Annals of Otology Rhinology and Laryngology最新文献

{"title":"Demand for Increased Financial Support to Families of Privately Insured Pediatric Hearing Aid Users.","authors":"Iman S Iqbal, Tyler Ostrowski, Jason Mouzakes, Jessica R Levi","doi":"10.1177/00034894241309212","DOIUrl":"https://doi.org/10.1177/00034894241309212","url":null,"abstract":"<p><strong>Purpose: </strong>The ability to hear is germane in fostering communiation skills in children and plays a crucial role in their overall wellbeing. Unfortunately, hearing impairment is one of the most common developmental discrepancies in children.</p><p><strong>Objective: </strong>To describe and evaluate the current legislation surrounding pediatric hearing aid reimbursement and the implications of these policies.</p><p><strong>Evidence review: </strong>A review of the scientific literature in addition to several state legislature sites was used to write this article.</p><p><strong>Major findings: </strong>Private insurance reimbursement for pediatric hearing aids is variable between vendors and states. Only half of United States have passed legislation requiring insurers to cover hearing aids for their subscribers. Due to the lack of reimbursement for these expensive yet medically necessary devices, families across the country experience financial distress associated with the lack of coverage for hearing aids. In many cases, this leaves children without the ability to hear to their fullest potential.</p><p><strong>Conclusion: </strong>It is time we as otolaryngologists advocate for a national solution to this issue and promote a national policy to require private insurers to cover the costs of hearing aids for their subscribers.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894241309212"},"PeriodicalIF":1.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supracricoid Partial Laryngectomy Versus Radiation Therapy for cT3N0M0 Glottic SCC: Outcomes in Candidates for Total Laryngectomy Responding Well to Induction Chemotherapy.","authors":"Ollivier Laccourreye, Michaele Francesco Corbisiero, Dominique Garcia, Haitham Mirghani, Philippe Giraud","doi":"10.1177/00034894241308797","DOIUrl":"https://doi.org/10.1177/00034894241308797","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether supracricoid partial laryngectomy (SCPL) may be a viable alternative to radiation therapy (RT) for patients with glottic cT3N0M0 squamous cell carcinoma (SCC) who are surgical candidates for total laryngectomy (TL) and respond well to platinum-based induction chemotherapy.</p><p><strong>Methods: </strong>Retrospective case series review of 18 consecutive patients with cT3N0M0 glottic SCC, initially considered surgical candidates only for TL who showed a good response to platinum-based induction chemotherapy, managed at a French university teaching institution with either SCPL (n = 9) or RT (n = 9). The main endpoints were 10-year local control and laryngeal preservation. The secondary endpoints were 10-year survival, causes of death analysis, and univariate analysis of local control and survival.</p><p><strong>Results: </strong>The 10-year actuarial local control, laryngeal preservation, survival rates were 77.8%, 88.9%, and 66.7% after SCPL, respectively, and 72.9%, 87.5%, and 33.3%, after RT without significant statistical differences. In univariate analysis none of the clinical variables under analysis were related to local control and survival.</p><p><strong>Conclusions: </strong>Our data suggest that SCPL may warrant further consideration as a treatment option for glottic cT3N0M0 SCC patients who respond well to platinum-based induction chemotherapy. However, additional prospective research is warranted given the retrospective, nonrandomized nature of the presented case series.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894241308797"},"PeriodicalIF":1.3,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic Screening for Laryngotracheal Complications in Children Following Prolonged Mechanical Ventilation Maintained Through Endotracheal Intubation: A Cross-Sectional Pilot Project.","authors":"Mainak Dutta, Debjit Jana, Diptanshu Mukherjee, Tanaya Panja, Amit Kumar Shukla, Divya Daga, Krishna Kumar Yadav, Swarnali Mondal, Saumendra Nath Bandyopadhyay","doi":"10.1177/00034894241308411","DOIUrl":"https://doi.org/10.1177/00034894241308411","url":null,"abstract":"<p><strong>Background: </strong>An endoscopic screening program following successful weaning from prolonged mechanical ventilation maintained through endotracheal tube (ET; <i>prolonged intubation</i>) may be justified to assess the upper (laryngotracheal) airway in children who may not always be symptomatic for intubation-related complications.