SP144 – Primary care perceptions of otolaryngology

members is low at 11.87%, women accounted for 14.65% of first authors delivering oral presentations and 19.46% of first authors giving poster presentations. The eventual publication rates of abstracts presented by female authors as well as the average time to publication - appear equal to that of men. Women presented a larger proportion of poster presentations than oral presentations, and most commonly presented in pediatric otolaryngology. SP144 – Primary care perceptions of otolaryngology Mark C. Domanski, MD (presenter); Neil Tanna, MD; Samaneh Ashktorab; David R. Nielsen, MD; Steven A. Bielamowicz, MD OBJECTIVES: 1) To learn the perceptions of otolaryngology by primary care physicians. 2) To identify diseases of the head and neck where primary care physicians underappreciates the role of the otolaryngologist. 3) To understand how primary care resident education can be improved regarding the scope of practice of the otolaryngologist. METHODS: A brief, web-based survey was administered via email to resident physicians of primary care, pediatrics, and internal medicine programs in the United States and Canada. The survey asked the responder which specialist they felt was an expert for a particular clinical entity. These included allergies, oral cancer, restoring a youthful face, sleep apnea, thyroid surgery, and tracheostomy. Respondents could choose from a dermatologist, general surgeon, ophthalmologist, oral maxillofacial surgeon, orthopedic surgeon, otolaryngologist, and plastic surgeon. The responder had the ability to choose more than one specialist for each question. RESULTS: A total of 739 completed surveys were analyzed. The percentage of primary care residents who picked otolaryngologists as experts was: 13.5% for allergies, 72.2% for oral cancer, 2.8% for restoring a youthful face, 42.7% for sleep apnea, 48.5% for thyroid surgery, 74.6% for tracheostomy. CONCLUSIONS: It is evident that there are omissions in the training of primary care physicians in regard to their awareness of the specialty of otolaryngology. This study demonstrates that many primary care residents are not aware of the scope of expertise that an otolaryngologist may offer. Therefore, increased exposure to otolaryngology during primary care residents training would increase understanding of the specialty among primary care physicians. SP153 – Quantitative medical decision-making: An overview Brian Blakley, MD, PhD, FRCSC (presenter) OBJECTIVES: To illustrate the application of medical decision analysis using two examples from clinical otolaryngology. METHODS: Although evidence-based medicine and random-

P139 ized clinical trials are accepted decision tools, most randomized controlled trials address only one question or treatment. Treatment options and adverse effects are typically not considered in the same study. Quantitative medical decision analysis represents an attempt to include as much information as possible to arrive at quantifiable treatment decisions. Decision analysis has not been widely applied in otolaryngology, but is gaining acceptance and may become crucial for clinicians and policy-makers in the future. RESULTS: Using evidence-based medicine with decision nodes, chance nodes, utility factors and other concepts, decision analysis will be illustrated. Two otolaryngology examples tonsillectomy and stapedectomy which vary in complexity will illustrate pitfalls. CONCLUSIONS: Although decision analysis is a quantitative, it has weaknesses that should be understood. SP148 – Septal perforation bleeding controlled by a biologic sponge Andrew J Lerrick, MD (presenter); Alexis M Mandli, PA-C OBJECTIVES: Epistaxis from a septal perforation site is generally more difficult to manage than bleeding from the intact septum because application of direct pressure is less sustainable. Placement of a biodegradable dressing provides an effective means for control of nasal bleeding. METHODS: The nasopore nasal dressing is a compressible, oblong-shaped, biodegradable, polyurethane foam. When moistened, the dressing expands, contours to the nasal cavity, and applies pressure to the surfaces it contacts. Over several days, exposure to nasal secretions causes its dissolution. Application of silver nitrate to the bleeding site(s) is not necessary in most situations. Antibiotic ointment is applied to the dressing. An 8cm sponge is inserted using a bayonet, with further advancement for precise positioning, as needed. Initial application of 1,000-2,000 units of thrombin is applied to the dressing, either via needle insertion or topically. RESULTS: Although breakthrough bleeding rarely occurs the dressing can be reinforced with additional packing to maintain adequate intranasal pressure and surface contact at the site of bleeding. CONCLUSIONS: The combination of a thrombin-activated biodegradable dressing possessing expansible properties establishes biochemical and physical effects are sufficient to control septal perforation bleeding. SP137 – Spindle cell lipoma of the oropharynx and hypopharynx Jacquelyn Brewer, MD (presenter); Ted Mau, MD, PhD

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