Introduction: Intraoperative nerve monitoring is used in otolaryngology to assist in identification of nerves at risk. It is hoped that this will lead to lower rates of nerve injury. The objective of this study was to...Introduction: Intraoperative nerve monitoring is used in otolaryngology to assist in identification of nerves at risk. It is hoped that this will lead to lower rates of nerve injury. The objective of this study was to quantify the use of monitoring technology in current clinical practice. Method: An electronic survey was distributed to 376 registered fellows of the Australian Society of Head and Neck Surgery. Results: One-hundred and twenty-five responses were obtained. The majority of respondents report using monitoring at least some of the time during thyroid, parotid, and mastoid surgery (80%, 87%, and 73% respectively). Predictors of use include experience with intraoperative monitoring during training, and high caseloads in parotid surgery. Practice setting did not predict use. Conclusion: Despite equivocal evidence that intraoperative nerve monitoring is associated with a reduction in nerve injuries, this study demonstrates that the technology is widely used amongst otolaryngologists.展开更多
Evidence-based enhanced recovery after surgery(ERAS)programs aim to improve patient outcomes and shorten hospital stays.The objective of this study is to describe the development,implementation,and evolution of an ERA...Evidence-based enhanced recovery after surgery(ERAS)programs aim to improve patient outcomes and shorten hospital stays.The objective of this study is to describe the development,implementation,and evolution of an ERAS protocol to optimize the perioperative management for patients undergoing endoscopic skull base surgery for pituitary tumors.A systematic review of the literature was performed,best practices were discussed with stakeholders,and institutional guidelines were established and implemented.Key performance indicators(KPI)were measured and patient-reported outcome surveys were collected.The ERAS protocol was introduced successfully at our institution.We describe the process of initiation of the program and the perioperative management of our patients.We demonstrated the feasibility of integration of ERAS protocols for pituitary tumors with multidisciplinary engagement,with a particular emphasis on the use of data informatics and metrics to monitor outcomes.We expect that this approach will translate to improved quality of care for these often-complex patients.展开更多
文摘Introduction: Intraoperative nerve monitoring is used in otolaryngology to assist in identification of nerves at risk. It is hoped that this will lead to lower rates of nerve injury. The objective of this study was to quantify the use of monitoring technology in current clinical practice. Method: An electronic survey was distributed to 376 registered fellows of the Australian Society of Head and Neck Surgery. Results: One-hundred and twenty-five responses were obtained. The majority of respondents report using monitoring at least some of the time during thyroid, parotid, and mastoid surgery (80%, 87%, and 73% respectively). Predictors of use include experience with intraoperative monitoring during training, and high caseloads in parotid surgery. Practice setting did not predict use. Conclusion: Despite equivocal evidence that intraoperative nerve monitoring is associated with a reduction in nerve injuries, this study demonstrates that the technology is widely used amongst otolaryngologists.
基金This research was funded in partthrough the NIH/NCI Cancer Center Support,Grant/Award Number:P30 CA008748。
文摘Evidence-based enhanced recovery after surgery(ERAS)programs aim to improve patient outcomes and shorten hospital stays.The objective of this study is to describe the development,implementation,and evolution of an ERAS protocol to optimize the perioperative management for patients undergoing endoscopic skull base surgery for pituitary tumors.A systematic review of the literature was performed,best practices were discussed with stakeholders,and institutional guidelines were established and implemented.Key performance indicators(KPI)were measured and patient-reported outcome surveys were collected.The ERAS protocol was introduced successfully at our institution.We describe the process of initiation of the program and the perioperative management of our patients.We demonstrated the feasibility of integration of ERAS protocols for pituitary tumors with multidisciplinary engagement,with a particular emphasis on the use of data informatics and metrics to monitor outcomes.We expect that this approach will translate to improved quality of care for these often-complex patients.