</p><p><strong>Objectives: </strong>To evaluate effects of prolonged intubation in children through endoscopic screening of the laryngotracheal airway.</p><p><strong>Methods: </strong>In this cross-sectional pilot project, children (2 months-12 years) successfully extubated following prolonged intubation were selected, irrespective of having symptoms, for a 1-time flexible nasolaryngoscopy at third to sixth month post-extubation (follow-up window). Laryngotracheal airway changes, if present, were noted.</p><p><strong>Results: </strong>Out of 122 children, 42 developed symptoms of complications. Five of them attended within 3 months post-extubation, the rest were evaluated in the follow-up window. Eighty children aged ≤6 years and 4 children >6 years were intubated with uncuffed ET. Symptoms, when present, included respiratory distress (100%), noisy breathing (~36%), cough (~29%), and dysphagia (~12%). Screening revealed positive findings in 40 out of 42 symptomatic children, and in 8 out of 80 asymptomatic children (χ² = 80.314; after Yate's correction; significant at <i>P</i> < .0001). The commonest lesion was subglottic stenosis (~54%) and intubation granuloma (~48%). Relationship between the nature of ET (cuffed/uncuffed) and complications of prolonged intubation was statistically significant (χ²46.553; significant at <i>P</i> < .0001).</p><p><strong>Conclusion: </strong>The present study proposes the potential utility of follow-up endoscopic screening of upper (laryngotracheal) airway in children successfully weaned from prolonged intubation. A statistically significant relationship existed between prolonged intubation and upper airway complications that were not always symptomatic.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894241308411"},"PeriodicalIF":1.3,"publicationDate":"2024-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laser Ablation of an Isolated External Auditory Canal Skin Wedge.","authors":"Koffi L Lakpa, Daniel G Eyassu, Joshua P Wiedermann","doi":"10.1177/00034894241309219","DOIUrl":"https://doi.org/10.1177/00034894241309219","url":null,"abstract":"<p><strong>Introduction: </strong>External ear malformations represent a spectrum of congenital anomalies that may involve the external auditory canal (EAC), tympanic membrane (TM), or associated structures. A rare anomaly, the EAC skin wedge, results from incomplete canalization during embryologic development. This report presents the clinical presentation, diagnostic evaluation, and surgical management of this condition.</p><p><strong>Objective: </strong>To detail the successful surgical management of an isolated EAC skin wedge and demonstrate the applicability of argon laser in treating these congenital anomalies.</p><p><strong>Methods: </strong>A 13-month-old female presented with recurrent otitis media and mild bilateral conductive hearing loss. Physical examination revealed a fan-like skin wedge spanning the EAC to the TM. Imaging with temporal bone computed tomography confirmed the extent of the anomaly. Under general anesthesia, the skin wedge was ablated using an argon laser, followed by antibiotic-soaked packing to prevent scarring and recurrence. Follow-up audiometry and endoscopic evaluations assessed outcomes.</p><p><strong>Results: </strong>The procedure was well-tolerated, with no intraoperative complications. At 3 weeks and 3 months postoperatively, no recurrence of the skin wedge was observed, and audiometry normalized. The patient demonstrated improved middle ear ventilation and resolution of conductive hearing loss.</p><p><strong>Conclusions: </strong>This case demonstrates the successful use of argon laser in the management of a rare congenital EAC anomaly. Argon lasers offer precise ablation and excellent hemostasis, making them a valuable option for similar cases. This report emphasizes the importance of tailored surgical approaches for rare pediatric ear malformations.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894241309219"},"PeriodicalIF":1.3,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142883577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stapler Versus Manual Suturing for Pharyngeal Closure in Total Laryngectomy.","authors":"Ahmed Abdelmoneim Teaima, Badr Eldin Mostafa, Khaled Mohamed Nabil, Ossama Mustafa Mady","doi":"10.1177/00034894241308403","DOIUrl":"https://doi.org/10.1177/00034894241308403","url":null,"abstract":"<p><strong>Background: </strong>Laryngeal carcinoma is not uncommon worldwide. We conducted this study to comprehensively compare the outcome of stapler versus conventional suturing in total laryngectomy primary or salvage.