Marc Thorne - Academia.edu (original) (raw)
Papers by Marc Thorne
Otolaryngology–Head and Neck Surgery
Objectives There is limited evidence regarding use of routine perioperative antibiotics for pedia... more Objectives There is limited evidence regarding use of routine perioperative antibiotics for pediatric otolaryngologic procedures. The objectives of this quality improvement study were (1) to characterize the otolaryngology case mix for which antibiotics were delivered and (2) determine the percentage of surgical encounters with appropriate timing of antibiotic administration. Methods Pediatric otolaryngology procedures meeting criteria from 2015 to 2019 were evaluated as a component of an institution-wide pediatric surgical antibiotic prophylaxis study using A3 problem solving to identify and roll out interventions for appropriate antibiotic administration. Descriptive statistical analysis of the interrupted time-series data was used to describe the otolaryngology case mix for which antibiotics were delivered. The primary outcome measure was percentage of surgical encounters with appropriate timing of antibiotic administration in minutes relative to incision. Results In total, 1520 ...
Otolaryngology–Head and Neck Surgery
Objective Outcomes following cochlear implantation in children with X-linked deafness-2 are varia... more Objective Outcomes following cochlear implantation in children with X-linked deafness-2 are variable, resulting in challenges in appropriate preoperative counseling. To address this uncertainty, we performed a systematic review and synthesis of the literature on audiologic and speech outcomes after cochlear implantation in these patients to inform prognostic counseling. Data Sources PubMed, Embase, and Cochrane Library were queried for articles published between January 2000 and July 2019. Review Methods We performed a systematic review of all studies published between 2000 and 2019 that reported on (1) children with confirmed X-linked deafness-2 undergoing cochlear implantation and (2) formal assessment of hearing and/or speech capabilities postimplantation. Results Our initial database search yielded 313 articles. Fourteen articles met inclusion criteria. These studies reported on 61 children with X-linked deafness-2 who underwent implantation at a wide age range (1-29 years) for ...
OTO Open
Objective Appropriate timing of subspecialty simulation is critical to maximize learner benefit a... more Objective Appropriate timing of subspecialty simulation is critical to maximize learner benefit and guide resource utilization. We aimed to determine optimal timing of a simulation-based curriculum designed to teach entry-level procedural skills for otolaryngology residency. Study Design Simulation curriculum intervention tested among 3 comparison groups of varying clinical levels. Setting Academic otolaryngology training program and medical school. Subjects and Methods We developed a simulation-based technical skills curriculum incorporating the following task trainers: flexible laryngoscopy, peritonsillar abscess drainage, and myringotomy and tube insertion. Preclinical medical students (n = 40), subintern rotators (n = 35), and midyear interns (n = 8) completed the simulation-based curriculum. Pre- and postintervention knowledge/confidence and “level appropriateness” were rated on a 5-point Likert scale, and effect size was calculated. Results Overall self-reported knowledge/conf...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, Jan 21, 2018
The future vibrancy, relevancy, and strength of our specialty depend on cultivating a pipeline of... more The future vibrancy, relevancy, and strength of our specialty depend on cultivating a pipeline of resident otolaryngologists who embody what our society wishes to become. In attracting, seeking, and nourishing physicians of all stripes, we offer several considerations regarding medical student education and the residency selection process.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2018
Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, a... more Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, and surgical specialists, including otolaryngologists, are at even higher risk for professional burnout. These trends have been identified at both the trainee and attending level. To combat resident burnout, the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) designed the Back to Bedside Initiative, the goals of which are to foster meaning in the learning environment and to help trainees to engage more deeply with patients. Two funded Back to Bedside proposals involve otolaryngology training programs. Herein, we discuss these 2 approaches in an effort to foster additional novel resident wellness initiatives and awareness thereof across our subspecialty.
