Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P159

Poster Presentations

Objectives: Laryngeal mask airway (LMA) presents an
alternative to endotracheal tube (ETT) for airway management during surgery. Although LMA may have anesthetic
advantages, there is some concern that a larger LMA may
interfere with oropharyngeal surgery and hemostasis. Our
objective is to determine if LMA use affects postoperative
bleeding for tonsillectomy.
Methods: A retrospective review was performed of patients
undergoing tonsillectomy in our institution's network within a
5-year period. We reviewed all cases of operative intervention
for post-tonsillectomy hemorrhage. When available, indicators of postoperative pain were also reviewed as a secondary
outcome.
Results: A total of 250 cases were reviewed, including data
from 6 hospitals, 6 ambulatory surgical centers, and 28 different surgeons. ETT was used in 199 cases, and LMA was used
in 51. The overall posttonsillectomy hemorrhage rate requiring operative intervention was 4.8%. A higher bleed rate was
seen in the LMA group, although this was not statistically significant (ETT 4.5%, LMA 5.9%, χ2[1] = 0.164, P = .685). The
average timing of bleed was postoperative day 8.4 for the ETT
group and 9.3 for LMA. No primary hemorrhages occurred.
No statistically significant difference was found in rates of
postoperative pain control: phone call into office (ETT 24.8%,
LMA 35.4%, χ2[1] = 1.199, P = .273), pain medication refill
(ETT 16.3%, LMA 21.9 %, χ2[1] = 0.559, P = .455), and visits
to the emergency department for pain or dehydration (ETT
7.8%, LMA 6.3%, χ2[1] = 0.084, P = .772).
Conclusions: The rate of secondary posttonsillectomy hemorrhage is low with both ETT and LMA. Bleeding rate is slightly
higher with LMA than ETT, although this difference is not statistically significant. Additional data collection is ongoing.
Interest in Otolaryngology-Head and Neck
Surgery Residency: Can Google Trends Be a
Predictive Tool?
Austin L. Johnson (Presenter); Trevor Torgerson;
Craig Cooper; Tom A. Hamilton, DO; Adam Corcoran;
Matt Vassar, PhD
Traditionally, otolaryngology has been one of the more
highly sought after and competitive medical residencies for
medical school graduates. However, recently, the number of
otolaryngology applications have trended downward as fewer
US senior medical students are applying even when compared
with other highly competitive specialties. Here, we evaluate
the association between the US senior applicant pool for otolaryngology residency programs and internet search queries
for otolaryngology residency. Using Google Trends, a search
was conducted on August 17, 2019, using the key terms oto-
laryngology residency and ENT residency and was limited to

the United States to better represent US senior medical graduates. The NRMP otolaryngology residency match data were
also obtained with permission for the time period of 2008 to
2018. The Google Trends tool showed a relative year-to-year
increase in search volume interest for both keyword terms
ENT residency and otolaryngology residency from 2008 to
2016. This increase in search volumes from 2008 to 2016 positively correlated with the number of US senior applicants for
an otolaryngology residency position. In 2016, both relative
search interest for keywords and the number of US senior
applicants experienced a decrease, with subsequent steady
recovery in the following years. The relative number of applicants to otolaryngology residencies mirrored the same relative
number of Google Trend inquiries during the "match crisis" in
2017. These results demonstrate the potential benefit of
Google Trends as a predictive tool to provide useful foresight
into medical school graduates' interest in pursuing otolaryngology for residency program directors and other stakeholders
in the field.
Monitoring Burnout: Tracking Outcomes of
a Novel Approach to Resident Wellness
Lawrence Kashat, MD (Presenter); Maua Mosha;
Todd E. Falcone, MD; Bridgette Carter; Kourosh
Parham, MD, PhD; Katherine Kavanagh, MD
Objectives: Wellness is a critical component of residency
education. The goals of this study are (1) to implement a resident wellness curriculum, (2) to regularly measure resident
burnout with the Maslach Burnout Inventory (MBI) and
Professional Fulfillment Index (PFI), and (3) to assess for
change and correlation between MBI and PFI scores.
Methods: Otolaryngology residents participated in a yearlong wellness curriculum, designed using a needs assessment
and focus group. Burnout symptoms were monitored prospectively using MBI and PFI at 0, 5, and 10 months. Resident
responses were coded for anonymity. Repeat-measures analysis of variance was performed to assess changes in MBI and
PFI. Correlation was measured using Pearson correlation.
Results: All residents surveyed showed signs of burnout.
Residents reported fewer symptoms of burnout at 5 months
but not at 10 months. A statistically significant decrease in
MBI depersonalization (DP) scores was noted at 5 months.
Among MBI categories, there was moderate correlation
between emotional exhaustion (EE) and DP (r = 0.554, P =
.006). EE also moderately correlated with PFI interpersonal
disengagement (ID; r = 0.457, P = .028) and inversely correlated with professional fulfillment (r = −0.452, P = .30).
Among PFI categories, there was moderate correlation
between ID and work exhaustion (r = 0.457, P = .028).
Conclusions: Our pilot study found that resident burnout
symptoms can be tracked longitudinally using MBI and
PFI. Correlation between PFI and MBI categories suggests
that PFI may be a cost-effective tool to track resident burnout. The routine monitoring of resident burnout is an important step in assessing the efficacy of residency wellness
measures.

Comprehensive

Influence of Laryngeal Mask Airway Versus
Endotracheal Intubation on Tonsillectomy
Postoperative Hemorrhage
Rebecca Chota Nelson, MD (Presenter); Eve Tranchito;
Alan Kominsky, MD

P159

Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts

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