Instruction Course Samples for the 2012 Annual Meeting & OTO EXPO: Pt 3
This is the third part of a Bulletin series of instruction courses samplers each month from myriad options to be offered at the AAO-HNSF 2012 Annual Meeting & OTO EXPO in September. One notable course in each of the nine categories will be listed with an excerpt from its objective each month. To read the full course description and to get your first choice of courses, sign up early at www.entnet.org/Annual_Meeting. Make sure to take advantage of the scheduler to review the full listing of courses and to find those of special interest to you. Business of Medicine/Practice Management 4612-1 Developing a Quality Control Program for Surgeons Carl H. Snyderman, MD; Erin M. McKean, MD 1:15 pm-2:15 pm, September 12 Quality issues affect all aspects of patient care at all levels of an institution. Benefits of measuring quality include generating data for informed consent, improving surgical care, and providing a marketing advantage. Measurement of quality is now required as part of Medicare Pay for Performance and for Accountable Care Organizations. Indicators of quality can be both tangible (readmission, death, infection, recurrence of disease) and intangible (patient satisfaction, duration of surgery, cosmesis, length of stay, cost, and experience). The government and consumer groups now rank physicians and hospitals on many of these measures. The first step in improving quality is deciding what to measure. Groups such as the American College of Surgeons have established national databases to assist surgeons and hospitals (NSQIP). In industry, there are multiple tools that are used to measure quality that can be applied to surgical practice. The primary goal of such tools is to minimize variation; these tools can be applied to both qualitative and quantitative data. Statistical methods allow the individual surgeon to assess quality measures over time and diagnose and eliminate cases of variation. It is only through a quality improvement program that surgeons can overcome their cognitive biases and improve surgical care. Facial Plastic and Reconstructive Surgery 2711-1 Open Rhinoplasty: Arming Novices for Success Edmund A. Pribitkin, MD 3:00 pm-4:00 pm, September 9 This course presents the author’s 18-year experience in teaching resident rhinoplasty in a program where residents actually perform the surgery rather than simply watching the attending physician work. The author’s approach is a distillation of safe techniques enabling residents to learn the procedure while minimizing the attending physician’s stress and maximizing patient outcomes. It proceeds step-by-step through cases and stops everywhere a mishap can occur, explaining how to avoid the mishap in the future and how to correct it in the present. Preoperative planning, patient encounters, and common rhinoplasty scenarios, as well as avoidance and management of postoperative complications are reviewed. General Otolaryngology 1723-1 Head and Neck Trauma: Lessons of War and Mass Casualties Joseph Brennan, MD 3:00 pm-4:00 pm, September 9 Great advances in the surgical management of head, facial, and neck trauma have been made during times of military combat and mass casualty treatment. This includes triage of mass casualty victims, management of acute airway injuries and control of bleeding, neck exploration for penetrating neck trauma, and reconstruction of soft tissue and bone injuries. The goal of this instruction course is to educate the otolaryngology community about the state-of-the-art management of specific otolaryngic injuries with emphasis on lessons learned in both Iraq and Afghanistan. The specific trauma topics to be discussed include the following: Role of otolaryngologist in a mass casualty Airway management during trauma Evaluation and treatment of penetrating neck trauma Reconstruction of bony and soft tissue head and neck trauma Controversies in the management of head and neck trauma The civilian practice of otolaryngology-head and neck surgery has benefited greatly from wartime surgical experience with this knowledge improving our ability to care for gunshot wounds, industrial and motor vehicle accidents, and other traumatic injuries in our civilian emergency rooms. With the looming threat of terrorism and mass casualties in the United States, otolaryngologists should be aware of the latest trauma advances. Head and Neck Surgery 3706-1 Conservation Surgery for Oropharyngeal Cancer Interactive F. Christopher Holsinger, MD; Olivier Laccourreye, MD 3:00 pm-4:00 pm, September 11 Both transoral and transcervical surgical approaches preserving the external framework of the upper aerodigestive tract without sacrificing critical neurologic and muscular structures. As such, conservation surgery for oropharyngeal cancer provides functional organ preservation and excellent oncologic outcomes. Yet radiation therapy (alone or with concomitant chemotherapy) has evolved as the primary treatment modality for oropharyngeal cancer (OC). However, the recent rise of HPV-associated OC has ushered in a new era. Patients present at a much earlier age and, as such, may be at greater risk for the long-term side effects of XRT and chemoradiation. Laryngology/Broncho-Esophagological 3825-1 Endoscopic Microsurgical Techniques for Laryngeal Disease Mark S. Courey, MD; Katherine C. Yung, MD 4:15 pm-5:15 pm, September 11 Hoarseness, voice change, is due to alterations in laryngeal vibration. Both neoplastic and non-neoplastic laryngeal diseases change laryngeal histology, which