Otolaryngology Head and Neck Surgery Volume 112 Number 5
Instruction Courses-- Monday P73
can survive individually and as a group in today's health care environment. There is no conclusive proof that managed care reduces costs or improves quality and employed physicians can have a conflict of interest if they advocate certain treatment for their patient, yet their employer demands another. Managed care and physicians employment will be discussed from the independent physicians's standpoint. The author, who has been in independent practice since 1979, will present the methods he currently employs to survive. These included patient satisfaction surveys, post operative outcomes surveys, LAUP outcomes with pre- and postoperative ambulatory sleep studies, intervention on behalf of the patient with review of hospital charges and efforts to control radiographic, laboratory, and anesthesia fees. The production of patient information and practice information pamphlets within the office will be presented as will the elimination of paper from the office with docuscanning of records. The author will discuss how independent private practitioners can publish meaningful and helpful scientific papers in the literature. In the second half of the course the author will lead a discussion of how the other attendees are surviving the current health care environment. Bring your ideas!
COURSE 2512-I One-period course ($20)
Room NOCC-61 12:30-1:30
COURSE 2513-1 One-period course ($20)
Room NOCC-62 12:30-1:30
Facial Nerve Surgery JACK L. PULEC,MD Los Angeles, Calif.
Educational objectives: To select and recommend to patients specific surgical procedures for facial nerve problems and to accurately perform facial nerve surgery, depending on participants' basic level of surgical competence. The surgical approaches and techniques to treat lesions of the facial nerve have been perfected to provide effective and predictable results. The objective of this course is to demonstrate the philosophy, principles, and current techniques to manage all facial nerve problems. The course will be illustrated by slides and videotapes. The methods to expose and identify the facial nerve anywhere between the brainstem and the parotid gland will be described. The method of performing facial nerve decompression without surgical complication will be demonstrated. The technique for facial nerve grafting and the procedure for excision of the geniculate ganglion and nervus intermedius for the treatment of geniculate ganglion neuralgia will be reviewed. The surgical management of hemifacial spasm will be described. The surgical technique for complete removal of cholesteatoma from the facial nerve without producing injury to the nerve will be described.
Functional Neck Dissection JAVIER GAVILAN, MD, JESOSHERRANZ,MD, and C~:SARGAVILAN, MD Madrid and La Corufia, Spain
COURSE 2514-1 One-period course ($20)
Educational objectives: To describe the step-by-step surgi-
Hearing Aids I: Fundamentals for the New Otolaryngologist
cal technique of functional neck dissection and to understand the rationale, indications, and results of functional neck dissection. Functional neck dissection (FND) was described by Osvaldo Su~rez in the early 1960s. The operation is based on the fascial compartmentalization of the neck. Although initially controversial, the procedure has been proven oncologically safe and has gained worldwide acceptance among head and neck surgeons. The functional and cosmetic advantages of FND are meritorious. The course is based on experience with more than 1500 FNDs performed since 1969. This is a surgically oriented course dedicated to emphasize the technical aspects of the operation. A step-by-step description of the surgical technique will be illustrated with high-quality slides and a videotape. The rationale, indications, and results of the procedure will also be discussed. Handouts given to attenders will reduce the need for notetaking and provide a valuable reference for later review. They include the slide elements and several articles with the surgical technique and results of the operation. Ample time will be allotted for discussion.
Room NOCC-63 12:30-1:30
RICHARD H. NODAR, PhD Cleveland, Ohio
Educational objectives: To determine candidacy for hearing aids, particularly the body aid, such as BTE, ITE, ITC, CIC, CROS, BiCROS, IROS, and Power CROS, and to understand earmold types and applications. This short course is designed to serve as a refresher for the beginning otolaryngologist. It will begin with a brief overview of a hearing aid, including its four basic components, and an overview of its development. There will be a discussion of determining a candidate for a hearing aid and the question of whether one or two aids are appropriate. We will then move to the different types of hearing aids and their applications and appropriateness for different types of hearing loss including a body aid, BTE, ITE, ITC, CIC, CROS, BiCROS, IROS, and Power CROS. The discussion will then turn to earrnolds and the appropriateness of vented versus open, closed, and filtered earmolds for the various types of hearing loss. The course will conclude with a discussion of the advantages and disadvantages of all of the above.