Otolaryngology-Head and Neck Surgery
Objective 1) Determine the operation specific decannulation rate of patients who required posteri... more Objective 1) Determine the operation specific decannulation rate of patients who required posterior costal cartilage grafting (PCCG) in the management of laryngeal stenosis. 2) Describe the complications associated with PCCG laryngotracheoplasty. 3) Describe voice outcomes for selected patients. Methods A retrospective review was performed on all cases of posterior graft laryngotracheoplasty (LTP) performed by the 2 senior authors over a 9-year period at a tertiary care children's hospital. Results There were 42 total patients. The operation specific decannulation rates were 100% (3/3) for Myer-Cotton grade II SGS, 75% (20/26) for grade III, and 60% (3/5) for grade IV. For posterior glottic stenosis (PGS), it was 57% (4/7) and for PGS with grade II SGS, it was 60% (6/10). There was no significant difference (p=0.727) among these groups. The overall decannulation rates were 100% (3/3), 96% (25/26), and 100% (5/5) for Myer-Cotton grades II, III and IV. For PGS, it was 83% (5/6), a...
Archives of Otolaryngology Head Neck Surgery, 2011
Otolaryngology -- Head and Neck Surgery, 2012
International Journal of Pediatric Otorhinolaryngology Extra, 2013
ABSTRACT The differential diagnosis for an external auditory canal mass is relatively broad, with... more ABSTRACT The differential diagnosis for an external auditory canal mass is relatively broad, with exostosis, osteoma, fibroma, keratoma, and congenital cholesteatoma among the more common diagnoses. However, an additional diagnosis, external auditory canal chondroma, should also be considered in the differential. These rare lesions are most often found in individuals of Asian ancestry. However, this is not always the case as demonstrated by this case report of an external auditory canal chondroma in a Caucasian teenager.
International journal of pediatric otorhinolaryngology, 2014
Presentation of a case of pediatric laryngeal neurofibroma (LNF) and review of the world literatu... more Presentation of a case of pediatric laryngeal neurofibroma (LNF) and review of the world literature. Comprehensive review of the world literature using Pubmed and Google scholar. Pediatric LNF was identified in 62 cases reported in the world literature. The most common presenting symptom is stridor and the most common location of the tumor in the larynx is the aryepiglottic fold. Recent reports demonstrate increased utilization of endoscopic resection with reduced need for tracheostomy. Pediatric LNF is a rare disorder. Review of the world literature since 1940 suggests a recent trend away from aggressive open resection and toward more conservative endoscopic resection with excellent functional results.
Paediatric respiratory reviews, Jan 28, 2015
Laryngomalacia is the most common cause of stridor in neonates and infants. Associated feeding di... more Laryngomalacia is the most common cause of stridor in neonates and infants. Associated feeding difficulties are present in approximately half of the children. A definitive diagnosis can generally be made with flexible fiberoptic laryngoscopy. The disorder is most often self-limited with resolution of symptoms within the first 24 months of life, and the majority of children can thus be managed conservatively. The approximately 5%-20% of children with severe or refractory disease may require more aggressive intervention, most commonly in the form of trans-oral supraglottoplasty [1,2]. High success rates and a low rate of complications have been reported for this procedure in otherwise healthy children. Children with syndromes or medical comorbidities are more likely to have complications or persistent symptoms after supraglottoplasty and may require additional interventions.
Ear, nose, & throat journal, 2012
The Annals of otology, rhinology, and laryngology, 2011
We evaluated the validity and efficacy of a pediatric airway foreign body simulation for otolaryn... more We evaluated the validity and efficacy of a pediatric airway foreign body simulation for otolaryngology resident training. We created a course using a high-fidelity toddler mannequin designed to instruct and evaluate otolaryngology residents in pediatric airway foreign body management. Seven junior and 5 senior residents participated. Their performance was evaluated by 2 observers using an Objective Structured Assessment of Technical Skills (OSATS) instrument. By the third trial, all junior and senior residents scored a proficiency level of "independent without errors" or "independent and efficient," and the performance of the junior residents was not different from that of the senior residents. After completing the course, the junior residents self-rated their abilities as commensurate with those of a senior resident, and senior residents rated themselves capable of performing foreign body extraction without supervision. All participants felt that the course and...