then hampers vibratory patterns and impairs the laryngeal vocal output. This course will briefly review normal laryngeal histology and the changes created by laryngeal diseases. With an understanding of these changes, case presentations will be used to demonstrate endoscopic microsurgical techniques using cold steel and laser instrumentation. At the completion of this course the participants will possess an understanding of these contemporary techniques and be able to apply them in their clinical practice. The course will discuss the instrumentation requirements for endoscopic exposure and microscopic visualization. To a limited extent the preoperative and postoperative management will also be presented. Otology/Neurotology 1720-2 Chronic Otitis Media: Ear Surgery Derald E. Brackmann, MD; William M. Luxford, MD 3:00 pm-5:00 pm, September 9 This course details the techniques used at the House Ear Clinic for the management of chronic otitis media. The course content varies from year to year. Topics that may be included are the office management of the draining ear and a discussion of the indication for surgery. The clinic favors the outer surface graft technique and the intact canal wall procedure for management of the mastoid in most cases of cholesteatoma. The clinic does not hesitate to perform canal wall down procedures, however, and the presenters may discuss any of these operations. Finally, management of complications of chronic otitis media may be discussed. This course is illustrated by slides and videotapes of surgical procedures and supplemented by handouts on the subject. Pediatric Otolaryngology 3621-1 Pediatric Airway 101 Robin T. Cotton, MD 1:45 pm-2:45 pm, September 11 A fundamental knowledge of the pediatric airway, including adequate assessment and basic airway management skills is an essential component of pediatric otolaryngology. This course seeks to provide a simple overview of basic management of the pediatric airway. This will include assessment of the pediatric airway, from office flexible endoscopy, through the techniques of rigid bronchoscopy of the neonatal and pediatric airway. Diagnosis of common conditions including laryngomalacia and vocal cord paralysis, as well as assessment of subglottic stenosis, laryngeal clefts, and complete tracheal rings will be covered. Operative management of laryngomalacia, as well as neonatal and pediatric tracheotomy will be discussed, as will the difficult intubation and foreign body management. The minimal desirable equipment for pediatric airway assessment and management will be covered. Rhinology/Allergy 1715-2 Gussack Memorial: Avoiding Bad Results in Sinus Surgery Martin J. Citardi, MD; Christopher T. Melroy, MD; Scott M. Graham, MD 3:00 pm-5:00 pm, September 9 This course presents the causes of recurrent/persistent rhinosinusitis and poor surgical results/outcomes after endoscopic sinus surgery by addressing the theory and technique of functional endoscopic sinus surgery (FESS). The review of cases in which surgery has failed can provide important information about appropriate treatment strategies. Inadequate initial surgical management may precipitate worsening or persistent disease. The discussion will include the surgical management of the middle turbinate, the maxillary ostium, the frontal recess, and the sphenoethmoid recess. Specific cases that illustrate appropriate surgical management in these areas will be discussed. Instrumentation, including the microdebrider and image-guided surgery, will be presented. Principles of postoperative management will be emphasized. The philosophy of FESS incorporates a comprehensive understanding of pre-existing medical conditions that may contribute to sinusitis. Immunological issues, antimicrobial resistance, sinusitis caused by enteric gram-negative organisms, fungal sinusitis, and nasal polyposis will also be addressed. Strategies for the incorporation of innovative treatments, such as topical antibiotic regimens, will be described. The major complications of FESS will be presented. Specific recommendations for the intraoperative management and prevention of these complications will be made. Review of clinical cases will serve to illustrate critical points. Sleep Medicine 3627-2 Integrating Oral Appliances into Your Sleep Apnea Practice Hands-On Ofer Jacobowitz, MD, PhD; Alan J. Chernick, DDS; Tod C. Huntley, MD; Christopher J. Lettieri, MD 1:45-3:45 pm, September 11 Comprehensive management of OSA requires a personalized approach. Non-adherence to CPAP and fear of surgery are common among OSA patients. Oral appliance therapy is recognized as an effective treatment for OSA and can be employed as a primary treatment modality or following a suboptimal surgical or CPAP outcome. In order to integrate this modality into the sleep apnea practice, otolaryngologists should acquire the requisite conceptual understanding and practical skills. What are the indications and contraindications for oral appliances? What is their mechanism of action? What are the relevant features for patient assessment? How is appliance fitting and titration performed? What are the relevant features of the informed consent for this modality, especially for otolaryngologists? What are the problems and complications of oral appliance therapy? How do you get reimbursed for your work? This course will use lecture and a hands-on session where participants will practice taking impressions and bite registrations. The participants will benefit from instruction by experts in the field of dental sleep medicine.
