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Sample records for plastic surgery otolaryngology

  1. Antibiotic prophylaxis in otolaryngologic surgery

    Directory of Open Access Journals (Sweden)

    Ottoline, Ana Carolina Xavier

    2013-01-01

    Full Text Available Aim: Antibiotic prophylaxis aims to prevent infection of surgical sites before contamination or infection occurs. Prolonged antibiotic prophylaxis does not enhance the prevention of surgical infection and is associated with higher rates of antibiotic-resistant microorganisms. This review of the literature concerning antibiotic prophylaxis, with an emphasis on otolaryngologic surgery, aims to develop a guide for the use of antibiotic prophylaxis in otolaryngologic surgery in order to reduce the numbers of complications stemming from the indiscriminate use of antibiotics.

  2. Plastic Surgery

    Science.gov (United States)

    ... Surgery? A Week of Healthy Breakfasts Shyness Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A A ... forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word "plastic" ...

  3. American Academy of Facial Plastic and Reconstructive Surgery

    Science.gov (United States)

    ... is the world's largest specialty association for facial plastic surgery. It represents more than 2,700 facial plastic ... the American Board of Otolaryngology , which includes facial plastic surgery. Others are certified in plastic surgery, ophthalmology, and ...

  4. Current trends in robotic surgery for otolaryngology.

    Science.gov (United States)

    Byrd, J Kenneth; Duvvuri, Umamaheswar

    2013-09-01

    As minimally invasive surgery has become common in head and neck surgery, the role of robotic surgery has expanded from thyroid surgery and transoral robotic surgery (TORS) of the oropharynx and supraglottic to other areas. Surgeons have advanced the limits of TORS, adapting lasers to the Da Vinci robot for glottic cancer, and combining existing techniques for transoral supraglottic laryngectomy and hypopharyngectomy to perform transoral total laryngectomy. Skull base approaches have been reported with some success in case reports and cadaver models, but the current instrument size and configuration limit the applicability of the current robotic system. Surgeons have reported reconstruction of the head and neck via local and free flaps. Using the previously reported approaches for thyroidectomy via modified facelift incision, neck dissection has also been reported. Future applications of robotic surgery in otolaryngology may be additionally expanded, as several new robotic technologies are under development for endolaryngeal work and neurotology.

  5. Plastic Surgery Statistics

    Science.gov (United States)

    ... PSN PSEN GRAFT Contact Us News Plastic Surgery Statistics Plastic surgery procedural statistics from the American Society of Plastic Surgeons. Statistics by Year Print 2016 Plastic Surgery Statistics 2015 ...

  6. Advances in otolaryngology-Head and neck surgery. Volume 1

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    Myers, E.N. (Univ. of Pittsburgh School of Medicine, Pittsburgh, PA (US)); Bluestone, C.D. (Univ. of Pittsburgh, Pittsburgh, PA (US))

    1987-01-01

    This book consists of 14 sections. The section titles are: The impact of AIDS on otolaryngology--head and neck surgery; The management of sleep apneas and snoring; Antimicrobial agents for infections in the ear, nose, and throat--head and neck; Nasal allergy: Medical and surgical treatment; Uses of computerized tomography and magnetic resonance imaging in temporal bone imaging; Surgical management of otitis media with effusion; middle ear reconstruction: Current status; Cochlear implants: an overview; Diagnosis and management of acute facial paralysis; The use of the laser in head and neck surgery; The management and prevention of subglottic stenosis in infants and children; Management of the mass in the thyroid; Suction-assisted lipectomy of the head and neck area; and Ambulatory surgery.

  7. Ear Plastic Surgery

    Science.gov (United States)

    ... ENTCareers Marketplace Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  8. Social media in otolaryngology-head and neck surgery.

    Science.gov (United States)

    Oyewumi, Modupe; Lee, John; Vescan, Allan

    2017-09-01

    The objective of this study was to assess the current use of social media tools within Canadian otolaryngology-head and neck surgery (OHNS) programs and to assess the interest within these programs to integrate social media for networking, social, and educational programs. A prospective study from September 2013 to February 2014 was performed involving residents and faculty in Canadian OHNS programs. A 26-item questionnaire was created and sent to staff and resident physicians who met the study inclusion criteria using an online survey tool (http://surveymonkey.com). There were 101 respondents for a 10% response rate. More than half (58.4%) of respondents reported use of social media for personal and/or professional matters. Residents and junior faculty physicians 39 years and younger were more likely to have social media accounts and used them more frequently than their older counterparts. Among staff physicians, pediatric otolaryngologists had the highest rate of use, and otologists exhibited the lowest rate. Cellular phones were the most commonly used devices to access social media sites. Fewer than 35% of social media users failed to separate their personal and professional accounts. Although OHNS trainees and practicing physicians identified the potential benefits of social media tools in their specialty, most were unsure how to apply these tools to their practice. Ours is the first study to assess social media use in OHNS. Otolaryngologists are currently using social media; however, their application as a communication and educational tool in otolaryngology remains to be defined.

  9. Development of plastic surgery

    Directory of Open Access Journals (Sweden)

    Pećanac Marija Đ.

    2015-01-01

    Full Text Available Introduction. Plastic surgery is a medical specialty dealing with corrections of defects, improvements in appearance and restoration of lost function. Ancient Times. The first recorded account of reconstructive plastic surgery was found in ancient Indian Sanskrit texts, which described reconstructive surgeries of the nose and ears. In ancient Greece and Rome, many medicine men performed simple plastic cosmetic surgeries to repair damaged parts of the body caused by war mutilation, punishment or humiliation. In the Middle Ages, the development of all medical braches, including plastic surgery was hindered. New age. The interest in surgical reconstruction of mutilated body parts was renewed in the XVIII century by a great number of enthusiastic and charismatic surgeons, who mastered surgical disciplines and became true artists that created new forms. Modern Era. In the XX century, plastic surgery developed as a modern branch in medicine including many types of reconstructive surgery, hand, head and neck surgery, microsurgery and replantation, treatment of burns and their sequelae, and esthetic surgery. Contemporary and future plastic surgery will continue to evolve and improve with regenerative medicine and tissue engineering resulting in a lot of benefits to be gained by patients in reconstruction after body trauma, oncology amputation, and for congenital disfigurement and dysfunction.

  10. Perception of Shame in Otolaryngology-Head and Neck Surgery Training.

    Science.gov (United States)

    McMains, Kevin Christopher; Peel, Jennifer; Weitzel, Erik K; Der-Torossian, Hirak; Couch, Marion

    2015-11-01

    This survey was developed to assess the prevalence and effects of the perception of shame in otolaryngology-head and neck surgery residency training in the United States. Survey. US otolaryngology training programs. Faculty and trainees in US otolaryngology training programs. A 14-item survey to assess the prevalence of the experience of shame and the attitudes toward use of shame in otolaryngology residency training was sent to all otolaryngology-head and neck surgery program directors for distribution among their respective faculty and resident cohorts. A total of 267 responses were received (women, 24.7%; men, 75.3%): 42.7% of respondents were trainees; 7.0% of trainees thought that shame was a necessary/effective tool, compared with 11.4% of faculty; 50% of respondents felt that they had been personally shamed during residency; and 69.9% of respondents had witnessed another trainee being shamed during residency training. Trainees were most commonly shamed in the operating room (78.4%). Otolaryngology faculty members did the shaming 95.1% of the time. Although shaming prompted internal reflection/self-improvement in 57.4% of trainees, it also caused loss of self-confidence in 52.5%. Trainees who had been shamed were more likely to view shame as an appropriate educational tool (P Otolaryngology—Head and Neck Surgery Foundation 2015.

  11. The scope of plastic surgery

    African Journals Online (AJOL)

    2013-08-03

    Aug 3, 2013 ... areas of surgery (especially general surgery), plastic surgeons are arguably the .... Who do you feel are experts in laparoscopic surgery? e (general surgeons) a. Maxillofacial .... of pressure sore. ORIF = open reduction internal fixation. ... Plastic versus cosmetic surgery: What's the difference? Plast Reconstr.

  12. Piezoelectric technology in otolaryngology, and head and neck surgery: a review.

    Science.gov (United States)

    Meller, C; Havas, T E

    2017-07-01

    Piezoelectric technology has existed for many years as a surgical tool for precise removal of soft tissue and bone. The existing literature regarding its use specifically for otolaryngology, and head and neck surgery was reviewed. The databases Medline, the Cochrane Central Register of Controlled Trials, PubMed, Embase and Cambridge Scientific Abstracts were searched. Studies were selected and reviewed based on relevance. Sixty studies were identified and examined for evidence of benefits and disadvantages of piezoelectric surgery and its application in otolaryngology. The technique was compared with traditional surgical methods, in terms of intra-operative bleeding, histology, learning curve, operative time and post-operative pain. Piezoelectric technology has been successfully employed, particularly in otology and skull base surgery, where its specific advantages versus traditional drills include a lack of 'blunting' and tissue selectivity. Technical advantages include ease of use, a short learning curve and improved visibility. Its higher cost warrants consideration given that clinically significant improvements in operative time and morbidity have not yet been proven. Further studies may define the evolving role of piezoelectric surgery in otolaryngology, and head and neck surgery.

  13. The financial value of fellowship training in otolaryngology.

    Science.gov (United States)

    Hull, Benjamin P; Darrow, David H; Derkay, Craig S

    2013-06-01

    To evaluate the financial impact of pursuing a fellowship in otolaryngology. Retrospective financial analysis using American Academy of Otolaryngology-Head and Neck Surgery survey data. The American Academy of Otolaryngology-Head and Neck Surgery report, entitled Socioeconomic Study among Members April 2011, gives a financial profile of respondents who reported their primary area of specialization as either general otolaryngology or a specific area of subspecialization. Weighted averages were calculated from the reported data. The weighted averages were used to calculate a net present value (NPV) over a 30-year contiguous career. The NPV for general otolaryngology was $4.73 million. The NPV for the following subspecialties in relation to general otolaryngology were (in hundred thousands) as follows: otolaryngologic allergy (-$1153), sleep medicine (-$677), otology/neurotology (-$339), laryngology (-$288), head and neck (-$191), pediatric otolaryngology (-$176), facial plastic surgery (-$139), skull base surgery ($122), rhinology ($285), and allergy and immunology ($350). Ninety-four percent of general otolaryngology respondents were in private practice. Most subspecialists worked in an academic setting. Fellowship training in otolaryngology will affect career earnings of prospective fellows. The overall financial impact of fellowship training, calculating in the delay in receiving a full clinical salary, should be factored into the decision to pursue fellowship training.

  14. American Academy of Otolaryngology--Head and Neck Surgery

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    ... Neck Mass in Adults is now available in Otolaryngology–Head and Neck Surgery. The guideline addresses the ... Interested in systematic review training? SAGE, publisher of Otolaryngology—Head and Neck Surgery , will offer three grants ...

  15. Holmium:YAG laser-assisted otolaryngologic surgery: Lahey Clinic experience

    Science.gov (United States)

    Shapshay, Stanley M.; Rebeiz, Elie E.; Pankratov, Michail M.

    1993-07-01

    The Holmium:YAG laser was used to assist in 36 rhinologic procedures including surgery for chronic sinus disease, chronic dacryocystitis, recurrent choanal stenosis, and a sphenoid sinus mucocele. There were no laser related complications. The laser permitted controlled ablation of bone and soft tissue in all cases with satisfactory results. The Ho:YAG laser can be used in otolaryngology to assist in cases where surgical access is difficult or when controlled, precise bone and soft tissue ablation is necessary.

  16. [Erythropoietin in plastic surgery].

    Science.gov (United States)

    Günter, C I; Rezaeian, F; Harder, Y; Lohmeyer, J A; Egert, S; Bader, A; Schilling, A F; Machens, H-G

    2013-04-01

    EPO is an autologous hormone, which is known to regulate erythropoiesis. For 30 years it has been used for the therapy of diverse forms of anaemia, such as renal anaemia, tumour-related anaemias, etc. Meanwhile, a multitude of scientific publications were able to demonstrate its pro-regenerative effects after trauma. These include short-term effects such as the inhibition of the "primary injury response" or apoptosis, and mid- and long-term effects for example the stimulation of stem cell recruitment, growth factor production, angiogenesis and re-epithelialisation. Known adverse reactions are increases of thromboembolic events and blood pressure, as well as a higher mortality in patients with tumour anaemias treated with EPO. Scientific investigations of EPO in the field of plastic surgery included: free and local flaps, nerve regeneration, wound healing enhancement after dermal thermal injuries and in chronic wounds.Acute evidence for the clinical use of EPO in the field of plastic surgery is still not satisfactory, due to the insufficient number of Good Clinical Practice (GCP)-conform clinical trials. Thus, the initiation of more scientifically sound trials is indicated.

  17. Laser safety in otolaryngology--head and neck surgery: anesthetic and educational considerations for laryngeal surgery.

    Science.gov (United States)

    Ossoff, R H

    1989-08-01

    Two investigations concerning anesthetic and educational considerations for laser safety in microlaryngeal carbon dioxide laser surgery have been performed. The first study demonstrated that attendance at a "hands-on" laser surgery course that stressed safety precautions was associated with a reduced rate of laser-related complications in the selected group of otolaryngologists who participated in the course, when compared to another selected group of otolaryngologists who were members of a senior otolaryngology society, and surveyed solely on the basis of their society membership. The second series of studies compared the incendiary characteristics of three endotracheal tubes in various mixtures of oxygen, diluted with either helium or nitrogen. It was determined that the polyvinyl chloride tube should not be used for laser surgery, even when wrapped with reflective, metallic tape. The safest anesthetic gas mixture was found to be 30% oxygen in helium; the addition of 2% halothane did not have an adverse effect, as had been previously reported. Both the Xomed Laser-Shield and Rusch red rubber endotracheal tubes were found to be safe, when used with the laser in the pulsed mode in an atmosphere of 100% oxygen. When the laser was used in the continuous mode, both tubes ignited in an atmosphere of 30% oxygen in helium. These findings challenged the previously reported levels of safety associated with the use of an unwrapped Xomed tube. Based on the results of this investigation, it has been concluded that both the Rusch red rubber tube and the Xomed Laser-Shield tube should be wrapped with reflective, metallic tape, when used for cases of microlaryngeal surgery with the carbon dioxide laser.

  18. Women in Otolaryngology.

    Science.gov (United States)

    O'Connell Ferster, Ashley P; Hu, Amanda

    2017-08-01

    Advances in gender equality have been sought in the field of medicine for centuries, including the specialty of otolaryngology. Currently, about 14.5% of practicing otolaryngologists are women. Strides have been made to support equality by the American Academy of Otolaryngology-Head and Neck Surgery through the development of the Women in Otolaryngology Section in 2010, among other efforts. This article reviews the literature of women in otolaryngology, as well as current trends toward equality among otolaryngologists of all genders.

  19. Computer-assessed performance of psychomotor skills in endoscopic otolaryngology surgery: construct validity of the Dundee Endoscopic Psychomotor Otolaryngology Surgery Trainer (DEPOST).

    Science.gov (United States)

    Ross, Peter D; Steven, Richard; Zhang, Dong; Li, Heng; Abel, Eric W

    2015-11-01

    This study was undertaken to introduce and establish the value of the Dundee Endoscopic Psychomotor Otolaryngology Surgery Trainer (DEPOST) as a customisable, objective real-time scoring system for trainee assessment. The construct validity of the system was assessed by comparing the performance of experienced otolaryngologists with that of otolaryngology trainees, junior doctors and medical students. Forty two subjects (13 Consultants, 8 senior trainees, 13 junior trainees and 8 junior doctors/medical students) completed a single test on DEPOST. The test involved using a 30° rigid endoscope and a probe with position sensor, to identify a series of lights in a complex 3-dimensional model. The system scored subjects for time, success rate, and economy of movement (distance travelled). An analysis of variance and correlation analysis were used for the data analysis, with statistical significance set at 0.05. Increasing experience led to significantly improved performance with the DEPOST (p < 0.01). Senior trainees' results were significantly better than those of consultant otolaryngologists in success rate and time (p < 0.05 & p < 0.05). Consultants were the most efficient in their movement (p = 0.051) CONCLUSIONS: The system provides an accurate and customisable assessment of endoscopic skill in otolaryngologists. The DEPOST system has construct validity, with master surgeons and senior trainees completing the tasks more accurately without sacrificing execution time, success rate or efficiency of movement.

  20. Surgery in World War II. Ophthalmology and Otolaryngology

    Science.gov (United States)

    1957-01-01

    hWO -- -------------- Marcl 1945 ----- 250) 250 553 I tw1m~ing twIin s for hi join I casualtivs amot eastialits recquiriav plistic surgery.I includring...Reliahilitat ion Center, Borden General H ospjit al. Thet wall chart shows thle V-posit ion assumed 1) the mnomt .i inl thle Ipromnnci:ittion of vowels

  1. The commercialization of plastic surgery.

    Science.gov (United States)

    Swanson, Eric

    2013-09-01

    The last decade has brought a major challenge to the traditional practice of plastic surgery from corporations that treat plastic surgery as a commercial product and market directly to the public. This corporate medicine model may include promotion of a trademarked procedure or device, national advertising that promises stunning results, sales consultants, and claims of innovation, superiority, and improved safety. This article explores the ethics of this business practice and whether corporate medicine is a desirable model for patients and plastic surgeons.

  2. Architecture of European Plastic Surgery

    NARCIS (Netherlands)

    Nicolai, J. -P. A.; Banic, A.; Molea, G.; Mazzola, R.; Poell, J. G.

    2006-01-01

    The architecture of European Plastic Surgery was published in 1996 [Nicolai JPA, Scuderi N. Plastic surgical Europe in an organogram. Eur J Plast Surg 1996; 19: 253-6.] It is the objective of this paper to update information of that article. Continuing medical education (CME), science, training,

  3. [Analysis of master degree thesis of otolaryngology head and neck surgery in Xinjiang].

    Science.gov (United States)

    Ayiheng, Qukuerhan; Niliapaer, Alimu; Yalikun, Yasheng

    2010-12-01

    To understand the basic situation and development of knowledge structure and ability of master degree of Otolaryngology Head and Neck Surgery in Xinjiang region in order to provide reference to further improve the quality of postgraduate students. Fourty-six papers of Otolaryngology master degree thesis were reviewed at randomly in terms of types, subject selection ranges as well as statistical methods during 1998-2009 in Xinjiang region in order to analyze and explore its advantages and characteristics and suggest a solution for its disadvantages. In 46 degree thesis, nine of them are scientific dissertations accounting for 19.57%, 37 are clinical professional degree thesis, accounting for 80.43%. Five are Experimental research papers, 30 are clinical research papers, 10 are clinical and experimental research papers, 1 of them is experimental epidemiology research paper; in this study, the kinds of diseases including every subject of ENT, various statistical methods are involved; references are 37.46 in average, 19.55 of them are foreign literatures references in nearly 5 years are 13.57; four ethnic groups are exist in postgraduate students with high teaching professional level of tutors. The clinical research should be focused in order to further research on ENT common diseases, the application of advanced research methods, the full application of the latest literature, tutors with high-level, training of students of various nationalities, basic research needs to be innovative and should be focus the subject characteristics, to avoid excessive duplication of research.

  4. Embedding quality and safety in otolaryngology-head and neck surgery education.

    Science.gov (United States)

    McCormick, Michael E; Stadler, Michael E; Shah, Rahul K

    2015-05-01

    Education in patient safety (PS) and quality improvement (QI) helps both medical students and residents understand the health care environment in the United States, where these concepts are now incorporated into virtually every aspect of patient care. The Accreditation Council of Graduate Medical Education has made PS/QI a mandatory component of resident education, and a number of specialties have published their experiences with incorporating PS/QI into their training programs. In otolaryngology-head and neck surgery, a strong curriculum can be built by teaching residents about the principles of PS/QI through both didactic and experiential learning, and morbidity and mortality and QI conferences can serve as the cornerstone of this curriculum. Understanding the potential challenges in PS/QI education can allow training programs to plan their strategy effectively for successful incorporation into their existing curricula.

  5. Free online otolaryngology educational modules: a pilot study.

    Science.gov (United States)

    Cabrera-Muffly, Cristina; Bryson, Paul C; Sykes, Kevin J; Shnayder, Yelizaveta

    2015-04-01

    Otolaryngology residents need concise, easily accessible modules to expand educational opportunities between surgical cases. These modules should be inexpensive to create and improve learning outcomes. The purpose of this pilot study was to assess whether otolaryngology residents at multiple institutions used online video modules to supplement their studying for the Otolaryngology Training Exam, whether the modules had any effect on their Otolaryngology Training Examination Scores, and to obtain survey feedback about the modules. This randomized trial was conducted in 3 academic departments of otolaryngology in the United States among 37 residents enrolled in 3 otolaryngology residency programs. Residents were randomized into 2 groups, one with access to the educational modules and the other with no access. Otolaryngology training examination scores were obtained from the year prior to the intervention (2012) and the year following module access (2013). Residents with access to the modules were also surveyed to assess use and obtain feedback about the modules. Otolaryngology training examination scores improved significantly from 2012 to 2013 among both residents who had access to the modules and those who did not in the sections of head and neck, laryngology, and sleep medicine. However, scores in the sections of pediatric otolaryngology (8% increase, P = .03), otology (7% increase, P = .02), and facial plastic surgery (10% increase, P = .02) improved from 2012 to 2013 only among residents with access to the modules. All respondents rated the videos as very helpful, with a rating of 4 of 5 on a Likert scale. Online otolaryngology educational modules are an inexpensive way to expand resident learning opportunities. Despite the lack of quantifiable improvement in otolaryngology training examination scores in this study, use of online modules sends a message to otolaryngology residents that their education is a priority; self-study outside the hospital

  6. [The history of plastic surgery in Israel].

    Science.gov (United States)

    Wiser, Itay; Scheflan, Michael; Heller, Lior

    2014-09-01

    The medical institutions in the country have advanced together with the development of the state of Israel. Plastic surgery, which has progressed significantly during the 20th century, has also grown rapidly in the new state. The arrival of Jewish plastic surgeons from all over the world with the knowledge and experience gained in their countries of origin, as well as the need for reconstructive surgical treatment for many combat injured soldiers, also contributed to the development of plastic surgery. This review tells the story of plastic surgery in Israel, since its foundation until nowadays. This article reviews the work of the founders of plastic surgery in Israel, indicating significant milestones in its development, and clinical and scientific contribution to the international plastic surgery profession. Moreover, the article describes the current condition of the field of plastic surgery in Israel and presents the trends and the future challenges facing the next generation of plastic surgery in Israel.

  7. Anaesthetic complications in plastic surgery.

    Science.gov (United States)

    Nath, Soumya Sankar; Roy, Debashis; Ansari, Farrukh; Pawar, Sundeep T

    2013-05-01

    Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist's concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients' experience and surgical outcome.

  8. Anaesthetic complications in plastic surgery

    Directory of Open Access Journals (Sweden)

    Soumya Sankar Nath

    2013-01-01

    Full Text Available Anaesthesia related complications in plastic surgeries are fortunately rare, but potentially catastrophic. Maintaining patient safety in the operating room is a major concern of anaesthesiologists, surgeons, hospitals and surgical facilities. Circumventing preventable complications is essential and pressure to avoid these complications in cosmetic surgery is increasing. Key aspects of patient safety in the operating room are outlined, including patient positioning, airway management and issues related to some specific conditions, essential for minimizing post-operative morbidity. Risks associated with extremes of age in the plastic surgery population, may be minimised by a better understanding of the physiologic changes as well as the pre-operative and post-operative considerations in caring for this special group of patients. An understanding of the anaesthesiologist′s concerns during paediatric plastic surgical procedures can facilitate the coordination of efforts between the multiple services involved in the care of these children. Finally, the reader will have a better understanding of the perioperative care of unique populations including the morbidly obese and the elderly. Attention to detail in these aspects of patient safety can help avoid unnecessary complication and significantly improve the patients′ experience and surgical outcome.

  9. "Oriental anthropometry" in plastic surgery

    Directory of Open Access Journals (Sweden)

    Senna-Fernandes Vasco

    2008-01-01

    Full Text Available Background : According to Chinese medicine, the acupuncture-points′ (acupoints locations are proportionally and symmetrically distributed in well-defined compartment zones on the human body surface Oriental Anthropometry" (OA. Acupoints, if considered as aesthetic-loci, might be useful as reference guides in plastic surgery (PS. Aim: This study aimed to use aesthetic-loci as anatomical reference in surgical marking of Aesthetic Plastic Surgery. Method: This was an observational study based on aesthetic surgeries performed in private clinic. This study was based on 106 cases, comprising of 102 women and 4 men, with ages varying from 07 to 73 years, and with heights of between 1.34 m and 1.80 m. Patients were submitted to aesthetic surgical planning by relating aesthetic-loci to conventional surgical marking, including breast surgeries, abdominoplasty, rhytidoplasty, blepharoplasty, and hair implant. The aesthetic-surgical-outcome (ASO of the patients was assessed by a team of plastic surgeons (who were not involved in the surgical procedures over a follow-up period of one year by using a numeric-rating-scale in percentage (% terms. A four-point-verbal-rating-scale was used to record the patients′ opinion of therapeutic-satisfaction (TS. Results: ASO was 75.3 ± 9.4% and TS indicated that most patients (58.5% obtained "good" results. Of the remainder, 38.7% found the results "excellent", and 2.8% found them "fair". Discussion and Conclusion : The data suggested that the use of aesthetic-loci may be a useful tool for PS as an anatomical reference for surgical marking. However, further investigation is required to assess the efficacy of the OA by providing the patients more reliable balance and harmony in facial and body contours surgeries.

  10. Attitudes toward professionalism education in Otolaryngology-Head and Neck Surgery residency programs.

    Science.gov (United States)

    Nichols, Brent G; Stadler, Michael E; Poetker, David M

    2015-02-01

    Resident professionalism development is important for physician training and patient care. Meaningful professionalism curriculum requires collaboration between learners and educators. We aimed to better understand attitudes of Otolaryngology-Head and Neck Surgery (OHNS) program directors (PDs) and residents toward professionalism education. Prospective survey. We identified contemporary methods of professionalism evaluation and education and formulated questions to assess attitudes toward professionalism education. Surveys were electronically distributed to 104 PDs who were asked to forward a separate survey to residents. The resident survey was completed by 110 OHNS residents, and the PD survey was completed by 33 OHNS PDs. The majority of residents (78%) and faculty (84%) believed professionalism could be taught. Role modeling (93%) and morbidity and mortality conference (90%) were the most common methods of education. Faculty questionnaires (100%) and nursing/ancillary staff questionnaires (93%) were the most common methods of resident evaluation. The majority of residents considered faculty mentoring (66%) and small group discussions (56%) to be useful methods for teaching professionalism, whereas only 14% considered formal lectures useful. Residents valued questionnaires by faculty (98%), medical staff (97%), and patients (94%) for professionalism evaluation. We are the first to study OHNS residents and PDs attitudes toward professionalism evaluation and education. Residents value mentoring programs and small group sessions rather than formal didactics and value evaluation from multiple sources. Programs should consider incorporating these specific educational and evaluative methods into their professionalism curricula. N/A. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  11. [Galactorrhea after mammary plastic surgery].

    Science.gov (United States)

    Inguenault, C; Capon-Degardin, N; Martinot-Duquennoy, V; Pellerin, P

    2005-04-01

    Galactorrhoea is a complication rarely observed after mammary plastic surgery. Our experience in the domain extends to three clinical cases - two after prosthetic insertion and one after breast reduction - wich will be presented here. The origin of this complication is uncertain. Nevertheless, it is likely to be multifocal, as surgery alone is not the only cause. Postsurgical galactorrhoea often follows a benign course culminating in spontaneous resolution. However, it may reveal the presence of o prolactin secreting adenoma, as was the case with one of our patients. A detailed history, exploring antecedent factors, is an essential step in guiding subsequent management. When faced with postsurgical galactorrhoea, serum prolactin levels should be measured. If serum prolactin levels exceed 150 ng/ml further investigation by way of an MRI of the sella turcica is advisable to rule out pituitary adenoma. Depending on symptom severity, treatment may be medical with the prescription of dopaminergic agonists, and/or surgical with drainage or removal of prostheses. Increased awareness of galactorrhea as a possible complication of plastic surgery to the breast will improve management.

  12. The Future of Plastic Surgery: Surgeon's Perspective.

    Science.gov (United States)

    Ozturk, Sinan; Karagoz, Huseyin; Zor, Fatih

    2015-11-01

    Since the days of Sushruta, innovation has shaped the history of plastic surgery. Plastic surgeons have always been known as innovators or close followers of innovations. With this descriptive international survey study, the authors aimed to evaluate the future of plastic surgeons by analyzing how plastic surgery and plastic surgeons will be affected by new trends in medicine. Aesthetic surgery is the main subclass of plastic surgery thought to be the one that will change the most in the future. Stem cell therapy is considered by plastic surgeons to be the most likely "game changer." Along with changes in surgery, plastic surgeons also expect changes in plastic surgery education. The most approved assumption for the future of plastic surgery is, "The number of cosmetic nonsurgical procedures will increase in the future." If surgeons want to have better outcomes in their practice, they must at least be open minded for innovations if they do not become innovators themselves. Besides the individual effort of each surgeon, international and local plastic surgery associations should develop new strategies to adopt these innovations in surgical practice and education.

  13. Association of Otolaryngology Resident Duty Hour Restrictions With Procedure-Specific Outcomes in Head and Neck Endocrine Surgery.

    Science.gov (United States)

    Smith, Aaron; Braden, Lauren; Wan, Jim; Sebelik, Merry

    2017-06-01

    Graduate medical education has undergone a transformation from traditional long work hours to a restricted plan to allow adequate rest for residents. The initial goal of this restriction is to improve patient outcomes. To determine whether duty hour restrictions had any impact on surgery-specific outcomes by analyzing complications following thyroid and parathyroid procedures performed before and after duty hour reform. Retrospective cross-sectional analysis of the National Inpatient Sample (NIS).The NIS was queried for procedure codes associated with thyroid and parathyroid procedures for the years 2000 to 2002 and 2006 to 2008. Hospitals were divided based on teaching status into 3 groups: nonteaching hospitals (NTHs), teaching hospitals without otolaryngology programs (THs), and teaching hospitals with otolaryngology programs (THs-OTO). Procedure-specific complication rates, length of stay, and mortality rates were collected. SAS statistical software (version 9.4) was used for analysis with adjustment using Charlson comorbidity index. Total numbers of head and neck endocrine procedures were 34 685 and 39 770 (a 14.7% increase), for 2000 to 2002 and 2006 to 2008, respectively. THs-OTO contributed a greater share of procedures in 2006 to 2008 (from 18% to 25%). With the earlier period serving as the reference, length of stay remained constant (2.1 days); however, total hospital charges increased (from $12 978 to $23 708; P otolaryngology programs.

  14. Does resident participation influence otolaryngology-head and neck surgery morbidity and mortality?

    Science.gov (United States)

    Abt, Nicholas B; Reh, Douglas D; Eisele, David W; Francis, Howard W; Gourin, Christine G

    2016-10-01

    Patients may perceive resident procedural participation as detrimental to their outcome. Our objective is to investigate whether otolaryngology-head and neck surgery (OHNS) housestaff participation is associated with surgical morbidity and mortality. Case-control study. OHNS patients were analyzed from the American College of Surgeons National Surgical Quality Improvement Program 2006 to 2013 databases. We compared the incidence of 30-day postoperative morbidity, mortality, readmissions, and reoperations in patients operated on by resident surgeons with attending supervision (AR) with patients operated on by an attending surgeon alone (AO) using cross-tabulations and multivariable regression. There were 27,018 cases with primary surgeon data available, with 9,511 AR cases and 17,507 AO cases. Overall, 3.62% of patients experienced at least one postoperative complication. The AR cohort had a higher complication rate of 5.73% than the AO cohort at 2.48% (P < .001). After controlling for all other variables, there was no significant difference in morbidity (odds ratio [OR] = 1.05 [0.89 to 1.24]), mortality (OR = 0.91 [0.49 to 1.70]), readmission (OR = 1.29 [0.92 to 1.81]), or reoperation (OR = 1.28 [0.91 to 1.80]) for AR compared to AO cases. There was no difference between postgraduate year levels for adjusted 30-day morbidity or mortality. There is an increased incidence of morbidity, mortality, readmission, and reoperation in OHNS surgical cases with resident participation, which appears related to increased comorbidity with AR patients. After controlling for other variables, resident participation was not associated with an increase in 30-day morbidity, mortality, readmission, or reoperation odds. These data suggest that OHNS resident participation in surgical cases is not associated with poorer short-term outcomes. 3b Laryngoscope, 126:2263-2269, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Commentary on "Otolaryngology-head and neck surgery physician workforce issues an analysis for future specialty planning" by Kim, Cooper, and Kennedy.

    Science.gov (United States)

    Pryor, Shannon P; Brodsky, Linda; Chandrasekhar, Sujana S; Zaretsky, Lauren; Taylor, Duane J; Yaremchuk, Kathleen L; Pillsbury, Harold C

    2012-02-01

    An impending physician shortage has been projected. The article by Kim, Cooper, and Kennedy, titled "Otolaryngology-Head and Neck Surgery Physician Workforce Issues: An Analysis for Future Specialty Planning," is an attempt to evaluate and address this potential shortage as it applies to otolaryngology. The authors of this comment have concerns about the article's assumptions, design, and recommendations. Kim et al attempt to extrapolate data from other specialties and other countries to the US otolaryngology workforce, use that data in modeling methods without demonstrated validity, and based on their analysis, they recommend drastic changes to otolaryngologic training and practice in the United States. Particularly troublesome are (1) the emphasis placed on gender and part-time work and (2) the measurement of productivity defined as hours worked per week. Before redefining our specialty, more thorough and systematic data acquisition and review are necessary to meet the needs of our patients now and in the future.

  16. On innovations in plastic surgery.

    Science.gov (United States)

    Mehta, Hemant

    2009-04-01

    The progress of surgery has been utterly dependent on continuing innovations by surgeon innovators, largely because surgeons work in an environment that is very conducive to innovating. Of all clinicians surgeons excel at improvisations and innovations. The aim of this review is to outline some of my innovations, the circumstances leading to their origin, and to explain some of the fundamental concepts behind those innovations, with a view to inviting and encouraging younger surgeons to consider breaking away - sensibly - from convention at times, and embark on a journey towards innovation. The context and the qualities required of a would-be innovator are explained and the process of innovation itself is analysed. Rigid adherence to prevailing assumptions and practices stifles originality, while adopting a questioning attitude with a smidgen of irreverence facilitates innovation. That an innovation has resulted purely by a chance observation or occurrence - serendipity - may render it less glamorous but never less useful. Innovations in surgical techniques necessitate adoption of a novel pragmatic surgical philosophy. Confined as they are to Oculoplasty, the concepts of innovations cited and illustrated in this review, are equally valid for Plastic surgery and indeed for Surgery in general. Working in a small hospital or an isolated Institution need not be a hindrance to a would-be innovator.

  17. Readability Trends of Online Information by the American Academy of Otolaryngology-Head and Neck Surgery Foundation.

    Science.gov (United States)

    Wong, Kevin; Levi, Jessica R

    2017-01-01

    Objective Previous studies have shown that patient education materials published by the American Academy of Otolaryngology-Head and Neck Surgery Foundation may be too difficult for the average reader to understand. The purpose of this study was to determine if current educational materials show improvements in readability. Study Design Cross-sectional analysis. Setting The Patient Health Information section of the American Academy of Otolaryngology-Head and Neck Surgery Foundation website. Subjects and Methods All patient education articles were extracted in plain text. Webpage navigation, references, author information, appointment information, acknowledgments, and disclaimers were removed. Follow-up editing was also performed to remove paragraph breaks, colons, semicolons, numbers, percentages, and bullets. Readability grade was calculated with the Flesch-Kincaid Grade Level, Flesch Reading Ease, Gunning-Fog Index, Coleman-Liau Index, Automated Readability Index, and Simple Measure of Gobbledygook. Intra- and interobserver reliability were assessed. Results A total of 126 articles from 7 topics were analyzed. Readability levels across all 6 tools showed that the difficulty of patient education materials exceeded the abilities of an average American. As compared with previous studies, current educational materials by the American Academy of Otolaryngology-Head and Neck Surgery Foundation have shown a decrease in difficulty. Intra- and interobserver reliability were both excellent, with intraclass coefficients of 0.99 and 0.96, respectively. Conclusion Improvements in readability is an encouraging finding and one that is consistent with recent trends toward improved health literacy. Nevertheless, online patient educational material is still too difficult for the average reader. Revisions may be necessary for current materials to benefit a larger readership.

  18. Medical leech therapy in plastic reconstructive surgery.

    Science.gov (United States)

    Houschyar, Khosrow S; Momeni, Arash; Maan, Zeshaan N; Pyles, Malcolm N; Jew, Olivia S; Strathe, Marion; Michalsen, Andreas

    2015-10-01

    The use of Hirudo medicinalis in clinical practice has increased in recent years. The primary indication in plastic surgery has traditionally been venous congestion. However, other reported clinical applications were in varicose veins, thrombophlebitis, and osteoarthritis. In this review, we summarize recent data elucidating the role that medicinal leeches play in the field of plastic surgery.

  19. Plastic Surgery and Suicide: A Clinical Guide for Plastic Surgeons.

    Science.gov (United States)

    Reddy, Vikram; Coffey, M Justin

    2016-08-01

    Several studies have identified an increased risk of suicide among patient populations which a plastic surgeon may have a high risk of encountering: women undergoing breast augmentation, cosmetic surgery patients, and breast cancer patients. No formal guidelines exist to assist a plastic surgeon when faced with such a patient, and not every plastic surgery team has mental health clinicians that are readily accessible for consultation or referral. The goal of this clinical guide is to offer plastic surgeons a set of practical approaches to manage potentially suicidal patients. In addition, the authors review a screening tool, which can assist surgeons when encountering high-risk patients.

  20. Knowledge and perception of plastic surgery among tertiary ...

    African Journals Online (AJOL)

    2015-10-16

    Oct 16, 2015 ... in that facility. The most common ... surgeons and known facilities for facial plastic surgery. Even though ... Location of plastic surgery services. Knowledge of ... decisions, actions, and acceptance of the entity. Plastic surgery ...

  1. Fifty Years of Innovation in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Richard M Kwasnicki

    2016-03-01

    Full Text Available BackgroundInnovation has molded the current landscape of plastic surgery. However, documentation of this process only exists scattered throughout the literature as individual articles. The few attempts made to profile innovation in plastic surgery have been narrative, and therefore qualitative and inherently biased. Through the implementation of a novel innovation metric, this work aims to identify and characterise the most prevalent innovations in plastic surgery over the last 50 years.MethodsPatents and publications related to plastic surgery (1960 to 2010 were retrieved from patent and MEDLINE databases, respectively. The most active patent codes were identified and grouped into technology areas, which were subsequently plotted graphically against publication data. Expert-derived technologies outside of the top performing patents areas were additionally explored.ResultsBetween 1960 and 2010, 4,651 patents and 43,118 publications related to plastic surgery were identified. The most active patent codes were grouped under reconstructive prostheses, implants, instruments, non-invasive techniques, and tissue engineering. Of these areas and other expert-derived technologies, those currently undergoing growth include surgical instruments, implants, non-invasive practices, transplantation and breast surgery. Innovations related to microvascular surgery, liposuction, tissue engineering, lasers and prostheses have all plateaued.ConclusionsThe application of a novel metric for evaluating innovation quantitatively outlines the natural history of technologies fundamental to the evolution of plastic surgery. Analysis of current innovation trends provides some insight into which technology domains are the most active.

  2. Simulation-based otolaryngology - head and neck surgery boot camp: 'how I do it'.

    Science.gov (United States)

    Chin, C J; Chin, C A; Roth, K; Rotenberg, B W; Fung, K

    2016-03-01

    In otolaryngology, surgical emergencies can occur at any time. An annual surgical training camp (or 'boot camp') offers junior residents from across North America the opportunity to learn and practice these skills in a safe environment. The goals of this study were to describe the set-up and execution of a simulation-based otolaryngology boot camp and to determine participants' confidence in performing routine and emergency on-call procedures in stressful situations before and after the boot camp. There were three main components of the boot camp: task trainers, simulations and an interactive panel discussion. Surveys were given to participants before and after the boot camp, and their confidence in performing the different tasks was assessed via multiple t-tests. Participants comprised 22 residents from 12 different universities; 10 of these completed both boot camp surveys. Of the nine tasks, the residents reported a significant improvement in confidence levels for six, including surgical airway and orbital haematoma management. An otolaryngology boot camp gives residents the chance to learn and practice emergency skills before encountering the emergencies in everyday practice. Their confidence in multiple skillsets was significantly improved after the boot camp. Given the shift towards competency-based learning in medical training, this study has implications for all surgical and procedural specialties.

  3. Plastic surgery after solid organ transplantations

    Institute of Scientific and Technical Information of China (English)

    QI Fa-zhi; ZHANG Yong; YANG Zhen; FENG Zi-hao; GU Jian-ying

    2009-01-01

    Background More patients receive organ transplantation surgeries due to the advancement in immunosuppressive agents and surgical techniques. Some of those patients may need to undergo plastic or reconstructive surgery.Long-term use of immunosuppressive agents raises some serious problems. Therefore, this study aimed to introduce our experience about the safety and effectiveness of plastic surgeries after solid organ allograft transplantation.Methods A retrospective review of 17 transplant recipients who underwent different reconstructive or cosmetic operations was carried out. The subjects included 1 heart transplant, 1 liver transplant and 15 kidney transplant recipients.Results "All patients tolerated the plastic surgery procedures well. Flaps and skin grafts were the main constructive methods. There were no postoperative infections and wound dehiscence. Transferred flaps survived completely. Skin grafts took well. Three of the cosmetic surgery patients were satisfied with the results.Conclusions Immunosuppressed organ transplant recipients can successfully undergo major reconstructive and cosmetic surgery when given special attention.

  4. [The history of pediatric plastic surgery].

    Science.gov (United States)

    Glicenstein, J

    2016-10-01

    The history of pediatric plastic surgery is linked to that of paediatrics. Until the early 19th century, there was no children's hospital. Only some operations were performed before the discovery of anesthesia, aseptic and antisepsis: cleft lip repair, amputation for polydactyly. Many operations were described in the 19th century for cleft lip and palate repair, hypospadias, syndactylies. The first operation for protruding ears was performed in 1881. Pediatric plastic surgery is diversified in the 2nd half of the 20th century: cleft lip and palate, burns, craniofacial surgery, hand surgery become separate parts of the speciality.

  5. Otolaryngology--head and neck surgery in undergraduate medical education: advances and innovations.

    Science.gov (United States)

    Fung, Kevin

    2015-02-01

    Medical students graduate with the knowledge and skills to be undifferentiated general physicians. Otolaryngology-head and neck surgery (OtoHNS) is an essential component of primary healthcare, but is disproportionately under-represented in undergraduate medical education (UME). Advances and innovations in educational technology may represent an exciting and creative solution to this important problem. Failure to meet this educational need will result in substantial downstream effects in primary healthcare delivery. The objectives of this study were to 1) demonstrate current deficits in OtoHNS teaching at the UME level; 2) develop, validate, and critically appraise educational innovations that may enrich OtoHNS teaching in medical school curricula; and 3) propose a process for standardization of learning objectives for OtoHNS in UME as it relates to development and deployment of such educational tools. A white paper, prepared as a Triological Society thesis, which consolidates a prospective 10-year investigation of the problem of and potential solutions for under-representation of OtoHNS in UME. Cited datasets include multicenter surveys, cohort studies, and prospective, randomized controlled trials. A series of published and unpublished data were synthesized that addresses the following: 1) the current state of OtoHNS teaching at the UME level with respect to content, volume, structure, and methods; and 2) educational innovations including e-learning and simulation with emphasis on validity and learning effectiveness. Educational innovations specific to postgraduate (residency) training were excluded. Data support the observation that there is uniformly disproportionate under-representation of OtoHNS within UME curricula. Medical school graduates, especially those pursuing primary care specialties, report poor overall comfort levels in managing OtoHNS problems. A series of novel teaching methods were developed and validated using e-learning and simulation

  6. Bibliometric trend analyses of plastic surgery research

    NARCIS (Netherlands)

    Loonen, M.P.J.

    2007-01-01

    The present thesis was designed to evaluate the qualitative and quantitative aspects of plastic surgery research by means of a bibliometric citation analysis of plastic surgical presentations and publications. Citations to such published work provides an indication of the impact and the relevance of

  7. Bibliometric trend analyses of plastic surgery research

    NARCIS (Netherlands)

    Loonen, M.P.J.

    2007-01-01

    The present thesis was designed to evaluate the qualitative and quantitative aspects of plastic surgery research by means of a bibliometric citation analysis of plastic surgical presentations and publications. Citations to such published work provides an indication of the impact and the relevance of

  8. Ophthalmic plastic and orbital surgery in Taiwan.

    Science.gov (United States)

    Hsu, Chi-Hsin; Lin, I-Chan; Shen, Yun-Dun; Hsu, Wen-Ming

    2014-06-01

    We describe in this paper the current status of ophthalmic plastic and orbital surgery in Taiwan. Data were collected from the Bureau of National Health Insurance of Taiwan, the Bulletin of the Taiwan Ophthalmic Plastic and Reconstructive Society, and the Statistics Yearbook of Practicing Physicians and Health Care Organizations in Taiwan by the Taiwan Medical Association. We ascertained that 94 ophthalmologists were oculoplastic surgeons and accounted for 5.8% of 1621 ophthalmologists in Taiwan. They had their fellowship training abroad (most ophthalmologists trained in the United States of America) or in Taiwan. All ophthalmologists were well trained and capable of performing major oculoplastic surgeries. The payment rates by our National Health Insurance for oculoplastic and orbital surgeries are relatively low, compared to Medicare payments in the United States. Ophthalmologists should promote the concept that oculoplastic surgeons specialize in periorbital plastic and aesthetic surgeries. However, general ophthalmologists should receive more educational courses on oculoplastic and cosmetic surgery.

  9. 21 CFR 878.3925 - Plastic surgery kit and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Plastic surgery kit and accessories. 878.3925... (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Prosthetic Devices § 878.3925 Plastic surgery kit and accessories. (a) Identification. A plastic surgery kit and accessories is a device intended...

  10. The epistemology of otolaryngology-head and neck surgery: a scientific evaluation of the knowledge base.

    Science.gov (United States)

    Sharp, Steve; Harvey, Richard J; Burton, Martin J

    2007-10-01

    There are nearly a quarter of a million ENT publications listed in MEDLINE alone and the knowledge within our field continues to accumulate at an increasing rate. Many factors influence publication and the production and dissemination of new knowledge. But the direction of research effort does not always reflect clinical need. A variety of external factors are implicated including-but certainly not limited to-funding, corporate interest and market forces, the political climate, tenacity and resourcefulness of special interest groups, and even fashion. Little detailed information on the current state of knowledge within otolaryngology has been available.

  11. Informed Consent in Otolaryngologic Surgery: Case Scenario from a Nigerian Specialist Hospital

    Directory of Open Access Journals (Sweden)

    O. A. Afolabi

    2014-01-01

    Full Text Available Informed consent is a foundational concept necessary for ethical conduct of clinical research and practice. It is a technical tool that shifts the autonomy to decide whether a medical procedure should be performed—from the doctor to the patient. However there is an ongoing discussion in bioethical circles on the level of comprehension of the informed consent process by the patients and research participants. We present this case vignette and the discussion afterwards to explore the question of to what extent a patient comprehends the information given to him/her before a surgical procedure is carried out. In other words, the question being asked here is how informed is informed consent in the context of oto-laryngological practice.

  12. Pilot Study Evaluating the Impact of Otology Surgery Videos on Otolaryngology Resident Education.

    Science.gov (United States)

    Poon, Charles; Stevens, Shawn M; Golub, Justin S; Pensak, Myles L; Samy, Ravi N

    2017-03-01

    Use of videos as educational tools is not a novel concept; however, there is a paucity of high-quality video resources available to otolaryngology trainees. We hypothesized that residents would deem surgical-videos using a multimedia-style format more valuable as preparatory tools. Aims of this study: 1) develop portfolio of otology/neurotology videos overviewing key steps, anatomy, and pearls by a senior surgeon; 2) have residents rate the effectiveness of the videos as a preoperative tool. Prospective study. A video-library of procedures at (https://www.youtube.com/user/cisurgeon) was formatted via time-stamping to coincide expert level narration with closed captioning, critical procedural steps, relevant instrumentation, radiographic pictures, orientation cues, and anatomical highlights. Otolaryngology trainees of postgraduate years 2 through 5 (n = 13) watched a minimum of three videos and completed an assessment addressing: current resource identification/usefulness comparison, self-efficacy, impact on preparation time, and prioritization of resources. The videos rated as highly useful compared with current resources (p = 0.002) and capable of promoting self-efficacy. Residents reported moderate-high prioritization of our multi-media formatted resource (scores >6) among their current preoperative regimen. The varied videos were rated highly in terms of usefulness, promoting self-efficacy and as a high-priority for a resident's surgical preparation. Multimedia-formatted training videos should be further explored for this generation of electronic-learners. Future studies with a larger cohort, objective approaches, and multidisciplinary involvement are needed to determine the full impact of this education medium on surgical-training.

  13. [Gingival recessions and periodontal plastic surgery

    NARCIS (Netherlands)

    Quincey, G. de; Padmos, J.A.; Renkema, A.M.

    2015-01-01

    Periodontal plastic surgery is defined as the set of surgical procedures that are performed to prevent or correct developmental disorders and anatomical, traumatic and pathological abnormalities of the gingiva, alveolar mucosa, and alveolar bone. Root coverage procedures fall under this term and hav

  14. [Gingival recessions and periodontal plastic surgery].

    Science.gov (United States)

    de Quincey, G de; Padmos, J A D; Renkema, A M

    2015-11-01

    Periodontal plastic surgery is defined as the set of surgical procedures that are performed to prevent or correct developmental disorders and anatomical, traumatic and pathological abnormalities of the gingiva, alveolar mucosa, and alveolar bone. Root coverage procedures fall under this term and have been applied for more than fifty years with varying degrees of success. There are several indications for the treatment of gingival recessions. When the treatment of choice - a conservative approach - offers no solace (any more), gingival recessions can be treated by applying periodontal plastic surgery. The goal of this surgery is complete recovery of the anatomical structures in the area of the recession. To this end several surgical techniques have been developed during the last decades. The choice of a particular technique depends on various factors, such as the number of defects, their size and the amount of keratinized gingiva around the defect.

  15. American Society of Ophthalmic Plastic and Reconstructive Surgery

    Science.gov (United States)

    ... of clinical practice in the fields of aesthetic, plastic and reconstructive surgery specializing in the face, orbits, eyelids, and lacrimal ... of clinical practice in the fields of aesthetic, plastic and reconstructive surgery specializing in the face, orbits, eyelids, and lacrimal ...

  16. American Academy of Facial Plastic and Reconstructive Surgery

    Science.gov (United States)

    ... Buyers Guide Links Become a Member About Our Academy The American Academy of Facial Plastic and Reconstructive Surgery is the ... Board of Facial Plastic and Reconstructive Surgery. The Academy About the Academy The AAFPRS Mission History Meet ...

  17. Telemedicine and Plastic Surgery: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Denis Souto Valente

    2015-01-01

    Full Text Available Background. Telemedicine can be defined as the use of electronic media for transmission of information and medical data from one site to another. The objective of this study is to demonstrate an experience of telemedicine in plastic surgery. Methods. 32 plastic surgeons received a link with password for real-time streaming of a surgery. At the end of the procedure, the surgeons attending the procedure by the Internet answered five questions. The results were analyzed with descriptive statistics. Results. 27 plastic surgeons attended the online procedure in real-time. 96.3% considered the access to the website as good or excellent and 3.7% considered it bad. 14.8% reported that the transmission was bad and 85.2% considered the quality of transmission as good or excellent. 96.3% classified the live broadcasting as a good or excellent learning experience and 3.7% considered it a bad experience. 92.6% reported feeling able to perform this surgery after watching the demo and 7.4% did not feel able. 100% of participants said they would like to participate in other surgical demonstrations over the Internet. Conclusion. We conclude that the use of telemedicine can provide more access to education and medical research, for plastic surgeons looking for medical education from distant regions.

  18. Public Perceptions of Plastic Surgery Practice in Brazil.

    Science.gov (United States)

    Denadai, Rafael; Araujo, Karin Milleni; Samartine, Hugo; Denadai, Rodrigo; Raposo-Amaral, Cassio Eduardo

    2016-12-01

    The perception of medical specialists by the public has a significant effect on health-care decisions, research funding allocation, and implantation of educational measures. The purpose of this survey was to assess the public's perception of the field of plastic surgery practice. General public members (n = 1290) completed a survey where they matched nine specialties with 28 plastic surgery-related scenarios. Response patterns were distributed as "plastic surgeon alone," "plastic surgeon combined with other specialists," or "no plastic surgeon." Sociodemographic data and previous plastic surgery contact were also collected. "Plastic surgeon alone" was identified as an expert by more than 70 % of respondents in four (40 %) aesthetic-related scenarios and in one (5.5 %) general/reconstructive-related scenario. "Plastic surgeon alone" was significantly (all p plastic surgeons in facial fracture surgery, facial paralysis management, chest wall surgery, hand surgery-related scenarios, and tumor surgery-related scenarios. Age, health-care professional, education level, and prior plastic surgery contact were significant (all p plastic surgeon" as a response pattern, according to bivariate analysis and multiple linear regression analysis. The public has a poor understanding of the broad field of plastic surgery practice. Therefore, improved public education about the scope of plastic surgery is needed.

  19. [Informed consent in aesthetic plastic surgery].

    Science.gov (United States)

    Fenger, H

    2006-02-01

    The informed consent plays a very decisive part in aesthetic plastic surgery. As there is often no medical indication in plastic surgery, the patient has to be informed about all the facts of an operation, especially about the possible risks. The legal requests for therapeutic and economic clarification gain in importance. The jurisdiction in Germany demands a merciless clarification for the patient. The patient needs to be clarified about all facts early enough so that he has a sufficient amount of time to weigh-up the pros und cons of the operation and if necessary to take advice from someone else. The sufficient documentation is very important at the sight of the extensive burden of proof at the expense of the physician.

  20. Teaching plastic surgery from different perspectives.

    Science.gov (United States)

    Cable, Christian; Chong, Tae; Pratt, Daniel D

    2012-06-01

    Just as everyone has a different learning style, teachers too approach the task from different perspectives. There are five basic teaching perspectives or styles: transmission, apprenticeship, developmental, nurturing, and social justice. The acronym BIAS is useful to describe the beliefs, intentions, assessments, and strategies associated with each perspective. The authors present a hypothetical 1-week rotation in plastic and reconstructive surgery in which a student encounters instructors who embody the five basic teaching perspectives. By presenting these perspectives, the authors introduce valuable teaching techniques that can benefit all those charged with the education of learners along the spectrum from premedical to continuing education venues. Educational objectives include the following: (1) explain and illustrate different approaches to effective teaching in plastic surgery; (2) introduce readers to the Teaching Perspectives Inventory as a means of determining their primary teaching style; and (3) argue for a "plurality of the good" in teaching.

  1. Evidence-Based Education in Plastic Surgery.

    Science.gov (United States)

    Johnson, Shepard P; Chung, Kevin C; Waljee, Jennifer F

    2015-08-01

    Educational reforms in resident training have historically been driven by reports from medical societies and organizations. Although educational initiatives are well intended, they are rarely supported by robust evidence. The Accreditation Council for Graduate Medical Education recently introduced competency-based training, a form of outcomes-based education that has been used successfully in nonmedical professional vocations. This initiative has promise to advance the quality of resident education, but questions remain regarding implementation within plastic surgery. In particular, how will competency-based training impact patient outcomes, and will the methodologies used to assess competencies (i.e., milestones) be accurate and validated by literature? This report investigates resident educational reform and the need for more evidence-based educational initiatives in plastic surgery training.

  2. Plastic Surgery Response in Natural Disasters.

    Science.gov (United States)

    Chung, Susan; Zimmerman, Amanda; Gaviria, Andres; Dayicioglu, Deniz

    2015-06-01

    Disasters cause untold damage and are often unpredictable; however, with proper preparation, these events can be better managed. The initial response has the greatest impact on the overall success of the relief effort. A well-trained multidisciplinary network of providers is necessary to ensure coordinated care for the victims of these mass casualty disasters. As members of this network of providers, plastic surgeons have the ability to efficiently address injuries sustained in mass casualty disasters and are a valuable member of the relief effort. The skill set of plastic surgeons includes techniques that can address injuries sustained in large-scale emergencies, such as the management of soft-tissue injury, tissue viability, facial fractures, and extremity salvage. An approach to disaster relief, the types of disasters encountered, the management of injuries related to mass casualty disasters, the role of plastic surgeons in the relief effort, and resource management are discussed. In order to improve preparedness in future mass casualty disasters, plastic surgeons should receive training during residency regarding the utilization of plastic surgery knowledge in the disaster setting.

  3. Psychiatric issues in cosmetic plastic surgery.

    Science.gov (United States)

    Ericksen, William Leif; Billick, Stephen Bates

    2012-09-01

    The objective of cosmetic surgery is increased patient self-esteem and confidence. Most patients undergoing a procedure report these results post-operatively. The success of any procedure is measured in patient satisfaction. In order to optimize patient satisfaction, literature suggests careful pre-operative patient preparation including a discussion of the risks, benefits, limitations and expected results for each procedure undertaken. As a general rule, the patients that are motivated to surgery by a desire to align their outward appearance to their body-image tend to be the most satisfied. There are some psychiatric conditions that can prevent a patient from being satisfied without regard aesthetic success. The most common examples are minimal defect/Body Dysmorphic Disorder, the patient in crisis, the multiple revision patient, and loss of identity. This paper will familiarize the audience with these conditions, symptoms and related illnesses. Case examples are described and then explored in terms of the conditions presented. A discussion of the patient's motivation for surgery, goals pertaining to specific attributes, as well as an evaluation of the patient's understanding of the risks, benefits, and limitations of the procedure can help the physician determine if a patient is capable of being satisfied with a cosmetic plastic surgery procedure. Plastic surgeons can screen patients suffering from these conditions relatively easily, as psychiatry is an integral part of medical school education. If a psychiatric referral is required, then the psychiatrist needs to be aware of the nuances of each of these conditions.

  4. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents.

    Science.gov (United States)

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M; Lee, Walter T

    2013-10-29

    Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership 'Basic Training' is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this 'Basic Training'. Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (pvirtue-based approach is valued by residents as a part of leadership training during residency.

  5. Predictors of Readmission after Inpatient Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Umang Jain

    2014-03-01

    Full Text Available Background Understanding risk factors that increase readmission rates may help enhance patient education and set system-wide expectations. We aimed to provide benchmark data on causes and predictors of readmission following inpatient plastic surgery. Methods The 2011 National Surgical Quality Improvement Program dataset was reviewed for patients with both "Plastics" as their recorded surgical specialty and inpatient status. Readmission was tracked through the "Unplanned Readmission" variable. Patient characteristics and outcomes were compared using chi-squared analysis and Student's t-tests for categorical and continuous variables, respectively. Multivariate regression analysis was used for identifying predictors of readmission. Results A total of 3,671 inpatient plastic surgery patients were included. The unplanned readmission rate was 7.11%. Multivariate regression analysis revealed a history of chronic obstructive pulmonary disease (COPD (odds ratio [OR], 2.01; confidence interval [CI], 1.12-3.60; P=0.020, previous percutaneous coronary intervention (PCI (OR, 2.69; CI, 1.21-5.97; P=0.015, hypertension requiring medication (OR, 1.65; CI, 1.22-2.24; P<0.001, bleeding disorders (OR, 1.70; CI, 1.01-2.87; P=0.046, American Society of Anesthesiologists (ASA class 3 or 4 (OR, 1.57; CI, 1.15-2.15; P=0.004, and obesity (body mass index ≥30 (OR, 1.43; CI, 1.09-1.88, P=0.011 to be significant predictors of readmission. Conclusions Inpatient plastic surgery has an associated 7.11% unplanned readmission rate. History of COPD, previous PCI, hypertension, ASA class 3 or 4, bleeding disorders, and obesity all proved to be significant risk factors for readmission. These findings will help to benchmark inpatient readmission rates and manage patient and hospital system expectations.

  6. Evaluating the referral preferences and consultation requests of primary care physicians with otolaryngology - head and neck surgery.

    Science.gov (United States)

    Scott, John R; Wong, Eric; Sowerby, Leigh J

    2015-12-29

    No literature exists which examines referral preferences to, or the consultation process with, Otolaryngology. In a recent Canadian Medical Association nation-wide survey of General Practitioners and Family Physicians, Otolaryngology was listed as the second-most problematic specialty for referrals. The purpose of this study was to learn about and improve upon the referral process between primary care physicians (PCPs) and Otolaryngology at an academic centre in Southwestern Ontario. PCPs who actively refer patients to Otolaryngology within the catchment area of Western University were asked to complete a short paper-based questionnaire. Data was analyzed using descriptive statistics. A total of 50 PCPs were surveyed. Subspecialty influenced 90.0% of the referrals made. Specialist wait times altered 58.0% of referrals. All PCPs preferred to communicate via fax. Half of those surveyed wanted clinical notes from every encounter. Seventy-four percent of respondents wanted inappropriate referrals forwarded to the proper specialist automatically. Twenty-two percent of those surveyed were satisfied with current wait times. A central referral system was favored by 74% of PCPs. Improvements could help streamline the referral and consultation practices with Otolaryngology in Southwestern Ontario. A central referral system and reduction in the frequency of consultative reports can be considered.

  7. Botulinum toxin in ophthalmic plastic surgery

    Directory of Open Access Journals (Sweden)

    Naik Milind

    2005-01-01

    Full Text Available Botulinum toxin chemodenervation has evolved greatly over the past 30 years since its introduction in the 1970s for the management of strabismus. Among ophthalmic plastic surgeons, botulinum toxins are often used as the first line treatment for facial dystonias. These toxins are also efficacious for the temporary management of various other conditions including keratopathies (through so called chemo-tarsorraphy, upper eyelid retraction, orbicularis overaction-induced lower eyelid entropion, gustatory epiphora, Frey′s syndrome, and dynamic facial rhytids such as lateral canthal wrinkles (crow′s feet, glabellar creases and horizontal forehead lines. This article describes the pharmacology, reconstitution techniques and common current applications of botulinum toxins in ophthalmic plastic surgery.

  8. Borderline personality disorder and aesthetic plastic surgery.

    Science.gov (United States)

    Morioka, Daichi; Ohkubo, Fumio

    2014-12-01

    Borderline personality disorder (BPD) is a common axis II disorder associated with a high risk of impulsivity and self-injury. Several authors have suggested that individuals with BPD are poor candidates for plastic surgery. Recent changes in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for BPD may be confusing to surgeons. This article reviews the literature on BPD and discusses how important it is to recognize this condition and how difficult it is to treat patients, highlighting features and signs of this condition in plastic surgery settings. Illustrative case examples from our experience are also described. Our careful search of the literature revealed that individuals with BPD may seek treatment from plastic surgeons in two different patterns: as treatment for self-injury or as insatiable requests for aesthetic procedures. Individuals with BPD tend to request corrections of multiple body parts to avoid abandonment by the surgeon or due to their impulsivity, but such preoccupation with appearance is less profound and shifts from one body part to another over time. While flexible and individualized psychological approaches are required to minimize the patient's impulsivity and abandonment fears, surgeons should be inflexible to any unrealistic requests. It is best to avoid surgery on patients with BPD. Surgeons should be aware of the nuances of this condition so as not to miss the proper timing for a psychiatric referral. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  9. A preoperative checklist in esthetic plastic surgery

    OpenAIRE

    Anger,Jaime; Letizio,Nelson; Orel,Maurício; Souza Junior,José Leão de; Santos,Márcio Martines dos

    2011-01-01

    The authors present a checklist to be used at the last stage of a preoperative visit for esthetic plastic surgery composed of 29 yes/no questions, four blank spaces for entering data, and one question for ranking the level of risk of deep vein thrombosis. The criteria are divided into three tables relating to three areas: anesthesia, psychological aspects, and clinical risk factors. The answers are framed in four colors that identify the level of risk and suggest the degree of attention warra...

  10. Laser surgery in otolaryngology: interaction of CO2 laser and soft tissue.

    Science.gov (United States)

    Mihashi, S; Jako, G J; Incze, J; Strong, M S; Vaughan, C W

    1976-01-30

    The sequence of histological change induced by CO2 laser irradiation was discussed in terms of two factors: the physiomechanical factor and the physiochemical factor. At sufficiently high heat energy levels, the immediate findings are characterized by crater formation resulting from rapid vaporization of the water and ejection of the solid component. In the immediate vicinity of the crater edge, the maximum tissue temperature rise is 65 degrees C above the 32 degrees C ambient tissue temperature and it decreases to the primary tissue temperature within a distance of 2 mm. The healing process of CO2 laser induced lesions proceeds with minimal delay. The lymphatic and vascular channels are occluded in the marginal area of coagulation resulting in a marked hemostatic effect. This sealing effect increases the margin of safety in preventing possible dissemination of tumor cells. By selecting the appropriate power, time, and focus cone angle, precise destruction of preselected areas of tissue can be achieved with an extraordinary hemostatic effect without damaging the underlying tissue. These advantages are especially helpful in function-preserving surgery.

  11. Challenges of randomized controlled trial design in plastic surgery.

    Science.gov (United States)

    Hassanein, Aladdin H; Herrera, Fernando A; Hassanein, Omar

    2011-01-01

    Randomized controlled trials are the gold standard of evidence-based medicine. In the field of plastic surgery, designing these studies is much more challenging than in pharmaceutical medicine. Randomized trials in plastic surgery encompass several road blocks including problems shared with other surgical trials: equipoise, high cost, placebo issues and learning curves following the establishment of a novel approach. In addition, plastic surgery has more subjective outcomes, thus making study design even more difficult in assessing the end result.

  12. [Lactation after breast plastic surgery: literature review].

    Science.gov (United States)

    Bouhassira, J; Haddad, K; Burin des Roziers, B; Achouche, J; Cartier, S

    2015-02-01

    The occurrence of lactation is a rare complication of breast plastic surgery. During the course of his practice, the plastic surgeon will probably encounter this complication. The goal of this article is to carry out a literature review of all published galactorrhea and/or galactocele cases following a breast-reduction or a breast-augmentation, representing a total of 34 cases reported in 21 articles. The physiopathology of this complication is linked to an inappropriate secretion of prolactin in a surgical context. The factors favoring this complication would be the number of pregnancies, a history of recent and extensive nursing, and the intake of certain medicines such as an oestro-progestative pill. The main symptom of this complication is the occurrence of a uni- or bilateral galactorrhea, on average 12.6 days after the surgery. The main differential diagnosis is a postoperative infection. The explorations presented a hyperprolactinemia in 69% of cases. No biological inflammatory syndrome was reported. A fluid collection evoking a galactocele was visible on the ultrasound in 65% of cases. One case of prolactin-secreting pituitary adenoma was reported. Depending on the case, the treatment varied from a simple surveillance to the association of a dopamine agonist, an antibiotic therapy, and a surgical revision. A diagnostic and therapeutic management strategy is proposed.

  13. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    Directory of Open Access Journals (Sweden)

    Kristine Schulz

    2013-10-01

    Full Text Available Introduction: Surgical Training and Education in Promoting Professionalism (STEPP was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii to assess the value of virtue education on residents. Methods: As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results: Virtues are shared between otolaryngology residents (n=9 and military personnel (n=2,433 as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS residents. There was a significant improvement (p<0.001 in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions: A virtue-based approach is valued by residents as a part of leadership training during residency.

