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Mixed-reality technology for clinical communication, cocaine screening in patients undergoing nasal reconstructive surgery and prognostic factors for vocal fold leukoplakia

Published online by Cambridge University Press:  27 September 2023

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Abstract

Type
Editorial
Copyright
Copyright © The Author(s), 2023. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED

In the post coronavirus disease 2019 educational landscape, virtual, augmented and mixed reality technologies may prove invaluable in training the next generation of surgeons.Reference Abbas, Kenth and Bruce1,Reference Frithioff, Frendø, von Buchwald, Trier Mikkelsen and Sølvsten Sørensen2 The authors of a study in this month's issue of The Journal of Laryngology & Otology sought out to objectively assess the impact of HoloLens, a mixed reality device, as a clinical communication device in a simulated on-call scenario.Reference Orchard, Van, Abbas, Malik, Stevenson and Tolley3 In their pilot study, 30 ENT trainees used either the HoloLens, or a traditional telephone, to communicate a clinical case to a senior colleague. The quality of the clinical communication was scored objectively and subjectively. This study demonstrated the benefit that mixed reality devices, such as the HoloLens, may bring to the clinical environment in terms of enabling improved communication. The authors recommend that further studies be undertaken in a real clinical setting to allow assessment of the practicalities of using such devices.

Nasal reconstructive surgery in the setting of cocaine abuse is complex, given its highly addictive properties (cocaine is the second most commonly used illicit drug in the UK behind cannabis) and potential to cause significant nasal defects.Reference Green, Gardiner, Vinod, Oparka and Ross4 There is, however, a paucity of literature on current practice among UK rhinologists regarding cocaine screening in patients undergoing nasal reconstructive surgery. Raja et al. have conducted a pan-UK survey of UK rhinologists into this specific issue, and their study is published in this month's issue of The Journal.Reference Raja, Lai and Sunkaraneni5 Fifty-three per cent asked patients about cocaine use prior to consideration of surgery, and 45 per cent specifically performed cocaine testing prior to consideration of surgery. Among the rhinologists who performed cocaine testing, urine drug screening was most commonly used, with 84 per cent of the respondents utilising urine testing, with or without other forms of testing. The authors propose a national formal policy for the pre-operative screening of active cocaine use in patients undergoing nasal reconstructive surgery.

Finally, Yin et al. conducted a study analysing predictive factors for poor prognosis (recurrence and malignant transformation) in 344 patients with vocal fold leukoplakia over a two-year period.Reference Yin, Huang, Sun and Zhang6 The results demonstrate that lesion size, lesion form under white light, surgical method and pathological subtype were independent risk factors for recurrence. Pathological subtype was found to be the sole independent risk factor for malignant transformation.

References

Abbas, JR, Kenth, JJ, Bruce, IA. The role of virtual reality in the changing landscape of surgical training. J Laryngol Otol 2020;134:863–6CrossRefGoogle Scholar
Frithioff, A, Frendø, M, von Buchwald, JH, Trier Mikkelsen, P, Sølvsten Sørensen, M, Arild Wuyts Andersen S. Automated summative feedback improves performance and retention in simulation training of mastoidectomy: a randomised controlled trial. J Laryngol Otol 2022;136:2936CrossRefGoogle ScholarPubMed
Orchard, L, Van, M, Abbas, J, Malik, R, Stevenson, J, Tolley, N. Mixed-reality technology for clinical communication: objective assessment of the HoloLens 2 as a clinical communication device in a simulated on-call scenario. J Laryngol Otol 2023;137:1165–9CrossRefGoogle Scholar
Green, RJ, Gardiner, Q, Vinod, K, Oparka, R, Ross, PD. A case series and literature review on patients with rhinological complications secondary to the use of cocaine and levamisole. J Laryngol Otol 2020;134:440–6CrossRefGoogle Scholar
Raja, H, Lai, K, Sunkaraneni, V. Cocaine screening in patients undergoing nasal reconstructive surgery: a cross-sectional, survey-based study of UK rhinology consultants. J Laryngol Otol 2023;137:1149–53CrossRefGoogle ScholarPubMed
Yin, S, Huang, H, Sun, P, Zhang, D. Analysis of prognostic factors for vocal fold leukoplakia based on 344 cases at a two-year follow up. J Laryngol Otol 2023;137:1170–5CrossRefGoogle Scholar