After implementation of a point-based reward system, resident research activity increased. The data suggest that this system may encourage resident research, although further refinement may be required to promote higher-quality research endeavors.

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Patients undergoing adenoidectomy for upper airway obstruction are likely to be at an increased risk of subsequent tonsillectomy when compared with those with other indications. Within this subgroup of patients with upper airway obstruction, young age, female sex, and large tonsil size may further increase the risk of subsequent tonsillectomy.

POSTERS Conclusion:Compound cervicofacial and cervicothoracic rotation flaps provide a straightforward, reliable, and efficient means to reconstruct compledefects of the face, lateral skull. Head and Neck SurgeryCervicoscopic Coblation thyroid Surgery Srinivasa Rao-Merugumala, MD, FRCS (presenter) Objective: 1) To evaluate the efficacy and safety of cervicoscopic and coblation assisted surgery (CCAS) of thyroid. 2) To present a rare case of myofibroblastic nodule with focal embryonal tissue in a 72-year-old woman. 3) To understand these rare presentations for effective management.Method: To evaluate the safety and efficacy of outcomes CCAS and conventional thyroid surgical procedures from October 2008 to September 2010. Arthrocare EVac 70 Xtra Plasma Wand was used for hemostasis and subcapsular dissection.Results: One representative case includes a 72-year-old AfroCaribbean woman who presented with 3-year history of progressive exertional dyspnea and hoarse voice due to diffuse multinodular goiter with a dominant solid nodule on ultrasound and a thy2 on needle aspirate. She was refused general anaesthesia. CCAS of thyroid under cervical block as a day case, revealed moth-eaten appearance thyroid follicles with areas of hemorrhage and cholesterol clefts with focal embryonal thyroid tissue and a prominent myofibroblastic nodule formation. In contrast the third patient in this series showed areas of fibrotic hemorrhagic nodules with cystic degeneration. Conclusion:This study illustrates that CCAS of thyroid provides a minimally invasive technique with less morbidity and has good cosmetic outcome and is amenable to be performed under cervical block in selected patients. Myofibroblastic proliferation commonly reported in papillary carcinoma was contrary to association with benign pathology in this case. Head and Neck SurgeryChanges in tumor Size and Margins due to Specimen Processing Jonathan C. Mills, MD (presenter); William A. Critchlow; Gregory J. Renner, MD Objective: 1) Identify and quantify changes that occur in tumor size and tumor-free margins between surgical resection and gross pathologic analysis of oral cavity squamous cell carcinoma specimens. 2) Determine the extent to which these changes occur before or after tissue fixation in formalin.Method: Preliminary analysis of this ongoing prospective study is presented. Patients with oral cavity squamous cell carcinoma undergoing surgical resection were included. Mucosal reference points were marked with sutures, representing tumor diameter and 2 separate resection margins.Measurements were recorded immediately before resection, after resection, and after fixation in formalin.Results: Specimens from 16 patients were examined. From before resection to after formalin fixation, tumor size decreased by a mean of 3.05 mm (95% CI 0.54-5.56 mm), an 11.2% reduction, P = .02. Most of this decrease (mean, 1.94 mm, 95% CI 0.04-3.84 mm) occurred between the pre-and postresection measurements (before formalin fixation), P = .046. Margins decreased by a mean of 0.84 mm (...

Objective: To determine if residency applicant measures are predictive of resident performance.Method: A retrospective review of the residents graduating from 2006-2012 was performed. Residency applicant measures including board scores, medical school grades, and applicant rank were recorded. These were compared to measures of resident performance including otolaryngology training exam (OTE) scores and composite 360° evaluation scores obtained during the final year of residency.Results: Data was available on 20 residents. Residency applicant board scores were minimally predictive of resident OTE scores during the final year of residency (r 2 = 0.377). There was no significant correlation between board scores and performance on evaluations (r 2 = 0.10). Grade received during the surgical clerkship had an inverse correlation with performance on the OTE (r 2 = 0.13). The surgical clerkship grade also had no correlation with evaluation score (r 2 = 0.04). Most notably, applicant rank had minimal correlation with final resident performance as measured by composite evaluation score (r 2 = 0.06). Conclusion:Commonly used measures of applicant quality are minimally predictive of ultimate resident performance. Further studies are indicated to identify better predictors of resident performance. Business of Medicine/Practice ManagementEffects of a Reward System on Resident Academic Productivity Jonathan C. Mills, MD (presenter); C. W. David Chang, MDObjective: 1) Implement a reward system that positively promotes academic productivity amongst otolaryngology residents. 2) Evaluate outcomes of the reward system with regards to resident academic output. Method:Residents earn points for completing various steps of a research project. Points may be redeemed for academic endeavors, including books, equipment, and travel expenses. Resident publications submitted between 7/1/1997 and 6/30/2011 were reviewed. This timeframe included equal periods before and after implementation of the reward system, which occurred in 2004.Results: The reward system was well-utilized, with median annual points earned per resident of 850 (range 0-3670). Fortynine resident authors on 40 unique publications were identified. Mean resident publications per year increased from 1.67 prior to the reward system to 5.57 after implementation of the reward system, P = .01. After implementation of the reward system, a significantly higher percentage of resident publications were of the case report type (10% before and 85% after, P < .001). Conclusion:The reward system is well-utilized by otolaryngology residents at our institution. One measure of academic achievement-number of publications-increased after implementing the reward system. These data suggest that this system may be effectively encouraging resident research, but may have the unintended effect of skewing publication output toward case reports. Business of Medicine/Practice ManagementHow to Avoid Malpractice in Forensic ENT Medicine Mohamed E. Attia, MD (presenter)Objective: With so many cases of medi...