Otology/Neurotology recommendations – Choosing Wisely campaign

Ma, Andrew K.; Nedzelski, Julian M.; Chen, Joseph; Le, Trung; Mick, Paul; Lea, Jane; Morris, David P.; Aron, Margaret; Agrawal, Sumit; Parnes, Lorne S.; Mijović, Tamara; Lin, Vincent

doi:10.1186/s40463-019-0381-4

Cited by 4 publications

(2 citation statements)

References 9 publications

(8 reference statements)

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“…A recent article as part of the Choosing Wisely campaign gave a recommendation against performing canalith repositioning maneuvers (including the Epley) without a clinical diagnosis of posterior semicircular canal BPPV in the affected ear. Establishing the diagnosis of BPPV specifically cited the use of DHT, 8 again enforcing the importance of familiarity with DHT. Finally, the fear that attributing symptoms to a benign process such as BPPV would lead to increased rates of missed strokes has been identified as one of the primary reasons why many ED providers do not use DHT and canalith repositioning maneuvers.…”

Section: Caveatsmentioning

confidence: 99%

Epley Maneuver (Canalith Repositioning) for Benign Positional Vertigo

Azad

Pan

Verma

2020

Academic Emergency Medicine

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Section: Caveatsmentioning

confidence: 99%

Epley Maneuver (Canalith Repositioning) for Benign Positional Vertigo

Azad

Pan

Verma

2020

Academic Emergency Medicine

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“…The Choosing Wisely Canada campaign raises awareness amongst physicians and patients regarding unnecessary or inappropriate tests and treatments. The Canadian Society of Otolaryngology -Head & Neck Surgery (CSOHNS) is a proud partner of Choosing Wisely Canada and has previously released recommendations for Head and Neck Surgical Oncology [1], Otology/Neurotology [2], and Rhinology [3].…”

Section: Introductionmentioning

confidence: 99%

Choosing Wisely Canada – pediatric otolaryngology recommendations

McDonough

Hathi

Corsten

et al. 2021

J of Otolaryngol - Head & Neck Surg

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The Choosing Wisely Canada campaign raises awareness amongst physicians and patients regarding unnecessary or inappropriate tests and treatments. Using an online survey, members of the Pediatric Otolaryngology Subspecialty Group within the Canadian Society of Otolaryngology – Head & Neck Surgery developed a list of nine evidence based recommendations to help physicians and patients make treatment decisions regarding common pediatric otolaryngology presentations: (1) Don’t routinely order a plain film x-ray in the evaluation of nasal fractures; (2) Don’t order imaging to distinguish acute bacterial sinusitis from an upper respiratory infection; (3) Don’t place tympanostomy tubes in most children for a single episode of otitis media with effusion of less than 3 months duration; (4) Don’t routinely prescribe intranasal/systemic steroids, antihistamines or decongestants for children with uncomplicated otitis media with effusion; (5) Don’t prescribe oral antibiotics for children with uncomplicated tympanostomy tube otorrhea or uncomplicated acute otitis externa; (6) Don’t prescribe codeine for post-tonsillectomy/adenoidectomy pain relief in children; (7) Don’t administer perioperative antibiotics for elective tonsillectomy in children; (8) Don’t perform tonsillectomy for children with uncomplicated recurrent throat infections if there have been fewer than 7 episodes in the past year, 5 episodes in each of the past 2 years, or 3 episodes in each of the last 3 years; and (9) Don’t perform endoscopic sinus surgery for uncomplicated pediatric chronic rhinosinusitis prior to failure of maximal medical therapy and adenoidectomy.

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Management of sudden sensorineural hearing loss among primary care physicians in Canada: a survey study

Crowson

Lin

2021

J of Otolaryngol - Head & Neck Surg

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Background Sudden Sensorineural Hearing Loss (SSNHL) is a medical emergency requiring immediate attention as delayed treatment can lead to permanent and devastating consequences. Primary care physicians are likely the first to be presented with SSNHL and therefore have the crucial role of recognizing it and initiating timely and appropriate management. The aim of this study was to gain insight into the current knowledge and practice trends pertaining to the diagnosis and management of SSNHL among family physicians in Canada. Methods An 18-question survey targeting Canadian family physicians was marketed through two, physician-only discussion groups on the social media platform Facebook. Responses were collected between August 1st and December 22nd 2019 then aggregated and quantified. Results 52 family physicians submitted responses. 94.2% (n = 49) reported that in their practice, unilateral SSNHL warrants urgent referral to otolaryngology and 84.6% (n = 44) reported that unilateral sudden-onset hearing loss warrants urgent referral for audiological testing. 73.1% of participants (n = 38) reported that they would attempt to differentiate between conductive and sensorineural hearing loss if presented with unilateral, acute or sudden-onset hearing loss. 61.5% (n = 32) would rely on tuning fork tests to inform management decisions, as compared to 94.2% (n = 49) relying on case history and 88.5% (n = 46) on otoscopy. 76.9% (n = 40) would prescribe corticosteroids if presented with confirmed, unilateral SSNHL. Conclusion The majority of family physicians in the study would make appropriate referral and treatment decisions in the management of SSNHL, understanding it is a medical emergency. Tuning fork tests are under-utilized for informing management decisions compared to other means of differentiating conductive and sensorineural hearing loss. Further research is needed to understand why some family physicians do not prescribe corticosteroids for treatment of SSNHL, which may then identify any gaps in knowledge or inform improvements in clinical protocol. Graphical abstract

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Otology/Neurotology recommendations – Choosing Wisely campaign

Cited by 4 publications

References 9 publications

Epley Maneuver (Canalith Repositioning) for Benign Positional Vertigo

Epley Maneuver (Canalith Repositioning) for Benign Positional Vertigo

Choosing Wisely Canada – pediatric otolaryngology recommendations

Management of sudden sensorineural hearing loss among primary care physicians in Canada: a survey study

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