  14. Surgical Training and Education in Promoting Professionalism: a comparative assessment of virtue-based leadership development in otolaryngology-head and neck surgery residents

    Science.gov (United States)

    Schulz, Kristine; Puscas, Liana; Tucci, Debara; Woodard, Charles; Witsell, David; Esclamado, Ramon M.; Lee, Walter T.

    2013-01-01

    Introduction Surgical Training and Education in Promoting Professionalism (STEPP) was developed in 2011 to train tomorrow's leaders during residency. It is based on virtue ethics and takes an approach similar to West Point military academy. The purpose of this research was: (i) to compare the virtue profiles of our residents with that of the military cohort using a standardized virtue assessment tool; and (ii) to assess the value of virtue education on residents. Methods As part of STEPP, otolaryngology residents participated in a virtue-based validated assessment tool called Virtue in Action (VIA) Inventory. This was completed at the initiation of STEPP in July 2011 as well as 1 year later in June 2012. Comparison of the VIA to a military cohort was performed. Leadership ‘Basic Training’ is a series of forums focused on virtues of initiative, integrity, responsibility, self-discipline, and accountability. A pre- and post-test was administered assessing resident perceptions of the value of this ‘Basic Training’. Results Virtues are shared between otolaryngology residents (n=9) and military personnel (n=2,433) as there were no significant differences in strength scores between two military comparison groups and otolaryngology-head and neck surgery (OHNS) residents. There was a significant improvement (p<0.001) in the understanding of components of the leadership vision and a significant improvement in the understanding of key leadership concepts based on ‘Basic Training’. All residents responded in the post-test that the STEPP program was valuable, up from 56%. Conclusions A virtue-based approach is valued by residents as a part of leadership training during residency. PMID:24172053

  15. Profiling the Association of Academic Chairmen of Plastic Surgery.

    Science.gov (United States)

    Zetrenne, Eleonore; Wirth, Garrett A; Kosins, Aaron M; Evans, Gregory R D; Wells, James H

    2008-05-01

    The purpose of this study was to identify the common characteristics that may determine potential academicians and chairpersons in academic plastic surgery. The study examined the motivations behind the pursuit of an academic plastic surgery career and the forces that shape this path. A 20-question survey was mailed to all members of the Association of Academic Chairmen of Plastic Surgery. This organization was targeted because the members are a group of successful academic plastic surgeons who can be profiled to evaluate the personal and professional characteristics that contribute to accomplishment. A total of 144 of 264 surveys were returned over the allotted 6-week period, for a response rate of 55 percent. The three most important motivating factors in pursuing academic plastic surgery were teaching opportunities (82 percent), influence of mentors (70 percent), and scope of clinical cases (65 percent). Eighty-two percent of respondents reported that their mentor (as a role model) had the most marked effect on their career. Despite the use of an open-ended question, most reported that "persistence and determination" and "passion for the vocation" were the most important characteristics for success in academic plastic surgery. Perseverance and passion for plastic surgery are essential for professional advancement. These qualities are manifested early in the academic and clinical accomplishments of plastic surgery residents. The data indicate that mentors/role models have the most marked effect on a trainee's decision to pursue a career in academic plastic surgery. To interest talented plastic surgery residents in academic plastic surgery, role models must inspire them and provide mentorship.

  16. Applying the concepts of innovation strategies to plastic surgery.

    Science.gov (United States)

    Wang, Yirong; Kotsis, Sandra V; Chung, Kevin C

    2013-08-01

    Plastic surgery has a well-known history of innovative procedures and products. However, with the rise in competition, such as aesthetic procedures being performed by other medical specialties, there is a need for continued innovation in plastic surgery to create novel treatments to advance this specialty. Although many articles introduce innovative technologies and procedures, there is a paucity of publications to highlight the application of principles of innovation in plastic surgery. The authors review the literature regarding business strategies for innovation. The authors evaluate concepts of innovation, process of innovation (i.e., idea generation, idea evaluation, idea conversion, idea diffusion, and adoption), ethical issues, and application to plastic surgery. Adopting a business model of innovation is helpful for promoting a new paradigm of progress to propel plastic surgery to new avenues of creativity.

  17. Otolaryngology workforce analysis.

    Science.gov (United States)

    Hughes, Charles Anthony; McMenamin, Patrick; Mehta, Vikas; Pillsbury, Harold; Kennedy, David

    2016-12-01

    The number of trained otolaryngologists available is insufficient to supply current and projected US health care needs. The goal of this study was to assess available databases and present accurate data on the current otolaryngology workforce, examine methods for prediction of future health care needs, and explore potential issues with forecasting methods and policy implementation based on these predictions. Retrospective analysis of research databases, public use files, and claims data. The total number of otolaryngologists and current practices in the United States was tabulated using the databases of the American Academy of Otolaryngology-Head and Neck Surgery, American Medical Association, American Board of Otolaryngology, American College of Surgeons, Association of American Medical Colleges, National Center for Health Statistics, and Department of Health and Human Services. Otolaryngologists were identified as surgeons and classified into surgical groups using a combination of AMA primary and secondary self-reported specialties and American Board of Medical Specialties certifications. Data gathered were cross-referenced to rule out duplications to assess total practicing otolaryngologists. Data analyzed included type of practice: 1) academic versus private and 2) general versus specialty; and demographics: 1) urban versus rural, 2) patient age, 3) reason for visit (referral, new, established, surgical follow-up), 4) reason for visit (diagnosis), and 5) payer type. Analysis from the above resources estimates the total number of otolaryngologists practicing in the United States in 2011 to be 12,609, with approximately 10,522 fully trained practicing physicians (9,232-10,654) and 2,087 in training (1,318 residents and 769 fellows/others). Based on 2011 data, workforce projections would place the fully trained and practicing otolaryngology workforce at 11,088 in 2015 and 12,084 in 2025 unless changes in training occur. The AAO-HNS Physicians Resource Committee

  18. Reconstructive pelvic surgery and plastic surgery: safety and efficacy of combined surgery.

    Science.gov (United States)

    Craig, Jocelyn B; Noblett, Karen L; Conner, Caroline A; Budd, Michael; Lane, Felicia L

    2008-12-01

    The purpose of this study was to address the safety of combining aesthetic and pelvic floor reconstructive procedures. Fifty-four subjects were included in a case-control study; 18 patients undergoing combined pelvic and plastic reconstructive surgery, age and procedure matched to 18 pelvic surgery and 18 plastic surgery only controls. Chi-square, t test, and Kruskal-Wallis analysis were used to compare the estimated blood loss (EBL), body mass index (BMI), hospital days, operative times, and complications between the groups. No differences were seen with regards to age, BMI, or EBL. There was, however, a significant increase in minor complications and hospital stay after combined procedures relative to the pelvic surgery control group but not the aesthetic control group. Operative times were only greater during combined procedures relative to isolated pelvic floor procedures. Combining pelvic and aesthetic procedures may increase complications, operative times, and length of hospital stay when compared to pelvic reconstructive surgery alone.

  19. Simulation Activity in Otolaryngology Residencies.

    Science.gov (United States)

    Deutsch, Ellen S; Wiet, Gregory J; Seidman, Michael; Hussey, Heather M; Malekzadeh, Sonya; Fried, Marvin P

    2015-08-01

    Simulation has become a valuable tool in medical education, and several specialties accept or require simulation as a resource for resident training or assessment as well as for board certification or maintenance of certification. This study investigates current simulation resources and activities in US otolaryngology residency programs and examines interest in advancing simulation training and assessment within the specialty. Web-based survey. US otolaryngology residency training programs. An electronic web-based survey was disseminated to all US otolaryngology program directors to determine their respective institutional and departmental simulation resources, existing simulation activities, and interest in further simulation initiatives. Descriptive results are reported. Responses were received from 43 of 104 (43%) residency programs. Simulation capabilities and resources are available in most respondents' institutions (78.6% report onsite resources; 73.8% report availability of models, manikins, and devices). Most respondents (61%) report limited simulation activity within otolaryngology. Areas of simulation are broad, addressing technical and nontechnical skills related to clinical training (94%). Simulation is infrequently used for research, credentialing, or systems improvement. The majority of respondents (83.8%) expressed interest in participating in multicenter trials of simulation initiatives. Most respondents from otolaryngology residency programs have incorporated some simulation into their curriculum. Interest among program directors to participate in future multicenter trials appears high. Future research efforts in this area should aim to determine optimal simulators and simulation activities for training and assessment as well as how to best incorporate simulation into otolaryngology residency training programs. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  20. [What do general, abdominal and vascular surgeons need to know on plastic surgery - aspects of plastic surgery in the field of general, abdominal and vascular surgery].

    Science.gov (United States)

    Damert, H G; Altmann, S; Stübs, P; Infanger, M; Meyer, F

    2015-02-01

    There is overlap between general, abdominal and vascular surgery on one hand and plastic surgery on the other hand, e.g., in hernia surgery, in particular, recurrent hernia, reconstruction of the abdominal wall or defect closure after abdominal or vascular surgery. Bariatric operations involve both special fields too. Plastic surgeons sometimes use skin and muscle compartments of the abdominal wall for reconstruction at other regions of the body. This article aims to i) give an overview about functional, anatomic and clinical aspects as well as the potential of surgical interventions in plastic surgery. General/abdominal/vascular surgeons can benefit from this in their surgical planning and competent execution of their own surgical interventions with limited morbidity/lethality and an optimal, in particular, functional as well as aesthetic outcome, ii) support the interdisciplinary work of general/abdominal/vascular and plastic surgery, and iii) provide a better understanding of plastic surgery and its profile of surgical interventions and options.

  1. Laser therapy in plastic surgery: decolorization in port wine stains

    Science.gov (United States)

    Peszynski-Drews, Cezary; Wolf, Leszek

    1996-03-01

    For the first time laserotherapy is described as a method of port wine stain decolorization in plastic surgery. The authors present their 20-year experience in the treatment of port wine stains with the argon laser and dye laser.

  2. Plastic surgery in Nigeria-Scope and challenges

    Directory of Open Access Journals (Sweden)

    TOG Chukwuanukwu

    2011-01-01

    Full Text Available Background Plastic surgery as a major subspecialty of surgery has existed in Nigeria for several decades but the populace including medical practitioners are yet to fully appreciate its scope. This leads to very late presentation/referral of cases and management of cases that should have been referred by less qualified practitioners with attendant poor outcomes and complications. Most people still regard plastic surgery as being synonymous with cosmetic/aesthetic surgery but the scope goes far beyond this entity. It is therefore important that the public including medical practitioners who are the main sources of referral to the subspecialty are aware of the range of cases handled by plastic surgery units. The plastic surgeon in Nigeria is also faced with a lot of challenges ranging from the arduous task of one having to manage very many different and complicated cases to being very poorly equipped and appreciated. Objectives To educate the populace especially the medical practitioners on the scope of plastic surgery and the extent of development of the subspecialty in Nigeria and solicit for colleague′s cooperation in order to move plastic surgery forward. To also highlight the difficulties faced by the plastic surgeon in Nigeria and seeking help from appropriate quarters which will help to reduce unnecessary referrals abroad while improving the services rendered to patients locally. Conclusion Plastic surgery in Nigeria has developed significantly both in scope and manpower but it is still faced with a lot of challenges. Knowledge of its scope will help to reduce unnecessary referrals abroad while improving services/skill here in Nigeria.

  3. [Science and research in academic plastic surgery in Germany].

    Science.gov (United States)

    Giunta, R E; Machens, H-G

    2009-12-01

    Plastic surgery has passed through a very positive evolution in the last decades on the solid fundament of constantly developing academic plastic surgery. Aim of this paper is an objective evaluation of the current status of academic plastic surgery regarding research topics, currently available ressources and scientific outcome based on a questionnaire. The return rate of the questionnaire in academic departments was 92%. Main topics in research besides wound healing were topics from regenerative medicine such as tissue engineering, biomaterials, genetherapy and angiogenesis with the main focus on skin and fat tissues. In the past five years a total of 25 million Euros of third party research grants were raised. Research relied mainly on interdisciplinary research facilities. Regarding the scientific outcome more than 200 scientific papers were published in basic science research journals having an impactfactor higher than two. These results clearly demonstrate that plastic surgery is scientifically highly productive in academic surroundings where independent departments are established. Considering that independent units of plastic surgery exist in a relatively small number of all 36 university hospitals in germany, it has to be claimed for further independent departments so to provide adequate research facilities for further evolution of academic plastic surgery.

  4. Citation Rate Predictors in the Plastic Surgery Literature.

    Science.gov (United States)

    Lopez, Joseph; Calotta, Nicholas; Doshi, Ankur; Soni, Ashwin; Milton, Jacqueline; May, James W; Tufaro, Anthony P

    The purpose of this study is to determine and characterize the scientific and nonscientific factors that influence the rate of article citation in the field of plastic surgery. Cross-sectional study. We reviewed all entries in Annals of Plastic Surgery and Journal of Plastic, Reconstructive, and Aesthetic Surgery from January 1, 2007 to December 31, 2007; and Plastic and Reconstructive Surgery from January 1, 2007 to December 31, 2008. All scientific articles were analyzed and several article characteristics were extracted. The number of citations at 5 years was collected as the outcome variable. A multivariable analysis was performed to determine which variables were associated with higher citations rates. A total of 2456 articles were identified of which only 908 fulfilled the inclusion criteria. Most studies were publications in the fields of reconstructive (26.3%) or pediatric/craniofacial (17.6%) surgery. The median number of citations 5 years from publication was 8. In the multivariable analysis, factors associated with higher citations rates were subspecialty field (p = 0.0003), disclosed conflict of interest (p = 0.04), number of authors (p = 0.04), and journal (p = 0.02). We have found that higher level of evidence (or other study methodology factors) is not associated with higher citation rates. Instead, conflict of interest, subspecialty topic, journal, and number of authors are strong predictors of high citation rates in plastic surgery. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  5. Promise and Limitations of Big Data Research in Plastic Surgery.

    Science.gov (United States)

    Zhu, Victor Zhang; Tuggle, Charles Thompson; Au, Alexander Francis

    2016-04-01

    The use of "Big Data" in plastic surgery outcomes research has increased dramatically in the last 5 years. This article addresses some of the benefits and limitations of such research. This is a narrative review of large database studies in plastic surgery. There are several benefits to database research as compared with traditional forms of research, such as randomized controlled studies and cohort studies. These include the ease in patient recruitment, reduction in selection bias, and increased generalizability. As such, the types of outcomes research that are particularly suited for database studies include determination of geographic variations in practice, volume outcome analysis, evaluation of how sociodemographic factors affect access to health care, and trend analyses over time. The limitations of database research include data which are limited only to what was captured in the database, high power which can cause clinically insignificant differences to achieve statistical significance, and fishing which can lead to increased type I errors. The National Surgical Quality Improvement Project is an important general surgery database that may be useful for plastic surgeons because it is validated and has a large number of patients after over a decade of collecting data. The Tracking Operations and Outcomes for Plastic Surgeons Program is a newer database specific to plastic surgery. Databases are a powerful tool for plastic surgery outcomes research. It is critically important to understand their benefits and limitations when designing research projects or interpreting studies whose data have been drawn from them. For plastic surgeons, National Surgical Quality Improvement Project has a greater number of publications, but Tracking Operations and Outcomes for Plastic Surgeons Program is the most applicable database for plastic surgery research.

  6. Cosmetic surgery in times of recession: macroeconomics for plastic surgeons.

    Science.gov (United States)

    Krieger, Lloyd M

    2002-10-01

    Periods of economic downturn place special demands on the plastic surgeon whose practice involves a large amount of cosmetic surgery. When determining strategy during difficult economic times, it is useful to understand the macroeconomic background of these downturns and to draw lessons from businesses in other service industries. Business cycles and monetary policy determine the overall environment in which plastic surgery is practiced. Plastic surgeons can take both defensive and proactive steps to maintain their profits during recessions and to prepare for the inevitable upturn. Care should also be taken when selecting pricing strategy during economic slowdowns.

  7. Applying to plastic surgery residency: factors associated with medical student career choice.

    Science.gov (United States)

    Greene, Arin K; May, James W

    2008-03-01

    Applications to plastic surgery residency increased 34 percent from 2002 to 2005, despite decreasing applications to other surgical subspecialties. During this period, medical education, reimbursement, work hours, and media coverage have changed. To determine factors responsible for rising applications to plastic surgery residencies, medical student applicants to plastic surgery residencies for 2005 were surveyed. Applicants recorded exposure to plastic surgery during medical school and graded the influence of personality, lifestyle, income potential, and media coverage on their decision to choose plastic surgery training. To further study the effects of plastic surgery exposure on career choice, the percentage of graduating students applying to plastic surgery residency was compared between medical schools with and without plastic surgery training programs. Medical schools that provided greater exposure to plastic surgery and schools with plastic surgery training programs had a higher percentage of graduates applying to plastic surgery residency (p personality of plastic surgeons as a significant factor in their career choice. Lifestyle and income potential were moderately important, whereas media coverage minimally affected career decision. Applicants typically decided on a plastic surgical career during the third year of medical school. Medical student exposure to plastic surgery is the most influential factor in a student's decision to pursue a career in plastic surgery. To continue the increasing applicant trend toward plastic surgery, plastic surgeon engagement of medical students should be emphasized, ideally before the third year of medical school.

  8. Patient preferences in print advertisement marketing for plastic surgery.

    Science.gov (United States)

    Sanan, Akshay; Quinn, Candace; Spiegel, Jeffrey H

    2013-05-01

    Plastic surgeons are competing for their share of a growing but still limited market, thus making advertising an important component in a successful plastic surgery practice. The authors evaluate the variables, characteristics, and presentation features that make print advertisements most effectively pique the interest of individuals selecting a plastic surgeon. An online survey was administered to 404 individuals with active interest in plastic surgery from 10 major metropolitan areas. Participants were presented with 5 different advertisements from plastic surgeons throughout the country and were asked a series of both closed- and open-ended questions to assess verity, quality, and marketability of each advertisement. Reponses to open-ended questions were analyzed using the Wordle program (www.wordle.net). The most frequent themes identified for all 5 ads were "Being beautiful is possible" (41%), "I could be beautiful" (24%), "Some people need surgery to be beautiful" (16%), and "Being beautiful is important" (14%). Advertisement 1-featuring 3 women and no pre- or posttreatment photography, no physician photography, and a listing of the 3 physicians' credentials but not a list of the services provided-received the highest overall preference rating. Factors including emotions felt while reading, unique qualities of the advertisement, list of procedures performed, use of models versus actual patients, and pictures of the plastic surgeons were found to contribute to the respondents' overall perception of advertisements used to market a plastic surgery practice.

  9. Impact factors and publication times for plastic surgery journals.

    Science.gov (United States)

    Labanaris, Apostolos P; Vassiliadu, Agapi P; Polykandriotis, Elias; Tjiawi, Jimmy; Arkudas, Andreas; Horch, Raymund E

    2007-12-01

    The purposes of the authors' analysis were to assess the values that plastic surgical journals demonstrate in terms of the standardized measures created by the Institute for Scientific Information's Journal Citation Report, and to assess the relationship between these values and the turnaround time of these journals. The overall indexes of surgical journals were compared with those of journals in other fields of medicine using the following parameters: highest impact factor, average impact factor, cited half-life, immediacy index, and number of journals. Similarly, plastic surgery journals were compared with the highest ranking journals from various fields of surgery. In addition, an evaluation of all original articles published in 2005, assessing the time intervals from submission to publication, submission to acceptance, and acceptance to publication, was conducted for all plastic surgical journals and the highest ranking journals from various surgical fields listed in the Journal Citation Report. Plastic surgical journals demonstrated low overall index values and a greater elongation of their turnaround time in comparison to journals in other fields of surgery and medicine. The fact that the field of plastic surgery targets a rather specific and limited medical audience, and that plastic surgical articles usually get quoted by this audience, partly explains these values. Furthermore, the elongated turnaround time contributes to their endurance. Since plastic surgical journals cannot attract a broader medical audience, journals should speed up their publication times to help these values rise.

  10. Medical Student Mentorship in Plastic Surgery: The Mentee's Perspective.

    Science.gov (United States)

    Barker, Jenny C; Rendon, Juan; Janis, Jeffrey E

    2016-06-01

    Mentorship is a universal concept that has a significant impact on nearly every surgical career. Although frequently editorialized, true data investigating the value of mentorship are lacking in the plastic surgery literature. This study evaluates mentorship in plastic surgery from the medical student perspective. An electronic survey was sent to recently matched postgraduate year-1 integrated track residents in 2014, with a response rate of 76 percent. Seventy-seven percent of students reported a mentoring relationship. Details of the mentoring relationship were defined. Over 80 percent of students reported a mentor's influence in their decision to pursue plastic surgery, and nearly 40 percent of students expressed interest in practicing the same subspecialty as their mentor. Benefits of the relationship were also described. Mentees value guidance around career preparation and advice and prioritized "a genuine interest in their career and personal development" above all other mentor qualities (p ≤ 1.6 × 10). Mentees prefer frequent, one-on-one interactions over less frequent interaction or group activities. Students did not prefer "assigned" relationships (91 percent), but did prefer "facilitated exposure." Major barriers to mentorship included mentor time constraints and lack of exposure to plastic surgery. Indeed, significant differences in the presence of a mentoring relationship correlated with involvement of the plastic surgery department in the medical school curriculum. This study defines successes and highlights areas for improvement of mentorship of plastic surgery medical students. Successful mentorship may contribute to the future of plastic surgery, and a commitment toward this endeavor is needed at the local, departmental, and national leadership levels.

  11. FUNCTIONAL PHYSICAL THERAPY PRACTICE DERMATO POSTOPERATIVELY OF PLASTIC SURGERIES

    Directory of Open Access Journals (Sweden)

    Julie Severo Migotto

    2013-01-01

    Full Text Available The surgery is a tissue damage that even well directed, can impair tissue function Physiotherapist Dermato Functional fitting to act with all available resources to minimize these changes being a strong contributor both pre and postoperatively. The study included 16 Doctors Plastic Surgeons working in Florianópolis - SC, Brazil, to which was applied a questionnaire to identify theincidence of plastic surgery, knowledge and recognition of dermato functional physical therapy postoperatively. It was found that, as in literature surgeries to enlarge breasts lead the ranking of plastic surgery. Furthermore, it was concluded that physicians not only understand the importance of physiotherapy dermato functional, but also refer their patients to treat postoperative physical therapy valuing employees and recognizing them as important in the rehabilitation process of his patients.

  12. 3D Rapid Prototyping for Otolaryngology-Head and Neck Surgery: Applications in Image-Guidance, Surgical Simulation and Patient-Specific Modeling.

    Directory of Open Access Journals (Sweden)

    Harley H L Chan

    Full Text Available The aim of this study was to demonstrate the role of advanced fabrication technology across a broad spectrum of head and neck surgical procedures, including applications in endoscopic sinus surgery, skull base surgery, and maxillofacial reconstruction. The initial case studies demonstrated three applications of rapid prototyping technology are in head and neck surgery: i a mono-material paranasal sinus phantom for endoscopy training ii a multi-material skull base simulator and iii 3D patient-specific mandible templates. Digital processing of these phantoms is based on real patient or cadaveric 3D images such as CT or MRI data. Three endoscopic sinus surgeons examined the realism of the endoscopist training phantom. One experienced endoscopic skull base surgeon conducted advanced sinus procedures on the high-fidelity multi-material skull base simulator. Ten patients participated in a prospective clinical study examining patient-specific modeling for mandibular reconstructive surgery. Qualitative feedback to assess the realism of the endoscopy training phantom and high-fidelity multi-material phantom was acquired. Conformance comparisons using assessments from the blinded reconstructive surgeons measured the geometric performance between intra-operative and pre-operative reconstruction mandible plates. Both the endoscopy training phantom and the high-fidelity multi-material phantom received positive feedback on the realistic structure of the phantom models. Results suggested further improvement on the soft tissue structure of the phantom models is necessary. In the patient-specific mandible template study, the pre-operative plates were judged by two blinded surgeons as providing optimal conformance in 7 out of 10 cases. No statistical differences were found in plate fabrication time and conformance, with pre-operative plating providing the advantage of reducing time spent in the operation room. The applicability of common model design and

  13. Recent randomized controlled trials in otolaryngology.

    Science.gov (United States)

    Banglawala, Sarfaraz M; Lawrence, Lauren A; Franko-Tobin, Emily; Soler, Zachary M; Schlosser, Rodney J; Ioannidis, John

    2015-03-01

    To assess recent trends in the prevalence and quality of reporting of randomized controlled trials (RCTs) in 4 otolaryngology journals. Methodology and reporting analysis. Randomized controlled trials in 4 otolaryngology journals. All RCTs published from 2011 to 2013 in 4 major otolaryngology journals were examined for characteristics of study design, quality of design and reporting, and funding. Of 5279 articles published in 4 leading otolaryngology journals from 2011 to 2013, 189 (3.3%) were RCTs. The majority of RCTs were clinical studies (86%), with the largest proportion consisting of sinonasal topics (31%). Most interventions were medical (46%), followed by surgical (38%) and mixed (16%). In terms of quality, randomization method was reported in 54% of RCTs, blinding in 33%, and adverse events in 65%. Intention-to-treat analysis was used in 32%; P values were reported in 87% and confidence intervals in 10%. Research funding was most often absent or not reported (55%), followed by not-for-profit (25%). Based on review of 4 otolaryngology journals, RCTs are still a small proportion of all published studies in the field of otolaryngology. There seem to be trends toward improvement in quality of design and reporting of RCTs, although many quality features remain suboptimal. Practitioners both designing and interpreting RCTs should critically evaluate RCTs for quality. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  14. Virtual Reality and Augmented Reality in Plastic Surgery: A Review.

    Science.gov (United States)

    Kim, Youngjun; Kim, Hannah; Kim, Yong Oock

    2017-05-01

    Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed.

  15. Computer Simulation and Digital Resources for Plastic Surgery Psychomotor Education.

    Science.gov (United States)

    Diaz-Siso, J Rodrigo; Plana, Natalie M; Stranix, John T; Cutting, Court B; McCarthy, Joseph G; Flores, Roberto L

    2016-10-01

    Contemporary plastic surgery residents are increasingly challenged to learn a greater number of complex surgical techniques within a limited period. Surgical simulation and digital education resources have the potential to address some limitations of the traditional training model, and have been shown to accelerate knowledge and skills acquisition. Although animal, cadaver, and bench models are widely used for skills and procedure-specific training, digital simulation has not been fully embraced within plastic surgery. Digital educational resources may play a future role in a multistage strategy for skills and procedures training. The authors present two virtual surgical simulators addressing procedural cognition for cleft repair and craniofacial surgery. Furthermore, the authors describe how partnerships among surgical educators, industry, and philanthropy can be a successful strategy for the development and maintenance of digital simulators and educational resources relevant to plastic surgery training. It is our responsibility as surgical educators not only to create these resources, but to demonstrate their utility for enhanced trainee knowledge and technical skills development. Currently available digital resources should be evaluated in partnership with plastic surgery educational societies to guide trainees and practitioners toward effective digital content.

  16. Academic Benchmarks for Otolaryngology Leaders.

    Science.gov (United States)

    Eloy, Jean Anderson; Blake, Danielle M; D'Aguillo, Christine; Svider, Peter F; Folbe, Adam J; Baredes, Soly

    2015-08-01

    This study aimed to characterize current benchmarks for academic otolaryngologists serving in positions of leadership and identify factors potentially associated with promotion to these positions. Information regarding chairs (or division chiefs), vice chairs, and residency program directors was obtained from faculty listings and organized by degree(s) obtained, academic rank, fellowship training status, sex, and experience. Research productivity was characterized by (a) successful procurement of active grants from the National Institutes of Health and prior grants from the American Academy of Otolaryngology-Head and Neck Surgery Foundation Centralized Otolaryngology Research Efforts program and (b) scholarly impact, as measured by the h-index. Chairs had the greatest amount of experience (32.4 years) and were the least likely to have multiple degrees, with 75.8% having an MD degree only. Program directors were the most likely to be fellowship trained (84.8%). Women represented 16% of program directors, 3% of chairs, and no vice chairs. Chairs had the highest scholarly impact (as measured by the h-index) and the greatest external grant funding. This analysis characterizes the current picture of leadership in academic otolaryngology. Chairs, when compared to their vice chair and program director counterparts, had more experience and greater research impact. Women were poorly represented among all academic leadership positions. © The Author(s) 2015.

  17. Ambulatory anesthesia in plastic surgery: opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Facque AR

    2015-10-01

    Full Text Available Alexander R Facque, Peter J Taub Division of Plastic and Reconstructive Surgery, Department of Surgery, Mount Sinai Medical Center, New York, NY, USA Abstract: In 2013, there were 17 million procedures performed by plastic and reconstructive surgeons in the United States in the private office or ambulatory “surgicenter” setting, as well as additional operations performed in hospitals on an outpatient basis. As interest in performing increasingly complex surgical procedures on an outpatient basis continues to grow, the surgeon and anesthesiologist alike must be prepared to offer safe and reliable anesthesia and analgesia in the ambulatory setting. Surgeons must be aware of the possible techniques that will be employed in their surgeries in order to anticipate and prepare patients for possible postoperative side effects, and anesthesiologists must be prepared to offer such techniques in order to ensure a relatively rapid return to normal activity despite potentially having undergone major surgery. The following is a review of the specific considerations that should be given to ambulatory plastic surgery patients with comments on recent developments in the techniques used to safely administer agreeable and effective anesthesia. Keywords: ambulatory surgery, cosmetic anesthesia, outpatient, ambulatory anesthesia

  18. American plastic surgery and global health: a brief history.

    Science.gov (United States)

    Hughes, Christopher D; Alkire, Blake; Martin, Christine; Semer, Nadine; Meara, John G

    2012-02-01

    Access to essential surgical care in resource-poor settings is gaining recognition as a major component of international public health efforts. As evidence is mounting about the burden of surgically treatable disease in low- and middle-income countries, so too is the evidence for the significant need for plastic surgery treatment of disease rising in these areas. American plastic surgery has a long history with international surgical efforts in resource-poor regions around the world. Early experiences were not formalized until after World War II, when a foundation partnership provided a venue for interested plastic surgeons to volunteer. These efforts progressed and advanced throughout the 1960s-1970s, but were ultimately devastated by the Vietnam War. Subsequent international plastic surgical experiences by American surgeons over the last 40 years have been largely through several nongovernmental organizations. American plastic surgical involvement in global surgery has changed significantly over the last 70 years. Although quality care is being delivered to resource-poor regions around the world, many of the challenges of regionally appropriate, sustainable care persist today.

  19. Orthopedic Prosthetic Infections: Plastic Surgery Management.

    Science.gov (United States)

    Meaike, Jesse D; Kaufman, Matthew G; Izaddoost, Shayan A

    2016-05-01

    Orthopedic prosthetic infections are potentially devastating complications. Plastic surgeons are frequently consulted to aid in the management of the soft tissue defects that are created by these infections. A review of the existing literature was performed to identify established treatment methods for soft tissue coverage of orthopedic hardware infections for a variety of anatomic locations. The following treatment guidelines and soft tissue reconstructive options were identified as viable options for the management of exposed or infected orthopedic hardware. This review provides descriptions of the various soft tissue reconstructive options available as well as adjunctive treatment methods.

  20. Patient Selection in Plastic Surgery: Recognizing Body Dysmorphic Disorder

    Directory of Open Access Journals (Sweden)

    Cihan Sahin

    2013-04-01

    Full Text Available Plastic surgery is a branch of medicine that provides significant improvements to the people with positive changes. But first of all, this branch has a characteristic which requires analysing patients' psychological situation very carefully. Plastic surgeons are often confronted by patients with mental disorders seeking aesthetic surgery. It is imperative for surgeons to recognize possible underlying psychiatric illnesses. Common psychiatric conditions seen in cosmetic surgery patients include body dysmorphic disorder (BDD, narcissistic personality disorder and histrionic personality disorders. BDD is of particular importance to plastic surgeons. Because outrageous dissatisfaction with one's appearance may conceal psychopathologic traits that are not always easily recognizable, and which, if neglected, may result in serious iatrogenic and medicolegal consequences, we hope that this paper will help plastic surgeons in ultimately preventing patient and surgeon dissatisfaction within the population of patients with psychiatric disorders, and should recognize the diagnostic features of body dysmorphic disorder and screen psychologically unstable patients who may never be satisfied with surgery. [Arch Clin Exp Surg 2013; 2(2.000: 109-115

  1. Different models of training and certification in plastic surgery

    NARCIS (Netherlands)

    Fodor, L.; Ciuce, C.; Fodor, M.; Shrank, C.; Lapid, O.; Kon, M.; Ramon, Y.; Ullmann, Y.

    2009-01-01

    A varying period of training followed by examinations is the usual way to become a specialist in one of the many fields of Medicine. Plastic Surgery is one of the surgical fields that require good technical and cognitive skills. The best way to train and evaluate a candidate is hard to judge. The mo

  2. Social media use and impact on plastic surgery practice.

    Science.gov (United States)

    Vardanian, Andrew J; Kusnezov, Nicholas; Im, Daniel D; Lee, James C; Jarrahy, Reza

    2013-05-01

    Social media platforms have revolutionized the way human beings communicate, yet there is little evidence describing how the plastic surgery community has adopted social media. In this article, the authors evaluate current trends in social media use by practicing plastic surgeons. An anonymous survey on the use of social media was distributed to members of the American Society of Plastic Surgeons. Prevalent patterns of social media implementation were elucidated. One-half of respondents were regular social media users. Reasons for using social media included the beliefs that incorporation of social media into medical practice is inevitable (56.7 percent), that they are an effective marketing tool (52.1 percent), and that they provide a forum for patient education (49 percent). Surgeons with a primarily aesthetic surgery practice were more likely to use social media. Most respondents (64.6 percent) stated that social media had no effect on their practice, whereas 33.8 percent reported a positive impact and 1.5 percent reported a negative impact. This study depicts current patterns of social media use by plastic surgeons, including motivations driving its implementation and impressions on its impact. Many feel that social media are an effective marketing tool that generates increased exposure and referrals. A small number of surgeons have experienced negative repercussions from social media involvement. Our study reveals the presence of a void. There is a definite interest among those surveyed in developing best practice standards and oversight to ensure ethical use of social media platforms throughout the plastic surgery community. Continuing discussion regarding these matters should be ongoing as our experience with social media in plastic surgery evolves.

  3. Clinical application of the Nd-YAG and Ho-YAG lasers in otolaryngology: head and neck surgery

    Science.gov (United States)

    Kukwa, Andrzej; Tulibacki, Marek P.; Dudziec, Katarzyna; Wojtowicz, Piotr

    1997-10-01

    The authors present their clinical experience regarding the possibilities of application of Nd:YAG and Ho:YAG lasers for the treatment of disorders in the area of the upper respiratory tract sinuses and ears. This technique makes it possible to perform a number of procedures in local anesthesia which considerably improves the economic effectiveness of the treatment. In case of the Nd:YAG laser they have also utilized the effect of deep coagulation of the soft tissues, whereas the Ho:YAG laser energy was applied for the surgery of bone tissue. The surgeries performed using laser beam enabled very good effect of treatment. They are competitive compared wit the methods used by traditional surgery.

  4. Reaching Our Successors: Millennial Generation Medical Students and Plastic Surgery as a Career Choice

    National Research Council Canada - National Science Library

    Ibrahim, Abdulrasheed; Asuku, Malachy E

    .... If plastic surgery is to continue to attract the best, factors that may dissuade the millennial generation medical students from pursuing plastic surgery as a career must be identified and addressed...

  5. Learning styles in two otolaryngology residency programs.

    Science.gov (United States)

    Laeeq, Kulsoom; Weatherly, Robert A; Carrott, Alice; Pandian, Vinciya; Cummings, Charles W; Bhatti, Nasir I

    2009-12-01

    Kolb portrays four learning styles depending on how an individual grasps or transforms experience: accommodating, assimilating, diverging, and converging. Past studies in surgery, medicine, and anesthesia identified the predominant learning style in each of these specialties. The prevalence of different learning styles and existence of a predominant style, if any, has not been reported for otolaryngology residency programs. The purpose of our study was to determine if otolaryngology residents have a preferred learning style that is different from the predominant learning styles reported for other specialties. We conducted a survey of the otolaryngology-head and neck surgery residents at two residency programs. Kolb's Learning Style Index (LSI) version 3.1 was administered to 46 residents from Johns Hopkins University and Kansas University Otolaryngology-Head and Neck Surgery programs. LSI is a widely used 12-item questionnaire, with each item followed by four options. The subjects graded the options depending on how the options applied to them. Forty-three otolaryngology residents completed the survey, with a response rate of 93.47%. The predominant learning style was converging (55.81%) followed by accommodating (18.61%), accounting for the learning styles of 74.42% of the total population. There were only 13.95% assimilating and 6.98% diverging learning styles. Two residents (4.65%) had their preference balanced across four learning styles. The predominant learning styles in otolaryngology were converging and accommodating, accounting for three fourths of the population. It would be desirable to modify our curriculum in a way that will optimize and facilitate learning.

  6. Accountable Care Organizations and Otolaryngology

    Science.gov (United States)

    Contrera, Kevin J.; Ishii, Lisa E.; Setzen, Gavin; Berkowitz, Scott A.

    2016-01-01

    Accountable Care Organizations represent a shift in health care delivery, while providing a significant potential for improved quality and coordination of care across multiple settings. Otolaryngologists have an opportunity to become leaders in this expanding arena. However, the field of otolaryngology-head and neck surgery currently lacks many of the tools necessary to implement value-based care, including performance-measurement, electronic health infrastructure and data management. These resources will become increasingly important for surgical specialists to be active participants in population health. This article reviews the fundamental issues that otolaryngologists should consider when pursuing new roles in Accountable Care Organizations. PMID:26044787

  7. Survey of Attitudes on Professionalism in Plastic and Reconstructive Surgery

    Directory of Open Access Journals (Sweden)

    Jin Yong Kim

    2013-03-01

    Full Text Available Background The purpose of this study is to analyze the current attitudes toward professionalism,the core values, and the type of professionalism among plastic surgeons in Korea to establish acode of ethics regarding the role of professionalism for plastic and reconstructive surgeons.Methods From March 9, to July 1, 2012, face-to-face and mail surveys were conductedtargeting the 325 participants (256 specialists and 69 residents who are registered membersof the Korean Society of Plastic and Reconstructive Surgeons. The proportion of each responsegiven to an item was obtained through statistical processing through frequency analysis. TheMann–Whitney U test was used to compare the differences in the responses between theresident group and the specialist group.Results The survey results on the perception of professionalism in plastic surgery showed thata high proportion (90.5% of the respondents viewed the future of plastic surgeons as bright.Through evaluation of the importance of the value items,”professional dominance” (4.58 pts,”autonomy” (4.45 pts, ”lifestyle” (4.34 pts, and ”commercialism” (4.31 pts were assessed ascritical values. ”Altruism” (3.84 pts, “interpersonal competence” (3.79 pts, and ”social justice”(3.61 pts were viewed as lesser values. This difference showed the characteristics of anentrepreneurial outlook.Conclusions Plastic surgeons should pursue excellence, humanism, accountability, andaltruism in order to overcome the crisis of professionalism in plastic surgery. In order todevelop the necessary competencies of professionals, vocational education should be arrangedby the Korean Society of Plastic Surgeons, and an appropriate code of ethics should beestablished.

  8. The possibility of clinical application of the solid state lasers: Nd:YAG, Ho:YAG, and Er:YAG in otolaryngology - head and neck surgery

    Science.gov (United States)

    Tomaszewska, M.; Kukwa, A.; Tulibacki, M.; Wójtowicz, P.; Olędzka, I.; Jeżewska, E.

    2007-02-01

    The purpose of this study was to summarize our experiences in clinical application of Nd:YAG, Ho:YAG and Er:YAG in otolaryngology- head and neck surgery. Choosing the laser type and parameters for the particular procedures was based on our previous research on tissue effects of those lasers. During the period of 1993-2006 we performed 3988 surgical procedures with the Nd:YAG laser. Over 87% of those were made for the nasal cavity pathologies as polyps, hyperplasia of inferior nasal turbinate, granulation tissue, postoperative adhesions, vascular malformations, under the local anesthesia conditions. In our experience Nd:YAG laser gives the possibility of good clinical control and low risk of side effects for disorders of high recurrence and frequent interventions necessity, as nasal polyps or respiratory papillomatosis. Nd:YAG assisted uvulopalatoplasty gives an interesting alternative for surgical procedures for snoring and slight/mild OSA-recognized patients. Due to its good hemostatic properties, it is a perfect tool for removal of the chemodectoma from meddle ear. During the period of 1995-2006 we performed 229 surgical procedures with the Ho:YAG laser, mostly for larynx pathologies (adhesion and scar tissue removal). In our experience Ho:YAG laser can serve as a precise laser knife for both soft and bony tissue. The ER:YAG laser still remain under clinical trial. Since 2001 year we performed 24 procedures of removing stone deposits from salivary glands. We believe it may become a promising method to cope with sialolithiasis which allows for glandule function preservation. All of the laser types mentioned above, can be easily coupled with endoscopes, what makes them available for all of the head and necklocalized disorders.

  9. Characteristics of otolaryngology claims to Medicare in 2012.

    Science.gov (United States)

    Bhattacharyya, Neil; Lin, Harrison W

    2014-11-01

    The Medicare provider utilization and payment public use datafile for 2012 was analyzed with respect to otolaryngology specialty providers to characterize otolaryngology services billed to and reimbursed by Medicare, both overall and according to provider characteristics. Among 8450 otolaryngology specialty providers submitting claims, the top 5 billed services were (count in millions): 99213 (2.23), 95165 (1.81), 99203 (0.92), 99214 (0.83), and 69210 (0.71), and the top 5 total reimbursed services were (aggregate total reimbursements in millions): 99213 ($114), 99203 ($68), 99214 ($63), 31231 ($60), and 31575 ($47). There was a mean of 1567 services billed per provider with an average (yearly) total reimbursement from Medicare of $76,068 per provider. These data characterize the current level of provision of otolaryngology services to the Medicare population. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2014.

  10. Nanotechnology and regenerative therapeutics in plastic surgery: The next frontier.

    Science.gov (United States)

    Tan, Aaron; Chawla, Reema; G, Natasha; Mahdibeiraghdar, Sara; Jeyaraj, Rebecca; Rajadas, Jayakumar; Hamblin, Michael R; Seifalian, Alexander M

    2016-01-01

    The rapid ascent of nanotechnology and regenerative therapeutics as applied to medicine and surgery has seen an exponential rise in the scale of research generated in this field. This is evidenced not only by the sheer volume of papers dedicated to nanotechnology but also in a large number of new journals dedicated to nanotechnology and regenerative therapeutics specifically to medicine and surgery. Aspects of nanotechnology that have already brought benefits to these areas include advanced drug delivery platforms, molecular imaging and materials engineering for surgical implants. Particular areas of interest include nerve regeneration, burns and wound care, artificial skin with nanoelectronic sensors and head and neck surgery. This study presents a review of nanotechnology and regenerative therapeutics, with focus on its applications and implications in plastic surgery.

  11. Nanotechnology and regenerative therapeutics in plastic surgery: The next frontier

    Science.gov (United States)

    Tan, Aaron; Chawla, Reema; Natasha, G; Mahdibeiraghdar, Sara; Jeyaraj, Rebecca; Rajadas, Jayakumar; Hamblin, Michael R.; Seifalian, Alexander M.

    2015-01-01

    Summary The rapid ascent of nanotechnology and regenerative therapeutics as applied to medicine and surgery has seen an exponential rise in the scale of research generated in this field. This is evidenced not only by the sheer volume of papers dedicated to nanotechnology but also in a large number of new journals dedicated to nanotechnology and regenerative therapeutics specifically to medicine and surgery. Aspects of nanotechnology that have already brought benefits to these areas include advanced drug delivery platforms, molecular imaging and materials engineering for surgical implants. Particular areas of interest include nerve regeneration, burns and wound care, artificial skin with nanoelectronic sensors and head and neck surgery. This study presents a review of nanotechnology and regenerative therapeutics, with focus on its applications and implications in plastic surgery. PMID:26422652

  12. ORIGIN OF SURGERY: A HISTORY OF EXPLORATION OF PLASTIC AND RECONSTRUCTIVE SURGERY

    Directory of Open Access Journals (Sweden)

    Panigrahi

    2013-10-01

    Full Text Available The Sushruta Samhita, Charaka samhita and Astanga sangraha are the tri compendia of Ayurveda encompassing all the aspects of Ayurveda. Plastic surgery (Sandhana karma is a very old branch of surgery described since Vedic era. Almost all the Samhitas described about the methods of Sandhana Karma (Plastic and reconstructive surgery. Now a day the world recognizes the pioneering nature of Sushruta’s plastic and reconstructive surgery and Sushruta is regarded as Father of Plastic surgery. The plastic operations of ear (otoplasty and Rhinoplasty (Plastic Surgery of nose are described in the 16th Chapter of first book (Sutrasthan of the compendium. First methods are described for piercing the earlobes of an infant which still is a widespread practice in India. Sushruta has described 15 methods of joining these cup-up ear lobes. For this plastic operation called karna bedha, a piece of skin was taken from the cheek, turned back, and suitably stitches the lobules. Sushruta has also described Rhinoplasty (Nasa Sandhana. Portion of the nose to be covered should be first measured with a leaf. Then a piece of skin of the required size should be dissected from the living skin of the cheek and turned back to cover the nose, keeping a small pedicle attaches to the cheek. The part of nose to which the skin is to be attached should be made raw by cutting of the nasal stump with a knife. The surgeon then should place the skin on the nose and stitch the two parts swiftly, keeping the skin properly elevated by inserting two tubes of eranda (castor oil plant in each part of nostril so that the new nose gets proper shape. It should then be sprinkled with a powder composed of liquorices, red sandalwood, and barberry plant. Finally it should be covered with cotton and clean sesame oil should be constantly applied to it. Sushruta also mentioned the reconstruction of the broken lip and hare-lip (ostha Sandhana.These descriptions are brief in nature in comparison to

  13. Self-reported problems and wishes for plastic surgery after bariatric surgery

    DEFF Research Database (Denmark)

    Wagenblast, Lene; Laessoe, Line; Printzlau, Andreas

    2014-01-01

    , since some of the patients will experience problems due to excess skin. Foreign studies estimate that ∼30% of all bariatric surgery patients will at some point seek plastic surgical correction of excess skin. The aim of this study is to investigate to what extent the GB patients themselves consider...... plastic surgery for removal of excess skin, and their reasons and motivations for this. The investigation was performed as an anonymous questionnaire handed out to 150 patients at the 1-year standard consultation for GB patients at a private hospital. The questionnaire contained information about......, and the investigation showed that 89.9% of the patients had a wish for plastic surgery for several different reasons. This patient demand showed to have no correlation to age, gender, smoking habits, or earlier comorbidity....

  14. A brief history of plastic surgery in Iran.

    Science.gov (United States)

    Kalantar-Hormozi, Abdoljalil

    2013-03-01

     Although the exact time of performing plastic surgery is not addressed in the medical and historical literature, it can be supposed that these surgical procedures have a long and fascinating history.  Recent excavations provided many documents regarding the application of medical instruments, surgical and even reconstructive procedures during the pre-historic and ancient periods. Actually, there is no historical definite time-zone separating general and cosmetic operations in the pre-modern time; however, historically there have been many surgeons who tried to perform reconstructive procedures during their usual medical practice. This article presents a brief look at the history of plastic surgery form the ancient to the contemporary era, with a special focus on Iran.

  15. Career evaluation and the decision process for plastic surgery graduates.

    Science.gov (United States)

    Davison, Steven P; Clemens, Mark W

    2011-08-01

    National experience shows that 50 percent of physicians change positions within the first 2 years of practice. Because of market pressures, medicine in general and plastic surgery in particular are shifting away from solo practice. The authors examine the primary reasons for turnover and discuss job search priorities for recent plastic surgery graduates and established surgeons in job transition, with a current analysis of the different job opportunities available, ranging from government to private practice. The advantages and disadvantages of different positions are compared and income data are presented. Academic income is close to that of private practice at a mean of $366,141 annually but requires more work as measured by an overall higher relative value unit of productivity. The concept of creating a personal inventory before seeking the best job match is introduced.

  16. Virtual Reality and Augmented Reality in Plastic Surgery: A Review

    Directory of Open Access Journals (Sweden)

    Youngjun Kim

    2017-05-01

    Full Text Available Recently, virtual reality (VR and augmented reality (AR have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed.

  17. Virtual Reality and Augmented Reality in Plastic Surgery: A Review

    Science.gov (United States)

    Kim, Youngjun; Kim, Hannah

    2017-01-01

    Recently, virtual reality (VR) and augmented reality (AR) have received increasing attention, with the development of VR/AR devices such as head-mounted displays, haptic devices, and AR glasses. Medicine is considered to be one of the most effective applications of VR/AR. In this article, we describe a systematic literature review conducted to investigate the state-of-the-art VR/AR technology relevant to plastic surgery. The 35 studies that were ultimately selected were categorized into 3 representative topics: VR/AR-based preoperative planning, navigation, and training. In addition, future trends of VR/AR technology associated with plastic surgery and related fields are discussed. PMID:28573091

  18. Patient perceptions on physician reimbursement in plastic surgery.

    Science.gov (United States)

    Garcia, Ryan M; Cassinelli, Ezequiel H; Hultman, C Scott; Erdmann, Detlev

    2014-07-01

    Public perception on physician reimbursement may be that considerable payments are received for procedures: a direct contrast to the actual decline. We aim to investigate patient perceptions toward plastic surgeon reimbursements from insurance companies. A survey of 4 common, single-staged procedures was administered to 140 patients. Patients were asked for their opinion on current insurance company reimbursement fees and what they believed the reimbursement fee should be. Eighty-four patients completed the survey. Patients estimated physician's reimbursements at 472% to 1061% more for breast reduction, 347% to 770% for abdominal hernia reconstruction, 372% to 787% for panniculectomy, and 290% to 628% for mandibular fracture repair. Despite these perceived higher-than-actual-fee payments, 87% of patients thought reimbursements should still be higher. Patients surveyed overestimated plastic surgery procedure fees by 290% to 1061%. Patients should be informed and educated regarding current fee schedules to plastic surgeons to correct current misconceptions.

  19. Platelet-rich fibrin matrix for facial plastic surgery.

    Science.gov (United States)

    Sclafani, Anthony P; Saman, Masoud

    2012-05-01

    Platelets are known primarily for their role in hemostasis, but there is increasing interest in the effect of platelets on wound healing. Platelet isolates such as platelet-rich plasma have been advocated to enhance and accelerate wound healing. This article describes the use of a novel preparation, platelet-rich fibrin matrix (PRFM), for facial plastic surgery applications such as volume augmentation, fat transfer supplementation, and as an adjunct to open surgical procedures.

  20. On One Application of Fourier Analysis in Plastic Surgery

    Science.gov (United States)

    Rakhimov, Abdumalik; Zainuddin, Hishamuddin

    In present paper, we discuss the spectral methods of measurement of the degree of speech and/or quality of sound by comparing the coefficient of performance indicators depending on energy distributions, ratio of energy of the fundamental tone and energy of overtones. Such a method is very efficient for string oscillation with different initial conditions and it is useful for justification of applications of Fourier analysis in plastic surgery in treatment of some medical diseases.

  1. Recent trends in resident career choices after plastic surgery training.

    Science.gov (United States)

    Herrera, Fernando A; Chang, Eric I; Suliman, Ahmed; Tseng, Charles Y; Bradley, James P

    2013-06-01

    The purpose of this study is to determine the initial career choice of plastic surgery residents after completion of training during the last five years and to identify any factors that may influence choice of career path. Demographic data were obtained from graduates of Accreditation Council for Graduate Medical Education (ACGME)-accredited US plastic surgery residency programs between the years of 2005 and 2010. The type of practice and pursuit of fellowship were recorded for each graduate. Sex, age at graduation, marital status, dependents, advanced degrees, previous research, type of training program, primary residency, and length of plastic surgery training were also documented. Comparison of outcomes between the two plastic surgery training pathways (integrated vs independent) was analyzed. Data were collected for 424 graduates from 37 different training programs. Of these programs, 11% were from the West coast, 32% from Midwest, 33% from East coast, and 24% from the South. Seventy-nine percent of residents were male, mean age at graduation was 35 (2.89) years. Forty-nine percent of residents were married, 30% had one or more dependents, 6% had advanced degrees, and 18% had previous research experience. Fifty-eight percent of graduates were from independent programs. Forty-eight percent of residents pursued private practice immediately after graduation, 8% pursued academic practice, 41% pursued specialty fellowships, and 3% had military commitments. Most of the residents chose to pursue private practice on completion of residency. Independent residents were significantly more likely to pursue private practice immediately compared to integrated/combined residents. No other factors were significant for practice choice.

  2. Medical requirements for design of endoscopes for otolaryngology

    Science.gov (United States)

    Parekh, Jai; Pankratov, Michail M.; Poe, Dennis S.; Rebeiz, Elie E.; Shapshay, Stanley M.

    1993-07-01

    Endoscopy has revolutionized the field of medicine and surgery by aiding the clinician in diagnostic and therapeutic modalities of patient care. Endoscopy in Otolaryngology has provided the surgeon with unique access to areas of the head and neck which were previously inaccessible for direct inspection in an atraumatic and minimally invasive fashion. Specific areas of Otolaryngology where endoscopy has made advances are the rhinology and otology. The relevant anatomy, clinical requirements, and `state of the art' endoscopic techniques are discussed for these areas. Further advances in endoscopy for otolaryngology requires the cooperation from both the clinical and technical standpoints.

  3. Operating room waste reduction in plastic and hand surgery

    Science.gov (United States)

    Albert, Mark G; Rothkopf, Douglas M

    2015-01-01

    BACKGROUND: Operating rooms (ORs), combined with labour and delivery suites, account for approximately 70% of hospital waste. Previous studies have reported that recycling can have a considerable financial impact on a hospital-wide basis; however, its importance in the OR has not been demonstrated. OBJECTIVE: To propose a method of decreasing cost through judicious selection of instruments and supplies, and initiation of recycling in plastic and hand surgery. METHODS: The authors identified disposable supplies and instruments that are routinely opened and wasted in common plastic and hand surgery procedures, and calculated the savings that can result from eliminating extraneous items. A cost analysis was performed, which compared the expense of OR waste versus single-stream recycling and the benefit of recycling HIPAA documents and blue wrap. RESULTS: Fifteen total items were removed from disposable plastic packs and seven total items from hand packs. A total of US$17,381.05 could be saved per year from these changes alone. Since initiating single-stream recycling, the authors’ institution has saved, on average, US$3,487 per month at the three campuses. After extrapolating at the current savings rate, one would expect to save a minimum of US$41,844 per year. DISCUSSION: OR waste reduction is an effective method of decreasing cost in the surgical setting. By revising the contents of current disposable packs and instrument sets designated for plastic and hand surgery, hospitals can reduce the amount of opened and unused material. CONCLUSIONS: Significant financial savings and environmental benefit can result from this judicious supply and instrument selection, as well as implementation of recycling. PMID:26665137

  4. Plastic surgery marketing in a generation of "tweeting".

    Science.gov (United States)

    Wong, Wendy W; Gupta, Subhas C

    2011-11-01

    "Social media" describes interactive communication through Web-based technologies. It has become an everyday part of modern life, yet there is a lack of research regarding its impact on plastic surgery practice. The authors evaluate and compare the prevalence of classic marketing methods and social media in plastic surgery. The Web sites of aesthetic surgeons from seven US cities were compared and evaluated for the existence of Facebook, Twitter, or MySpace links and promotions. To find the sites, the authors conducted a Google search for the phrase "plastic surgery" with the name of each city to be studied: Beverly Hills, California; Dallas, Texas; Houston, Texas; Las Vegas, Nevada; Miami, Florida; New York City, New York; and San Francisco, California. The trends of social networking memberships were also studied in each of these cities. In comparison to aesthetic surgeons practicing in other cities, those in Miami, Florida, favored social media the most, with 50% promoting a Facebook page and 46% promoting Twitter. Fifty-six percent of New York City aesthetic surgeons promoted their featured articles in magazines and newspapers, whereas 54% of Beverly Hills aesthetic surgeons promoted their television appearances. An increase in the number of new Facebook memberships among cosmetic providers in the seven cities began in October 2008 and reached a peak in October, November, and December 2009, with subsequent stabilization. The increase in the number of new Twitter memberships began in July 2008 and remained at a steady rate of approximately 15 new memberships every three months. Social media may seem like a new and unique communication tool, but it is important to preserve professionalism and apply traditional Web site-building ethics and principles to these sites. We can expect continued growth in plastic surgeons' utilization of these networks to enhance their practices and possibly to launch direct marketing campaigns.

  5. Plastic surgery-myths and realities in developing countries: experience from eastern Nepal.

    Science.gov (United States)

    Mishra, Brijesh; Koirala, Robin; Tripathi, Nalini; Shrestha, Kajan Raj; Adhikary, Buddhinath; Shah, Surendra

    2011-01-01

    B.P. Koirala Institute of Health Sciences, Dharan, Nepal, is the only tertiary care referral centre in the eastern region of Nepal. This paper discusses the author's experience of starting a plastic surgery unit in eastern Nepal regarding need and present status of plastic surgery care in Nepal. Methods. We analyzed the data of patients treated in Plastic surgery unit from July 2007 to February 2009. We did evaluation regarding type of patients, procedures, and their outcome. We also evaluated the limitations and their possible solutions to overcome the barriers to establish effective plastic surgical centers in developing countries. Results. Plastic surgery services were started as a unit in general surgery by single plastic surgeon and one general surgery resident on rotation. Total 848 patients were treated for different plastic-surgery-related conditions, which included 307 acute burn patients 541 general plastic surgery patients. Trauma constituted the major bulk 22%, followed by tumors 20%, while aesthetic surgery operations were only 10.1%. Conclusions. In developing countries, aesthetic procedures constitute very small part of plastic surgery interventions and plastic surgery units are primarily required for reconstructive needs for optimum management of patients.

  6. Emerging Applications of Bedside 3D Printing in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Michael P Chae

    2015-06-01

    Full Text Available Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D reconstructions, are limited by their representation on 2D workstations. 3D printing has been embraced by early adopters to produce medical imaging-guided 3D printed biomodels that facilitate various aspects of clinical practice. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. With increasing accessibility, investigators are now able to convert standard imaging data into Computer Aided Design (CAD files using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography (SLA, multijet modeling (MJM, selective laser sintering (SLS, binder jet technique (BJT, and fused deposition modeling (FDM. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without out-sourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. In this review the existing uses of 3D printing in plastic surgery practice, spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative aesthetics, are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, patient and surgical trainee education, and the development of intraoperative guidance tools and patient-specific prosthetics in everyday surgical practice.

  7. Emerging Applications of Bedside 3D Printing in Plastic Surgery.

    Science.gov (United States)

    Chae, Michael P; Rozen, Warren M; McMenamin, Paul G; Findlay, Michael W; Spychal, Robert T; Hunter-Smith, David J

    2015-01-01

    Modern imaging techniques are an essential component of preoperative planning in plastic and reconstructive surgery. However, conventional modalities, including three-dimensional (3D) reconstructions, are limited by their representation on 2D workstations. 3D printing, also known as rapid prototyping or additive manufacturing, was once the province of industry to fabricate models from a computer-aided design (CAD) in a layer-by-layer manner. The early adopters in clinical practice have embraced the medical imaging-guided 3D-printed biomodels for their ability to provide tactile feedback and a superior appreciation of visuospatial relationship between anatomical structures. With increasing accessibility, investigators are able to convert standard imaging data into a CAD file using various 3D reconstruction softwares and ultimately fabricate 3D models using 3D printing techniques, such as stereolithography, multijet modeling, selective laser sintering, binder jet technique, and fused deposition modeling. However, many clinicians have questioned whether the cost-to-benefit ratio justifies its ongoing use. The cost and size of 3D printers have rapidly decreased over the past decade in parallel with the expiration of key 3D printing patents. Significant improvements in clinical imaging and user-friendly 3D software have permitted computer-aided 3D modeling of anatomical structures and implants without outsourcing in many cases. These developments offer immense potential for the application of 3D printing at the bedside for a variety of clinical applications. In this review, existing uses of 3D printing in plastic surgery practice spanning the spectrum from templates for facial transplantation surgery through to the formation of bespoke craniofacial implants to optimize post-operative esthetics are described. Furthermore, we discuss the potential of 3D printing to become an essential office-based tool in plastic surgery to assist in preoperative planning, developing

  8. Plastic Surgery Residents' Understanding and Attitudes Toward Biostatistics: A National Survey.

    Science.gov (United States)

    Susarla, Srinivas M; Lifchez, Scott D; Losee, Joseph; Hultman, Charles Scott; Redett, Richard J

    2016-08-01

    An understanding of biostatistics is a critical skill for the practicing plastic surgeon. The purpose of the present study was to assess plastic surgery residents' attitudes and understanding of biostatistics. This was a cross-sectional study of plastic surgery residents. A survey assessing resident attitudes regarding biostatistics, confidence with biostatistical concepts, and objective knowledge of biostatistics was distributed electronically to trainees in plastic surgery programs in the United States. Bivariate and regression analyses were used to identify significant associations and adjust for confounders/effect modifiers. One hundred twenty-three residents responded to the survey (12.3% response rate). Respondents expressed positive attitudes regarding biostatistics in plastic surgery practice, but only moderate levels of confidence with various biostatistical concepts. Both attitudes and confidence were positively associated with the number of plastic surgery journals read monthly and formal coursework in biostatistics (P biostatistics in the practice of plastic surgery but have only a fair understanding of core statistical concepts.

  9. Association of Fellowship Training With Otolaryngology Training Examination Scores.

    Science.gov (United States)

    Akinboyewa, Ibukun; Cabrera-Muffly, Cristina

    2016-03-01

    No prior studies have evaluated whether residents who pursue fellowship training achieve higher performance on the Otolaryngology Training Examination (OTE) and whether a specific fellowship will demonstrate a correlation with the corresponding specialty-specific OTE score. To determine whether residents pursuing fellowship training achieve higher performance on the OTE and whether fellowship choice is correlated with higher scores on the related subspecialty section of the OTE. This retrospective analysis included 35 residents training in an academic otolaryngology residency program from July 1, 2003, to June 30, 2014. The OTE scores for postgraduate years 2 through 5 and the type of fellowship were collected for all residents meeting inclusion criteria. Data were collected from September 1 to October 15, 2014, and analyzed from October 16 to December 1, 2014. Residents were divided by whether they pursued fellowship training and by the type of fellowship chosen. Outcome measures included comparison of scores between residents who pursued vs those who did not pursue fellowship training and comparison of subspecialty OTE scores between residents who pursued the corresponding fellowship and those who did not. Of the 35 residents who met the inclusion criteria (24 men and 11 women), 17 (49%) pursued fellowship training. The 3 most common fellowship choices were facial plastic and reconstructive surgery, pediatric otolaryngology, and rhinology (4 residents each [24%]). For all residents, mean scores on the OTE improved each subsequent training year, but this difference was only significant between postgraduate years 2 and 3 (from 60.9% to 68.6% correct; P otolaryngology, 72.9% vs 71.3% [P = .79]; and for rhinology, 72.2% vs 71.2% [P = .91]). Residents who pursued fellowship training did not achieve higher scores on the OTE in any examination year compared with residents who did not pursue fellowship training and did not achieve higher scores within the OTE

  10. Plastic surgery in chest wall reconstruction: relevant aspects - case series

    Directory of Open Access Journals (Sweden)

    Diogo Franco

    Full Text Available Objective: to discuss the participation of Plastic Surgery in the reconstruction of the chest wall, highlighting relevant aspects of interdisciplinaryness. Methods: we analyzed charts from 20 patients who underwent extensive resection of the thoracic integument, between 2000 and 2014, recording the indication of resection, the extent and depth of the raw areas, types of reconstructions performed and complications. Results: among the 20 patients, averaging 55 years old, five were males and 15 females. They resections were: one squamous cell carcinoma, two basal cell carcinomas, five chondrosarcomas and 12 breast tumors. The extent of the bloody areas ranged from 4x9 cm to 25x40 cm. In 12 patients the resection included the muscular plane. In the remaining eight, the tumor removal achieved a total wall thickness. For reconstruction we used: one muscular flap associated with skin grafting, nine flaps and ten regional fasciocutaneous flaps. Two patients undergoing reconstruction with fasciocutaneous flaps had partially suffering of the flap, solved with employment of a myocutaneous flap. The other patients displayed no complications with the techniques used, requiring only one surgery. Conclusion: the proper assessment of local tissues and flaps available for reconstruction, in addition to the successful integration of Plastic Surgery with the specialties involved in the treatment, enable extensive resections of the chest wall and reconstructions that provide patient recovery.

  11. The Utility of Outcome Studies in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Hani Sinno, MD, MEng

    2014-07-01

    Full Text Available Summary: Outcome studies help provide the evidence-based science rationalizing treatment end results that factor the experience of patients and the impact on society. They improve the recognition of the shortcoming in clinical practice and provide the foundation for the development of gold standard care. With such evidence, health care practitioners can develop evidence-based justification for treatments and offer patients with superior informed consent for their treatment options. Furthermore, health care and insurance agencies can recognize improved cost-benefit options in the purpose of disease prevention and alleviation of its impact on the patient and society. Health care outcomes are ultimately measured by the treatment of disease, the reduction of symptoms, the normalization of laboratory results and physical measures, saving a life, and patient satisfaction. In this review, we outline the tools available to measure outcomes in plastic surgery and subsequently allow the objective measurements of plastic surgical conditions. Six major outcome categories are discussed: (1 functional measures; (2 preference-based measures and utility outcome scores; (3 patient satisfaction; (4 health outcomes and time; (5 other tools: patient-reported outcome measurement information system, BREAST-Q, and Tracking Operations and Outcomes for Plastic Surgeons; and (6 cost-effectiveness analysis. We use breast hypertrophy requiring breast reduction as an example throughout this review as a representative plastic surgical condition with multiple treatments available.

  12. Medical Ethics in Plastic Surgery: A Mini Review.

    Science.gov (United States)

    Nejadsarvari, Nasrin; Ebrahimi, Ali; Ebrahimi, Azin; Hashem-Zade, Haleh

    2016-09-01

    Currently, cosmetic surgery is spread around the world. Several factors are involved in this rapidly evolving field such as socio-economic development, changes in cultural norms, globalization and the effects of Western culture, advertising, media, and mental disorders. Nowadays the cosmetic surgery is becoming a profitable business, which deals exclusively with human appearance and less from the perspective of beauty based on physical protests and considering factors such as sex, age, and race. The morality of plastic surgery subspecialty has undergone many moral dilemmas in the past few years. The role of the patient regardless of his unrealistic dreams has questionable ethical dimension. The problem is the loss of human values and replacing them with false values, of pride and glory to a charismatic person of higher status, that may underlie some of the posed ethical dilemmas. Cosmetic surgery has huge difference with the general principle of legal liability in professional orientation, because the objective for cosmetic surgeries is different from common therapeutic purposes. To observe excellence in the medical profession, we should always keep in mind that these service providers, often as a therapist (healer) must maintain a commitment and priority for patient safety and prior to any action, a real apply for this service recipient should be present. Also, patient-physician confidentiality is the cornerstone of medical ethics. In this review, we study the issues addressed and the ways that they can be resolved.