</p><p><strong>Patients and methods: </strong>This is a retrospective study conducted in our tertiary institute from 2015 to 2022 involving patients diagnosed with laryngeal carcinoma who underwent total laryngectomy either primary or salvage. We divided patients into 4 groups: primary or salvage laryngectomy, closed with stapler or manual suturing. The reported outcomes included : operative time, length of hospital stay, start of oral feeding, incidence of pharyngocutaneous fistula, positivity of surgical margins, and surgical site infection. Patients with multiple comorbidities and those requiring a flap for pharyngeal closure were excluded .</p><p><strong>Results: </strong>A total of 91 patients were included in our study. Pharyngocutaneous fistula rate was 19% in conventional patient group in comparison to 6.7% in stapler group for primary total laryngectomy while it was 12.5% for salvage with stapler and 25% for salvage with conventional. Hospital stay was 6 ± 1.5 days for stapler and 11.4 ± 2.9 days for conventional suturing in primary laryngectomy. It was 8.8 ± 1.3 days for stapler and 13.1 ± 1.8 for conventional suturing in salvage laryngectomy. There was highly significant difference found as regard mean operative time, start of oral feeding and hospital stay in favor of stapler use.</p><p><strong>Conclusion: </strong>Stapler use in total laryngectomy is is a simple, fast, and effective technique with tension free watertight closure, better hemostasis, less contamination of surgical field than manual suturing.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"34894241308403"},"PeriodicalIF":1.3,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long Term Cardiovascular Outcomes Between Sleep Surgery and Continuous Positive Airway Pressure.","authors":"Ann M Martin, Zachary Elliott, Eric Mastrolonardo, Richard Wu, Joshua Mease, Maurits Boon, Colin Huntley","doi":"10.1177/00034894241284169","DOIUrl":"10.1177/00034894241284169","url":null,"abstract":"<p><strong>Objectives: </strong>Individuals with obstructive sleep apnea (OSA) suffer from a multitude of concurrent morbidities including cardiovascular disease (CVD). Limited data exists comparing long term cardiovascular disease (CVD) clinical outcomes for patients treated with surgical intervention versus continuous positive airway pressure (CPAP). The purpose of this study was to compare CVD outcomes at multiple time points comparing those treated with sleep surgery versus CPAP alone.</p><p><strong>Methods: </strong>A research database was used to assess outcomes: death, myocardial infarction, atrial fibrillation, heart failure, essential hypertension, and pulmonary hypertension at 5, 8, and 20 years for patients with OSA treated with surgical interventions (upper airway stimulation [UAS], uvulopalatopharyngoplasty [UPPP], and tonsillectomy) or CPAP alone. Subjects were identified using ICD and CPT codes and analyses were conducted with and without propensity score matching for age, sex, race, BMI, myocardial infarction (MI), essential hypertension, pulmonary hypertension, atrial fibrillation, and heart failure.</p><p><strong>Results: </strong>All surgical interventions demonstrated benefit over CPAP alone at most time points for most surgical interventions. At 8 years, for all sleep surgeries (UAS or UPPP or tonsillectomy) (n = 6627) versus treatment with CPAP alone (n = 6627), matched subjects demonstrated decreased risk (odds ratios) and superior survival (hazard ratios and log ranks tests) for death (OR = 0.49 [0.39, 0.62] <i>P</i> ≤ .0001, HR = 0.29 [0.23, 0.37], χ² = 109.58 <i>P</i> ≤ .0001), myocardial infarction (OR = 0.67 [0.54, 0.84] <i>P</i> = .0005*, HR = 0.48 [0.38, 0.60], χ² = 42.40 <i>P</i> ≤ .0001), atrial fibrillation (OR = 0.70 [0.59, 0.83] <i>P</i> ≤ .0001, HR = 0.54 [0.45, 0.64], χ² = 51.53 <i>P</i> ≤ .0001), heart failure (OR = 0.55 [0.47, 0.64] <i>P</i> ≤ .0001, HR = 0.41 [0.35, 0.47], χ² = 137.416 <i>P</i> ≤ .0001), essential hypertension (OR = 0.88 [0.82, 0.94] <i>P</i> = .0002, HR = 0.78 [0.74, 0.82], χ² = 76.38 <i>P</i> ≤ .0001), and pulmonary hypertension (OR = 0.51 [0.40, 0.65] <i>P</i> ≤ .0001, HR = 0.38 [0.29, 0.48], χ² = 60.67 <i>P</i> ≤ .0001) where <i>P</i> ≤ .00037 indicated statistical significance*.</p><p><strong>Conclusion: </strong>This investigation suggests surgical management of obstructive sleep apnea may contribute to the mitigation of long-term clinical CVD morbidity.