Ear, nose, & throat journal, 2010
Despite the presence of normal facial nerve function in the immediate postoperative period, patie... more Despite the presence of normal facial nerve function in the immediate postoperative period, patients may develop facial nerve dysfunction anywhere from several hours to several days after otologic surgery. This delayed facial paresis, following a broad range of otologic surgeries, has been well described in adults but not in pediatric patients. Viral reactivation is increasingly implicated as the underlying etiology of delayed facial paresis. We present a case of delayed facial paresis in a pediatric patient with a clinical course consistent with viral reactivation.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2006
International Journal of Pediatric Otorhinolaryngology, 2014
Deep space neck infections (DNI) are a significant clinical entity in the pediatric population, c... more Deep space neck infections (DNI) are a significant clinical entity in the pediatric population, commonly affecting the retropharyngeal, parapharyngeal, or peritonsillar spaces [1]. While most pediatric DNI respond to intravenous antibiotics and surgical incision and drainage, rare cases can lead to lifethreatening complications. Pediatric DNI have been associated with mediastinitis, jugular vein thrombosis, and airway obstruction [2,3]. There has been concern that the incidence of DNI in children is increasing [4-6]. Widespread use of antibiotics in the primary care setting has contributed to an increase in drug-resistant bacterial strains in normal oropharyngeal flora. Methicillin-resistant Staphylococcus aureus (MRSA) is becoming a more common organism isolated from head and neck aspirates [7-13]. Although it has been demonstrated that the nature of pediatric DNI is changing, there has not been a study at the national level to
International Journal of Pediatric Otorhinolaryngology, 2009
Otolaryngology–Head and Neck Surgery
Objectives There is limited evidence regarding use of routine perioperative antibiotics for pedia... more Objectives There is limited evidence regarding use of routine perioperative antibiotics for pediatric otolaryngologic procedures. The objectives of this quality improvement study were (1) to characterize the otolaryngology case mix for which antibiotics were delivered and (2) determine the percentage of surgical encounters with appropriate timing of antibiotic administration. Methods Pediatric otolaryngology procedures meeting criteria from 2015 to 2019 were evaluated as a component of an institution-wide pediatric surgical antibiotic prophylaxis study using A3 problem solving to identify and roll out interventions for appropriate antibiotic administration. Descriptive statistical analysis of the interrupted time-series data was used to describe the otolaryngology case mix for which antibiotics were delivered. The primary outcome measure was percentage of surgical encounters with appropriate timing of antibiotic administration in minutes relative to incision. Results In total, 1520 ...
Otolaryngology–Head and Neck Surgery
Objective Outcomes following cochlear implantation in children with X-linked deafness-2 are varia... more Objective Outcomes following cochlear implantation in children with X-linked deafness-2 are variable, resulting in challenges in appropriate preoperative counseling. To address this uncertainty, we performed a systematic review and synthesis of the literature on audiologic and speech outcomes after cochlear implantation in these patients to inform prognostic counseling. Data Sources PubMed, Embase, and Cochrane Library were queried for articles published between January 2000 and July 2019. Review Methods We performed a systematic review of all studies published between 2000 and 2019 that reported on (1) children with confirmed X-linked deafness-2 undergoing cochlear implantation and (2) formal assessment of hearing and/or speech capabilities postimplantation. Results Our initial database search yielded 313 articles. Fourteen articles met inclusion criteria. These studies reported on 61 children with X-linked deafness-2 who underwent implantation at a wide age range (1-29 years) for ...
