck surgeon to develop appropriate surgical skills. As the specialty continued to strive toward this goal in reconstructive surgery and in maxillofacial trauma, it predictably developed a greater interest in elective cosmetic surgery. The American Board of Otolaryngology appropriately responded in past years to this evolution by including topics on facial plastic surgery as a significant part of the certification
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Head and neck oncologic surgery is a time-consuming specialty that requires extensive resources and manpower. Case mix index (CMI) is used in evaluating the complexity and economic impact of surgeons. Head and neck oncologic surgeons generate significant revenue for hospitals, yet compensation is relatively low.Retrospective review of a tertiary hospital's case mix data for 605 otolaryngology admissions from 2009 to 2011 was performed. CMI comparison for head and neck oncologic surgeons versus general otolaryngology was performed.In an otolaryngology department of 9 surgeons; there was a significant difference (p < .01) in the CMI and a significantly greater chance to have a "good CMI" (CMI >1) favoring head and neck oncologic surgeons.Head and neck oncologic surgeons increase the CMI for hospitals and ultimately influence the hospital's reimbursement. There is a need for increased collaboration between hospitals and departments in fostering and furthering their head and neck surgical oncology programs by taking CMI into consideration.
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Atlanta, Ga.; and Washington, D.C. From the Division of Plastic and Reconstructive Surgery, Emory University, and the Department of Plastic and Reconstructive Surgery, Georgetown University. Received for publication February 3, 2009; accepted April 3, 2009. Disclosure:Maurice Nahabedian, M.D., is a speaker for LifeCell Corporation. Albert Losken, M.D., is a speaker for LifeCell Corporation and a consultant for Mentor Corporation. Albert Losken, M.D., Division of Plastic Surgery, Emory University, 550 Peachtree Street, Suite 84300, Atlanta, Ga. 30308, [email protected]
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Abstract Background Perioperative practices in thyroid surgery vary from one specialty, institution, or country to the next. We evaluated the preoperative, intraoperative, and postoperative practices of thyroid surgeons focusing on preoperative ultrasound, vocal cord evaluation, wound drains, and hospitalization duration, among others. Methods A survey was sent to 7 different otolaryngology and endocrine/general surgery associations. Results There were 965 respondents from 52 countries. Surgeon‐performed ultrasound is practiced by more than one third of respondents. Otolaryngologists perform preoperative and postoperative vocal cord evaluation more often than endocrine/general surgeons ( p < .001). Sixty percent of respondents either never place drains or place drains <50% of the time in thyroid lobectomies (43% for total thyroidectomies). Outpatient thyroid surgery is most frequently performed by surgeons in the United States (63%). Conclusion This epidemiologic study is the first global thyroid survey of its kind and clearly demonstrates the variability and evolving trends in thyroid surgery. © 2017 Wiley Periodicals, Inc. Head Neck 39 : 1296–1305, 2017
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