Impact of the COVID-19 pandemic on Otolaryngology trainee education.

BackgroundThe COVID-19 pandemic has reduced clinical volume with a negative impact on trainee education.MethodsSurvey study of Otolaryngology trainees in North America, during the COVID-19 pandemic in April 2020.ResultsOf 216 respondents who accessed the survey, 175 (83%) completed the survey. Respondents reported a universal decrease in clinical activities (98.3%). Among participants who felt their program utilized technology well, there were significantly decreased concerns to receiving adequate educational knowledge (29.6% vs 65.2%, P = .003). However, 68% of trainees still expressed concern in ability to receive adequate surgical training. In addition, 54.7% of senior trainees felt that the pandemic had a negative impact on their ability to secure a job or fellowship after training.ConclusionsTrainees universally felt a negative impact due to the COVID-19 pandemic. Use of technology was able to alleviate some concerns in gaining adequate educational knowledge, but decreased surgical training remained the most prevalent concern

Advanced head and neck surgery training during the COVID-19 pandemic

The COVID-19 pandemic has significantly impacted medical training. Here we assess its effect on head and neck surgical education. Methods Surveys were sent to current accredited program directors and trainees to assess the impact of COVID-19 on the fellow's experience and employment search. Current fellows' operative logs were compared with those of the 2018 to 2019 graduates. Results Despite reduction in operative volume, 82% of current American Head and Neck Society fellows have reached the number of major surgical operations to support certification. When surveyed, 86% of program directors deemed their fellow ready to enter practice. The majority of fellows felt prepared to practice ablative (96%), and microvascular surgery (73%), and 57% have secured employment to follow graduation. Five (10%) had a pending job position put on hold due to the pandemic. Conclusions Despite the impact of the COVID-19 pandemic, current accredited trainees remain well-positioned to obtain proficiency and enter the work-force

Outcomes after definitive surgery for mandibular osteoradionecrosis

ObjectivesTo analyze charges, complications, survival, and functional outcomes for definitive surgery of mandibular osteoradionecrosis (ORN).Materials and MethodsRetrospective analysis of 76 patients who underwent segmental mandibulectomy with reconstruction from 2000 to 2009.ResultsComplications occurred in 49 (65%) patients and were associated with preoperative drainage (odds ratio [OR] 4.40, 95% confidence interval [CI] 1.01–19.27). The adjusted median charge was $343 000, and higher charges were associated with double flap reconstruction (OR 8.15, 95% CI 2.19–30.29) and smoking (OR 5.91, 95% CI 1.69–20.72). Improved swallow was associated with age <67 years (OR 3.76, 95% CI 1.16–12.17) and preoperative swallow (OR 3.42, 95% CI 1.23–9.51). Five-year ORN-recurrence-free survival was 93% while overall survival was 63% and associated with pulmonary disease (HR [hazard ratio] 3.57, 95% CI 1.43–8.94).ConclusionsAlthough recurrence of ORN is rare, surgical complications are common and charges are high. Poorer outcomes and higher charges are associated with preoperative factors.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/172253/1/hed27024_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/172253/2/hed27024.pd