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This article discusses the importance of preoperative considerations for septoplasty before endoscopic transsphenoidal pituitary resection. The endoscopic transsphenoidal approach is a minimally invasive technique used for accessing and removing anterior skull base masses. However, anatomical variations within the nasal cavity, such as septal deviation, can pose challenges during surgery. The study evaluates preoperative CT scan parameters to determine if any of these measurements are associated with increased rates of concurrent septoplasty during endoscopic transsphenoidal surgeries. The findings suggest that the angle of maximal septal deviation, the angle of the internal nasal valve, and the cross-sectional area at the head of the right inferior turbinate are significantly correlated with the need for intraoperative septoplasty. [Extracted from the article]

Objectives/Hypothesis To evaluate the impact of electronic health records (EHRs) on the workflow of otolaryngology residents. Study Design Prospective, time-motion study. Methods A time-motion study was conducted both in the 2009 to 2010 and 2012 to 2013 postgraduate years. Eight otolaryngology residents were directly observed on both operative and clinic days, with resident activities categorized by way of a database program. Comparisons were made to the same data collected in the same setting prior to and following integration of an EHR system. Results Residents spent their day on direct patient care (41.1%), indirect patient care (35.3%), didactic education (14.0%), personal activities (6.9%), and transit (3.1%). The primary activity during operative days was direct patient care, and during clinic days it was indirect patient care. Activities of marginal educational value comprised a considerable component of their time (16.5%). Compared to data collected prior to use of an EHR, time was spent similarly. However, residents using an EHR devoted significantly more time to indirect patient care on clinic days (P < .05). Conclusions This is the first study to evaluate EHR integration on otolaryngology resident workflow. Overall resident efficiency was not significantly altered by the implementation of an EHR. However, more time was shifted from directly caring for patients to documenting on the EHR in the clinic setting. These findings provide an important objective insight into EHRs, especially given the looming mandate for their use and the need to streamline resident curriculum in the duty hours era. Level of Evidence 4. Laryngoscope, 125:594-598, 2015 [ABSTRACT FROM AUTHOR]

The authors reflect on California-based Otolaryngology Program Directors' Organization's (OPDO) approach to endorse the standardized letter of recommendation (SLOR) as a means of both streamlining the residency selection process and to select the best applicants for training. They mention that one of the most critical elements of the residency application is the letter of recommendation (LOR). They also present several tables that show survey results of respondents' response to SLOR.

Objective: To investigate workflow in an otolaryngology-head and neck surgery residency program over 1 year and identify areas for improvement in the efficiency of resident education and training., Study Design: Time-motion study., Setting: An urban, county hospital and a Veterans Affairs medical center hospital. Subjects and Methods. Eight otolaryngology residents (4 residents at postgraduate year [PGY] 2 and 4 at PGY 4) were studied using direct observations early and late in the 2008-2009 academic year. Resident activities were categorized, and a database program was generated for a handheld computer to facilitate time entry. Resident activities were classified into a taxonomy of tasks and their educational value was assessed. For each PGY level studied, observations were made for clinic and operative days., Results: Residents spent their day on direct patient care (43.5%), indirect patient care (33.7%), didactic education (9.6%), personal activities (7.5%), and transit (5.8%), with activities of marginal educational value consuming 16% of their time. Major inefficiencies included managing administrative tasks, scheduling, and technical difficulties. On average, residents devoted significantly more time to marginal tasks on clinic days (19%) than on operative days (12%; P < .001). These data were compared with previously published data obtained during the pre–Accreditation Council for Graduate Medical Education (ACGME) duty hour mandates era., Conclusion: This study evaluates resident workflow and efficiency over the course of a PGY in an ACGME-accredited otolaryngology residency program. By understanding the time motion of residents, interruptions and inefficiencies in workflow can be identified to direct future changes to enhance resident education and training in the era of the ACGME duty hours mandate.