Wed, 28 October 2015
OTO: Geographic Variation of Endoscopic Sinus Surgery in Canada: An Alberta-Based Small Area Variation Analysis
This podcast highlights a systematic review and meta-analysis published in the November 2015 issue of Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief John Krouse is joined by senior author Luke Rudmik and associate editor Gordon Sun in discussing geographic variation in the use of endoscopic sinus surgery.
The phenomenon of geographic variation in the delivery of health care has been recognized for decades. Variation in small areas can be a driver of health care costs and is associated with differences in the utilization of both medical and surgical services. The importance of variation in both the cost and the quality of care has been highlighted by many, including several impactful publications by Atul Gawande. In the present study, Dr. Rudmik and colleagues review differences in the number of endoscopic sinus surgical procedures in the province of Alberta, Canada, and demonstrate that significant differences can occur in proximate geographic areas, much as the authors have previously noted in the United States. In this podcast, Dr. Rudmik discusses the measurement of geographic variation, the findings from his important study, and the implications for both practice and further investigation. Drs. Rudmik and Sun then discuss the implications of these interesting observations for health care delivery and some of their potential causes, as well as examining the importance of additional research in further characterizing the nature of surgical variation in otolaryngology.
Tue, 6 October 2015
This podcast highlights a systematic review and meta-analysis published in the October 2015 issue of Otolaryngology - Head and Neck Surgery, the official journal of the American Academy of Otolaryngology - Head and Neck Surgery (AAO-HNS) Foundation. Editor in chief John Krouse is joined by senior author Nausheen Jamal and associate editor Kenneth Altman in discussing partial epiglottoplasty for specific forms of pharyngeal dysphagia.
Patients commonly experience difficulty swallowing due to structural abnormalities that impinge on their normal pharyngeal anatomy. In these patients various pathologies, such as severe cervical osteophytes or the presence of cervical spinal hardware, can interfere with their ability to swallow smoothly and successfully. In this study, Dr. Jamal describes a simple transoral procedure that was demonstrated to significantly improve swallowing in this select group of 12 individuals with pharyngeal dysphagia. In this podcast, she discusses this procedure as well as the outcomes of its use to treat dysphagia. Drs. Jamal and Altman then discuss the implications of these interesting findings and the potential complications that could arise, as well as examining the need for additional research in expanding and further demonstrating the role for this innovative procedure.