Improving Patient Education of Facial Fractures Using 3-Dimensional Computed Tomography.

OBJECTIVE: Advances in 3-dimensional modeling have revolutionized presurgical planning for maxillofacial reconstruction, yet little is known about how this technology may affect patient education. This study was designed to evaluate the efficacy of 2-dimensional computed tomography versus 3-dimensional computed tomography for patient education in maxillofacial reconstruction. STUDY DESIGN: Crossover study. SETTING: General otolaryngology outpatients from a tertiary referral center were recruited. METHODS: A single computed tomography data set of a zygomaticomaxillary complex fracture was used to generate 2 educational video tutorials: one in a 2-dimensional format and one in a 3-dimensional format. The tutorials were embedded into the QualtricsXM platform. Participants were randomly assigned into 2 groups. Group 1 viewed the 2-dimensional tutorial, took a self-assessment survey, took an information recall survey, viewed the 3-dimensional tutorial, and finally took a tutorial comparison survey. Group 2 followed the same sequence but viewed the 3-dimensional tutorial followed by the 2-dimensional tutorial. RESULTS: Group 2 participants (viewing the 3-dimensional tutorial first) scored better on the self-assessment survey than their counterparts in group 1 did (P = .023). Group 2 also scored better on the recall survey (P = .042). Of all participants, 61% preferred the 3-dimensional tutorial, and 31% preferred the use of both tutorials together in the comparison survey. CONCLUSIONS: Three-dimensional patient educational tutorial regarding a zygomaticomaxillary complex fracture resulted in better knowledge retention and was preferred over the 2-dimensional format.

Lead poisoning risk assessment of radiology workers using lead shields.

Purpose: Lead containing dust may be present on the exterior surfaces of shields used to prevent radiation exposure. We determined whether use of lead shields poses an exposure risk for radiology personnel.Methods: We collected hand dustwipe and blood samples from 58 Radiology Department employees of an academic hospital. Samples were analyzed for lead content by atomic absorption spectroscopy. Results were compared between lead apron users (46) and nonusers (12).Results: Hand dustwipe lead was undetectable (<3 µg/sample) in all cases. Blood lead levels ranged from 0-3 µg/dL.Conclusions: In this study of Radiology Department workers, we did not find an increased risk of lead contamination on their hands or in their blood. Although our sample size is small, we conclude that lead poisoning is unlikely to occur with high frequency in lead shield users.

Lead Aprons Are a Lead Exposure Hazard.

PURPOSE: To determine whether lead-containing shields have lead dust on the external surface. METHODS: Institutional review board approval was obtained for this descriptive study of a convenience sample of 172 shields. Each shield was tested for external lead dust via a qualitative rapid on-site test and a laboratory-based quantitative dust wipe analysis, flame atomic absorption spectrometry (FAAS). The χ2 test was used to test the association with age, type of shield, lead sheet thickness, storage method, and visual and radiographic appearance. RESULTS: Sixty-three percent (95% confidence interval [CI]: 56%-70%) of the shields had detectable surface lead by FAAS and 50% (95% CI: 43%-57%) by the qualitative method. Lead dust by FAAS ranged from undetectable to 998 µg/ft2. The quantitative detection of lead was significantly associated with the following: (1) visual appearance of the shield (1 = best, 3 = worst): 88% of shields that scored 3 had detectable dust lead; (2) type of shield: a greater proportion of the pediatric patient, full-body, and thyroid shields were positive than vests and skirts; (3) use of a hanger for storage: 27% of shields on a hanger were positive versus 67% not on hangers. Radiographic determination of shield intactness, thickness of interior lead sheets, and age of shield were unrelated to presence of surface dust lead. CONCLUSIONS: Sixty-three percent of shields had detectable surface lead that was associated with visual appearance, type of shield, and storage method. Lead-containing shields are a newly identified, potentially widespread source of lead exposure in the health industry.