Objective: Residency interviews serve as an opportunity for prospective applicants to evaluate programs and to determine their potential fit within them. The 2019 SARS-CoV2 pandemic mandated programs conduct interviews virtually for the first time. The purpose of this study was to assess applicant perspectives on the virtual interview. Methods: A Qualtrics survey assessing applicant characteristics and attitudes toward the virtual interview was designed and disseminated to otorhinolaryngology applicants from 3 large academic institutions in the 2020 to 2021 application cycle. Results: A total of 33% of survey applicants responded. Most applicants were satisfied with the virtual interview process. Applicants reported relatively poor quality of interactions with residents and an inability to assess the “feel” of a geographic area. Most applicants received at least 11 interviews with over a third of applicants receiving >16 interviews. Only 5% of applicants completed >20 interviews. Most applicants believed interviews should be capped between 15 and 20 interviews. Most applicants reported saving >$5000, with over a quarter of applicants saving >$8000, and roughly one-third of applicants saving at least 2 weeks of time with virtual versus in-person interviews. Conclusions: While virtual interviews have limitations, applicants are generally satisfied with the experience. Advantages include cost and time savings for both applicants and programs, as well as easy use of technology. Continuation of the virtual interview format could be considered in future application cycles; geographical limitations may be overcome with in-person second looks, and increased emphasis should be placed on resident interactions during and prior to interview day.
Objective The purpose of our study was to correlate sentinel lymph nodes (SLN) found on planar lymphoscintigraphy (LS) to SLN found with gamma probe–directed sentinel lymph node biopsy (SLNB) for T1/T2 N0 oral cavity cancer. Study Design Prospective cooperative group trial. Setting Academic medical centers. Subjects and Methods One hundred forty adults with untreated T1/T2 N0 squamous cell carcinoma (SCC) of the oral cavity underwent planar LS, resection, SLNB, and neck dissection. Location of SLN by planar LS and SLNB and of metastases were compared to each other and historical data of regional metastases. Results SLNs located by planar LS and SLNB were predominantly in levels I through IV. There was heterogeneity in the number of SLNs found at planar LS and at SLNB, which was significantly different in levels II and III (P < .0001). In 14 of 33 cases with bilateral drainage on planar LS, SLNB detected only unilateral SLN. Sensitivity of planar LS in predicting the level of SLN was 41% to 63%, and specificity was 68% to 95%. Comparison of locations of the metastases to historical data showed fewer metastases to level I in our study (P = .03). Metastases occurred predominantly in levels I through III. In 1 case of a lateral tongue cancer, a contralateral SLN was the only positive node. Conclusion Lymphatic drainage patterns and metastases involved predominantly levels I through III. Planar LS is not sensitive for predicting the levels of SLN, and in levels II and III, the rate of detection of SLN between the 2 modalities is significantly different.
The trigeminocardiac reflex can be provoked by a number of head and neck and skull base procedures including parotidectomy and posterior maxillectomy. Surgeons and anesthesiologists should be wary of inciting the reflex during manipulation of trigeminal branches. Careful dissection for prevention and early intervention with stimulus removal and anticholinergic use as needed are paramount to ensure good outcomes.
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