XXXVII Pan-American Congress of Otolaryngology—Head and Neck Surgery - Call for Science Scientific Orals and Posters

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* 1. Proposal Title

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* 2. Submission Type

Scientific Oral Presentations are short oral presentations focusing on current evidence-based research, surgical procedures, and approaches in clinical sciences and their application to patient care.

Scientific Posters are visual displays detailing the latest advancements in otolaryngology research that allow the viewers the opportunity to appraise and assimilate scientific evidence for improved patient care practices.

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* 3. Specialty Area – Proposals must be submitted in one of the following subject areas that best describes your presentation:

Business of Medicine/Practice Management

Endocrine Surgery

Facial Plastic and Reconstructive Surgery

Comprehensive Otolaryngology

Head and Neck Surgery

Laryngology/Broncho-Esophagology

Otology/Neurotology

Patient Safety and Quality Improvement

Pediatric Otolaryngology

Professional and Personal Development

Rhinology/Allergy

Sleep Medicine

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* 4. Introduction – 1 or 2 sentences that explain the topic, purpose, and research question(s).

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* 5. Methods – Summarize the information listed below in paragraph form, not a bulleted list. •Study design; •Year(s)/month(s) study conducted; •Disease/condition studied; •Subjects studied; •Setting in which subjects studied; •Intervention(s); •Outcome measurement(s); •Independent variables; •Preliminary analyses (analysis of ongoing study)

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* 6. Results – State the main outcome(s) of the study, including confidence levels or P values, if applicable.

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* 7. Conclusion – Include a precise statement of conclusion(s) directly supported by the results, giving equal emphasis to positive and negative scientific findings.

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* 8. Submitter Contact Information

Name

Company

Address

Address 2

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State/Province

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* 9. Lead Author Contact Information

Name

Company

Address

Address 2

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Country

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Phone Number

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* 10. Lead Presenter Disclosure: The Pan-American Congress supports fair and unbiased participation of our volunteers in activities. Any actual or potential conflicts of interest must be identified and managed. All direct financial and intellectual relationships with a company that directly impact and/or might conflict with Congress activities must be disclosed, or you must disclose that you have no direct financial relationships. Other relationships that could cause private interests to conflict with professional interests must also be identified. This policy is intended to openly identify any potential conflict so that any potential bias may be identified and the risk thereof mitigated. Failure or refusal to complete the disclosure form or disclose all relevant relationships will result in disqualification to participate in the Pan-American Congress.

I have no financial or intellectual relationships to disclose over the past 36 months

I have the following financial and/or intellectual relationship(s) to disclose over the past 36 months

Financial and/or intellectual relationship(s) to disclose. Examples: Salary; Royalty; Consulting Fee; Honoraria; Stock or Stock Options; Intellectual Property Rights; Research Funding; Other

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* 11. Co-Author #1 Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 12. Co-Author #1 Disclosure: The Pan-American Congress supports fair and unbiased participation of our volunteers in activities. Any actual or potential conflicts of interest must be identified and managed. All direct financial and intellectual relationships with a company that directly impact and/or might conflict with Congress activities must be disclosed, or you must disclose that you have no direct financial relationships. Other relationships that could cause private interests to conflict with professional interests must also be identified. This policy is intended to openly identify any potential conflict so that any potential bias may be identified and the risk thereof mitigated. Failure or refusal to complete the disclosure form or disclose all relevant relationships will result in disqualification to participate in the Pan-American Congress.

I have no financial or intellectual relationships to disclose over the past 36 months

I have the following financial and/or intellectual relationship(s) to disclose over the past 36 months

Financial and/or intellectual relationship(s) to disclose. Examples: Salary; Royalty; Consulting Fee; Honoraria; Stock or Stock Options; Intellectual Property Rights; Research Funding; Other

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* 13. Co-Author #2 Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 14. Co-Author #2 Disclosure: The Pan-American Congress supports fair and unbiased participation of our volunteers in activities. Any actual or potential conflicts of interest must be identified and managed. All direct financial and intellectual relationships with a company that directly impact and/or might conflict with Congress activities must be disclosed, or you must disclose that you have no direct financial relationships. Other relationships that could cause private interests to conflict with professional interests must also be identified. This policy is intended to openly identify any potential conflict so that any potential bias may be identified and the risk thereof mitigated. Failure or refusal to complete the disclosure form or disclose all relevant relationships will result in disqualification to participate in the Pan-American Congress.

I have no financial or intellectual relationships to disclose over the past 36 months

I have the following financial and/or intellectual relationship(s) to disclose over the past 36 months

Financial and/or intellectual relationship(s) to disclose. Examples: Salary; Royalty; Consulting Fee; Honoraria; Stock or Stock Options; Intellectual Property Rights; Research Funding; Other

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* 15. Co-Author #3 Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 16. Co-Author #3 Disclosure: The Pan-American Congress supports fair and unbiased participation of our volunteers in activities. Any actual or potential conflicts of interest must be identified and managed. All direct financial and intellectual relationships with a company that directly impact and/or might conflict with Congress activities must be disclosed, or you must disclose that you have no direct financial relationships. Other relationships that could cause private interests to conflict with professional interests must also be identified. This policy is intended to openly identify any potential conflict so that any potential bias may be identified and the risk thereof mitigated. Failure or refusal to complete the disclosure form or disclose all relevant relationships will result in disqualification to participate in the Pan-American Congress.

I have no financial or intellectual relationships to disclose over the past 36 months

I have the following financial and/or intellectual relationship(s) to disclose over the past 36 months

Financial and/or intellectual relationship(s) to disclose. Examples: Salary; Royalty; Consulting Fee; Honoraria; Stock or Stock Options; Intellectual Property Rights; Research Funding; Other

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* 17. Co-Author #4 Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 18. Co-Author #4 Disclosure: The Pan-American Congress supports fair and unbiased participation of our volunteers in activities. Any actual or potential conflicts of interest must be identified and managed. All direct financial and intellectual relationships with a company that directly impact and/or might conflict with Congress activities must be disclosed, or you must disclose that you have no direct financial relationships. Other relationships that could cause private interests to conflict with professional interests must also be identified. This policy is intended to openly identify any potential conflict so that any potential bias may be identified and the risk thereof mitigated. Failure or refusal to complete the disclosure form or disclose all relevant relationships will result in disqualification to participate in the Pan-American Congress.

I have no financial or intellectual relationships to disclose over the past 36 months

I have the following financial and/or intellectual relationship(s) to disclose over the past 36 months

Financial and/or intellectual relationship(s) to disclose. Examples: Salary; Royalty; Consulting Fee; Honoraria; Stock or Stock Options; Intellectual Property Rights; Research Funding; Other

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* 19. Co-Author #5 Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 20. Co-Author #5 Disclosure: The Pan-American Congress supports fair and unbiased participation of our volunteers in activities. Any actual or potential conflicts of interest must be identified and managed. All direct financial and intellectual relationships with a company that directly impact and/or might conflict with Congress activities must be disclosed, or you must disclose that you have no direct financial relationships. Other relationships that could cause private interests to conflict with professional interests must also be identified. This policy is intended to openly identify any potential conflict so that any potential bias may be identified and the risk thereof mitigated. Failure or refusal to complete the disclosure form or disclose all relevant relationships will result in disqualification to participate in the Pan-American Congress.

I have no financial or intellectual relationships to disclose over the past 36 months

I have the following financial and/or intellectual relationship(s) to disclose over the past 36 months

Financial and/or intellectual relationship(s) to disclose. Examples: Salary; Royalty; Consulting Fee; Honoraria; Stock or Stock Options; Intellectual Property Rights; Research Funding; Other