International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Clinical pearls in endoscopic sinus surgery: Key steps in preventing and dealing with complications

Increasing prevalence of patients undergoing endoscopic sinus surgery (ESS) makes understanding methods to preventing complications important to otolaryngologists. This commentary details clinical pearls and perioperative strategies that may minimize complications and increase preparedness for appropriate decision making in the event of a complication. Preoperative preparation is an important factor in preventing adverse events in ESS. This includes ensuring the presence of objective radiographic findings before pursuing operative management, both for patients\u27 safety as well as medicolegal reasons, and providing adequate preoperative patient education. Appreciating variants in skull base and orbital wall anatomy through preoperative imaging is crucial for avoidance of intracranial and orbital complications. The importance of optimal visualization intraoperatively and the appropriate role of CT-guided imaging are also discussed. Finally, strategies for dealing with postoperative sequelae of more common complications are noted. This article represents a brief review for introductory sinus surgeons and is not meant as an all encompassing review. (C) 2014 Elsevier Inc. All rights reserved

Expert witness testimony guidelines: identifying areas for improvement

Expert witnesses play an invaluable, if controversial, role by deciphering medical events for juries in cases of alleged negligence. We review expert witness guidelines among major surgical societies and identify gaps within these standards, as our hope is that this spurs discussion addressing areas for improvement. Of 8 surgical societies with accessible guidelines, none included specific compensation guidelines or limits, detailed reporting mechanisms regarding unethical behavior by legal professionals, or addressed the appropriateness of testifying frequently and exclusively for one side. Several processes possibly deterring grossly inaccurate testimony have been adopted by other surgical societies and should potentially be addressed by the American Academy of Otolaryngology-Head and Neck Surgery. These include offering an expert witness testimony certification path, strengthening the formalized grievance process, and encouraging members to sign an affirmation statement

AAO-HNSF CORE Grant Acquisition Is Associated with Greater Scholarly Impact

Objective To determine whether receiving funding from the American Academy of OtolaryngologyHead and Neck Surgery Foundation (AAO-HNSF) Centralized Otolaryngology Research Efforts (CORE) grant program is associated with career choice (in terms of practice setting) and scholarly impact. Study Design and Setting Examination of bibliometrics among academic otolaryngologists, including CORE grants funding history. Methods An Internet search was conducted to determine the current practice setting and, for academic otolaryngologists, academic rank of individuals receiving CORE grants since 1985. The Scopus database was used to determine scholarly impact, as measured by the h-index, and publication experience (in years) of these practitioners along with a control cohort of nonfunded academic otolaryngologists. Results Of 432 unique individuals receiving CORE grant funding since 1985, 44.4% are currently academicians. This cohort had a higher h-index (mean, 11.9; median, 10; interquartile range [IQR], 6-18) than their non-CORE grant-funded academic peers (mean, 9.2; median, 7; IQR, 3-13; P = .002) and colleagues who are not currently in academic practice (mean, 4.4; median, 3; IQR, 0-6; P \u3c .001). CORE grant-funded academic otolaryngologists had a statistically higher scholarly impact on controlling for academic rank and among practitioners with greater than 10 years of publication experience. No statistical differences in academic promotion patterns were noted between those with and those without a CORE grant funding history. Conclusions Procurement of an AAO-HNSF CORE grant is associated with greater scholarly impact, as measured by the h-index. This relationship persists among practitioners with more than 10 years of publication experience, as well as upon comparison of CORE grant-funded and non-CORE grant-funded otolaryngologists at all academic ranks. Practitioners awarded these grants may be more likely to go into and remain in academic practice

Does receiving an American Academy of Otolaryngology-Head and Neck Surgery Foundation Centralized Otolaryngology Research Efforts grant influence career path and scholarly impact among fellowship-trained rhinologists?

BackgroundTo determine whether American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) Centralized Otolaryngology Research Efforts (CORE) grants influence career paths and scholarly impact of fellowship-trained rhinologists, and whether funding from the National Institutes of Health (NIH) and CORE programs is associated with increased scholarly impact among rhinologists. Another aim was to explore whether obtaining CORE grant funding is associated with NIH award acquisition. MethodsPractice setting, academic rank, and fellowship-training status were determined for individuals in the CORE grant database. The h-index and publication experience of practitioners was calculated using the Scopus database. Faculty listings were used to determine this data for a non-CORE-grants-funded control group of academic rhinologists. Active and past NIH funding was obtained using the NIH RePORTER database. ResultsFifteen of 26 (57.7%) fellowship-trained rhinologists receiving CORE grants were funded for rhinologic projects. Five of 6 rhinologists receiving NIH funding had a CORE-grants-funding history. Twenty-two of 26 (84.6%) rhinologists receiving CORE funding are currently in academic practice. Academic rhinologists receiving CORE or NIH funding had higher h-indices, a result reaching significance among promoted faculty and those with greater than 10 years of publication experience. ConclusionEncouraging the pursuit of CORE grants among junior faculty as well as trainees interested in rhinology may be a strategy for developing highly effective research habits that pay dividends after the first few years of one\u27s career. Fellowship-trained rhinologists with a CORE funding history predominantly pursue careers in academic medicine, although their CORE projects are not necessarily related to rhinologic topics. (C) 2013 ARS-AAOA, LLC