New Application: Neurotology Review Committee for Otolaryngology acgme program Personnel and Resources



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New Application: Neurotology

Review Committee for Otolaryngology

ACGME


Program Personnel and Resources
Program Director
Briefly describe how the program director will coordinate combined interdisciplinary educational conferences that emphasize cooperative diagnostic efforts and surgical team approaches to operative therapy with neurological surgeons, and combined approaches to rehabilitative efforts with physical medicine and rehabilitation physicians. [PR II.A.4.p)]


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Resources


  1. Indicate whether the following resources are available to the program [PR II.D.1.]




  1. A temporal bone dissection laboratory ☐ YES ☐ NO




  1. Testing facilities for complete auditory and vestibular evaluation and cranial nerve monitoring
    ☐ YES ☐ NO




  1. This form must include data for the most recently completed academic year from each participating site in the neurotology program. The list should include all procedures performed by the otolaryngology/neurotology service. [PR II.D.2.]




PROCEDURE CATEGORIES

CPT Code(s)

Site #1

Site #2

Site #3

Site #4

Total

Approaches for Skull Base Surgery

Middle fossa approach for removal of tumor

61590, 61591, 61592, 66970

#

#

#

#

#

Posterior fossa approach for removal tumor

Translabyrinthine

61526, 61595

#

#

#

#

#

Retrosigmoid/ Suboccipital

61595

#

#

#

#

#

Transcochlear

61596

#

#

#

#

#

Transcondylar

61597

#

#

#

#

#

Transpetrosal

61598

#

#

#

#

#

Combined approach for CPA

61530

#

#

#

#

#

Middle fossa approach-Other

Semicircular canal dehiscence

61590

#

#

#

#

#

Decompression of IAC

69960

#

#

#

#

#

Repair encephalocele

Posterior fossa

62121

#

#

#

#

#

Middle Fossa

62120

#

#

#

#

#

Resection of Neurotologic Tumors

Glomus Tumor Surgery

Tympanomastoid

69552

#

#

#

#

#

Jugulare, extradural

69554, 61615

#

#

#

#

#

Jugulare, intradural

61616

#

#

#

#

#

Middle fossa tumors

Extradural/ Petrous apex

61605

#

#

#

#

#

IAC lesions

61606

#

#

#

#

#

Cavernous sinus, extradural

61607

#

#

#

#

#

Kawase triangle, intradural

61608

#

#

#

#

#

Facial nerve tumor

69970

#

#

#

#

#

Posterior fossa tumors

Retrosigmoid, extradural

61615

#

#

#

#

#

Retrosigmoid, intradural

61616, 61518, 61619

#

#

#

#

#

Translabyrinthine

61616, 61526, 61530

#

#

#

#

#

Temporal bone resection

Temporal bone resection

69150, 69155, 69535

#

#

#

#

#

Reconstruction after Resection of Neurotologic Tumors

By tissue graft (fat, fascia, etc.)