  13. Plastic Surgeons' Opinions of Facial Surgery for Individuals with Down Syndrome.

    Science.gov (United States)

    May, Deborah C.; Turnbull, Nancy

    1992-01-01

    One hundred plastic surgeons responded to a survey on opinions toward facial plastic surgery for individuals with Down's syndrome. Twenty-four of the surgeons had performed the surgery. Surgeons indicated appropriate circumstances for the surgery, consent requirements, degree of understanding expected of the patient, and degree of discomfort…

  14. Telemedicine in plastic surgery: E-consult the attending surgeon.

    Science.gov (United States)

    Pap, Stephen A; Lach, Elliot; Upton, Joseph

    2002-08-01

    Telemedicine has evolved into a valuable but underused resource for the delivery of health care to patients at a distance, particularly where patient transport is impractical, expensive, complicated, and/or urgent. Today, over 250,000 telemedicine consults are generated annually, involving various specialties in both military and civilian health delivery systems. The ability to evaluate and triage plastic surgery patients through the use of telemedicine has not been widely explored. We have designed, developed, and tested a "store-and-forward" solution at UMass Memorial Hospital and Beth Israel Deaconess Hospital whereby the plastic surgery residents who responded to a consult request transmitted digital photographs by means of the Internet to the attending physician on call. The customary telephone call between resident and attending physician benefited from the additional photographic data, and patient management resulted in a clear, concise, and unambiguous treatment plan. The initial management suggested by the resident was modified on some occasions, particularly with complex problems. The use of digital images was especially helpful for evaluation of radiographs and complex wounds of the hand and face. The solution proved to be very valuable for both attending physicians and residents in plastic surgery. The photographs provide rich detail and resolution comparable to high-quality prints. The mechanics of obtaining images and the process of sending them electronically was readily mastered. Images reached their destination in only a few minutes over standard telephone lines. No problems were encountered while sending or viewing images on Macintosh or Windows platforms. Determining course of action with a complete clinical history now includes a level of visual detail previously not available. As this application expands into wider use, data integrity and safety will have to be more formally secured and monitored. Our model of telemedicine has broad

  15. Sir William Arbuthnot Lane and His Contributions to Plastic Surgery.

    Science.gov (United States)

    Breakey, Richard William F; Mulliken, John B

    2015-07-01

    Surgical subspecialties were just emerging at the turn of the 20th Century, before this time, general surgeons had to adjust their operative skills to address disorders throughout the body. Sir William Arbuthnot Lane was a British surgeon, whose restless mind led him to wander throughout the field of general surgery and beyond. Although controversial, he advanced in the repair of cleft lip and palate, introduced the "no touch" operative technique, internal fixation of fractures, and is credited as the first surgeon to perform open massage of the heart. During The Great War, he established the British Plastic Surgery unit at Sidcup and delegated the care of facial and jaw injuries to young Major Harold Gillies. Lane later founded The New Health Society, an organization that stimulated the natural food movement. Sadly, in his latter years Lane's thinking drifted further away from with the times and his professional credibility waned. Nevertheless, Lane's variegated life is of sufficient interest to deserve reassessment.

  16. [Monitoring and conditioning in plastic and reconstructive ENT-surgery].

    Science.gov (United States)

    Dacho, A; Dietz, A

    2006-11-01

    Plastic and reconstructive ENT surgery serves for reconstruction of form and function. Frequent indications in ENT surgery are the covering of large tissue defects after tumor operations, firing and/or explosion injuries, accidents, burns or massive infections. A high revision rate of up to 20 % in selective patient groups show that more knowledge of both monitoring and ischemia-/reperfusion mechanisms is necessary. Besides improved monitor proceedings biochemical cell procedures in pedicled and free flaps are getting more focused. In the last years certain physical and medical factors appear, which have influence on the long-term surviving of a pedicled or free flap, e. g. pre- and/or postconditioning. The increasing knowledge of changes in perfusion and oxygenation, which prevail in the flap, as well as different options of physical and pharmacological therapies permit a promising view into the future, in order to achieve an improved surviving of a pedicled or free flap in combination with improved monitor proceedings.

  17. Mathematical Modeling of the Consumption of Low Invasive Plastic Surgery Practices: The Case of Spain

    OpenAIRE

    E. De la Poza; Alkasadi, M. S. S.; L. Jódar

    2013-01-01

    Plastic surgery practice grows continuously among the women in Western countries due to their body image dissatisfaction, aging anxiety, and an ideal body image propagated by the media. The consumption growth is so important that plastic surgery is becoming a normal practice among women, like any other cosmetic product, with the risk of suffering psychopathology disorders in the sense that plastic surgery could be employed as an instrument to recover personal self-esteem or even happiness. Pl...

  18. Journal impact factor versus the evidence level of articles published in plastic surgery journals.

    Science.gov (United States)

    Rodrigues, Maria A; Tedesco, Ana C B; Nahas, Fabio X; Ferreira, Lydia M

    2014-06-01

    The aim of this study was to assess the correlation between impact factor and the level of evidence of articles in plastic surgery journals. The four plastic surgery journals with the top impact factors in 2011 were selected. Articles were selected using the PubMed database between January 1 and December 31, 2011. The journal evidence index was calculated by dividing the number of randomized clinical trials by the total number of articles published in the specific journal, multiplied by 100. This index was correlated to the impact factor of the journal and compared with the average of the other journals. Two investigators independently evaluated each journal, followed by a consensus and assessment of the interexaminer concordance. The kappa test was used to evaluate the concordance between the two investigators and Fisher's exact test was used to evaluate which journal presented the highest number of randomized clinical trials. The journal evidence index values were as follows: Plastic and Reconstructive Surgery, 1.70; Journal of Plastic, Reconstructive and Aesthetic Surgery, 0.40; Aesthetic Plastic Surgery, 0.56; and Annals of Plastic Surgery, 0.35. The impact factors of these journals in 2011 were as follows: Plastic and Reconstructive Surgery, 3.382; Journal of Plastic, Reconstructive and Aesthetic Surgery, 1.494; Aesthetic Plastic Surgery, 1.407; and Annals of Plastic Surgery, 1.318. After consensus, the quantity of adequate studies was low and similar between these journals; only the journal Plastic and Reconstructive Surgery showed a higher journal evidence index. The journal Plastic and Reconstructive Surgery exhibited the highest journal evidence index and had the highest impact factor. The number of adequate articles was low in all of the assessed journals.

  19. Perioperative corticosteroids for preventing complications following facial plastic surgery

    Directory of Open Access Journals (Sweden)

    Edina Mariko Koga da Silva

    Full Text Available BACKGROUND:Early recovery is an important factor for people undergoing facial plastic. However, the normal inflammatory processes that are a consequence of surgery commonly cause oedema (swelling and ecchymosis (bruising, which are undesirable complications. Severe oedema and ecchymosis delay full recovery, and may make patients dissatisfied with procedures. Perioperative corticosteroids have been used in facial plastic surgery with the aim of preventing oedema and ecchymosis.OBJECTIVES:To determine the effects, including safety, of perioperative administration of corticosteroids for preventing complications following facial plastic surgery in adults.METHODS:Search strategy: In January 2014, we searched the following electronic databases: the Cochrane Wounds Group Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL (The Cochrane Library; Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations; Ovid Embase; EBSCO CINAHL; and Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS. There were no restrictions on the basis of date or language of publication. Selection criteria: We included RCTs that compared the administration of perioperative systemic corticosteroids with another intervention, no intervention or placebo in facial plastic surgery. ata collection and analysis: Two review authors independently screened the trials for inclusion in the review, appraised trial quality and extracted data.MAIN RESULTS: We included 10 trials, with a total of 422 participants, that addressed two of the outcomes of interest to this review: swelling (oedema and bruising (ecchymosis. Nine studies on rhinoplasty used a variety of different types, and doses, of corticosteroids. Overall, the results of the included studies showed that there is some evidence that perioperative administration of corticosteroids decreases formation of oedema over the first two postoperative days. Meta-analysis was only

  20. Decision aiding in plastic surgery: a multicriteria analysis

    Directory of Open Access Journals (Sweden)

    Luiz Flávio Autran Monteiro Gomes

    2012-08-01

    Full Text Available The aim of this article is to present, through a real case, a practical way, based on Multicriteria Decision Aiding, to support decision making in Plastic Surgery. The case studied was a Caucasian woman of 36 years of age with mammarian hypertrophia with ptosis and abdominal lipodystrophy, making it necessary to select the most adequate techniques for the best aesthetic result. For this purpose, the multicriteria methods Even Swaps and PrOACT were used. Three plastic surgeons working in the city of Rio de Janeiro with equivalent professional experience were consulted as decision agents. In order to define the objectives to be achieved, the criteria relevant to the making of the decision and the alternatives which could be used were identified. Throughout this identification and in the later analysis the surgeons participated in the application of the methods, which contributed towards facilitating their acceptance of the multicriteria analysis in their decision making. It was confirmed, in this case study, that the use of Multicriteria Decision Aiding tends to make the medical decision more wide ranging and, above all, transparent. The plastic surgeons themselves validated the analysis, considering it fully consistent with their professional experience.

  1. Publication misrepresentation among otolaryngology residency applicants.

    Science.gov (United States)

    Beswick, Daniel M; Man, Li-Xing; Johnston, Bruce A; Johnson, Jonas T; Schaitkin, Barry M

    2010-12-01

    To assess the extent of research publication misrepresentation among otolaryngology residency applicants and to determine applicant attributes associated with misrepresentation. Prospective study. A single otolaryngology residency program. Electronic Residency Application Service (ERAS) applications to the incoming 2010 class of an otolaryngology residency program were reviewed for peer-reviewed journal publications reported as "provisionally accepted," "accepted," or "in print." Publications were verified by searching PubMed, Google Scholar, and electronic journals. Applicants with remaining unverified publications were e-mailed before announcing interviews. Erroneously reported or unverifiable publications were considered misrepresented. There were 432 publications reported by 173 of 325 applicants (53.2%). Twenty-two publications (5.1%) were misrepresented by 17 applicants (9.8%). Contacting applicants verified 26 publications and identified 10 errors. Seven publications were inappropriately reported as provisionally accepted, three articles were not peer-reviewed, and applicants were erroneously listed as first author on two publications. Ten publications remained unverifiable. Multivariate logistic regression models showed that being an international medical graduate (P = 0.002) and male gender (P = 0.040) were predictors of misrepresentation after adjusting for potential confounders. Among international medical graduates alone, no attributes were associated with misrepresentation. All U.S. applicants with misrepresented publications were male (P = 0.033) and were from a medical school not ranked in the top 50 by U.S. News & World Report for research (P = 0.002) or primary care (P = 0.018). Misrepresentation of research experience exists among otolaryngology residency applicants. ERAS should develop standardized definitions for publication statuses to help reduce inadvertent misrepresentation. Copyright © 2010 American Academy of Otolaryngology-Head and Neck

  2. Current incidence of duplicate publication in otolaryngology.

    Science.gov (United States)

    Cheung, Veronique Wan Fook; Lam, Gilbert O A; Wang, Yun Fan; Chadha, Neil K

    2014-03-01

    Duplicate publication--deemed highly unethical--is the reproduction of substantial content in another article by the same authors. In 1999, Rosenthal et al. identified an 8.5% incidence of duplicate articles in two otolaryngology journals. We explored the current incidence in three otolaryngology journals in North America and Europe. Retrospective literature review. Index articles in 2008 in Archives of Otolaryngology-Head and Neck Surgery, Laryngoscope, and Clinical Otolaryngology were searched using MEDLINE. Potential duplicate publications in 2006 through 2010 were identified using the first, second, and last authors' names. Three authors independently investigated suspected duplicate publications--classifying them by degree of duplication. Of 358 index articles screened, 75 (20.9%) had 119 potential duplicates from 2006 to 2010. Full review of these 119 potential duplicates revealed a total of 40 articles with some form of redundancy (33.6% of the potential duplicates) involving 27 index articles (7.5% of 358 index articles); one (0.8%) "dual" publication (identical or nearly identical data and conclusions to the index article); three (2.5%) "suspected" dual publications (less than 50% new data and same conclusions); and 36 (30.3%) publications with "salami-slicing" (portion of the index article data repeated) were obtained. Further analysis compared the likelihood of duplicate publication by study source and subspecialty within otolaryngology. The incidence of duplicate publication has not significantly changed over 10 years. "Salami-slicing" was a concerning practice, with no cross-referencing in 61% of these cases. Detecting and eliminating redundant publications is a laborious task, but it is essential in upholding the journal quality and research integrity. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  3. Declining Otolaryngology Resident Training Experience in Tracheostomies: Case Log Trends from 2005 to 2015.

    Science.gov (United States)

    Lesko, David; Showmaker, Jason; Ukatu, Ceisha; Wu, Qiwei; Chang, C W David

    2017-06-01

    Objective To evaluate recent tracheostomy surgical experience among otolaryngology residents and general surgery residents. Study Design Retrospective database review. Setting Accreditation Council for Graduate Medical Education otolaryngology and general surgery programs. Subjects and Methods Accreditation Council for Graduate Medical Education case log data from 2005 to 2015 for resident graduates in otolaryngology and general surgery were used to obtain mean graduate tracheostomy numbers, mean graduate composite case numbers, and number of graduating residents. Market share for each specialty was estimated through the derived metric of nationwide total tracheostomy graduate experience, calculated by multiplying the number of graduating residents by the mean number of graduate tracheostomies. Linear regression analysis was used to calculate trends. Multiple linear regression analysis was used for pairwise comparison of trends. Results From 2005 to 2015, mean graduate tracheostomy numbers for otolaryngology residents declined 2.3% per year, while those for general surgery residents increased 1.8% per year. Accounting for changes in number of resident graduates, market share of tracheostomy decreased 1.0% per year for otolaryngology and increased 3.0% per year for general surgery. Mean graduate composite case numbers increased significantly by 1.8% and 1.0% per year for otolaryngology and general surgery residents, respectively. Conclusion Tracheostomy case volume in otolaryngology residency has decreased steadily in comparison with general surgery residency. However, current otolaryngology graduates have more experience in tracheostomy when compared with general surgery graduates. While otolaryngology residents have excellent exposure to tracheostomy, otolaryngology programs should be made aware of this declining trend as well as changing procedural trends, which may affect training needs.

  4. [Photography in plastic surgery: practices, uses and legislation].

    Science.gov (United States)

    de Runz, A; Simon, E; Brix, M; Sorin, T; Brengard-Bresler, T; Pineau, V; Guyon, G; Claudot, F

    2015-02-01

    Photography in plastic surgery is omnipresent. Through its various uses, it may present both ethical and forensic risks. The objective of this study is to analyze the use of medical photography by the plastic surgeon, the perception of this use by the patient, and consequence of such use. A questionnaire about the use of medical photography was assessed to 629 plastic surgeons. A questionnaire was given to patients, about their perception of the use of photography by their surgeon. One hundred and seventy-six surgeon's questionnaires and 93 patient's questionnaires were analyzed. For 97.7% of the responding surgeons, the proportion of patients refusing to be photographed was less then 1/20. The objective of the photography was especially medicolegal for 62.5% of the surgeons, especially for following the patient progress (87.5%), partially for the formation (72.1%), partially for scientific publications (57.8%) and not at all for the personal publicity (73.1%). Surgeons often share his photographs with others surgeons (71.1%), sometimes with others medical personnel (48.8%). The security and the access to photographs were determined to be correct for 67.6% of the surgeons and perfect for 23.3%. In total, 17.2% of the surgeons obtained a written consent, 41.4% obtained an oral consent, and 38.5% did not request patient consent. It was found that 48.3% of the surgeons and 40.2% of the patients think that the right to the photographic images belong to the patient. Medical photographs expose the plastic surgeon to medico-legal risks. He must know and follow the law in order to prevent eventual legal proceedings. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Knowledge and perception of plastic surgery among tertiary education students in Enugu, South-East Nigeria.

    Science.gov (United States)

    Isiguzo, C M; Nwachukwu, C D

    2016-01-01

    Knowledge, perception, and acceptance of plastic surgery among any population are influenced by channel of presentation. A good understanding of the public awareness will define the way plastic surgery services will be provided. To assess the knowledge, awareness of availability, and acceptance of plastic surgery practice in Enugu, South East Nigeria. A questionnaire-based prospective study. The electronic media is the most common medium of awareness. Less than half the sample knew about the existence of plastic surgeons in Enugu even though a large proportion was aware of the existence of plastic surgery as a specialty. The concentration of plastic surgeons in a center is directly related to awareness of plastic surgery services in that facility. The most common esthetic procedure done by a plastic surgeon in Enugu is tattoo removal and scar refashioning. Orthopedic surgeons are thought to be key players in the management of burn patients as much as the plastic surgeons due to the "SIGNPOST EFFECT." The level of awareness is high in the sampled population with associated increase in acceptance of its practice and willing utilization. All public hospitals should be encouraged to employ the services of plastic surgeons. Appropriate branding of specialized hospitals where plastic surgery service is available will advance the practice significantly.

  6. WHO Surgical Checklist and Its Practical Application in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Shady Abdel-Rehim

    2011-01-01

    Full Text Available The WHO surgical checklist was introduced to most UK surgical units following the WHO “Safe Surgery Saves Lives” initiative. The aim of this audit was to review patient's safety in the delivery of surgical care and to evaluate the practical application of the new WHO surgical checklist. We conducted a retrospective audit of patients who received operative treatment under general anaesthesia at our Plastic Surgery Department, involving a total number of 90 patients. The WHO form was compared to its former equivalents. Complications or incidents occurring during or after surgery were recorded. Using the department's previous surgical checklist, “Time out” was only performed in only 30% of cases. One patient arrived at theatre reception without a completed consent form, and two clinical incidents were reported without patients suffering harm. Following introduction of current WHO surgical checklist, “Time out” was recorded in 80% of cases. In all cases, the new WHO surgical checklist was used and no incidents were reported. The WHO surgical checklist provides a structured frame work that standardizes the delivery of care across hospitals and specialized units; however, it will take some time and practice for teams to learn to use the checklist effectively and reliably.

  7. How should unmatched otolaryngology applicants proceed?

    Science.gov (United States)

    Schwan, Josianna; Abaza, Mona; Cabrera-Muffly, Cristina

    2015-10-01

    To determine the attitudes of otolaryngology residency program directors and chairpersons toward unmatched residency applicants, including whether a surgical internship or research year is preferred in considering repeat applicants. Cross-sectional survey. Approval was obtained from the Colorado Multiple Institution Review Board. A 12-question Web-based survey was sent to otolaryngology residency program directors and chairpersons three times over a 6-week period. Responses collected from respondents were anonymous, with no identifying characteristics. Forty-five percent of those contacted responded to the survey. The most commonly recommended course of action for an unmatched applicant was completion of a general surgery intern year (43%) or a year of research (31%). Program directors were more likely than chairpersons to recommend a year of research (P value 0.014). Ninety-seven percent of the respondents felt it was important or essential to obtain new letters of recommendation. Respondents ranked poor interview skills as the most common reason for applicants remaining unmatched (29%). Otolaryngology residency match is even more competitive for previously unmatched applicants. Unmatched applicants should be advised to proceed with either a research year or postgraduate year 1 general surgery year. Before applying again, applicants should obtain new letters of recommendation, and the importance of improving poor interviewing skills should be emphasized by advisors. N/A. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  8. Detecting Tweet-Based Sentiment Polarity of Plastic Surgery Treatment

    Directory of Open Access Journals (Sweden)

    Marvi Jokhio

    2015-10-01

    Full Text Available Sentiment analysis is a growing research these days. Many companies perform this analysis on public opinions to get a general idea about any product or service. This paper presents a novel approach to get views or comments of Twitter users about plastic surgery treatments. The proposed approach uses machine-learning technique embedded with the naïve Bayesian classifier to assign polarities (i.e. positive, negative or neutral to the tweets, collected from ?Twitter micro-blogging website?. The accuracy of the obtained results has been validated using precision, recall and F-score measures. It has been observed from 25000 tweets dataset that people tend to have positive as well as substantial negative opinions regarding particular treatments. The experimental results show the effectiveness of the proposed approach

  9. Plastic surgery within the Veterans Affairs Medical System: proposed modified indications for operative procedures.

    Science.gov (United States)

    Erdmann, Detlev; Pradka, Sarah P; Similie, Ernest; Marcus, Jeffrey R; Moyer, Kurtis E; Shelburne, John D; Tyler, Douglas S; Levin, Scott L

    2009-07-01

    Many plastic surgery procedures span the divide between aesthetic ("cosmetic") and reconstructive surgery. However, definitions and guidelines may be inconsistent, which may decrease patients' access to legitimate procedures. The article aims to assist Veterans' Health Administration-affiliated plastic surgeons in continuing to provide optimal care to the Nation's Veterans and family members, and should be regarded as an open discussion.

  10. Plastic Surgery Intervention with Down Syndrome Persons: Summary of a Conference.

    Science.gov (United States)

    Exceptional Parent, 1983

    1983-01-01

    The article discusses the role of plastic surgery for persons with Down Syndrome, as considered in a recent conference. The functions of team plastic surgery, importance of intensive speech therapy, and the question of ultimate therapeutic value are among questions considered. (CL)

  11. Cloud-Based Applications for Organizing and Reviewing Plastic Surgery Content.

    Science.gov (United States)

    Luan, Anna; Momeni, Arash; Lee, Gordon K; Galvez, Michael G

    2015-01-01

    Cloud-based applications including Box, Dropbox, Google Drive, Evernote, Notability, and Zotero are available for smartphones, tablets, and laptops and have revolutionized the manner in which medical students and surgeons read and utilize plastic surgery literature. Here we provide an overview of the use of Cloud computing in practice and propose an algorithm for organizing the vast amount of plastic surgery literature. Given the incredible amount of data being produced in plastic surgery and other surgical subspecialties, it is prudent for plastic surgeons to lead the process of providing solutions for the efficient organization and effective integration of the ever-increasing data into clinical practice.

  12. Malignant Hyperthermia in Dental and Facial Plastic surgeries

    Directory of Open Access Journals (Sweden)

    Ramin Maheri

    2015-04-01

    Full Text Available Preoperative evaluation of the patients scheduled for ambulatory surgery is of great importance in regards of both surgery and anesthesia considerations. Malignant Hyperthermia (MH is a pharmacogenetic clinical syndrome which mostly arises from volatile anesthesia with halothane and the depolarizing muscle relaxant succinylcholine. Clinical manifestations of MH are acidosis and rhabdomyolysis which occur following uncontrolled increases in skeletal muscle metabolism and rapidly increasing body temperature (by as much as 1°C/5 min (1. Primary cases of MH were reported to be of a 70% mortality rate; however, thanks to the emergence of diagnostic tools such as end-expired carbon dioxide and the administration of dantrolene, this rate has decreased to less than 5%.      MH might occur even in those with no previous or familial history. Even a safe history of the previous surgery under the administration of MH triggering agents cannot guarantee a next safe surgery. A noteworthy point in the preoperative evaluation is the probable association of MH with certain musculoskeletal disorders including Duchenne, Becker, and myotonic muscular dystrophies, strabismus, osteogenesis imperfecta, ptosis, myelomeningocele, kyphoscoliosis, King-Denborough syndrome, periodic paralysis, hernias, marfanoid syndrome, and central core disease (1. These diseases are frequently encountered by dental and facial plastic surgeons and having the knowledge of the probable association between MH and these conditions could aware the dental and facial plastic surgeons and the anesthesiologists to be more vigilant.      Although MH workup leads to the definite diagnosis, no convincing intraoperative diagnostic tool has been introduced so far. Masseter spasm is a condition which might follow administration of depolarizing neuromuscular blocking agents due to the slow tonic fibers of masseter and lateral pterygoid muscles (2-4. The severer forms of masseter spasm would

  13. Academic plastic surgery: a study of current issues and future challenges.

    Science.gov (United States)

    Zetrenne, Eleonore; Kosins, Aaron M; Wirth, Garrett A; Bui, Albert; Evans, Gregory R D; Wells, James H

    2008-06-01

    The objectives of this study were (1) to evaluate the role of a full-time academic plastic surgeon, (2) to define the indicators predictive of a successful career in academic plastic surgery, and (3) to understand the current issues that will affect future trends in the practice of academic plastic surgery. A questionnaire was developed to evaluate the role of current full-time academic plastic surgeons and to understand the current issues and future challenges facing academic plastic surgery. Each plastic surgery program director in the United States was sent the survey for distribution among all full-time academic plastic surgeons. Over a 6-week period, responses from 143 full-time academic plastic surgeons (approximately 31%) were returned. Fifty-three percent of respondents had been academic plastic surgeons for longer than 10 years. Seventy-three percent of respondents defined academic plastic surgeons as clinicians who are teachers and researchers. However, 53% of respondents believed that academic plastic surgeons were not required to teach or practice within university hospitals/academic centers. The 3 factors reported most frequently as indicative of a successful career in academic plastic surgery were peer recognition, personal satisfaction, and program reputation. Dedication and motivation were the personal characteristics rated most likely to contribute to academic success. Forty-four percent of respondents were unable to identify future academic plastic surgeons from plastic surgery residency applicants, and 27% were not sure. Most (93%) of the respondents believed that academic surgery as practiced today will change. The overall job description of a full-time academic plastic surgeon remains unchanged (teacher and researcher). Whereas peer recognition, personal satisfaction, and program reputation were most frequently cited as indicative of a successful plastic surgery career, financial success was rated the least indicative. Similarly, whereas the

  14. Mathematical Modeling of the Consumption of Low Invasive Plastic Surgery Practices: The Case of Spain

    Directory of Open Access Journals (Sweden)

    E. De la Poza

    2013-01-01

    Full Text Available Plastic surgery practice grows continuously among the women in Western countries due to their body image dissatisfaction, aging anxiety, and an ideal body image propagated by the media. The consumption growth is so important that plastic surgery is becoming a normal practice among women, like any other cosmetic product, with the risk of suffering psychopathology disorders in the sense that plastic surgery could be employed as an instrument to recover personal self-esteem or even happiness. Plastic surgery practice depends on economic, demographic, and social contagion factors. In this paper, a mathematical epidemiological model to forecast female plastic surgery consumption in Spain is fully constructed. Overconsumer subpopulation is predicted and simulated. Robustness of the model versus uncertain parameters is studied throughout a sensitivity analysis.

  15. The Evolution of Photography and Three-Dimensional Imaging in Plastic Surgery.

    Science.gov (United States)

    Weissler, Jason M; Stern, Carrie S; Schreiber, Jillian E; Amirlak, Bardia; Tepper, Oren M

    2017-03-01

    Throughout history, the technological advancements of conventional clinical photography in plastic surgery have not only refined the methods available to the plastic surgeon, but have invigorated the profession through technology. The technology of the once traditional two-dimensional photograph has since been revolutionized and refashioned to incorporate novel applications, which have since become the standard in clinical photography. Contrary to traditional standardized two-dimensional photographs, three-dimensional photography provides the surgeon with an invaluable volumetric and morphologic analysis by demonstrating true surface dimensions both preoperatively and postoperatively. Clinical photography has served as one of the fundamental objective means by which plastic surgeons review outcomes; however, the newer three-dimensional technology has been primarily used to enhance the preoperative consultation with surgical simulations. The authors intend to familiarize readers with the notion that three-dimensional photography extends well beyond its marketing application during surgical consultation. For the cosmetic surgeon, as the application of three-dimensional photography continues to mature in facial plastic surgery, it will continue to bypass the dated conventional photographic methods plastic surgeons once relied on. This article reviews a paradigm shift and provides a historical review of the fascinating evolution of photography in plastic surgery by highlighting the clinical utility of three-dimensional photography as an adjunct to plastic and reconstructive surgery practices. As three-dimensional photographic technology continues to evolve, its application in facial plastic surgery will provide an opportunity for a new objective standard in plastic surgery.

  16. The impact of advancing age on postoperative outcomes in plastic surgery.

    Science.gov (United States)

    Shih, Kevin; De Oliveira, Gildasio S; Qin, Charles; Kim, John Y

    2015-11-01

    Age has been shown to be an independent predictor of complications in general surgery patients. In contrast, the effect of age on outcomes after plastic surgery has yet to be confirmed or refuted. The objective of the current investigation was to evaluate a possible association between age and postoperative outcomes after plastic surgery. The 2005-2012 NSQIP database was retrospectively reviewed for all patients undergoing plastic surgery. Patients ≥60 years with procedures under the category of plastic surgery in NSQIP were selected for analysis. The primary outcome of interest was 30-day overall complication rates. Multivariate regression models were constructed to control for potential perioperative confounders. Of the 2,320,920 patients captured in the NSQIP database, 36,819 patients underwent plastic surgery and met inclusion criteria. The incidence of unadjusted overall complications increased with age with an overall complication rate of 9.0% in patients plastic surgery. Medical complications and mortality were more likely in extremes of age (>80 years). Age alone should not be included as a decisional factor in patients plastic surgery.

  17. Learning styles in otolaryngology fellowships.

    Science.gov (United States)

    Varela, David A Diaz Voss; Malik, Mohammad U; Laeeq, Kulsoom; Pandian, Vinciya; Brown, David J; Weatherly, Robert A; Cummings, Charles W; Bhatti, Nasir I

    2011-12-01

    Previous studies have identified a predominant learning style in trainees from different specialties, more recently in otolaryngology residents. The purpose of our study was to determine a predominant learning style within otolaryngology fellowships and to identify any differences between otolaryngology fellows and residents. We conducted a survey of otolaryngology fellows at 25 otolaryngology fellowship programs accredited by the Accreditation Council for Graduate Medical Education. We emailed Kolb's Learning Style Index version 3.1 to 16 pediatric otolaryngology (PO) and 24 otology/neurotology (ON) fellows. This index is a widely used 12-item questionnaire. The participants answered each item in the questionnaire as it applied to their preferred learning style: accommodating, converging, diverging, or assimilating. Results were then analyzed and compared between each subspecialty and the previously reported preferred styles of otolaryngology residents. Ten PO and 20 ON fellows completed the survey, with an overall response rate of 75%. PO and ON fellows (60% of each group) preferred a learning style that was "balanced" across all four styles. For ON fellows, 35% preferred converging and 5% preferred accommodating styles. For PO fellows, converging and accommodating styles accounted for 20% each. It was previously reported that 74.4% of otolaryngology residents prefer either converging or accommodating styles. We believe that the fellowship training environment calls for fellows to use more than one learning style to become proficient physicians, hence the trend toward potentially developing a balanced style when at this level. Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.

  18. Canary in a coal mine: does the plastic surgery market predict the american economy?

    Science.gov (United States)

    Wong, Wendy W; Davis, Drew G; Son, Andrew K; Camp, Matthew C; Gupta, Subhas C

    2010-08-01

    Economic tools have been used in the past to predict the trends in plastic surgery procedures. Since 1992, U.S. cosmetic surgery volumes have increased overall, but the exact relationship between economic downturns and procedural volumes remains elusive. If an economic predicting role can be established from plastic surgery indicators, this could prove to be a very powerful tool. A rolling 3-month revenue average of an eight-plastic surgeon practice and various economic indicators were plotted and compared. An investigation of the U.S. procedural volumes was performed from the American Society of Plastic Surgeons statistics between 1996 and 2008. The correlations of different economic variables with plastic surgery volumes were evaluated. Lastly, search term frequencies were examined from 2004 to July of 2009 to study potential patient interest in major plastic surgery procedures. The self-payment revenue of the plastic surgery group consistently proved indicative of the market trends approximately 1 month in advance. The Standard and Poor's 500, Dow Jones Industrial Average, National Association of Securities Dealers Automated Quotations, and Standard and Poor's Retail Index demonstrated a very close relationship with the income of our plastic surgery group. The frequency of Internet search terms showed a constant level of interest in the patient population despite economic downturns. The data demonstrate that examining plastic surgery revenue can be a useful tool to analyze and possibly predict trends, as it is driven by a market and shows a close correlation to many leading economic indicators. The persisting and increasing interest in plastic surgery suggests hope for a recovering and successful market in the near future.

  19. Psychological change after aesthetic plastic surgery: a prospective controlled outcome study.

    Science.gov (United States)

    Moss, Timothy P; Harris, David L

    2009-10-01

    Aesthetic plastic surgery has been long practiced for primarily psychological rather than physical benefit to patients. However, evaluation of the psychological impact of aesthetic plastic surgery has often been of limited methodological rigor in both study design and appropriate measurement. This study is intended to evaluate the psychological impact of aesthetic surgery on patients seeking such intervention in regard to concerns about breasts, nose or upper limbs using standardised psychometric instruments. Participants were recruited through the Plastic Surgery Unit (Patients) and general surgery, ENT surgery and Maxillo-facial surgery (Comparisons) at a UK General Hospital. Outcome measures included the Crown-Crisp Experiential Inventory anxiety scale, Beck Depression Inventory and Derriford Appearance Scale-24, a valid and reliable measure of distress and dysfunction in relation to self-consciousness of appearance. Data were collected pre-operatively (T1) and 3 months post-operatively (T2) for both groups. Longitudinal appearance adjustment for the plastic surgery group was also assessed at 12 months (T3). Both groups were less depressed and anxious post-operatively. The improvement in anxiety was significantly greater in the plastic surgery group. Body site specific appearance distress was significantly improved for the plastics group only, and the level of improvement was related to the body site affected.

  20. Nose Surgery

    Science.gov (United States)

    ... Patient Health Home Copyright © 2017 American Academy of Otolaryngology–Head and Neck Surgery. Reproduction or republication strictly ... Terms of Use © Copyright 2017. American Academy of Otolaryngology — Head and Neck Surgery 1650 Diagonal Rd Alexandria, ...

  1. 21 CFR 878.4810 - Laser surgical instrument for use in general and plastic surgery and in dermatology.

    Science.gov (United States)

    2010-04-01

    ... plastic surgery and in dermatology. 878.4810 Section 878.4810 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GENERAL AND PLASTIC SURGERY DEVICES Surgical Devices § 878.4810 Laser surgical instrument for use in general and plastic surgery and...

  2. 76 FR 42713 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Science.gov (United States)

    2011-07-19

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting was... of the General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee would be...

  3. Plastic Surgery on Children with Down Syndrome: Parents' Perceptions of Physical, Personal, and Social Functioning.

    Science.gov (United States)

    Kravetz, Shlomo; And Others

    1992-01-01

    This study compared perceptions of parents of 19 children with Down's syndrome (DS) who had undergone plastic facial surgery with perceptions of parents of DS children who had not received surgery. The comparison found little evidence of positive impact of the surgery on parents' perceptions of their children's physical, personal, and social…

  4. Reaching Our Successors: Millennial Generation Medical Students and Plastic Surgery as a Career Choice

    Science.gov (United States)

    Ibrahim, Abdulrasheed; Asuku, Malachy E

    2016-01-01

    Background: Research shows that career choices are made as a result of preconceived ideas and exposure to a specialty. If plastic surgery is to continue to attract the best, factors that may dissuade the millennial generation medical students from pursuing plastic surgery as a career must be identified and addressed. We explored the determinants of interest in plastic surgery as a career choice amongst millennial generation medical students. Materials and Methods: A survey regarding factors considered important in choosing plastic surgery was conducted amongst final year medical students in September 2011. Participants were asked to rate their agreement or disagreement with 18 statements on a four-point Likert scale (1 = very unimportant; 4 = very important). Statistical analyses were performed using Chi-square test to compare categorical variables between male and female medical students. Values of P 3.0 was seen in all the subscales except in gender equity and life style concerns. There were statistically significant differences between male and female students in opinions of a spouse, a significant other, or family members in choosing plastic surgery P < 0.5 and my choice of plastic surgery will be influenced by my decision to have a family P < 0.5. Conclusion: Factors influencing the decision of medical students to choose plastic surgery were related to the perceived quality of life as a plastic surgeon and the ability of plastic surgeons to provide good role models for medical students. Female medical students were more concerned with gender equity and work-life balance in selecting plastic surgery compared to male medical students. PMID:27013852

  5. Reaching Our Successors: Millennial Generation Medical Students and Plastic Surgery as a Career Choice

    Directory of Open Access Journals (Sweden)

    Abdulrasheed Ibrahim

    2016-01-01

    Full Text Available Background: Research shows that career choices are made as a result of preconceived ideas and exposure to a specialty. If plastic surgery is to continue to attract the best, factors that may dissuade the millennial generation medical students from pursuing plastic surgery as a career must be identified and addressed. We explored the determinants of interest in plastic surgery as a career choice amongst millennial generation medical students. Materials and Methods: A survey regarding factors considered important in choosing plastic surgery was conducted amongst final year medical students in September 2011. Participants were asked to rate their agreement or disagreement with 18 statements on a four-point Likert scale (1 = very unimportant; 4 = very important. Statistical analyses were performed using Chi-square test to compare categorical variables between male and female medical students. Values of P 3.0 was seen in all the subscales except in gender equity and life style concerns. There were statistically significant differences between male and female students in opinions of a spouse, a significant other, or family members in choosing plastic surgery P < 0.5 and my choice of plastic surgery will be influenced by my decision to have a family P < 0.5. Conclusion: Factors influencing the decision of medical students to choose plastic surgery were related to the perceived quality of life as a plastic surgeon and the ability of plastic surgeons to provide good role models for medical students. Female medical students were more concerned with gender equity and work-life balance in selecting plastic surgery compared to male medical students.

  6. Reaching Our Successors: Millennial Generation Medical Students and Plastic Surgery as a Career Choice.

    Science.gov (United States)

    Ibrahim, Abdulrasheed; Asuku, Malachy E

    2016-01-01

    Research shows that career choices are made as a result of preconceived ideas and exposure to a specialty. If plastic surgery is to continue to attract the best, factors that may dissuade the millennial generation medical students from pursuing plastic surgery as a career must be identified and addressed. We explored the determinants of interest in plastic surgery as a career choice amongst millennial generation medical students. A survey regarding factors considered important in choosing plastic surgery was conducted amongst final year medical students in September 2011. Participants were asked to rate their agreement or disagreement with 18 statements on a four-point Likert scale (1 = very unimportant; 4 = very important). Statistical analyses were performed using Chi-square test to compare categorical variables between male and female medical students. Values of P 3.0 was seen in all the subscales except in gender equity and life style concerns. There were statistically significant differences between male and female students in opinions of a spouse, a significant other, or family members in choosing plastic surgery P < 0.5 and my choice of plastic surgery will be influenced by my decision to have a family P < 0.5. Factors influencing the decision of medical students to choose plastic surgery were related to the perceived quality of life as a plastic surgeon and the ability of plastic surgeons to provide good role models for medical students. Female medical students were more concerned with gender equity and work-life balance in selecting plastic surgery compared to male medical students.

  7. Coblation in otolaryngology

    Science.gov (United States)

    Woloszko, Jean; Kwende, Martin; Stalder, Kenneth R.

    2003-06-01

    Coblation is a unique method of delivering radiofrequency energy to soft tissue for applications in Otolaryngology (ENT). Using radiofrequency in a bipolar mode with a conductive solution, such as saline. Coblation energizes the ions in the saline to form a localized plasma near the target tissue. The plasma has enough energy to dissociate water molecules from the saline, as well as ionizing the saline salt species, thus forming chemical conditions leading to the breaking of the tissue's molecular bonds. Energetic electrons in the plasma also possess enough energy to directly dissociate tissue chemical bonds. The overall effect results in tissue ablation and localized removal or reduction of tissue volume. The heat dissipated in the process, aided by continual cooling from the surrounding saline solution, produces tissue temperature raises of approximately 45 - 85°C, significantly lower than traditional radio-frequency techniques. Coblation has been used for Otolaryngological applications such as Uvulopalatopharyngoplasty (UPPP), tonsillectomy, turbinate reduction, palate reduction, base of tongue reduction and various Head and Neck cancer procedures. The decreased thermal effect of Coblation has led to less pain and faster recovery for cases where tissue is excised. Several clinical studies have shown the benefits of using Coblation for both extra and intra-capsular tonsillectomy.

  8. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena Felicia; Rose, Michael; Bentzon, Niels;

    2015-01-01

    INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level...... surgeons and 22 plastic surgeons; the response rate was 67%. All breast surgery units had an established cooperation with plastic surgeons. Most breast surgeons used unilateral displacement techniques; plastic surgeons also included breast reduction techniques and replacement with local flaps. Almost all...

  9. The Evolution of Surgical Simulation: The Current State and Future Avenues for Plastic Surgery Education.

    Science.gov (United States)

    Kazan, Roy; Cyr, Shantale; Hemmerling, Thomas M; Lin, Samuel J; Gilardino, Mirko S

    2017-02-01

    Alongside the ongoing evolution of surgical training toward a competency-based paradigm has come the need to reevaluate the role of surgical simulation in residency. Simulators offer the ability for trainees to acquire specific skills and for educators to objectively assess the progressive development of these skills. In this article, the authors discuss the historical evolution of surgical simulation, with a particular focus on its past and present role in plastic surgery education. The authors also discuss the future steps required to further advance plastic surgery simulation in an effort to continue to train highly competent plastic surgery graduates.

  10. Post-operative brachial plexus neuropraxia: A less recognised complication of combined plastic and laparoscopic surgeries

    Directory of Open Access Journals (Sweden)

    Jimmy Thomas

    2014-01-01

    Full Text Available This presentation is to increase awareness of the potential for brachial plexus injury during prolonged combined plastic surgery procedures. A case of brachial plexus neuropraxia in a 26-year-old obese patient following a prolonged combined plastic surgery procedure was encountered. Nerve palsy due to faulty positioning on the operating table is commonly seen over the elbow and popliteal fossa. However, injury to the brachial plexus has been a recently reported phenomenon due to the increasing number of laparoscopic and robotic procedures. Brachial plexus injury needs to be recognised as a potential complication of prolonged combined plastic surgery. Preventive measures are discussed.

  11. Surgisis acellular collagen matrix in aesthetic and reconstructive plastic surgery soft tissue applications.

    Science.gov (United States)

    Centeno, Robert F

    2009-04-01

    Tissue engineering in aesthetic and reconstructive plastic surgery remains an elusive goal. The advent of Surgisis extracellular collagen matrix and its performance characteristics suggest that the use of a bioengineered tissue substitute can meet some of our reconstructive requirements. Incorporation and replacement by host tissue with minimal allergic or immune response seems to be achievable today. The ability to engineer the device, the ready availability of substrate, and its cost effectiveness support the use of Surgisis in aesthetic and reconstructive plastic surgery applications. Future product innovations and engineering seem promising. The permanent role of Surgisis in aesthetic and reconstructive plastic surgery will be determined by its documented long-term performance.

  12. The bioethics of separating conjoined twins in plastic surgery.

    Science.gov (United States)

    Lee, Michelle; Gosain, Arun K; Becker, Devra

    2011-10-01

    The incidence of craniopagus twins approximates four to six per 10 million births. Although rare, surgical separation of conjoined twins poses significant technical and ethical challenges. The present report uses the case of craniopagus twins AD and TD to examine the bioethical issues faced by a multidisciplinary medical team in planning the separation of craniopagus twins. AD and TD are craniopagus twins conjoined at the head. TD's head is conjoined to the back of AD's head. Neurologically, AD has the dominant cerebral circulation. TD has two normal kidneys, whereas AD has none. AD depends on TD's renal function and, on separation, will require either a kidney transplant or lifelong dialysis. This case report reviews one approach to analyzing and solving complex ethical dilemmas in pediatric plastic surgery. The principles reviewed are (1) autonomy and informed consent, focusing especially on the role of children in the informed consent process; (2) beneficence and nonmaleficence, two intricately intertwined principles because separation could potentially cause irreversible harm to one twin while improving the quality of life for the other (as separation is not a life-saving procedure, is it ethical to perform a procedure with unknown surgical risk to improve children's quality of life?); and (3) justice (is it fair to allocate excessive medical resources for the twins' separation?). The present report explores the ethics behind such decisions with respect to the separation of conjoined twins.

  13. Plastic surgery trends parallel Playboy magazine: the pudenda preoccupation.

    Science.gov (United States)

    Placik, Otto J; Arkins, John P

    2014-09-01

    Aesthetic vulvovaginal procedures are being performed with increased frequency. Many experts have suggested that the growing demand for these procedures relates to the availability and revealing nature of nude images on the Internet and in other media. The authors examined chronologically organized nude photographs from a popular magazine and objectively measured the position of the vulva relative to the center of focus to observe trends for the past 6 decades. Playboy magazine centerfold photographs from 1954 to 2013 were analyzed and categorized. The positions of the vaginal area (V-line) and the breast area (N-line) were measured in relation to the horizontal midline of the photograph. Images also were assessed for degree of grooming and exposure of the breast and pubic areas, as well as visibility of the pudendal cleft, labia majora, and labia minora. Four hundred ninety images met inclusion criteria for the analysis. Full exposure of the V-line increased from 0 instances in the 1950s to 78.6% of images from 2010 through 2013 (P<.001). Moreover, the V-line position became 41.0% closer to the photographic midline (P=.045). The results demonstrate a trend toward increased visibility and prominence of the female genitalia as the focal point of popular nude photographs. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

  14. Evaluation of plastic surgery information on the Internet.

    Science.gov (United States)

    Jejurikar, Sameer S; Rovak, Jason M; Kuzon, William M; Chung, Kevin C; Kotsis, Sandra V; Cederna, Paul S

    2002-11-01

    The Internet allows vast access to medical information. Unlike most plastic surgery literature, the Internet is a quagmire of unfiltered information, not subject to peer review. To assess the accuracy of medical information on the Internet the authors studied one commonly performed elective procedure, classifying and defining the information retrieved. Using the keyword "breast augmentation," the authors compiled a list of the first 300 web sites, obtained from six distinct search engines, yielding 215 unique sites. They devised an instrument to evaluate each site for its accessibility, relevance, and accuracy. Of the 215 unique web sites evaluated, 20 were inaccessible, 24 were irrelevant, and 41 contained no medical information. Of the remaining 130 sites, almost 34% contained false or misleading information. Errors pertained most often to the technical details of the operation, potential benefits, and risks. In addition, exaggerated claims concerning alternative breast enhancement regimens, adverse sequelae of silicone breast implants, and potential effects on lactation were also seen commonly. A considerable amount of information regarding breast augmentation on the Internet was either misleading or inaccurate. Physicians can assist their patients with specific guidelines to allow them to process information discerningly, thereby diminishing the likelihood that medical decisions are based on misinformation.

  15. Medical tourism in plastic surgery: ethical guidelines and practice standards for perioperative care.

    Science.gov (United States)

    Iorio, Matthew L; Verma, Kapil; Ashktorab, Samaneh; Davison, Steven P

    2014-06-01

    The goal of this review was to identify the safety and medical care issues that surround the management of patients who had previously undergone medical care through tourism medicine. Medical tourism in plastic surgery occurs via three main referral patterns: macrotourism, in which a patient receives treatments abroad; microtourism, in which a patient undergoes a procedure by a distant plastic surgeon but requires postoperative and/or long-term management by a local plastic surgeon; and specialty tourism, in which a patient receives plastic surgery from a non-plastic surgeon. The ethical practice guidelines of the American Medical Association, International Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and American Board of Plastic Surgeons were reviewed with respect to patient care and the practice of medical tourism. Safe and responsible care should start prior to surgery, with communication and postoperative planning between the treating physician and the accepting physician. Complications can arise at any time; however, it is the duty and ethical responsibility of plastic surgeons to prevent unnecessary complications following tourism medicine by adequately counseling patients, defining perioperative treatment protocols, and reporting complications to regional and specialty-specific governing bodies. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  16. Training and Simulation in Otolaryngology

    Science.gov (United States)

    Wiet, Gregory J.; Stredney, Don; Wan, Dinah

    2011-01-01

    This article focuses on key issues surrounding the needs and application of simulation technologies for technical skills training in otolaryngology. The discussion includes an overview of key topics in training and learning, the application of these issues in simulation environments, and the subsequent applications of these simulation environments to the field of otolaryngology. Examples of past applications are presented, with discussion of how the interplay of cultural changes in surgical training in general, along with the rapid advancements in technology have shaped and influenced their adoption and adaptation. The authors conclude with emerging trends and potential influences advanced simulation and training will have on technical skills training in otolaryngology. PMID:22032486

  17. Telemedicine in otolaryngology.

    Science.gov (United States)

    Holtel, Michael R; Burgess, Lawrence P A

    2002-12-01

    More research is needed in otolaryngology telemedicine, but it would be a mistake to stop at only determining if telemedicine is as good as an in-person exam. The digital image recorded in a telemedicine encounter can be manipulated to increase diagnostic information not currently available. Radiologists currently take a chest radiograph in which a chest mass or the tip of an nasogastric tube is difficult to visualize, and by inverting the gray scale or viewing other digital manipulations of that image, the mass or tube tip becomes obvious. Examples in otolaryngology might include images of the larynx manipulated to better demonstrate the inflamed tissue of reflux, or images of the tympanic membrane manipulated to better demonstrate early retraction. Despite dramatic and likely continued decreases, equipment cost is still an issue. Current research points to good consumer acceptance, and certainly with each new generation the technology is more readily accepted. As Nesbitt [4] points out, it is certainly not difficult to look to the future and see ubiquitous broadband with video as common as telephone, or even extreme broadband enabling robotics and virtual reality TV with three-dimensional touch. Robotics and genomics will eventually play a greater role in telemedicine and our lives in general. Applications for remote diagnosis in biologic warfare defense and homeland security are currently raising interest in telemedicine. Telemedicine will be combined with new technological advances such as virtual "fly-through" computerized axial tomography examinations. Instead of performing an exploratory tympanotomy, surgeons will use computer programs to "fly through" and examine all aspects of a patient's middle or even inner ear. Spectral imaging of the eardrum, larynx, or oropharynx will immediately identify bacteria without cultures, or gram stain, and potential malignancy without biopsy. By measuring fluorescence emitted from an oropharynx illuminated with a specific

  18. Plastic Surgery and the Breast: A Citation Analysis of the Literature

    Directory of Open Access Journals (Sweden)

    Cormac W. Joyce, MB BCh

    2014-11-01

    Conclusions: This study has identified the most influential articles on breast in the plastic surgery literature over the past 68 years and highlighted many important scientific breakthroughs and landmarks that have occurred during this time.

  19. Fundraising and philanthropy in plastic surgery: an essential tool for academic excellence.

    Science.gov (United States)

    Bentz, Michael L; Ahmad, Jamil; Rohrich, Rod J

    2011-05-01

    In a time of multiple economic challenges in healthcare and society as a whole, academic plastic surgery units are also struggling to support teaching initiatives, research programs, and poorly remunerative patient care activities. A practical, available, and realistic solution is the establishment of formal fundraising and philanthropic efforts within plastic surgery divisions, sections, and departments. An understanding of donors and their motivations and how the fundraising process operates can lead to a successful long-term fundraising effort, benefitting various areas of the academic plastic surgery unit. Fundraising and philanthropic efforts are essential for the continued success and survival of academic plastic surgery units and will be requisite to ensure that education, research, and clinical programs flourish well into the future.

  20. Rising up to the challenge in Plastic Surgery in Nigeria | Oluwatosin ...

    African Journals Online (AJOL)

    Introduction: The environment for the practice of Plastic Surgery in Nigeria has become ... Conclusion: Although myriads of problems which include inadequate ... are challenged to rise up to the challenge of ensuring global best practices.

  1. Interest in facial plastic and reconstructive surgery among otorhinolaryngologists: a survey in The Netherlands.

    NARCIS (Netherlands)

    Pinxteren, S.A. van; Lohuis, P.J.; Ingels, K.J.A.O.; Nolst Trenite, G.J.

    2005-01-01

    OBJECTIVE: To assess the interest of Dutch otorhinolaryngologists in facial plastic and reconstructive surgery (FPRS). METHODS: We conducted a 22-question survey among otorhinolaryngology physicians and residents concerning their experience with and interest in FPRS. The response rate was 71%

  2. The use of robotics in plastic and reconstructive surgery: A systematic review

    Directory of Open Access Journals (Sweden)

    Jean Nehme

    2017-09-01

    Conclusions: Robot-assisted plastic and reconstructive surgery provides clinical outcomes comparable to conventional techniques. Advantages include reported improved cosmesis, functional outcomes and greater surgeon comfort. Disadvantages included longer operating and set-up times, a learning curve, breaking of microneedles, high monetary costs and authors consistently recommended improved end-effectors. All authors were optimistic about the use of robotics in plastic and reconstructive surgery.

  3. The Plastic Surgery Compass: Navigating the Reconstructive Ladder in the Personalized Health Care Era.

    Science.gov (United States)

    Sandberg, Lars Johan M

    2016-09-01

    The reconstructive ladder and the reconstructive elevator have withstood the test of time as didactic tools for resident education. Over time, many alternative models have been suggested to incorporate the technological advances in plastic surgery, but none of them have focused on the patient. Changes in practice and the trend toward personalized health care demand a 360-degree evaluation and solution of surgical problems incorporating patient-specific characteristics. We, therefore, suggest the concept of the plastic surgery compass to navigate the ladder.

  4. An Overview of the Relationship Between Helicobacter Pylori Infection and Otolaryngology Head and Neck Surgery Diseases%幽门螺旋杆菌感染与耳鼻咽喉头颈外科疾病关系研究综述

    Institute of Scientific and Technical Information of China (English)

    杜芬

    2012-01-01

    Helicobacter pylori is closely related to diseases like chronic gastritis and peptic ulcer, but recent studies show that there is also some connection with certain diseases concerning otolaryngology head and neck surgery. This paper begins with the de scription about helicobacter pylori biology, diagnosis, epidemiology and anti helicobacter pylori treatment and comprehensively states the relationship between helicobacter pylori and diseases concerning otolaryngology head and neck surgery in the hope providing a new perspective for the research of diseases connected with otolaryngology head and neck surgery.%幽门螺旋杆菌与慢性胃炎及消化性溃疡密切相关,但最近研究发现与某些耳鼻咽喉头颈外科疾病亦有一定关系。本文从阐述幽门螺旋杆菌的生物学性状、诊断技术、流行病学及抗幽门螺旋杆菌治疗入手,综述了幽门螺旋杆菌与耳鼻咽喉头颈外科疾病的关系,为从系统因素出发研究耳鼻咽喉头颈外科疾病提供新思路。

  5. Conflict of interest reporting in otolaryngology clinical practice guidelines.

    Science.gov (United States)

    Sun, Gordon H

    2013-08-01

    Clinical practice guidelines (CPGs) have become increasingly important in recent years due to an increasing emphasis on evidence-based practice, as well as serious discussions in academic, medical, and legal circles about their possible role in measuring physician performance, setting provider reimbursement strategy, and establishing protection from litigation in the future. At the same time, CPGs are costly to develop. Thus, as CPGs gain influence in medical practice, it will become essential that CPGs are developed using trustworthy standards and that the authors of CPGs are not being unduly influenced by financial pressures from external stakeholders. Since 2004, the 9 CPGs sponsored by the American Academy of Otolaryngology-Head and Neck Surgery Foundation have been developed with full disclosure and appropriate management of potential financial conflicts of interest. This commentary discusses the potential for conflict of interest in otolaryngology CPGs and how the otolaryngology guideline development process can serve as a model for other professional medical organizations.

  6. The Effect of Financial Conflicts of Interest in Plastic Surgery Literature.

    Science.gov (United States)

    Leavitt, Adam; Pace, Elizabeth; Reintgen, Christian; Mast, Bruce A

    2016-06-01

    Medical research has a long history of joint venture between commercial entities and nonindustry researchers. Significant concern exists among accrediting bodies for medical education and federal granting agencies that conflicts of interest (COIs) exist that affect the validity of the research. This study evaluates the legitimacy of this concern.All clinical breast and cosmetic articles in Plastic and Reconstructive Surgery and Annals of Plastic Surgery were reviewed for calendar year 2013. If a financial disclosure was present, the article was then reviewed to determine if the subject/findings were in favor of the commercial conflict and, if so, whether the study was valid. To assess plastic surgery versus other specialties, articles from Dermatology and Journal of Bone and Joint Surgery were similarly reviewed from January to April of 2013.Two hundred seventy-two clinical articles were reviewed. Only 15 (5.5%) had a true COI: the article's findings favored the commercial interest of at least 1 author: for each journal, Plastic and Reconstructive Surgery, 7.7%; Annals of Plastic Surgery, 3.3%; Dermatology, 2.2%; Journal of Bone and Joint Surgery, 7.5%. Conflicts of interest were not statistically significant between pooled articles of plastic surgery versus dermatology/orthopedics. However, COI was statistically greater (P = 0.05) in Plastic and Reconstructive Surgery compared with Annals and Dermatology.Despite public and regulatory concerns, this assessment demonstrates that the peer-review process of leading journals polices true COIs. Published articles provide sound research despite presumed COIs. As such, the integrity and validity of published research remain high.

  7. The role of primary plastic surgery in the management of open fractures.

    Science.gov (United States)

    Court-Brown, Charles M; Honeyman, Calum S; Clement, Nick D; Hamilton, Stuart A; McQueen, Margaret M

    2015-12-01

    A study was undertaken to determine the requirement for primary plastic surgery in the treatment of open fractures. We reviewed 3297 consecutive open fractures in a 22-year period in a defined population. Analysis showed that 12.6% of patients required primary plastic surgery with 5.6% being treated with split skin grafting and 7.2% with a flap. Only 3.5% of open upper limb fractures required primary plastic surgery compared to 27.9% of open lower limb fractures. The fractures that required most primary plastic surgery were those of the femoral diaphysis and all fractures between the proximal tibia and the midfoot. The incidence of open fractures that require primary plastic surgery was 28/10(6)/year. The incidence in open upper and lower limb fractures was 5.3/10(6)/year and 22.7/10(6)/year respectively. Using these figures it is possible to estimate the numbers of open fractures that will require primary plastic surgery each year in the United Kingdom.

  8. Current demand of paediatric otolaryngology input for children with Down's syndrome in a tertiary referral centre.

    Science.gov (United States)

    Khalid-Raja, M; Tzifa, K

    2016-11-01

    This study aimed to evaluate the activity of paediatric otolaryngology services required for children with Down's syndrome in a tertiary referral centre. A review of the paediatric otolaryngology input for children with Down's syndrome was performed; data were obtained from the coding department for a two-year period and compared with other surgical specialties. Between June 2011 and May 2013, 106 otolaryngology procedures were performed on children with Down's syndrome. This compared to 87 cardiac and 81 general paediatrics cases. The most common pathologies in children with Down's syndrome were obstructive sleep apnoea, otitis media, hearing loss and cardiac disease. The most common otolaryngology procedures performed were adenoidectomy, tonsillectomy, grommet insertion and bone-anchored hearing aid implant surgery. ENT manifestations of Down's syndrome are common. Greater provisions need to be made to streamline the otolaryngology services for children and improve transition of care to adult services.

  9. Patient Safety and Quality Improvement in Otolaryngology Education: A Systematic Review.

    Science.gov (United States)

    Gettelfinger, John D; Paulk, P Barrett; Schmalbach, Cecelia E

    2017-06-01

    Objective The breadth and depth of patient safety/quality improvement (PS/QI) research dedicated to otolaryngology-head and neck surgery (OHNS) education remains unknown. This systematic review aims to define this scope and to identify knowledge gaps as well as potential areas of future study to improved PS/QI education and training in OHNS. Data Sources A computerized Ovid/Medline database search was conducted (January 1, 1965, to May 15, 2015). Similar computerized searches were conducted using Cochrane Database, PubMed, and Google Scholar. Review Methods The study protocol was developed a priori using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Articles were classified by year, subspecialty, Institute of Medicine (IOM) Crossing the Chasm categories, and World Health Organization (WHO) subclass. Results Computerized searches yielded 8743 eligible articles, 267 (3.4%) of which met otolaryngology PS/QI inclusion criteria; 51 (19%) were dedicated to resident/fellow education and training. Simulation studies (39%) and performance/competency evaluation (23.5%) were the most common focus. Most projects involved general otolaryngology (47%), rhinology (18%), and otology (16%). Classification by the IOM included effective care (45%), safety/effective care (41%), and effective and efficient care (7.8%). Most research fell into the WHO category of "identifying solutions" (61%). Conclusion Nineteen percent of OHNS PS/QI articles are dedicated to education, the majority of which are simulation and focus on effective care. Knowledges gaps for future research include facial plastics PS/QI and the WHO category of "studies translating evidence into safer care."

  10. Dr. J. F. S. Esser and his influence on the development of plastic and reconstructive surgery

    NARCIS (Netherlands)

    B. Haeseker (Barend)

    1983-01-01

    textabstractJan F.S. Esser (1877-1946) was a remarkable and gifled Dutch surgeon whose contributions to plastic and reconstructive surgery, made long befare this specialty was recognised as a branch of surgery, are part of our surgical heritage. His interest in the bloodsupply of skin flaps was the

  11. Construction of professional curriculum website for otolaryngology-head and neck surgery based on CMS and its application%基于CMS构建耳鼻咽喉-头颈外科专业课程网站

    Institute of Scientific and Technical Information of China (English)

    石照辉; 石力; 乔莉; 陈福权; 薛涛; 陈晓栋

    2013-01-01

    精品专业课程网站建设是医学教学质量与教学改革工程的重要组成部分.为了解决传统静态网站建设中产生的系列问题,结合耳鼻咽喉-头颈外科学的专业特点,采用以动态网页技术和数据库技术为基础的内容管理系统(content management system,CMS),提出该学科的专业课程网站建设要求,介绍网站的设计、构建和评价过程,以期建设更高质量的学科专业课程网站.%Construction of excellent professional curriculum website is the most important part of medical teaching quality and teaching innovation.Requirements,designing procedure,construction and evaluation process as well as the future development for construction of professional curriculum website of otolaryngology-head and neck surgery were proposed by applying content management system (CMS),which based on the technology of dynamic web page and database and by combining with characteristics of the discipline to resolve problems occurred in construction of tradition statical network station.High-quality professional curriculum website is expected to improve teaching quality.

  12. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena; Rose, Michael; Bentzon, Niels;

    2015-01-01

    surgeons and 22 plastic surgeons; the response rate was 67%. All breast surgery units had an established cooperation with plastic surgeons. Most breast surgeons used unilateral displacement techniques; plastic surgeons also included breast reduction techniques and replacement with local flaps. Almost all......INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level...... of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...

  13. Self-citation rate and impact factor in the field of plastic and reconstructive surgery.

    Science.gov (United States)

    Miyamoto, Shimpei

    2017-05-09

    Journal ranking based on the impact factor (IF) can be distorted by self-citation. The aim of this study is to investigate the present status of self-citation in the plastic surgery journals and its effect on the journals' IFs. IF, IF without self-citations (corrected IF), self-cited rate, and self-citing rate for 11 plastic surgery journals were investigated from 2009-2015, by reviewing the Journal Citation Report(®). The correlations of the IF with the self-cited rate and the self-citing rate were statistically assessed. In addition, Plastic and Reconstructive Surgery was compared with 15 top journals from other surgical specialties in 2015. IF was significantly correlated with the self-cited rate (R: 0.594, p = 0.001) and the self-citing rate (R: 0.824, p journals from other surgical specialties. The IFs of Microsurgery and Journal of Cranio-Maxillo-Facial Surgery increased greatly in recent years, but they were inflated by high self-cited and self-citing rates. The self-citation rate positively affects the IF in plastic surgery journals. A high concentration of self-citation of some journals could distort the ranking among plastic surgery journals in general.

  14. Social media in plastic surgery practices: emerging trends in North America.

    Science.gov (United States)

    Wheeler, Chad K; Said, Hakim; Prucz, Roni; Rodrich, Rod J; Mathes, David W

    2011-05-01

    Social media is a common term for web-based applications that offer a way to disseminate information to a targeted audience in real time. In the current market, many businesses are utilizing it to communicate with clients. Although the field of plastic surgery is constantly changing in response to innovative technologies introduced into the specialty, the utilization of social media in plastic surgery practices is currently unclear. The authors evaluate the current attitudes and practices of aesthetic surgeons to emerging social media technology and compare these to attitudes about more traditional modes of communication. A 19-question web-based survey was disseminated by e-mail to all board-certified or board-eligible American plastic surgeons (n = 4817). Respondents were asked to answer questions on three topics: (1) their use of social media in their personal and professional lives, (2) their various forms of practice marketing, and (3) their demographic information. There were 1000 responses (20.8%). Results showed that 28.2% of respondents used social media in their practice, while 46.7% used it in their personal life. Most plastic surgeons managed their social media themselves or through a staff member. The majority of respondents who used social media in their practice claimed that their efforts were directed toward patient referrals. The typical plastic surgery practice that used social media was a solo practice in a large city with a focus on cosmetic surgery. Local competition of plastic surgeons did not correlate with social media use. Most plastic surgeons (88%) advertised, but the form of marketing varied. The most common forms included websites, print, and search engine optimization, but other modalities, such as television, radio, and billboards, were still utilized. Social media represents a new avenue that many plastic surgeons are utilizing, although with trepidation. As social media becomes commonplace in society, its role in plastic surgery

  15. 75 FR 61507 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Science.gov (United States)

    2010-10-05

    ... HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting was... Surgery Devices Panel of the Medical Devices Advisory Committee would be held on November 18, 2010. On...

  16. Face recognition via edge-based Gabor feature representation for plastic surgery-altered images

    Science.gov (United States)

    Chude-Olisah, Chollette C.; Sulong, Ghazali; Chude-Okonkwo, Uche A. K.; Hashim, Siti Z. M.

    2014-12-01

    Plastic surgery procedures on the face introduce skin texture variations between images of the same person (intra-subject), thereby making the task of face recognition more difficult than in normal scenario. Usually, in contemporary face recognition systems, the original gray-level face image is used as input to the Gabor descriptor, which translates to encoding some texture properties of the face image. The texture-encoding process significantly degrades the performance of such systems in the case of plastic surgery due to the presence of surgically induced intra-subject variations. Based on the proposition that the shape of significant facial components such as eyes, nose, eyebrow, and mouth remains unchanged after plastic surgery, this paper employs an edge-based Gabor feature representation approach for the recognition of surgically altered face images. We use the edge information, which is dependent on the shapes of the significant facial components, to address the plastic surgery-induced texture variation problems. To ensure that the significant facial components represent useful edge information with little or no false edges, a simple illumination normalization technique is proposed for preprocessing. Gabor wavelet is applied to the edge image to accentuate on the uniqueness of the significant facial components for discriminating among different subjects. The performance of the proposed method is evaluated on the Georgia Tech (GT) and the Labeled Faces in the Wild (LFW) databases with illumination and expression problems, and the plastic surgery database with texture changes. Results show that the proposed edge-based Gabor feature representation approach is robust against plastic surgery-induced face variations amidst expression and illumination problems and outperforms the existing plastic surgery face recognition methods reported in the literature.

  17. Current and future applications of nanotechnology in plastic and reconstructive surgery

    Directory of Open Access Journals (Sweden)

    Dana K Petersen

    2014-09-01

    Full Text Available Although nanotechnology is a relatively young field, there are countless biomedical applications in use or under investigation. Many specialties have benefitted from nanoscale refinements of diagnostic and therapeutic techniques. Plastic and reconstructive surgery is an incredibly diverse specialty, encompassing craniofacial and hand surgery; trauma, oncologic and congenital reconstruction; burn care, and aesthetic surgery. Advances in nanotechnology have significantly impacted wound management, topical skin care, implant and prosthetic design, tissue engineering, and drug delivery systems. Currently, plastic surgeons are researching the utility of nanoscale tools for bone regeneration, bone prosthetics, and drug delivery. Nanotechnology will continue to build upon preceding discoveries, and its biomedical applications in the field of plastic and reconstructive surgery will expand significantly.

