Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic

Importance The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists–head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19

Needs Assessment in Head and Neck Surgical Oncology Training: A Qualitative Study of Expert Opinions

Head and neck surgical training in North America has had a long and distinguished history; however, few studies have aimed to assess needs in fellowships accredited by the American Head and Neck Society (AHNS). Furthermore, the need for a formal certification process has been vigorously debated by the AHNS leadership and the community of head and neck surgeons. To characterize the current state of head and neck surgery training and identify areas for improvement, we conducted interviews with fifty-eight program directors and senior faculty in head and neck surgery. We found that all experts were in favor of a national standardized curriculum. The most commonly mentioned elements of a standard curriculum included multidisciplinary exposure, participation in a regular tumor board, a recommended reading list, balance of clinic and operating time, and a detailed case log. The majority of experts believed that a formal certification process would be beneficial, though there was no consensus as to the optimal format. Additionally, opinions were mixed regarding whether accreditation by the Accreditation Council for Graduate Medical Education (ACGME) should be pursued

AHNS Series: Do you know your guidelines? Evidence-based management of oral cavity cancers

© 2017 Wiley Periodicals, Inc. Oral cavity squamous cell carcinoma (OCSCC) is the most common nonmelanoma head and neck cancer in the world, with an estimated 405 000 new cases expected each year. Subsites of the oral cavity include the alveolar ridge, buccal mucosa, anterior tongue, tonsillar pillar, retromolar trigone, hard palate, gingiva, and floor of the mouth. In this issue of the AHNS “Do you know your guidelines?” series, we review the evidence-based approach to the management of oral cavity carcinomas based on the framework provided by the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology

Qualitative assessment of online information available on accredited head and neck surgery fellowship programs

Background The present study aims to assess the quality and availability of online information about fellowships accredited by the American Head & Neck Society (AHNS). Methods AHNS directory pages and institutional web sites of 50 AHNS‐accredited fellowships were identified. Web pages were scored using 20 standardized criteria including general information, application information, alumni, surgical training, research, and quality‐of‐life. Results Median scores for AHNS directory pages and institutional web sites were 11 (range: 7–14) and 10 (4–15), respectively. Faculty listings, contact information, program location, number of positions, and breadth of surgical exposure were the most commonly listed criteria. Less common criteria included didactic schedule, protected academic time, previous research projects, year of accreditation, work‐life balance, fellow selection criteria, interview information, and salary. Conclusions The AHNS directory and institutional web sites are most comprehensive in general program information and details about surgical training. Information about the application process, work‐life balance, and research opportunities were less common

Distribution of the head and neck surgical oncology workforce in the United States

BACKGROUNDThe recent trends in education and geographic distribution of the head and neck surgery workforce have not been studied extensively. METHODSWe reviewed publicly available sources to locate all fellowship-trained head and neck surgeons and recent graduates. The number of surgeons in each state was compared against head and neck cancer incidence data from the Centers for Disease Control. RESULTSThe number of graduates increased annually by 1 per 100 000 000 people from 2011-2020. The average number of fellowship-trained surgeons per state was 10 (SD: 12). The average number of new head and neck cancer cases per surgeon was 247 (SD: 135). Ten states (20%) had cases >1 SD above the national average/surgeon, while 3 (6%) had cases >1 SD below the national average. CONCLUSIONHead and neck surgeons are located in most states, but not uniformly. Most states have approximately average density of surgeons; however, several states are outliers