Zahra Abdallah

Objective: Representation of women and minority groups is traditionally low in Otolaryngology–Head & Neck Surgery (OHNS). This cross‐sectional study aims to assess the difference in gender and racial/ethnic representation within Academic North American pediatric OHNS. Study Design: Cross‐sectional study of North American pediatric OHNS faculty websites. Setting: North America. Methods: Canadian and American residency program registries were searched for accredited OHNS programs. Pediatric OHNS faculty were identified through program websites. Information regarding gender, race/ethnicity, time in practice, research productivity, academic title, and leadership positions was extracted from public profiles and Scopus. Demographic and academic data was also extracted for OHNS and pediatric OHNS department/division chairs. Results: North American academic pediatric OHNS websites listed 516 surgeons, of whom 39.9% were women. Most surgeons were perceived as White (69.0%), followed by Asian (24.0%), Hispanic (3.7%), and Black (3.3%). Women surgeons had lower h‐indices, less publications, and less citations than men ( P < .001). Despite women surgeons having fewer years in practice (median 8.0 vs 13.0, P < .001), gender‐differences in h‐index persisted when controlling for years in practice ( P < .05). Men surgeons had higher academic titles ( P < .001), but there was no gender difference in leadership roles while accounting for years in practice ( P = .559). White surgeons had higher academic titles than non‐White surgeons ( P = .018). There was no racial/ethnic difference in leadership roles ( P = .392). Conclusion: Most pediatric OHNS surgeons are men and/or White. Significant gender‐differences in research productivity and academic title exist, however surgeons of racial/ethnic minority have similar research productivity as their racial/ethnic majority counterparts.

Introduction Interviews are central to many qualitative studies in health professions education (HPE). However, researchers often rely only on oral questioning despite the existence of techniques tailored to elicit the rich data needed to address complex problems and meaningfully engage participants. Elicitation techniques are strategies – e.g. participant photography, neighbourhood walks – used to generate rich conversations, but guidance on these techniques is scattered across literatures from diverse fields. In this synthesis, we offer an overview of the elicitation techniques available and advice about how to choose between them. Methods We conducted an integrative review, drawing on methodological literature from across the health and social sciences. Our interdisciplinary searches yielded 3056 citations. We included 293 citations that were methodologically focused and discussed elicitation techniques used in interviews with adults. We then extracted specific elicitation techniques, summarizing each technique to capture key features, as well as strengths and weaknesses. From this, we developed a framework to help researchers identify challenges in their interview-based research, and to select elicitation techniques that address their challenges. Results Elicitation techniques serve two main purposes: they can enrich data and engage participants in new ways. To enrich data, researchers might seek to shift conversations away from participants’ entrenched narratives, to externalize conversations on sensitive topics, or to elicit affect, tacit knowledge, or contextual details. When engaging participants in new ways, researchers might seek to increase equity between the researcher and participant or interview accessibility across diverse participant populations. Discussion When chosen with study goals in mind, elicitation techniques can enrich interview data. To harness this potential, we need to re-conceptualize interviews as co-production of knowledge by researcher(s) and participant(s). To make interviews more accessible, we need to consider flexibility so that each participant can engage in ways that best suit their needs and preferences.

Necrotizing soft tissue infection (NSTI) is a rare, but life-threatening, complication of head and neck surgery. We present a 70-year-old male with a history of immunosuppression who presented with polymicrobial NSTI following parotidectomy and neck dissection for cutaneous squamous cell carcinoma. The objective of this report was to promote awareness for NSTI following parotidectomy and selective neck dissection and highlight the management measures that can optimize survival outcomes. We performed a database search that identified 1,025 citations, of which 5 articles described classified as craniocervical necrotizing fasciitis following major head and neck surgery. Consent was obtained from the patient for inclusion in the research study and Institutional Review Board approval was waived. Our literature review yielded 6 cases of craniocervical necrotizing fasciitis following major head and neck surgery. This NSTI, however—unlike the others previously reported—was predominantly mediated by Escherichia coli , a bacterium associated with elevated mortality rates. Despite immediate awake fiberoptic intubation, repeated surgical debridement, and empirical antibiotic therapy, he deteriorated rapidly and was withdrawn from life-support on postoperative day seven. Prophylactic antibiotics, airway management, prompt diagnosis, and surgical debridement are critical for limiting mortality in NSTI of the head and neck.

Objective: Endoscopic sinus surgery (ESS) and endoscopic skull base surgery (ESBS) approaches have revolutionized the management of sinonasal and intracranial pathology. Maintaining surgical hemostasis is essential as bleeding can obscure the visibility of the surgical field, thus increasing surgical duration, risk of complications, and procedural failure. Tranexamic acid (TXA) acts to reduce bleeding by inhibiting fibrin degradation. This review aims to assess whether TXA improves surgical field quality and reduces intraoperative blood loss compared with control.Methods: We searched PubMed, MEDLINE, Embase, Web of Science, and Cochrane Library from inception until September 1, 2022. Two reviewers independently screened citations, extracted data, and assessed methodological quality using the Cochrane risk‐of‐bias tool for randomized trials. Data were pooled using a random‐effect model, with continuous data presented as mean differences and dichotomous data presented as odds ratios.Results: Seventeen ESS randomized controlled trials (n = 1377) and one ESBS randomized controlled trial (n = 50) were reviewed. Significant improvement in surgical field quality was achieved with both systemic TXA (six studies, p < 0.00001) and topical TXA (six studies, p = 0.01) compared with the control. Systemic TXA (eight studies) and topical TXA (three studies) both achieved a significant reduction in intraoperative blood loss compared with the control (p < 0.00001). There were significant differences in operative times (p < 0.001) but no significant difference in perioperative outcomes (p = 0.30).Conclusion: This meta‐analysis demonstrated that the administration of TXA in ESS can improve surgical field quality and reduce intraoperative blood loss. TXA use did not result in increased perioperative complications including thrombotic events.

Introduction: Alzheimer’s disease is a type of dementia characterized by a buildup of ꞵ-amyloid plaques and neurofibrillary tangles. Prior to the development of Alzheimer’s disease, patients may experience mild cognitive impairment, characterized by a decline in cognitive abilities while maintaining independent function. Electroencephalography has shown promise as a clinical predictor of mild cognitive impairment. The purpose of this study is to review the existing literature on clinical biomarkers using resting-state electroencephalography or event-related potentials to differentiate Alzheimer’s disease or mild cognitive impairment from normal aging. Methods: A search of primary research articles was conducted in PubMed. Selected articles examined mild cognitive impairment and Alzheimer’s disease utilising electroencephalography, event-related potential data, and resting-state data. Reviews, conference abstracts, and studies without human controls were excluded. Results: Our search identified 100 and 125 records on resting-state and event-related potential data, respectively. The most common findings from resting-state studies included a reduction in alpha power, an increase in delta and theta power, a reduction in signal complexity, and differences in functional connectivity. The most common findings from event-related potential studies included reduction in P3 wave amplitude, as well as latency in both P3 and N2 waves. Discussion: Resting-state and event-related potential electroencephalography studies indicate distinct changes in oscillatory brain activity and waveform shape which indicate distinct differences in MCI or AD compared to HC which may be clinically relevant. Conclusion: There is evidence to support the use of certain electroencephalographic biomarkers for the diagnosis of Alzheimer’s disease or mild cognitive impairment. Future research should seek to examine how best to apply these findings in a clinical setting.