  18. From time-based to competency-based standards: core transitional competencies in plastic surgery.

    Science.gov (United States)

    Lutz, Kristina; Yazdani, Arjang; Ross, Douglas

    2015-01-01

    Competency-based medical education is becoming increasingly prevalent and is likely to be mandated by the Royal College in the near future. The objective of this study was to define the core technical competencies that should be possessed by plastic surgery residents as they transition into their senior (presently postgraduate year 3) years of training. A list of potential core competencies was generated using a modified Delphi method that included the investigators and 6 experienced, academic plastic surgeons from across Canada and the United States. Generated items were divided into 7 domains: basic surgical skills, anesthesia, hand surgery, cutaneous surgery, esthetic surgery, breast surgery, and craniofacial surgery. Members of the Delphi group were asked to rank particular skills on a 4-point scale with anchored descriptors. Item reduction resulted in a survey consisting of 48 skills grouped into the aforementioned domains. This self-administered survey was distributed to all Canadian program directors (n = 11) via e-mail for validation and further item reduction. The response rate was 100% (11/11). Using the average rankings of program directors, 26 "core" skills were identified. There was agreement of core skills across all domains except for breast surgery and esthetic surgery. Of them, 7 skills were determined to be above the level of a trainee at this stage; a further 15 skills were agreed to be important, but not core, competencies. Overall, 26 competencies have been identified as "core" for plastic surgery residents to possess as they begin their senior, on-service years. The nature of these skills makes them suitable for teaching in a formal, simulated environment, which would ensure that all plastic surgery trainees are competent in these tasks as they transition to their senior years of residency. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. The evolution of racial, ethnic, and gender diversity in US otolaryngology residency programs.

    Science.gov (United States)

    Schwartz, Joseph S; Young, Meredith; Velly, Ana M; Nguyen, Lily H P

    2013-07-01

    To examine the evolution of racial, ethnic, and gender diversity in US otolaryngology-head and neck surgery residency programs and compare these figures with other residency programs. Retrospective database review. US residency programs. Information concerning minority and female representation in US residency programs was obtained from annually published graduate medical education reports by the Journal of the American Medical Association from 1975 to 2010. Minority representation among US population and university students was obtained from the US Census Bureau. The racial, ethnic, and gender diversity of otolaryngology residents was then compared with other medical fields (general surgery, family medicine, and internal medicine). Underrepresentation in otolaryngology-head and neck surgery is particularly disconcerting for African Americans (-2.3%/y, P = .09) and Native Americans (1.5%/y, P = .11) given their nonsignificant annual growth rates. Hispanic representation (17.3%/y, P otolaryngology but is half the rate of growth of the Hispanic American population (32.8%/y, P otolaryngology residents. Despite increasing gender, ethnic, and racial diversity among medical residents in general, female and certain minority group representation in US otolaryngology residency programs is lagging. These findings are in contrast to rising trends of diversity within other residency programs including general surgery.

  20. Cost-Benefit Analysis of an Otolaryngology Emergency Room Using a Contingent Valuation Approach.

    Science.gov (United States)

    Naunheim, Matthew R; Kozin, Elliot D; Sethi, Rosh K; Ota, H Gregory; Gray, Stacey T; Shrime, Mark G

    2015-10-01

    Dedicated otolaryngology emergency rooms (ERs) provide a unique mechanism of health care delivery. Relative costs and willingness to pay (WTP) for these services have not been studied. This study aims to provide a cost-benefit analysis of otolaryngology-specific ER care. Cost-benefit analysis based on contingent valuation surveys. An otolaryngology-specific ER in a tertiary care academic medical center. Adult English-speaking patients presenting to an otolaryngology ER were included. WTP questions were used to assess patient valuations of specialty emergency care. Sociodemographic data, income, and self-reported levels of distress were assessed. State-level and institution-specific historical cost data were merged with WTP data within a cost-benefit analysis framework. The response rate was 75.6%, and 199 patients were included in the final analysis. Average WTP for otolaryngology ER services was $319 greater than for a general ER (95% CI: $261 to $377), with a median value of $200. The historical mean cost per visit at a general ER was $575, and mean cost at the specialty ER was $551 (95% CI: $529 to $574). Subtracting incremental cost from incremental WTP yielded a net benefit of $343. Dedicated otolaryngology ER services are valued by patients for acute otolaryngologic problems and have a net benefit of $343 per patient visit. They appear to be a cost-beneficial method for addressing acute otolaryngologic conditions. This study has implications for ER-based otolaryngologic care and direct-to-specialist services. © American Academy of Otolaryngology-Head and Neck Surgery Foundation 2015.

  1. [Independence in Plastic Surgery - Benefit or Barrier? Analysis of the Publication Performance in Academic Plastic Surgery Depending on Varying Organisational Structures].

    Science.gov (United States)

    Schubert, C D; Leitsch, S; Haertnagl, F; Haas, E M; Giunta, R E

    2015-08-01

    Despite its recognition as an independent specialty, at German university hospitals the field of plastic surgery is still underrepresented in terms of independent departments with a dedicated research focus. The aim of this study was to analyse the publication performance within the German academic plastic surgery environment and to compare independent departments and dependent, subordinate organisational structures regarding their publication performance. Organisational structures and number of attending doctors in German university hospitals were examined via a website analysis. A pubmed analysis was applied to assess the publication performance (number of publications, cumulative impact factor, impact factor/publication, number of publications/MD, number of publications/unit) between 2009 and 2013. In a journal analysis the distribution of the cumulative impact factor and number of publications in different journals as well as the development of the impact factor in the top journals were analysed. Out of all 35 university hospitals there exist 12 independent departments for plastic surgery and 8 subordinate organisational structures. In 15 university hospitals there were no designated plastic surgery units. The number of attending doctors differed considerably between independent departments (3.6 attending doctors/unit) and subordinate organisational structures (1.1 attending doctors/unit). The majority of publications (89.0%) and of the cumulative impact factor (91.2%) as well as most of the publications/MD (54 publications/year) and publications/unit (61 publications/year) were created within the independent departments. Only in departments top publications with an impact factor > 5 were published. In general a negative trend regarding the number of publications (- 13.4%) and cumulative impact factor (- 28.9%) was observed. 58.4% of all publications were distributed over the top 10 journals. Within the latter the majority of articles were published in

  2. Quality of Life and Aesthetic Plastic Surgery: A Systematic Review and Meta-analysis

    Science.gov (United States)

    Blaya, Carolina; Tenório, Juliana L.C.; Saltz, Renato; Ely, Pedro B.; Ferrão, Ygor A.

    2016-01-01

    Background: Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis. Methods: The search was made in two electronic databases (LILACS and PUBMED) using Mesh and non-Mesh terms related to aesthetic plastic surgery and QoL. We performed qualitative and quantitative analyses of the gathered data. We calculated a random effect meta-analysis with Der Simonian and Laird as variance estimator to compare pre- and postoperative QoL standardized mean difference. To check if there is difference between aesthetic surgeries, we compared reduction mammoplasty to other aesthetic surgeries. Results: Of 1,715 identified, 20 studies were included in the qualitative analysis and 16 went through quantitative analysis. The random effect of all aesthetic surgeries shows that QoL improved after surgery. Reduction mammoplasty has improved QoL more than other procedures in social functioning and physical functioning domains. Conclusions: Aesthetic plastic surgery increases QoL. Reduction mammoplasty seems to have better improvement compared with other aesthetic surgeries.

  3. Bone scanning in otolaryngology.

    Science.gov (United States)

    Noyek, A M

    1979-09-01

    Modern radionuclide bone scanning has introduced a new concept in physiologic and anatomic diagnostic imaging to general medicine. As otolaryngologists must diagnose and treat disease in relation to the bony and/or cartilaginous supporting structures of the neurocranium and upper airway, this modality should be included in the otolaryngologist's diagnostic armamentarium. It is the purpose of this manuscript to study the specific applications of bone scanning to our specialty at this time, based on clinical experience over the past three years. This thesis describes the development of bone scanning in general (history of nuclear medicine and nuclear physics; history of bone scanning in particular). General concepts in nuclear medicine are then presented; these include a discussion of nuclear semantics, principles of radioactive emmissions, the properties 99mTc as a radionuclide, and the tracer principle. On the basis of these general concepts, specific concepts in bone scanning are then brought forth. The physiology of bone and the action of the bone scan agents is presented. Further discussion considers the availability and production of the bone scan agent, patient factors, the gamma camera, the triphasic bone scan and the ultimate diagnostic principle of the bone scan. Clinical applications of bone scanning in otolaryngology are then presented in three sections. Proven areas of application include the evaluation of malignant tumors of the head and neck, the diagnosis of temporomandibular joint disorders, the diagnosis of facial fractures, the evaluation of osteomyelitis, nuclear medicine imaging of the larynx, and the assessment of systemic disease. Areas of adjunctive or supplementary value are also noted, such as diagnostic imaging of meningioma. Finally, areas of marginal value in the application of bone scanning are described.

  4. Leadership Training in Otolaryngology Residency.

    Science.gov (United States)

    Bent, John P; Fried, Marvin P; Smith, Richard V; Hsueh, Wayne; Choi, Karen

    2017-06-01

    Although residency training offers numerous leadership opportunities, most residents are not exposed to scripted leadership instruction. To explore one program's attitudes about leadership training, a group of otolaryngology faculty (n = 14) and residents (n = 17) was polled about their attitudes. In terms of self-perception, more faculty (10 of 14, 71.4%) than residents (9 of 17, 52.9%; P = .461) considered themselves good leaders. The majority of faculty and residents (27 of 31) thought that adults could be taught leadership ability. Given attitudes about leadership ability and the potential for improvement through instruction, consideration should be given to including such training in otolaryngology residency.

  5. The polymerase chain reaction and its application to clinical plastic surgery.

    LENUS (Irish Health Repository)

    Rea, S

    2012-02-03

    Molecular biology has become an essential component in many fields of modern medical research, including plastic surgery. Research into the molecular mechanisms underlying many disease processes offer increased understanding of the pathogenesis of disease and provide exciting therapeutic possibilities. Yet for many clinicians, the presentation of much research into molecular biological processes is couched in confusing terminology and based on scientific techniques, the basis of which are frequently difficult for the clinician to understand. The purpose of this review is to present an introduction to some of the molecular biological techniques currently in use, namely the polymerase chain reaction (PCR) and explore its applications to different aspects of plastic surgery. This review explores the role PCR now plays in all aspects of modern plastic surgery practise, with particular emphasis on normal and abnormal wound healing, the diagnosis of craniofacial anomalies, the diagnosis and treatment of cancer including melanoma and squamous cell carcinoma of the head and neck, and burns.

  6. Better to light a candle: Arthur Barsky and global plastic surgery.

    Science.gov (United States)

    Hughes, Christopher D; Barsky, Emily; Hagander, Lars; Barsky, Arthur J; Meara, John G

    2013-08-01

    Plastic and reconstructive surgery has had a long history with international humanitarian efforts. As the field of global surgery continues to gain momentum in academic centers throughout the world, the role of the surgical subspecialist in the public health infrastructure of low-resource communities has also begun to gain a new sense of wonder and importance. Arthur Barsky, Jr was arguably one of the most influential forefathers of global plastic surgery. Throughout his notable career spanning most of the 20th century, Barsky remained dedicated to delivering plastic and reconstructive surgical care to the disadvantaged worldwide, as well as educating others to do the same. Although he was not the first surgeon with an interest in global health, Barsky's work was unique and influential in its originality, magnitude, and scope. An appreciation and understanding of Barsky's groundbreaking work will help inform the future development of sustainable surgical systems in resource-poor settings.

  7. "Does the Organization of Plastic Surgery Units into Independent Departments Affect Academic Productivity?"

    Science.gov (United States)

    Loewenstein, Scott N; Duquette, Stephen; Valsangkar, Nakul; Avula, Umakanth; Lad, Neha; Socas, Juan; Flores, Roberto L; Sood, Rajiv; Koniaris, Leonidas G

    2017-07-12

    There is an increased push for plastic surgery units in the United States to become independent departments administered autonomously rather than as divisions of a multispecialty surgery department. The purpose of this research was to determine if there are any quantifiable differences in the academic performance of departments versus divisions. Using a list of the plastic surgery units affiliated with The American Council of Academic Plastic Surgeons (ACAPS), unit websites were queried for departmental status and to obtain a list of affiliated faculty. Academic productivity was then quantified using the SCOPUS database. National Institute of Health (NIH) funding was determined through the Research Portfolio Online Reporting Tools database. Plastic surgery departments were comparable to divisions in academic productivity, evidenced by a similar number of publications per faculty (38.9 versus 38.7; p=0.94), number of citations per faculty (692 versus 761; p=0.64), H-indices (9.9 versus 9.9; p=0.99), and NIH grants (3.25 versus 2.84; p=0.80), including RO1 grants (1.33 versus 0.84; p=0.53). There was a trend for departments to have a more equitable male to female ratio (2.8 versus 4.1; p=0.06), and departments trained a greater number of integrated plastic surgery residents (9.0 versus 5.28; p=0.03). This study demonstrates that the academic performance of independent plastic surgery departments is generally similar to divisions, but with nuanced distinctions.

  8. [Bariatric and plastic surgery in obese adolescents: an alternative treatment].

    Science.gov (United States)

    Dubern, Béatrice; Tounian, Patrice

    2014-06-01

    The increased frequency of extreme forms of obesity in adolescents and the disappointing results of conventional treatments are now leading pediatricians to consider bariatric or cosmetic surgery as the only real long-term effective therapeutic alternative. The two main techniques currently used for bariatric surgery in adolescents are gastric bypass and adjustable gastric banding. Whatever the technique, weight loss is significant with improvement of comorbidities and quality of life. In addition, the complications are identical to those in adults and equally frequent. However, because of the particularities of this age, caution is still required. Adolescence is indeed characterized by specific nutritional needs, but also changes in body image in which surgery could have a negative effect. Currently, all obese teenagers making a request for bariatric surgery should have a comprehensive assessment with global care for at least 6 months. The indication is then discussed on a case-by-case basis by multidisciplinary teams and experts. To date, the type of surgery (gastric banding, gastric sleeve, or bypass) is still widely discussed. Based on experience with adults, we believe that gastric sleeve and bypass should be preferred. In addition, obesity in adolescents almost always involves psychosocial consequences, while somatic complications are rare. Thus, the care of adipo- or gynecomastia, abdominal fat excess, and concealed penis is essential and therefore justifies cosmetic surgery.

  9. [Information and assent: presentation of 32 information cards concerning plastic and aesthetic surgery].

    Science.gov (United States)

    Flageul, G; Horay, P; Rouanet, F

    2009-06-01

    Obligation to deliver full information and obtaining enlightened assent are now, for the whole French practitioner, a necessary preliminary to each operation. Henceforth, in case of suit, the practitioner must prove the reality and the quality of preoperative information. The authors propose 32 information cards corresponding to the most currently operations of plastic and aesthetic surgery. They will being clear and simple, with a large agreement, strictly informative and yearly up to date. They have the label and therefore the scientific guaranty of the French Society of Plastic Reconstructive and Aesthetic Surgery.

  10. [Jean-Louis-Paul Denucé (1824-1889): A forgotten pioneer of plastic surgery].

    Science.gov (United States)

    Marck, K W; Martin, D

    2016-02-01

    The authors propose to define as main characterization of plastic reconstructive surgery the conceptual thinking that leads to a rational choice of an operative treatment. Conceptual thinking in plastic surgery started halfway the nineteenth century with the first schematic representations of the operative procedures available at that time, in which Von Ammon and Baumgarten, Szymanowski and Denucé played a prominent role. These four authors and their works are presented with special attention for the less known of them, Jean-Paul Denucé, surgeon in Bordeaux.

  11. The Plastic Surgery Compass: Navigating the Reconstructive Ladder in the Personalized Health Care Era

    Science.gov (United States)

    2016-01-01

    Summary: The reconstructive ladder and the reconstructive elevator have withstood the test of time as didactic tools for resident education. Over time, many alternative models have been suggested to incorporate the technological advances in plastic surgery, but none of them have focused on the patient. Changes in practice and the trend toward personalized health care demand a 360-degree evaluation and solution of surgical problems incorporating patient-specific characteristics. We, therefore, suggest the concept of the plastic surgery compass to navigate the ladder. PMID:27757348

  12. The Ethics of Stem Cell-Based Aesthetic Surgery: Attitudes and Perceptions of the Plastic Surgery Community.

    Science.gov (United States)

    Nayar, Harry S; Caplan, Arthur L; Eaves, Felmont F; Rubin, J Peter

    2014-08-01

    The emerging field of stem cell-based aesthetics has raised ethical concerns related to advertising campaigns and standards for safety and efficacy. The authors sought to characterize the attitudes of plastic surgeons regarding the ethics of stem cell-based aesthetics. A cross-sectional electronic survey was distributed to 4592 members of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. Statements addressed ethical concerns about informed consent, conflicts of interest, advertising, regulation, and stem cell tourism. An agreement score (AS) from 0 to 100 was calculated for each statement. Majority agreement was designated as ≥60 and majority disagreement as ≤40. A total of 770 questionnaires were received (16.7%). The majority of respondents indicated that knowledge regarding the risks and benefits of stem cell procedures is insufficient to obtain valid informed consent (AS, 29) and that direct-to-consumer advertising for these technologies is inappropriate and unethical (AS, 23). Most respondents reported that patients should be actively warned against traveling abroad to receive aesthetic cell therapies (AS, 86) and that registries and evaluations of these clinics should be made publicly available (AS, 71). Even more respondents noted that financial conflicts of interest should be disclosed to patients (AS, 96) and that professional societies should participate in establishing regulatory standards (AS, 93). The plastic surgeons surveyed in this study support a well-regulated, evidence-based approach to aesthetic procedures involving stem cells. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

  13. A study of an assisting robot for mandible plastic surgery based on augmented reality.

    Science.gov (United States)

    Shi, Yunyong; Lin, Li; Zhou, Chaozheng; Zhu, Ming; Xie, Le; Chai, Gang

    2017-02-01

    Mandible plastic surgery plays an important role in conventional plastic surgery. However, its success depends on the experience of the surgeons. In order to improve the effectiveness of the surgery and release the burden of surgeons, a mandible plastic surgery assisting robot, based on an augmented reality technique, was developed. Augmented reality assists surgeons to realize positioning. Fuzzy control theory was used for the control of the motor. During the process of bone drilling, both the drill bit position and the force were measured by a force sensor which was used to estimate the position of the drilling procedure. An animal experiment was performed to verify the effectiveness of the robotic system. The position error was 1.07 ± 0.27 mm and the angle error was 5.59 ± 3.15°. The results show that the system provides a sufficient accuracy with which a precise drilling procedure can be performed. In addition, under the supervision's feedback of the sensor, an adequate safety level can be achieved for the robotic system. The system realizes accurate positioning and automatic drilling to solve the problems encountered in the drilling procedure, providing a method for future plastic surgery.

  14. Clinical Use of GalaFLEX in Facial and Breast Cosmetic Plastic Surgery.

    Science.gov (United States)

    Adams, William P; Toriumi, Dean M; Van Natta, Bruce W

    2016-11-01

    Resolution of ptosis is a key step to the success of many plastic surgery procedures. Ptosis is a manifestation of tissue stretch. Tissue stretch can occur as a result of the natural aging process or health of the patient, or tissue may stretch under added weight or volume, such as when implants are placed. Surgical rejuvenation of ptotic tissues is very effective and results in marked changes in the patient profile yet the tissue that resulted in the need for the procedure first place has not improved and ptosis can recur. Recent developments in long-term resorbable porous materials have provided surgeons with the opportunity to experiment with tissue reinforcement in plastic surgery procedures. These new materials have a low profile, rapid tissue integration, and a long-term strength retention profile. Long-term resorbable scaffolds such as poly-4-hydroxybutyrate (P4HB) natural scaffold (GalaFLEX scaffold, Galatea Surgical, Inc., Lexington, MA) have shown promise for a host of plastic surgery indications. This article presents clinical experience with GalaFLEX for soft tissue reinforcement in three different clinical applications; including the reinforcement of the superficial muscular aponeurotic system (SMAS) in minimally invasive facelift, reinforcement of the skin envelope in mastopexy, and reinforcement of the breast capsule (pocket) in revisional breast surgery. Soft tissue reinforcement has been shown to provide increased mechanical strength as well as improved maintenance of postoperative results. 5 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  15. International plastic surgery missions: a framework for resident education using the CanMEDS competencies.

    Science.gov (United States)

    White, Colin P; Lecours, Catherine; Bortoluzzi, Patricia; Caouette-Laberge, Louise; Ying, Yvonne

    2013-10-01

    Residency education has shifted over the past decade in an attempt to graduate well-rounded physicians. There is a recognition that a physician's abilities must extend beyond medical knowledge. The Royal College of Physicians and Surgeons of Canada introduced the CanMEDS physician competency framework in 2005. The framework provides 7 areas of competencies that are aimed at providing improved patient care. These competencies are medical expert, communicator, collaborator, manager, health advocate, scholar, and professional. Teaching and evaluating many of these competencies is often challenging for residency training programs. We believe that international surgical missions provide a prime opportunity to teach and evaluate all CanMEDS' roles.Plastic surgery is a field with many different organizations involved in international surgery. Many plastic surgery training programs offer opportunities for residents to become involved in these international surgical missions. Through these trips, residents gain surgical experience, see a variety and volume of clinical cases, and have the opportunity to travel to a foreign country and experience different cultures. We believe that international plastic surgery surgical missions also provide an exceptional micro environment for the teaching of CanMEDS roles. Using examples from residents' personal experiences on international plastic surgery missions to China, Mali, and Cambodia, we describe the benefits of these missions in transferring the CanMEDS competencies to resident training.

  16. Stratifying the Risk of Venous Thromboembolism in Otolaryngology

    Science.gov (United States)

    Shuman, Andrew G.; Hu, Hsou Mei; Pannucci, Christopher J.; Jackson, Christopher R.; Bradford, Carol R.; Bahl, Vinita

    2015-01-01

    Objective The consequences of perioperative venous thromboembolism (VTE) are devastating; identifying patients at risk is an essential step in reducing morbidity and mortality. The utility of perioperative VTE risk assessment in otolaryngology is unknown. This study was designed to risk-stratify a diverse population of otolaryngology patients for VTE events. Study Design Retrospective cohort study. Setting Single-institution academic tertiary care medical center. Subjects and Methods Adult patients presenting for otolaryngologic surgery requiring hospital admission from 2003 to 2010 who did not receive VTE chemoprophylaxis were included. The Caprini risk assessment was retrospectively scored via a validated method of electronic chart abstraction. Primary study variables were Caprini risk scores and the incidence of perioperative venous thromboembolic outcomes. Results A total of 2016 patients were identified. The overall 30-day rate of VTE was 1.3%. The incidence of VTE in patients with a Caprini risk score of 6 or less was 0.5%. For patients with scores of 7 or 8, the incidence was 2.4%. Patients with a Caprini risk score greater than 8 had an 18.3% incidence of VTE and were significantly more likely to develop a VTE when compared to patients with a Caprini risk score less than 8 (P otolaryngology patients for 30-day VTE events and allows otolaryngologists to identify patient subgroups who have a higher risk of VTE in the absence of chemoprophylaxis. PMID:22261490

  17. Resident fatigue in otolaryngology residents: a Web based survey.

    Science.gov (United States)

    Nida, Andrew M; Googe, Benjamin J; Lewis, Andrea F; May, Warren L

    2016-01-01

    Resident fatigue has become a point of emphasis in medical education and its effects on otolaryngology residents and their patients require further study. The purpose of our study was to evaluate the prevalence and nature of fatigue in otolaryngology residents, evaluate various quality of life measures, and investigate associations of increased fatigue with resident safety. Anonymous survey. Internet based. United States allopathic otolaryngology residents. None. The survey topics included demographics, residency structure, sleep habits and perceived stress. Responses were correlated with a concurrent Epworth Sleep Scale questionnaire to evaluate effects of fatigue on resident training and quality of life. 190 residents responded to the survey with 178 completing the Epworth Sleep Scale questionnaire. Results revealed a mean Epworth Sleep Scale score of 9.9±5.1 with a median of 10.0 indicating a significant number of otolaryngology residents are excessively sleepy. Statistically significant correlations between Epworth Sleep Scale and sex, region, hours of sleep, and work hours were found. Residents taking in-house call had significantly fewer hours of sleep compared to home call (p=0.01). Residents on "head and neck" (typically consisting of a large proportion of head and neck oncologic surgery) rotations tended to have higher Epworth Sleep Scale and had significantly fewer hours of sleep (p=.003) and greater work hours (potolaryngology residents are excessively sleepy. Our data suggest that the effects of fatigue play a role in resident well-being and resident safety. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Health Literacy Assessment in an Otolaryngology Clinic Population.

    Science.gov (United States)

    Megwalu, Uchechukwu C; Lee, Jennifer Y

    2016-12-01

    To assess health literacy in an adult tertiary care otolaryngology clinic population and to explore potential determinants of inadequate health literacy. Cross-sectional study. Tertiary care otolaryngology clinic. The study population included all adult patients treated at 3 of Stanford University's adult otolaryngology clinic sites between March 1 and 11, 2016. Data were collected via an anonymous questionnaire. Health literacy was assessed with the Brief Health Literacy Screen. Ten percent of patients had inadequate health literacy. White race (odds ratio [OR], 0.23) and having English as the primary language (OR, 0.12) were associated with adequate health literacy, while high school or lower level of education (OR, 3.2) was associated with inadequate health literacy. Age, sex, and Hispanic ethnicity were not associated with health literacy. Our study highlights the need for health literacy screening in the otolaryngology clinic setting and identifies sociodemographic risk factors for inadequate health literacy. Further studies are needed to assess the impact of health literacy on patient outcomes and to test specific interventions to address health literacy and health outcomes. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  19. [Two French pioneers of plastic surgery: François Dubois and Raymond Passot].

    Science.gov (United States)

    Derquenne, François

    2015-01-01

    After World War, especially during the interwar years, new plastic surgical techniques were highly developed by I two French surgeons: Dr Raymond Passot, a pupil of Pr Hippolyte Morestin, Head of surgery department in Val-de-Grâce military hospital, Father of the Gueules cassées and Dr François Dubois, a pupil of Pr Sébileau, head of ear nose throat disorders department at Lariboisière Hospital in Paris. By the way of papers, publications and interviews to media, they described new French cosmetic techniques (rhitidectomy, sutures, liposuccion) and extensively developed this outpatient surgery. They used to renove famous actresse's and actors' face and nose and those of hundreds of patients. They participate to French societies of plastic surgery meetings and publications. Their enthusiastic dare largely participated to the current success of cosmetic surgery in France.

  20. [Plastic surgery in patients with surgical wound infection].

    Science.gov (United States)

    Gostishchev, V K; Lipatov, K V; Komarova, E A; Marakutsa, E V

    2009-01-01

    Results of various skin plastic operations performed in 312 patients with soft-tissue infection were analyzed. The choice of the method depended on size and site of the wound, predisposing pathological process, age and general patient's condition. Differential approach to the choice of reconstruction method allowed satisfactory short-term results in 91,4% of patients. 80% of patients demonstrated good long-term results.

  1. Presentation of Mycobacterium abscessus infection following rhytidectomy to a UK plastic surgery unit

    OpenAIRE

    Bowles, Philippe; Miller, Mary-Clare; Cartwright, Samuel; Jones, Martin

    2014-01-01

    We report the presentation of a patient to a UK plastic surgery unit with Mycobacterium abscessus infection following a facelift surgery in Southern India. Treatment was protracted requiring surgical debridement and 6 months of antibiotics including a 3-week hospital admission for intravenous antibiotic therapy. We describe the clinical presentation, diagnosis and treatment of this unusual microorganism with reference to more familiar pyogenic infections.

  2. Presentation of Mycobacterium abscessus infection following rhytidectomy to a UK plastic surgery unit.

    Science.gov (United States)

    Bowles, Philippe; Miller, Mary-Clare; Cartwright, Samuel; Jones, Martin

    2014-05-28

    We report the presentation of a patient to a UK plastic surgery unit with Mycobacterium abscessus infection following a facelift surgery in Southern India. Treatment was protracted requiring surgical debridement and 6 months of antibiotics including a 3-week hospital admission for intravenous antibiotic therapy. We describe the clinical presentation, diagnosis and treatment of this unusual microorganism with reference to more familiar pyogenic infections.

  3. The Value of Postconditioning in Plastic and Reconstructive Surgery: A Systematic Review.

    Science.gov (United States)

    Weng, Weidong; Zhang, Feng; Lineaweaver, William C; Gao, Weiyang; Yan, Hede

    2016-05-01

    Background Ischemia-reperfusion (I/R) injury by abrupt restoration of circulation after prolonged ischemia has still been an unsolved problem in plastic and reconstructive surgery. The concept of postconditioning (post-con), which has been well described in cardiovascular surgery, has been recently introduced in plastic and reconstructive surgery. As an "after-injury strategy," post-con may be a promising approach to reduce I/R injury and improve flap survival after ischemia. Methods A systematic review was performed by searching electronic databases of PubMed and web of science to identify all the studies regarding the application of the post-con technique in plastic and reconstructive surgery between 1950 and 2015. Inclusion criteria were English articles with clear reporting the post-con techniques and detailed outcomes. Results In total, 476 articles were identified and 18 studies reporting post-con in plastic and reconstructive surgery met the inclusion criteria in this review, including 11 studies of mechanical post-con, 3 studies of pharmacological post-con, 1 study of both mechanical and pharmacological post-con, and 3 studies of remote post-con. All these studies reported protective effects of any kind of post-con techniques in I/R injuries and could improve flap survivals. Conclusion In general, the strategy of post-con may effectively reduce I/R injury and improve the survival of flaps after ischemia in animal studies, yet no consensus regarding the exact technical details (intervention timing, cycles, intermittent duration, etc.) has been reached. Further studies aiming to explore its mechanisms as well as specific methodology are required before clinical application in plastic and reconstructive surgery.

  4. Beauty, health and risk in Brazilian plastic surgery

    NARCIS (Netherlands)

    Edmonds, A.

    2009-01-01

    In this paper, I take up the theme of the volume by analyzing the dynamic and sometimes conflicting relationship between ‘health’ and ‘beauty’ in the practice of cosmetic surgery. Approaching Brazil as a case study, I show how cosmetic and medical rationales are merged within a broader field of ‘aes

  5. Reduction Mammoplasty: A Comparison Between Operations Performed by Plastic Surgery and General Surgery

    OpenAIRE

    Kordahi, Anthony M.; Hoppe, Ian C.; Lee, Edward S.

    2015-01-01

    Background: Reduction mammoplasty is an often-performed procedure by plastic surgeons and increasingly by general surgeons. The question has been posed in both general surgical literature and plastic surgical literature as to whether this procedure should remain the domain of surgical specialists. Some general surgeons are trained in breast reductions, whereas all plastic surgeons receive training in this procedure. The National Surgical Quality Improvement Project provides a unique opportuni...

  6. 75 FR 47606 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-08-06

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical.... ACTION: Notice. SUMMARY: The meeting of the General and Plastic Surgery Devices Panel of the...

  7. 76 FR 65200 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee: Notice of...

    Science.gov (United States)

    2011-10-20

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee scheduled for December...

  8. 75 FR 1395 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Amendment of...

    Science.gov (United States)

    2010-01-11

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... the General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee. This meeting...

  9. Combined Soft and Hard Tissue Peri-Implant Plastic Surgery Techniques to Enhance Implant Rehabilitation: A Case Report

    Science.gov (United States)

    Baltacıoğlu, Esra; Korkmaz, Fatih Mehmet; Bağış, Nilsun; Aydın, Güven; Yuva, Pınar; Korkmaz, Yavuz Tolga; Bağış, Bora

    2014-01-01

    This case report presents an implant-aided prosthetic treatment in which peri-implant plastic surgery techniques were applied in combination to satisfactorily attain functional aesthetic expectations. Peri-implant plastic surgery enables the successful reconstruction and restoration of the balance between soft and hard tissues and allows the option of implant-aided fixed prosthetic rehabilitation. PMID:25489351

  10. State of otolaryngology match: has competition increased since the "early" match?

    Science.gov (United States)

    Cabrera-Muffly, Cristina; Sheeder, Jeanelle; Abaza, Mona

    2015-05-01

    To examine fluctuations in supply and demand of otolaryngology residency positions after the shift from an "early match" coordinated by the San Francisco match to a "conventional" matching process through the National Residency Matching Program (NRMP). To determine whether competition among otolaryngology residency positions have changed during this time frame. Database analysis. Matching statistics from 1998 to 2013 were obtained for all first-year residency positions through the NRMP. Matching statistics from 1998 to 2005 were obtained for otolaryngology residency positions through the San Francisco match. Univariate analysis was performed, with a P value less than .05 determined as significant. The number of otolaryngology positions and applicants remained proportional to the overall number of positions and applicants in the NRMP match. Otolaryngology applicants per position and the matching rate of all applicants did not change between the 2 time periods studied. The overall match rate of US seniors applying to otolaryngology did not change, while the match rate of non-US seniors decreased significantly following initiation of the conventional match. There was no significant change in United States Medical Licensing Exam step 1 scores or percentage of unfilled otolaryngology residency positions between the 2 time periods. When comparing the early versus conventional otolaryngology match time periods, the only major change was the decreased percentage of matching among non-US senior applicants. Despite a significant shift in match timing after 2006, the supply, demand, and competitiveness of otolaryngology residency positions have not changed significantly. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  11. Parents Speak Out: Facial Plastic Surgery for Children with Down Syndrome.

    Science.gov (United States)

    Goeke, Jennifer

    2003-01-01

    This qualitative study examined comments of 250 parents of children with Down syndrome concerning facial plastic surgery as a means of improving the physical functioning, appearance, and social acceptance of these children. Most respondents viewed improvement of negative societal attitudes toward individuals with Down syndrome and futhering their…

  12. Quality of Life and Aesthetic Plastic Surgery: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Dreher, Rodrigo; Blaya, Carolina; Tenório, Juliana L C; Saltz, Renato; Ely, Pedro B; Ferrão, Ygor A

    2016-09-01

    Quality of life (QoL) is an important outcome in plastic surgery. However, authors use different scales to address this subject, making it difficult to compare the outcomes. To address this discrepancy, the aim of this study was to perform a systematic review and a random effect meta-analysis.

  13. Parents Speak Out: Facial Plastic Surgery for Children with Down Syndrome.

    Science.gov (United States)

    Goeke, Jennifer

    2003-01-01

    This qualitative study examined comments of 250 parents of children with Down syndrome concerning facial plastic surgery as a means of improving the physical functioning, appearance, and social acceptance of these children. Most respondents viewed improvement of negative societal attitudes toward individuals with Down syndrome and futhering their…

  14. Face recognition across makeup and plastic surgery from real-world images

    Science.gov (United States)

    Moeini, Ali; Faez, Karim; Moeini, Hossein

    2015-09-01

    A study for feature extraction is proposed to handle the problem of facial appearance changes including facial makeup and plastic surgery in face recognition. To extend a face recognition method robust to facial appearance changes, features are individually extracted from facial depth on which facial makeup and plastic surgery have no effect. Then facial depth features are added to facial texture features to perform feature extraction. Accordingly, a three-dimensional (3-D) face is reconstructed from only a single two-dimensional (2-D) frontal image in real-world scenarios. Then the facial depth is extracted from the reconstructed model. Afterward, the dual-tree complex wavelet transform (DT-CWT) is applied to both texture and reconstructed depth images to extract the feature vectors. Finally, the final feature vectors are generated by combining 2-D and 3-D feature vectors, and are then classified by adopting the support vector machine. Promising results have been achieved for makeup-invariant face recognition on two available image databases including YouTube makeup and virtual makeup, and plastic surgery-invariant face recognition on a plastic surgery face database is compared to several state-of-the-art feature extraction methods. Several real-world scenarios are also planned to evaluate the performance of the proposed method on a combination of these three databases with 1102 subjects.

  15. [Plastic surgery defect coverage in the area of the pelvis and trunk].

    Science.gov (United States)

    Germann, G; Erdmann, D; Sauerbier, M; Bickert, B

    1997-05-01

    Complex defects of the trunk and pelvic region are rare, but are mostly the sequelae of serious conditions. Stable soft tissue coverage after radical debridement of all avital tissue may be of vital importance for the patient. The article will demonstrate the options of plastic surgery procedures that should be known by the general surgeon to be eventually integrated into a interdisciplinary therapeutic concept.

  16. Identification of Best Practices for Resident Aesthetic Clinics in Plastic Surgery Training: The ACAPS National Survey

    Directory of Open Access Journals (Sweden)

    C. Scott Hultman, MD, MBA, FACS

    2015-03-01

    Conclusions: RACs are an important component of plastic surgery education. Most clinics are financially viable but carry high malpractice risk and consume significant resources. Best practices, to maximize patient safety and optimize resident education, include use of accredited procedural rooms and direct faculty supervision of all components of care.

  17. 76 FR 20840 - Medical Devices; General and Plastic Surgery Devices; Classification of the Low Level Laser...

    Science.gov (United States)

    2011-04-14

    ... HUMAN SERVICES Food and Drug Administration 21 CFR Part 878 Medical Devices; General and Plastic Surgery...? In accordance with section 513(f)(1) of the Federal Food, Drug, and Cosmetic Act (the FD&C Act) (21 U... Medical devices. Therefore, under the Federal Food, Drug, and Cosmetic Act and under authority...

  18. A novel suturing approach for tissue displacement within minimally invasive periodontal plastic surgery.

    Science.gov (United States)

    Ronco, Vincent; Dard, Michel

    2016-08-01

    This paper describes a novel suturing approach that achieves harmonious and atraumatic soft tissue displacement in periodontal plastic surgery and soft tissue management around implants. The technique relies on a combination of horizontal and vertical mattress that are anchored at the splinted incisal contact points.

  19. A novel suturing approach for tissue displacement within minimally invasive periodontal plastic surgery

    OpenAIRE

    Ronco, Vincent; Dard, Michel

    2016-01-01

    Key Clinical Message This paper describes a novel suturing approach that achieves harmonious and atraumatic soft tissue displacement in periodontal plastic surgery and soft tissue management around implants. The technique relies on a combination of horizontal and vertical mattress that are anchored at the splinted incisal contact points.

  20. RECONSTRUCTIVE PLASTIC SURGERIES IN PATIENTS WITH MALIGNANCIES OF TONGUE AND FLOOR OF THE MOUTH. TYPES OF PLASTICS

    Directory of Open Access Journals (Sweden)

    Z. A. Radjabova

    2015-01-01

    Full Text Available Issues of tissue defects replacement after radical surgery for tumors of the head and neck do not lose their relevance. The article presents the results of plastics and replacement of the perforating combined defects of the floor of the mouth, portion of the upper and lower lips, the angle of the mouth, cheeks, neck lateral parts with simultaneous reduction of the configuration and function of the operated organs. Depending on the depth and nature of the existing tissue defect various methods of plastics were applied using arterialized flaps on the vascular pedicle in a free and non-free version. Satisfactory cosmetic and functional results were achieved in patients allowing to improve life quality and to adapt socially.

  1. Outcome-based residency education: teaching and evaluating the core competencies in plastic surgery.

    Science.gov (United States)

    Bancroft, Gregory N; Basu, C Bob; Leong, Mimi; Mateo, Carol; Hollier, Larry H; Stal, Samuel

    2008-06-01

    Through its oversight of residency education in the United States, the Accreditation Council for Graduate Medical Education has mandated new structural changes in resident education with its newly created core competencies and an emphasis on outcomes-based education. These core competencies represent the central areas in which the Accreditation Council for Graduate Medical Education believes a plastic surgery resident should receive adequate and appropriate education and training. In addition, as part of this outcomes-based education, residents are to be evaluated on their level of mastery in these core competencies. Increasingly, the Accreditation Council for Graduate Medical Education will assess the ability of residency programs to integrate the teaching and evaluating of the core competencies in their accreditation process of plastic surgery residency programs. This shift in residency evaluation initiated by the Outcomes Project by the Accreditation Council for Graduate Medical Education will have a significant impact in how plastic surgery residents are taught and, as importantly, evaluated in the coming years. The objectives of this work were as follows: (1) to outline the different methods available to foster a core competency-based plastic surgery training curriculum and (2) to serve as a primer to help both full-time academic and clinical faculty to further develop their curriculum to successfully teach and constructively evaluate their residents in the core competencies in accordance with the Accreditation Council for Graduate Medical Education guidelines. At the conclusion of this review, the reader should have a better understanding of what is necessary to formulate and help foster a plastic surgery core competency curriculum, particularly with an emphasis on the contemporary methods used for outcomes evaluations.

  2. Three-dimensional surface imaging in plastic surgery: foundation, practical applications, and beyond.

    Science.gov (United States)

    Chang, Jessica B; Small, Kevin H; Choi, Mihye; Karp, Nolan S

    2015-05-01

    Three-dimensional surface imaging has gained clinical acceptance in plastic and reconstructive surgery. In contrast to computed tomography/magnetic resonance imaging, three-dimensional surface imaging relies on triangulation in stereophotography to measure surface x, y, and z coordinates. This study reviews the past, present, and future directions of three-dimensional topographic imaging in plastic surgery. Historically, three-dimensional imaging technology was first used in a clinical setting in 1944 to diagnose orthodontologic conditions. Karlan established its use in the field of plastic surgery in 1979, analyzing contours and documenting facial asymmetries. Present use of three-dimensional surface imaging has focused on standardizing patient topographic measurements to enhance preoperative planning and to improve postoperative outcomes. Various measurements (e.g., volume, surface area, vector distance, curvature) have been applied to breast, body, and facial topography to augment patient analysis. Despite the rapid progression of the clinical applications of three-dimensional imaging, current use of this technology is focused on the surgeon's perspective and secondarily the patient's perspective. Advancements in patient simulation may improve patient-physician communication, education, and satisfaction. However, a communal database of three-dimensional surface images integrated with emerging three-dimensional printing and portable information technology will validate measurements and strengthen preoperative planning and postoperative outcomes. Three-dimensional surface imaging is a useful adjunct to plastic and reconstructive surgery practices and standardizes measurements to create objectivity in a subjective field. Key improvements in three-dimensional imaging technology may significantly enhance the quality of plastic and reconstructive surgery in the near future.

  3. Bibliometric analysis of health services research in otolaryngology journals.

    Science.gov (United States)

    Sun, Gordon H

    2012-11-01

    Determine current health services research (HSR) publication trends in major general otolaryngology journals. Bibliometric analysis. All main issues of 8 high-impact general-interest otolaryngology journals published worldwide in 2002, 2005, 2008, and 2011 were searched for HSR-related publications. To qualify as HSR, the abstract of the article must discuss access to care, cost, delivery of care, financing, health organizational or system issues, quality of care, resource utilization, and/or health outcomes. Otolaryngology topics were classified as general, pediatrics, oncology, otology and neurotology, sleep disorders, sinonasal disease, facial plastics, and/or laryngology. Other key measures included study authorship and external sponsorship or mechanism of support. Of 5958 total articles, 449 (7.5%) qualified as HSR. There was a statistically significant increase in the number of HSR publications across all journals from 2002 to 2011 (P research (337, 75.1%) was the most common type of HSR being published. The most common subject was oncology (112, 24.9%), whereas the least represented was trauma and facial plastics (4, 0.9%). First and corresponding authors were based in 31 countries, although the United States was the predominant country of origin. Nearly 95% of HSR articles in the current sample demonstrated multidisciplinary authorship. An estimated 22.9% of first authors and 17.8% of corresponding authors were female. Two-thirds of HSR publications reported no external sponsor, whereas the remainder was supported most commonly by philanthropy and hospital-based sources. Health services research is an international, multidisciplinary field of inquiry with an increasing presence in major otolaryngology journals.

  4. A systematic review of the factors predicting the interest in cosmetic plastic surgery

    Directory of Open Access Journals (Sweden)

    Panagiotis Milothridis

    2016-01-01

    Full Text Available Background: A systematic review of the literature was performed to clarify the psychosocial characteristics of patients who have an interest in cosmetic plastic surgery. Methods: Medical literature was reviewed by two independent researchers, and a third reviewer evaluated their results. Results: Twelve studies addressing the predictors of interest in cosmetic surgery were finally identified and analysed. Interest in cosmetic surgery was associated with epidemiological factors, their social networks, their psychological characteristics, such as body image, self-esteem and other personality traits and for specific psychopathology and found that these may either positively or negatively predict their motivation to seek and undergo a cosmetic procedure. Conclusions: The review examined the psychosocial characteristics associated with an interest in cosmetic surgery. Understanding cosmetic patients' characteristics, motivation and expectation for surgery is an important aspect of their clinical care to identify those patients more likely to benefit most from the procedure.

  5. Venous Thromboembolism Prophylaxis in Plastic Surgery: A Literature Review.

    Science.gov (United States)

    Hernandez, Sergio; Valdes, Jorge; Salama, Moises

    2016-06-01

    Venous thromboembolism (VTE) is a major health concern because it increases morbidity and mortality after a surgical procedure. A number of well-defined, evidence-based guidelines are available delineating suitable use of prophylaxis to prevent deep vein thrombosis and pulmonary embolism. Despite the available literature, there are clear gaps between recommendations and clinical practice, affecting the incidence of VTE. Plastic surgeons underuse the substantiated literature and risk stratification tools that are available to decrease the incidence of VTE in the office-based surgical setting because of fear of bleeding or hematoma complications postoperatively. Venous thromboembolism creates an economic burden on both the patient and the healthcare system. The intent of this literature review is to determine existing VTE risk using assessment models available to aid in the implementation of protocols for VTE prevention, specifically for high-risk cosmetic surgical patients in office-based settings.

  6. Preparation of Plaster Moulage (Cast in Plastic Surgery patients

    Directory of Open Access Journals (Sweden)

    Rana R

    2003-01-01

    Full Text Available The purpose of this paper is to describe the technique of making casts using alginate compound for negative and dental stone plaster for positive impressions. With certain modifications a cast could be made of any part of the body and one can make a museum of interesting cases. Casts serve as useful teaching material especially in cleft lip and palate patients to study the effect of surgery on growth and development of the cleft lip-palate-nose complex in relation to the remaining face. It also helps in planning reconstruction in cases of facial defects, recording serial changes in multistage surgery, pre-operative and post-operative comparison as in rhinoplasty, ear reconstruction, hand etc; for comparing results before and after treatment in keloid and hypertrophic scars, fabrication of implants and preparation of prosthesis. In spite of newer modalities like 3-D imaging and stereolithography, the usefulness of this old technique in certain interesting cases can not be denied.

  7. Medical Specialty Society Sponsored Data Registries – Opportunities in Plastic Surgery

    Science.gov (United States)

    Hume, Keith M.; Crotty, Catherine A.; Simmons, Christopher J.; Neumeister, Michael W.; Chung, Kevin C.

    2014-01-01

    Clinical data registries are commonly used worldwide and are implemented for a variety of purposes ranging from physician or facility clinic logs for tracking patients, collecting outcomes data, to measuring quality improvement or safety of medical devices. In the United States, the Food and Drug Administration has used data collected through registries to facilitate the drug and device regulatory process, ongoing surveillance during the product life-cycle, and for disease appraisals. Furthermore, the Centers for Medicare and Medicaid Services, in certain instances, base registry participation and submitting data to registries as factors for reimbursement decisions. The purpose of this article is to discuss the use of clinical data registries, the role that medical specialty societies, in particular the American Society of Plastic Surgeons and The Plastic Surgery Foundation, can have in the development and management of registries, and the opportunities for registry use in Plastic Surgery. As outcomes data are becoming essential measures of quality healthcare delivery, participating in registry development and centralized data collection has become a critical effort for Plastic Surgery to engage in to proactively participate in the national quality and performance measurement agenda. PMID:23806935

  8. Emerging trends in social media and plastic surgery.

    Science.gov (United States)

    Gould, Daniel J; Leland, Hyuma A; Ho, Adelyn L; Patel, Ketan M

    2016-12-01

    Social media has increasingly changed the landscape of medicine and surgery and is rapidly expanding its influence in most peoples' lives. The average person spends nearly 2 hours per day using social media, consuming information about everything from family updates to entertainment news to presidential elections. The concentration of consumers on social media platforms has resulted in direct medicine and medical products marketing to consumers. Similarly, social media is increasingly becoming a platform for interaction between physicians and potential patients. Some physicians have taken this opportunity to better educate patients, while allowing patients to learn more about their surgeons online. These tools can increase internet traffic online to bonafide internet sites, as well as bolster marketing for many hospitals, hospital systems, and individual doctors. It can also serve to increase knowledge about procedures and conditions through direct outreach to patients. Social media is a powerful tool which needs to be utilized wisely to avoid pitfalls.

  9. Acellular Dermal Matrix in Reconstructive Breast Surgery: Survey of Current Practice among Plastic Surgeons

    Science.gov (United States)

    Ibrahim, Ahmed M. S.; Koolen, Pieter G. L.; Ashraf, Azra A.; Kim, Kuylhee; Mureau, Marc A. M.; Lee, Bernard T.

    2015-01-01

    Background: Acellular dermal matrices (ADMs) in plastic surgery have become increasingly popular particularly for breast reconstruction. Despite their advantages, questions exist regarding their association with a possible increased incidence of complications. We describe a collective experience of plastic surgeons’ use of ADMs in reconstructive breast surgery using an internet-based survey. Methods: Members of the American Society of Plastic Surgeons were recruited through voluntary, anonymous participation in an online survey. The web-based survey garnered information about participant demographics and their experience with ADM use in breast reconstruction procedures. After responses were collected, all data were anonymously processed. Results: Data were ascertained through 365 physician responses of which 99% (n = 361) completed the survey. The majority of participants were men (84.5%) between 51 and 60 years (37.4%); 84.2% used ADM in breast reconstruction, including radiated patients (79.7%). ADM use was not favored for nipple reconstruction (81.5%); 94.6% of participants used drains, and 87.8% administered antibiotics postoperatively. The most common complications were seroma (70.9%) and infection (16%), although 57.4% claimed anecdotally that overall complication rate was unchanged after incorporating ADM into their practice. High cost was a deterrent for ADM use (37.5%). Conclusions: Plastic surgeons currently use ADM in breast reconstruction for both immediate and staged procedures. Of those responding, a majority of plastic surgeons will incorporate drains and use postoperative antibiotics for more than 48 hours. PMID:25973359

  10. Legal issues of computer imaging in plastic surgery: a primer.

    Science.gov (United States)

    Chávez, A E; Dagum, P; Koch, R J; Newman, J P

    1997-11-01

    Although plastic surgeons are increasingly incorporating computer imaging techniques into their practices, many fear the possibility of legally binding themselves to achieve surgical results identical to those reflected in computer images. Computer imaging allows surgeons to manipulate digital photographs of patients to project possible surgical outcomes. Some of the many benefits imaging techniques pose include improving doctor-patient communication, facilitating the education and training of residents, and reducing administrative and storage costs. Despite the many advantages computer imaging systems offer, however, surgeons understandably worry that imaging systems expose them to immense legal liability. The possible exploitation of computer imaging by novice surgeons as a marketing tool, coupled with the lack of consensus regarding the treatment of computer images, adds to the concern of surgeons. A careful analysis of the law, however, reveals that surgeons who use computer imaging carefully and conservatively, and adopt a few simple precautions, substantially reduce their vulnerability to legal claims. In particular, surgeons face possible claims of implied contract, failure to instruct, and malpractice from their use or failure to use computer imaging. Nevertheless, legal and practical obstacles frustrate each of those causes of actions. Moreover, surgeons who incorporate a few simple safeguards into their practice may further reduce their legal susceptibility.

  11. Do plastic surgery division heads and program directors have the necessary tools to provide effective leadership?

    Science.gov (United States)

    Arneja, Js; McInnes, Cw; Carr, Nj; Lennox, P; Hill, M; Petersen, R; Woodward, K; Skarlicki, D

    2014-01-01

    Effective leadership is imperative in a changing health care landscape driven by increasing expectations in a setting of rising fiscal pressures. Because evidence suggests that leadership abilities are not simply innate but, rather, effective leadership can be learned, it is prudent for plastic surgeons to evaluate the training and challenges of their leaders because there may be opportunities for further growth and support. To investigate the practice profiles, education/training, responsibilities and challenges of leaders within academic plastic surgery. Following research ethics board approval, an anonymous online survey was sent to division heads and program directors from all university-affiliated plastic surgery divisions in Canada. Survey themes included demographics, education/training, job responsibilities and challenges. A response rate of 74% was achieved. The majority of respondents were male (94%), promoted to their current position at a mean age of 48 years, did not have a leadership-focused degree (88%), directly manage 30 people (14 staff, 16 faculty) and were not provided with a job description (65%). Respondents worked an average of 65 h per week, of which 18% was devoted to their leadership role, 59% clinically and the remainder on teaching and research. A discrepancy existed between time spent on their leadership role (18%) and related compensation (10%). Time management (47%) and managing conflict (24%) were described as the greatest leadership challenges by respondents. Several gaps were identified among leaders in plastic surgery including predominance of male sex, limitations in formal leadership training and requisite skill set, as well as compensation and human resources management (emotional intelligence). Leadership and managerial skills are key core competencies, not only for trainees, but certainly for those in a position of leadership. The present study provides evidence that academic departments, universities and medical centres may

  12. [Gender patterns in Spanish otolaryngologic doctoral theses].

    Science.gov (United States)

    Prim-Espada, María Pilar; De Diego-Sastre, Juan Ignacio; Pérez-Fernández, Elia

    2010-01-01

    In last decades women in Spain have a greater access to postgraduate education. The objective of this study was to perform a gender analysis on the Otolaryngology doctoral theses presented in a 25 year-period. The TESEO data base on doctoral theses was searched for theses on Otorhinolaryngology written between 1981 and 2005. As strategy for the research we employed the terms: 1) Otorrinolaringología (Otorhinolaryngology); 2) Cirugía de garganta, nariz y oídos (Ear, nose and throat surgery); 3) Fisiología de la audición (Physiology of hearing); 4) Fisiología del equilibrio (Physiology of balance); 5) Física de la audición (Physics of hearing); and 6) Bioacústica (Bioacoustics). A total of 450 theses (18.0±8.3 theses/year) were found, of which 129 were written by females (28.6%). There was a gender imbalance among authors, with 5.2±3.4 theses/year for women vs. 12.9±6.6 theses/year for men (p=0.0002). Nevertheless, there was a tendency toward equality in the last 10 years (p=0.001). On the other hand, the PhD student's gender was clearly related to the supervisor's gender (p=0.0001). With respect to the main topics in our area (otology, audiology/vestibular diseases, rhinology and pathology of paranasal sinuses and neck diseases), there were no significant differences between males and females (p=0.231). These results indicate a tendency towards equality in the number of men and women successfully completing doctoral studies in Otolaryngology. However, the PhD student's gender is clearly related to the supervisor's gender. Copyright © 2010 Elsevier España, S.L. All rights reserved.

  13. Patient safety in plastic surgery: identifying areas for quality improvement efforts.

    Science.gov (United States)

    Hernandez-Boussard, Tina; McDonald, Kathryn M; Rhoads, Kim F; Curtin, Catherine M

    2015-05-01

    Improving quality of health care is a global priority. Before quality benchmarks are established, we first must understand rates of adverse events (AEs). This project assessed risk-adjusted rates of inpatient AEs for soft tissue reconstructive procedures.Patients receiving soft tissue reconstructive procedures from 2005 to 2010 were extracted from the Nationwide Inpatient Sample. Inpatient AEs were identified using patient safety indicators (PSIs), established measures developed by Agency for Healthcare Research and Quality.We identified 409,991 patients with soft tissue reconstruction and 16,635 (4.06%) had a PSI during their hospital stay. Patient safety indicators were associated with increased risk-adjusted mortality, longer length of stay, and decreased routine disposition (P plastic surgery patients had significantly lower risk-adjusted rate compared to other surgical inpatients for all events evaluated except for failure to rescue and postoperative hemorrhage or hematoma, which were not statistically different. Risk-adjusted rates of hematoma hemorrhage were significantly higher in patients receiving size-reduction surgery, and these rates were further accentuated when broken down by sex and payer. In general, plastic surgery patients had lower rates of in-hospital AEs than other surgical disciplines, but PSIs were not uncommon. With the establishment of national basal PSI rates in plastic surgery patients, benchmarks can be devised and target areas for quality improvement efforts identified. Further prospective studies should be designed to elucidate the drivers of AEs identified in this population.

  14. Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics.

    Science.gov (United States)

    Joseph, Andrew W; Ishii, Lisa; Joseph, Shannon S; Smith, Jane I; Su, Peiyi; Bater, Kristin; Byrne, Patrick; Boahene, Kofi; Papel, Ira; Kontis, Theda; Douglas, Raymond; Nelson, Christine C; Ishii, Masaru

    2017-07-01

    Body dysmorphic disorder (BDD) is a relative contraindication for facial plastic surgery, but formal screening is not common in practice. The prevalence of BDD in patients seeking facial plastic surgery is not well documented. To establish the prevalence of BDD across facial plastic and oculoplastic surgery practice settings, and estimate the ability of surgeons to screen for BDD. This multicenter prospective study recruited a cohort of 597 patients who presented to academic and private facial plastic and oculoplastic surgery practices from March 2015 to February 2016. All patients were screened for BDD using the Body Dysmorphic Disorder Questionnaire (BDDQ). After each clinical encounter, surgeons independently evaluated the likelihood that a participating patient had BDD. Validated instruments were used to assess satisfaction with facial appearance including the FACE-Q, Blepharoplasty Outcomes Evaluation (BOE), Facelift Outcomes Evaluation (FOE), Rhinoplasty Outcomes Evaluation (ROE), and Skin Rejuvenation Outcomes Evaluation (SROE). Across participating practices (9 surgeons, 3 sites), a total of 597 patients were screened for BDD: 342 patients from site 1 (mean [SD] age, 44.2 [16.5] years); 158 patients, site 2 (mean [SD] age, 46.0 [16.2] years), site 3, 97 patients (mean [SD] age, 56.3 [15.5] years). Overall, 58 patients [9.7%] screened positive for BDD by the BDDQ instrument, while only 16 of 402 patients [4.0%] were clinically suspected of BDD by surgeons. A higher percentage of patients presenting for cosmetic surgery (37 of 283 patients [13.1%]) compared with those presenting for reconstructive surgery (21 of 314 patients [6.7%]) screened positive on the BDDQ (odds ratio, 2.10; 95% CI, 1.20-3.68; P = .01). Surgeons were only able to correctly identify 2 of 43 patients (4.7%) who screened positive for BDD on the BDDQ, and the positive likelihood ratio was only 1.19 (95% CI, 0.28-5.07). Patients screening positive for BDD by the BDDQ had lower

  15. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena Felicia; Rose, Michael; Bentzon, Niels

    2015-01-01

    INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level...... symmetrisation procedures were performed by plastic surgeons. Breast surgeons had sought more specific education, both international observerships and specific courses. In both groups of surgeons, the majority expressed that both tumour removal and reconstruction should be performed by doctors of their own...

  16. Biopolymers for Hard and Soft Engineered Tissues: Application in Odontoiatric and Plastic Surgery Field

    Directory of Open Access Journals (Sweden)

    Barbara Zavan

    2011-02-01

    Full Text Available The goal of modern dentistry and plastic surgery is to restore the patient to normal function, health and aesthetics, regardless of the disease or injury to the stomatognathic and cutaneous system respectively. In recent years tissue engineering and regenerative medicine have yielded many novel tissue replacements and implementation strategies. Scientific advances in biomaterials, stem cell isolation, growth and differentiation factors and biomimetic environments have created unique opportunities to fabricate tissues in the laboratory. Repairing of bone and skin is likely to become of clinical interest when three dimensional tissue reconstructive procedures and the appropriate supporting biomimetic materials are correctly assembled. In the present review, we provide an overview of the most promising biopolymers that may find clinical application in dento-maxillo-facial and plastic surgery.

  17. Pressure sores–a constant problem for plegic patients and a permanent challenge for plastic surgery

    Science.gov (United States)

    Marinescu, S; Florescu, IP; Jecan, C

    2010-01-01

    Pressure sores–a constant problem for plegic patients and a permanent challenge for plastic surgery Pressure sores can be defined as lesions caused by unrelieved pressure resulting in damage of the underlying tissue. They represent a common problem in the pathology of plegic patients and, plastic surgery has a significant role in their treatment. Pressure sores occur over bony prominences and so, they are most commonly seen at the sacrum and trochanters in paralyzed patients and at ischium for the patients who sit in a wheelchair for a long time. For these patients, surgical treatment is very important because on one hand, it stops the loss of nutrients and proteins at the site of the pressure sore, and on the other hand, it permits the initiation of neuromuscular recuperation treatment much faster. PMID:20968200

  18. [The Body Dysmorphic Disorder in Plastic Surgery - A Systematic Review of Screening Methods].

    Science.gov (United States)

    Houschyar, K S; Philipps, H M; Duscher, D; Rein, S; Weissenberg, K; Nietzschmann, I; Maan, Z N; Pyles, M N; Siemers, F

    2017-08-01

    Background The body dysmorphic disorder (BDD) is considered to be a sub-form of somatoform disorders. BDD can express itself in a delirious experience, an excessive evaluation and employment of the external appearance, in particular the face. Preliminary results suggest that individuals with BDD do not benefit from plastic surgery, so that aesthetic surgery often results in aggravation of their symptoms. Thus, the identification of signs for a BDD is crucial, whether a patient should be operated plastically-aesthetically. This overview explains the often difficult diagnostics of the BDD by summarizing the current literature on its screening. Study design Systematic overview Methods An electronic search was conducted in the German and English-language literature in order to identify all screening instruments for the BDD. The specific development and validation processes are assessed whether the screening instruments have a positive predictive value for the BDD. Results Six different screening instruments were identified for the BDD. Only two of these were evaluated in a cosmetic setting: the "Body Dysmorphic Disorder Questionnaire Dermatology Version" (BDDQ-DV) and the "Dysmorphic Concern Questionnaire" (DCQ). The influence on the subjective results after a plastic-aesthetic procedure was measured only for the DCQ. Conclusion The limited availability of validated screening instruments for BDD in plastic surgery is markedly in contrast to the supposedly high prevalence of the disease of 2.4 %. Among the currently used screening tools, the BDDQ-DV and the DCQ appear to be most suitable. Further research efforts are needed to establish better screening methods for the BDD in the plastic surgical patient population and to examine the effects of BDD on treatment results. Georg Thieme Verlag KG Stuttgart · New York.

  19. Conversion of Plastic Surgery meeting abstract presentations to full manuscripts: a brazilian perspective.

    Science.gov (United States)

    Denadai, Rafael; Pinho, André Silveira; Samartine, Hugo; Denadai, Rodrigo; Raposo-Amaral, Cassio Eduardo

    2017-01-01

    to assess the conversion rate of Plastic Surgery meeting abstract presentations to full manuscript publications and examine factors associated with this conversion. we assessed the abstracts presented at the 47th and 48th Brazilian Congresses of Plastic Surgery by cross-referencing with multiple databases. We analyzed the Abstracts' characteristics associated with full manuscript publications. of the 200 abstracts presented, 50 abstracts were subsequently published in full, giving the conference a conversion rate of 25%. The mean time to publish was 15.00±13.75 months. In total, there were 4.93±1.63 authors per abstract and 67.8±163 subjects per abstract; 43.5% of the abstracts were of retrospective studies; 69% comprised the plastic surgery topics head and neck, and chest and trunk, and 88.5% had no statistical analysis. Overall, 80% of the manuscripts were published in plastic surgery journals, 76% had no impact factor and 52% had no citations. Bivariate and multivariate analyses revealed the presence of statistical analysis to be the most significant (previstas de Cirurgia Plástica, 76% não exibiam fator de impacto e 52% não possuíam citações. As análises bivariada e multivariada revelaram que a presença de análise estatística foi o fator preditivo significativo (p<0,05) para a conversão de resumos em manuscritos completos. a taxa de conversão deste estudo bibliométrico foi inferior à tendência de conversão descrita em congressos internacionais de Cirurgia Plástica, e a presença de análise estatística foi um determinante para o sucesso de conversão.

  20. Plastic surgery residents' attitudes and understanding of biostatistics: a pilot study.

    Science.gov (United States)

    Susarla, Srinivas M; Redett, Richard J

    2014-01-01

    To assess plastic surgery residents' knowledge, attitudes, and comfort with biostatistics. Cross-sectional study. Department of Plastic and Reconstructive Surgery at Johns Hopkins Hospital. A total of 22 plastic surgery residents (91% response rate) completed the study. The study sample consisted of 18 residents in the integrated training path and 4 in the independent training track and was equally divided between junior and senior residents. Most respondents (>54%) had taken at least 1 course in biostatistics or epidemiology. More than 90% of residents reported reading at least 1 plastic surgical journal on a regular basis (mean 2.1 ± 1.5 journals/month). Most residents expressed a desire to learn more about biostatistics (68.2%), reported using statistical information in forming clinical opinions (86.3%), and placed a high value on knowledge of biostatistics in appraising the surgical literature (90.9%). However, only 45% of respondents reported being able to understand all the statistical terms encountered in journal articles. Only 50% of respondents felt comfortable with assessing whether the appropriate statistical tests were used to answer a research question. In case studies, the mean percentage of correct responses was 53.0 ± 24.5% (range: 0-83.3). Higher performance scores were associated with a prior course in biostatistics (p = 0.04) and the number of journals read monthly (p = 0.003). Respondents had difficulty with study design (45.5% correct), analysis of variance (45.5% correct), time to event analysis (9.1% correct), and interpreting a 95% confidence interval (45.5% correct). The number of correct responses strongly correlated with respondent confidence in biostatistics (r = 0.70, p biostatistics but have only a fair understanding of core statistical concepts. Copyright © 2014 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  1. Challenges of periodontal plastic surgery in a depressed economy: a report of two cases

    OpenAIRE

    Solomon O Nwhator

    2010-01-01

    Solomon O NwhatorDepartment of Preventive and Community Dentistry, Obafemi Awolowo University, Ile-Ife, NigeriaAbstract: Advancements in restorative dentistry have resulted in people keeping their teeth for longer, and an increase in gingival recession as the gums recede due to age, periodontal disease, thin gingiva, or other factors. The demand for periodontal plastic surgery appears to be increasing. Several methods have been used in the treatment of denuded roots. Of these, the free gingiv...

  2. [Some similarities between the work of M.C. Escher and plastic surgery].

    Science.gov (United States)

    Marck, K W

    2002-12-21

    At first sight there would appear to be no similarities between the work of the Dutch graphic artist M.C. Escher and plastic surgery. M.C. Escher was a gifted graphic artist who produced a large collection of work. Most of his fame is due to the works that play with symmetry, space and infinity and leave the viewer astounded. However, how Escher came to produce these works is less well known. A theory which he developed himself formed the basis of the regular plane division. It later became apparent that this theory almost completely agreed with the mathematics of plane division. Two movements (isometries) defined in mathematics, translation and rotation, are equivalent to two techniques for transferring local skin in plastic surgery, namely, advancement and transposition. Escher's performance on the plane of a sheet of paper and a plastic surgeon's performance on the plane of the skin, therefore have a similar mathematical background. Escher has visualised these mathematical rules in an unusual and artistic manner, whereas plastic surgeons apply these rules in the grace of an elastic and healing nature.

