There is a high incidence of SALs in patients undergoing supraglottoplasty. Neurological conditions, hypoplastic mandible, SGS greater than 35%, and preexisting LE independently adversely affected the postoperative course.
BACKGROUND
The significance of osteitis in the management of recalcitrant chronic rhinosinusitis (CRS) has yet to be clearly understood and clinical outcomes data for these patients is lacking. Osteitis has been characterized by inflammatory infiltrate, osteoneogenesis, and bony sclerosis with remodeling. In this study we sought to determine if osteitis negatively impacts quality-of-life (QOL) or clinical outcomes following endoscopic sinus surgery (ESS).
METHODS
190 adult patients with CRS were prospectively enrolled. Osteitis was characterized by quantifiable bony thickening on sinus computed tomography (CT). Baseline measures and post-operative outcomes were evaluated using endoscopy exam, olfactory testing, and two validated disease-specific QOL surveys: the Chronic Sinusitis Survey and Rhinosinusitis Disability Index (RSDI). Bivariate and multivariate analyses were performed to evaluate differences between patients with and without osteitis.
RESULTS
Patients with osteitis (n=79) had higher prevalence of nasal polyposis and prior ESS (both p<0.001) and significantly worse baseline CT, endoscopy, and olfactory scores (all p<0.001) than patients without osteitis. There was no difference in baseline QOL scores between patients with and without osteitis. Following ESS, there were significant improvements in all QOL measures in both groups, however patients without osteitis were more likely to exhibit clinically meaningful improvement on physical RSDI subscale scores, independent of other clinical factors (79.0% vs 62.3%; OR: 3.85, p=0.011).
CONCLUSIONS
Osteitis is associated with worse baseline measures of disease severity and inflammation. Our data suggest that while patients with osteitis improve after ESS, the presence of osteitis is associated with a reduced chance of improvement in some outcome measures.
Inferior turbinate surgery results in favorable outcomes and continues to be recommended as a treatment for turbinate hypertrophy not responsive to medical therapy. Evidence level in the literature is improving. Future well designed studies involving prospective data collection, validated outcome measures, statistical analysis, comparison or control groups, and long-term follow-up would strengthen the level of evidence.
Objectives
To investigate how the decision to report United States Medical Licensing Examination (USMLE) Step 1 score as pass/fail will influence future otolaryngology residency application and match processes.
Study Design
Survey study.
Methods
An anonymous and voluntary survey approved by the Otolaryngology Program Directors Organization was administered to academic faculty members from April 24, 2020 through May 19, 2020.
Results
Two hundred fifty‐seven surveys were received from department chairs (17.5%), program directors (24.1%), associate program directors (12.5%), and department faculty (45.9%). USMLE Step 1 has been the most heavily weighted metric for offering interviews (44.0%), and it has correlated with residents' medical knowledge (77.0%) and in‐service performance (79.8%) but not with surgical skills (57.6%) or patient care (47.1%). In total, 68.1% disagreed with the decision to make USMLE Step 1 pass/fail. This change is anticipated to lead to an increase in significance of USMLE Step 2 CK (89.1%), core clerkship grades (80.9%), elective rotation at the respective institutions (65.7%), Alpha Omega Alpha and other awards (64.6%), and letters of recommendation (63.8%). The new scoring is also anticipated to especially benefit students from top‐ranked schools (70.8%), increase medical students' anxiety/uncertainty regarding obtaining interview invites (59.1%), and negatively affect international (51.4%), doctor of osteopathic medicine (45.9%), and underrepresented students (36.9%). Indication that USMLE Step 2 CK will significantly increase in weight varied according to department position (P = .049), geographic region (P = .047), years of practice (P < .001), and residency program size (P = .002).
Conclusion
Most academic otolaryngologists disagreed with changing USMLE Step 1 scoring to pass/fail and believe that it will increase other objective/subjective metrics' weight and put certain student populations at a disadvantage.
Level of Evidence: N/A. Laryngoscope, 131:E738–E743, 2021
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.