61618, 20926

#

#

#

#

#

By local or regional vascularized flap

61619

#

#

#

#

#

Other Skull Base Surgery

Middle fossa approach-Other

Semicircular canal dehiscence

61590

#

#

#

#

#

Decompression of IAC

69960

#

#

#

#

#

Repair CSF leak

Transmastoid

69670

#

#

#

#

#

Intracranial

62100

#

#

#

#

#

Stereotactic Radiation for Skull Base Lesions

One complex lesion

61798

#

#

#

#

#

Application of stereotactic frame

61800

#

#

#

#

#

Auditory Brainstem Implant

Auditory brainstem implant

61875

#

#

#

#

#

Other Relevant Cases

Facial Nerve Surgery

Decompression: Lateral to geniculate ganglion

69720

#

#

#

#

#

Decompression: Total-Transtemporal

69725, 69955

#

#

#

#

#

Facial Nerve Repair: Intratemporal

69740

#

#

#

#

#

Facial Nerve Repair: Extracranial

64864

#

#

#

#

#

XII-VII Anastomosis

64868

#

#

#

#

#

Nerve Graft Harvest

64885, 64886

#

#

#

#

#

Facial Nerve Repair: Medial to geniculate ganglion

69745

#

#

#

#

#

Ear canal procedures

69140, 69145, 69205, 69222, 69420, 69421, 69424, 69433, 69436

#

#

#

#

#

Reconstructive procedures

69310, 69320

#

#

#

#

#

Middle Ear and Mastoid procedures

Tympanoplasty

69610, 69620, 69631, 69632, 69633

#

#

#

#

#

Tympanomastoidectomy

69635, 69636, 69637, 69641, 69642, 69643, 69644, 69645, 69646

#

#

#

#

#

Mastoidectomy

69501, 69502, 69505, 69511

#

#

#

#

#

Revision Mastoidectomy

69601, 69602, 69603, 69604, 69605

#

#

#

#

#

Mastoid Obliteration

69670

#

#

#

#

#

Stapedectomy

69650, 69660, 69661, 69662

#

#

#

#

#

Middle ear exploration

69440, 69450

#

#

#

#

#

Glomus tympanicum, transcanal

69550

#

#

#

#

#

Perilymph fistula repair

69666, 69667

#

#

#

#

#

Vestibular Surgery

Endolymphatic Sac Surgery

69805, 69806

#

#

#

#

#

Labyrinthectomy-transcanal

69905

#

#

#

#

#

Labyrinthectomy-transmastoid

69910

#

#

#

#

#

Rehabilitative Surgery

Congenital Aural Atresia

69310

#

#

#

#

#

Cochlear Implantation

69930

#

#

#

#

#

Electromagnetic Hearing Device

69710

#

#

#

#

#

Removal/repair

69711

#

#

#

#

#

Bone Conduction Device

69714

#

#

#

#

#

With mastoidectomy

69715

#

#

#

#

#

Replacement

69717, 69718

#

#

#

#

#




DIAGNOSES

Site #1

Site #2

Site #3

Site #4

Total

Glomus tumor (tympanicum); Glomus tumor (jugulare)

#

#

#

#

#

Vestibular schwannoma (acoustic neuroma)

#

#

#

#

#

Facial nerve tumor

#

#

#

#

#



Fellow Appointments - Other Learners
Briefly describe how the program director will ensure the presence of other learners, including otolaryngology residents, residents from other specialties, unaccredited neurotology fellows, other subspecialty fellows, PhD students, and nurse practitioners, will not interfere with the appointed fellows’ education. [PR III.C.]


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Educational Program
Regularly Scheduled Didactic Sessions


  1. List the type and frequency of didactic sessions that will be included in the program. Add rows as needed. [PR IV.A.3.]




Type

Frequency












































































  1. Describe how the program director will ensure that fellows participate in both planning and conducting conferences. [PR IV.A.3.a).(1)]




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  1. Describe how the program director will ensure that both faculty members and fellows attend and participate in multidisciplinary conferences. [PR IV.A.3.a).(2)]




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  1. Provide a list of all the didactic sessions that will be given during the two-year educational program. Add rows as needed. [PR IV.A.3.b)-c)]




Title of Session

Topic

Presenter

































































Patient Care
Indicate the settings and activities in which fellows will demonstrate competence in each of the following areas of patient care. Also indicate the method(s) used to assess competence.


Competency Area

Settings/Activities

Assessment Method(s)

Performance of key procedures, including: [PR IV.A.5.a).(2).(a)]

Lateral skull base approach to the jugular fossa

[PR IV.A.5.a).(2).(a).(i)]



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Middle cranial fossa craniotomy

[PR IV.A.5.a).(2).(a).(ii)]



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Retrosigmoid approach to the cerebellopontine angle

[PR IV.A.5.a).(2).(a).(iii)]



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Translabyrinthine approach to the cerebellopontine angle

[PR IV.A.5.a).(2).(a).(iv)]



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Medical and surgical management strategies, including intracranial exposure, as well as the postoperative care necessary to treat congenital, inflammatory, neoplastic, idiopathic, and traumatic diseases of the petrous apex, internal auditory canal, cerebellopontine angle, cranial nerves, and lateral skull base, including the occipital bone, temporal bone, craniovertebral junction, and vascular neoplasms of the lateral and posterior fossa skull base

[PR IV.A.5.a).(2).(b)]



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The habilitation and rehabilitation of the vertiginous patient, and the treatment of intracranial and intratemporal facial nerve disorders

[PR IV.A.5.a).(2).(c)]



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Medical Knowledge
Indicate the activities (lectures, conferences, journal clubs, clinical teaching rounds, etc.) in which fellows will demonstrate knowledge in the following area. Also indicate the method(s) that will be used to evaluate fellow knowledge.


Area of Knowledge

Settings/Activities

Assessment Method(s)

Neurotology to a level appropriate for unsupervised practice, as defined by the required didactic curriculum

[PR IV.A.5.b).(1)]



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Practice-based Learning and Improvement


  1. Briefly describe one planned learning activity in which fellows engage to identify strengths, deficiencies, and limits in their knowledge and expertise (self-reflection and self-assessment); set learning and improvement goals; and identify and perform appropriate learning activities to achieve self-identified goals (life-long learning). [PR IV.A.5.c).(1)-(3)] (Limit response to 400 words)




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  1. Briefly describe one planned quality improvement activity or project that will allow the fellow to demonstrate an ability to analyze, improve, and change practice or patient care. Describe planning, implementation, evaluation, and provisions of faculty member support and supervision that will guide this process. [PR IV.A.5.c).(4)] (Limit response to 400 words)