  3. Practice Patterns and Projections for the US Pediatric Otolaryngology Workforce.

    Science.gov (United States)

    Bell, Jason R; Ruch-Ross, Holly; Hotaling, Andrew J

    2016-09-01

    This study represents up-to-date information on the current status of and future projections for the pediatric otolaryngology workforce. To provide an update on the practice patterns of and projections for the US pediatric otolaryngology workforce. An online survey was sent to all 172 members of the American Academy of Pediatrics Section on Otolaryngology-Head and Neck Surgery and fielded from May 29, 2014, to September 17, 2014. Current status of and perceived trends in the pediatric otolaryngology workforce. Eighty-four (48.8%) of the 172 members responded to the survey. Not all respondents answered all questions, and so totals and percentages might not reflect a total of 84 for any given response. The demographics and practice characteristics of the responding pediatric otolaryngologists were similar to those noted in a 1997 workforce survey. Fifty-four percent of respondents (n = 38) planned to continue full-time work over the next 5 years, and 47% (n = 31) believed that the number of patients in their practice was increasing. The proportion of those who believed that the need for pediatric otolaryngologists in their community was increasing (31%; n = 21) or decreasing (13%; n = 9) remained relatively constant from the 1997 survey (34% and 12%, respectively). Forty-nine percent (n = 35) reported believing that the number of pediatric otolaryngologists being trained was appropriate and that the need in their community was stable. Eighty-three percent (n = 55) reported believing that employment opportunities for pediatric otolaryngologists in the United States would be plentiful in the near future. The overall state of the pediatric otolaryngology workforce appears stable. The perceived current and future needs for pediatric otolaryngologists appear to be met by the current number of trainees. Employment opportunities appear promising for future pediatric otolaryngologists based on our respondents' opinions. This represents up

  4. Otolaryngology Training for Family Practice Residents.

    Science.gov (United States)

    And Others; Rood, Stewart R.

    1980-01-01

    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  5. 3D animation of facial plastic surgery based on computer graphics

    Science.gov (United States)

    Zhang, Zonghua; Zhao, Yan

    2013-12-01

    More and more people, especial women, are getting desired to be more beautiful than ever. To some extent, it becomes true because the plastic surgery of face was capable in the early 20th and even earlier as doctors just dealing with war injures of face. However, the effect of post-operation is not always satisfying since no animation could be seen by the patients beforehand. In this paper, by combining plastic surgery of face and computer graphics, a novel method of simulated appearance of post-operation will be given to demonstrate the modified face from different viewpoints. The 3D human face data are obtained by using 3D fringe pattern imaging systems and CT imaging systems and then converted into STL (STereo Lithography) file format. STL file is made up of small 3D triangular primitives. The triangular mesh can be reconstructed by using hash function. Top triangular meshes in depth out of numbers of triangles must be picked up by ray-casting technique. Mesh deformation is based on the front triangular mesh in the process of simulation, which deforms interest area instead of control points. Experiments on face model show that the proposed 3D animation facial plastic surgery can effectively demonstrate the simulated appearance of post-operation.

  6. Validity, Reliability, and the Questionable Role of Psychometrics in Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Eric Swanson, MD

    2014-06-01

    Full Text Available Summary: This report examines the meaning of validity and reliability and the role of psychometrics in plastic surgery. Study titles increasingly include the word “valid” to support the authors’ claims. Studies by other investigators may be labeled “not validated.” Validity simply refers to the ability of a device to measure what it intends to measure. Validity is not an intrinsic test property. It is a relative term most credibly assigned by the independent user. Similarly, the word “reliable” is subject to interpretation. In psychometrics, its meaning is synonymous with “reproducible.” The definitions of valid and reliable are analogous to accuracy and precision. Reliability (both the reliability of the data and the consistency of measurements is a prerequisite for validity. Outcome measures in plastic surgery are intended to be surveys, not tests. The role of psychometric modeling in plastic surgery is unclear, and this discipline introduces difficult jargon that can discourage investigators. Standard statistical tests suffice. The unambiguous term “reproducible” is preferred when discussing data consistency. Study design and methodology are essential considerations when assessing a study’s validity.

  7. Big Data and Machine Learning in Plastic Surgery: A New Frontier in Surgical Innovation.

    Science.gov (United States)

    Kanevsky, Jonathan; Corban, Jason; Gaster, Richard; Kanevsky, Ari; Lin, Samuel; Gilardino, Mirko

    2016-05-01

    Medical decision-making is increasingly based on quantifiable data. From the moment patients come into contact with the health care system, their entire medical history is recorded electronically. Whether a patient is in the operating room or on the hospital ward, technological advancement has facilitated the expedient and reliable measurement of clinically relevant health metrics, all in an effort to guide care and ensure the best possible clinical outcomes. However, as the volume and complexity of biomedical data grow, it becomes challenging to effectively process "big data" using conventional techniques. Physicians and scientists must be prepared to look beyond classic methods of data processing to extract clinically relevant information. The purpose of this article is to introduce the modern plastic surgeon to machine learning and computational interpretation of large data sets. What is machine learning? Machine learning, a subfield of artificial intelligence, can address clinically relevant problems in several domains of plastic surgery, including burn surgery; microsurgery; and craniofacial, peripheral nerve, and aesthetic surgery. This article provides a brief introduction to current research and suggests future projects that will allow plastic surgeons to explore this new frontier of surgical science.

  8. Financial conflicts of interest in plastic surgery: background, potential for bias, disclosure, and transparency.

    Science.gov (United States)

    Luce, Edward A

    2015-04-01

    Relationships between physicians and industry, whether it be pharmaceutical companies, medical device manufacturers, or purveyors of medical technology, contain both an element of potential for good and a potential for harm. Certainly, the potential for good is realized when the collaboration results in improved plastic surgery patient care due to product and technology development. If the collaboration contains a financial component, the potential for harm exists in the form of a financial conflict of interest on the part of the physician. Recently, considerable discussion has been directed toward the pervasiveness of financial conflict of interest in all three arenas of the profession of medicine: education, research, and clinical practice, although an overlap exists among all three with respect to the issue of conflict of interest. This article will focus on conflict of interest in plastic surgery education, both continuing medical education for practitioners and graduate medical education for plastic surgery residents, as well as conflict of interest in research, such as conflicts related to publications in our literature.

  9. Plastic surgery in the treatment of primary melanoma of the skin

    Directory of Open Access Journals (Sweden)

    Panajotović Ljubomir

    2003-01-01

    Full Text Available Surgery is still the most effective treatment modality of skin melanoma. The margins of excision are determined by the thickness of primary tumor. From January 1999 to December 2001, 99 patients (57 male and 42 female, of the average age 55, were surgically treated at the Clinic for Plastic Surgery and Burns of the Military Medical Academy. The most usual localization of the primary tumor was the back (23.23%, followed by the forearm, and the lower leg. Regarding the clinical type of the melanoma, nodular melanoma dominated (62.62%. Microscopic staging of the melanoma (classification according to Clark and Breslow, showed that the majority of patients already suffered from the advanced primary disease, which called for radical excision and the choice of reconstructive methods in the closure of post-excision defects. The reconstructive plastic surgical methods enabled the closure of post-excision tissue defects, regardless of their size, structure, and localization. During the closure of post-excision defects, direct wound closure or split skin draft was performed in 76.76% of patients. Flaps were applied in 19.19% of patients with the primary melanoma of the head, face foot, and hand. The sufficiency of the available reconstructive procedures makes plastic surgery irreplaceable in the surgical treatment of the primary melanoma of the skin.

  10. Efficacy of communication amongst staff members at plastic and reconstructive surgery section using smartphone and mobile WhatsApp

    National Research Council Canada - National Science Library

    Wani, Shabeer Ahmad; Rabah, Sari M; Alfadil, Sara; Dewanjee, Nancy; Najmi, Yahya

    2013-01-01

    The objective of this study is to assess the efficacy of smartphone and its WhatsApp application as a communication method amongst the staff of plastic and reconstructive surgery section at tertiary care health facility...

  11. The burn disease: a disease of great value in the cultural heritage of plastic surgery.

    Science.gov (United States)

    Mazzoleni, F

    2014-06-30

    In 1961 I began my career as a plastic surgeon at the Department of Plastic Surgery of the Civic Hospital of Padua. In those years, the department was headed by its founder, Prof. G. Dogo, who had just gained his independence to work within the discipline of surgery. Its key feature consisted, at its core, in an entirely new section for those times: the Burn Centre, later known as the "Intensive Care Unit for Acute Burn Victims." At that time, Prof. Masellis, the founder of the Mediterranean Burn Club, was also working among us. The department was still dealing with the disastrous traumatic pathologies that the Italian population had from the Second World War. The beds were still largely occupied by patients suffering from war injuries caused by bomb explosions and fires. These were the reason for the creation of the Burn Centre and subsequently for the promotion of the establishment of a department of plastic surgery. I therefore had the opportunity to see a multitude of different clinical cases and to experiment with the various operation techniques known to plastic surgeons at the time. But it was not only the surgical aspect that fascinated me; I was fascinated by the burn as a disease - the extraordinary problems of their pathophysiology and the logic of treating them, generally and locally - no longer as had been suggested by vague suppositions, but by suggestive hypotheses based on clinical and experimental observations. Over the years, the skills involved in plastic surgery have expanded: its numerous therapeutic procedures have been applied to the treatment of many other diseases. But the burn-as-disease was always at the top of my cultural interests. It always had something to teach me, whether clinically, scientifically or ethically. Yes, even ethically, because the burn patient, like few others who are ill, truly challenges his physician's ethical core and moral strength. The contents of this piece of writing stem from "opinions" that the author has had

  12. The burn disease: a disease of great value in the cultural heritage of plastic surgery

    Science.gov (United States)

    Mazzoleni, F.

    2014-01-01

    Personal introduction In 1961 I began my career as a plastic surgeon at the Department of Plastic Surgery of the Civic Hospital of Padua. In those years, the department was headed by its founder, Prof. G. Dogo, who had just gained his independence to work within the discipline of surgery. Its key feature consisted, at its core, in an entirely new section for those times: the Burn Centre, later known as the “Intensive Care Unit for Acute Burn Victims.” At that time, Prof. Masellis, the founder of the Mediterranean Burn Club, was also working among us. The department was still dealing with the disastrous traumatic pathologies that the Italian population had from the Second World War. The beds were still largely occupied by patients suffering from war injuries caused by bomb explosions and fires. These were the reason for the creation of the Burn Centre and subsequently for the promotion of the establishment of a department of plastic surgery. I therefore had the opportunity to see a multitude of different clinical cases and to experiment with the various operation techniques known to plastic surgeons at the time. But it was not only the surgical aspect that fascinated me; I was fascinated by the burn as a disease – the extraordinary problems of their pathophysiology and the logic of treating them, generally and locally – no longer as had been suggested by vague suppositions, but by suggestive hypotheses based on clinical and experimental observations. Over the years, the skills involved in plastic surgery have expanded: its numerous therapeutic procedures have been applied to the treatment of many other diseases. But the burn-as-disease was always at the top of my cultural interests. It always had something to teach me, whether clinically, scientifically or ethically. Yes, even ethically, because the burn patient, like few others who are ill, truly challenges his physician’s ethical core and moral strength. The contents of this piece of writing stem from

  13. Quality Improvement in Otolaryngology Residency: Survey of Program Directors.

    Science.gov (United States)

    Bowe, Sarah N

    2016-02-01

    The Clinical Learning Environment Review focuses on the responsibility of the sponsoring institution for quality and patient safety. Very little information is known regarding the status of quality improvement (QI) education during otolaryngology training. The purpose of this survey is to evaluate the extent of resident and faculty participation in QI and identify opportunities for both resident curriculum and faculty development. Cross-sectional survey A 15-item survey was distributed to all 106 otolaryngology program directors. The survey was developed after an informal review of the literature regarding education in QI and patient safety. Questions were directed at the format and content of the QI curriculum, as well as barriers to implementation. There was a 39% response rate. Ninety percent of responding program directors considered education in QI important or very important to a resident's future success. Only 23% of responding programs contained an educational curriculum in QI, and only 33% monitored residents' individual outcome measures. Barriers to implementation of a QI program included inadequate number of faculty with expertise in QI (75%) and competing resident educational demands (90%). Every program director considered morbidity and mortality conferences as an integral component in QI education. Program directors recognize the importance of QI in otolaryngology practice. Unfortunately, this survey identifies a distinct lack of resources in support of these educational goals. The results highlight the need to generate a comprehensive and stepwise approach to QI for faculty development and resident instruction. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  14. 76 FR 39882 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-07-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  15. 78 FR 30928 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2013-05-23

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  16. 76 FR 62419 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-10-07

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  17. 76 FR 14415 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2011-03-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  18. 78 FR 16684 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2013-03-18

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  19. 77 FR 20642 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2012-04-05

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  20. 75 FR 49940 - General and Plastic Surgery Devices Panel of the Medical Devices Advisory Committee; Notice of...

    Science.gov (United States)

    2010-08-16

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration General and Plastic Surgery Devices Panel of the Medical... Administration (FDA). The meeting will be open to the public. Name of Committee: General and Plastic...

  1. Esthetic plastic surgery: Experiencies concerning corporal (reconstructions and implications for nursin

    Directory of Open Access Journals (Sweden)

    Carla Fernanda Voese

    2015-05-01

    Full Text Available Objective: to identify reasons which lead healthy subjects to search, for the first time, surgical methods for corporal modifications. Methods: it is a descriptive, exploratory and qualitative study. Data were collected through semi-structured interviews which were recorded. The interviews were made with eight women and resulted into four analytic categories. Results: the reasons which took healthy subjects to face surgical risks are regarding the improvement of the satisfaction with their own corporal image aiming at reaching a higher social insertion. It was observed that dissatisfaction concerning physical appearance was generated by inherited characteristics or by marks left after pregnancy. Financial cost, fear and family support, can make the decision to undergo the surgery difficult. Conclusion: the plastic surgery can promote the regain of self-esteem in the subject who makes the surgery.

  2. Perceptual Assessment of Velopharyngeal Dysfunction by Otolaryngology Residents.

    Science.gov (United States)

    Butts, Sydney C; Truong, Alan; Forde, Christina; Stefanov, Dimitre G; Marrinan, Eileen

    2016-12-01

    To assess the ability of otolaryngology residents to rate the hypernasal resonance of patients with velopharyngeal dysfunction. We hypothesize that experience (postgraduate year [PGY] level) and training will result in improved ratings of speech samples. Prospective cohort study. Otolaryngology training programs at 2 academic medical centers. Thirty otolaryngology residents (PGY 1-5) were enrolled in the study. All residents rated 30 speech samples at 2 separate times. Half the residents completed a training module between the rating exercises, with the other half serving as a control group. Percentage agreement with the expert rating of each speech sample and intrarater reliability were calculated for each resident. Analysis of covariance was used to model accuracy at session 2. The median percentage agreement at session 1 was 53.3% for all residents. At the second session, the median scores were 53.3% for the control group and 60% for the training group, but this difference was not statistically significant. Intrarater reliability was moderate for both groups. Residents were more accurate in their ratings of normal and severely hypernasal speech. There was no correlation between rating accuracy and PGY level. Score at session 1 positively correlated with score at session 2. Perceptual training of otolaryngology residents has the potential to improve their ratings of hypernasal speech. Length of time in residency may not be best predictor of perceptual skill. Training modalities incorporating practice with hypernasal speech samples could improve rater skills and should be studied more extensively. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  3. 以学生为中心的耳鼻咽喉头颈外科学本科临床教学体系构建及意义%Construction of student-centered learning system for undergraduate clinical training in otolaryngology-head and neck surgery

    Institute of Scientific and Technical Information of China (English)

    钟诚; 张学渊; 姜振东; 魏运军; 袁伟

    2013-01-01

    对本科医学生耳鼻咽喉头颈外科学临床学习阶段的教学实践加以总结,提出以学生为中心的教学策略并应用于教学过程.构建涵盖教学理念整体化、教学手段形象化、教学目标多元化、教学方式互动化的四个框架,采用内镜、多媒体等形式教学,设定不同的教学目标,实施不同的临床教学策略,推动学生综合素质和临床能力发展.%The author proposed student-centered learning system in otolaryngology-head and neck surgery for undergraduate clinical training after exploration and intentions.Four mutual impacted frames were built including integration of teaching philosophy,visualization of training methods,diversification of educational targets and interaction of training courses.Endoscopic navigated learning and multimedia aided training were applied,respective teaching purposes were set and various clinical training courses were introduced to students in their learning of otolaryngology,which were believed to help develop more medical talents with higher comprehensive qualities and better clinical skills.

  4. Otolaryngology Education: Recent Trends in Publication.

    Science.gov (United States)

    Cass, Nathan D; Okland, Tyler S; Rodriguez, Kenny; Mann, Scott E

    2017-06-01

    Objectives (1) Evaluate peer-reviewed publications regarding education in otolaryngology since 2000. (2) Analyze publication trends as compared with overall otolaryngology publications. Study Design Bibliometric analysis. Setting Academic medical center. Subjects and Methods A search for articles regarding education in otolaryngology from 2000 to 2015 was performed with MEDLINE and EMBASE databases, yielding 1220 articles; 362 relevant publications were categorized by topic, subspecialty, subject, article type, and funding source. Impact factors for each journal by year were obtained, and trends of each category over time were analyzed. These were then compared with publication numbers and impact factors for all otolaryngology journals. Results From 2000 to 2015, publications in otolaryngology education increased more rapidly than the field of otolaryngology overall. The most published topics included operative skills training, surgical simulation, and professionalism/career development. Recently there has been a decline in publications related to residency administration and duty hours relative to other topics. Only 12.2% of publications reported a funding source, and only 12.2% of studies were controlled. Conclusion Recent trends in otolaryngology literature reflect an increasing focus on education; however, this work is underfunded and often lacks high-quality evidence.

  5. Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice-A Comparative Study.

    Science.gov (United States)

    Farid, M; Vaughan, R; Thomas, S

    2017-01-01

    The undergraduate medical curriculum has been overcrowded with core learning outcomes with no formal exposure to plastic surgery. The aim of this study was to compare medical students from two educational settings for the basic understanding, preferred learning method, and factors influencing a career choice in plastic surgery. A prospective cohort study based on a web-based anonymous questionnaire sent to final year medical students at Birmingham University (United Kingdom), McGill University (Canada), and a control group (non-medical staff). The questions were about plastic surgery: (1) source of information and basic understanding; (2) undergraduate curriculum inclusion and preferred learning methods; (3) factors influencing a career choice. A similar questionnaire was sent to non-medical staff (control group). The data was analysed based on categorical outcomes (Chi-square χ2) and level of significance p ≤ 0.05. Questionnaire was analysed for 243 students (Birmingham, n = 171/332, 52%) (McGill n = 72/132, 54%). Birmingham students (14%) considered the word "plastic" synonymous with "cosmetic" more than McGill students (4%, p inclusion. The preferred learning method was lectures for McGill students (61%, p inclusion in the undergraduate curriculum. There was a difference for plastic surgery source of information, operations, and preferred method of learning for students. The study highlighted the urgent need to reform plastic surgery undergraduate teaching in collaboration with national educational bodies worldwide.

  6. Increasing Competitiveness for an Otolaryngology Residency: Where We Are and Concerns about the Future.

    Science.gov (United States)

    Kaplan, Alyson B; Riedy, Katherine N; Grundfast, Kenneth M

    2015-11-01

    For graduating medical students, securing a residency in otolaryngology-head and neck surgery has become exceedingly difficult. This commentary explores the ways that applicants and residency programs are reacting to the increasing competitiveness in applying to, interviewing for, and matching to an otolaryngology residency. The commonly held perceptions of applicants are compared to perspectives held by residency program directors and resident selection committees. Unintended consequences of the growing trend for medical students to add a research year to their curriculum are presented. Some cautions and suggestions about how to improve the application and selection process are offered.

  7. Compliance of Systematic Reviews in Plastic Surgery With the PRISMA Statement.

    Science.gov (United States)

    Lee, Seon-Young; Sagoo, Harkiran; Whitehurst, Katharine; Wellstead, Georgina; Fowler, Alexander J; Agha, Riaz A; Orgill, Dennis

    2016-01-01

    Systematic reviews attempt to answer research questions by synthesizing the data in primary articles. They are an increasingly important tool within evidence-based medicine, guiding clinical practice, future research, and health care policy. To determine the reporting quality of recent systematic reviews and meta-analyses in plastic surgery with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. MEDLINE and EMBASE were searched for systematic reviews published between January 1, 2013, and December 31, 2014, in 5 major plastic surgery journals. Screening, identification, and data extraction were performed independently by 2 teams. Articles were reviewed for compliance with reporting of 27 items in the PRISMA checklist. Data analysis was conducted from January 1 to July 30, 2015. The sum of PRISMA checklist items (1-27) per systematic review. From an initial set of 163 articles, 79 met the inclusion criteria. The median PRISMA score was 16 of 27 items (59%) (range, 6%-26%; 95% CI, 14%-17%). Compliance varied between individual PRISMA items. It was poorest for items related to the use of review protocol (item 5; 4 articles [5%]) and presentation of data on the risk of bias of each study (item 19; 14 articles [18%]). Compliance was the highest for description of rationale (item 3; 78 articles [99%]), sources of funding and other support (item 27; 75 articles [95%]), and inclusion of a structured summary in the abstract (item 2; 75 articles [95%]). The reporting quality of systematic reviews in plastic surgery requires improvement. Enforcement of compliance through journal submission systems, as well as improved education, awareness, and a cohesive strategy among all stakeholders, is called for. NA.

  8. A family operation: plastic surgeons who perform aesthetic surgery on spouses or other family members.

    Science.gov (United States)

    Slavin, Sara A; Slavin, Sumner A; Goldwyn, Robert M

    2010-03-01

    The purpose of this study was to investigate whether plastic surgeons would perform elective cosmetic surgery on spouses or other family members and how many have done so, the type of procedures, the circumstances under which the surgery took place, and the results. Participants were 465 members of the American Society for Aesthetic Plastic Surgery, representing 30.7 percent of the overall sample pool of 1513 members recruited through anonymous, voluntary participation in an online survey. Approximately half (51.8 percent) were 51 to 65 years old, most were men (91.2 percent), and most were from large urban areas; respondents had been in practice for 1 to 40 years. The plastic surgeons who returned the survey were comfortable performing elective cosmetic procedures on family members, the majority having already done so. Eighty-eight percent reported they would operate on a spouse or other family member, and 83.9 percent reported they already had. The main motivation (67 percent) was their belief that they were the best surgeon for the procedure. The most commonly listed operations were rhinoplasty, abdominoplasty, eyelidplasty, face lift, breast augmentation, and liposuction. Patients included spouses, children, parents, cousins, and in-laws, ranging from teenaged males to women in their 70s. The overwhelming majority (94.2 percent) reported no complications, and 99.5 percent believed the patients were satisfied with their outcome. Survey participants are comfortable with the idea of performing elective cosmetic procedures on family members. Regardless of the invasiveness of the procedure or their relationship with the patient, respondents reported no complications and a high level of patient satisfaction anomalous for any patient-surgeon sample, suggesting that surgeons who operate on family members hold confident opinions of their surgical skills and results.

  9. Ultrasound Screening for Deep Venous Thrombosis Detection: A Prospective Evaluation of 200 Plastic Surgery Outpatients

    Directory of Open Access Journals (Sweden)

    Eric Swanson, MD

    2015-03-01

    Conclusions: The natural history of thromboembolism in plastic surgery outpatients differs from orthopedic patients. The risk of a deep venous thrombosis in a patient treated with Spontaneous breathing, Avoid gas, Face up, Extremities mobile anesthesia is approximately 0.5%. Thromboses are unlikely to develop intraoperatively. In the single affected patient, the thrombosis was located distally, in a location that is less prone to embolism and highly susceptible to anticoagulation. Ultrasound screening is an effective and highly feasible method to identify affected patients for treatment.

  10. A Simple Method for International Standardization of Photographic Documentation for Aesthetic Plastic Surgery.

    Science.gov (United States)

    Rhee, Seung Chul

    2017-02-03

    Due to the lack of internationally standardized, objective, and scientific photographic standardization methods, differences in photographic documents have gravely affected the truth of surgical outcomes by visual misperception or illusion, thus hindering the development of plastic surgery clinically and scholastically. Here I suggest a simple method for standardization of facial photographs. The method consists of an imaginary transverse line (tentatively the "PSA line") rather than the Frankfort horizontal plane and uses a white background with black grids and standard RGB with CMYK circles. This simplified method of photographic standardization would help our professional society to make international standards on facial photographic documentation to maintain scholastic ethics, conscience, and morals.

  11. Global contributions to Annals of Plastic Surgery: authorship in an English language journal by international colleagues.

    Science.gov (United States)

    Pu, Lee; Lineaweaver, William

    2012-06-01

    We reviewed the contributor demographics of recent volumes of Annals of Plastic Surgery to quantify the contributions of authors from countries where the primary language is not English. For 2 volumes of Annals (63 and 65), such authors contributed 57% of the total articles published. Within the new section format of volume 66, authors from non-English language countries accounted for 60% of all original articles with substantial and often dominant representation in all sections. This survey shows that Annals publishes articles from an international population of contributors with effective inclusion of authors from countries with primary languages other than English.

  12. Clinical Application of Three-Dimensional Printing Technology in Craniofacial Plastic Surgery

    OpenAIRE

    Choi, Jong Woo; Kim, Namkug

    2015-01-01

    Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to m...

  13. Bone-added periodontal plastic surgery: a new approach in esthetic dentistry.

    Science.gov (United States)

    Gholami, Gholam Ali; Gholami, Hadi; Amid, Reza; Kadkhodazadeh, Mahdi; Mehdizadeh, Amir Reza; Youssefi, Navid

    2015-01-01

    This article proposes a combined technique including bone grafting, connective tissue graft, and coronally advanced flap to create some space for simultaneous bone regrowth and root coverage. A 23 year-old female was referred to our private clinic with a severe class II Miller recession and lack of attached gingiva. The suggested treatment plan comprised of root coverage combined with xenograft bone particles. The grafted area healed well and full coverage was achieved at 12-month follow-up visit. Bone-added periodontal plastic surgery can be considered as a practical procedure for management of deep gingival recession without buccal bone plate.

  14. Clinical application of three-dimensional printing technology in craniofacial plastic surgery.

    Science.gov (United States)

    Choi, Jong Woo; Kim, Namkug

    2015-05-01

    Three-dimensional (3D) printing has been particularly widely adopted in medical fields. Application of the 3D printing technique has even been extended to bio-cell printing for 3D tissue/organ development, the creation of scaffolds for tissue engineering, and actual clinical application for various medical parts. Of various medical fields, craniofacial plastic surgery is one of areas that pioneered the use of the 3D printing concept. Rapid prototype technology was introduced in the 1990s to medicine via computer-aided design, computer-aided manufacturing. To investigate the current status of 3D printing technology and its clinical application, a systematic review of the literature was conducted. In addition, the benefits and possibilities of the clinical application of 3D printing in craniofacial surgery are reviewed, based on personal experiences with more than 500 craniofacial cases conducted using 3D printing tactile prototype models.

  15. Bridging the Otolaryngology Peer Review Knowledge Gap: A Call for a Residency Development Program.

    Science.gov (United States)

    Schmalbach, Cecelia E

    2016-07-01

    Current otolaryngology literature and future scientific direction rely heavily on a rigorous peer review process. Just as manuscripts warrant thoughtful review with constructive feedback to the authors, the same can be said for critiques written by novice peer reviewers. Formal scientific peer review training programs are lacking. Recognizing this knowledge gap, Otolaryngology-Head and Neck Surgery is excited to offer its new Resident Reviewer Development Program. All otolaryngology residents who are postgraduate year 2 and above and in excellent academic standing are eligible to participate in this mentored program, during which they will conduct 6 manuscript reviews under the direction of a seasoned reviewer in his or her subspecialty area of interest. By completing reviews alongside a mentor, participants gain the required skills to master the peer review process-a first step that often leads to journal editorial board and associate editor invitations.

  16. Author Self-Citation in the Otolaryngology Literature: A Pilot Study.

    Science.gov (United States)

    Tolisano, Anthony M; Song, Sungjin A; Cable, Benjamin B

    2016-02-01

    To determine the prevalence of author self-citation in the field of otolaryngology. A retrospective review of bibliographic references in 5 otolaryngology journals. Five high-impact otolaryngology journals were reviewed over a 3-month period between January and March 2014 to identify the pattern of author self-citations. Data included study type, otolaryngology topic, authorship, total citations, author self-citations, and country of origin. Nearly two-thirds of articles contained at least 1 self-citation, with an average of 2.6 self-citations per article. Self-citations represented nearly 10% of total citations. Articles with at least 1 self-citation had more authors (5.8 vs 4.9, P otolaryngology literature is common and compares similarly to other medical specialties previously studied. Self-citation should not be considered inappropriate, as it is often done to expand on earlier research. Nevertheless, editors, researchers, and readers should be aware of this increasingly recognized phenomenon and its associated potential implications to the process of scientific inquiry. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  17. The effect of duty hour regulation on resident surgical case volume in otolaryngology.

    Science.gov (United States)

    Curtis, Stuart H; Miller, Robert H; Weng, Cindy; Gurgel, Richard K

    2014-10-01

    Evaluate the effect of duty hour regulation on graduating otolaryngology resident surgical case volume and analyze trends in surgical case volume for Accreditation Council for Graduate Medical Education (ACGME) key indicator cases from 1996 to 2011. Time-trend analysis of surgical case volume. Nationwide sample of otolaryngology residency programs. Operative logs from the American Board of Otolaryngology and ACGME for otolaryngology residents graduating in the years 1996 to 2011. Key indicator volumes and grouped domain volumes before and after resident duty hour regulations (2003) were calculated and compared. Independent t test was performed to evaluate overall difference in operative volume. Wilcoxon rank sum test evaluated differences between procedures per time period. Linear regression evaluated trend. The average total number of key indicator cases per graduating resident was 440.8 in 1996-2003 compared to 500.4 cases in 2004-2011, and overall average per number of key indicators was 31.5 and 36.2, respectively (P = .067). Four key indicator cases showed statistically significant (P otolaryngology residents. The overall trend in operative volume is increasing for several specific key indicators. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  18. A review of prophylactic antibiotics use in plastic surgery in China and a systematic review.

    Science.gov (United States)

    Li, Ge-hong; Hou, Dian-ju; Fu, Hua-dong; Guo, Jing-ying; Guo, Xiao-bo; Gong, Hui

    2014-12-01

    The purpose of this study was to investigate the use of antibiotic prophylaxis for plastic surgical procedures at our hospital, and to perform a systematic literature review of randomized controlled trials evaluating the use of prophylactic antibiotics in plastic surgery. The records of patients who received plastic surgical procedures with Class I surgical incisions between 2009 and 2010 were retrospectively reviewed. A systematic literature review was conducted for studies examining the use of prophylactic antibiotics for Class I surgical wounds. A total of 13,997 cases with Class I surgical incisions were included. Prophylactic antibiotics were given in 13,865 cases (99.1%). The antibiotics used were primarily cefuroxime, clindamycin, metronidazole, cefoxitin sodium, and gentamicin. The average duration of administration was 4.84 ± 3.07 (range, 1-51) days. Antibiotics were administered postoperatively in >99% of cases while preoperative antibiotic administration was only given in 32 cases (0.23%). Wound infections occurred in 21 cases for an overall infection rate of 0.15%. Fourteen studies met the inclusion criteria of the systematic review. There was marked variation in the timing of antibiotic administration with antibiotics given pre-, peri-, and postoperatively. Of studies that compared the use of prophylactic antibiotics with placebo, a reduction in wound infections was noted in 4 trials and no difference was noted in 6 trials. No significant difference in infection rates was shown between the prophylactic and postoperative arms. In conclusion, prophylactic antibiotics are overused in plastic surgical procedures. Evidence-based guidelines for the use of prophylactic antibiotics in plastic surgical procedures are needed.

  19. Evaluation of Body Image and Sexual Satisfaction in Women Undergoing Female Genital Plastic/Cosmetic Surgery.

    Science.gov (United States)

    Goodman, Michael P; Placik, Otto J; Matlock, David L; Simopoulos, Alex F; Dalton, Teresa A; Veale, David; Hardwick-Smith, Susan

    2016-10-01

    Little prospective data exists regarding the procedures constituting female genital plastic/cosmetic surgery (FGPS). To evaluate whether the procedures of labiaplasty and vaginoperineoplasty improve genital self image, and evaluate effects on sexual satisfaction. Prospective cohort case-controlled study of 120 subjects evaluated at baseline, 6, 12, and 24 months postoperative, paired with a demographically similar control group. Interventions include labiaplasty, clitoral hood reduction, and/or aesthetic vaginal tightening, defined as perineoplasty + "vaginoplasty" (aka "vaginal rejuvenation."). Outcome measures include body image, genital self-image, sexual satisfaction, and body esteem. As a group, study patients tested at baseline showing body dissatisfaction, negative genital self-image, and poorer indices of sexual satisfaction. Preoperative body image of study patients were in a range considered to be mild to moderately dysmorphic, but matched controls at one and two years; genital self-image scores at entry were considerably lower than controls, but by 2-year follow-up had surpassed control value at entry. Similarly, sexual satisfaction values, significantly lower at entry, equaled at one, and surpassed control values, at 2 years. Postoperatively, at all points in time, these differences in body image and genital self-image disappeared, and sexual satisfaction markedly improved. Overall body esteem did not differ between study and control groups, with the exception of the genital esteem quotient, which improved after surgery. Women requesting and completing FGPS, when tested by validated instruments, at entry report sexual dissatisfaction and negative genital self-image. When tested at several points in time after surgery up to two years, these findings were no longer present. When performed by an experienced surgeon, FGPS appears to provide sexual and genital self-image improvement. 2 Therapeutic. © 2016 The American Society for Aesthetic Plastic Surgery

  20. Plastic Surgery Inclusion in the Undergraduate Medical Curriculum: Perception, Challenges, and Career Choice—A Comparative Study

    Science.gov (United States)

    Vaughan, R.; Thomas, S.

    2017-01-01

    Objective The undergraduate medical curriculum has been overcrowded with core learning outcomes with no formal exposure to plastic surgery. The aim of this study was to compare medical students from two educational settings for the basic understanding, preferred learning method, and factors influencing a career choice in plastic surgery. Design and Setting A prospective cohort study based on a web-based anonymous questionnaire sent to final year medical students at Birmingham University (United Kingdom), McGill University (Canada), and a control group (non-medical staff). The questions were about plastic surgery: (1) source of information and basic understanding; (2) undergraduate curriculum inclusion and preferred learning methods; (3) factors influencing a career choice. A similar questionnaire was sent to non-medical staff (control group). The data was analysed based on categorical outcomes (Chi-square χ2) and level of significance p ≤ 0.05. Results Questionnaire was analysed for 243 students (Birmingham, n = 171/332, 52%) (McGill n = 72/132, 54%). Birmingham students (14%) considered the word “plastic” synonymous with “cosmetic” more than McGill students (4%, p inclusion. The preferred learning method was lectures for McGill students (61%, p inclusion in the undergraduate curriculum. There was a difference for plastic surgery source of information, operations, and preferred method of learning for students. The study highlighted the urgent need to reform plastic surgery undergraduate teaching in collaboration with national educational bodies worldwide. PMID:28630768

  1. Microsurgery: The Top 50 Classic Papers in Plastic Surgery: A Citation Analysis

    Directory of Open Access Journals (Sweden)

    Cormac Weekes Joyce

    2014-03-01

    Full Text Available Background The number of citations that a published article has received reflects the importance of the paper in the particular area of practice. In microsurgery, thus far, which journal articles are cited most frequently is unknown. The purpose of this study was to identify and analyze the characteristics of the top 50 papers in the field of microsurgery in the plastic surgery literature. Methods The 50 most cited papers published in high impact plastic surgery and microsurgery journals were identified. The articles were ranked in the order of the number of citations received. These 50 classic papers were analyzed for article type, journal distribution, and geographic and institutional origin. Results Six international journals contributed to the top 50 papers in microsurgery. The most cited paper reported on the early use of the vascularized bone graft and was cited 116 times. The top 50 papers originated from just 10 countries with the United States producing the most. The Preston and Northcote Community Hospital, Melbourne published 5 papers and this was the most productive institution in the top 50. Conclusions These papers represent many important milestones in the relatively short history of microsurgery. Furthermore, our citation analysis provides useful information to budding authors as to what makes a paper attain a "classic" status.

  2. Challenges of periodontal plastic surgery in a depressed economy: a report of two cases

    Directory of Open Access Journals (Sweden)

    Solomon O Nwhator

    2010-09-01

    Full Text Available Solomon O NwhatorDepartment of Preventive and Community Dentistry, Obafemi Awolowo University, Ile-Ife, NigeriaAbstract: Advancements in restorative dentistry have resulted in people keeping their teeth for longer, and an increase in gingival recession as the gums recede due to age, periodontal disease, thin gingiva, or other factors. The demand for periodontal plastic surgery appears to be increasing. Several methods have been used in the treatment of denuded roots. Of these, the free gingival autograft, the coronally displaced flap, guided tissue regeneration, and, lately, the connective tissue graft appear to be the main methods employed. There are as yet no reports of periodontal plastic surgery performed in Nigeria. We report two cases of Miller’s Class 2 gingival recession treated by free gingival autografts in the specialist periodontal clinic of a South-Western teaching hospital in Nigeria. The challenges of awareness, a dearth of expertise, cost of materials, consequent cost of treatment, and how these affect the accessing of treatment are highlighted. The methods used in getting over these hurdles to provide treatment are also discussed.Keywords: gingival recession, free gingival autograft, Nigeria

  3. Development of Standardized Clinical Assessment and Management Plans (SCAMPs) in Plastic and Reconstructive Surgery.

    Science.gov (United States)

    Caterson, Stephanie A; Singh, Mansher; Orgill, Dennis; Ghazinouri, Roya; Han, Elizabeth; Ciociolo, George; Laskowski, Karl; Greenberg, Jeffery O

    2015-09-01

    With rising cost of healthcare, there is an urgent need for developing effective and economical streamlined care. In clinical situations with limited data or conflicting evidence-based data, there is significant institutional and individual practice variation. Quality improvement with the use of Standardized Clinical Assessment and Management Plans (SCAMPs) might be beneficial in such scenarios. The SCAMPs method has never before been reported to be utilized in plastic surgery. The topic of immediate breast reconstruction was identified as a possible SCAMPs project. The initial stages of SCAMPs development, including planning and implementation, were entered. The SCAMP Champion, along with the SCAMPs support team, developed targeted data statements. The SCAMP was then written and a decision-tree algorithm was built. Buy-in was obtained from the Division of Plastic Surgery and a SCAMPs data form was generated to collect data. Decisions pertaining to "immediate implant-based breast reconstruction" were approved as an acceptable topic for SCAMPs development. Nine targeted data statements were made based on the clinical decision points within the SCAMP. The SCAMP algorithm, and the SDF, required multiple revisions. Ultimately, the SCAMP was effectively implemented with multiple iterations in data collection. Full execution of the SCAMP may allow better-defined selection criteria for this complex patient population. Deviations from the SCAMP may allow for improvement of the SCAMP and facilitate consensus within the Division. Iterative and adaptive quality improvement utilizing SCAMPs creates an opportunity to reduce cost by improving knowledge about best practice.

  4. 3D Printing: current use in facial plastic and reconstructive surgery.

    Science.gov (United States)

    Hsieh, Tsung-Yen; Dedhia, Raj; Cervenka, Brian; Tollefson, Travis T

    2017-08-01

    To review the use of three-dimensional (3D) printing in facial plastic and reconstructive surgery, with a focus on current uses in surgical training, surgical planning, clinical outcomes, and biomedical research. To evaluate the limitations and future implications of 3D printing in facial plastic and reconstructive surgery. Studies reviewed demonstrated 3D printing applications in surgical planning including accurate anatomic biomodels, surgical cutting guides in reconstruction, and patient-specific implants fabrication. 3D printing technology also offers access to well tolerated, reproducible, and high-fidelity/patient-specific models for surgical training. Emerging research in 3D biomaterial printing have led to the development of biocompatible scaffolds with potential for tissue regeneration in reconstruction cases involving significant tissue absence or loss. Major limitations of utilizing 3D printing technology include time and cost, which may be offset by decreased operating times and collaboration between departments to diffuse in-house printing costs SUMMARY: The current state of the literature shows promising results, but has not yet been validated by large studies or randomized controlled trials. Ultimately, further research and advancements in 3D printing technology should be supported as there is potential to improve resident training, patient care, and surgical outcomes.

  5. Variables Influencing the Depth of Conscious Sedation in Plastic Surgery: A Prospective Study

    Science.gov (United States)

    Kim, Wonwoo; Park, Hyochun; Kim, Hoonnam

    2017-01-01

    Background Conscious sedation has been widely utilized in plastic surgery. However, inadequate research has been published evaluating adequate drug dosage and depth of sedation. In clinical practice, sedation is often inadequate or accompanied by complications when sedatives are administered according to body weight alone. The purpose of this study was to identify variables influencing the depth of sedation during conscious sedation for plastic surgery. Methods This prospective study evaluated 97 patients who underwent plastic surgical procedures under conscious sedation. Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and glucose levels were measured. Midazolam and ketamine were administered intravenously according to a preset protocol. Bispectral index (BIS) recordings were obtained to evaluate the depth of sedation 4, 10, 15, and 20 minutes after midazolam administration. Associations between variables and the BIS were assessed using multiple regression analysis. Results Alcohol intake and female sex were positively associated with the mean BIS (P<0.01). Age was negatively associated with the mean BIS (P<0.01). Body mass index (P=0.263), creatinine clearance (P=0.832), smoking history (P=0.398), glucose (P=0.718), AST (P=0.729), and ALT (P=0.423) were not associated with the BIS. Conclusions Older patients tended to have a greater depth of sedation, whereas females and patients with greater alcohol intake had a shallower depth of sedation. Thus, precise dose adjustments of sedatives, accounting for not only weight but also age, sex, and alcohol consumption, are required to achieve safe, effective, and predictable conscious sedation. PMID:28194341

  6. Generation Y and the Integrated Plastic Surgery Residency Match: A Cross-sectional Study of the 2011 Match Outcomes.

    Science.gov (United States)

    Sue, Gloria R; Narayan, Deepak

    2013-08-01

    Plastic surgery is the most competitive specialty in medicine. We sought to identify factors associated with the successful match of generation Y applicants into integrated plastic surgery residency. We utilized the most recent data from the Charting Outcomes in the Match published by the National Resident Matching Program in 2011. We had data on US senior or independent applicant status, Alpha Omega Alpha (AOA) status, attendance of top 40 medical schools, advanced degree status, and number of contiguous ranks within plastic surgery. Our main outcome measure was match status. A total of 81 out of 197 applicants (41.1%) successfully matched into integrated plastic surgery in the 2011 main match. US seniors matched at a significantly higher rate compared to independent applicants (44.0% vs 24.1%, P = 0.044). Matched US seniors were more likely to have AOA membership compared to unmatched US seniors (45.9% vs 27.7%, P = 0.014) and attend a top 40 medical school (52.7% vs 35.1%, P = 0.022). There were no differences in terms of advanced degrees between matched and unmatched US seniors. Unmatched US seniors were more likely to have 3 or fewer contiguous ranks of plastic surgery residency programs than matched US seniors (86.2% vs 68.9%, P = 0.007). US senior status, AOA membership, and attendance at a top 40 medical school are predictors of matching into integrated plastic surgery. Program directors need to be aware of the background of the millennial applicants to recruit and maintain top residents.

  7. [Plastic surgery in day hospital conditions: comparison between two hospital models].

    Science.gov (United States)

    Faga, A; Carminati, M; Falconi, D; Gatti, S; Rottino, A

    2003-12-01

    Personal experience of plastic surgery carried out in Day Hospital conditions is reported. The experience took place within the hospital structure through two different organisational models called here transversal and divisional organisation models: characteristic of the former is that it uses a dedicated interdivisional structure within the hospital involving the centralization of all day-surgery activities, whereas the latter organizes Day Surgery activities within the operating unit whose structures it shares. On the basis of a comparison between the two models we were able to note advantages and disadvantages. We can review our experience in brief by stating that our own preference went to the transversal model which presents the indubitable advantage of being a logistic structure which is hinged on daytime activity and is ready therefore to satisfy on the one hand the needs of this type of patient and, on the other, the needs of the structure itself in efficiency terms. We propose to correct the disadvantages of the transversal model which can be outlined in its lack of homogeneity in the pathology treated and in the subtraction of the criterion of clinical priority in waiting lists through the attainment of a critical dimensional threshold such as to permit programmable sessions with patients with homogeneous pathology (i.e. belonging to the same hospital unit) and through the maintenance of a certain number of Day Hospital beds (around 25%) reserved for new emergency clinical cases.

  8. The power of words: sources of anxiety in patients undergoing local anaesthetic plastic surgery.

    Science.gov (United States)

    Caddick, J; Jawad, S; Southern, S; Majumder, S

    2012-03-01

    With local or regional anaesthesia being employed for more as well as more complex surgical procedures, an increasing number of patients remain fully conscious during their operation. This is generally perceived as being advantageous to the patient as less time is spent in hospital and the side effects of general anaesthesia are avoided. However, there is no direct measure of the patient experience during 'awake surgery', in particular of which aspects of the process may be distressing. Seventy patients undergoing day case plastic surgery under local anaesthesia were asked to complete a short questionnaire immediately following their operation. This was designed to identify specific factors likely to either increase or reduce anxiety during surgery. The questionnaire was initially validated on a pilot group of ten patients. Unsurprisingly, painful stimuli such as injections were identified as potential stressors. More interestingly, the data highlighted that some commonly used surgical terms such as 'knife' and 'scalpel' provoke considerable anxiety in the conscious patient. This varied according to age and sex with younger and female patients being most vulnerable. Other events identified as potential stressors, such as casual conversations and movements among theatre staff, were actually shown to be non-stressful and, in some cases, stress relieving. Technical jargon used by surgical staff can elevate anxiety levels among patients who are awake for their operation. Careful consideration of the words we use may reduce this, particularly in female patients.

  9. Residency characteristics that matter most to plastic surgery applicants: a multi-institutional analysis and review of the literature.

    Science.gov (United States)

    Sinno, Sammy; Mehta, Karan; Squitieri, Lee; Ranganathan, Kavitha; Koeckert, Michael S; Patel, Ashit; Saadeh, Pierre B; Thanik, Vishal

    2015-06-01

    The National Residency Matching Program Match is a very unique process in which applicants and programs are coupled to each other based on a ranking system. Although several studies have assessed features plastic surgery programs look for in applicants, no study in the present plastic surgery literature identifies which residency characteristics are most important to plastic surgery applicants. Therefore, we sought to perform a multi-institutional assessment as to which factors plastic surgery residency applicants consider most important when applying for residency. A validated and anonymous questionnaire containing 37 items regarding various program characteristics was e-mailed to 226 applicants to New York University, Albany, University of Michigan, and University of Southern California plastic surgery residency programs. Applicants were asked to rate each feature on a scale from 1 to 10, with 10 being the most important. The 37 variables were ranked by the sum of the responses. The median rating and interquartile range as well as the mean for each factor was then calculated. A Wilcoxon signed rank test was used to compare medians in rank order. A total of 137 completed questionnaires were returned, yielding a 61% response rate. The characteristics candidates considered most important were impressions during the interview, experiences during away rotations, importance placed on resident training/support/mentoring by faculty, personal experiences with residents, and the amount of time spent in general surgery. The characteristics candidates considered least important were second-look experiences, compensation/benefits, program reputation from Internet forums, accessibility of program coordinator, opportunity for laboratory research, and fellowship positions available at the program. Applicants value personal contact and time spent in general surgery when selecting residency programs. As the number of integrated programs continues to grow, programs will benefit

  10. Application of transoral robotic surgery in otolaryngology-head and neck surgery%经口入路机器人手术在耳鼻咽喉头颈外科中的应用

    Institute of Scientific and Technical Information of China (English)

    陈伟; 邱德叶; 许风雷; 吴昆旻; 江满杰; 程友; 季俊峰; 李泽卿

    2016-01-01

    目的 总结经口入路机器人手术(transoral robotic surgery,TORS)在耳鼻咽喉头颈外科应用的临床经验.方法 2010年11月~ 2015年7月南京军区南京总医院耳鼻咽喉科应用“达芬奇”机器人手术系统对10例咽喉部病变患者行TORS,回顾性分析患者临床资料,总结手术体会.结果 10例患者均顺利完成手术.术野暴露平均用时34 min(20 ~ 60 min),调整开口器次数2~5次,平均手术时间为67 min(30 ~ 130 min).患者平均住院时间为8 d(6 ~ 14 d),恢复经口进食平均需要5 d(2 ~10 d),出院时均可经口进食.术中及术后均未出现并发症.恶性肿瘤患者的术后病理学检查示切缘均未见癌细胞残留.结论 在掌握好适应证的前提下,应用“达芬奇”机器人手术系统可以独立完成多种类型耳鼻咽喉头颈外科手术,其手术创伤小,患者术后恢复快,有着巨大的临床应用价值.

  11. A smartphone-optimized web site for conveniently viewing otolaryngology journal abstracts.

    Science.gov (United States)

    Golub, Justin S; Sharma, Arun; Samy, Ravi N

    2014-12-01

    Access to the medical literature has not kept pace with the mobile revolution. We aimed to (1) gauge interest in a smartphone-optimized Web site for conveniently accessing otolaryngology literature and (2) create an easy-to-access and convenient Web site that displays otolaryngology journal abstracts in a format optimized for smartphones. A survey was sent to physicians of a major US academic otolaryngology-head and neck surgery department. Demographics, literature-browsing habits, and barriers to staying updated were assessed. The response rate was 87%. Ninety-one percent of respondents used a smartphone, and 85% wished they could stay more up to date with the otolaryngology literature. Most respondents believed a convenient smartphone-optimized Web site could help them achieve this goal. A Web site was then developed in collaboration with a university creative department as a proof of concept. The site uses a simple RSS aggregator to display journal abstracts formatted for smartphone-sized screens (www.otosurg.com). © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.

  12. Otolaryngology outreach to Komfo Anokye Teaching Hospital: a medical and educational partnership.

    Science.gov (United States)

    Waller, B; Larsen-Reindorf, R; Duah, M; Opoku-Buabeng, J; Edwards, B M; Brown, D; Moyer, J; Prince, M; Basura, G J

    2017-07-01

    Medical and educational partnerships between high- and low-resourced countries provide opportunities to have a long-term meaningful impact on medical training and healthcare delivery. An otolaryngology partnership between Komfo Anokye Teaching Hospital in Kumasi, Ghana, and the University of Michigan Department of Otolaryngology/Head and Neck Surgery has been undertaken to enhance healthcare delivery at both institutions. A temporal bone dissection laboratory, with the equipment to perform dedicated otological surgery, and academic platforms for clinical and medical education and residency training have been established. This article describes the details of this partnership in otological surgery and hearing health, with an emphasis on creating in-country surgical simulation, training on newly acquired medical equipment and planning regarding the formulation of objectified metrics to gauge progress going forward.

  13. The performance and publication of cost-utility analyses in plastic surgery: Making our specialty relevant.

    Science.gov (United States)

    Thoma, Achilleas; Ignacy, Teegan A; Ziolkowski, Natalia; Voineskos, Sophocles

    2012-01-01

    Increased spending and reduced funding for health care is forcing decision makers to prioritize procedures and redistribute funds. Decision making is based on reliable data regarding the costs and benefits of medical and surgical procedures; such a study design is known as an economic evaluation. The onus is on the plastic surgery community to produce high-quality economic evaluations that support the cost effectiveness of the procedures that are performed. The present review focuses on the cost-utility analysis and its role in deciding whether a novel technique/procedure/technology should be accepted over one that is prevalent. Additionally, the five steps in undertaking a cost-utility (effectiveness) analysis are outlined.

  14. Reporting the level of evidence in the Canadian Journal of Plastic Surgery: Why is it important?

    Science.gov (United States)

    Thoma, Achilleas; Ignacy, Teegan A; Li, Yu Kit; Coroneos, Christopher J

    2012-01-01

    The levels of evidence (LOE) table has been increasingly used by many surgical journals and societies to emphasize the importance of proper study design. Since their origin, LOE have evolved to consider multiple study designs and also the rigour of not only the study type but multiple aspects of its design. The use of LOE aids readers in appraising the literature while encouraging clinical researchers to produce high-quality evidence. The current article discusses the benefits and limitations of the LOE, as well as the LOE of articles published in the Canadian Journal of Plastic Surgery (CJPS). Along with an assessment of the LOE in the CJPS, the authors have provided recommendations to improve the quality and readability of articles published in the CJPS.

  15. Parotitis after epidural anesthesia in plastic surgery: report of three cases.

    Science.gov (United States)

    Rosique, Marina Junqueira Ferreira; Rosique, Rodrigo Gouvea; Costa, Ilson Rosique; Lara, Brunno Rosique; Figueiredo, Jozé Luiz Ferrari; Ribeiro, Davidson Gomes Barbosa

    2013-08-01

    Acute swelling of the parotid glands after general anesthesia has become known as anesthesia mumps. Its cause is unknown. Only one case of postsurgical parotitis without general anesthesia is reported. This report describes three cases in this setting after plastic surgery. A 37-year-old women underwent breast surgery and abdominoplasty with a dual thoracic/lumbar epidural block (bupivacaine 0.5 %). The operative time totaled almost 6 h. Subsequently, 4 h after surgery, the patient experienced painless bilateral parotid swelling without palpable crepitus. The edema resolved completely within 12 h under clinical observation and parenteral hydration. A 45-year-old patient received subglandular breast implants and body contouring with liposuction, all with the patient under a dual thoracic/lumbar epidural block with 0.5 % marcaine. The total surgical time was 5 h. Subsequently, 3 h after surgery, the patient experienced a similar clinical presentation. The problem resolved completely in 36 h with clinical observation and parenteral hydration. CASE 3: A 30-year-old patient received a subglandular breast implant and underwent liposuction of the outer thighs using a dual thoracic/lumbar epidural block with lidocaine 1 %. The duration of surgery was 1 h. Subsequently, 5 h postoperatively, the patient experienced a similar clinical presentation. Dexamethasone and parenteral hydration were administered. The problem resolved completely in 48 h without sequelae. The occurrence of parotitis in patients undergoing surgery under epidural anesthesia is a novel situation, which increases the range of possible etiologies for this little known condition. Dehydration leading to transient parotid secretion obstruction may play a significant role. Further reports of parotitis occurring in the regional anesthesia setting are expected to help elucidate its pathophysiology. This journal requires that authors assign a level of evidence to each article. For a full description of

  16. Looking at plastic surgery through Google Glass: part 1. Systematic review of Google Glass evidence and the first plastic surgical procedures.

    Science.gov (United States)

    Davis, Christopher R; Rosenfield, Lorne K

    2015-03-01

    Google Glass has the potential to become a ubiquitous and translational technological tool within clinical plastic surgery. Google Glass allows clinicians to remotely view patient notes, laboratory results, and imaging; training can be augmented via streamed expert master classes; and patient safety can be improved by remote advice from a senior colleague. This systematic review identified and appraised every Google Glass publication relevant to plastic surgery and describes the first plastic surgical procedures recorded using Google Glass. A systematic review was performed using PubMed National Center for Biotechnology Information, Ovid MEDLINE, and the Cochrane Central Register of Controlled Trials, following modified Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Key search terms "Google" and "Glass" identified mutually inclusive publications that were screened for inclusion. Eighty-two publications were identified, with 21 included for review. Google Glass publications were formal articles (n = 3), editorial/commentary articles (n = 7), conference proceedings (n = 1), news reports (n = 3), and online articles (n = 7). Data support Google Glass' positive impact on health care delivery, clinical training, medical documentation, and patient safety. Concerns exist regarding patient confidentiality, technical issues, and limited software. The first plastic surgical procedure performed using Google Glass was a blepharoplasty on October 29, 2013. Google Glass is an exciting translational technology with the potential to positively impact health care delivery, medical documentation, surgical training, and patient safety. Further high-quality scientific research is required to formally appraise Google Glass in the clinical setting.

  17. Platelet-rich plasma in otolaryngology.

    Science.gov (United States)

    Stavrakas, M; Karkos, P D; Markou, K; Grigoriadis, N

    2016-12-01

    Platelet-rich plasma is a novel material that is being used more frequently in many surgical specialties. A literature review on the current and potential uses of platelet-rich plasma in otolaryngology was performed. There is limited evidence on the use of platelet-rich plasma in otolaryngology compared with other specialties: only 11 studies on various subspecialties (otology, rhinology and laryngology) were included in the final review. Based on the limited number of studies, we cannot draw safe conclusions about the value of platelet-rich plasma in otolaryngology. Nevertheless, the available literature suggests that platelet-rich plasma holds promise for future research and may have a number of clinical applications.

  18. Applicant Perspectives on the Otolaryngology Residency Application Process.

    Science.gov (United States)

    Ward, Matthew; Pingree, Christian; Laury, Adrienne M; Bowe, Sarah N

    2017-08-01

    It has been nearly 25 years since medical students were queried regarding their perspectives on otolaryngology-head and neck surgery (OHNS) residency selection. Understanding this viewpoint is critical to improving the current application process. To evaluate the perceptions of 2016 OHNS residency applicants regarding the application process and offer suggestions for reform. In this cross-sectional study of anonymous online survey data, a 14-question survey was designed based on resources obtained from a computerized PubMed, Ovid, and GoogleScholar database search of the English language from January 1, 1990, through December 31, 2015, was conducted using the following search terms: (medical student OR applicant) AND (application OR match) AND otolaryngology. The survey was administered to 2016 OHNS residency applicants to examine 4 primary areas: current attitudes toward the match, effect of the new Otolaryngology Program Directors Organization personal statement mandate, sources of advice and information, and suggestions for improvement. In January 2016, an email was sent to 100 program directors asking them to distribute the survey to current OHNS applicants at their institution. One follow-up reminder email was sent in February 2016. A link to the survey was posted on the Otomatch.com homepage on January 28, 2016, with the last response received on March 28, 2016. Survey responses regarding the residency application process. A total of 150 of 370 residency applicants (40.5%) responded to the survey. Of these, 125 respondents (90.6%) noted applying to programs in which they had no specific interest simply to improve their chances of matching. Applicants intended to apply to more programs than they actually did (63.6 vs 60.8; r = 0.19; 95% CI, -0.03 to 0.40). Program directors advised fewer applications than other sources; however, 58 respondents (38.7%) did not receive advice from a program director. A total of 121 respondents (80.7%) found online program

  19. Student Teachers' Evaluations of Slides of Children with Down Syndrome: Impact of Facial Plastic Surgery, Labelling and Factual Knowledge.

    Science.gov (United States)

    Elkabetz, R.; And Others

    1990-01-01

    This study examined the impact of facial plastic surgery, labeling (mentally retarded, normal, Down's syndrome), and level of knowledge of Down's syndrome on 127 student teachers' evaluations of slides of persons with such characteristics. Although there was no overall significant main effect for the pre-post operation condition, there was a…

  20. Undiagnosed Long-Lasting Ulcerative Colitis Engaging Transplant after Vaginal Plastic Surgery with Colon: a Case Report

    Directory of Open Access Journals (Sweden)

    Ivaylo Vazharov, PhD¹

    2013-06-01

    Full Text Available This is the report of a 59-year-old woman suffering from recurrent vaginal pain and bleeding and episodes of anal bleeding. At the age of 16 she underwent vaginal plastic surgery. The case demonstrates the ulcerative engagement of the vaginal transplant.

  1. Generation Y and the Integrated Plastic Surgery Residency Match: A Cross-sectional Study of the 2011 Match Outcomes

    Directory of Open Access Journals (Sweden)

    Gloria R. Sue, MA

    2013-08-01

    Conclusions: US senior status, AOA membership, and attendance at a top 40 medical school are predictors of matching into integrated plastic surgery. Program directors need to be aware of the background of the millennial applicants to recruit and maintain top residents.

  2. Telemedicina y Cirugía Plástica Telemedicine and Plastic Surgery

    Directory of Open Access Journals (Sweden)

    E. Cabrera Sánchez

    2010-09-01

    Full Text Available La Telemedicina es aplicable a todos los campos médicos, incluyendo la Cirugía. Poca atención se ha prestado a sus aplicaciones diagnósticas, de las que sin embargo, nuestra especialidad, en la que es perfectamente aplicable el antiguo proverbio chino "una imagen vale mil palabras", podría salir muy beneficiada. Esto permitiría una mayor reducción de costes con contundentes mejoras en eficiencia y calidad. Presentamos un modelo de Telemedicina tipo envío y almacenaje (store and forward desarrollado y aplicado en un hospital británico del sureste de Inglaterra desde hace 7 años. Comentamos las ventajas e inconvenientes del sistema y sus posibles aplicaciones en nuestro medio. Es un hecho claro que estas tecnologías van a producir un gran cambio en la sociedad y en el quehacer diario del médico durante la próxima década. Lo que hoy conocemos como Telemedicina, en breve perderá el prefijo "tele" porque la población entenderá este tipo de Medicina y de aplicaciones telemáticas como algo habitual. Sin duda, nuestra especialidad será una de las grandes beneficiadas de la aplicación de estas tecnologías.Telemedicine is available in any medical fields, including Surgery. Poor attention has been showed to diagnosis application. Nevertheless, Plastic Surgery, is a practice in which the application of the old chinese proverb: "A picture is better than thousand words", would be very benefited, reducing costs and improving efficiency and quality. We present a Telemedicine store and forward model developed and worked in a Plastic Surgery Unit of southern England for 7 years. We show system advantages and disvantages and its potential applications in our country. It's clear that this technology will be able to produce a great change in our society and in our daily medical activity in the next years. What today we knows as Telemedicine, in a few time will lose "tele" prefix, because people will understand as usual this kind of Medicine and

  3. Plastic Surgery and Acellular Dermal Matrix: Highlighting Trends from 1999 to 2013.

    Science.gov (United States)

    Daar, David A; Gandy, Jessica R; Clark, Emily G; Mowlds, Donald S; Paydar, Keyianoosh Z; Wirth, Garrett A

    2016-05-01

    The last decade has ushered in a rapidly expanding global discussion regarding acellular dermal matrix (ADM) applications, economic analyses, technical considerations, benefits, and risks, with recent emphasis on ADM use in breast surgery. This study aims to evaluate global trends in ADM research using bibliometric analysis. The top nine Plastic Surgery journals were determined by impact factor (IF). Each issue of the nine journals between 1999 and 2013 was accessed to compile a database of articles discussing ADM. Publications were further classified by IF, authors' geographic location, study design, and level of evidence (LOE, I-V). Productivity index and productivity share were calculated for each region. In total, 256 ADM articles were accessed. The annual global publication volume increased significantly by 4.2 (0.87) articles per year (p<0.001), with a mean productivity index of 36.3 (59.0). The mean impact factor of the nine journals increased significantly from 0.61 (0.11) to 2.47 (0.99) from 1993 to 2013 (p<0.001). Despite this increase in the global ADM literature, the majority of research was of weaker LOE (level I: 2.29% and level II: 9.17%). USA contributed the most research (87%), followed by Asia (4.76%) and Western Europe (4.71%). USA contributed the greatest volume of research. Regarding clinical application of ADM, the majority of publications focused on ADM use in breast surgery, specifically breast reconstruction (154 articles, 60.2%). The majority of research was of lower LOE; thus, efforts should be made to strengthen the body of literature, particularly with regard to cost analysis.

  4. Do otolaryngology residency applicants relocate for training?

    Science.gov (United States)

    Gebhard, Grant M; Hauser, Leah J; Dally, Miranda J; Weitzenkamp, David A; Cabrera-Muffly, Cristina

    2016-04-01

    To determine whether there is an association between the geographic location of an applicant's undergraduate school, medical school, and residency program among matched otolaryngology residency applicants. Observational. Otolaryngology residency program applications to our institution from 2009 to 2013 were analyzed. The geographic location of each applicant's undergraduate education and medical education were collected. Online public records were queried to determine the residency program location of matched applicants. Applicants who did not match or who attended medical school outside the United States were excluded. Metro area, state, and region were determined according to US Census Bureau definitions. From 2009 to 2013, 1,089 (78%) of 1,405 applicants who matched into otolaryngology residency applied to our institution. The number of subjects who attended medical school and residency in the same geographic region was 241 (22%) for metropolitan area, 305 (28%) for state, and 436 (40%) for region. There was no difference in geographic location retention by gender or couples match status of the subject. United States Medical Licensing Exam step 1 scores correlated with an increased likelihood of subjects staying within the same geographic region (P = .03). Most otolaryngology applicants leave their previous geographic area to attend residency. Based on these data, the authors recommend against giving weight to geography as a factor when inviting applicants to interview. NA. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice.

    Science.gov (United States)

    Al-Himdani, Sarah; Jessop, Zita M; Al-Sabah, Ayesha; Combellack, Emman; Ibrahim, Amel; Doak, Shareen H; Hart, Andrew M; Archer, Charles W; Thornton, Catherine A; Whitaker, Iain S

    2017-01-01

    Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind. The Medical Research Council states that regenerative medicine and tissue engineering "holds the promise of revolutionizing patient care in the twenty-first century." The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment. The long-term aim of successful biomanufacture to repair composite defects depends on interdisciplinary collaboration between cell biologists, material scientists, engineers, and associated medical specialties; however currently, there is a current lack of coordination in the field as a whole. Barriers to translation are deep rooted at the basic science level, manifested by a lack of consensus on the ideal cell source, scaffold, molecular cues, and environment and manufacturing strategy. There is also insufficient understanding of the long-term safety and durability of tissue-engineered constructs. This review aims to highlight that individualized approaches to the field are not adequate, and research collaboratives will be essential to bring together differing areas of expertise to expedite future clinical translation. The use of tissue engineering in reconstructive surgery would result in a paradigm shift but it is important to maintain realistic expectations. It is generally accepted that it takes 20-30 years from the start of basic science research to clinical utility

  6. Functional exercise after high temporomandibular joint plastic surgery%高位颞下颌关节成形术后的功能康复

    Institute of Scientific and Technical Information of China (English)

    洪霞; 羊玉荣; 赵丽

    2002-01-01

    Objective To investigate the impact of functional exercise following high temporomandibular joint plastic surgery on functional recovery.Methods High temporomandibular joint plastic surgery was performed on 31 patients suffered from temporomandibular ankylosis.Titanium fragment and pedicle fascia were inserted.Functional exercise as well as locally hot compress and healthy education were carried out after operation.Results 29 subjects showed favorable functional recovery.Results showed 2 subjects developed ankylosis again due to poor mouth opening training (2/31).Conclusion Functional exercise after high temporomandibular joint plastic surgery is effective for recovery of temporomandibular joint functional.

  7. Appropriate Roles for the Subscriber, Publisher, Editor, Author, and Reviewer in the Archives of Plastic Surgery

    Directory of Open Access Journals (Sweden)

    Kun Hwang

    2013-11-01

    Full Text Available Authors, editors and reviewers, publishers, and subscribers all play their role in scientific journals. These 5 stakeholders are essential to journals. In this paper, firstly, I briefly summarize the role of each journal stakeholder and their respective goals. Secondly, the status of each participant in the Archives of Plastic Surgery is described. Finally, I propose an appropriate role and plan for each of them. Specific roles and responsibilities include the following: subscribers should welcome and submit the critiques of published papers in letters to the editor. Publishers should trust editors and provide them with adequate financial support for ongoing quality improvement of the journal. The editor-in-chief should be given a sufficient period of time-several years-to build up journal quality and train the incoming editor. The editors, including section editors, are also responsible for increasing the author pool. One editor might be designated a 'devil's referee', that is, a kind of devil's advocate with the responsibility of examining the originality of the manuscript, taking a skeptical view of the manuscript, and looking for holes in the methods and results of reported experiments. Authors' responsibilities include submitting manuscripts with scientific integrity and being ready to take responsibility for their articles even long after publication. Finally, reviewers' responsibilities include identifying similar articles not cited. Reviewers are also welcome to write a discussion on the article they review.