OTO Open
Objective Appropriate timing of subspecialty simulation is critical to maximize learner benefit a... more Objective Appropriate timing of subspecialty simulation is critical to maximize learner benefit and guide resource utilization. We aimed to determine optimal timing of a simulation-based curriculum designed to teach entry-level procedural skills for otolaryngology residency. Study Design Simulation curriculum intervention tested among 3 comparison groups of varying clinical levels. Setting Academic otolaryngology training program and medical school. Subjects and Methods We developed a simulation-based technical skills curriculum incorporating the following task trainers: flexible laryngoscopy, peritonsillar abscess drainage, and myringotomy and tube insertion. Preclinical medical students (n = 40), subintern rotators (n = 35), and midyear interns (n = 8) completed the simulation-based curriculum. Pre- and postintervention knowledge/confidence and “level appropriateness” were rated on a 5-point Likert scale, and effect size was calculated. Results Overall self-reported knowledge/conf...
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, Jan 21, 2018
The future vibrancy, relevancy, and strength of our specialty depend on cultivating a pipeline of... more The future vibrancy, relevancy, and strength of our specialty depend on cultivating a pipeline of resident otolaryngologists who embody what our society wishes to become. In attracting, seeking, and nourishing physicians of all stripes, we offer several considerations regarding medical student education and the residency selection process.
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 2018
Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, a... more Rates of burnout, mental illness, and suicide are disproportionately elevated among physicians, and surgical specialists, including otolaryngologists, are at even higher risk for professional burnout. These trends have been identified at both the trainee and attending level. To combat resident burnout, the Accreditation Council for Graduate Medical Education (ACGME) Council of Review Committee Residents (CRCR) designed the Back to Bedside Initiative, the goals of which are to foster meaning in the learning environment and to help trainees to engage more deeply with patients. Two funded Back to Bedside proposals involve otolaryngology training programs. Herein, we discuss these 2 approaches in an effort to foster additional novel resident wellness initiatives and awareness thereof across our subspecialty.
Otolaryngology-Head and Neck Surgery
Objective 1) Determine the operation specific decannulation rate of patients who required posteri... more Objective 1) Determine the operation specific decannulation rate of patients who required posterior costal cartilage grafting (PCCG) in the management of laryngeal stenosis. 2) Describe the complications associated with PCCG laryngotracheoplasty. 3) Describe voice outcomes for selected patients. Methods A retrospective review was performed on all cases of posterior graft laryngotracheoplasty (LTP) performed by the 2 senior authors over a 9-year period at a tertiary care children's hospital. Results There were 42 total patients. The operation specific decannulation rates were 100% (3/3) for Myer-Cotton grade II SGS, 75% (20/26) for grade III, and 60% (3/5) for grade IV. For posterior glottic stenosis (PGS), it was 57% (4/7) and for PGS with grade II SGS, it was 60% (6/10). There was no significant difference (p=0.727) among these groups. The overall decannulation rates were 100% (3/3), 96% (25/26), and 100% (5/5) for Myer-Cotton grades II, III and IV. For PGS, it was 83% (5/6), a...
Archives of Otolaryngology Head Neck Surgery, 2011
Otolaryngology -- Head and Neck Surgery, 2012
International Journal of Pediatric Otorhinolaryngology Extra, 2013
ABSTRACT The differential diagnosis for an external auditory canal mass is relatively broad, with... more ABSTRACT The differential diagnosis for an external auditory canal mass is relatively broad, with exostosis, osteoma, fibroma, keratoma, and congenital cholesteatoma among the more common diagnoses. However, an additional diagnosis, external auditory canal chondroma, should also be considered in the differential. These rare lesions are most often found in individuals of Asian ancestry. However, this is not always the case as demonstrated by this case report of an external auditory canal chondroma in a Caucasian teenager.
