Giovanni Cammaroto1,2, Giulia Bianchi3, Henry Zhang4, Vik Veer4, Bhik Kotecha4, Ofer Jacobowitz5, Marina Carrasco Llatas6, Paula Martínez Ruiz de Apodaca6, Rodolfo Lugo7, Giuseppe Meccariello8, Giannicola Iannella8, Riccardo Gobbi8, Song Tar Toh9, Ying-Shuo Hsu10, Ahmed Yassin Baghat11, Jerome R Lechien12,13, Christian Calvo-Henriquez12,14, Carlos Chiesa-Estomba12,15, Maria Rosaria Barillari12,16, Badr Ibrahim12,17, Tareck Ayad12,17, Nicolas Fakhry12,18, Paul Hoff19, Eric Rodrigues Thuler20, Lyndon Chan21, Chloe Kastoer22, Madeline Ravesloot23, Andrea De Vito24, Filippo Montevecchi8, Claudio Vicini8,12. 1. Unit of Otolaryngology, Hospital Morgagni Pierantoni, Via Carlo Forlanini 2, 47100, Forlì, Italy. giovanni.cammaroto@hotmail.com. 2. Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. giovanni.cammaroto@hotmail.com. 3. Unit of Otolaryngology, University of Ferrara, Ferrara, Italy. 4. Unit of Otolaryngology, Head and Neck Surgery, Royal National Throat, Nose and Ear Hospital, London, UK. 5. ENT and Allergy Associates, New York, NY, USA. 6. Department of Otorhinolaryngology, Dr. Peset University Hospital, Valencia, Spain. 7. Department of Otorhinolaryngology, Grupo Medico San Pedro, Monterrey, Mexico. 8. Unit of Otolaryngology, Hospital Morgagni Pierantoni, Via Carlo Forlanini 2, 47100, Forlì, Italy. 9. Department of Otolaryngology, Singapore General Hospital, Singhealth Duke-NUS Sleep Centre, National University of Singapore, Yong Loo Lin School of Medicine & Duke-NUS Medical School, Singapore, Singapore. 10. Department of Otolaryngology, Shin Kong Wu Ho-Su memorial Hospital, Taipei, Taiwan. 11. Department of Otorhinolaryngology, Alexandria University, Alexandria, Egypt. 12. Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France. 13. Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium. 14. Service of Otolaryngology, Travesía de Choupana, Hospital Complex of Santiago de Compostela, Santiago de Compostela, Spain. 15. Service of Otolaryngology, Donostia University Hospital, San Sebastian, Spain. 16. Department of Mental and Physical Health and Preventive Medicine, University of L. Vanvitelli, Naples, Italy. 17. Division of Otolaryngology-Head and Neck Surgery, Centre Hospitalier de l'Université de Montréal, Montreal, QC, Canada. 18. Department of Otorhinolaryngology-Head and Neck Surgery, La Conception University Hospital, APHM, Aix Marseille University, Marseille, France. 19. Department of Otolaryngology, Head and Neck Surgery, University of Michigan, Ann Arbor, MI, USA. 20. Samaritano Hospital, São Paulo, Brazil. 21. Illawarra ENT Head and Neck Clinic, Wollongong, NSW, Australia. 22. Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium. 23. Department of Otorhinolaryngology - Head and Neck Surgery, OLVG, Amsterdam, the Netherlands. 24. Head & Neck Department, Ear Nose Throat (ENT) Unit, Santa Maria delle Croci Hospital, Romagna Health Company, Ravenna, Italy.
Abstract
PURPOSE: No study to date has described the overall landscape of sleep disorders management and training in otolaryngology departments of different countries. The aim of our study was to investigate and compare settings, diagnostic and therapeutic approaches and training programmes. METHODS: An international online survey was developed with the collaboration of the YO-IFOS (Young Otolaryngologists-International Federation of Otorhinolaryngological Societies) to assess the current practice of otolaryngologists in the management of sleep disorders. The survey also included a session dedicated to training. RESULTS: A total of 126 otolaryngologists completed the survey. The larger part of responses was collected from Central/South America and Europe. The majority of responders from South/Central America (97%) declared to be certified as sleep specialist while 49% of Europeans stated the opposite. Of responders 83% perform a drug-induced sleep endoscopy (DISE) before planning a possible surgical intervention. Soft palate and base of tongue interventions were the most common procedure, respectively performed in 94% and 79% of the cases. Residents were allowed to perform soft palate surgery in 77% of the cases. Upper airway stimulation (26% vs 10%), trans-oral robotic surgery (36% vs 11%) and radiofrequency of the base of the tongue (58% vs 25%) were preferred more frequently by European responders. The highest caseloads of soft palate surgery and bi-maxillary advancement were registered in the academic institutions. CONCLUSION: Significant concordance and few interesting divergences in diagnosis and treatment of sleep disorders were observed between nationalities and types of institution. Economic resources might have played a significant role in the therapeutic choice. Trainees' lack of exposure to certain interventions and to a sufficient caseload appeared to be the main burden to overcome.
PURPOSE: No study to date has described the overall landscape of sleep disorders management and training in otolaryngology departments of different countries. The aim of our study was to investigate and compare settings, diagnostic and therapeutic approaches and training programmes. METHODS: An international online survey was developed with the collaboration of the YO-IFOS (Young Otolaryngologists-International Federation of Otorhinolaryngological Societies) to assess the current practice of otolaryngologists in the management of sleep disorders. The survey also included a session dedicated to training. RESULTS: A total of 126 otolaryngologists completed the survey. The larger part of responses was collected from Central/South America and Europe. The majority of responders from South/Central America (97%) declared to be certified as sleep specialist while 49% of Europeans stated the opposite. Of responders 83% perform a drug-induced sleep endoscopy (DISE) before planning a possible surgical intervention. Soft palate and base of tongue interventions were the most common procedure, respectively performed in 94% and 79% of the cases. Residents were allowed to perform soft palate surgery in 77% of the cases. Upper airway stimulation (26% vs 10%), trans-oral robotic surgery (36% vs 11%) and radiofrequency of the base of the tongue (58% vs 25%) were preferred more frequently by European responders. The highest caseloads of soft palate surgery and bi-maxillary advancement were registered in the academic institutions. CONCLUSION: Significant concordance and few interesting divergences in diagnosis and treatment of sleep disorders were observed between nationalities and types of institution. Economic resources might have played a significant role in the therapeutic choice. Trainees' lack of exposure to certain interventions and to a sufficient caseload appeared to be the main burden to overcome.
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