  8. Two stage study of wound microorganisms affecting burns and plastic surgery inpatients.

    Science.gov (United States)

    Miranda, Benjamin H; Ali, Syed N; Jeffery, Steven L A; Thomas, Sunil S

    2008-01-01

    This study was designed to identify wound microorganisms and the reasons for differing prevalence between the wards, burns unit and intensive care unit (ICU) in a regional centre for burns and plastic surgery. Antibiotic sensitivities of the 10 most prevalent microorganisms cultured from inpatient wound swabs were also investigated. Inpatient wound swab data were collected retrospectively using notes and departmental database information between January and June 2007. Data were analyzed using chi-squared tests and P-values. Eight hundred five positive wound swabs from 204 swab positive inpatients were analyzed. Stage 1 of this study demonstrated 917 positive swab episodes and 30 varieties of organism. The five most prevalent organisms cultured were Staphylococcus (23.9%), Acinetobacter (21.2%), Methicillin Resistant Staphylococcus aureus (MRSA) (20.8%), Pseudomonas (9.7%) and Enterococcus (5.2%). Stage 2 revealed that Acinetobacter baumanni (ABAU) was significantly more prevalent in military over civilian inpatients (P PAER) was significantly more prevalent in military inpatients over civilian inpatients (P PAER were significantly more prevalent in the ICU setting. Furthermore, military inpatient wounds grew more ABAU, MRSA, and PAER than civilians, probably due to the longer inpatient stay, dirty nature of wounds, site and complex mechanism of injury. Finally, this study suggests that ABAU was brought into the unit by military patients.

  9. Readability of pediatric otolaryngology information by children's hospitals and academic institutions.

    Science.gov (United States)

    Wong, Kevin; Levi, Jessica R

    2017-04-01

    Evaluate the readability of pediatric otolaryngology-related patient education materials from leading online sources. Cross-sectional analysis. All pediatric otolaryngology-related articles from the online patient health libraries of the top 10 US News & World Report-ranked children's hospitals, top 5 Doximity-ranked pediatric otolaryngology fellowships, and the American Academy of Otolaryngology-Head and Neck Surgery were collected. Each article was copied in plain text format into a blank document. Web page navigation, appointment information, references, author information, appointment information, acknowledgements, and disclaimers were removed. Follow-up editing was also performed to remove paragraph breaks, colons, semicolons, numbers, percentages, and bullets. Readability grade was calculated using the Flesch-Kincaid Grade Level, Flesch Reading Ease Score, Gunning-Fog Index, Coleman-Liau Index, Automated Readability Index, and Simple Measure of Gobbledygook. Intraobserver and interobserver reliability were assessed. A total of 502 articles were analyzed. Intraobserver and interobserver reliability were both excellent, with an intraclass correlation coefficient of 0.99 and 0.96, respectively. The average readability grade across all authorships and readability assessments exceeded the reading ability of the average American adult. Only 142 articles (28.3%) were written at or below the reading ability of the average American adult, whereas the remaining 360 articles (71.7%) were written above the reading level of the average adult. Current online health information related to pediatric otolaryngology may be too difficult for the average reader to understand. Revisions may be necessary for current materials to benefit a larger readership. NA Laryngoscope, 127:E138-E144, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  10. Acellular Dermal Matrix in Reconstructive Breast Surgery: Survey of Current Practice among Plastic Surgeons

    Directory of Open Access Journals (Sweden)

    Ahmed M. S. Ibrahim, MD

    2015-04-01

    Conclusions: Plastic surgeons currently use ADM in breast reconstruction for both immediate and staged procedures. Of those responding, a majority of plastic surgeons will incorporate drains and use postoperative antibiotics for more than 48 hours.

  11. The increasing role of otolaryngology in the management of surgical thyroid disorders.

    Science.gov (United States)

    Chambers, Kyle J; Bhattacharyya, Neil

    2013-12-01

    To determine trends in office visits and medical specialty seen for surgical diagnoses of the thyroid gland. A cross-sectional analysis of a national healthcare database. From the National Ambulatory Medical Care Survey (NAMCS), all cases of surgical thyroid disorders (e.g., benign neoplasm of thyroid gland, malignant neoplasm of thyroid gland, multinodular goiter) were extracted for 2 calendar year cohorts: 1995 to 1999 and 2005 to 2009. In addition to demographic information, the medical specialty of the health care provider seen was extracted. Comparisons were conducted for the proportion of surgical thyroid cases seen between general surgeons and otolaryngologists for the respective cohorts. In the 1995 to 1999 cohort, there were a total of 107 ± 13 thousand outpatient visits annually to either general surgery or otolaryngology for surgical thyroid conditions. Among these, 62.7 ± 8.4 thousand visits (58.3 ± 5.6%) were seen by general surgery versus 44.8 ± 9.1 thousand (41.7 ± 5.6%) seen by otolaryngology. In comparison, in the 2005 to 2009 cohort, there were 218 ± 29 thousand visits annually for surgical thyroid conditions. Among these, 88.4 ± 17 thousand (40.5 ± 5.4%) were seen by general surgery versus 130 ± 21 thousand (59.5 ± 5.4%) seen by otolaryngology. The increase in proportion of surgical thyroid patients seen by otolaryngology in the second 5 year cohort was statistically significant (P = 0.032, chi-square). There is a national trend in the United States toward otolaryngologists seeing an increasing majority proportion of increasingly prevalent surgical thyroid conditions. These data objectively confirm the perceived increasing role of otolaryngologists in the management of surgical thyroid disorders on a national level. Copyright © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  12. Tissue-Engineered Solutions in Plastic and Reconstructive Surgery: Principles and Practice

    Science.gov (United States)

    Al-Himdani, Sarah; Jessop, Zita M.; Al-Sabah, Ayesha; Combellack, Emman; Ibrahim, Amel; Doak, Shareen H.; Hart, Andrew M.; Archer, Charles W.; Thornton, Catherine A.; Whitaker, Iain S.

    2017-01-01

    Recent advances in microsurgery, imaging, and transplantation have led to significant refinements in autologous reconstructive options; however, the morbidity of donor sites remains. This would be eliminated by successful clinical translation of tissue-engineered solutions into surgical practice. Plastic surgeons are uniquely placed to be intrinsically involved in the research and development of laboratory engineered tissues and their subsequent use. In this article, we present an overview of the field of tissue engineering, with the practicing plastic surgeon in mind. The Medical Research Council states that regenerative medicine and tissue engineering “holds the promise of revolutionizing patient care in the twenty-first century.” The UK government highlighted regenerative medicine as one of the key eight great technologies in their industrial strategy worthy of significant investment. The long-term aim of successful biomanufacture to repair composite defects depends on interdisciplinary collaboration between cell biologists, material scientists, engineers, and associated medical specialties; however currently, there is a current lack of coordination in the field as a whole. Barriers to translation are deep rooted at the basic science level, manifested by a lack of consensus on the ideal cell source, scaffold, molecular cues, and environment and manufacturing strategy. There is also insufficient understanding of the long-term safety and durability of tissue-engineered constructs. This review aims to highlight that individualized approaches to the field are not adequate, and research collaboratives will be essential to bring together differing areas of expertise to expedite future clinical translation. The use of tissue engineering in reconstructive surgery would result in a paradigm shift but it is important to maintain realistic expectations. It is generally accepted that it takes 20–30 years from the start of basic science research to clinical utility

  13. Otolaryngologic emergencies in the outpatient setting.

    Science.gov (United States)

    Belleza, Walter G; Kalman, Suzanne

    2006-03-01

    Disease processes involving the ear, nose, and throat account for millions of office visits to primary care physicians per year. Because of their proximity to the airway as well as critical neurologic and vascular structures, the disease process in each individual case carries the potential for significant complications. Fortunately, improvements in medical care have significantly reduced the prevalence of these complications. As a result of their relative rarity, most physicians may be unfamiliar with the clinical presentation of these entities. This article familiarizes the physician with the pathophysiology and clinical presentation of the more commonly encountered otolaryngologic complications. The physician should seek to rule out the presence of the aforementioned complications in each patient who presents with an otolaryngologic complaint. Any suggestion of their presence should prompt an immediate referral to a subspecialist or an emergency department. It is hoped that continued familiarization with these' disease processes will maintain them as rare entities of medical practice.

  14. 无痛化眼部美容术%Painless plastic surgery on ocular region

    Institute of Scientific and Technical Information of China (English)

    王昕; 陈小平; 林金德; 朴相根; 唐安; 徐利刚; 郑翔宇

    2011-01-01

    Objective To explore the feasibility of painless plastic surgery on ocular region. Meth ods About 136 patients with painful scare who could make a good communication with aesthetic surgeons were performed the aesthetic surgery on ocular region under local anesthesia combining the intravenous Midazolam and Ketamine, and the effects of sedation and pain, postoperative amnesia, treatment dependence and behavior therapy efficacy were observed and evaluated. The vital signs such as SpO2 , HR, SBP and ECG were detected. Results Patients who treated with intravenous infusion of Midazolam and Ketamine in advance were performed the aesthetic surgery on ocular region under local anesthesia. There was no injective pain during local anesthesia and no pain reaction during the operation because the patients were in deep sleep. It was significant good for intraoperative sedation, analgesia and anterograde amnesia without significant respiratory and cardiovascular depression during operation. However, 6 cases were with temporary hypoxemia (SpO2 < 80% ) and 15 cases with oculocardiac reflex, which did not affect to finish the whole operation. No severe complications were detected. The treat dependence and behavior therapy efficacy were satisfied. Conclusion This study demonstrates that the intravenous Midazolam and Ketamine combining with local anesthesia provided satisfactory intraoperarive sedation, analgesia and amnesia in oculoplastic surgery patients with dread pain.%目的 探讨实施无痛化眼部美容手术的可行性.方法 对136例因恐惧手术疼痛但能与医师良好沟通的眼部美容受术者,采用静脉注射咪达唑仑复合氯胺酮辅助局部麻醉实施无痛化眼部美容术,并对镇痛、镇静效果、治疗依从性和治疗行为效果及术后遗忘进行了临床观察和评定,并在术中全程监测SpO2、HR、SBP和心电图变化.结果 静脉注射咪达唑仑和氯胺酮后,恐惧疼痛的受术者均顺利接受局麻注射和

  15. Prophylactic plastic surgery closure of neurosurgical scalp incisions reduces the incidence of wound complications in previously-operated patients treated with bevacizumab (Avastin®) and radiation.

    Science.gov (United States)

    Golas, Alyssa Reiffel; Boyko, Tatiana; Schwartz, Theodore H; Stieg, Philip E; Boockvar, John A; Spector, Jason A

    2014-09-01

    Neurosurgical craniotomy, craniectomy, or other trans-galeal interventions are performed for a variety of indications, including the resection of benign or malignant tumors, hematoma evacuation, and for the management of intractable seizure disorders. Despite an overall low complication rate of intervention, wound healing complications such as dehiscence, surgical site infection, and cerebrospinal fluid leak are not uncommon. A retrospective review was performed of all patients who underwent scalp incision closure at a single institution by a single plastic surgeon between 2006 and 2013. Sixty patients (83 procedures) were included in the study. Fifty-seven patients (95.0 %) underwent previous craniotomy, craniectomy, or other trans-galeal procedure. Of the total 60 patients, 35 patients received preoperative radiation. Sixteen patients received bevacizumab prior to their index case, while 12 received bevacizumab postoperatively. Ten patients (16.7 %) required additional plastic surgical intervention for wound complications after their index plastic surgery procedure. Plastic surgery was consulted prophylactically in 34 patients (38 procedures). When plastic surgery was consulted prophylactically, 4 patients (11.8 %) required further wound revision. None of the 14 patients who underwent prophylactic plastic surgery closure for previous scalp incision, preoperative bevacizumab, and XRT administration required re-intervention. Plastic surgery closure of complex scalp incisions reduces the incidence of wound complications among patients who underwent previous neurosurgical intervention, XRT administration, and preoperative bevacizumab administration. This is particularly true when plastic surgery closure is performed "prophylactically." Further collaboration between the neurosurgical and plastic surgery teams is therefore warranted, particularly in the setting of these high-risk cases.

  16. Current requirements for polymeric biomaterials in otolaryngology

    Directory of Open Access Journals (Sweden)

    Sternberg, Katrin

    2009-01-01

    Full Text Available In recent years otolaryngology was strongly influenced by newly developed implants which are based on both, innovative biomaterials and novel implant technologies. Since the biomaterials are integrated into biological systems they have to fulfill all technical requirements and accommodate biological interactions. Technical functionality relating to implant specific mechanical properties, a sufficiently high stability in terms of physiological conditions, and good biocompatibility are the demands with regard to suitability of biomaterials. The goal in applying biomaterials for implants is to maintain biofunctionality over extended periods of time. These general demands to biomaterials are equally valid for use in otolaryngology. Different classes of materials can be utilized as biomaterials. Metals belong to the oldest biomaterials. In addition, alloys, ceramics, inorganic glasses and composites have been tested successfully. Furthermore, natural and synthetic polymers are widely used materials, which will be in the focus of the current article with regard to their properties and usage as cochlear implants, osteosynthesis implants, stents, and matrices for tissue engineering. Due to their application as permanent or temporary implants materials are differentiated into biostable and biodegradable polymers. The here identified general and up to date requirements for biomaterials and the illustrated applications in otolaryngology emphasize ongoing research efforts in this area and at the same time demonstrate the high significance of interdisciplinary cooperation between natural sciences, engineering, and medical sciences.

  17. Plastic and Reconstructive Surgery in the Treatment of Oncological Perineal and Genital Defects

    Directory of Open Access Journals (Sweden)

    Rebekka eBrodbeck

    2015-10-01

    Full Text Available Defects of the perineum may result from ablative procedures of different malignancies. The evolution of more radical excisional surgery techniques resulted in an increase in large defects of the perineum. The perineogenital region per se has many different functions for urination, bowel evacuation, sexuality and reproduction. Up-to-date individual and interdisciplinary surgical treatment concepts are necessary to provide optimum oncological as well as quality of life outcome.Not only the reconstructive method but also the timing of the reconstruction is crucial. In cases of postresectional exposition of e. g. pelvic or femoral vessels or intrapelvic and intra-abdominal organs, simultaneous flap procedure is mandatory. In particular, the reconstructive armamentarium of the plastic surgeon should not only include pedicled, but also free microsurgical flaps so that no compromise in terms of the extent of the oncological resection has to be accepted. For intra-abdominally and/or pelvic tumors of the rectum, the anus or the female reproductive system, which were resected through an abdominally and a sacrally surgical access, simultaneous VRAM flap reconstruction is recommendable. In terms of soft tissue sarcoma of the pelvic / caudal abdomen / proximal thigh region, two-stage reconstructions are possible.This review focuses on the treatment of perineum, genitals and pelvic floor defects after resection of malignant tumors, giving a distinct overview of the different type of defects faced in this region and describing a number of reconstructive techniques, especially VRAM flap and pedicled flaps like ALT flap or free flaps. Finally, this review outlines some considerations concerning timing of the different operative steps.

  18. Bra Sizing and the Plastic Surgery Herd Effect: Are Breast Augmentation Patients Getting Accurate Information?

    Science.gov (United States)

    Costa, Christopher R; Small, Kevin H; Adams, William P

    2017-01-17

    Bra sizing is a common method to preoperatively select implants for breast augmentation; however, no series has analyzed the accuracy of this modality postoperatively. Alternatively, previous investigations have validated the accuracy and utility of three-dimensional (3D) imaging for preoperative simulation in breast augmentation. This investigation utilizes 3D analysis to determine if preoperative bra sizing provides equivocal information compared to surgical 3D simulation for patient education and planning prior to a breast augmentation. During primary breast augmentation consultation, patients received preoperative 3D images and associated simulations. Sizers, equivocal to the implants chosen in the simulation, were placed in a surgical bra, and 3D images were repeated. Volumetric and contour analyses were compared between the surgical simulation and the bra/sizer image. All patients used a surgical bra and smooth, round silicone sizers (average volume, 302 cc; range, 265-339 cc). Seven patients (14 breasts) underwent analysis and comparison. The mean bra/sizer volume image was 22.3% greater than the preoperative simulated breast image. The mean absolute difference of all surface points between the two breast images was 9.25 mm (range, 5.98-11.96 mm; standard deviation, 8.59). The maximum anterior displacement of the bra image from the simulated image was 19.52 mm, centered at the upper pole; the maximum posterior displacement was 25.49 mm, centered at the lower pole. In comparison to 3D simulation, preoperative bra sizing overestimates postoperative volume, and upper pole fullness and underestimates lower pole projection. This investigation outlines some deficiencies of bra sizing and offers solutions for clinical management in primary breast augmentation. LEVEL OF EVIDENCE 2. © 2017 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  19. Surgical site infections in paediatric otolaryngology operative procedures.

    Science.gov (United States)

    Ifeacho, S N; Bajaj, Y; Jephson, C G; Albert, D M

    2012-07-01

    An assessment of the rate of surgical site infections associated with elective paediatric otolaryngology surgical procedures. Prospective data was collected for a 3-week period for all children undergoing surgery where either mucosa or skin was breached. The parents of the children were requested to complete a questionnaire at 30 days after the operation. Data was collected on 80 consecutive cases. The majority of cases were admitted on the day of the procedure. The procedures included adenotonsillectomy (24), grommets (12), cochlear implantation (6), bone-anchored hearing aid (2), submandibular gland excision (1), branchial sinus excision (1), cystic hygroma excision (3), nasal glioma excision (1), microlaryngobronchoscopy (13), tracheostomy (3) and other procedures (14). Nearly half the cases had more than one operation done at the same time. 26/80 (32.5%) patients had a temporary or permanent implant inserted at the time of operation (grommet, bone-anchored hearing aid, cochlear implant). 25/80 (31%) operative fields were classed as clean and 55/80 (68.7%) as clean contaminated operations. The duration of the operation varied from 6 min to 142 min. Hospital antibiotic protocol was adhered to in 69/80 (86.3%) cases but not in 11/80 cases. In our series, 3/80 (3.7%) patients had an infection in the postoperative period. Surgical site infections do occur at an appreciable rate in paediatric otolaryngology. With the potential for serious consequences, reduction in the risk of surgical site infections is important. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  20. Periodontal plastic surgery to improve aesthetics in patients with altered passive eruption/gummy smile: a case series study.

    Science.gov (United States)

    Cairo, Francesco; Graziani, Filippo; Franchi, Lorenzo; Defraia, Efisio; Pini Prato, Giovan Paolo

    2012-01-01

    Altered passive eruption/gummy smile is a common challenge in patients requiring aesthetic treatment. A specific surgical protocol was designed and tested in patients with altered passive eruption. Standardized preoperative X-rays were used to assess crown length at baseline and to place submarginal incisions. Osseous respective therapy was performed to achieve biological width. Clinical outcomes were recorded 6 months after surgery. Eleven patients with a total of 58 teeth were treated with flap surgery and osseous resective therapy at upper anterior natural teeth. At the last followup, a significant and stable improvement of crown length was obtained when compared to the baseline (P periodontal plastic surgery including osseous resection leads to predictable outcomes in the treatment of altered passive eruption/gummy smile: A careful preoperative planning avoids unpleasant complications and enhances postsurgical stability of the gingival margin.

  1. Trends in Otolaryngology Consultation Patterns at an Academic Quaternary Care Center.

    Science.gov (United States)

    Choi, Kevin J; Kahmke, Russel R; Crowson, Matthew G; Puscas, Liana; Scher, Richard L; Cohen, Seth M

    2017-05-01

    The consultation patterns of an otolaryngology-head and neck surgery service have not previously been reported. The time, resources, and attention required to operate such a consultation service are unknown. To assess trends in otolaryngology-head and neck surgery consultations conducted in emergency departments (EDs) and inpatient services. A retrospective analysis was conducted of the medical records of patients at a quaternary care center receiving inpatient otolaryngology consultations from January 1 to December 31, 2014. Clinical evaluation and bedside and operative procedures performed by the otolaryngology-head and neck surgery service. Demographics, reason for consultation, diagnosis, bedside procedures, operative interventions, and admission variables. A total of 1491 consultations were completed for adult (1091 [73.2%]; 854 men and 637 women; mean [SD] age 50.3 [19.3] years) and pediatric (400 [26.8%]; 232 boys and 168 girls; mean [SD] age, 4.0 [5.2] years) patients. Of the 1491 consultations, 766 (51.4%) originated from inpatient teams vs 725 (48.6%) from the ED. A total of 995 of all consultations (66.7%) resulted in a bedside procedure, and 243 (16.3%) required operative intervention. Consultations regarding airway evaluation (362 [47.3%] vs 143 [19.7%]), management of epistaxis (78 [10.2%] vs 33 [4.6%]), and rhinologic evaluation (79 [10.3%] vs 18 [2.5%]) were more frequent from inpatient teams than from the ED. Consultations regarding management of head and neck infections (162 [22.3%] vs 32 [4.2%]), facial trauma (235 [32.4%] vs 16 [2.1%]), and postoperative complications (73 [10.1%] vs 2 [0.3%]) were more frequent in the ED. Of the 725 consultations performed in the ED, 212 patients (29.2%) required hospitalization. The consultation volume of an otolaryngology-head and neck surgery service requires significant time and resources. Consultations are most often for rhinologic or laryngologic issues and are reflective of the clinical setting in which

  2. Characterization of the Hospitalized Patients of the Otolaryngology and Maxillofacial Unit of the Hospital Universitario San Ignacio from February 2001 to October 2012

    OpenAIRE

    Pérez García, Irene Camila; Pontificia Universidad Javeriana-Hospital Universitario San Ignacio; Ronderos Suárez, Ángela María; Pontificia Universidad Javeriana; Gutiérrez Maldonado, Santiago; Hospital Universitario de San Ignacio-Pontificia Universidad Javeriana

    2014-01-01

    Objective: To characterize the population of hospitalized patients in the Otolaryngology and Maxillofacial Surgery Unit of the Hospital Universitario San Ignacio, from February 2001 to October 2012.Materials and methods: A retrospective, observational, cross-sectional study was performed for the patients registered in the database of the Otolaryngology and Maxillofacial Surgery Unit for a period of 11 years from February 2001 to October 2012. The variables studied were: Sex, age group and pri...

  3. 整形外科新进展与发展设想%Recent advancements and prospects of plastic surgery

    Institute of Scientific and Technical Information of China (English)

    邢新

    2011-01-01

    目的 综述国内外整形外科研究现状和发展动态,提出未来我军整形外科的发展方向、目标和重点.方法 在PubMed、Medline和中文生物医学期刊文献数据库(CMCC)中检索近5年发表的相关文献并进行综述,同时对军队整形外科近5年来取得的成就进行统计调查.结果 近5年来,整形外科在基础研究和临床治疗方面都取得了可喜进展,在战创伤早期救治中的作用和地位也得到重视和认可;我军整形外科在慢性创面修复、皮肤软组织爆炸伤及海水浸泡伤的损伤机制和防治方法 、战创伤面部畸形救治新技术、同种异体面部复合组织移植等方面取得了令人瞩目的成就.结论未来我军整形外科的发展应以战创伤组织缺损和畸形的修复与重建作为主要研究方向,重点开展组织工程、同种异体复合组织移植、干细胞治疗、异常瘢痕形成机制等科研工作,以解决严重面部毁损伤、广泛性胸腹壁全层缺损、慢性溃疡以及异常瘢痕等临床治疗难题,同时应注重发挥专业特长,积极参与战创伤的早期救治.%Objective To summarize the recent advancements and developmentalprospects of plastic surgery worldwide, and to describe the future directions, aims, and highlights of Chinese military plastic surgery. Methods Relevant articles published in the last five years were retrieved through a search in PubMed, Medline, and CMCC. A statistical survey was conducted to summarize the achievements obtained by the Chinese military plastic surgery unit in the last five years. Results Considerable progress has been achieved in both clinical treatment and basic research of plastic surgery in the past five years. Its important role in the early treatment of combat injury and trauma has been recognized and emphasized Chinese military plastic surgery has achieved considerable accomplishments in the last five years, especially in chronic wound repair; mechanism

  4. A brief history of the development of plastic surgery in The Netherlands East-Indies from World War I until the independence of Indonesia (1914-1950).

    Science.gov (United States)

    Haeseker, B

    1990-05-01

    This study of surgical operations published in the Medical Journal of the Netherlands East-Indies over the period 1914-1950, supplemented with a series of interviews with retired Dutch East-Indian surgeons and their relatives, shows a vivid interest in plastic surgery from World War I until the independence of Indonesia. One can conclude that plastic surgery was performed more frequently and on a larger scale than in Holland, due to a larger number of patients, specific tropical pathology and often a longer patient delay, requiring extensive reconstructive procedures. The East-Indian publications on plastic surgical topics outnumber the Dutch ones enormously.

  5. Staged ridge-split evaluated using cone beam computed tomography and peri-implant plastic surgery in the mandibular arch

    Directory of Open Access Journals (Sweden)

    Nikhil Vasant Jain

    2015-01-01

    Full Text Available Lack of sufficient bone to place an implant at a functionally and an esthetically appropriate position is a common problem, especially in the mandibular posterior region. Narrow edentulous alveolar ridges <5 mm wide require bone augmentation before implant placement to establish a bony wall of at least 1 mm around the endosseous implant. Various surgical widening techniques are available, including lateral augmentation with or without guided bone regeneration, ridge-split technique and horizontal distraction osteogenesis. The ridge-split technique aims at creating a new implant bed by longitudinal osteotomy of the alveolar bone. The buccal cortex is repositioned laterally by greenstick fracture, and the space between the buccal and lingual cortices is filled with a graft material. Peri-implant plastic surgery focuses on harmonizing peri-implant structures by means of hard- and soft-tissue engineering and includes bone structure enhancement, soft-tissue enhancement, precision in implant placement and improves quality of the prosthetic restoration. The rationale for the peri-implant plastic surgery approach goes well beyond pure esthetics as it creates peri-implant keratinized mucosa and interimplant soft-tissue height in order to avoid food impaction, interimplant airflow, and speech problems. This case report demonstrates a staged ridge-split technique evaluated with cone beam computed tomography using a piezosurgical unit and a surgical technique to restore a papilla-like tissue at the time of the second-stage implant surgery.

  6. [Practice of reconstructive plastic surgery of the clitoris after genital mutilation in Burkina Faso. Report of 94 cases].

    Science.gov (United States)

    Ouédraogo, C M R; Madzou, S; Touré, B; Ouédraogo, A; Ouédraogo, S; Lankoandé, J

    2013-06-01

    To describe and evaluate the results of reconstructive plastic surgery of the clitoris in order to promote reproductive health. We conducted a retrospective study from 2007 to 2010. Ninety-four women were included in our study. The mean age was 32.3 years. The evaluation of the experience of sexuality before reconstruction showed that 41.5 % of patients had never had a sexual desire before surgery, more than half did not have a clitoral orgasm and dyspareunia was experienced by about a third of them. The main reason for consultation in our series was related to sexual dysfunction in more than half of our study population. All patients were operated using the technique of Dr Pierre Foldès. Evaluation with a decline of at least 6 months after surgery showed us a massive restoration of the clitoris at 89.7 %. There was a significant difference between sexual desire before and after surgery. A significant improvement in sexuality was observed in 83.6 % of patients. However, there was no significant difference between orgasm before and after surgery. This showed us that getting an orgasm is multifactorial and it is not enough to have a clitoris to have an orgasm, you have to use it. Regardless of the anatomical and functional results, all women were satisfied with respect to body found. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. Resection And Reconstructive-plastic Surgery In Treatment Of Extended And Multifocal Cicatrical Tracheal Stenosis

    Directory of Open Access Journals (Sweden)

    Otabek Eshonkhodjaev

    2015-12-01

    Full Text Available Background. Main issues of treatment of patients with cicatricial stenosis of trachea (CST are to increase its efficacy and safety, as well as to determine indications and contraindications for circular resection and reconstructive interventions on the trachea in patients with extended lesions of trachea, with stenoses involving subvocal cords part of larynx and well as multifocal narrowing of the trachea which could improve treatment results and quality of life of patients, to gain recovery and reduce disability and mortality.Material and methods. One hundred two patients aged from 11 to 62 years with CST were surgically treated. Stenotic site length in patients varied from 0,3 to 7 cm. Most frequently (64,2%, CST length of more than 2 cm was observed. In critical and decompensated stenosis with diameter of CST up to 5 mm with the threat of asphyxiation by the first stage we used endoscopic laser-and electric destruction of constriction followed by restricted zone bouging. If long-term rehabilitation was necessary and in case of absence of the conditions to the implementation of circular tracheal resection, we used tracheal stents. Circular resection of the trachea was performed in 24 patients. In case of contraindications, 28 patients underwent reconstructive plastic surgery with dissection the stenosis, excision of scar tissue and formation of trachea lumen in T-tube. After removing T-tube plasty of anterior tracheal wall and of soft tissues of the neck defects was performed using local tissues and grafts with microsurgical techniques.Results. Long-term results of treatment evaluated and studied in a period of 6 months to 5 years in 89 (87.3% patients. 13 patients continues to one of the stages of complex treatment. Еhe patients are under dynamic endoscopic control. Good results were achieved in the treatment of 71 patients (79.8%, satisfactory - in 12 (13.4%, unsatisfactory results in 6 (6.7% patients.Conclusions. 1. Patients with CST

  8. Current Interview Trail Metrics in the Otolaryngology Match.

    Science.gov (United States)

    Cabrera-Muffly, Cristina; Chang, C W David; Puscas, Liana

    2017-06-01

    Objectives To identify how applicants to otolaryngology residency determine how to apply to, interview with, and rank programs on the interview trail and to determine the extent of the financial burden of the otolaryngology interview trail. Study Design Web-based survey distributed in March and April 2016. Setting Otolaryngology residency applicants throughout the United States. Subjects and Methods Applicants to otolaryngology residency during the 2016 match cycle and current otolaryngology residents were surveyed. Results Median number of applications, interview offers, interviews attended, and programs ranked was not different during the 2016 match and the previous 5 match years. The most important factor affecting the number of applications was the need to apply widely to ensure sufficient interview offers. The most common reason for declining an interview offer was scheduling conflict. Applicants during the 2016 match spent a median of $5400 applying and interviewing for otolaryngology residency. Conclusions Median number of applications, interview offers, interviews attended, and programs ranked has not changed. The most cited reason for applying to many programs was to increase the chances of matching, but this is not statistically likely to increase match success. We advocate for continued attempts to make the otolaryngology match process more transparent for both applicants and resident selection committees, but recognize that applicants are likely to continue to overapply for otolaryngology residency positions.

  9. Temporal bone dissection simulator for training pediatric otolaryngology surgeons

    Science.gov (United States)

    Tabrizi, Pooneh R.; Sang, Hongqiang; Talari, Hadi F.; Preciado, Diego; Monfaredi, Reza; Reilly, Brian; Arikatla, Sreekanth; Enquobahrie, Andinet; Cleary, Kevin

    2017-03-01

    Cochlear implantation is the standard of care for infants born with severe hearing loss. Current guidelines approve the surgical placement of implants as early as 12 months of age. Implantation at a younger age poses a greater surgical challenge since the underdeveloped mastoid tip, along with thin calvarial bone, creates less room for surgical navigation and can result in increased surgical risk. We have been developing a temporal bone dissection simulator based on actual clinical cases for training otolaryngology fellows in this delicate procedure. The simulator system is based on pre-procedure CT (Computed Tomography) images from pediatric infant cases (surgery environment, (2) a newly developed haptic interface for holding the surgical drill, (3) an Oculus Rift to provide a microscopic-like view of the temporal bone surgery, and (4) user interface to interact with the simulator through the Oculus Rift and the haptic device. To evaluate the system, we have collected 10 representative CT data sets and segmented the key structures: cochlea, round window, facial nerve, and ossicles. The simulator will present these key structures to the user and warn the user if needed by continuously calculating the distances between the tip of surgical drill and the key structures.

  10. What Is Refractive Surgery?

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  11. LASIK - Laser Eye Surgery

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  12. Simulation in otolaryngology: smart dummies and more.

    Science.gov (United States)

    Deutsch, Ellen S

    2011-12-01

    Simulation is revolutionizing medical education, certification, and ongoing professional development. Simulation encompasses a variety of technologies as well as nontechnical approaches to improve individual psychomotor skills, group effectiveness, and systems processes, all without direct risk to patients. Simulation-enhanced learning experiences, addressing learning objectives based on the needs of the individual or the group and following the principles of adult education, can be used to ensure consistent and comprehensive learning opportunities, thereby creatively complementing didactic and clinical learning experiences. Pockets of simulation expertise are already present in the field of otolaryngology; more will develop as these exciting and important innovations blossom.

  13. Does an Otolaryngology-Specific Database Have Added Value? A Comparative Feasibility Analysis.

    Science.gov (United States)

    Bellmunt, Angela M; Roberts, Rhonda; Lee, Walter T; Schulz, Kris; Pynnonen, Melissa A; Crowson, Matthew G; Witsell, David; Parham, Kourosh; Langman, Alan; Vambutas, Andrea; Ryan, Sheila E; Shin, Jennifer J

    2016-07-01

    There are multiple nationally representative databases that support epidemiologic and outcomes research, and it is unknown whether an otolaryngology-specific resource would prove indispensable or superfluous. Therefore, our objective was to determine the feasibility of analyses in the National Ambulatory Medical Care Survey (NAMCS) and National Hospital Ambulatory Medical Care Survey (NHAMCS) databases as compared with the otolaryngology-specific Creating Healthcare Excellence through Education and Research (CHEER) database. Parallel analyses in 2 data sets. Ambulatory visits in the United States. To test a fixed hypothesis that could be directly compared between data sets, we focused on a condition with expected prevalence high enough to substantiate availability in both. This query also encompassed a broad span of diagnoses to sample the breadth of available information. Specifically, we compared an assessment of suspected risk factors for sensorineural hearing loss in subjects 0 to 21 years of age, according to a predetermined protocol. We also assessed the feasibility of 6 additional diagnostic queries among all age groups. In the NAMCS/NHAMCS data set, the number of measured observations was not sufficient to support reliable numeric conclusions (percentage standard error among risk factors: 38.6-92.1). Analysis of the CHEER database demonstrated that age, sex, meningitis, and cytomegalovirus were statistically significant factors associated with pediatric sensorineural hearing loss (P otolaryngology-specific database has added utility when compared with already available national ambulatory databases. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  14. Human Papillomavirus Vaccination Counseling in Pediatric Training: Are We Discussing Otolaryngology-Related Manifestations?

    Science.gov (United States)

    Gnagi, Sharon H; Gnagi, Forrest T; Schraff, Scott A; Hinni, Michael L

    2016-07-01

    Demonstrate the need for increased education regarding otolaryngology-related manifestations of human papillomavirus (HPV). Highlight a need to incorporate otolaryngology-related manifestations of HPV in vaccine counseling. Survey. Tertiary care academic children's hospital. Pediatric residents, fellows, and staff. An online survey was made available regarding HPV education and vaccination. Participants (N = 348) initiated the survey representing 28.4%, 25.6%, and 19.0% postgraduate year 1, 2, and 3 residents, respectively, as well as 17.5% chief residents/fellows and 9.5% attendings. Participants rated their prior education as none or fair regarding recurrent respiratory papillomatosis (63.8%) and oropharyngeal squamous cell carcinoma (68.3%). In contrast, 60.6% and 70.9% rated their education on genital warts and cervical cancer correspondingly as good or excellent. When asked what was routinely discussed during HPV vaccine counseling, 63.3% reported "never" discussing recurrent respiratory papillomatosis and 52.9% "never" discussing oropharyngeal squamous cell carcinoma. A range from 92.7% to 95.5% responded that there was a need for increased education regarding HPV and its role in recurrent respiratory papillomatosis and oropharyngeal squamous cell carcinoma. Increased education about HPV and its otolaryngology-related manifestations should be undertaken to increase provider, patient, and parent awareness of recurrent respiratory papillomatosis and oropharyngeal squamous cell carcinoma. We propose that discussing the risks of otolaryngology-related disease be routinely included in HPV vaccination counseling. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  15. The influence of social media and easily accessible online information on the aesthetic plastic surgery practice: literature review and our own experience.

    Science.gov (United States)

    Montemurro, Paolo; Porcnik, Ales; Hedén, Per; Otte, Maximilian

    2015-04-01

    Patients interested in aesthetic plastic surgery procedures increasingly seek advice on social media and rely on easily accessible online information. The investigatory goal was to determine the impact of this phenomenon on the everyday aesthetic plastic surgery practice. Five hundred consecutive patients completed a questionnaire prior to their consultation with a plastic surgeon at our clinic. A questionnaire was also completed by 128 plastic surgeons practising in 19 different countries. A literature review was performed. Almost all patients (95%) used the internet to collect information prior to consultation, for 68% of them it being their first search method. Social media were used by 46% of patients and 40% of these were strongly influenced when choosing a specific doctor. The majority of plastic surgeons (85%) thought the information found on social media could lead to unrealistic expectations. However, 45% of plastic surgeons believed that their consultations became easier after the advent of social media, 29% found them more difficult. A literature review showed a high percentage of poor quality internet websites regarding plastic surgery and an increase in use of social media among plastic surgeons. The internet and social media play an important and growing role in plastic surgery. This results in more informed patients but may create unrealistic expectations. Even if the internet provides ample information, it cannot replace the face-to-face consultation, which always should remain a detailed process, covering both risks and limitations of alternative procedures. Available literature on how social media influences the medical practice is still scarce and further research is needed. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  16. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena; Rose, Michael; Bentzon, Niels

    2015-01-01

    INTRODUCTION: More than 4,000 Danish women are diagnosed with operable breast cancer annually, and 70% receive breast conserving surgery. Without the use of oncoplastic surgery (OPS), 20-30% will get an unsatisfactory cosmetic result. The aim of this study was to illustrate the level of implement...

  17. Evaluation of the Current Perspectives on Letters of Recommendation for Residency Applicants among Plastic Surgery Program Directors

    Directory of Open Access Journals (Sweden)

    K. Shultz

    2012-01-01

    Full Text Available Background. The goals of this project were to evaluate the current perspective on letters of recommendation and to assess the need for, and acceptance of, a more standardized letter of recommendation (LOR. Methods. An eight-question survey was distributed to plastic surgery program directors. A five-point Likert scale was selected as a means of quantifying the participants’ responses to the survey. Results. Twenty-eight of 71 program directors (39.4% completed the survey. The majority of participants felt that current LOR did not offer a realistic way to compare applicants (mean±SD, 2.9±0.8. While most agreed that increasing the objectivity of LOR would be valuable in comparing applicants (mean±SD, 4.1±0.9, the overall average response to whether a more standardized letter format would improve the resident selection process remained only slightly better than neutral (mean±SD, 3.5±1.2. Most of the chairmen supported the notion that familiarity with the author of the LOR strengthened the recommendation (mean±SD, 4.5±0.6. Conclusion. The majority of plastic surgery program directors would like more objectivity in comparing applicants but are ambivalent about a standardized letter of recommendation.

  18. Multiaxial mechanical properties and constitutive modeling of human adipose tissue: a basis for preoperative simulations in plastic and reconstructive surgery.

    Science.gov (United States)

    Sommer, Gerhard; Eder, Maximilian; Kovacs, Laszlo; Pathak, Heramb; Bonitz, Lars; Mueller, Christoph; Regitnig, Peter; Holzapfel, Gerhard A

    2013-11-01

    A preoperative simulation of soft tissue deformations during plastic and reconstructive surgery is desirable to support the surgeon's planning and to improve surgical outcomes. The current development of constitutive adipose tissue models, for the implementation in multilayer computational frameworks for the simulation of human soft tissue deformations, has proved difficult because knowledge of the required mechanical parameters of fat tissue is limited. Therefore, for the first time, human abdominal adipose tissues were mechanically investigated by biaxial tensile and triaxial shear tests. The results of this study suggest that human abdominal adipose tissues under quasi-static and dynamic multiaxial loadings can be characterized as a nonlinear, anisotropic and viscoelastic soft biological material. The nonlinear and anisotropic features are consequences of the material's collagenous microstructure. The aligned collagenous septa observed in histological investigations causes the anisotropy of the tissue. A hyperelastic model used in this study was appropriate to represent the quasi-static multiaxial mechanical behavior of fat tissue. The constitutive parameters are intended to serve as a basis for soft tissue simulations using the finite element method, which is an apparent method for obtaining promising results in the field of plastic and reconstructive surgery.

  19. Pulmonary Hemorrhagic Infarction due to Fat Embolism and Thromboembolism after Maxillofacial Plastic Surgery: a Rare Case Report

    Institute of Scientific and Technical Information of China (English)

    ZOU Dong-hua; SHAO Yu; ZHANG Jian-hua; QIN Zhi-qiang; LIU Ning-guo; HUANG Ping; CHEN Yi-jiu

    2012-01-01

    Pulmonary fat embolism (PFE) and pulmonary thromboembolism (PTE) are common post-operative complications of orthopedic surgical procedures,but are reported less often following maxillofacial plastic surgical procedures,especially with respect to PFE.Thrombi,or together with fat emboli in pulmonary vessels can induce hemorrhagic infarction and cause death.Herein this report introduced a death due to pulmonary hemorrhagic infarction following maxillofacial plastic surgery.The female patient underwent several osteotomies of the mandible,zygomas and autologous bone grafting within a single operation.The operative time was longer than normal and no preventive strategies for pulmonary embolism were implemented.The patient died 20 days after hospital discharge.The autopsy confirmed pulmonary hemorrhagic infarction.The fat emboli and thrombi were also noted in the pulmonary vessels,which were thought to have resulted from the maxillofacial osteotomy.Suggestions were offered to forensic pathologists that risk factors of PFE and PTE,such as the type and length of surgery,the surgical sites,and the preventive strategies,should be considered when handling deaths after maxillofacial operations.

  20. Objective assessment of surgical performance and its impact on a national selection programme of candidates for higher surgical training in plastic surgery.

    LENUS (Irish Health Repository)

    Carroll, Sean M

    2012-02-01

    OBJECTIVE: The objective of this study was to develop and validate a transparent, fair and objective assessment programme for the selection of surgical trainees into higher surgical training (HST) in plastic surgery in the Republic of Ireland. METHODS: Thirty-four individuals applied for HST in plastic surgery at the Royal College of Surgeons in Ireland (RCSI) in the academic years 2005-2006 and 2006-2007. Eighteen were short-listed for interview and further assessment. All applicants were required to report on their undergraduate educational performance and their postgraduate professional development. Short-listed applicants completed validated objective assessment simulations of surgical skills, an interview and assessment of their suitability for a career in surgery. RESULTS: When applicants\\' short-listing scores were combined with their interview scores and assessment of their suitability for a career in surgery, individuals who were selected for HST in plastic surgery performed significantly better than those who were not (P<0.002). However, when the assessment of technical skills scores were added the significance level of this difference increased further (P<0.0001) as did the statistical power of the difference to 99.9%, thus increasing the robustness of the selection package. CONCLUSION: The results from this study suggest that the assessment protocol we used to select individuals for HST in plastic surgery reliably and statistically significantly discriminated between the performances of candidates.

  1. Impact of fellowship training on research productivity in academic otolaryngology.

    Science.gov (United States)

    Eloy, Jean Anderson; Svider, Peter F; Mauro, Kevin M; Setzen, Michael; Baredes, Soly

    2012-12-01

    Assessment of scholarly productivity as measured by research output is a key component of decisions regarding appointment and advancement in academic otolaryngology. An increasing number of graduating residents are pursuing postresidency fellowships, and evaluation of research productivity among these subspecialists is important in determining their role in academic otolaryngology departments. The h-index is a reliable indicator of research productivity, as it takes into account both quantity and relevance of research contributions. Our objective was to evaluate and compare trends in research productivity among the various otolaryngology subspecialties. Analysis of research productivity trends among otolaryngology subspecialties using the h-index. Faculty members from 92 academic otolaryngology departments were organized by subspecialty and academic rank, and their research productivity, as measured by the h-index, was calculated using the Scopus database. Fellowship-trained otolaryngologists in academic programs had higher h-indices than non-fellowship-trained otolaryngologists. Head and neck surgeons and otologists had significantly higher research productivity than their peers in other otolaryngology subspecialties. Analysis of the subspecialties of chairpersons indicated that 62% were either head and neck surgeons or otologists. Fellowship-trained otolaryngologists had higher h-indices, and faculty members trained in the subspecialties with the highest research productivity were disproportionately represented in positions of leadership within academic otolaryngology, probably reflecting the importance of research contributions in the academic advancement process, although other factors, such as educational contributions and clinical performance, may also be important factors. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

  2. Factors Impacting Successfully Competing for Research Funding: An Analysis of Applications Submitted to The Plastic Surgery Foundation

    Science.gov (United States)

    Hume, Keith M.; Giladi, Aviram M.; Chung, Kevin C.

    2016-01-01

    BACKGROUND Federal research funding is decreasing, forcing specialty organizations to have an increasingly important position in developing and fostering research.1,2 As the research and innovation arm of the American Society of Plastic Surgeons, The Plastic Surgery Foundation (PSF) has a key role in supporting promising plastic surgery research. Understanding the grant review process, as well as factors that contribute to funding well-written grant funding applications, is paramount for aspiring academic surgeons. METHODS All research grant applications submitted to The PSF in 2012 and 2013 were evaluated. Each reviewer comment was independently assessed by two study team members and classified into key weakness categories. Chi-square test compared results between funded and unfunded grants. Linear regression identified which critique elements corresponded to changes in scores, and logistic regression identified elements that predicted funding. RESULTS We analyzed 1,764 comments from 240 applications. Of these, 55 received funding. Funded grants had significantly fewer reviewer comments in 4 of 5 weakness categories. As expected, funded grants received better (lower) scores. Concerns in the categories of “plan for execution” and “other elements/granstmanship” significantly affected score as well as odds of funding. CONCLUSION Ensuring that a grant addresses all required elements is important for receiving a low reviewer score. Our study demonstrates that “plan for execution” and “grantsmanship” influence reviewer scoring more than others. Investigators must clearly address items associated with conducting their experiments and performing the analysis. Investigators must also give equal attention to elements of overall quality and completeness to optimize chances of funding. PMID:25626827

  3. [Analysis of the application and funding projects of National Natural Science Foundation of China in the field of burns and plastic surgery from 2010 to 2016].

    Science.gov (United States)

    Zhang, Z C; Dou, D; Wang, X Y; Xie, D H; Yan, Z C

    2017-02-20

    We analyzed the data of application and funding projects of the National Natural Science Foundation of China (NSFC) during 2010-2016 in the field of burns and plastic surgery and summarized the NSFC funding pattern, the research hotspots, and weaknesses in this field. The NSFC has funded 460 projects in the field of burns and plastic surgery, with total funding of RMB 227.96 million. The scientific issues involved in the funding projects include orthotherapy against malformations, wound repair, basic research of burns, skin grafting, scars prevention, and regeneration of hair follicle and sweat glands. The research techniques involved in the funding projects are diversified. NSFC plays an important role in the scientific research and talents training in the field of burns and plastic surgery.

  4. Navigation-guided oral and maxillofacial surgery (reconstructive and plastic, orthognathic, oncology)

    Institute of Scientific and Technical Information of China (English)

    Shen GF; Zhang SL; Wang CT

    2008-01-01

    @@ Purpose: Advance in the field of compeer assisted surgery enables the surgical procedures to be less invasive and more accurate for the support of diagnosis imaging, pre-operative simulation and intraoperative navigation.

  5. Patient safety in otolaryngology: a descriptive review.

    Science.gov (United States)

    Danino, Julian; Muzaffar, Jameel; Metcalfe, Chris; Coulson, Chris

    2017-03-01

    Human evaluation and judgement may include errors that can have disastrous results. Within medicine and healthcare there has been slow progress towards major changes in safety. Healthcare lags behind other specialised industries, such as aviation and nuclear power, where there have been significant improvements in overall safety, especially in reducing risk of errors. Following several high profile cases in the USA during the 1990s, a report titled "To Err Is Human: Building a Safer Health System" was published. The report extrapolated that in the USA approximately 50,000 to 100,000 patients may die each year as a result of medical errors. Traditionally otolaryngology has always been regarded as a "safe specialty". A study in the USA in 2004 inferred that there may be 2600 cases of major morbidity and 165 deaths within the specialty. MEDLINE via PubMed interface was searched for English language articles published between 2000 and 2012. Each combined two or three of the keywords noted earlier. Limitations are related to several generic topics within patient safety in otolaryngology. Other areas covered have been current relevant topics due to recent interest or new advances in technology. There has been a heightened awareness within the healthcare community of patient safety; it has become a major priority. Focus has shifted from apportioning blame to prevention of the errors and implementation of patient safety mechanisms in healthcare delivery. Type of Errors can be divided into errors due to action and errors due to knowledge or planning. In healthcare there are several factors that may influence adverse events and patient safety. Although technology may improve patient safety, it also introduces new sources of error. The ability to work with people allows for the increase in safety netting. Team working has been shown to have a beneficial effect on patient safety. Any field of work involving human decision-making will always have a risk of error. Within

  6. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena Felicia; Rose, Michael; Bentzon, Niels

    2015-01-01

    of implementation of OPS in Denmark. METHODS: An electronic questionnaire was sent to breast and plastic surgeons performing breast cancer treatment. The questionnaire included demographics, education, experience with operative procedures and opinions on OPS. RESULTS: The questionnaire was sent to 50 breast...

  7. Certificate-of-Need regulation in outpatient surgery and specialty care: implications for plastic surgeons.

    Science.gov (United States)

    Pacella, Salvatore J; Comstock, Matthew; Kuzon, William M

    2005-09-15

    For plastic surgeons, independent development of outpatient surgical centers and specialty facilities is becoming increasingly common. These facilities serve as important avenues not only for increasing access and efficiency but in maintaining a sustainable, competitive specialty advantage. Certificate of Need regulation represents a major hurdle to plastic surgeons who attempt to create autonomy in this fashion. At the state level, Certificate of Need programs were initially established in an effort to reduce health care costs by preventing unnecessary capital outlays for facility expansion (i.e., managing supply of health care resources) in addition to assisting with patient safety and access to care. The purpose of this study was to examine the effect of Certificate of Need regulations on health care costs, patient safety, and access to care and to discuss specific implications of these regulations for plastic surgeons. Within Certificate of Need states, these regulations have done little, if anything, to control health care costs or affect patient safety. Presently, Certificate of Need effects coupled with recent provisions in the Medicare Modernization Act banning development of specialty hospitals may restrict patient access to ambulatory surgical and specialty care. For the plastic surgeon, these effects not only act as an economic barrier to entry but can threaten the efficiencies gained from providing surgical care in an ambulatory setting. An appreciation of these effects is critical to maintaining specialty autonomy and access to fiscal policy.

  8. Knowledge and opinions on oncoplastic surgery among breast and plastic surgeons

    DEFF Research Database (Denmark)

    Carstensen, Lena; Rose, Michael; Bentzon, Niels;

    2015-01-01

    specialty. CONCLUSION: OPS has become integrated in all breast centres, but has not yet been fully implemented. For optimal results in all patients, this study underlines the importance of the inclusion of a dedicated plastic surgeon within the multidisciplinary team for optimal initial evaluation of all...

  9. Examining the validity of the ACS-NSQIP Risk Calculator in plastic surgery: lack of input specificity, outcome variability and imprecise risk calculations.

    Science.gov (United States)

    Johnson, Cassandra; Campwala, Insiyah; Gupta, Subhas

    2017-03-01

    American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) created the Surgical Risk Calculator, to allow physicians to offer patients a risk-adjusted 30-day surgical outcome prediction. This tool has not yet been validated in plastic surgery. A retrospective analysis of all plastic surgery-specific complications from a quality assurance database from September 2013 through July 2015 was performed. Patient preoperative risk factors were entered into the ACS Surgical Risk Calculator, and predicted outcomes were compared with actual morbidities. The difference in average predicted complication rate versus the actual rate of complication within this population was examined. Within the study population of patients with complications (n=104), the calculator accurately predicted an above average risk for 20.90% of serious complications. For surgical site infections, the average predicted risk for the study population was 3.30%; this prediction was proven only 24.39% accurate. The actual incidence of any complication within the 4924 patients treated in our plastic surgery practice from September 2013 through June 2015 was 1.89%. The most common plastic surgery complications include seroma, hematoma, dehiscence and flap-related complications. The ACS Risk Calculator does not present rates for these risks. While most frequent outcomes fall into general risk calculator categories, the difference in predicted versus actual complication rates indicates that this tool does not accurately predict outcomes in plastic surgery. The ACS Surgical Risk Calculator is not a valid tool for the field of plastic surgery without further research to develop accurate risk stratification tools.

  10. Wall Street's assessment of plastic surgery--related technology: a clinical and financial analysis.

    Science.gov (United States)

    Krieger, L M; Shaw, W W

    2000-02-01

    Many plastic surgeons develop technologies that are manufactured by Wall Street-financed companies. Others participate in the stock market as investors. This study examines the bioengineered skin industry to determine whether it integrates clinical and financial information as Wall Street tenets would predict, and to see whether the financial performance of these companies provides any lessons for practicing plastic surgeons. In efficient markets, the assumptions on which independent financial analysts base their company sales and earnings projections are clinically reasonable, the volatility of a company's stock price does not irrationally differ from that of its industry sector, and the buy/sell recommendations of analysts are roughly congruent. For the companies in this study, these key financial parameters were compared with a benchmark index of 69 biotech companies of similar age and annual revenues (Student's t test). Five bioengineered skin companies were included in the study. Analysts estimated that each company would sell its product to between 24 and 45 percent of its target clinical population. The average stock price volatility was significantly higher for study companies than for those in the benchmark index (p cycle of poor clinical correlation when assigning sales projections, which in turn leads to price volatility and discordance of buy/sell recommendations. This study's findings have implications for plastic surgeons who develop new technology or who participate in the equities markets as investors. Plastic surgeons who develop new medical devices or technology cannot universally depend on the market to drive clinically reasonable financial performance. Although inflated sales estimates have benefits in the short term, failure to meet projections exacts severe financial penalties. Plastic surgeons who invest in the stock market, because of their unique clinical experience, may sometimes be in the position to evaluate new technologies and

  11. Periodontal Plastic Surgery to Improve Aesthetics in Patients with Altered Passive Eruption/Gummy Smile: A Case Series Study

    Directory of Open Access Journals (Sweden)

    Francesco Cairo

    2012-01-01

    Full Text Available Altered passive eruption/gummy smile is a common challenge in patients requiring aesthetic treatment. A specific surgical protocol was designed and tested in patients with altered passive eruption. Standardized preoperative X-rays were used to assess crown length at baseline and to place submarginal incisions. Osseous respective therapy was performed to achieve biological width. Clinical outcomes were recorded 6 months after surgery. Eleven patients with a total of 58 teeth were treated with flap surgery and osseous resective therapy at upper anterior natural teeth. At the last followup, a significant and stable improvement of crown length was obtained when compared to the baseline (P<0.0001. All patients rated as satisfactory in the final outcomes (final VAS value = 86.6. In conclusion, this study showed that periodontal plastic surgery including osseous resection leads to predictable outcomes in the treatment of altered passive eruption/gummy smile: A careful preoperative planning avoids unpleasant complications and enhances postsurgical stability of the gingival margin.

  12. Patient access in plastic surgery: an operational and financial analysis of service-based interventions to improve ambulatory throughput in an academic surgery practice.

    Science.gov (United States)

    Hultman, Charles Scott; Gilland, Wendell G; Weir, Samuel

    2015-06-01

    Inefficient patient throughput in a surgery practice can result in extended new patient backlogs, excessively long cycle times in the outpatient clinics, poor patient satisfaction, decreased physician productivity, and loss of potential revenue. This project assesses the efficacy of multiple throughput interventions in an academic, plastic surgery practice at a public university. We implemented a Patient Access and Efficiency (PAcE) initiative, funded and sponsored by our health care system, to improve patient throughput in the outpatient surgery clinic. Interventions included: (1) creation of a multidisciplinary team, led by a project redesign manager, that met weekly; (2) definition of goals, metrics, and target outcomes; 3) revision of clinic templates to reflect actual demand; 4) working down patient backlog through group visits; 5) booking new patients across entire practice; 6) assigning a physician's assistant to the preoperative clinic; and 7) designating a central scheduler to coordinate flow of information. Main outcome measures included: patient satisfaction using Press-Ganey surveys; complaints reported to patient relations; time to third available appointment; size of patient backlog; monthly clinic volumes with utilization rates and supply/demand curves; "chaos" rate (cancellations plus reschedules, divided by supply, within 48 hours of booked clinic date); patient cycle times with bottleneck analysis; physician productivity measured by work Relative Value Units (wRVUs); and downstream financial effects on billing, collection, accounts receivable (A/R), and payer mix. We collected, managed, and analyzed the data prospectively, comparing the pre-PAcE period (6 months) with the PAcE period (6 months). The PAcE initiative resulted in multiple improvements across the entire plastic surgery practice. Patient satisfaction increased only slightly from 88.5% to 90.0%, but the quarterly number of complaints notably declined from 17 to 9. Time to third

  13. [Otolaryngological complaints in tongue amyloidosis: a case report].

    Science.gov (United States)

    Pons Rocher, F; Guallart Doménech, F; Mompó Romero, L; Artazkozl del Toro, J J; Serrano Badía, E; Dalmau Galofré, J; Faubel Serra, M

    1994-01-01

    We present a case of Amyloidosis of the oral cavity associated to multiple mieloma, with otolaryngological symptom. Review of structural characterization of the disease, its pathogenesis and clinical disorders when displayed in thyroid, oral cavity and upper respiratory tract.

  14. Plastic bronchitis

    National Research Council Canada - National Science Library

    Singhi, Anil Kumar; Vinoth, Bharathi; Kuruvilla, Sarah; Sivakumar, Kothandam

    2015-01-01

    Plastic bronchitis, a rare but serious clinical condition, commonly seen after Fontan surgeries in children, may be a manifestation of suboptimal adaptation to the cavopulmonary circulation with unfavorable hemodynamics...

  15. Status and trends of general otolaryngology in academia.

    Science.gov (United States)

    Lin, Jiahui; Kacker, Ashutosh; Trujillo, Oscar; Stewart, Michael G

    2016-09-01

    This article focuses on the hiring trends of academic general otolaryngology practices to clarify the status of academic general otolaryngology in the face of today's changing medical landscape. Cross-sectional study. We conducted a survey to evaluate past, present, and projected hiring issues in academic otolaryngology, specifically related to general otolaryngology. Surveys were sent via e-mail to all academic chairpersons of accredited otolaryngology residency programs in the United States. Data included faculty appointments, work hours, clinical and research roles, academic productivity, patient load, promotions, and criteria for future hires. The response rate was 34.3%. On average, general otolaryngologists (generalists) represented 17% of otolaryngology faculty in academic practices. Whereas most generalists were employed as assistant professors (65%), nearly half of promotions in recent years were given to generalists (49%). Between 2009 and 2014, there was an average of six new hires per academic otolaryngology practice (range: 1-13); of these new hires, 21% were generalists. Chairpersons estimated that in the next 5 years they would hire an average of three new otolaryngologists per practice (range: 0-7), of whom 39% would be generalists. Although 82% of chairpersons reported an increase in subspecialty hires, 94% reported that they would also require the same or increasing numbers of generalists. Despite the increase in subspecialization in academic otolaryngology, the role of general otolaryngologists in academic practices will continue to be important and perhaps will increase. N/A. Laryngoscope, 126:1995-1998, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  16. [Application of platelet rich plasma (PRP) and its derivatives in dental implantologie and plastic surgery].

    Science.gov (United States)

    González, Maczy; Arteaga-Vizcaíno, Melvis; Benito, Marisol; Benito, Mariluz

    2012-12-01

    The platelet rich plasma (PRP), as its name implies, has a high concentration of thrombocytes; is a non-toxic and non-allergenic autologous preparation, obtained by blood centrifugation at low speed. Its function is directly linked to the release of growth factors (FC) by platelets. These factors have properties of induction of tissue regeneration. For the preparation of the present work, a literature search was performed in different documentary sources using the following descriptors: platelet rich plasma, PRP, growth factors, GF, dentistry and cosmetic surgery. This article is a description of some relevant aspects of the PRP and its application in the areas of dentistry and cosmetic surgery.

  17. Still under the microscope: can a surgical aptitude test predict otolaryngology resident performance?

    Science.gov (United States)

    Moore, Eric J; Price, Daniel L; Van Abel, Kathryn M; Carlson, Matthew L

    2015-02-01

    Application to otolaryngology-head and neck surgery residency is highly competitive, and the interview process strives to select qualified applicants with a high aptitude for the specialty. Commonly employed criteria for applicant selection have failed to show correlation with proficiency during residency training. We evaluate the correlation between the results of a surgical aptitude test administered to otolaryngology resident applicants and their performance during residency. Retrospective study at an academic otolaryngology-head and neck surgery residency program. Between 2007 and 2013, 224 resident applicants participated in a previously described surgical aptitude test administered at a microvascular surgical station. The composite score and attitudinal scores for 24 consecutive residents who matched at our institution were recorded, and their residency performance was analyzed by faculty survey on a five-point scale. The composite and attitudinal scores were analyzed for correlation with residency performance score by regression analysis. Twenty-four residents were evaluated for overall quality as a clinician by eight faculty members who were blinded to the results of surgical aptitude testing. The results of these surveys showed good inter-rater reliability. Both the overall aptitude test scores and the subset attitudinal score showed reliability in predicting performance during residency training. The goal of the residency selection process is to evaluate the candidate's potential for success in residency and beyond. The results of this study suggest that a simple-to-administer clinical skills test may have predictive value for success in residency and clinician quality. 4. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  18. A 3D Finite Element model of the face for simulation in plastic and maxillo-facial surgery

    CERN Document Server

    Chabanas, M; Chabanas, Matthieu; Payan, Yohan

    2000-01-01

    This paper introduces a new Finite Element biomechanical model of the human face, which has been developed to be integrated into a simulator for plastic and maxillo-facial surgery. The idea is to be able to predict, from an aesthetic and functional point of view, the deformations of a patient face, resulting from repositioning of the maxillary and mandibular bone structures. This work will complete the simulator for bone-repositioning diagnosis that has been developed by the laboratory. After a description of our research project context, each step of the modeling is precisely described: the continuous and elastic structure of the skin tissues, the orthotropic muscular fibers and their insertions points, and the functional model of force generation. First results of face deformations due to muscles activations are presented. They are qualitatively compared to the functional studies provided by the literature on face muscles roles and actions.

  19. Efficacy of communication amongst staff members at plastic and reconstructive surgery section using smartphone and mobile WhatsApp

    Directory of Open Access Journals (Sweden)

    Shabeer Ahmad Wani

    2013-01-01

    Full Text Available Objective: The objective of this study is to assess the efficacy of smartphone and its WhatsApp application as a communication method amongst the staff of plastic and reconstructive surgery section at tertiary care health facility. Materials and Methods: From January 2012 onwards, the authors used smartphones and its WhatsApp application as a communication method amongst their team for various aspects of patient management and as a tool for academic endorsements. Results: During the period of this study, there were 116 episodes regarding patient management, which were handled, in a timely fashion by using this application. In addition opinion of rotating residents in the section was sought regarding the efficacy of this method of communication. Overall majority of residents were satisfied with this mode of communication. Conclusions: This new method of communication is an effective method for clinical and academic endorsements. The method is cheap and quick and easy to operate.

  20. New internalized distraction device for craniofacial plastic surgery using Ni-free, Ti-based shape memory alloy.

    Science.gov (United States)

    Kanetaka, Hiroyasu; Shimizu, Yoshinaka; Kudo, Tada-aki; Zhang, Ye; Kano, Mitsuhiro; Sano, Yuya; Ichikawa, Hiroyuki; Hosoda, Hideki; Miyazaki, Shuichi

    2010-11-01

    This study was undertaken to examine effects and biocompatibility of a new internalized distraction device made from newly developed Ti-Nb-Al shape memory alloy (SMA). Crania of Wistar rats were expanded using a U-shaped wire of this SMA set on each cranium in an experimental group. At 2 or 4 weeks after operation, the rats were killed; width measurements and three-dimensional observations of crania were conducted using soft x-ray and microfocus x-ray computed tomography photography. After photography, histologic sections were made and stained with hematoxylin and eosin. No pathologic change in the experimental duration was observed macroscopically or histologically. Significantly increased size was found for the rat crania in the experimental group compared with the control group. Results demonstrated the feasibility and biocompatibility of internalized distraction osteogenesis using Ni-free, Ti-based SMA in craniofacial plastic surgery for craniofacial deformities.

  1. Parents' and Doctors' Attitudes toward Plastic Facial Surgery for Persons with Down Syndrome.

    Science.gov (United States)

    Katz, Shlomo; Kravetz, Shlomo; Marks, Yoval

    1997-01-01

    A study of 42 Israeli parents of children with Down syndrome and 48 family doctors found no differences between the parents and doctors regarding support for facial surgery. However, parents who showed less acceptance of their child expressed more support for the operation than parents who showed more acceptance. (Author/CR)

  2. Remote Digital Preoperative Assessments for Cleft Lip and Palate May Improve Clinical and Economic Impact in Global Plastic Surgery.

    Science.gov (United States)

    Hughes, Christopher; Campbell, Jacob; Mukhopadhyay, Swagoto; McCormack, Susan; Silverman, Richard; Lalikos, Janice; Babigian, Alan; Castiglione, Charles

    2017-09-01

    Reconstructive surgical care can play a vital role in the resource-poor settings of low- and middle-income countries. Telemedicine platforms can improve the efficiency and effectiveness of surgical care. The purpose of this study is to determine whether remote digital video evaluations are reliable in the context of a short-term plastic surgical intervention. The setting for this study was a district hospital located in Latacunga, Ecuador. Participants were 27 consecutive patients who presented for operative repair of cleft lip and palate. We calculated kappa coefficients for reliability between in-person and remote digital video assessments for the classification of cleft lip and palate between two separate craniofacial surgeons. We hypothesized that the technology would be a reliable method of preoperative assessment for cleft disease. Of the 27 (81.4%) participants, 22 received operative treatment for their cleft disorder. Mean age was 11.1 ± 8.3 years. Patients presented with a spectrum of disorders, including cleft lip (24 of 27, 88.9%), cleft palate (19 of 27, 70.4%), and alveolar cleft (19 of 27, 70.4%). We found a 95.7% agreement between observers for cleft lip with substantial reliability (κ = .78, P cleft palate, with a moderate interrater reliability (κ = .55, P = .01). We found only a 47.8% agreement between observers for alveolar cleft with a nonsignificant, weak kappa agreement (κ = .06, P = .74). Remote digital assessments are a reliable way to preoperatively diagnose cleft lip and palate in the context of short-term plastic surgical interventions in low- and middle-income countries. Future work will evaluate the potential for real-time, telemedicine assessments to reduce cost and improve clinical effectiveness in global plastic surgery.

  3. Simulating plastic surgery: from human skin tensile tests, through hyperelastic finite element models to real-time haptics.

    Science.gov (United States)

    Lapeer, R J; Gasson, P D; Karri, V

    2010-12-01

    In this paper, we provide a summary of a number of experiments we conducted to arrive at a prototype real-time simulator for plastic surgical interventions such as skin flap repair and inguinal herniotomy. We started our research with a series of in-vitro tensile stress tests on human skin, harvested from female patients undergoing plastic reconstructive surgery. We then used the acquired stress-strain data to fit hyperelastic models. Three models were considered: General Polynomial, Reduced Polynomial and Ogden. Only Reduced Polynomial models were found to be stable, hence they progressed to the next stage to be used in an explicit finite element model aimed at real-time performance in conjunction with a haptic feedback device. A total Lagrangian formulation with the half-step central difference method was employed to integrate the dynamic equation of motion of the mesh. The mesh was integrated into two versions of a real-time skin simulator: a single-threaded version running on a computer's main central processing unit and a multi-threaded version running on the computer's graphics card. The latter was achieved by exploiting recent advances in programmable graphics technology.

  4. Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database.