International journal of pediatric otorhinolaryngology, 2014
Presentation of a case of pediatric laryngeal neurofibroma (LNF) and review of the world literatu... more Presentation of a case of pediatric laryngeal neurofibroma (LNF) and review of the world literature. Comprehensive review of the world literature using Pubmed and Google scholar. Pediatric LNF was identified in 62 cases reported in the world literature. The most common presenting symptom is stridor and the most common location of the tumor in the larynx is the aryepiglottic fold. Recent reports demonstrate increased utilization of endoscopic resection with reduced need for tracheostomy. Pediatric LNF is a rare disorder. Review of the world literature since 1940 suggests a recent trend away from aggressive open resection and toward more conservative endoscopic resection with excellent functional results.
Paediatric respiratory reviews, Jan 28, 2015
Laryngomalacia is the most common cause of stridor in neonates and infants. Associated feeding di... more Laryngomalacia is the most common cause of stridor in neonates and infants. Associated feeding difficulties are present in approximately half of the children. A definitive diagnosis can generally be made with flexible fiberoptic laryngoscopy. The disorder is most often self-limited with resolution of symptoms within the first 24 months of life, and the majority of children can thus be managed conservatively. The approximately 5%-20% of children with severe or refractory disease may require more aggressive intervention, most commonly in the form of trans-oral supraglottoplasty [1,2]. High success rates and a low rate of complications have been reported for this procedure in otherwise healthy children. Children with syndromes or medical comorbidities are more likely to have complications or persistent symptoms after supraglottoplasty and may require additional interventions.
Ear, nose, & throat journal, 2012
The Annals of otology, rhinology, and laryngology, 2011
We evaluated the validity and efficacy of a pediatric airway foreign body simulation for otolaryn... more We evaluated the validity and efficacy of a pediatric airway foreign body simulation for otolaryngology resident training. We created a course using a high-fidelity toddler mannequin designed to instruct and evaluate otolaryngology residents in pediatric airway foreign body management. Seven junior and 5 senior residents participated. Their performance was evaluated by 2 observers using an Objective Structured Assessment of Technical Skills (OSATS) instrument. By the third trial, all junior and senior residents scored a proficiency level of "independent without errors" or "independent and efficient," and the performance of the junior residents was not different from that of the senior residents. After completing the course, the junior residents self-rated their abilities as commensurate with those of a senior resident, and senior residents rated themselves capable of performing foreign body extraction without supervision. All participants felt that the course and...
Ear, nose, & throat journal, 2010
Despite the presence of normal facial nerve function in the immediate postoperative period, patie... more Despite the presence of normal facial nerve function in the immediate postoperative period, patients may develop facial nerve dysfunction anywhere from several hours to several days after otologic surgery. This delayed facial paresis, following a broad range of otologic surgeries, has been well described in adults but not in pediatric patients. Viral reactivation is increasingly implicated as the underlying etiology of delayed facial paresis. We present a case of delayed facial paresis in a pediatric patient with a clinical course consistent with viral reactivation.
Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology, 2006
International Journal of Pediatric Otorhinolaryngology, 2014
Deep space neck infections (DNI) are a significant clinical entity in the pediatric population, c... more Deep space neck infections (DNI) are a significant clinical entity in the pediatric population, commonly affecting the retropharyngeal, parapharyngeal, or peritonsillar spaces [1]. While most pediatric DNI respond to intravenous antibiotics and surgical incision and drainage, rare cases can lead to lifethreatening complications. Pediatric DNI have been associated with mediastinitis, jugular vein thrombosis, and airway obstruction [2,3]. There has been concern that the incidence of DNI in children is increasing [4-6]. Widespread use of antibiotics in the primary care setting has contributed to an increase in drug-resistant bacterial strains in normal oropharyngeal flora. Methicillin-resistant Staphylococcus aureus (MRSA) is becoming a more common organism isolated from head and neck aspirates [7-13]. Although it has been demonstrated that the nature of pediatric DNI is changing, there has not been a study at the national level to
International Journal of Pediatric Otorhinolaryngology, 2009