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"1019-1028"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Atypical Presentation and Postoperative Management of Vagal Nerve Tumors.","authors":"Samuel R Shing, Maria Armache, Pablo Llerena, Mackenzie O'Connor, Kira Murphy, Joseph M Curry, Adam J Luginbuhl","doi":"10.1177/00034894241288416","DOIUrl":"10.1177/00034894241288416","url":null,"abstract":"<p><strong>Objectives: </strong>Tumors involving the vagus nerve are often clinically silent. We offer a case series with different clinical presentations and distinctive post-surgical sequelae that highlight some of the challenges associated with managing cervical vagal nerve tumors.</p><p><strong>Methods: </strong>Single-institution, retrospective review of patients with tumors involving the vagus nerve. We describe clinical presentations and postoperative sequelae of five patients who underwent surgical management of vagal nerve pathology with atypical presentation or subsequent clinical course.</p><p><strong>Results: </strong>Here, we present five patients treated at our institution for vagal tumors. In four of the five patients, the presenting symptoms resolved after surgery. Two patients presented with intractable neurogenic cough, and another two presented with autonomic symptoms, one with syncope/palpitations and the other with intractable sweating. The final patient presented with a rapidly enlarging vagal paraganglioma and developed intractable cough after resection. We present two patients with novel approach to vagal paragangliomas that underwent ligation of feeding blood supply without removing the tumor, resulting in resolution of an intractable cough in one patient and resolution of severe nighttime sweating in the other.</p><p><strong>Conclusion: </strong>Management of tumors associated with the cervical vagus nerve that present with symptoms or rapid growth poses a clinical dilemma. Consideration of the tumor origin with either enucleation of schwannomas or ligation of feeding vessels may preserve function while addressing the presenting symptoms.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"1037-1041"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Morbidity and Mortality Conference: How Do We Learn From Special Cases?","authors":"Michael B Cohen, Emily A Garvey, Jocelyn L Kohn, Sean A Setzen, Kenneth M Grundfast, Michael P Platt","doi":"10.1177/00034894241280694","DOIUrl":"10.1177/00034894241280694","url":null,"abstract":"<p><strong>Objective: </strong>Physicians experience scary cases in the course of usual medical practice. Cases of near misses, legal and ethical dilemmas, or unique clinical challenges are great sources of education. However, there is no format for presentation and dissemination of cases that do not meet criteria for morbidity and mortality (M&M) conferences. The Scary Cases Conference is an innovative educational forum for scrutiny and analysis of these challenging clinical cases. Scary Cases differs from traditional Morbidity and Mortality conferences as it explores outcomes beyond the scope of medical or surgical errors.</p><p><strong>Methods: </strong>From 2011 to 2021: 11 regional and 10 national \"Otolaryngology Scary Cases\" conferences and mini-seminars were held. The cases presented were analyzed for case specialty, area of management deemed troublesome, and compared to M&M conference criteria.</p><p><strong>Results: </strong>187 cases were presented. 62% percent of cases included traditional medical problems, whereas 21% involved legal issues, and 17% focused on ethical dilemmas. For the cases with medical problems, 31% involved airway obstruction, 17% nerve injuries, and 17% malignancy. 49% of cases would have met criteria for presentation at traditional M&M conferences. Of all the \"scary cases,\" 25% were near misses and 26% represented ethical or legal dilemmas which would not be classified as morbitidy, mortality, or near miss.</p><p><strong>Conclusions: </strong>The Scary Cases provides a forum conducive to learning amongst peers and experts. It allows medical and surgical specialties to share the cases deemed most impactful. The M&M conference would only include half of such cases, but could be expanded beyond the traditional scope in the future.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"993-997"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality of Life After Pediatric Tympanomastoidectomy.","authors":"Benjamin D Lovin, Aaron C Nguyen, Nathan R Lindquist, Duc Nguyen, Rodrigo Silva, Alex D Sweeney","doi":"10.1177/00034894241286980","DOIUrl":"10.1177/00034894241286980","url":null,"abstract":"<p><strong>Objectives: </strong>To assess quality of life (QOL) outcomes after canal wall up (CWU) and canal wall down (CWD) tympanomastoidectomy in the pediatric population.