Antibiotic therapy against non-tuberculous mycobacteria (NTM) is prolonged and can be associated with toxicity. We sought to evaluate whether chest physical therapy (PT) was associated with clinical improvement in patients with NTM not receiving anti-mycobacterial pharmacotherapy. A retrospective review of 77 subjects that were followed from June 2006 to September 2014 was performed. Baseline time point was defined as the first positive sputum culture for NTM; symptoms, pulmonary function, and radiology reports were studied. Subjects were followed for up to 24 months and results analyzed at specified time points. Half of the subjects received chest PT at baseline. Cough improved at 12 (p = 0.001) and 24 months (p = 0.003) in the overall cohort when compared with baseline, despite lack of NTM antibiotic treatment. Cough decreased at 6 (p = 0.01), 9 (p = 0.02), 12 (p = 0.02) and 24 months (p = 0.002) in subjects that received chest PT. Sputum production also improved at 24 months in the overall cohort (p = 0.01). There was an increase in the percent change of total lung capacity in subjects that received chest PT (p = 0.005). Select patients with NTM may have clinical improvement with chest PT, without being subjected to prolonged antibiotic therapy. Future studies are warranted to prospectively evaluate outcomes in the setting of non-pharmacologic treatment and aid with the decision of antibiotic initiation.

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While otolaryngology (ORL) bootcamps are being increasingly utilized for resident education, many simulators are prohibitively expensive or complicated to construct. We constructed and validated a novel low cost and low fidelity endoscopic sinus surgery skills trainer (ESSST). After construction, participants were divided into 3 groups based on endoscopic sinus surgery (ESS) experience. The study participants were asked to perform 3 tasks. Their performance was videotaped and subsequently blindly evaluated by two rhinologists. Each task was scored based on performance and economy of motion using a standard scoring sheet. A one-way ANOVA and Post Hoc Tukey Tests were used to determine if there was a significant difference in performance of the 3 groups. The data suggests that skill and experience with ESS directly translates to the simulator, supporting that the ESSST is low cost, validated, renewable and a useful adjunct to higher fidelity simulators.