Parents' Opinions About Pediatric Otolaryngology on Social Media.

OBJECTIVE: Social media is a novel tool that many parents turn to when looking for a new healthcare provider. The purpose of this study is to assess how parents of children attending a pediatric otolaryngology practice engage with social media. STUDY DESIGN: Survey. SETTING: Two pediatric otolaryngology clinics associated with a tertiary care children's hospital in Buffalo, NY. METHODS: Parents of children aged <18 years were surveyed. The survey consisted of 25 questions divided into 5 categories: demographics, social media accounts, social media use, use of social media to interact with pediatric otolaryngologists, and perception of pediatric otolaryngologists' social media accounts. Frequencies were calculated. RESULTS: Three hundred five parent participants were included. 247 (81.0) were female and 57 (18.97) were male. 258 (84.6%) of the participants reported use of Facebook, which was the most popular social media platform. 238 (78.0%) of participants indicated that they would want to see medical posts and 98 (32.1%) participants indicated that they would want to see personal posts on the pediatric otolaryngologist's social media page. Younger parents were statistically more likely to check social media more often (P = .001) and seek a pediatric otolaryngologist's social media before seeing them (P = .018). CONCLUSION: Use of social media by pediatric otolaryngologists may positively impact the way a small percentage of their patients' parents perceive them. Social media accounts do not appear to be a vital part of pediatric otolaryngology practice in 2022.

Does Medical School Rank Impact Matching into Otolaryngology?

OBJECTIVE(S): To describe how medical school rank may be associated with matriculation into otolaryngology residency programs. METHODS: A list of medical students who matched into otolaryngology residencies in 2020, 2021, and 2022 was obtained from Otomatch (Otomatch.com). For each student, their medical school, U.S. News & World Report Best Medical School (Research) ranking, and region based on the U.S. Census divisions were recorded. The medical schools were divided into four Tiers according to rank: 1-40 (Tier 1), 41-80 (Tier 2), 81-124 (Tier 3), and 125-191 (Tier 4). Residency programs were also grouped by region, whether they were large (>3 residents/year) or small (<3 residents/year), and their Doximity reputation ranking: 1-31 (Tier 1), 32-61 (Tier 2), 62-91 (Tier 3), and 92-125 (Tier 4). RESULTS: Nine hundred and ninety-five medical students were included in this study. The majority of residency matriculants were MDs (N = 988, 99.3%) who came from Tier 1 (N = 410, 41.2%) or Tier 2 (N = 313, 31.5%) medical schools. Those who attended higher-tier medical schools were more likely to match into higher-tier residency programs (p < 0.001). 57.8% (N = 237) of the applicants who attended Tier 1 medical schools matriculated into a Tier 1 residency program, whereas only 24.7% (N = 42) of the applicants from Tier 4 medical schools matriculated into a Tier 1 residency program. CONCLUSION: Applicants who attend top-tier medical schools represent significantly more residents at top-tier otolaryngology residency programs than those from lower tier medial schools. LEVEL OF EVIDENCE: NA Laryngoscope, 133:3353-3357, 2023.

Pediatric Bronchoscopy for Airway Foreign Bodies in the ACS NSQIP-P: Morbidity and Mortality 2014-2019.