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  1. Briefly describe how fellows will receive and incorporate formative evaluation feedback into daily practice. (If a specific tool is used to evaluate these skills, have it available for review by the site visitor.) [PR IV.A.5.c).(5)] (Limit response to 400 words)




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  1. Briefly describe one example of a learning activity in which fellows engage to develop the skills needed to use information technology to locate, appraise, and assimilate evidence from scientific studies and apply it to their patients' health problems. [PR IV.A.5.c).(6)-(7)] (Limit response to 400 words)

The description should include:



  • Locating information

  • Using information technology

  • Appraising information

  • Assimilating evidence information (from scientific studies)

  • Applying information to patient care




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  1. Briefly describe how fellows will participate in the education of patients, families, students, and other health professionals: [PR IV.A.5.c).(8)] (Limit your response to 400 words)




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Interpersonal and Communication Skills


  1. Briefly describe one learning activity in which fellows develop competence in communicating effectively with patients and families across a broad range of socioeconomic and cultural backgrounds, and with physicians, other health professionals, and health-related agencies. [PR IV.A.5.d).(1)-(2)] (Limit response to 400 words)




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  1. Briefly describe one learning activity in which fellows develop their skills and habits to work effectively as members or leaders of a health care team or other professional group. In the example, identify the members of the team, responsibilities of the team members, and how team members communicate to accomplish responsibilities. [PR IV.A.5.d).(3)] (Limit response to 400 words)




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  1. Briefly describe how fellows will be provided with opportunities to act in a consultative role to other physicians and health professionals. [PR IV.A.5.d).(4)] (Limit response to 400 words)




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  1. Briefly describe how fellows will be provided with opportunities to maintain comprehensive, timely, and legible medical records, if applicable. [PR IV.A.5.d).(5)] (Limit response to 400 words)




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Professionalism
Briefly describe the learning activity(ies), other than lecture, by which fellows develop a commitment to carrying out professional responsibilities and an adherence to ethical principles, including: compassion, integrity, and respect for others; responsiveness to patient needs that supersedes self-interest; respect for patient privacy and autonomy; accountability to patients, society, and the profession; and sensitivity and responsiveness to a diverse patient population, including diversity in gender, age, culture, race, religion, disabilities, and sexual orientation. [PR IV.A.5.e).(1)-(5)] (Limit response to 400 words)


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Systems-based Practice


  1. Describe the learning activity(ies) through which fellows achieve competence in the elements of systems-based practice: working effectively in various health care delivery settings and systems, coordinate patient care within the health care system; incorporating considerations of cost-containment and risk-benefit analysis in patient care; advocating for quality patient care and optimal patient care systems; and working in interprofessional teams to enhance patient safety and care quality. [PR IV.A.5.f).(1)-(5)] (Limit response to 400 words)




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2. Describe an activity that fulfills the requirement for experiential learning in identifying system errors and implementing potential systems solutions. [PR IV.A.5.f).(6)] (Limit response to 400 words)




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Curriculum Organization and Fellow Experiences


  1. How will the program ensure that fellows are provided with graduated responsibility for patients in both inpatient and outpatient environments? [PR IV.A.6.a).(1)]




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  1. Briefly describe how the program will ensure that fellows document, in the ACGME Case Log System, their experiences as both assistant surgeon and surgeon in surgical procedures. [PR IV.A.6.a).(3)]




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  1. Briefly describe the planned experience in audiometric testing. [PR IV.A.6.a).(4)]




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  1. Briefly describe the planned experiences in neurological surgery, neurology, neuropathology, neuroradiology and, physical medicine and rehabilitation. [PR IV.A.6.a).(5)]




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Fellows’ Scholarly Activities


  1. Briefly describe how research methodology, epidemiology, statistical methods, experimental design and manuscript preparation will be addressed in the curriculum. [PR IV.B.1.a)-b)]




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  1. Briefly describe how fellows will be provided with protected time for the pursuit of scholarly activities and research. [PR IV.B.3.a)]




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Fellow Duty Hours in the Learning and Working Environment
Clinical Responsibilities


  1. Briefly describe the planned composition of the surgical teams. [PR VI.E.2.]




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  1. Briefly describe how the program director will ensure the work of the caregiver team is assigned to team members based on each fellow’s level of education, experience, and competence. [PR VI.E.3.]




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Teamwork


  1. Describe the planned composition of the interprofessional teams. [PR VI.F.2.]




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  1. Describe how the program director will ensure fellows collaborate with surgical residents, and especially with faculty, other physicians outside of their specialty, and non-traditional health care providers, to best formulate treatment plans for an increasingly diverse patient population. [PR VI.F.3.]




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  1. Describe how the program director will ensure that fellows assume personal responsibility to complete all tasks to which they are assigned (or which they voluntarily assume) in a timely fashion. [PR VI.F.4.]




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Neurotology Updated 8/2015

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