</p><p><strong>Methods: </strong>A retrospective review tabulated pediatric patients undergoing CWU and CWD tympanomastoidectomy for cholesteatoma by 2 senior surgeons at a single tertiary academic referral center between March 2017 and March 2023. Chronic Ear Survey (CES) and cosmetic survey outcomes were collected post-operatively.</p><p><strong>Results: </strong>A total of 77 ears in 75 patients were identified, with 35 undergoing CWU and 42 undergoing CWD as the most recent (index) otologic surgery. Seventeen patients (23%) participated in the survey. Of this cohort, the mean age was 14.6 years, 12 (71%) were male, and 10 (59%) had CWD as the most recent otologic surgery. The mean time from index surgery to survey completion was 3.4 years (range, 0.1-6.7 years). Regarding QOL outcomes, there were no statistically significant differences in total CES score, CES subscores, and cosmetic survey scores between groups when categorizing by gender or index surgery. Total CES, symptom subscale, medical resource subscale, and cosmetic survey scores showed a tendency to decrease with an increasing number of surgeries (<i>R</i> = -.18, -.28, -.53, and -.56, respectively). Pediatric total CES scores appeared comparable to those reported in the published adult literature.</p><p><strong>Conclusions: </strong>It does not appear that there are worse QOL outcomes for pediatric patients who undergo CWD tympanomastoidectomy compared to those who undergo CWU tympanomastoidectomy. There appears to be no difference in QOL outcomes between pediatric and adult patients undergoing tympanomastoidectomy.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"1004-1009"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142367234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Airway Quality Improvement Program: Reducing Life-Threatening Airway Complications.","authors":"Zachary M Helmen, Riley Larkin, Sophia Peifer, Miguel A Escanelle, Alexander W M Hall, Thomas Luka, Carlos De Varona, Pilar Hombreiro, Jennifer Farrell, Brittany McClure, Michele Harris, Alexander Ruche, Diana Levy, Joseph P Falise, Doreen Ashley, Andrea Gabrielli, Marie Anne Sosa, Zoukaa Sargi, Jose W Ruiz, David J Arnold, Tanira Ferreira, Elizabeth Nicolli","doi":"10.1177/00034894241285236","DOIUrl":"10.1177/00034894241285236","url":null,"abstract":"<p><strong>Objective: </strong>There is often unfamiliarity with the care of artificial airway devices (ie, endotracheal tubes, tracheostomies, and laryngectomies). The objective of this study was to design an Airway Quality Improvement Program (AQIP) to improve airway care.</p><p><strong>Methods: </strong>This was a retrospective chart review of a prospectively-initiated AQIP. The AQIP has 3 parts: 1) Mandatory \"airway signs\" 2) In-service teaching with a corresponding order set and 3) an overhead \"Surgical Airway Emergency\" page involving automatic pages to Anesthesia, Otolaryngology, and Respiratory Therapy. Pre- and post-intervention survey data was collected. The incidence of airway emergency was the primary patient outcome and was hypothesized to decrease after AQIP intervention.</p><p><strong>Results: </strong>Airway emergencies decreased 8.4% after AQIP (<i>P</i> = .45). Length of stay decreased after AQIP, 47.0 ± 76.5 days compared to 23.5 ± 23.6 (<i>P</i> = .004). Two hundred eight-one nurses and 76 respiratory therapists were educated. Pre-AQIP comfortability scores improved for the routine care of endotracheal tubes, tracheostomies, and laryngectomies, 4.3 ± 0.9, 4.3 ± 0.8, and 3.5 ± 1.2, compared to 4.7 ± 0.6, 4.5 ± 0.7, and 4.4 ± 0.7 post-AQIP (<i>P</i> = .0006, <i>P</i> = .02, <i>P</i> = .0001). The same improvement was noted for emergency airway care. Tracheostomy vs. laryngectomy recognition increased from 66.5 to 97.0% (<i>P</i> = .0001). Quiz questions regarding emergency airway management for laryngectomies improved from 76.2 to 93.8% (<i>P</i> = .0001).</p><p><strong>Conclusion: </strong>The AQIP was associated with decreased length of hospital stay and improved competency in airway care among hospital staff. Further application of AQIP is needed for replication in other institutions and long-term application.</p>","PeriodicalId":50975,"journal":{"name":"Annals of Otology Rhinology and Laryngology","volume":" ","pages":"1010-1018"},"PeriodicalIF":1.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142378557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}