OBJECTIVE: Examine morbidity and mortality associated with bronchoscopy for pediatric airway foreign body (AFB). Identify factors associated with adverse events. METHODS: A retrospective analysis from 2014 to 2019 using the multicenter public data set from the American College of Surgeons National Surgical Quality Improvement Program- Pediatric. Patients under 18 who underwent bronchoscopy for AFB were identified. Demographics, comorbidities, perioperative events, length of stay, and complications were collected. Regression analysis was used to identify factors associated with adverse events. RESULTS: 2302 patients were included; 1427 (62%) males and 875 (38%) females. Mean age was 3.9 years. (95% CI 3.7-4.1). 2025 (88%) retained AFB as the postoperative diagnosis. Comorbidities included structural pulmonary abnormalities in 234 (10.5%), asthma in 149 (6.5%), and impaired cognitive status in 134 (5.8%). Most common complications were pneumonia in 19 (0.8%) and reintubation in 10 (0.4%). 10 (0.4%) had a prolonged LOS >30 days. Nine (0.4%) children died within 30 days of surgery; 7 (78%) were ventilated and 6 (67%) had CPR prior to surgery. 18 (0.8%) returned to OR and 15 (0.7%) were readmitted for related reasons. Linear regression showed an association between ASA class (ß = 0.708, p < 0.001), operative time (ß = 0.015, p = 0.013) and reintubation (ß = 10.5, p < 0.001) with LOS. Time in the OR was associated with return to OR (ß = .008, p = 0.004) through logistic regression. CONCLUSION: Morbidity is low in children with AFB and mortality is usually associated with preoperative lifesaving maneuvers. LEVEL OF EVIDENCE: 4 Laryngoscope, 133:689-693, 2023.

Foreign Body Aspiration Complicated by Pneumothorax in Children: HCUP-KID Perspective.

OBJECTIVE: Children with airway foreign bodies (AFB) occasionally have pneumothorax complicating their course. We aimed to compare the clinical course of these children to those without this complication. METHODS: Data was obtained from the 2016 Kids' Inpatient Database of Healthcare Cost Utilization Project. ICD-10 code of T17XXXX was used to locate records. They were grouped based on the presence of preoperative pneumothorax, postoperative pneumothorax, or none. Variables included demographics, AFB type, AFB location, length of stay (LOS), pneumothorax treatment modality, mortality, hospital setting, primary payor, and total charges. RESULTS: A total of 4165 children with AFB were identified, 57.8% male and 42.2% female. Of these 75 (1.8%) patients presented with preoperative pneumothorax, 29 (0.7%) with postoperative pneumothorax, and 4061 (97.5%) with no pneumothorax. The preoperative pneumothorax patients were older than the postoperative pneumothorax and unaffected AFB patients (mean age = 9.5 [95% CI 7.7-11.3] vs 8.2 [95% CI 5.4-11.1] vs 5.5 [95% CI 5.3-5.7]; P < .001). Preoperative pneumothorax patients incurred higher total charges than the other groups (mean US = $939K [95% Cl 673K-1,204K] vs $599K [95% Cl 377K-821K] vs $228K [95% Cl 211K-244K]; P < .001), had a longer LOS in days (mean = 37.7 [95% Cl 28.7-46.7] vs 31.6 [95% Cl 16.9-46.2] vs 15.8 [95% CI 15.0-16.7]; P < .001), and had a higher mortality rate (16% vs 0% vs 3.7%, P < .001). CONCLUSION: Pneumothorax can significantly impact a child's hospital course, and preoperative pneumothorax should alert clinicians to the potential for increased mortality risk.

Impact of COVID-19 Pandemic on Expenses of Medical Students Applying to Otolaryngology Residency Programs.

INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic has led to many changes in the residency application process. The purpose of this study was to determine the impact of these changes on the cost of applying to otolaryngology residency programs.  Materials and Methods: A retrospective, cross-sectional analysis was conducted using the Texas Seeking Transparency in Application to Residency (Texas STAR) Dashboard database to determine the differences in residency application costs from 2019 to 2022. Applicant information and cost data including application fees, interview expenses, away rotation expenses, total expenses, and geographic regions were collected. Median expenses and interquartile ranges were reported for each year and geographic region. Non-parametric comparisons were conducted. RESULTS: Data from 499 otolaryngology applicants were collected from the Texas STAR database. The total expenses, interview expenses, and away rotation expenses of applicants from 2019 to 2022 were significantly decreased (p < 0.001) in all regions of the United States with the greatest decrease between 2020 and 2021. Application fees (p = 0.005) were not significantly different among regions of the United States throughout the time period studied. CONCLUSION: The COVID-19 pandemic significantly decreased the total expenses of applying to otolaryngology residencies including away rotation and interview expenses.