This is the third part of a Bulletin series of instruction courses samplers each month from myriad options to be offered at the AAO-HNSF 2012 Annual Meeting & OTO EXPO in September. One notable course in each of the nine categories will be listed with an excerpt from its objective each month. To read the full course description and to get your first choice of courses, sign up early at www.entnet.org/Annual_Meeting. Make sure to take advantage of the scheduler to review the full listing of courses and to find those of special interest to you.
Business of Medicine/Practice Management
4612-1 Developing a Quality Control Program for Surgeons
Carl H. Snyderman, MD; Erin M. McKean, MD
1:15 pm-2:15 pm, September 12
Quality issues affect all aspects of patient care at all levels of an institution. Benefits of measuring quality include generating data for informed consent, improving surgical care, and providing a marketing advantage. Measurement of quality is now required as part of Medicare Pay for Performance and for Accountable Care Organizations. Indicators of quality can be both tangible (readmission, death, infection, recurrence of disease) and intangible (patient satisfaction, duration of surgery, cosmesis, length of stay, cost, and experience). The government and consumer groups now rank physicians and hospitals on many of these measures. The first step in improving quality is deciding what to measure. Groups such as the American College of Surgeons have established national databases to assist surgeons and hospitals (NSQIP). In industry, there are multiple tools that are used to measure quality that can be applied to surgical practice. The primary goal of such tools is to minimize variation; these tools can be applied to both qualitative and quantitative data. Statistical methods allow the individual surgeon to assess quality measures over time and diagnose and eliminate cases of variation. It is only through a quality improvement program that surgeons can overcome their cognitive biases and improve surgical care.
Facial Plastic and Reconstructive Surgery
2711-1 Open Rhinoplasty: Arming Novices for Success
Edmund A. Pribitkin, MD
3:00 pm-4:00 pm, September 9
This course presents the author’s 18-year experience in teaching resident rhinoplasty in a program where residents actually perform the surgery rather than simply watching the attending physician work. The author’s approach is a distillation of safe techniques enabling residents to learn the procedure while minimizing the attending physician’s stress and maximizing patient outcomes. It proceeds step-by-step through cases and stops everywhere a mishap can occur, explaining how to avoid the mishap in the future and how to correct it in the present. Preoperative planning, patient encounters, and common rhinoplasty scenarios, as well as avoidance and management of postoperative complications are reviewed.
General Otolaryngology
1723-1 Head and Neck Trauma: Lessons of War and Mass Casualties
Joseph Brennan, MD
3:00 pm-4:00 pm, September 9
Great advances in the surgical management of head, facial, and neck trauma have been made during times of military combat and mass casualty treatment. This includes triage of mass casualty victims, management of acute airway injuries and control of bleeding, neck exploration for penetrating neck trauma, and reconstruction of soft tissue and bone injuries. The goal of this instruction course is to educate the otolaryngology community about the state-of-the-art management of specific otolaryngic injuries with emphasis on lessons learned in both Iraq and Afghanistan. The specific trauma topics to be discussed include the following:
- Role of otolaryngologist in a mass casualty
- Airway management during trauma
- Evaluation and treatment of penetrating neck trauma
- Reconstruction of bony and soft tissue head and neck trauma
- Controversies in the management of head and neck trauma
The civilian practice of otolaryngology-head and neck surgery has benefited greatly from wartime surgical experience with this knowledge improving our ability to care for gunshot wounds, industrial and motor vehicle accidents, and other traumatic injuries in our civilian emergency rooms. With the looming threat of terrorism and mass casualties in the United States, otolaryngologists should be aware of the latest trauma advances.
Head and Neck Surgery
3706-1 Conservation Surgery for Oropharyngeal Cancer
Interactive
F. Christopher Holsinger, MD; Olivier Laccourreye, MD
3:00 pm-4:00 pm, September 11
Both transoral and transcervical surgical approaches preserving the external framework of the upper aerodigestive tract without sacrificing critical neurologic and muscular structures. As such, conservation surgery for oropharyngeal cancer provides functional organ preservation and excellent oncologic outcomes. Yet radiation therapy (alone or with concomitant chemotherapy) has evolved as the primary treatment modality for oropharyngeal cancer (OC). However, the recent rise of HPV-associated OC has ushered in a new era. Patients present at a much earlier age and, as such, may be at greater risk for the long-term side effects of XRT and chemoradiation.
