What is the scope of pediatric otolaryngology practice within and outside the United States and how has that changed over the past decade?
In this survey study of 42 pediatric otolaryngology departments, 33 respondents reported the least involvement in procedures pertaining to facial plastic and reconstructive surgery, aerodigestive endoscopy, and congenital anomalies and the most involvement in otology, airway, rhinology, and general procedures. Most reported that their department’s degree of involvement in each procedure remained the same from 2006 to 2016.
Involvement by the pediatric otolaryngology department varies by procedure, but these changes should be monitored to adequately adjust clinical practices.
Monitoring current trends in pediatric otolaryngology will help adjust our training and practice paradigms in a way that ensures the long-term viability of the specialty.
To gauge the current scope of pediatric otolaryngology (ORL) practice within and outside of the United States and to identify changes in caseload over the past decade.
Design, Setting, and Participants
An online survey was sent to pediatric ORL chairs and/or fellowship directors at 42 institutions in the United States and abroad. For 59 procedures, respondents were asked to estimate the percentage of cases performed by their department, determine whether this percentage has changed over the past 10 years (2006-2016), and identify any other specialties performing the procedure. Data were collected during a 2-week period in October 2016, from October 7 through 21, and analyzed from November 2016 through February 2017.
Main Outcomes and Measures
Main outcomes included the percentage of operations currently performed by the respondent’s department for each procedure; whether this percentage has decreased, increased, or remained the same over the past decade; other specialties that perform each procedure; and any procedures added to or eliminated from the respondent’s practice over the past decade.
Respondents from 33 of the 42 academic institutions completed the survey (23 in the United States and 10 international; 79% response rate). Respondents reported the least involvement in procedures pertaining to facial plastic and reconstructive surgery, aerodigestive endoscopy, and congenital anomalies. Conversely, a mean (SD) of 91% (7%) reported performing 90% to 100% of otology, airway, rhinology, and general procedures. A mean (SD) of 82% (11%) reported that their department’s involvement in each procedure has remained the same from 2006 to 2016.
Conclusions and Relevance
The specialty of pediatric ORL has evolved over the past decade. There has been a notable decline in involvement in facial plastic and reconstructive surgery and treatment of vascular malformations and esophageal disorders. The management of thyroid disease is in flux. Monitoring current trends to adjust training and practice paradigms will ensure the long-term viability of the specialty.
Irace AL, Shank C, Adil EA, Cunningham MJ, Kawai K, Sideridis G, Rahbar R. Changes in Scope of Procedures Performed by Pediatric Otolaryngologists in the Past Decade. JAMA Otolaryngol Head Neck Surg. Published online February 22, 2018. doi:10.1001/jamaoto.2017.3164
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