    Science.gov (United States)

    Lim, Seokchun; Jordan, Sumanas W; Jain, Umang; Kim, John Y S

    2014-08-01

    Studies that evaluate the predictors and causes of unplanned re-operation in outpatient plastic surgery. This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified all plastic surgery outpatient cases performed in 2011. Multiple logistic regression analysis was utilised to identify independent risk factors and causes of unplanned reoperations. Of the 6749 outpatient plastic surgery cases identified, there were 125 (1.9%) unplanned re-operations (UR). Regression analysis demonstrated that body mass index (BMI, OR = 1.041, 95% CI = 1.019-1.065), preoperative open wound/wound infection (OR = 3.498, 95% CI = 1.593-7.678), American Society of Anesthesiologists (ASA) class 3 (OR = 2.235, 95% CI = 1.048-4.765), and total work relative value units (RVU, OR = 1.014, 95% CI = 1.005-1.024) were significantly predictive of UR. Additionally, the presence of any complication was significantly associated with UR (OR = 15.065, 95% CI = 5.705-39.781). In an era of outcomes-driven medicine, unplanned re-operation is a critical quality indicator for ambulatory plastic surgery facilities. The identified risk factors will aid in surgical planning and risk adjustment.

  5. 小儿手烧伤瘢痕畸形的整形外科治疗%Plastic surgery treatment on cicatricial deformation in child burn of hand

    Institute of Scientific and Technical Information of China (English)

    葛乃航; 朱云

    2002-01-01

    Background: Cicatricial deformation in child burn of hand often leads to severe squaelae. According to different causes of disease , different plastic surgery were adopted .The key of operation lies in skin repairing , articulation dealing, and thumb correcting, which aim is to resume normal longitudinal and transverse arcs ,holding and clenching ability.

  6. Comparison of preoperative quality of life in breast reconstruction, breast aesthetic and non-breast plastic surgery patients: A cross-sectional study.

    Science.gov (United States)

    Duraes, Eliana F R; Durand, Paul; Duraes, Leonardo C; Orra, Susan; Moreira-Gonzalez, Andrea; Sousa, Joao Batista de; Djohan, Risal S; Zins, James; Bernard, Steven; Schwarz, Graham S

    2016-11-01

    A breast cancer diagnosis imposes significant emotional and psychological duress. The purpose of this study is to assess the baseline quality of life (QOL) of immediate, delayed, and secondary breast reconstruction patients, comparing these results with QOL in women seeking plastic surgery for cosmetic breast, and non-breast procedures. From 2012 through 2013, immediate (group 1), delayed (group 2), and secondary (Group 3) reconstruction patients, aesthetic breast (group 4) and non-breast plastic surgery patients (group 5) answered Breast-Q questionnaires. Groups 1, 2, 3, 4, and 5 answered 141, 12, 23, 72 and 160 preoperative questionnaires respectively. There was no difference (p = NS) in breast satisfaction, psychosocial well-being, physical well-being-chest, and sexual well-being between groups 1 and 5. Group 1 had higher satisfaction with breast (p breasts (p breasts, psychosocial, and sexual well-being, compared to groups 2 and 3. Group 4 had lower scores in all domains, compared to groups 1 and 5 (p reconstruction patients had similar satisfaction with breasts, psychosocial well-being, and chest physical well-being, compared to non-breast plastic surgery patients. Aesthetic breast surgery patients demonstrate similar low scores in satisfaction with breasts, psychosocial well-being, and sexual well-being to those of patients prior to delayed breast reconstruction, or secondary salvage procedures. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  7. Plastic paradise: transforming bodies and selves in Costa Rica's cosmetic surgery tourism industry.

    Science.gov (United States)

    Ackerman, Sara L

    2010-10-01

    Long popular as a nature tourism destination, Costa Rica has recently emerged as a haven for middle class North Americans seeking inexpensive, state-of-the-art cosmetic surgery. This paper examines "cosmetic surgery tourism" in Costa Rica as a form of medicalized leisure, situated in elite private spaces and yet inextricably linked to a beleaguered national medical program. Through historical context and ethnographic analysis of activities at medical hotels and clinics, I describe how the recovery industry operates on the embodied subjectivities of visiting patients and their local caretakers. Recovery sociality and healing landscapes facilitate patients' transition through a period of post-surgical liminality and provide nostalgic transport to an imagined medical arcadia, while clinicians are attracted by a neoliberal promise of prosperity and autonomy. Ultimately, Costa Rica's transformation into a paradise of medical consumption and self-optimization is contingent on a mythology that obscures growing uncertainties and inequities in the nation's broader medical landscape.

  8. Parental knowledge in pediatric otolaryngology surgical consultations: A qualitative content analysis.

    Science.gov (United States)

    Gorodzinsky, Ayala Y; Hong, Paul; Chorney, Jill MacLaren

    2015-07-01

    To understand the source of parents' knowledge prior to and desire for further information following pediatric otolaryngology surgical consultations. Mixed-methods approach using descriptive and qualitative content analysis of interviews with parents following otolaryngology consultations for children under the age of 6 years was performed. The children were being seen for either tonsillitis, obstructive sleep apnea, otitis media, and/or sinusitis/nasal obstruction. Forty-one parents completed a phone interview two weeks following their child's surgical consultation. The majority of parents indicated that their primary care physician referred their child for either: investigation of symptoms (50%), to have a specific discussion about surgery (27.5%), or because other treatment options were no longer working (20%). Many parents (56.5%) indicated that the Internet was their primary source of information prior to the appointment. Most parents (93%) wanted more information; majority of these parents noted that a technology-based mode of delivery of information available prior to the appointment would be most desirable. Desired information was most often regarding the surgical procedure, including risks and benefits, and symptoms of concern prior to surgery. This study provides a description of parental knowledge and information sources prior to their child's surgical consultation and continued desire for information. This information may lead to decreased knowledge barriers and increased communication to facilitate shared decision-making between the provider and parents. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  9. Prophylactic Antibiotics in Otolaryngologic Surgeries: From Knowledge to Practice

    Directory of Open Access Journals (Sweden)

    Minoo Khatami-Moghadam

    2011-01-01

    Our results indicate that prophylactic antibiotics were being significantly misused in a tertiary referral center of a university hospital. Although teaching the principles of prophylaxis to physicians is important, we think that finding a way to bring this knowledge to practice is more important.

  10. Education on, Exposure to, and Management of Vascular Anomalies During Otolaryngology Residency and Pediatric Otolaryngology Fellowship.

    Science.gov (United States)

    Chun, Robert; Jabbour, Noel; Balakrishnan, Karthik; Bauman, Nancy; Darrow, David H; Elluru, Ravindhra; Grimmer, J Fredrik; Perkins, Jonathan; Richter, Gresham; Shin, Jennifer

    2016-07-01

    The field of vascular anomalies presents diverse challenges in diagnosis and management. Although many lesions involve the head and neck, training in vascular anomalies is not universally included in otolaryngology residencies and pediatric otolaryngology (POTO) fellowships. To explore the education in, exposure to, and comfort level of otolaryngology trainees with vascular anomalies. A survey was distributed to 39 POTO fellows and 44 residents in postgraduate year 5 who matched into POTO fellowships from April 22 through June 16, 2014. Survey responses from trainees on exposure to, education on, and comfort with vascular anomalies. Forty-four residents in postgraduate year 5 who applied to POTO fellowships and 39 POTO fellows were emailed the survey. Fourteen respondents were unable to be contacted owing to lack of a current email address. Thirty-six of 69 residents and fellows (18 fellows and 18 residents [52%]) responded to the survey. Twenty-seven trainees (75%) reported no participation in a vascular anomalies clinic during residency; 6 of these 27 individuals (22%) trained at institutions with a vascular anomalies clinic but did not participate in the clinic, and 28 of the 36 respondents (78%) reported that they had less than adequate or no exposure to vascular anomalies in residency. Among POTO fellows, 11 of 17 (65%) did not participate in a vascular anomalies clinic during fellowship, even though 8 of the 11 had a vascular anomalies clinic at their fellowship program. During fellowship training, 12 of 18 fellows (67%) reported that they had adequate exposure to vascular anomalies. Only 20 respondents (56%) felt comfortable distinguishing among diagnoses of vascular anomalies, and only 4 residents (22%) and 9 fellows (50%) felt comfortable treating patients with vascular anomalies. All fellows believed that training in vascular anomalies was important in fellowship, and 100% of respondents indicated that increased exposure to diagnosis and management of

  11. Plasticity of cognitive functions before and after awake brain tumor surgery

    Directory of Open Access Journals (Sweden)

    Djaina Satoer

    2015-04-01

    Results: P1 and P2 showed opposite preoperative cognitive profiles. P1 obtained normal cognitive results and P2 had clinically significant impairments in all cognitive domains, (language, memory, attentional and executive deficits (z-score ≥-1.50. P3 and P4 also demonstrate opposite preoperative profiles. P4 obtained intact cognitive results, whereas P3 was impaired in memory and executive functions (z-score ≥-1.50. Intraoperatively, in both P3 and P4 positive language sites were found (left inferior frontal gyrus and left parietal lobe. At 3 months postoperatively, P3 presented language deficits followed by recovery at 12 months, whereas P4 appeared to have recovered at 3 months postoperatively from the observed premorbid impairments in memory and executive functioning (z-score <-1.50. Pathological examination revealed a slow growing brain tumor (low-grade in P1 and P3 and a fast growing brain tumor (high-grade in P2 and P4. Conclusion: In patients with similar brain tumor localizations, we found distinct cognitive profiles, possibly affected by different neural plasticity processes. Preoperatively, a favorable plasticity effect on cognition was found in P1 (temporoparietal area, potentially affected by tumor grade. Preserved cognitive functions was possibly facilitated by the slow growth rate of a low-grade tumor allowing functional reorganization (Mandonnet et al., 2003. However, P2 with a brain tumor in the same area showed preoperative deficits in several domains (language, memory and attention/executive functions. A faster growth rate of a high-grade tumor could have more aggressively affected cognition. In P3 and P4 with the same localization (insula, we found a different effect on the cognitive recovery process; at short term (3 months, improvement of the preoperatively observed cognitive impairments in a low-grade tumor P3, whereas a more gradual functional reorganization was found in language (3-12 months in P4, a high-grade tumor, contrasting Habets

  12. Otolaryngology Needs in a Free Clinic Providing Indigent Care.

    Science.gov (United States)

    Hu, Amanda; Sibert, Thomas; Zhao, Wei; Zarro, Vincent

    2016-06-01

    To determine the otolaryngology needs in a free clinic providing care to medically indigent patients, as perceived by the patients and health care providers. Cross-sectional survey. A survey was administered to patients and health care providers of a free clinic from September 2014 through January 2015 in an urban, inner-city location. One hundred and thirty-seven patients (35.8% male, age 50.8 ± 13.0 years) completed the survey. Mean household income was $29,838 ± $10,425; 32.1% spoke English; 54.7% were employed; 10.2% had health insurance; and 37.2% had seen a primary care provider outside of the free clinic. The top three otolaryngology symptoms among patients were sleep apnea/snoring (39.4%), heartburn/reflux (30.7%), and dizziness (29.9%). Eleven health care providers (45% male, age 50.5 ± 15.3 years, 63.6% physician, 36% nurse) completed the survey. Providers perceived the following otolaryngology complaints as the most prevalent, in descending order: cough, nasal congestion, reflux/heartburn, sore throat, and ear infection/otalgia. Providers felt that sleep apnea and hearing loss were the less common otolaryngology complaints, whereas surveyed patients indicated these symptoms with high frequency. The most requested diagnostic tool among patients and providers was chest X-rays. There are unmet otolaryngology needs in a free clinic. Medically indigent patients have significant barriers to accessing health care. Patient and provider perceptions of top otolaryngology complaints differed, but both identified access to chest X-rays as a major unmet need. Knowledge of patient perceptions may help providers elicit the breadth of otolaryngology complaints. 4. Laryngoscope, 126:1321-1326, 2016. © 2015 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Predictors of regional Medicare expenditures for otolaryngology physician services.

    Science.gov (United States)

    Smith, Alden; Handorf, Elizabeth; Arjmand, Ellis; Lango, Miriam N

    2017-06-01

    To describe geographic variation in spending and evaluate regional Medicare expenditures for otolaryngologist services with population- and beneficiary-related factors, physician supply, and hospital system factors. Cross-sectional study. The average regional expenditures for otolaryngology physician services were defined as the total work relative value units (wRVUs) collected by otolaryngologists in a hospital referral region (HRR) per thousand Medicare beneficiaries in the HRR. A multivariable linear regression model tested associations with regional sociodemographics (age, sex, race, income, education), the physician and hospital bed supply, and the presence of an otolaryngology residency program. In 2012, the mean Medicare expenditure for otolaryngology provider services across HRRs was 224 wRVUs per thousand Medicare beneficiaries (standard deviation [SD] 104), ranging from 31 to 604 wRVUs per thousand Medicare beneficiaries. In 2013, the average Medicare expenditures for each HRR was highly correlated with expenditures collected in 2012 (Pearson correlation coefficient .997, P = .0001). Regional Medicare expenditures were independently and positively associated with otolaryngology, medical specialist, and hospital bed supply in the region, and were negatively associated with the supply of primary care physicians and presence of an otolaryngology residency program after adjusting for other factors. The magnitude of associations with physician supply and hospital factors was stronger than any population or Medicare beneficiary factor. Wide variations in regional Medicare expenditures for otolaryngology physician services, highly stable over 2 years, were strongly associated with regional health system factors. Changes in health policy for otolaryngology care may require coordination with other physician specialties and integrated hospital systems. NA. Laryngoscope, 127:1312-1317, 2017. © 2016 The American Laryngological, Rhinological and Otological Society

  14. A need for otolaryngology education among primary care providers

    Science.gov (United States)

    Hu, Amanda; Sardesai, Maya G.; Meyer, Tanya K.

    2012-01-01

    Objective Otolaryngic disorders are very common in primary care, comprising 20–50% of presenting complaints to a primary care provider. There is limited otolaryngology training in undergraduate and postgraduate medical education for primary care. Continuing medical education may be the next opportunity to train our primary care providers (PCPs). The objective of this study was to assess the otolaryngology knowledge of a group of PCPs attending an otolaryngology update course. Methods PCPs enrolled in an otolaryngology update course completed a web-based anonymous survey on demographics and a pre-course knowledge test. This test was composed of 12 multiple choice questions with five options each. At the end of the course, they were asked to evaluate the usefulness of the course for their clinical practice. Results Thirty seven (74%) PCPs completed the survey. Mean knowledge test score out of a maximum score of 12 was 4.0±1.7 (33.3±14.0%). Sorted by area of specialty, the mean scores out of a maximum score of 12 were: family medicine 4.6±2.1 (38.3±17.3%), pediatric medicine 4.2±0.8 (35.0±7.0%), other (e.g., dentistry, emergency medicine) 4.2±2.0 (34.6±17.0%), and adult medicine 3.9±2.1 (32.3±17.5%). Ninety one percent of respondents would attend the course again. Conclusion There is a low level of otolaryngology knowledge among PCPs attending an otolaryngology update course. There is a need for otolaryngology education among PCPs. PMID:22754276

  15. Periodontal plastic surgery for management of cleft alveolar ridge: a case report.

    Science.gov (United States)

    Agrawal, Amit A; Yeltiwar, Ramreddy K

    2012-02-01

    Cleft lips, alveoli, and palates are the most common congenital malformations of the head and neck region, all of which often can be managed successfully when presented at a young age. It is a common belief that clefts in the alveolar ridge should be treated with the help of bone grafting materials. This could be the best option when the cleft is to be treated in early age, when the patient is still developing and has high regenerative potential. However, in adults, the literature supports the fact that bone grafting in alveolar clefts has a higher chance for failure. The present case report exemplifies a periodontal plastic surgical procedure involving a combination of connective tissue and free gingival grafting to restore the form and function of a cleft alveolar ridge in an adult patient.

  16. Otolaryngological presentations of Cornelia de Lange syndrome.

    Science.gov (United States)

    Hamilton, Jane; Clement, W Andrew; Kubba, Haytham

    2014-09-01

    Children with Cornelia de Lange syndrome frequently present to otolaryngology services with hearing problems. Airway problems have not previously been reported. We wish to describe our experience of the overall management in a series of children with Cornelia de Lange syndrome. Retrospective case note review of children diagnosed with Cornelia de Lange syndrome presenting to our department between 2005 and 2014. Six patients were seen. Airway problems consisted of laryngeal overspill with severe gastroesophageal dysmotility and reflux despite structurally normal airway (1 case), laryngomalacia requiring supraglottoplasty (2 cases), reflux laryngitis with secondary laryngomalacia and coincidental tracheal diverticulum (1 case) choanal atresia requiring stents (1 case) and obstructive sleep apnoea (1 case). Supraglottoplasty produced a dramatic improvement in feeding and breathing in both children who underwent the procedure. Two children had palatal anomalies and one underwent cochlear implantation for a profound sensorineural hearing loss. Children with Cornelia de Lange syndrome have multifaceted ENT problems. Airway pathology has not previously been described in Cornelia de Lange syndrome but has been common in our experience. We wish to highlight that laryngomalacia in Cornelia de Lange syndrome responds well to supraglottoplasty. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  17. Interactive instruction in otolaryngology resident education.

    Science.gov (United States)

    Schweinfurth, John M

    2007-12-01

    Today's academic faculty was typically trained under an education system based entirely on didactic lectures. However, if the aim is to teach thinking or change attitudes beyond the simple transmission of factual knowledge, then lectures alone, without active involvement of the students, are not the most effective method of teaching. If the goals of teaching are to arouse and keep students' interest, give facts and details, to make students think critically about the subject, and to prepare for independent studies by demonstration of problem solving and professional reasoning, then only two of these purposes are suited to didactic lectures. The problem then is how to organize lecture material so that individual student's learning needs are better addressed. The education literature suggests that instruction include a variety of activities designed to stimulate individual thought. These activities include small group discussion, working problems during lecture time, questions included in the lecture, and quizzes at the end of lecture, among others. The current study was undertaken to examine the feasibility of using these types of interactive learning techniques in an otolaryngology residency program. Possibilities considered in the current study include standard interactive lecturing, facilitated discussion, brainstorming, small group activities, problem solving, competitive large group exercises, and the use of illustrative cliff hanger and incident cases. The feasibility of these methodologies being effectively incorporated into a residency curriculum is discussed.

  18. Epidemiologic Profile of an Otolaryngologic Emergency Service

    Directory of Open Access Journals (Sweden)

    Prestes, Luciano

    2014-06-01

    Full Text Available Introduction According to current research, the number of patients seen in the emergency room is progressively increasing. There are few studies on the characteristics of ear, nose, and throat diseases treated in the emergency room. Objectives (1 To establish the epidemiologic profile of patients with these complaints treated at a referral emergency hospital in locoregional city Curitiba, and (2 to evaluate the calls that truly required emergency care. Methods This is a contemporary cross-study of urgent and emergency referrals to a hospital with otolaryngologic services during the year 2012. Data were collected and epidemiologic characteristics analyzed. Results We analyzed 1,067 patients: 312 presented in spring, 255 in summer, 253 in autumn, and 247 in winter. We found 17 diseases that were common during the year, with 244 (23.99% upper respiratory tract infections being the most frequent disease. There was no statistically significant difference in the incidence of diseases, except that acute otitis media was most common during the summer (p = 0.02; distribution between the sexes was balanced. The predominant age group was adults. We found 9.27% cases were true emergencies. Conclusion Patients were 20 to 40 years, with upper respiratory tract infection the most incident disease; 9.27% of cases were emergencies.

  19. Globalization of Craniofacial Plastic Surgery: Foreign Mission Programs for Cleft Lip and Palate.

    Science.gov (United States)

    Laub, Donald R

    2015-06-01

    International Humanitarian Interchanges are a bona fide component of surgery and medicine. Additionally, these programs also provide substantial benefit both to the doers and the recipients.The foreign mission program is potentially a weapon of foreign policy which is underutilized and underestimated.Physician job dissatisfaction is increasing. However, the happiness and satisfaction of the participants in the short-term multidisciplinary trips, repeated, well-organized and respectful, with rather complete integration of the surgical system of the sister countries ("Plan B"), approaches 100%.The theory of the International Humanitarian Interchanges is based on substance, on medical theory. These trips are particularly successful in interchanges with medium-resourced countries.Furthermore, the academic visiting professor ("Plan A": hi-resource place to hi-resource place), the One Man Can Save the World model ("Plan C": to the low-resource place), and the intriguing Horton Peace Plan have possibilities for long-term benefit to the doer, recipient, the field of surgery, and the body of knowledge. In all of these, our country and the family of nations advance.The theoretical basis is not always religious nor the grand strategy plan; both have either proselytizing or political dominance as primary motives, and are mentioned as historically helpful.

  20. EMPIRIC THERAPY IN OTOLARYNGOLOGIC MANIFESTATIONS OF GASTROESOPHAGEAL REFLUX DISEASE

    Directory of Open Access Journals (Sweden)

    M. Mohammadi

    2005-04-01

    Full Text Available The review of literature shows that a strong relationship exists between the symptoms of otolaryngologic diseases and gastroesophageal reflux disease (GERD. It is commonly observed that an extended physical examination is needed to determine the occurrence of GERD. This non-randomized,prospective quasi-experimental study was performed to clinically verify the relationship between otolaryngologic symptoms and GERD and to show that a search for GERD is necessary under conditions that patients do not respond to initial routine treatment for otolaryngologic symptoms. Extended physical examination of patients who had been referred to an Ear, Nose and throat (ENThospital revealed that GERD-related laryngeal signs were present in 55 patients. Otolaryngologic symptoms detected in decreasing order of occurrence were posterior nasal drip, chronic pharyngitis, chronic cough, hoarseness, ear pain, chronic throat clearing and pruritus in the ear. Furthermore, 66% of the patients had gastrointestinal symptoms that included heartburn, dysphagia, odynophagia, aspiration, globus hystericus, dyspepsia and foreign body sensation. Signs observed during the physical examination were posterior pharyngitis, granular pharyngitis, inflamed arytenoids, contact granuloma, and pachyderma laryngitis. We administered proton pump inhibitor to all patients and recommended to change their life style. The follow up program was a 6-month period. Only 53 patients showed up for the follow up. The overall response rate to the therapeutic regimen was 83%. In treating otolaryngologic patients, especially those who are resistant to routine treatments, a careful extended physical examination including an indirect laryngoscopy for diagnosis of GERD is recommended.

  1. Applicant characteristics associated with successful matching into otolaryngology.

    Science.gov (United States)

    Hauser, Leah J; Gebhard, Grant M; Blumhagen, Rachel; Carlson, Nichole E; Cabrera-Muffly, Cristina

    2017-05-01

    To identify resident applicant characteristics that increase the odds of matching to otolaryngology residency. Cross-sectional analysis. Residency applications to our institution from 2009 through 2013 were reviewed. The available data represented 81.1% of applicants to otolaryngology programs nationwide. Online public records were searched to determine whether an applicant matched to an otolaryngology residency position. Factors that were significantly associated with the odds of matching were determined using logistic regression. A total of 1,479 unique applications were analyzed. On univariate analysis, 27 demographic, academic, personal, medical school, prior training, and application-specific factors were associated with the odds of matching into otolaryngology. On multivariate analysis, indicators of academic achievement, such as Alpha Omega Alpha Honor Medical Society (AOA) status, whether applicant received awards, and publications, were significantly associated with the odds of matching (odds ratio [OR] 2.03, 1.39, 1.66, respectively). The odds of matching increased with increasing step 1 scores (P otolaryngology residency. Although this information allows medical students to determine the strength of their application, these criteria have not been correlated with resident success. We urge selection committees to begin identifying applicant selection methods that reflect the values we want to cultivate in our future colleagues. N/A. Laryngoscope, 127:1052-1057, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Three-dimensional medical images and its application for surgical simulation of plastic and reconstructive surgery

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    Kaneko, Tsuyoshi; Kobayashi, Masahiro; Nakajima, Hideo; Fujino, Toyomi (Keio Univ., Tokyo (Japan). School of Medicine)

    1992-12-01

    The author's three surgical simulation systems are presented. First the computer graphics surgical simulation system has been developed which make the three dimensional skull image from CT scans and the arbitrary osteotomy, mobilization of bone segments and prediction of post-operative appearance is made possible. The second system is solid modeling of the skull using laser curable resin and it is concluded that life-sized skull model is useful not only for surgical simulation of major craniofacial surgery but also educational purposes. The third one is solid modeling of the ear using non-contact 3-D shape measurement with slit laser scanner. The mirror image life-sized wax model is made from the normal side of th ear and the autologous cartilage framework is assembled to simulate the wax model, thus the precise three dimensional reconstruction of the auricle is made possible. (author).

  3. The best marketing strategy in aesthetic plastic surgery: evaluating patients' preferences by conjoint analysis.

    Science.gov (United States)

    Marsidi, Nick; van den Bergh, Maurice W H M; Luijendijk, Roland W

    2014-01-01

    To provide the best marketing strategy for a private clinic, knowledge of patients' preferences is essential. In marketing, conjoint analysis has been frequently used to calculate which attributes of a product are most valuable to consumers. This study investigates the relative importance of attributes that influence the selection and decision-making process when choosing an aesthetic private clinic, using conjoint analysis. The following attributes were chosen by the senior author (R.W.L.) and a marketing and communications director after a preselection of 25 randomly selected people: relative cost of the procedure, travel time, experience of the plastic surgeon, size of the clinic, method of referral, and online presentation. The attributes were then divided into levels. Using a random factor conducted by SPSS, 18 different scenarios were created and rated online by 150 potential patients before their potential visit or consultation. The patients could rate these scenarios on a scale from 1 to 7 with respect to the likeliness of visiting the clinic. The most important attribute was experience of the surgeon (35.6 percent), followed by method of referral (21.5 percent), travel time (14.2 percent), cost of procedure (12.9 percent), online presentation (9.7 percent), and size of the clinic (6.1 percent). Six of 16 levels gave a negative influence on the decision making. The authors' study shows that the two most important attributes are the experience of the surgeon and the method of referral and that conjoint analysis is effective in determining patients' preferences. It also shows which levels positively or negatively contribute per attribute.

  4. How to Approach Laryngopharyngeal Reflux: An Otolaryngology Perspective.

    Science.gov (United States)

    Dhillon, Vaninder K; Akst, Lee M

    2016-08-01

    In the otolaryngology practice, there is a rising concern with the current diagnosis and management of laryngopharyngeal reflux (LPR). The implication of LPR in many common head and neck symptoms, along with the rising cost of empiric therapy and no overall improvement in patient symptoms, has established a need to review what are indeed laryngopharyngeal complaints secondary to reflux and what are not. This article reviews the otolaryngologist's approach to LPR, the various ways diagnosis is made, and the guidelines that inform the current trends in otolaryngology management of LPR. The goal of this article is to recognize that reflux can be the cause of a variety of laryngopharyngeal complaints seen within an otolaryngology practice, but when empiric therapy does not improve symptoms, consideration should be given to other non-reflux causes.

  5. 妇科整形术后护理的临床体会%Clinical Experience of the Nursing After Gynecological Plastic Surgery

    Institute of Scientific and Technical Information of China (English)

    宁虹梅

    2013-01-01

    目的:分析总结妇科美容中常用的术后护理方法,探讨妇科美容整形护理的发展趋势。方法:对我院2010年9月~2012年3月收治的56例接受妇科整形的患者进行护理,总结和分析术后护理的效果和患者术后恢复情况,为妇科整形护理的发展提供参考。结果:所有患者手术均顺利完成,术后对患者实施护理后均恢复良好,患者很快恢复自信,重新融入日常生活。结论:随着生活水平的提高,女性对美容整形的要求越来越高,妇科美容整形受到更多青睐,对于妇科整形患者的护理不仅能使其术后恢复良好,还能消除心理负担,使之更快的恢复到正常生活中去,值得临床推广。%Objective To analyze and summarize the commonly used nursing method after gynecological plastic surgery,and to explore gynecological cosmetic surgery nursing trend. Methods 56 cases received nursing after gynecological plastic surgery in the hospital from September,2010 to March,2012. The effect of postoperative nursing and postoperative recovery were summarized and analyzed to provide reference for the development of gynecological surgery nursing. Results All patients successfully received the operation,and patients recovered well after postoperative nursing. The patients’ self-confidence recovered quickly,and got back into their daily life. Conclusion With the improvement of living standards,women have more and more requirement on plastic surgery,and gynecological plastic surgery gets the patients more and more attention. The nursing of patients who undergo gynecological plastic surgery can not only make its recovery good,but also can eliminate the psychological burden,to make them faster return to normal life. It is worthy of clinical promotion.

  6. Acquisition and elaboration of superficial three-dimensional images in plastic and reconstructive surgery: Applications

    Directory of Open Access Journals (Sweden)

    Alfano C

    2005-01-01

    Full Text Available Since 1970, as computed axial tomography machines became easily available and became more sophisticated, image acquisition techniques and analysis improved, developed rapidly and became very useful in medical diagnosis. Today it is possible to examine either the anatomic and functional aspects of deep body organs and tissues including all the minute details as well as their morphological relations with superficial structures. Through precise graphic elaboration programs we can obtain information about spatial relations which was not possible using simply classical clinical examination. It is possible, for example, to "point out" an area of interest from its anatomic context, to carry out virtual cleavage of planes and to measure volumes and distances. New developments in image acquisition systems permit transfer of three-dimensional data directly from existing objects. The three -dimensional computerized axial tomography for deep structures, and the laser scanners for superficial structure, quickly furnish (1-3 seconds for the laser scanners useful information to plan the surgical operation. When analysing 3D-imaging techniques it is important to appreciate their utility for the planning and the follow up of surgery, particularly for the head and thorax, where the three dimensional evaluation is better than the classic double dimensional system that is incomplete and difficult to interpret. In the future, these systems will be important for the best aesthetic and functional results and above all for reducing the surgical time.

  7. [Contribution of the physical and rehabilitation medicine in pediatric plastic surgery].

    Science.gov (United States)

    Gottrand, L; Devinck, F; Martinot Duquennoy, V; Guerreschi, P

    2016-10-01

    Physical, non-painful processes guide the scar reshaping in children in order to prevent growth anomalies due to cutaneous shrinkage. The objective of the surgical treatment, coordinated with the reeducation care, is to improve the physical abilities of the skin, to restore the function and avoid the deformations. Reeducation uses various techniques (i.e. sensitive-motility, massage and mobilizations) with or without physical agent (water, aspiration and touch-drive technique). Posture and positioning rely on the small or major aids, from orthosis to prosthesis. Compression is obtained by the adjustment of aids on molding and compression garment. Indications of the reeducation treatment depend on the timing of cutaneous covering and the advance of the healing process. It also depends on the underlying condition including skin traumas (frictions, wounds, burns), skin surgeries (purpura fulminans consequences, skin graft reconstruction after giant nevus resection, malignant lesion or vascular malformations). The final goal is the rehabilitation and development of the child and the adolescent in its entire somatopsychic dimension.

  8. Industry ties in otolaryngology: initial insights from the physician payment sunshine act.

    Science.gov (United States)

    Rathi, Vinay K; Samuel, Andre M; Mehra, Saral

    2015-06-01

    To characterize nonresearch payments made by industry to otolaryngologists in order to explore how the potential for conflicts of interests varies among otolaryngologists and compares between otolaryngologists and other surgical specialists. Retrospective cross-sectional database analysis. Open Payments program database recently released by Centers for Medicare and Medicaid Services. Surgeons nationwide who were identified as receiving nonresearch payment from industry in accordance with the Physician Payment Sunshine Act. The proportion of otolaryngologists receiving payment, the mean payment per otolaryngologist, and the standard deviation thereof were determined using the Open Payments database and compared to other surgical specialties. Otolaryngologists were further compared by specialization, census region, sponsor, and payment amount. Less than half of otolaryngologists (48.1%) were reported as receiving payments over the study period, the second smallest proportion among surgical specialties. Otolaryngologists received the lowest mean payment per compensated individual ($573) compared to other surgical specialties. Although otolaryngology had the smallest variance in payment among surgical specialties (SD, $2806), the distribution was skewed by top earners; the top 10% of earners accounted for 87% ($2,199,254) of all payment to otolaryngologists. Otolaryngologists in the West census region were less likely to receive payments (38.6%, P industry compared to other surgeons, though variation exists within otolaryngology. Further refinement of the Open Payments database is needed to explore differences between otolaryngologists and leverage payment information as a tool for self-regulation. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  9. Self-audit in plastic surgery: toward total quality management of personal professional practice.

    Science.gov (United States)

    Alhoqail, Rola Abdullah

    2011-03-01

    Researchers did not describe before the process of self-audit as proposed in this research. A new concept of total quality management of personal professional practice (TQM-PPP) is introduced. A prospective audit of a personal professional practice, clinical and academic, for the first 7 years as a consultant plastic surgeon is described. The number of patients reported was 248; 145 (59.4%) were male patients and 99 (40.6%) were female patients, of whom 159 (65.2%) and 85 (34.8%) were Saudis and non-Saudis, respectively. Sources of admission were mainly emergency (118, 47.8%) and outpatient departments (115, 46.6%). Operations were performed in 177 (72%) of patients; the author was the actual surgeon in 155 (62.5%) of patients, which were classified as intermediate (48.3%), major (38.4%), minor (12.6%), and major complex (0.7%). Operations were elective in 109 patients (61.6%), and the rest were emergencies. Clinicopathologic typing was mostly traumatic in 108 patients (59%), followed by aesthetic in 42 patients (23.0%). The region most operated on was the upper limb and then the head and neck; 89 (70.6%) of operations were done in 2 hours. Six complications were detected. Significant relations observed between clinicopathologic typing and age groups, nationality, and sex. However, no significant difference was detected between adults and pediatric age groups or between elective and emergency cases with respect to total hospital stay. There was no significant difference in the mean length of stay in relation to age groups. Various academic achievements in the same period and the pyramid of TQM-PPP are included. In conclusion, it was a satisfying experience, and I encourage other colleagues to do the same. Identifying the zone of practice of the individual consultant/health professional, designing audit tools for each, and accurate record keeping; using specific staff for data collection, entry, and analysis; and developing outcome evaluation techniques from

  10. L-PRP/L-PRF in esthetic plastic surgery, regenerative medicine of the skin and chronic wounds.

    Science.gov (United States)

    Cieslik-Bielecka, Agata; Choukroun, Joseph; Odin, Guillaume; Dohan Ehrenfest, David M

    2012-06-01

    The use of platelet concentrates for topical use is of particular interest for the promotion of skin wound healing. Fibrin-based surgical adjuvants are indeed widely used in plastic surgery since many years in order to improve scar healing and wound closure. However, the addition of platelets and their associated growth factors opened a new range of possibilities, particularly for the treatment of chronic skin ulcers and other applications of regenerative medicine on the covering tissues. In the 4 families of platelet concentrates available, 2 families were particularly used and tested in this clinical field: L-PRP (Leukocyte- and Platelet-rich Plasma) and L-PRF (Leukocyte- and Platelet-Rich Fibrin). These 2 families have in common the presence of significant concentrations of leukocytes, and these cells are important in the local cleaning and immune regulation of the wound healing process. The main difference between them is the fibrin architecture, and this parameter considerably influences the healing potential and the therapeutical protocol associated to each platelet concentrate technology. In this article, we describe the historical evolutions of these techniques from the fibrin glues to the current L-PRP and L-PRF, and discuss the important functions of the platelet growth factors, the leukocyte content and the fibrin architecture in order to optimize the numerous potential applications of these products in regenerative medicine of the skin. Many outstanding perspectives are appearing in this field and require further research.

  11. Postmastectomy radiation therapy and immediate autologous breast reconstruction: integrating perspectives from surgical oncology, radiation oncology, and plastic and reconstructive surgery.

    Science.gov (United States)

    Rochlin, Danielle H; Jeong, Ah-Reum; Goldberg, Leah; Harris, Timothy; Mohan, Kriti; Seal, Stella; Canner, Joe; Sacks, Justin M

    2015-03-01

    The effect of postmastectomy radiation therapy (PMRT) on immediately reconstructed abdominal wall-based tissue remains imprecisely defined. We evaluated evidence from all fields involved in care of the breast cancer patient in order to advance a unified recommendation regarding this therapeutic sequence. We performed a MEDLINE and manual reference search to identify studies of PMRT with immediate autologous breast reconstruction. Inclusion criteria required studies to describe patients, flaps, and complication rates. Analyses were based on a random effects model. Surgical and radiation oncology literature was reviewed. Eleven retrospective studies of 337 patients with an average follow-up of 18-60 months (out of 268 patients) were selected for inclusion. Overall rates of fat necrosis, revisional surgery, volume loss, and fibrosis/contracture ranged from 16.9% to 35.4%. One out of 260 patients experienced total flap loss. There was an increased probability of fat necrosis in the irradiated breast (OR = 3.13, 95% CI = 1.42-6.89, P = 0.005) among three studies with non-irradiated controls. Five studies evaluated aesthetics with variable outcomes. There is mixed evidence for the utility of PMRT with immediate autologous abdominal wall breast reconstruction. Further investigation requires prospective studies with collaboration among surgical oncologists, radiation oncologists, and plastic surgeons. © 2014 Wiley Periodicals, Inc.

  12. Photogrammetric Techniques for Analysis and Visualization of Changes in 2d and 3d Data: Plastic Surgery Application

    Science.gov (United States)

    Knyaz, V. A.; Zheltov, S. Y.; Chibunichev, A.

    2017-05-01

    Accurate measurements of 3D scenes and change detection of spatial distributed data are of great importance in different areas of research and application. For more accurate data analysis it is useful to take into account the all available data from various sensors and sources. The common case is that the different kinds of data available in their own coordinate systems and it is needed to transform all data in common coordinate system. This can be provided by finding correspondence between features in data of different types and different sources. Photogrammetry provides structurally connected 2D and 3D data which gives valuable information about correspondence of 2D and 3D features. The approaches to 2D and 3D data fusion and analysis are proposed which are based on complex processing of 2D and 3D data for changes detection and visualization. The techniques for data fusion are developed. The results of applying the developed techniques are presented for plastic surgery application.

  13. Topography of the greater palatine artery and the palatal vault for various types of periodontal plastic surgery.

    Science.gov (United States)

    Kim, Da-Hye; Won, Sung-Yoon; Bae, Jung-Hee; Jung, Ui-Won; Park, Dong-Soo; Kim, Hee-Jin; Hu, Kyung-Seok

    2014-05-01

    The purpose of the present study is to provide useful data that could be applied to various types of periodontal plastic surgery by detailing the topography of the greater palatine artery (GPA), looking in particular at its depth from the palatal masticatory mucosa (PMM) and conducting a morphometric analysis of the palatal vault. Forty-three hemisectioned hard palates from embalmed Korean adult cadavers were used in this study. The morphometry of the palatal vault was analyzed, and then the specimens were decalcified and sectioned. Six parameters were measured using an image-analysis system after performing a standard calibration. In one specimen, the PMM was separated from the hard palate and subjected to a partial Sihler's staining technique, allowing the branching pattern of the GPA to be observed in a new method. The distances between the GPA and the gingival margin, and between the GPA and the cementoenamel junction were greatest at the maxillary second premolar. The shortest vertical distance between the GPA and the PMM decreased gradually as it proceeded anteriorly. The GPA was located deeper in the high-vault group than in the low-vault group. The premolar region should be recommended as the optimal donor site for tissue grafting, and in particular the second premolar region. The maximum size and thickness of tissue that can be harvested from the region were 9.3 mm and 4.0 mm, respectively.

  14. Documentation in Otolaryngology. Sharing Otolaryngology research data in an open science ecosyste

    Directory of Open Access Journals (Sweden)

    Fernanda PESET

    2016-11-01

    Full Text Available Introduction and objective: The present text addresses the most significant aspects to share research data in otolaryngology in the context of open science as an ecosystem. Its aim is to offer a panoramic view that helps the researcher to manage their data as part of enriched science. Method: A bibliographical review and of the own experience in the field of the investigation data was performed. Results: The basic pillars for success are offered: its political, technical and necessary capacities. Discussion: The tasks of making data available should be recognized as part of the researcher's curriculum because documenting them to be reusable is a highly specialized and time-consuming task. Conclusions: It is considered that we are at a crucial moment to begin to share data. It is being considered in all scientific policy scenarios as in the EU through the European Open Science Computing.

  15. [Body modifications and sexual health : Impact of tattoos, body piercing and esthetic genital plastic surgery on the sexual health of women and men].

    Science.gov (United States)

    Stirn, Aglaja Valentina; Zannoni, Ronja

    2017-07-25

    The present paper addresses the psychological impact of body modifications (e.g. tattoos, body piercing and esthetic genital plastic surgery) on the sexual health of individuals and refers to past and present research insights. Body modifications are understood as invasive interventions on the human body, especially interventions on the human skin which result in (semi-)permanent changes. Tattoos and body piercing (in particular genital piercing) positively affect the sexual satisfaction and the sexual appeal of men and women but there is a controversial association with high risk sexual behavior. Moreover, this article focuses on esthetic genital plastic surgery based on the increasing interest and insights of the impact on female genital self-perception and sexual behavior.

  16. Dynamics of shock waves and cavitation bubbles in bilinear elastic-plastic media, and the implications to short-pulsed laser surgery

    Science.gov (United States)

    Brujan, E.-A.

    2005-01-01

    The dynamics of shock waves and cavitation bubbles generated by short laser pulses in water and elastic-plastic media were investigated theoretically in order to get a better understanding of their role in short-pulsed laser surgery. Numerical simulations were performed using a spherical model of bubble dynamics which include the elastic-plastic behaviour of the medium surrounding the bubble, compressibility, viscosity, density and surface tension. Breakdown in water produces a monopolar acoustic signal characterized by a compressive wave. Breakdown in an elastic-plastic medium produces a bipolar acoustic signal, with a leading positive compression wave and a trailing negative tensile wave. The calculations revealed that consideration of the tissue elasticity is essential to describe the bipolar shape of the shock wave emitted during optical breakdown. The elastic-plastic response of the medium surrounding the bubble leads to a significant decrease of the maximum size of the cavitation bubble and pressure amplitude of the shock wave emitted during bubble collapse, and shortening of the oscillation period of the bubble. The results are discussed with respect to collateral damage in short-pulsed laser surgery.

  17. Improving applicant selection: identifying qualities of the unsuccessful otolaryngology resident.

    Science.gov (United States)

    Badran, Karam W; Kelley, Kanwar; Conderman, Christian; Mahboubi, Hossein; Armstrong, William B; Bhandarkar, Naveen D

    2015-04-01

    To identify the prevalence and management of problematic residents. Additionally, we hope to identify the factors associated with successful remediation of unsuccessful otolaryngology residents. Self-reported Internet and paper-based survey. An anonymous survey was distributed to 152 current and former program directors (PDs) in 2012. The factors associated with unsuccessful otolaryngology residents and those associated with the successful remediation of problematic residents were investigated. An unsuccessful resident is defined as one who quit or was removed from the program for any reason, or one whose actions resulted in criminal action or citation against their medical license after graduation from residency. Remediation is defined as an individualized program implemented to correct documented weaknesses. The overall response rate was 26% (40 PDs). Seventy-three unsuccessful or problematic residents were identified. Sixty-six problematic or unsuccessful residents were identified during residency, with 58 of 66 (88%) undergoing remediation. Thirty-one (47%) residents did not graduate. The most commonly identified factors of an unsuccessful resident were: change in specialty (21.5%), interpersonal and communication skills with health professionals (13.9%), and clinical judgment (10.1%). Characteristics of those residents who underwent successful remediation include: poor performance on in-training examination (17%, P otolaryngology PDs in this sample identified at least one unsuccessful resident. Improved methods of applicant screening may assist in optimizing otolaryngology resident selection. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  18. Trends in U.S. Pediatric Otolaryngology Fellowship Training.

    Science.gov (United States)

    Espinel, Ali; Poley, Marian; Zalzal, George H; Chan, Kenny; Preciado, Diego

    2015-10-01

    Interest in pediatric otolaryngology fellowship training is growing. The workforce implications of this growing interest are unclear and understudied. To analyze trends in pediatric otolaryngology training, determine where fellows who graduated over the past 10 years are currently practicing, and test the hypothesis that graduates from Accreditation Council for Graduate Medical Education (ACGME)–accredited programs were more likely to have academic tertiary positions with faculty appointments. We conducted a web-based analysis of pediatric otolaryngology fellowship graduates. The names of all 274 applicants who were matched to pediatric otolaryngology fellowships from May 31, 2003, to May 31, 2014, were obtained from the SF Match website. Accreditation status of each program for each match year was obtained from the ACGME website. We then performed an Internet search for the current practice location of each matched applicant. Analysis was conducted from January 1, 2015, to May 1, 2015. Practice setting per year of fellowship match and accreditation status of program. For the 2003 to the 2014 match years, there was an increase from 5 to 22 accredited pediatric otolaryngology fellowship programs overall; simultaneously, the number of yearly matched applicants increased from 14 to 35. More graduates with ACGME accreditation practice at academic settings compared with graduates without ACGME accreditation although the difference was not statistically significant (67.1% vs. 50.7%; P = .15). Graduates from accredited programs, however, were significantly more likely to practice at a hospital-based setting compared with those from nonaccredited programs (81.7% vs. 65.5%; P = .003). Fellows trained in the last 10 years are relatively well distributed across the country. The number of pediatric otolaryngology fellowship applicants as well as total number of matched applicants and ACGME-accredited positions has risen in the last 10 years. It appears that a higher

  19. “Inscrutable Intelligence”: The Case against Plastic Surgery in the Works of Jean Stafford and Sylvia Plath

    Directory of Open Access Journals (Sweden)

    Mercè Cuenca

    2009-06-01

    Full Text Available Jean Stafford’s short story “The Interior Castle” (1946 and Sylvia Plath’s “Face Lift” and “The Plaster”, written in the early 1960s but published posthumously in Crossing the Water (1971, dwell on a theme which is rarely tackled in Postwar American literature: plastic surgery. Using a markedly mnemonic tone, both authors trace in detail the passive submission of female bodies to male (reconstruction. While the history of women in early Cold War America is usually associated with the patriarchal mystifying of housewifery, the myth of ideal, domestic femininity was also intimately related to bodily beauty. The demand for physical “perfection” which resulted from constructing women as, primarily, objects of male desire was mirrored in popular magazines, such as Ladies’ Home Journal, which endorsed women’s seeking medical aid to model themselves into “ideal” sexual mates (Meyerowitz in Meyerowitz ed., 244. Women’s submission to the notion that they should use any means necessary to become aesthetic objects to be appraised by men was thus represented as desirable. In this paper, I shall trace how both Stafford and Plath adopted a confessional style of writing in the abovementioned pieces in order to denounce the cultural construction of women as passive bodies to be moulded at will, instead of as active, thinking subjects. I shall argue that by reproducing the recollections and thoughts of the women being stitched, sewn and bandaged in their pieces, both authors articulated an alternative protofeminist aesthetics based on the beauty of what Stafford described as “inscrutable intelligence”.

  20. Surgical treatment of burns sequelae. our experience in the Department of Plastic and Reconstructive Surgery, Pristina, Kosovo.

    Science.gov (United States)

    Buja, Z; Arifi, H; Hoxha, E; Duqi, S

    2015-09-30

    Burn injuries are very frequent in Kosovo, leading to long-lasting physical, functional, aesthetic, psychological and social consequences directly proportional to the time of healing; the longer it takes for the burn wound to heal, the more serious are the sequelae. The objectives of the present study are to review the epidemiological, clinical and therapeutic aspects of burn patients presenting with post-burn sequelae and treated at the Department of Plastic and Reconstructive Surgery, Pristina, Kosovo, from January 2005 until December 2011. This study included 188 patients with burns sequelae. The following variables were considered: age, sex, anatomical location, pathological types, and surgical procedure. There were 82 men (43.6%) and 106 women (56.4%), ranging in age from 0 to 67 years (mean age 33.5 years), most of the patients were children (139 = 73.9%). Burn contractures were observed in 135 (71.8%) patients, hypertrophic scars in 32 (17%), keloids in 10 (5.3%), alopecia in 6 (3.2%), syndactyly in 12 (6.4%), ectropion in 4 (2.1%) and ear deformity in 1 (0.53%) cases. To correct the deformities the most common choice was the Z-plasty technique, used in 31.4% of cases, followed by Z-plasty+full thickness skin grafts in 21.8%, full thickness skin grafts in 18.1%, tissue expansion in 8%, Z-plasty+local flaps in 4.8%, flaps (local, fascio-cutaneous, radial forearm) in 6.9% and direct closure in 6.4%. Timely wound closure and the development of an individual programme for surgical treatment of burns sequelae are crucial for optimal outcomes in patients with burns.

  1. Deliberate Self-Harm and the Elderly: A Volatile Combination—An Overview from the Plastic Surgery Perspective

    Directory of Open Access Journals (Sweden)

    J. Packer

    2012-01-01

    Full Text Available Aims. To study the factors associated with the DSH in the elderly group of 60 years and above and to recommend changes to be implemented in order to improve the management in this specific group. Materials and Methods. Five-year retrospective study was undertaken from July 2005 to July 2010 in the Plastic Surgery Department of the Royal Preston Hospital, NHS Trust. A Performa was designed to collect data about the inpatient admission and included certain areas of key information. The case notes for all patients were extensively analysed in order to gather adequate information for the devised Performa. Results. DSH is getting more common in the elderly group, and males are more affected than females. 60% of the patients had a previous history of DSH. A large number (80% of patients had a previous history of mental illness. 60% of those DSH patients were living with family. Almost all patients (90% were reviewed by the Psychiatry Liaison Team. The timing of patients being assessed was highly variable. Conclusions. Marriage is not a protective factor in the prevention of the DSH in the elderly group. A mental health team referral in the early phases of the management would be of huge benefit and a likely step to prevent possible future admissions. The Department would benefit from the creation of a protocol for the management of these patients. There should be a joint effort of the professionals in the management of DSH in the elderly, and GPs play a very important role in the prevention of DSH in the later life.

  2. Topical negative pressure therapy Recent experience of the department of plastic surgery at Ibn Sina University Hospital, Rabat, Morocco

    Directory of Open Access Journals (Sweden)

    Abdelmoughit Echchaoui

    2014-12-01

    Full Text Available IntroductionThe topical negative pressure therapy (TNP is a non-invasive method to treat chronic and acute wounds locally, using a continuous or intermittent negative pressure.The objective of this study is to present the first experience of this type of treatment used in clinical cases in our department. By presenting these cases, we highlight indication and efficiency of this new technique applied in relatively complicated situations, at the same time it also allows a significant improvement in treating injuries and chronic wounds.Materials and methodsIn this study, we present the recent experience of the Department of Reconstructive and Plastic Surgery of the University Hospital Center of Avicenne in Rabat. This therapy was used for the first time this year (in 2014, in three young patients who presented with chronic wounds associated with local and general factors that are unfavorable for the healing process.ResultsIn all three of our cases we obtained highly satisfactory clinical results.TNP allows wounds to bud in a shorter time, as well as a fast healing by second intention due to controlled wound healing or split-skin graft without using flaps. This enables to decrease the margin of error, the time and the number of dressing replacements, and to reduce the length of hospital stay.ConclusionThis is an expensive and specific equipment. However, the cost-benefit ratio analysis shows that it is an essential method that should be part of our therapeutic strategies.Keywords: loss of substance, negative pressure, budding, healing.  

  3. Otolaryngology Residency Program Research Resources and Scholarly Productivity.

    Science.gov (United States)

    Villwock, Jennifer A; Hamill, Chelsea S; Nicholas, Brian D; Ryan, Jesse T

    2017-06-01

    Objective To delineate research resources available to otolaryngology residents and their impact on scholarly productivity. Study Design Survey of current otolaryngology program directors. Setting Otolaryngology residency programs. Subjects and Methods An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. Results Thirty-nine percent (n = 38) of queried programs responded. Fourteen (37%) programs had 11 to 15 full-time, academic faculty associated with the residency program. Twenty (53%) programs have a dedicated research coordinator. Basic science lab space and financial resources for statistical work were present at 22 programs (58%). Funding is uniformly provided for presentation of research at conferences; a minority of programs (13%) only funded podium presentations. Twenty-four (63%) have resident research requirements beyond the Accreditation Council for Graduate Medical Education (ACGME) mandate of preparing a "manuscript suitable for publication" prior to graduation. Twenty-five (67%) programs have residents with 2 to 3 active research projects at any given time. None of the investigated resources were significantly associated with increased scholarly output. There was no uniformity to research curricula. Conclusions Otolaryngology residency programs value research, evidenced by financial support provided and requirements beyond the ACGME minimum. Additional resources were not statistically related to an increase in resident research productivity, although they may contribute positively to the overall research experience during training. Potential future areas to examine include research curricula best practices, how to develop meaningful mentorship and resource allocation that inspires continued research interest, and intellectual stimulation.

  4. Delayed otolaryngology referral for voice disorders increases health care costs.

    Science.gov (United States)

    Cohen, Seth M; Kim, Jaewhan; Roy, Nelson; Courey, Mark

    2015-04-01

    Despite the accepted role of laryngoscopy in assessing patients with laryngeal/voice disorders, controversy surrounds its timing. This study sought to determine how increased time from first primary care to first otolaryngology outpatient visit affected the health care costs of patients with laryngeal/voice disorders. Retrospective analysis of a large, national administrative claims database was performed. Patients had an International Classification of Diseases, 9(th) Revision-coded diagnosis of a laryngeal/voice disorder; initially saw a primary care physician and, subsequently, an otolaryngologist as outpatients; and provided 6 months of follow-up data after the first otolaryngology evaluation. The outpatient health care costs accrued from the first primary care outpatient visit through the 6 months after the first otolaryngology outpatient visit were determined. There were 260,095 unique patients who saw a primary care physician as an outpatient for a laryngeal/voice disorder, with 8999 (3.5%) subsequently seeing an otolaryngologist and with 6 months postotolaryngology follow-up data. A generalized linear regression model revealed that, compared with patients who saw an otolaryngologist ≤1 month after the first primary care visit, patients in the >1-month and ≤3-months and >3-months time periods had relative mean cost increases of $271.34 (95% confidence interval $115.95-$426.73) and $711.38 (95% confidence interval $428.43-$993.34), respectively. Increased time from first primary care to first otolaryngology evaluation is associated with increased outpatient health care costs. Earlier otolaryngology examination may reduce health care expenditures in the evaluation and management of patients with laryngeal/voice disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Breast Reduction Surgery

    Science.gov (United States)

    ... breastfeeding: A systematic review. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2010;63:1688. Kerrigan CL, et al. Evidence-based medicine: Reduction mammoplasty. Plastic and Reconstructive Surgery. 2013;132: ...

  6. Objective Evaluation of Otoscopy Skills Among Family and Community Medicine, Pediatric, and Otolaryngology Residents.

    Science.gov (United States)

    Oyewumi, Modupe; Brandt, Michael G; Carrillo, Brian; Atkinson, Adelle; Iglar, Karl; Forte, Vito; Campisi, Paolo

    2016-01-01

    The objective of this study is to evaluate and compare the perceived need for otolaryngology training and otoscopy diagnostic skills in primary care (Family and Community Medicine, Pediatric Medicine), and Otolaryngology Head and Neck Surgery (OTO-HNS) postgraduate trainees. Participant otoscopy skills were evaluated using the OtoSim simulator. Family and Community Medicine, Pediatric, and OTO-HNS residents were recruited. Each resident participated in 3 separate otoscopy training and assessment sessions. The ability to correctly identify middle ear pathology was objectively evaluated using OtoSim™. Pretest, posttest, and 3-month retention test results were compared among residents in a paired comparison paradigm. Survey data assessing exposure to OTO-HNS during undergraduate and postgraduate training were also collected. A total of 57 residents participated in the study. All residents reported limited exposure to OTO-HNS during undergraduate medical training. Primary care trainees performed poorly on pretest assessments (30% ± 7.8%; 95% CI). Significant improvement in diagnostic accuracy was demonstrated following a single 1-hour teaching session (30%-62%; p < 0.001). Primary care residents demonstrated a significant decrease in diagnostic accuracy at a 3-month follow-up assessment (62%-52%, p < 0.001). Self-perceived comfort with otology was poorly correlated to pretest performance among primary care trainees (r = 0.26) and showed a stronger positive correlation among OTO-HNS trainees (r = 0.56). A single teaching session with an otoscopy simulator significantly improved diagnostic accuracy in primary care and OTO-HNS trainees. Improved performance is susceptible to deterioration at 3 months if acquired skills are not frequently used. Self-perceived comfort with otology may not be an accurate predictor of otoscopic diagnostic skill. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. 四步法眼袋整形术在老年眼部整形中的应用分析%Four-step blepharoplasty plastic surgery in elderly Eye Surgery Application Analysis

    Institute of Scientific and Technical Information of China (English)

    陈大艳

    2013-01-01

    Objective To investigate the application of eye surgery for elderly four-step analysis of the efficacy. Methods In our hospital ophthalmology patients in need of eye surgery were randomly selected elderly patients 80 cases as the study, patients were divided into a control group of 40 patients with the study group of 40 patients in the control group were treated with traditional surgical methods that lower eyelid skin into the road method to remove bags under the eyes;study group were treated with four-step blepharoplasty plastic surgery to remove bags under the eyes, and all patients in the postoperative one week stitches, observed under different plastic surgery patients in each group and eye bags removal recovery. Results All patients in the postoperative ocular conditions have improved, patients in the control group occurred ectropion two cases, one case of wound infection, hematoma in one case a small study group of patients with no complications. Conclusion The application of four-step pouch bags have plastic surgery to remove the safety, efficacy, is more suitable for elderly patients with an ocular plastic surgery.%目的:探讨老年眼部整形中应用四步法的疗效。方法将我院眼部整形老年患者80例分为两组各40例,对照组应用下睑皮肤入路法去除眼袋;研究组应用四步法(疝出眶隔脂肪切除、眶隔加固、外眦韧带悬吊和多余皮肤切除)眼袋整形术去除眼袋,术后1周拆线,观察两组眼袋去除效果及眼部恢复情况。结果所有患者术后眼部状况都得到改善,对照组患者中有2例发生眼睑外翻、1例切口感染、1例小血肿,研究组无并发症发生。结论四步法眼袋整形术去除眼袋安全有效,是目前比较适合老年患者的一种眼部整形术。

  8. PLASTIC SURGERY AND BURNS

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    Objective Endotoxin as the inciting agentof cytokines and other mediators, whose highlevel expression correlates with the septicshock and MOF, has been the one of leadingcauses of death in ICU. Methods For treatingsepsis and MOF caused by endotoxin, the anti-lipid A of LPS antibody was used. 19 burned

  9. PLASTIC SURGERY AND BURNS

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    The amount and constitution of protein, itsultraviolet photo-absorption ability, andesterase in homogenates of human cadavericand guinea pig skin (each consisted of newborn,fresh adult and stored adult skin) were assayedby using ultraviolet spectrophotometer,polyacrylamide gel electrophoresis and sodiumdodecyl sulphate polyacrylamide gel electro-

  10. Periodontal Plastic Surgery Procedures

    Science.gov (United States)

    ... Periodontal Externships Scholarships & Grants Educators Residents Careers in Periodontics Competencies for Predoc Perio Perio Exam for Dental Licensure Career Options in Periodontics In-Service Examination Dental Hygiene Educators Periodontal Literature ...

  11. Periodontal plastic surgery.

    Science.gov (United States)

    Zucchelli, Giovanni; Mounssif, Ilham

    2015-06-01

    The aim of the present article is to summarize current knowledge in terms of the etiology, diagnosis, prognosis and surgical treatment of gingival recession. Whilst the main etiological factors (i.e. toothbrushing trauma and bacterial plaque) are well established, challenges still remain to be solved in the diagnostic, prognostic and classification processes of gingival recession, especially when the main reference parameter - the cemento-enamel junction - is no longer detectable on the affected tooth or when there is a slight loss of periodontal interdental attachment. Root coverage in single type gingival recession defects is a very predictable outcome following the use of various surgical techniques. The coronally advanced flap, with or without connective tissue grafting, is the technique of choice. The adjunctive use of connective tissue grafts improves the probability of achieving complete root coverage. Surgical coverage of multiple gingival recessions is also predictable with the coronally advanced flap and the coronally advanced flap plus the connective tissue graft, but no data are available indicating which, and how many, gingival recessions should be treated adjunctively with connective tissue grafting in order to limit patient morbidity and improve the esthetic outcome. None of the allograft materials currently available can be considered as a full substitute for the connective tissue graft, even if some recent results are encouraging. The need for future studies with patient-based outcomes (i.e. esthetics and morbidity) as primary objectives is emphasized in this review.

  12. American Society of Plastic Surgeons

    Science.gov (United States)

    ... PRS PRS GO PSN PSEN GRAFT Contact Us Cosmetic Surgery New procedures and advanced technologies offer plastic surgery ... David Berman MD 14 Pidgeon Hill Drive Berman Cosmetic Surgery & S... Sterling, VA 20165 Website Franklin Richards MD Suite ...

  13. Image guidance in endoscopic sinus surgery and skull base surgery

    Institute of Scientific and Technical Information of China (English)

    Mitchell R.Gore; Brent A.Senior

    2012-01-01

    Objective The objective of this study was to review the current clinical applications and impact of intraoperative imaging on endoscopic sinonasal and skull base procedures in adult and pediatric patients.Methods The PubMed database was searched for articles related to the use of image guidance in otolaryngology using the search terms "image guidance otolaryngology".This was supplemented by the authors′ experience utilizing image guidance in nearly 3000 endoscopic sinus and skull base procedures.Results The literature demonstrates that intraoperative image guidance has utility in primary and revision endoscopic sinus surgery,as well as endoscopic surgery of the skull base.Image guidance also has applications in pediatric endoscopic surgery,such as pediatric sinus surgery and repair of choanal atresia.Conclusions Intraoperative image guidance,when combined with a thorough knowledge of paranasal sinus and skull base anatomy and technical proficiency,can provide improved safety when performing otolaryngologic procedures from endoscopic sinus surgery to endoscopic skull base surgery.While not a substitute for knowledge of anatomy,the increased availability and usability of image guidance systems make them a useful tool in the armamentarium of the otolaryngologist/head and neck surgeon and neurosurgeon.

  14. Silicone rubber materials in facial plastic surgery%硅橡胶材料在面部整形中的应用

    Institute of Scientific and Technical Information of China (English)

    汪海涵; 龙腾河; 何勇; 王佳

    2011-01-01

    BACKGROUND: Silicone rubber can be used as an ideal material for facial plastic.OBJECTIVE: To evaluate the application of silicone rubber in facial plastic surgery.METHODS: A computer-based search was performed using the keywords of “Silicone rubber,Composite, Mechanical properties,Computer Aided Design and Manufacturing, Head and facial plastic surgery” in Chinese and English for articles about silicone rubber in facial reconstruction published from 2001-01 to 2010-12. Repetitive articles and Meta analysis were excluded, and finally 22 articles were eligible.RESULTS AND CONCLUSION: A computer model can be used for surgical design of facial plastic. All kinds of complications occur in 6% patients receiving facial plastic surgery, and the reasons are as follows: ①operative misconduct; ②do not perform the surgery according to the cosmetic principles; ③weak of sterile concept. Based on preoperative computer simulation design and effectiveness preview, the patients can participate in the individual design of their cosmetic surgery, which greatly increases the success rate of surgery. As long as a good grasp of cosmetic elements using solid silicone materials and surgical principle, the majority of complications can be avoided.%背景:硅橡胶材料可作为一种较理想的面部整形植入材料.目的:评价硅橡胶材料在面部整形的应用.方法:以 "硅橡胶,复合材料,生物力学性能,计算机辅助设计与制造,头面部整形"为中文关键词;以"Silicone rubber,Composite,Mechanical properties,Computer Aided Design and Manufacturing,Head and facial plastic surgery" 为英文关键词,采用计算机检索2001-01/2010-12相关文章.纳入与硅橡胶材料在面部整形的应用相关的文章;排除重复研究或Meta分析类文章.以22篇文献为主重点进行了讨论硅橡胶材料的研究及其在面部整形的应用.结果与结论:计算机的模型可用于面部整形的手术方案设计.整形术可解决了

  15. Improving Otolaryngology Residency Selection Using Principles from Personnel Psychology.

    Science.gov (United States)

    Bowe, Sarah N; Laury, Adrienne M; Gray, Stacey T

    2017-03-01

    There has been a heightened focus on improving the resident selection process, particularly within highly competitive specialties. Previous research, however, has generally lacked a theoretical background, leading to inconsistent and biased results. Our recently published systematic review examining applicant characteristics and performance in residency can provide historical insight into the predictors (ie, constructs) and outcomes (ie, criteria) previously deemed pertinent by the otolaryngology community. Personnel psychology uses evidence-based practices to identify the most qualified candidates for employment using a variety of selection methods. Extensive research in this discipline has shown that integrity tests, structured interviews, work samples, and conscientiousness offer the greatest increase in validity when combined with general cognitive ability. Blending past research knowledge with the principles of personnel selection can provide the necessary foundation with which to engage in theory-driven, longitudinal studies on otolaryngology resident selection moving forward.

  16. Incorporating Interpersonal Skills into Otolaryngology Resident Selection and Training.

    Science.gov (United States)

    Lu-Myers, Yemeng; Myers, Christopher G

    2017-09-01

    Increasing attention has been paid to the selection of otolaryngology residents, a highly competitive process but one with room for improvement. A recent commentary in this journal recommended that residency programs more thoroughly incorporate theory and evidence from personnel psychology (part of the broader field of organizational science) in the resident selection process. However, the focus of this recommendation was limited to applicants' cognitive abilities and independent work-oriented traits (eg, conscientiousness). We broaden this perspective to consider critical interpersonal skills and traits that enhance resident effectiveness in interdependent health care organizations and we expand beyond the emphasis on selection to consider how these skills can be honed during residency. We advocate for greater use of standardized team-based care simulations, which can aid in assessing and developing the key interpersonal leadership skills necessary for success as an otolaryngology resident.

  17. Physical Models and Virtual Reality Simulators in Otolaryngology.

    Science.gov (United States)

    Javia, Luv; Sardesai, Maya G

    2017-07-14

    The increasing role of simulation in the medical education of future otolaryngologists has followed suit with other surgical disciplines. Simulators make it possible for the resident to explore and learn in a safe and less stressful environment. The various subspecialties in otolaryngology use physical simulators and virtual-reality simulators. Although physical simulators allow the operator to make direct contact with its components, virtual-reality simulators allow the operator to interact with an environment that is computer generated. This article gives an overview of the various types of physical simulators and virtual-reality simulators used in otolaryngology that have been reported in the literature. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. Preventive application of antibiotic in plastic surgery%抗生素在整形外科中的预防性应用

    Institute of Scientific and Technical Information of China (English)

    万睿; 舒瑛; 庞星原; 任军

    2014-01-01

    Objective To investigate the reasonable proposal of prophylactic antibiotics use in plastic surgery with type Ⅰ incision.Methods The data of 748 patients with plastic surgery in our hospital were collected and the operation number was 770.Using a retrospective case-control study,we analysed the clinical effect of different administration methods.Results Clinical effects were compared among the multiple days medication group,normative administration group and no medication groups,and there was no significant difference in the prevention of postoperative infection results.Conclusions Plastic surgery with type Ⅰ incision does not need the prophylactic application of antibiotics.In special circumstances we should take medicine in strict accordance with the "Guiding Principles for Clinical Application of Antibiotics".%目的 探讨整形外科Ⅰ类切口手术预防性应用抗生素的合理方案.方法 采用回顾性对照研究,对比观察748例整形外科Ⅰ类切口住院患者围手术期不给药及不同给药方式的临床感染率.结果 多天数给药组(A组)、规范给药组(B组)、不给药组(C组)3个组别互相比较,其预防术后感染的效果差异无统计学意义.结论 整形外科大多数Ⅰ类切口不需预防性应用抗生素,特殊情况者严格按照《抗菌药物临床应用指导原则》进行给药即可达到良好的临床疗效.