Laryngology/Broncho-Esophagological
3825-1 Endoscopic Microsurgical Techniques for Laryngeal Disease
Mark S. Courey, MD; Katherine C. Yung, MD
4:15 pm-5:15 pm, September 11
Hoarseness, voice change, is due to alterations in laryngeal vibration. Both neoplastic and non-neoplastic laryngeal diseases change laryngeal histology, which then hampers vibratory patterns and impairs the laryngeal vocal output. This course will briefly review normal laryngeal histology and the changes created by laryngeal diseases. With an understanding of these changes, case presentations will be used to demonstrate endoscopic microsurgical techniques using cold steel and laser instrumentation. At the completion of this course the participants will possess an understanding of these contemporary techniques and be able to apply them in their clinical practice. The course will discuss the instrumentation requirements for endoscopic exposure and microscopic visualization. To a limited extent the preoperative and postoperative management will also be presented.
Otology/Neurotology
1720-2 Chronic Otitis Media: Ear Surgery
Derald E. Brackmann, MD; William M. Luxford, MD
3:00 pm-5:00 pm, September 9
This course details the techniques used at the House Ear Clinic for the management of chronic otitis media. The course content varies from year to year. Topics that may be included are the office management of the draining ear and a discussion of the indication for surgery. The clinic favors the outer surface graft technique and the intact canal wall procedure for management of the mastoid in most cases of cholesteatoma. The clinic does not hesitate to perform canal wall down procedures, however, and the presenters may discuss any of these operations. Finally, management of complications of chronic otitis media may be discussed. This course is illustrated by slides and videotapes of surgical procedures and supplemented by handouts on the subject.
Pediatric Otolaryngology
3621-1 Pediatric Airway 101
Robin T. Cotton, MD
1:45 pm-2:45 pm, September 11
A fundamental knowledge of the pediatric airway, including adequate assessment and basic airway management skills is an essential component of pediatric otolaryngology. This course seeks to provide a simple overview of basic management of the pediatric airway. This will include assessment of the pediatric airway, from office flexible endoscopy, through the techniques of rigid bronchoscopy of the neonatal and pediatric airway. Diagnosis of common conditions including laryngomalacia and vocal cord paralysis, as well as assessment of subglottic stenosis, laryngeal clefts, and complete tracheal rings will be covered. Operative management of laryngomalacia, as well as neonatal and pediatric tracheotomy will be discussed, as will the difficult intubation and foreign body management. The minimal desirable equipment for pediatric airway assessment and management will be covered.
Rhinology/Allergy
1715-2 Gussack Memorial: Avoiding Bad Results in Sinus Surgery
Martin J. Citardi, MD; Christopher T. Melroy, MD; Scott M. Graham, MD
3:00 pm-5:00 pm, September 9
This course presents the causes of recurrent/persistent rhinosinusitis and poor surgical results/outcomes after endoscopic sinus surgery by addressing the theory and technique of functional endoscopic sinus surgery (FESS). The review of cases in which surgery has failed can provide important information about appropriate treatment strategies. Inadequate initial surgical management may precipitate worsening or persistent disease. The discussion will include the surgical management of the middle turbinate, the maxillary ostium, the frontal recess, and the sphenoethmoid recess. Specific cases that illustrate appropriate surgical management in these areas will be discussed. Instrumentation, including the microdebrider and image-guided surgery, will be presented. Principles of postoperative management will be emphasized. The philosophy of FESS incorporates a comprehensive understanding of pre-existing medical conditions that may contribute to sinusitis. Immunological issues, antimicrobial resistance, sinusitis caused by enteric gram-negative organisms, fungal sinusitis, and nasal polyposis will also be addressed. Strategies for the incorporation of innovative treatments, such as topical antibiotic regimens, will be described. The major complications of FESS will be presented. Specific recommendations for the intraoperative management and prevention of these complications will be made. Review of clinical cases will serve to illustrate critical points.
Sleep Medicine
3627-2 Integrating Oral Appliances into Your Sleep Apnea Practice
Hands-On
Ofer Jacobowitz, MD, PhD; Alan J. Chernick, DDS; Tod C. Huntley, MD; Christopher J. Lettieri, MD
1:45-3:45 pm, September 11
Comprehensive management of OSA requires a personalized approach. Non-adherence to CPAP and fear of surgery are common among OSA patients. Oral appliance therapy is recognized as an effective treatment for OSA and can be employed as a primary treatment modality or following a suboptimal surgical or CPAP outcome. In order to integrate this modality into the sleep apnea practice, otolaryngologists should acquire the requisite conceptual understanding and practical skills. What are the indications and contraindications for oral appliances? What is their mechanism of action? What are the relevant features for patient assessment? How is appliance fitting and titration performed? What are the relevant features of the informed consent for this modality, especially for otolaryngologists? What are the problems and complications of oral appliance therapy? How do you get reimbursed for your work? This course will use lecture and a hands-on session where participants will practice taking impressions and bite registrations. The participants will benefit from instruction by experts in the field of dental sleep medicine.