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Objectives: To examine the quantity and nature of undergraduate otolaryngology instruction in the Canadian medical school system and to present the management of the undergraduate otolaryngology curriculum at the University of Toronto medical school with a yearly enrolment of 224 students., Study Design: Survey questionnaire and narrative description., Methods: A structured one-page survey was administered to the education directors of all 16 Canadian medical schools. The administration of core learning material, scheduling, patient encounter logging, and student and instructor evaluations with computerized, on-line systems at the University of Toronto was described., Results: Rotations in otolaryngology were highly variable across medical schools. Mandatory rotations in otolaryngology were identified in only 6 of the 16 undergraduate curricula. The average length of clinical experience in schools with mandatory rotations was 4.6 days., Conclusions: The majority of Canadian medical graduates complete their undergraduate training with minimal clinical experience in otolaryngology. There is a clear discrepancy between the quantity and perceived need for training. To provide a thorough and equitable exposure to otolaryngology, a curriculum with standardized lectures and evaluation procedures is required.

Objective: To compare the trends and specific outcomes of patients treated surgically for parotid neoplasms between 1994 and 2005 with those of patients who were treated between 1985 and 1993 at Mount Sinai Hospital in Toronto and to identify preoperative indicators of malignancy., Methods: A retrospective chart review was performed that included all patients who received treatment from 1994 to 2005 at Mount Sinai Hospital. The results of this review was compared with those of another group at the same institution., Results: The study included 242 patients. Of these patients, 183 (75.6%) had benign neoplasms, 51 (21.1%) had malignant neoplasms, and 8 (3.3%) had inflammatory or lymphatic lesions. The most common associated symptoms were swelling (17.4%) and pain (16.5%). Only 5.8% of patients presented with facial weakness; however, the likelihood of malignancy was high (64.3%). Total parotidectomy was reserved for 26.4% of patients; the majority (68.2%) received a subtotal parotidectomy. Common postoperative complications included temporary facial nerve palsy (23.6%), Frey syndrome (12.4%), and salivary fistula (5.0%). Analysis of the correlation between fine-needle aspiration and final cytology revealed that fine-needle aspiration sensitivity and specificity were 60.0% and 96.1%, respectively. Comparison of these results with the other study at our institution revealed no significant differences in patient predictors or outcomes., Conclusions: These results were compared with those of a previous study conducted at the same institution between 1985 and 1993. There was no significant deviation from former trends. The presenting symptoms of facial nerve weakness and lymphadenopathy were found to be strong indicators of malignant disease. Facial pain was found not to be a reliable prognostic feature for malignancy.