Acquisition of endoscopic nasal surgery skills with a lamb's head model

Abstract Objectives: To evaluate the acquisition of surgical skills by otolaryngology residents and established the minimum number of dissections of a lamb's model to be performed before practicing on human patients. Methods: Nineteen second-year otolaryngology residents performed ten dissections each, five on each nasal cavity, always practicing the same three surgical procedures on the lamb model. Each student's training lasted 2-months, and the entire training intervention lasted 4-years, over four generations of residents. All dissections were recorded and were selected at random for examination by two independent otolaryngology surgeons, who were otherwise not involved in the research. Assessment of the 190 dissections used an instrument validated for surgical training of medical residents. Results: To a 1% significance level, statistical analysis revealed increased performance and satisfactory results were observed after the sixth dissection. Furthermore, after the eighth dissection, skill acquisition was relevant and sustained. Conclusion: Training in endoscopic nasal surgery on a lamb's head model improves surgical skills and handling of surgical instruments. Our results showed the relevance of the lamb model for training in otolaryngology surgery, impacting on patient safety. Level of evidence: 2.

Conhecimento de fonoaudiólogos e otorrinolaringologistas do Distrito Federal acerca do implante coclear / Knowledge of cochlear implants in Federal District Audiologists, Speech-Language Pathologists, and Otolaryngologists

Resumo:OBJETIVO:descrever a auto-avaliação de otorrinolaringologistas e fonoaudiólogos do Distrito Federal acerca do conhecimento em relação ao implante coclear.MÉTODOS:estudo transversal e analítico com coleta de dados obtidos por meio da aplicação de questionários on-line. Participaram do estudo 73 fonoaudiólogos e 33 otorrinolaringologistas que responderam questões acerca do conhecimento do Implante Coclear na cidade de Brasília-Distrito Federal.RESULTADOS:31% (n=22) dos fonoaudiólogos acreditam ter conhecimento suficiente no que se refere ao procedimento cirúrgico, enquanto que no grupo dos otorrinolaringologistas esse número chegou a 59,4% (n=19), apresentando significância estatística entre os grupos (p<0,01). Ambos os grupos mostraram conhecimento insatisfatório em relação ao tipos de implante, mapeamentos, ativação, acompanhamento, custos, manutenção e o IC inserido no SUS.CONCLUSÃO:os profissionais otorrinolaringologistas e fonoaudiólogas pesquisados, atuantes no Distrito Federal, não apresentaram o conhecimento satisfatório acerca do implante coclear na análise geral dos domínios pesquisados.

Abstract:PURPOSE:to describe the self-assessment of Otolaryngologists, Audiologists, and Speech-Language Pathologists from the Federal District on their knowledge concerning cochlear implants.METHODS:cross-sectional and analytical study with data collection obtained by applying online questionnaires.73 Audiologists and Speech-Language Pathologists, and 33 Otolaryngologists participated in the study. They answered questions regarding their knowledge of Cochlear Implants in Brasília - Federal District, Brazil.RESULTS:31% (n=22) of the Audiologists and Speech-Language Pathologists believe they have sufficient knowledge regarding the surgical procedure, whereas in the group of otolaryngologists, the figure was 59.4% (n = 19). Statistical significance between groups is observed (p <0.01). Both groups showed poor knowledge regarding implant types, mappings, activation, monitoring, and maintenance costs and cochlear implantation performed by the SUS (Brazilian Unified Health System).CONCLUSION:Otolaryngologists, Audiologists, and Speech-Language Pathologists surveyed, who work in the Federal District, did not show satisfactory knowledge of the cochlear implant in the overall analysis of the areas surveyed.

Sucesso no tratamento do zumbido com terapia em grupo / Group therapy for patients with tinnitus at the University of Brasilia Medical School

Embora os tratamentos em grupos para o zumbido sejam uma área bem documentada na literatura internacional, até onde sabemos nunca foram realizados no Brasil. Este estudo apresenta uma experiência bem-sucedida de um tratamento em grupo para zumbido baseado na terapia de retreinamento do zumbido aliada com as técnicas cognitivo-comportamentais. O objetivo deste estudo é avaliar pacientes com zumbido antes e depois do tratamento em grupo estruturado baseado da terapia de retreinamento do zumbido e na terapia cognitivo comportamental. Material e método: Estudo coorte prospectivo: 27 sujeitos aplicaram-se para a pesquisa. Responderam ao inventário do Handicap do Zumbido (THI) e à escala da Ansiedade e Depressão Hospitalar (HAD),antes e depois do tratamento. Foram realizadas 6 sessões estruturadas segundo os princípios da terapia de retreinamento do zumbido associada com técnicas cognitivo-comportamentais. Resultados: 27 pacientes iniciaram e 19 terminaram o tratamento (8 excluídos). 47,4 por cento homens, média das idades 47.6. O resultado do THI antes e depois do tratamento foi respectivamente: funcionais, 29 e 14; emocional, 24 e 10; e catastrófico, 12 e 5; a escala HAD: ansiedade, 12 e 9 e depressão, 10 e 6. Conclusão: O tratamento descrito é efetivo na melhora do zumbido.

Although group therapy for tinnitus is a well documented field in the international literature, as far as we know it has never been held in Brazil. This study represents a successful experience of a group therapy for tinnitus based on the tinnitus retraining therapy associated with behavioral cognitive techniques. The goal of the present study is to assess patients with tinnitus before and after the group therapy based on the tinnitus retraining therapy and the behavioral cognitive therapy. Materials and methods: Prospective cohort study: 27 subjects signed in for the study, and answered the Tinnitus Handicap Inventory (THI) and the Hospital Depression and Anxiety Scale (HAD), before and after the treatment. We held six structured sessions according to the principles of tinnitus retraining therapy associated with behavioral cognitive techniques. Results: 27 patients started and 19 finished the treatment (8 were taken off). 47.4 percent men, mean age of 47.6. THI results before and after treatment were respectively: functional: 29 and 14, emotional 24 and 10 and catastrophic 12 and 5 and the HAD scale: anxiety 2 and 9 and depression 10 and 6. Conclusion: The treatment described is effective in improving tinnitus symptoms.