  19. Global health-related publications in otolaryngology are increasing.

    Science.gov (United States)

    Chambers, Kyle J; Creighton, Francis; Abdul-Aziz, Dunia; Cheney, Mack; Randolph, Gregory W

    2015-04-01

    Determine trends in global health-related publication in otolaryngology. A review of research databases. A search of publications available on PubMed and nine additional databases was undertaken reviewing two time periods 10 years apart for the timeframes 1998 to 2002 (early time period) and 2008 to 2012 (recent time period) using specific search terms to identify global health-related publications in otolaryngology. Publications were examined for region of origin, subspecialty, type of publication, and evidence of international collaboration. χ and t test analyses were used to identify trends. In the 1998 to 2002 time period, a total of 26 publications met inclusion criteria for the study, with a mean of 5.2 ± 2.8 publications per year. In the 2008 to 2012 time period, a total of 61 publications met inclusion criteria, with a mean of 12.3 ± 5.6 publications per year. The 235% increase in global health-related publications identified between the two study periods was statistically significant (P = .02). The absolute number of publications in which collaboration occurred between countries increased from three in the early time period to nine the recent time period. There has been a significant increase in the volume of global health-related publications in English language otolaryngology journals over the past decade, providing strong evidence of the increasing trend of global health as an academic pursuit within the field of otolaryngology. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  20. Impact of Otolaryngology theses in their authors' scientific production.

    Science.gov (United States)

    Encinas-Vicente, Alberto; Prim-Espada, María Pilar; Cenjor-Español, Carlos; de Diego-Sastre, Juan Ignacio

    2015-01-01

    The writing of a thesis has 2 main objectives: the appropriate training to be a good researcher and the publication of the first original research work. This study attempted to check this statement applied to theses in Otolaryngology by analysing the variation in the authors' publications. We used the database TESEO to obtain the data relative to Otolaryngology theses in Spain published between 1993 and 2003. We found the publications of each author by using de programme "Publish or Perish" and we analysed the variations in their work in 3 periods (prior to, around and after thesis publication). The publications, the citations and the parameters analysed all increased in the second and third periods (around and after) with regard to the first period. However, there were no significant differences in some of them in the first 2 periods. The elaboration of a thesis in Otolaryngology increased the scientific production of its author. Almost a third of the authors did not publish any work. There was a significant increase in all the parameters studied and the bibliometric indices between the period before thesis publication and the around and after thesis periods. Copyright © 2014 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Patología Cérvico-Facial. All rights reserved.

  1. Extremes in Otolaryngology Resident Surgical Case Numbers: An Update.

    Science.gov (United States)

    Baugh, Tiffany P; Franzese, Christine B

    2017-06-01

    Objectives The purpose of this study is to examine the effect of minimum case numbers on otolaryngology resident case log data and understand differences in minimum, mean, and maximum among certain procedures as a follow-up to a prior study. Study Design Cross-sectional survey using a national database. Setting Academic otolaryngology residency programs. Subjects and Methods Review of otolaryngology resident national data reports from the Accreditation Council for Graduate Medical Education (ACGME) resident case log system performed from 2004 to 2015. Minimum, mean, standard deviation, and maximum values for total number of supervisor and resident surgeon cases and for specific surgical procedures were compared. Results The mean total number of resident surgeon cases for residents graduating from 2011 to 2015 ranged from 1833.3 ± 484 in 2011 to 2072.3 ± 548 in 2014. The minimum total number of cases ranged from 826 in 2014 to 1004 in 2015. The maximum total number of cases increased from 3545 in 2011 to 4580 in 2015. Multiple key indicator procedures had less than the required minimum reported in 2015. Conclusion Despite the ACGME instituting required minimum numbers for key indicator procedures, residents have graduated without meeting these minimums. Furthermore, there continues to be large variations in the minimum, mean, and maximum numbers for many procedures. Variation among resident case numbers is likely multifactorial. Ensuring proper instruction on coding and case role as well as emphasizing frequent logging by residents will ensure programs have the most accurate data to evaluate their case volume.

  2. The Role of the Away Rotation in Otolaryngology Residency.

    Science.gov (United States)

    Villwock, Jennifer A; Hamill, Chelsea S; Ryan, Jesse T; Nicholas, Brian D

    2017-06-01

    Objective To determine the availability and purpose of away rotations during otolaryngology residency. Study Design Cross-sectional survey. Setting Otolaryngology residency programs. Subjects and Methods An anonymous web-based survey was sent to 98 allopathic otolaryngology training program directors, of which 38 programs responded. Fisher exact tests and nonparametric correlations were used to determine statistically significant differences among various strata of programs. A P value of 151 miles from the home institution and typically used to address deficiencies in clinical exposure (67%) or case volume (50%). Participants of mandatory away rotations were universally provided housing, with other consideration such as stipend (33%), relocation allowance (33%), or food allowance (16%) sometimes offered. In contrast to mandatory rotations, half of elective rotations were to obtain a unique international mission trip experience. Nearly one-third of surveyed program directors (29%) would consider adding an away rotation to their curriculum in the next 3 years. Conclusions Mandatory and elective away rotations play a role in a small, but not insignificant, number of training programs. The rationale for these rotations is variable. Given that nearly one-third of program directors would consider adding an away rotation in the near future, further research into components of a meaningful away rotation and how to optimize the away rotation experience is warranted.

  3. Standardized letters of recommendation and successful match into otolaryngology.

    Science.gov (United States)

    Kimple, Adam J; McClurg, Stanley W; Del Signore, Anthony G; Tomoum, Mohamed O; Lin, Feng-Chang; Senior, Brent A

    2016-05-01

    Historically, narrative letters of recommendation have been utilized in the selection of applicants for otolaryngology residency programs. In the last two application cycles, our specialty adopted a standardized letter of recommendation (SLOR). The intent was to decrease time burden for letter writers and to provide readers with an objective evaluation of applicants. The objective of this study was to determine attributes in the SLOR that correlate with matching into a residency program. We performed a retrospective study using SLOR, United States Medical Licensing Examination (USMLE) step 1 scores, and matched outcomes of applicants who applied to our institution for the 2013 and 2014 match cycle. We included the following variables from the SLOR in the statistical analysis to determine which ones were associated with matching: patient care, medical knowledge, communication skills, procedural skills, research, initiative and drive, commitment to otolaryngology, commitment to academic medicine, match potential, and USMLE1 scores. We identified 532 applicants and 963 SLOR. In successful applicants, scores for patient care, medical knowledge, communication skills, initiative and drive, and match potential were statistically higher (P otolaryngology, commitment to academic medicine, and USMLE step 1 scores were not higher among successfully matched applicants. Although SLOR can save time for letter writers and provide an objective description of applicants, the utility of individual domains within the SLOR is questionable. Additionally, it is concerning that applicants' professionalism and procedural skills are not correlated with matching in our specialty. NA. Laryngoscope, 126:1071-1076, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Coblation technology: plasma-mediated ablation for otolaryngology applications

    Science.gov (United States)

    Woloszko, Jean; Gilbride, Charles

    2000-05-01

    Coblation is a unique method of delivering radio frequency energy to soft tissue for applications in Otolaryngology (ENT). Using radio frequency in a bipolar mode with a conductive solution, such as saline, Coblation energizes the ions in the saline to form a small plasma field. The plasma has enough energy to break the tissue's molecular bonds, creating an ablative path. The thermal effect of this process is approximately 45 - 85 degrees Celsius, significantly lower than traditional radio-frequency techniques. Coblation has been used for Otolaryngological applications such as Uvulopalatopharyngoplasty (UPPP), tonsillectomy, turbinate reduction, palate reduction, base of tongue reduction and various Head and Neck cancer procedures. The decreased thermal effect of Coblation anecdotally has led to less pain and faster recovery for cases where tissue is excised. In cases where Coblation is applied submucosally to reduce tissue volume (inferior turbinate, soft palate), the immediate volume reduction may lead to immediate clinical benefits for the patient. Coblation is currently being tested in various clinical studies to document the benefits for otolaryngological applications.

  5. Undergraduate otolaryngology education at the University of Toronto: a review using a curriculum mapping system.

    Science.gov (United States)

    Oyewumi, Modupe; Isaac, Kathryn; Schreiber, Martin; Campisi, Paolo

    2012-02-01

    The aim of Canadian medical school curricula is to provide educational experiences that satisfy the specific objectives set out by the Medical Council of Canada. However, for specialties such as otolaryngology, there is considerable variability in student exposure to didactic and clinical teaching across Canadian medical schools, making it unclear whether students receive sufficient teaching of core otolaryngology content and clinical skills. The goal of this review was to assess the exposure to otolaryngology instruction in the undergraduate medical curriculum at the University of Toronto. Otolaryngology objectives were derived from objectives created by the Medical Council of Canada and the University of Toronto. The University of Toronto's recently developed Curriculum Mapping System (CMap) was used to perform a keyword search of otolaryngology objectives to establish when and to what extent essential topics were being taught. All (10 of 10) major topics and skills identified were covered in the undergraduate medical curriculum. Although no major gaps were identified, an uneven distribution of teaching time exists. The majority (> 90%) of otolaryngology education occurs during year 1 of clerkship. The amount of preclerkship education was extremely limited. Essential otolaryngology topics and skills are taught within the University of Toronto curriculum. The CMap was an effective tool to assess the otolaryngology curriculum and was able to identify gaps in otolaryngology education during the preclerkship years of medical school. As a result, modifications to the undergraduate curriculum have been implemented to provide additional teaching during the preclerkship years.

  6. Does the Press Ganey Survey Correlate to Online Health Grades for a Major Academic Otolaryngology Department?

    Science.gov (United States)

    Ryan, Timothy; Specht, Jessica; Smith, Sarah; DelGaudio, John M

    2016-09-01

    Analyze the correlation between online-based review websites and the Press Ganey Patient Satisfaction Survey (PGPSS) in an academic otolaryngology department. Retrospective cross sectional. Tertiary academic institution. All available data were collected for Vitals.com and Healthgrades.com, along with PGPSS data for 16 otolaryngology attending physicians from 2012 to 2014. A mean rating was calculated for each topic category for online websites and compared with 7 PGPSS content questions using zero-order correlations. A paired t test was used to analyze the difference between the PGPSS and online scores. There were no statistically significant correlations between time spent with the patient (r = 0.391, P = .208) and overall provider scores (r = 0.193, P = .508) when compared between Vitals.com and the PGPSS. The correlations were not statistically significant when Healthgrades.com was compared with the PGPSS in the items "probability of recommending the provider" (r = -0.122, P = .666) and "trust in provider" (r = -0.025, P = .929). The most important factors in a patient recommending the provider were as follows, per resource: time spent with the patient for Vitals.com (r = 0.685, P = .014), listening for Healthgrades.com (r = 0.981, P ≤ .001), and trust in the provider for the PGPSS (r = 0.971, P ≤ .001). This study suggests that online-based reviews do not have statistically significant correlations with the widely used PGPSS and may not be an accurate source of information for patients. Patients should have access to the most reliable and least biased surveys available to the public to allow for better-informed decisions regarding their health care. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  7. 整形清创美容缝合术处理面部外伤的研究%Study on the treatment of facial trauma by plastic surgery and cosmetic surgery

    Institute of Scientific and Technical Information of China (English)

    周明; 安杏星; 孙同祖; 胡尧; 李章; 李凯

    2015-01-01

    Objective To explore the effect of the treatment of plastic surgery for the treatment of facial trauma patients. Methods 122 patients with facial trauma were treated in our hospital from January 2014 to January in.The patients were divided into conventional group and beauty group according to the random method,61 cases in each group.The conventional group was treated with routine debridement and suture,and the patients were treated with plastic surgery and cosmetic surgery. Results The treatment effect of the patients in the beauty group was significantly higher than that of the conventional group,and the difference between the two groups was statistically significant( P<0.05). Conclusion The treatment of facial trauma patients with plastic surgery and cosmetic surgery can obtain better results,improve the quality of treatment and meet the aesthetic needs of patients.%目的:探究对面部外伤患者应用整形清创美容缝合术治疗的效果.方法:选取本院2014年1月-2015年1月收治的面部外伤患者122例,依照随机方式将其分为常规组与美容组,每组均为61例.对常规组患者实施常规清创缝合处理,对美容组患者采用整形清创美容缝合术治疗.结果:美容组患者的治疗效果明显比常规组患者好,且两组差异具有统计学意义(P<0.05).结论:对面部外伤患者采用整形清创美容缝合术治疗可获取较好效果,提升治疗质量,满足患者的美观需求.

  8. The collection of Adipose Derived Stem Cells using Water Jet Assisted Lipoplasty for their use in Plastic and Reconstructive Surgery: a preliminary study

    Directory of Open Access Journals (Sweden)

    Valeria Purpura

    2016-11-01

    Full Text Available The graft of autologous fat for the augmentation of soft tissue is a common practice frequently used in the field of plastic and reconstructive surgery. In addition, the presence of adipose derived stem cells (ASCs in adipose tissue stimulates the regeneration of tissue in which it is applied after the autologous fat grafting improving the final clinical results. Due to these characteristics, there is an increasing interest in the use of ASCs for the treatment of several clinical conditions. As a consequence, the use of clean room environment is required for the production of cell-based therapies. The present study is aimed to describe the biological properties of adipose tissue and cells derived from it cultured in vitro in clean room environment according to current regulation. The collection of adipose tissue was performed using the water – jet assisted liposuction in order to preserve an high cell viability increasing their chances of future use for different clinical application in the field of plastic and reconstructive surgery.

  9. [Prevention of operational thromboembolic risk in plastic and aesthetic surgery. Analysis of cases, inquiries of practice and recommendations of professional practices].

    Science.gov (United States)

    Raulo, C; Samama, C M; Benhamou, D; Jeandel, T

    2012-08-01

    Thromboembolic accidents are a frightening complication of plastic and aesthetic surgery. The absence of recommendations for professional practices for the prevention of such accidents justified this work. The therapeutic practices of the surgeons were analysed and the results were then compared with those of the international literature. The analysis by a group of experts made it possible to establish recommendations for professional practices. This work consisted in collecting, retrospectively, the therapeutic practices and the complications of 440 surgeons, concerning four types of interventions (abdominoplasty, mammoplasty, abdominal lift and liposuction), from 2006 to 2008, i.e., approximately 110.000 interventions. The intervention with the greatest risk is abdominoplasty with 0.9% of thromboembolic accidents; the intervention with the least risk is mammoplasty with 0.1% of accidents. The risk with the abdominal lift and liposuction of more than three zones is similar and intermediate with 06% of accidents. A protocol of prevention of thromboembolic accidents in plastic surgery is proposed. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  10. 整形美容手术中知情同意的伦理探讨%The investigation of informed consent in the plastic surgery

    Institute of Scientific and Technical Information of China (English)

    沈慧青; 陆尔奕; 吴正一

    2014-01-01

    目的 明确知情同意在整形美容行业中的必要性和重要性,探讨其中隐藏的伦理学意蕴,用知情同意这一重要的伦理原则规范医务人员的行为.方法 使用文献检索法、专家咨询法、抽样调查等方法对整形美容手术中的知情同意情况进行调查,分析实施过程中的规范化情况和遇到的难点和伦理困境.结果 整形美容医师牢牢把握了知情同意这一原则,作为术前常规工作执行,但在实际操作过程中还有些难点.结论 整形美容医生应规范履行知情告知义务,尊重患者的知情权;院方须制定一系列的制度来规范知情同意这一原则.%Object To emphasize the necessity and significance of informed consent in the plastic surgery.Further investigating the ethical implication involved in informed consent principles.To standardize the medical treatment action according to the informed consent principles.Methods Through the literature search method,counseling for experts,sampling surveys and other approaches to elucidate the importancy of informed consent in plastic surgery,to survey and analyze the difficulties and ethical dilemma encountered in the process of standardization.Results Plastic surgeons firmly are aware of the principles of informed consent,as a routine preoperative procedure,however there are still some difficulties in practice.Conclusions To respect the patient's right to know,plastic surgery doctors should be standardized to perform the principle of informed consent; meanwhile hospital should develop a series of systems to regulate the principle of informed consent.

  11. The Medical Mission and Modern Core Competency Training: A 10-Year Follow-Up of Resident Experiences in Global Plastic Surgery.

    Science.gov (United States)

    Yao, Caroline A; Swanson, Jordan; McCullough, Meghan; Taro, Trisa B; Gutierrez, Ricardo; Bradshaw, Allison; Campbell, Alex; Magee, William P; Magee, William P

    2016-09-01

    The emphasis on cultural competency for physicians and surgeons is increasingly important, as communication with both patients and other providers significantly affects individual and system-wide outcomes. International surgical training has been shown to improve leadership skills, cultural competency, and technical proficiency of participants in short-term follow-up. This study explores the long-term impact of international surgical mission experiences on developing participants' core competencies, professional outcomes, and commitment to global health. All 208 plastic and reconstructive surgeons who completed the Operation Smile Regan/Stryker fellowship programs between 2006 and 2015 were surveyed electronically. One hundred sixty-five surveys were returned, for an overall response rate of 79.3 percent. The majority of participants reported that the fellowship positively impacted all six Accreditation Council for Graduate Medical Education core competencies. Most participants who were attending physicians at the time of the survey were practicing general plastic surgery, with 42 percent in an academic/teaching environment, 32 percent in assistant/associate professor positions, and 6 percent in either a program director or department chairman position. The majority currently volunteer on local or international missions, and all respondents would consider volunteering again. Carefully structured and rigorously proctored programs such as the Regan/Stryker Fellowship offer plastic surgery residents the opportunity to gain valuable professional and personal experiences that benefit them long after their service experience. Programs of this nature can not only effectively improve cultural competency of physicians, but also positively influence their attitudes toward leadership and direct that potential to meet the growing need for surgical care in low- and middle-income countries.

  12. Application of Plastic Surgery in Diabetic Foot%整形外科技术在糖尿病足中的应用

    Institute of Scientific and Technical Information of China (English)

    林炜; 朱立群; 卫裴; 李发强

    2016-01-01

    目的:探讨整形外科治疗措施在糖尿病足中的应用,以保留肢体降低伤残率。方法23例患者在控制血糖、抗感染的基础上,根据创面的不同情况,采取个体化的治疗方案。7例简单创面换药,11例游离植皮,3例局部皮瓣修复,2例保守截趾手术。结果23例患者中,7例通过单纯换药愈合,14例通过整形外科技术愈合,保肢成功率91.3%;仅2例因创面较深,保肢失败,通过截肢手术封闭创面痊愈。结论在系统治疗的基础上,结合整形外科的治疗手段,治疗糖尿病足慢性溃疡创面,能够获得满意的效果,大大降低病人伤残率。%Objective To investigate the application of plastic surgery in the treatment of diabetic foot, in order to reduce the rate of disability. Methods Based on the control of blood glucose and anti infection, 23 patients were treated according to the different conditions of the wound. 7 cases of simple wound dressing, 11 cases of skin graft, 3 cases of local skin flaps, 2 cases of conservative amputation surgery. Results Among the 23 cases, 7 cases were healed by dressing change, 14 cases were healed by plastic surgery, and the limb salvage rate was 91.3%. Only 2 cases were failed because of the wound, and the wound healed by amputation. Conclusion On the basis of systematic treatment, combined with plastic surgery treatment, the treatment of diabetic foot chronic ulcer wound, can obtain satisfactory results, greatly reduce the patient's disability rate.

  13. Plastic Surgeons Often Miss Patients' Mental Disorders

    Science.gov (United States)

    ... More Health News on: Mental Disorders Plastic and Cosmetic Surgery Recent Health News Related MedlinePlus Health Topics Mental Disorders Plastic and Cosmetic Surgery About MedlinePlus Site Map FAQs Customer Support Get ...

  14. Otolaryngology in the medical school curriculum: Current trends in the United States.

    Science.gov (United States)

    Boscoe, Elizabeth F; Cabrera-Muffly, Cristina

    2017-02-01

    To identify trends in medical school otolaryngology curriculum requirements. Survey of United States allopathic medical schools. A survey was sent to deans of curriculum at allopathic medical schools. We identified opportunities for medical students to learn basic concepts in otolaryngology during their undergraduate medical training. The opportunities were classified into preclinical and clinical as well as elective and mandatory rotations. Of the schools surveyed, 60% responded. Mean class size was 149 students. Sixty-eight percent of surveyed schools noted that 75% to 100% of their students participated in preclinical otolaryngology experiences, with 59% reporting a mandatory preclinical otolaryngology module for all students. Eighty-nine percent of schools offered otolaryngology as a clinical elective rotation, with a mean of 12 students participating yearly. Only 7% of schools required a mandatory otolaryngology clinical rotation. Our data suggest that medical students do not receive sufficient exposure to otolaryngology during medical school. Increased requirements for otolaryngology curriculum may be beneficial to all medical students, regardless of their specialty choice. NA. Laryngoscope, 00:000-000, 2016 127:346-348, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  15. Gender differences in successful NIH grant funding in otolaryngology.

    Science.gov (United States)

    Eloy, Jean Anderson; Svider, Peter F; Kovalerchik, Olga; Baredes, Soly; Kalyoussef, Evelyne; Chandrasekhar, Sujana S

    2013-07-01

    To evaluate gender differences in NIH funding among faculty in otolaryngology departments and discuss potential reasons for these differences. Analysis of NIH funding data available on the online NIH RePORTER system. Fiscal year 2011 and 2012 NIH funding awards to principal investigators (PIs) in otolaryngology departments were obtained and used to examine faculty listings from otolaryngology departments for academic rank and gender. The Scopus database was used to determine publication range of these faculty members. Individual mean NIH awards to men ($362,946 ± $21,247 standard error of mean) were higher than those to women ($287,188 ± $38,029). Male PIs were found to have higher mean NIH funding totals (aggregating grants for PIs with multiple awards) than female PIs ($498,593 vs $359,276). Upon organization by academic rank and years active, men had significantly higher funding levels at both the level of assistant professor and at 10 to 20 years of experience. Of all NIH grants awarded, men had a higher percentage of the more prestigious R-series grants (76.2%) than did women (63.4%). Male faculty members have higher NIH funding levels than their female colleagues, a disparity that exists separate from career longevity, as it is true both at the rank of assistant professor and for those with 10 to 20 years of research experience. The larger proportion of R-series NIH grants awarded to male faculty may contribute to this finding. This discrepancy in percentage and dollars of funding exists despite the increasing percentages of women in higher ranks.

  16. Does formal research training lead to academic success in otolaryngology?

    Science.gov (United States)

    Bobian, Michael R; Shah, Noor; Svider, Peter F; Hong, Robert S; Shkoukani, Mahdi A; Folbe, Adam J; Eloy, Jean Anderson

    2017-01-01

    To evaluate whether formalized research training is associated with higher researcher productivity, academic rank, and acquisition of National Institutes of Health (NIH) grants within academic otolaryngology departments. Each of the 100 civilian otolaryngology program's departmental websites were analyzed to obtain a comprehensive list of faculty members credentials and characteristics, including academic rank, completion of a clinical fellowship, completion of a formal research fellowship, and attainment of a doctorate in philosophy (PhD) degree. We also recorded measures of scholarly impact and successful acquisition of NIH funding. A total of 1,495 academic physicians were included in our study. Of these, 14.1% had formal research training. Bivariate associations showed that formal research training was associated with a greater h-index, increased probability of acquiring NIH funding, and higher academic rank. Using a linear regression model, we found that otolaryngologists possessing a PhD had an associated h-index of 1.8 points higher, and those who completed a formal research fellowship had an h-index of 1.6 points higher. A PhD degree or completion of a research fellowship was not associated with a higher academic rank; however, a higher h-index and previous acquisition of an NIH grant were associated with a higher academic rank. The attainment of NIH funding was three times more likely for those with a formal research fellowship and 8.6 times more likely for otolaryngologists with a PhD degree. Formalized research training is associated with academic success in otolaryngology. Such dedicated research training accompanies greater scholarly impact, acquisition of NIH funding, and a higher academic rank. NA Laryngoscope, 127:E15-E21, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  17. Otolaryngology externships and the match: Productive or futile?

    Science.gov (United States)

    Thomas, Carissa M; Cabrera-Muffly, Cristina

    2017-10-01

    The objectives of this study were to summarize externship experiences among recent graduates and current residents in otolaryngology residency programs and determine whether externships affect the match process. Cross-sectional survey. A survey was distributed to otolaryngology residents in allopathic US residency programs and otolaryngology graduates from the past 5 years (2011-2015). There were 2,141 surveys distributed. There were 654 subjects who responded, for a 30.5% response rate. Most respondents were residents (n = 438, 67%). Of the residents, 85.6% had completed at least one externship compared to 75.9% of graduates (P = .002). The most common reasons for selecting a particular externship were geographic location (74.2%) and program reputation (71.1%), whereas the most common reason for not completing an externship was being advised not to (59.1%). Furthermore, 82.6% of respondents received at least one interview from their externships, 90% went to those interviews, and 89.1% reported that externship experiences affected their rank list. Respondents had a 32.7% match rate to the externship residency program if it was ranked versus a 48.8% match rate if the program was ranked first. Respondents who matched at the externship residency program matched higher on their rank list (P < .001). Of the respondents, 90.7% found externships to be valuable, and 74.5% recommended completing one. Externships are beneficial because they influence the rank list of applicants and are viewed as valuable experiences. Completing an externship is advisable for the experience, but applicants should weigh the benefits versus the possible risk of being judged more harshly during a month-long rotation. NA Laryngoscope, 127:2242-2246, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  18. 面部软组织损伤的整形美容修复分析%Analysis of Plastic Surgery for Repairing Facial Soft Tissue Injury

    Institute of Scientific and Technical Information of China (English)

    牛兴红

    2014-01-01

    目的:探讨整形美容修复面部软组织损伤的效果。方法:选取本院整形科门诊与住院部在2012年3月~2013年1月间收治的100例面部软组织创伤患者,进行整形美容修复,观察治疗后效果。结果:经过修复治疗后,伤口在Ⅰ期的愈合率为90%。结论:整形美容修复对面部创面进行修复,能够有效的达到较佳的修复效果。%Objective:To study the effect of cosmetic surgery to repair facial soft tissue injuries. Methods:Selecting 100 patients with facial soft tissue trauma in plastic outpatient and inpatient deparments from March,2012 to January,doing cosmetic surgery repair,and observing the therapeutic effect after treatment. Results:After repair therapy,the wound in Ⅰ healing rate was 90%. Conclusion:Cosmetic surgery on facial wounds repair can effectively achieve the best effect.

  19. Plastic bronchitis

    Directory of Open Access Journals (Sweden)

    Anil Kumar Singhi

    2015-01-01

    Full Text Available Plastic bronchitis, a rare but serious clinical condition, commonly seen after Fontan surgeries in children, may be a manifestation of suboptimal adaptation to the cavopulmonary circulation with unfavorable hemodynamics. They are ominous with poor prognosis. Sometimes, infection or airway reactivity may provoke cast bronchitis as a two-step insult on a vulnerable vascular bed. In such instances, aggressive management leads to longer survival. This report of cast bronchitis discusses its current understanding.

  20. Panic in otolaryngology patients presenting with dizziness or hearing loss.

    Science.gov (United States)

    Clark, D B; Hirsch, B E; Smith, M G; Furman, J M; Jacob, R G

    1994-08-01

    This study compared 50 patients presenting to an otolaryngology clinic with a complaint of dizziness and 50 patients presenting with hearing loss on questionnaire measures of panic, phobic avoidance, generalized anxiety, and depression. Clinical and laboratory evaluations of vestibular and audiological complaints were also completed. Twenty percent of the group with dizziness and none of the group with hearing loss reported symptoms that met DSM-III-R criteria for panic disorder. Patients with dizziness and peripheral vestibulopathy had more symptoms of phobic avoidance, generalized anxiety, and depression than patients with confirmed hearing loss.

  1. Assessment and management of pain in pediatric otolaryngology.

    Science.gov (United States)

    Rodríguez, Maria Claudia; Villamor, Perla; Castillo, Tatiana

    2016-11-01

    Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction. The aim of this review is to address the current definitions of pain, its physiological mechanisms and the consequences of its inadequate management, as well as, to guide the clinicians in the assessment and management of pain in the pediatric population at otolaryngology services. Narrative review by selective MeSH search terms: Children, Pediatrics, Otolaryngology, Pain measurement, Pain Management, Analgesics and Analgesia, from databases: MEDLINE/PubMed, Cochrane, ISI, Current Contents, Scielo and LILACS, between January 2000 and May 2016. 129 articles were reviewed according to the requirements of the objectives. Pain measurement is a challenge in children as there are no physical signs that constitute an absolute or specific indicator of pain, and its diagnosis must rely on physiological, behavioral and self-report methods. Regarding treatment, a suitable alternative are the non-pharmacological cognitive/behavioral therapies helped by pharmacological therapies tailored to the severity of pain and the child's age. We provide evidence-based recommendations on pain treatment, including non-opioid analgesics, opioid analgesics and adjuvant medicines to improve the management of pain in children in otolaryngology services. We present a global review about assessment and management of pain in pediatric otolaryngology, which leads to future specific reviews on each topic. Research gaps on pain assessment and

  2. A general review of the otolaryngologic manifestations of Down Syndrome.

    Science.gov (United States)

    Chin, Christopher J; Khami, Maria M; Husein, Murad

    2014-06-01

    Down Syndrome (DS) is the most common chromosome abnormality in liveborn children. Otolaryngologists frequently encounter these patients in their practice; in one survey, 50% of DS patients had been seen by Otolaryngology at least once. As such, it is essential that the practicing Otolaryngologist is aware of the otologic, rhinologic, and laryngologic manifestations of this complex disease and comfortable in the management and treatment of these unique patients. Our goal was to provide this information in a concise and definitive document. A comprehensive literature review using PubMed was completed. The terms "Otolaryngology", "Head and neck", "Ear, nose, throat", "Down Syndrome", and "Trisomy 21" were searched in various combinations. Applicable articles that discussed the Otolaryngologic manifestations of Down Syndrome were included. In total, fifty articles were included for review. The Down Syndrome child tends to have smaller external ear canals, have higher rates of chronic ear disease, and may present with conductive, sensorineural, or mixed hearing loss. As such, DS patients should receive behaviouralaudiological testing every 6 monthsand annually after the age of three in addition to closer follow-up by an Otolaryngologist if tympanic membranes cannot be visualized or if the external auditory canals are significantly stenosed. Management should involve close follow-up and a low threshold for PE tube placement to reduce the risks for speech and language delay. Chronic rhinitis in the Down Syndrome patient is common. Retrognathia, hypotonia, and macroglossia can all cause obstructive sleep apnea (OSA) in this population and therefore each DS patient should get an overnight polysomnograph. Subglottic stenosis, vocal cord paralysis and laryngomalacia are not infrequently seen in the Down Syndrome patient. To reduce acquired subglottic stenosis, endotracheal tubes that are at least two sizes smaller than what is appropriate for the patient's age should be used

  3. The geographic distribution of the otolaryngology workforce in the United States.

    Science.gov (United States)

    Lango, Miriam N; Handorf, Elizabeth; Arjmand, Ellis

    2017-01-01

    To describe the deployment of otolaryngologists and evaluate factors associated with the geographic distribution of otolaryngologists in the United States. Cross-sectional study. The otolaryngology physician supply was defined as the number of otolaryngologists per 100,000 in the hospital referral region (HRR). The otolaryngology physician supply was derived from the American Medical Association Masterfile or from the Medicare Enrollment and Provider Utilization Files. Multiple linear regression tested the association of population, physician, and hospital factors on the supply of Medicare-enrolled otolaryngologists/HRR. Two methods of measuring the otolaryngology workforce were moderately correlated across hospital referral regions (Pearson coefficient 0.513, P = .0001); regardless, the supply of otolaryngology providers varies greatly over different geographic regions. Otolaryngologists concentrate in regions with many other physicians, particularly specialist physicians. The otolaryngology supply also increases with regional population income and education levels. Using AMA-derived data, there was no association between the supply of otolaryngologists and staffed acute-care hospital beds and the presence of an otolaryngology residency-training program. In contrast, the supply of otolaryngology providers enrolled in Medicare independently increases for each HRR by 0.8 per 100,000 for each unit increase in supply of hospital beds (P otolaryngology residency-training program (P = .006), accounting for all other factors. Irrespective of methodology, the supply of otolaryngologists varies widely across geographic regions in the United States. For Medicare beneficiaries, regional hospital factors-including the presence of an otolaryngology residency program-may improve access to otolaryngology services. NA Laryngoscope, 127:95-101, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Factors influencing referral of patients with voice disorders from primary care to otolaryngology.

    Science.gov (United States)

    Cohen, Seth M; Kim, Jaewhan; Roy, Nelson; Courey, Mark

    2014-01-01

    To evaluate the frequency, timing, and factors that influence referral of patients with laryngeal/voice disorders to otolaryngology following initial evaluation by a primary care physician (PCP). Retrospective analysis of a large, national administrative US claims database. Patients with a laryngeal disorder based on International Classification of Diseases, Ninth Revision, Clinical Modification codes from January 1, 2004 to December 31, 2008, seen by a PCP as an outpatient (with or without otolaryngology involvement), and continuously enrolled for 12 months were included. Patient age, gender, geographic region, last PCP laryngeal diagnosis, comorbid conditions, time from first PCP visit to first otolaryngology visit, number of PCP outpatient visits, and number of PCP laryngeal diagnoses were collected. Cox and generalized linear regressions were performed. A total of 149,653 unique patients saw a PCP as an outpatient for a laryngeal/voice disorder, with 136,152 (90.9%) only seeing a PCP, 6,013 (4.0%) referred by a PCP to an otolaryngologist, and 3,820 (2.6%) self-referred to an otolaryngologist. Acute laryngitis had a lower hazard ratio (HR) for otolaryngology referral than chronic laryngitis, nonspecific dysphonia, and laryngeal cancer. Having multiple comorbid conditions was associated with a greater HR for otolaryngology referral than having no comorbidities. Patient age, gender, and geographic region also affected otolaryngology referral. The time to otolaryngology evaluation ranged from 3 months. PCP-referred patients had less time to the otolaryngology evaluation than self-referred patients. Multiple factors affected otolaryngology referral for patients with laryngeal/voice disorders. Further education of PCPs regarding appropriate otolaryngology referral for laryngeal/voice disorders is needed. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  5. 整形外科住院医师医患沟通能力的培养%Experience of resident-patient communication training in plastic surgery

    Institute of Scientific and Technical Information of China (English)

    李杨; 马显杰; 宋保强; 郭树忠

    2016-01-01

    Objective To discuss the resident-patient communication training methods based on the problems of the residents in clinical work of plastic surgery .Methods According to the characteristics of plastic surgery , we analyzed the problems and reasons of the residents in the resident-patient communication.Based on the experience of the faculty in the department of plastic surgery , we proposed the methods of resident-patient communication training. Results Several dos and don'ts were proposed for the problems of the resident-patient communication.And a series of training methods were suggested from the aspects of residents , attending surgeons and the department programs . Conclusion It is vital of the ability of the resident-patient communication in the complicated modern medical environment in China.The discussion of the training methods in this paper is mainly based on the experience of the faculty in our department.A perfect resident-patient training program should be formulated with the experience of developed country and scientific methods.%目的:结合整形外科临床工作中住院医师在医患沟通中存在的问题,探讨医患沟通能力培养方案。方法根据整形外科的执业特点,分析目前住院医师在医患沟通中存在的问题及原因,结合本科室多年的经验,探讨医患沟通能力的培养方案。结果针对医患沟通的问题及原因,提出了注意事项,并从住院医师、上级医师及科室制度层面等多角度提出一系列培养方案。结论整形外科住院医师医患沟通能力在当代复杂的医疗环境下尤为重要,本文对培养方案的探讨是本科室多年经验的总结,为进一步完善培养方案的制定,需要借鉴发达国家的经验,并通过科学方法逐步建立一整套完善的医患沟通培养方案,以适应临床工作的需要。

  6. Procedural Portfolio Planning in Plastic Surgery, Part 1: Strategic Changes in Clinical Practice to Increase Physician Revenue, Improve Operative Throughput, and Maintain Patient Satisfaction.

    Science.gov (United States)

    Hultman, Charles Scott

    2016-06-01

    Portfolio planning in health care represents the strategic prioritization of services that permits an organization to better achieve its goals of margin and mission. Because of recent volatility in the economy, declining reimbursement, and rising costs of providing care, such strategic planning has become increasingly important if physicians want to remain leaders in health care. This project assesses the financial impact of procedural portfolio planning on an academic plastic surgery practice from the physician's perspective. We tracked the top 50 procedures, defined as total charges per CPT code, that were performed in our baseline year, for 6 providers in a stable plastic surgery practice. At the end of the first year, we implemented 3 types of strategic changes: growth of areas with high contribution margin (laser resurfacing of burn scars), curtailment of high-risk procedures with negative contribution margin (panniculectomy in smokers), and improved efficiency of mission-critical services with high resource consumption (free-flap breast reconstruction). During the 2-year study period, we had no turnover in faculty, did not pursue any formal marketing, did not change our surgical fees or billing system, provided care independent of payer mix, and maintained our commitment to indigent care. Outcome measures included procedural charges and revenue, collection rates, work relative value units, operating room times, idle times (room time less case time), receipts/minute in operating room, uncompensated charity care, and patient satisfaction (Press-Gainey scores). Before the study period, annual incremental growth in our practice was 1% to 2%, in terms of charges and receipts. After implementation of the portfolio planning project, the financial position of our division improved significantly, with patient satisfaction rates increasing from 85.5% to 94.1% and charity care remaining constant at US $400,000 per year. Encounters, work relative value units, charges

  7. Application of Traditional Chinese Medicine in Breast Cosmetic Plastic Surgery%中医在乳房整形术后的应用

    Institute of Scientific and Technical Information of China (English)

    周德晔

    2014-01-01

    Objective:To investigate the value of Chinese medicine in breast plastic surgery. Methods:Selecting 50 patients with breast plastic surgery in the hospital were randomly divided into the control group and the study group, with 25 cases in each group. The control group had routine postoperative recovery treatment, and the study group had conventional therapy combined with traditional Chinese medicine to restore treatment. Congestion, edema, pain and other symptoms after 7d were compared. Results:Discomfort index of the patients in the study group was significantly lower than the control group. So the difference was statistically significant (P <0.05). Conclusion:The combined Chinese medicine treatment of breast plastic surgery can effectively reduce the incidence of symptoms and indicators of postoperative recovery and psychological effects are helpful, and is worthy of clinical use.%目的:探讨中医药在乳房美容整形手术后的应用价值。方法:选取我院实施乳房美容整形手术术后患者50例,随机分为对照组和研究组两组各25例,其中对照组在术后进行常规恢复治疗;研究组采取常规恢复治疗联合中医药治疗,对比两组患者术后7d淤血、水肿、疼痛等不适症状。结果:研究组患者不适症状指数明显低于对照组患者,差异具有统计学意义(P<0.05)。结论:采用联合中医药治疗能够有效降低乳房美容整形手术后的不适症状发生率和指数,对患者术后恢复效果及心理具有很大程度上的帮助作用,值得临床推广使用。

  8. [52th Commemoration of French Journal of Plastic Aesthetic Surgery (1956-2007). Fifty-four years of editorial; five Editors-in-chief].

    Science.gov (United States)

    Cariou, J-L

    2007-08-01

    The french Society of Plastic Reconstructive and Aesthetic Surgery (SOF.CPRE) is born December 3th 1952. Initially without "aesthetic", this "key-word" is agreed in 1983 and the symbols are advanced since: SFCPR, SFCPRE, SOF.CPRE. Its official organ, formerly included in Annales de chirurgie (1954-1955), become Annales de chirurgie plastique in 1956, Annales de chirurgie plastique et esthétique in 1983 and finally Annales de chirurgie plastique esthétique (ACPE) in 1992. Since the origin, five Editors-in-chief succeded: Claude Dufourmentel, Raymond Vilain, Jean-Pierre Lalardrie, Claude Lê-Quang, Jean-Luc Cariou. Four of them are alive, Raymond Vilain is dead. The author relate here the natural story of these five editors who had all a triple route: personnal, surgical and editorial.

  9. Under the microscope: assessing surgical aptitude of otolaryngology residency applicants.

    Science.gov (United States)

    Carlson, Matthew L; Archibald, David J; Sorom, Abraham J; Moore, Eric J

    2010-06-01

    Application to otolaryngology residency is a highly competitive process. Programs identify the best candidates by evaluating academic performance in medical school, board scores, research experience, performance during an interview, and letters of recommendation. Unfortunately, none of these metrics completely assess an applicant's capacity to learn and perform surgical skills. We describe a direct assessment of an applicant's ability for rapid surgical skill acquisition, manual dexterity, and response to stress that can be performed during the interview process. A retrospective study at an academic otolaryngology residency program. After orientation, applicants were seated at a microsurgical training station and allotted 20 minutes to suture an incision using 10-0 nylon suture on a latex practice card. Their performance was graded using a 1-to-5 scoring system for the following categories: microscope use, respect for tissue, instrument handling, knot tying and suture control, skills acquisition, and attitude toward the exercise. Applicants were given some instruction and assessed on their ability to incorporate what they had learned into their technique. The average total applicant score was 23.2, standard deviation (SD) 3.6 (maximum 30); 13.4% of applicants scored 1 SD above the mean. The value of applicant screening tests in predicting surgical competency is controversial. We describe a direct assessment tool that may prove useful in identifying outliers, both high and low, to aid in final applicant ranking.

  10. Risk of contamination of nasal sprays in otolaryngologic practice

    Directory of Open Access Journals (Sweden)

    Akkuzu Babur

    2007-03-01

    Full Text Available Abstract Background Reusable nasal-spray devices are frequently used in otolaryngologic examinations, and there is an increasing concern about the risk of cross-contamination from these devices. The aim of our study was to determine, by means of microbiologic analysis, the safety of a positive-displacement or pump-type atomizer after multiple uses. Methods A reusable nasal spray bottle, pump, and tips were used in the nasal physical examination of 282 patients admitted to a tertiary otolaryngology clinic. The effectiveness of 2 different methods of prophylaxis against microbiologic contamination (the use of protective punched caps or rinsing the bottle tip with alcohol was compared with that of a control procedure. Results Although there was no statistically significant difference in positive culture rates among the types of nasal spray bottles tested, methicillin-resistant coagulase-negative staphylococci were isolated in 4 of 198 cultures. Conclusion Given these findings, we concluded that additional precautions (such as the use of an autoclave between sprays, disposable tips, or disposable devices are warranted to avoid interpatient cross-contamination from a reusable nasal spray device.

  11. Quantifying Medical Student Education and Exposure to Otolaryngology.

    Science.gov (United States)

    Wong, Kevin; Jang, Minyoung; Gilad, Amir; Levi, Jessica R

    2017-06-01

    Evaluate the educational and exposure opportunities provided to students by national otolaryngology organizations. Twenty-four otolaryngology organizations and subspecialty societies were reviewed for medical student involvement opportunities, educational and enrichment opportunities, costs of involvement, and available research and travel scholarships. Nine organizations (37.5%) offered membership; 6 charged a membership fee, averaging $73 ± $30 (mean ± SD). Membership was limited to associate status for 7 organizations (77.8%; 7/9). Three organizations (12.5%) provided service opportunities, 4 (16.7%) allowed students to vote, and 1 (4.2%) allowed students to endorse others for membership. Most organizations allowed students to attend conferences (95.8%), and 19 (79.2%) allowed students to present research. Twenty-one (87.5%) organizations charged a conference registration fee ($366 ± $300). Seven organizations (29.2%) offered research scholarships, and 5 (20.8%) offered travel awards. Opportunities exist for medical students to attend conferences and present research; however, educational and enrichment activities in other areas were limited. Future efforts may be warranted to increase the number and type of opportunities for students.

  12. Indications and Outcomes of the Components Separation Technique in the Repair of Complex Abdominal Wall Hernias: Experience From the Cambridge Plastic Surgery Department

    Science.gov (United States)

    Adekunle, Shola; Pantelides, Nicholas M.; Hall, Nigel R.; Praseedom, Raaj; Malata, Charles M.

    2013-01-01

    Objectives: The components separation technique (CST) is a widely described abdominal wall reconstructive technique. There have, however, been no UK reports of its use, prompting the present review. Methods: Between 2008 and 2012, 13 patients who underwent this procedure by a single plastic surgeon (C.M.M.) were retrospectively evaluated. The indications, operative details, and clinical outcomes were recorded. Results: There were 7 women and 6 men in the series with a mean age of 53 years (range: 30-80). Patients were referred from a variety of specialties, often as a last resort. The commonest indication for CST was herniation following abdominal surgery. All operations except 1 were jointly performed with general surgeons (for bowel resection, stoma reversal, and hernia dissection). The operations lasted a mean of 5 hours (range: 3-8 hours). There were no major intra- and postoperative problems, except in 1 patient who developed intra-abdominal compartment syndrome, secondary to massive hemorrhage. All patients were satisfied with the cosmetic improvement in their abdominal contours. None of the patients have developed a clinical recurrence after a mean follow-up of 16 months (range: 3-38 months). Conclusions: The components separation technique is an effective method of treating large recalcitrant hernias but appears to be underutilized in the United Kingdom. The management of large abdominal wall defects requires a multidisciplinary approach, with input across a variety of specialities. Liaison with plastic surgery teams should be encouraged at an early stage and the CST should be more widely considered when presented with seemingly intractable abdominal wall defects. PMID:24058718

  13. IOL Implants: Lens Replacement and Cataract Surgery (Intraocular Lenses)

    Science.gov (United States)

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center ...

  14. Use of selfie sticks and iPhones to record operative photos and videos in plastic surgery.

    Science.gov (United States)

    Chandrappa, Ashok Basur; Nagaraj, Pradeep Kumar; Vasudevan, Srikanth; Nagaraj, Anantheswar Yelampalli; Jagadish, Krithika; Shah, Ankit

    2017-01-01

    Use of smartphone has become ubiquitous. With smartphone cameras becoming powerful, they are replacing digital cameras and digital SLRs as primary instruments to take photos and record videos. It is natural even for plastic surgeons that smartphones are handy to take still photographs and even record high-definition or 4K videos. Another invention which has become popular with smartphone photography is a selfie stick. We explain the possibility and methodology of using an iPhone and selfie stick to take operative photographs and high-quality videos.

  15. Use of selfie sticks and iPhones to record operative photos and videos in plastic surgery

    Directory of Open Access Journals (Sweden)

    Ashok Basur Chandrappa

    2017-01-01

    Full Text Available Use of smartphone has become ubiquitous. With smartphone cameras becoming powerful, they are replacing digital cameras and digital SLRs as primary instruments to take photos and record videos. It is natural even for plastic surgeons that smartphones are handy to take still photographs and even record high-definition or 4K videos. Another invention which has become popular with smartphone photography is a selfie stick. We explain the possibility and methodology of using an iPhone and selfie stick to take operative photographs and high-quality videos.

  16. Periodontal Plastic Surgery to Improve Aesthetics in Patients with Altered Passive Eruption/Gummy Smile: A Case Series Study

    OpenAIRE

    Francesco Cairo; Filippo Graziani; Lorenzo Franchi; Efisio Defraia; Giovan Paolo Pini Prato

    2012-01-01

    Altered passive eruption/gummy smile is a common challenge in patients requiring aesthetic treatment. A specific surgical protocol was designed and tested in patients with altered passive eruption. Standardized preoperative X-rays were used to assess crown length at baseline and to place submarginal incisions. Osseous respective therapy was performed to achieve biological width. Clinical outcomes were recorded 6 months after surgery. Eleven patients with a total of 58 teeth were treated with ...

  17. Otolaryngologic findings in prepubertal obese children with sleep-disordered breathing.

    Science.gov (United States)

    de Sousa Caixêta, Juliana Alves; Saramago, Alex Martins; Moreira, Gustavo Antonio; Fujita, Reginaldo Raimundo

    2013-10-01

    To evaluate otolaryngologic findings in obese prepubertal children with sleep-disordered breathing. We prospectively evaluated 29 obese children referred by pediatric endocrinologist, complaining of snoring and without a history of nasal surgery or removal of the palatine tonsils and/or adenoids. Patients underwent ear, nose and throat (ENT) examination, endoscopy, measurements of weight, height, calculation of body mass index (BMI), assessment of BMI z-score and polysomnography, from which were divided into two groups: those with obstructive sleep apnea syndrome (nine children) and those with primary snoring (20 children). Then we proceeded to the statistical analysis of the data collected. The groups did not differ in age, gender, weight, height, BMI and BMI z-score. Among the findings of the ENT examination, the adenoid size was the only one that differed between the groups (p = 0.01). The evaluation of the adenoid size is an important in obese children with symptoms of sleep-disordered breathing and is related to the presence of obstructive sleep apnea syndrome. Published by Elsevier Ireland Ltd.

  18. A Video-Based Module for Teaching Communication Skills to Otolaryngology Residents.

    Science.gov (United States)

    Patki, Aniruddha; Puscas, Liana

    2015-01-01

    To determine whether instructional videos modeling examples of "good" and "bad" patient communication skills are useful as an educational tool for improving resident-patient communication. Retrospective study in which resident participants in the module gave survey responses indicating perceived utility of the exercise. Tertiary academic medical center. A total of 11 otolaryngology trainees from postgraduate year 1-5 who attended the course over 2 separate sessions and provided feedback on the benefits of the module. All 11 residents attended both sessions. Of 22 total survey responses, 21 found that the videos were "realistic and engaging" and were a true representation of commonly encountered clinical scenarios. Residents identified multiple themes and behaviors distinguishing "good" vs "bad" communication with patients and felt they could incorporate these into daily practice. A perceived weakness was the lack of opportunity for "role playing" with a video-based module as opposed to standardized patients. Instructional videos, when realistic, are useful for modeling effective patient communication skills for residents. By watching the videos, residents are able to identify specific techniques they can incorporate into their daily practice. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  19. Melting the Plastic Ceiling: Overcoming Obstacles to Foster Leadership in Women Plastic Surgeons.

    Science.gov (United States)

    Silva, Amanda K; Preminger, Aviva; Slezak, Sheri; Phillips, Linda G; Johnson, Debra J

    2016-09-01

    The underrepresentation of women leaders in plastic surgery echoes a phenomenon throughout society. The importance of female leadership is presented, and barriers to gender equality in plastic surgery, both intrinsic and extrinsic, are discussed. Strategies for fostering women in leadership on an individual level and for the specialty of plastic surgery are presented.

  20. 韦伯斯特与中国整形外科的蕴育%American surgeon J.P.Webster and the beginning of plastic surgery in China

    Institute of Scientific and Technical Information of China (English)

    胡俊; 甄橙; 李东

    2011-01-01

    目的 研究美国医生韦伯斯特在中国整形外科早期发展过程中所扮演的角色和所起的作用.方法 通过查阅哥伦比亚大学图书馆馆藏档案资料、检索相关文献、资料分析并辅以口述历史的研究方法.结果 获得了韦伯斯特两次来华的经历资料和1948年上海整形外科学习班的细节.了解了参加过这次学习班的中围医生以后所从事的工作,特别是朱洪荫、汪良能和张涤生.客观评价了韦伯斯特在中国整形外科学的发展上所起到的作用.结论 韦伯斯特于20世纪20年代较早地在北京协和医院开展整形外科临床实践,后又通过上海整形外科学习班启发了中国最早一批专门从事整形外科的医生.%Objective To investigate the role of American plastic surgeon Jerome P. Webster in the history of plastic surgery in China. Methods The archives stored in J. P. Webster' s library and documents are analyzed and information is also collected by interviewing some senior plastic surgeon ( oral history). Results The experience of Webster in China for two times and the documents about the Shanghai plastic surgery course in 1948 were acquired. The doctors who participated the Shanghai plastic surgery course were studied for their career, especially Hongyin Zhu, Liangneng Wang, and Disheng Zhang. The role of Webster in the development of plastic surgery in China was evaluated objectively. Conclusions Webster started his career in Peking Union Medical College at early 1920s, who went back to China in 1948 to enlighten the first group of Chinese plastic surgeon in Shanghai plastic surgery course.

  1. Think small: nanotechnology for plastic surgeons.

    Science.gov (United States)

    Nasir, Amir R; Brenner, Sara A

    2012-11-01

    The purpose of this article is to introduce the topic of nanotechnology to plastic surgeons and to discuss its relevance to medicine in general and plastic surgery in particular. Nanotechnology will be defined, and some important historical milestones discussed. Common applications of nanotechnology in various medical and surgical subspecialties will be reviewed. Future applications of nanotechnology to plastic surgery will be examined. Finally, the critical field of nanotoxicology and the safe use of nanotechnology in medicine and plastic surgery will be addressed.

  2. Expressions and Roles of Periostin in Otolaryngological Diseases

    Directory of Open Access Journals (Sweden)

    Nobuo Ohta

    2014-01-01

    Full Text Available Periostin is a 90-kDa member of the fasciclin-containing family; it functions as part of matricellular proteins, and its production by airway epithelial cells is induced by IL-4 and IL-13. Periostin is secreted by fibroblasts and upregulated in the airway epithelia of patients with bronchial asthma; it is considered to contribute to remodeling under this pathological condition. However, despite many studies in diverse research areas, our overall understanding of this intriguing molecule is still inadequate. Here, we integrate the available evidence on periostin expression and its roles in otolaryngological diseases, including allergic rhinitis, chronic rhinosinusitis with nasal polyps, aspirin-induced asthma, organized hematoma, eosinophilic otitis media, and IgG4-related disease. Periostin might be involved as an important structural mediator in pathological processes such as insult and injury, Th2-driven inflammation, extracellular matrix restructuring, fibrosclerosis, tumor angiogenesis, and tissue remodeling.

  3. Confounding Effect in Clinical Research of Otolaryngology and Its Control.

    Science.gov (United States)

    Yu, Yong-qiang; Huang, Dong-yan; Armijo Olivo, Susan; Yang, Huai-an; Bambanini, Yagesh; Sonnenberg, Lyn; Clark, Brenda; Constantinescu, Gabriela; Qian Yu, Jason; Zhang, Ming

    2015-06-01

    Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research's conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research's design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research's design in which appropriate methods have been applied to prevent this effect.They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.

  4. Confounding Effect in Clinical Research of Otolaryngology and Its Control

    Institute of Scientific and Technical Information of China (English)

    Yong-qiang Yu; Ming Zhang; Dong-yan Huang; Susan Armijo Olivo; Huai-an Yang; Yagesh Bambanini; Lyn Sonnenberg; renda Clark; Gabriela Constantinescu; Jason Qian Yu

    2015-01-01

    Confounding effect is a critical issue in clinical research of otolaryngology because it can distort the research’s conclusion. In this review, we introduce the definition of confounding effect, the methods of verifying and controlling the effect. Confounding effect can be prevented by research’s design, and adjusted by data analysis. Clinicians would be aware and cautious about confounding effect in their research. They would be able to set up a research’s design in which appropriate methods have been applied to prevent this effect. They would know how to adjust confounding effect after data collection. It is important to remember that sometimes it is impossible to eliminate confounding effect completely, and statistical method is not a master key. Solid research knowledge and critical thinking of our brain are the most important in controlling confounding effect.

  5. Standardized Letter of Recommendation for Otolaryngology Residency Selection

    Science.gov (United States)

    Perkins, Jonathan N.; Liang, Conan; McFann, Kim; Abaza, Mona M.; Streubel, Sven-Olrik; Prager, Jeremy D.

    2013-01-01

    Objectives/Hypothesis Develop a standardized letter of recommendation (SLOR) for otolaryngology residency application that investigates the qualities desired in residents and letter writer’s experience. Compare this SLOR to narrative letters of recommendation (NLOR). Study Design Prospective SLOR/NLOR Comparison. Methods The SLOR was sent to a NLOR writer for each applicant. The applicant’s NLOR/SLOR pair was blinded and ranked in seven categories by three reviewers. Inter-rater reliability and NLOR/SLOR rankings were compared. Means of cumulative NLOR and SLOR scores were compared to our departmental rank list. Results Thirty-one SLORs (66%) were collected. The SLORs had higher inter-rater reliability for applicant’s qualifications for otolaryngology, global assessment, summary statement, and overall letter ranking. Writer’s background, comparison to contemporaries/predecessors, and letter review ease had higher inter-rater reliability on the NLORs. Mean SLOR rankings were higher for writer’s background (p=0.0007), comparison of applicant to contemporaries/predecessors (p=0.0031), and letter review ease (p<0.0001). Mean SLOR writing time was 4.17±2.18 minutes. Mean ranking time was significantly lower (p<0.0001) for the SLORs (39.24±23.45 seconds) compared to the NLORs (70.95±40.14 seconds). Means of cumulative SLOR scores correlated with our rank list (p=0.004), whereas means of cumulative NLOR scores did not (p=0.18). Means of cumulative NLOR and SLOR scores did not correlate (p=0.26). Conclusions SLORs require little writing time, save reviewing time, and are easier to review compared to NLORs. Our SLOR had higher inter-rater reliability in 4 of 7 categories and was correlated with our rank list. This tool conveys standardized information in an efficient manner. PMID:23172646

  6. Beauty is in the eye of the beholder: body dysmorphic disorder in ophthalmic plastic and reconstructive surgery.

    Science.gov (United States)

    McConnell, Lindsay K; Lee, Wendy W; Black, Donald W; Shriver, Erin M

    2015-01-01

    Despite the fact that up to 15% of patients in an aesthetic surgery practice have body dysmorphic disorder (BDD), little has been written about the condition in the oculoplastic literature. The authors describe 3 patients with suspected BDD who presented with perceived periocular defects. To appear "Asian," a 39-year-old Hispanic woman underwent over 30 surgeries. She developed disfiguring scars and lagophthalmos with corneal scarring, remained unsatisfied, and tragically committed suicide. A 52-year-old woman with moderate dermatochalasis underwent a blepharoplasty to improve her vision and appearance and help her gain employment. Despite a good outcome, she remained dissatisfied and blamed the surgeon for her unemployment. Finally, a 73-year-old woman presented demanding treatment for brow rhytids causing severe emotional distress. She was denied intervention due to unrealistic expectations. These patients are suspected to be suffering from BDD. Increased awareness is critical as BDD patients often remain unsatisfied after surgical intervention and are in need of psychiatric care.

  7. International Pediatric Otolaryngology Group (IPOG) consensus recommendations : Hearing loss in the pediatric patient

    NARCIS (Netherlands)

    Liming, Bryan J; Carter, John; Cheng, Alan; Choo, Daniel; Curotta, John; Carvalho, Daniela; Germiller, John A; Hone, Stephen; Kenna, Margaret A; Loundon, Natalie; Preciado, Diego; Schilder, Anne; Reilly, Brian J; Roman, Stephane; Strychowsky, Julie; Triglia, Jean-Michel; Young, Nancy; Smith, Richard J H

    OBJECTIVE: To provide recommendations for the workup of hearing loss in the pediatric patient. METHODS: Expert opinion by the members of the International Pediatric Otolaryngology Group. RESULTS: Consensus recommendations include initial screening and diagnosis as well as the workup of

  8. Resident Involvement in Professional Otolaryngology Organizations: Current Trends in the United States.

    Science.gov (United States)

    Wong, Kevin; Jang, Minyoung; Gilad, Amir; Levi, Jessica R

    2017-08-01

    Involvement by residents in professional medical organizations can enrich their training, but little data exist regarding the number and types of involvement opportunities available to otolaryngology residents. We sought to fill this gap in knowledge by quantifying the extent to which major otolaryngology-related organizations in the United States provide involvement opportunities to otolaryngology residents. Our analysis included 23 organizations and subspecialty societies. Results showed that many opportunities exist for residents to attend conferences and present research; however, fewer involvement and funding opportunities existed in any other leadership, health policy, or service-learning experiences. These findings were consistent across general and subspecialty societies. Given the many purported benefits of resident involvement in otolaryngology outside of the standard training environment, future efforts may be warranted to increase the number and type of involvement opportunities currently available in professional societies.

  9. Resultsobservation of VSD in reducing plastic surgery infection%VSD在降低整形外科感染中的效果观察

    Institute of Scientific and Technical Information of China (English)

    李娜; 方园; 钱洪军; 陈铮; 郭燕飞

    2014-01-01

    Objective To explore the clinical effect of VSD in reducing plastic surgery infection. Methods 86 patients with cosmetic plastic surgery in our hospital from March 2011 to October 2013, they were divided into observation group and control group, 43 cases in each group, the control group was given conventional treatment process, the observation group was given the VSD treatment, the treatment effect, wound repair time and the incidence of infection in two groups were compared. Results The wound healed well, no solutions in 40 cases (93.02%) of observation group, the wound healed well, no solutions in 34 cases (79.07%) of observation group, the difference was statistically significant (P<0.05). patients with 1 week the healing rate was 48.8%in observation group, significantly higher than the control group 20.9%, the difference was statistically significant (P<0.05). The infection rate was 4.65%in observation group, the control group was 18.60%, the difference was statistically significant (P<0.05). Conclusion The VSD in reducing plastic surgery infection in clinical effect is remarkable.%目的:探讨VSD在降低整形外科感染中的临床效果。方法将本院2011年3月~2013年10月整形外科收治的86例整形患者分为观察组和对照组,每组各43例,对照组给予常规换药处理,观察组给予VSD治疗,比较两组患者的治疗效果、创面修复时间和感染发生率。结果观察组患者的创面愈合良好、无渗液者40例(93.02%),对照组创面愈合良好、无渗液者34例(79.07%),两组间比较,差异有统计学意义(P<0.05)。观察组患者的1周愈合率为48.8%,明显高于对照组的20.9%,两组间比较,差异有统计学意义(P<0.05)。观察组患者的感染发生率为4.65%,对照组为18.60%,两组间比较,差异有统计学意义(P<0.05)。结论 VSD在降低整形外科感染中的临床效果显著。

  10. Otoplasty (Cosmetic Ear Surgery)

    Science.gov (United States)

    ... By Mayo Clinic Staff Otoplasty — also known as cosmetic ear surgery — is a procedure to change the ... Society of Plastic Surgeons. http://www.plasticsurgery.org/Cosmetic-Procedures/Ear-Surgery.html. Accessed June 16, 2015. ...

  11. An analysis of registered clinical trials in otolaryngology from 2007 to 2010: ClinicalTrials.gov.

    Science.gov (United States)

    Witsell, David L; Schulz, Kristine A; Lee, Walter T; Chiswell, Karen

    2013-11-01

    To describe the conditions studied, interventions used, study characteristics, and funding sources of otolaryngology clinical trials from the ClinicalTrials.gov database; compare this otolaryngology cohort of interventional studies to clinical visits in a health care system; and assess agreement between clinical trials and clinical activity. Database analysis. Trial registration data downloaded from ClinicalTrials.gov and administrative data from the Duke University Medical Center from October 1, 2007 to September 27, 2010. Data extraction from ClinicalTrials.gov was done using MeSH and non-MeSH disease condition terms. Studies were subcategorized to create the following groupings for descriptive analysis: ear, nose, allergy, voice, sleep, head and neck cancer, thyroid, and throat. Duke Health System visits were queried by using selected ICD-9 codes for otolaryngology and non-otolaryngology providers. Visits were grouped similarly to ClinicalTrials.gov for further analysis. Chi-square tests were used to explore differences between groups. A total of 1115 of 40,970 registered interventional trials were assigned to otolaryngology. Head and neck cancer trials predominated. Study models most frequently incorporated parallel design (54.6%), 2 study groups (46.6%), and randomization (69.1%). Phase 2 or 3 studies constituted 46.4% of the cohort. Comparison of the ClinicalTrials.gov database with administrative health system visit data by disease condition showed discordance between national research activity and clinical visit volume for patients with otolaryngology complaints. Analysis of otolaryngology-related clinical research as listed in ClinicalTrials.gov can inform patients, physicians, and policy makers about research focus areas. The relative burden of otolaryngology-associated conditions in our tertiary health system exceeds research activity within the field.

  12. Plastic Surgery for Repairing Facial Soft Tissue Injury%面部软组织损伤的整形美容修复

    Institute of Scientific and Technical Information of China (English)

    李咏红

    2014-01-01

    Objective:To investigate the effects and the application of cosmetic repair of patients with injury of facial soft tissue. Method:130 patients for surgery from February,2012 to December,2013 were selected,high-tech means and minimally invasive techniques was used,and plastic repair of facial soft tissue injury was adopted. Result:The repair effect is ideal with good functional recovery,without infection, hematoma and skin flap necrosis. After 1~12 months follow-up,rehabilitation effect was significant. Conclusion:The facial soft tissue injury of the situation is more complicated,and recovery effect is not ideal by using the traditional plastic method. The new technology and minimally invasive technique for facial repair is used with significant effect.%目的:探讨面部软组织损伤患者整形美容修复效果以及应用方法。方法:我所选取2012年2月至2013年12月间进行整容的130例患者,采用高科技手段与微创技术,进行面部软组织损伤的整形美容修复。结果:修复效果理想,功能恢复良好,且未出现感染、皮瓣坏死以及血肿等情况。随访1~12月后,康复效果显著。结论:面部软组织损伤的情况较为复杂,利用传统整形美容方法恢复效果不理想,我们采用新型科技手段与微创技术进行面部修复,效果显著。

  13. What is the Ultimate Fate of Presented Abstracts? Conversion Rates of Presentations to International Publications from the 31st National Congress of Plastic, Reconstructive, and Aesthetic Surgery

    Directory of Open Access Journals (Sweden)

    Burak Ersoy

    2016-03-01

    Full Text Available Objective: Oral and poster presentations held at national congresses are regarded as important means for sharing of latest scientific data and personal experiences. However, many ideas shared at annual conferences fail to be published. The objective of this study was to examine the publication rate of presentations held at the 31st National Congress of the Turkish Society of Plastic Reconstructive and Aesthetic Surgeons and to analyze various factors associated with publication. Material and Methods: The PubMed database was searched for peer-reviewed publications, corresponding to abstracts presented at the 2009 congress. For all abstracts, parameters including presentation type, topic, institution, author details, publication time, journal name, and impact factor were recorded. Collected data were analyzed using chi-square, Mann–Whitney U, and Kruskal–Wallis tests for statistical significance. Results: In five years 16.8% of 569 proceedings were published in international peer-reviewed journals. The mean time to publication following the congress was 22 months (1–57 months for 75 presentations, whereas 21 proceedings had been published prior to the congress. Compared with posters, the publication rate for oral presentations was significantly greater (30.5% vs. 13.3%; p<0.001. The type of institution had no significant effect on the publication rate. Conclusion: The overall publication rate for the 31st National Plastic Surgery Congress was found to be similar with other Turkish-based studies, but was somewhat lower than that of international counterparts. The significant difference found between the publication rates of oral and poster presentations was interpretted as a positive sign demonstrating a relatively higher level of scientific value and appeal.

  14. 烧伤整形患儿的围手术期护理%Peri operation period nursing of burn and plastic surgery in children

    Institute of Scientific and Technical Information of China (English)

    魏玉建; 张海霞

    2014-01-01

    Objective:Analysis of peri operation period nursing method of burn and plastic surgery in children. Methods:Burn patients in our hospital were selected randomly were 90 cases,the staging of the observation group and the control group with 45 cases in each group,the control group routine nursing for patients in peri operation period nursing,the two groups of children with infection,psychological anxiety, arthrogryposis and compare. Results:After the different nursing models,observation group were significantly better than the control group(P<0.05)have significant differences,with statistical significance. Conclusion:To burn and plastic surgery with peri operation period nursing,it is worth promoting in clinical use.%目的:分析烧伤整形患儿的围手术期护理方法。方法:选取我院收治的烧伤整形患儿共90