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Otolaryngology—Head and Neck Surgery

Joao Subtil, Ana Jardim, João Araujo, Carla Moreira, Tiago Eµa, Merlin McMillan, Sara Simoes Dias, Paulo Vera Cruz, Richard Voegels, Joao Paço, Richard Rosenfeld
OBJECTIVES: Tympanostomy with ventilation tube insertion is the most common otologic surgery. Many surgeons recommend water precautions, although its utility is questioned. We aimed to investigate if water precautions reduce the rate of otorrhea after transtympanic tube insertion. STUDY DESIGN: Multicenter randomized controlled trial. SUBJECTS AND METHODS: A total of 244 children aged 2 to 10 years undergoing their first set of Shepard tubes for otitis media with effusion and concomitant adenoidectomy were randomized to 2 groups: 1 with ear protection during water exposure (ear plugs and headbands, n = 130) and 1 without (n = 114)...
April 16, 2019: Otolaryngology—Head and Neck Surgery
Kristen L Seligman, Bryan J Liming, Richard J H Smith
OBJECTIVE: To determine the successful decannulation rate with a published pediatric tracheostomy decannulation protocol. STUDY DESIGN: Case series with chart review. SETTING: A single tertiary care institution. SUBJECTS AND METHODS: A chart review was performed for patients aged ≤5 years who underwent tracheostomy. Extracted data included demographic data, indication for tracheostomy, age at tracheostomy and decannulation, comorbidities, and surgical complications...
April 16, 2019: Otolaryngology—Head and Neck Surgery
Ramaswamy Balakrishnan, Pooja Dalakoti, Dipak Ranjan Nayak, Kailesh Pujary, Rohit Singh, Rajesh Kumar
OBJECTIVE: The prognosis of patients with malignant external otitis (MEO) depends on the extent of the inflammatory changes in the temporal bone and skull base. The efficacy of high-resolution computed tomography (HRCT) imaging in accurately assessing the extent of disease is compared with that of single-photon emission computed tomography/computed tomography (SPECT/CT) scan. STUDY DESIGN: A clinical chart review was conducted with medical records and radiologic images...
April 16, 2019: Otolaryngology—Head and Neck Surgery
Tanya K Meyer, Regan Bergmark, Marcy Zatz, Maya G Sardesai, Jamie R Litvack, Anne Starks Acosta
OBJECTIVE: Although the literature adequately identifies the current gender inequality that exists in academic otolaryngology and describes the barriers to advancement of women in academic medicine, there is little information regarding the daily details of how successful women in academic otolaryngology achieve work-life balance. This study was designed to better understand how women in academic otolaryngology achieve work-life balance while negotiating family and childrearing commitments, clinical workload, and scholarly activity, as well as to highlight coping strategies and behaviors that women have used to achieve these successes...
April 16, 2019: Otolaryngology—Head and Neck Surgery
Giuseppe Riva, Federico Dagna, Eugenia Ricci, Andrea Luigi Cavalot
Tracheoesophageal puncture with voice prosthesis placement is used to restore vocal function after total laryngectomy. However, closure of the fistula is sometimes needed. At our department, a simple and effective technique for closure was developed. It does not require interposed tissues or materials. Moreover, our procedure allows for a short rehabilitation time for swallowing and a short hospitalization. We describe advantages, pitfalls, and errors to avoid. This technique should not be performed for patients who are irradiated and those with large fistulas...
April 16, 2019: Otolaryngology—Head and Neck Surgery
Isaac E Schwartz, Gregory G Capra, David P Mullin, Terence E Johnson, Gilbert E Boswell
OBJECTIVES: To describe parathyroid computed tomography angiography (PCTA), determine its accuracy, and, as a secondary objective, calculate its mean radiation dosimetry. STUDY DESIGN: Retrospective chart review of patients who underwent parathyroidectomy for primary hyperparathyroidism from 2007 to 2015. SETTING: Single-center tertiary care academic military hospital. SUBJECTS AND METHODS: PCTA is a 2-phase computed tomography imaging technique that uses individualized timing of contrast infusion and novel patient positioning to accurately identify parathyroid adenomas...
April 9, 2019: Otolaryngology—Head and Neck Surgery
Sei Y Chung, Aparna Govindan, Archana Babu, Andrew Tassler
OBJECTIVE: To (1) analyze postoperative thyroidectomy outcomes in patients with diabetes mellitus (DM), who are prone to deleterious effects of glucose dysmetabolism, and (2) apply findings to optimize perioperative management of diabetics requiring thyroid surgery. STUDY DESIGN: Retrospective database analysis. SETTING: University hospital. SUBJECTS AND METHODS: The National Inpatient Sample was queried using International Classification of Diseases, Ninth Revision, Clinical Modification and Procedure Coding System (PCS) codes for patients with benign or malignant thyroid disease who underwent thyroid surgery between 2002 and 2013...
April 9, 2019: Otolaryngology—Head and Neck Surgery
Peter M Debbaneh, Anna K Bareiss, Sarah K Wise, Edward D McCoul
OBJECTIVE: Combination therapy with intranasal azelastine and fluticasone propionate is an option for treatment of allergic rhinitis. This systematic review and meta-analysis examines existing literature to determine efficacy in treating allergic rhinitis compared to monotherapy. DATA SOURCES: The PubMed, EMBASE, Cochrane, and MEDLINE databases were systematically searched for randomized controlled trials using AzeFlu nasal spray. REVIEW METHODS: Randomized, controlled trials that reported symptom relief of allergic rhinitis in males and females of all ages were included...
April 9, 2019: Otolaryngology—Head and Neck Surgery
Eugenie Du, Zainab Farzal, Elizabeth Stephenson, April Tanner, Katherine Adams, Douglas Farquhar, Mark Weissler, Samip Patel, Jeffrey Blumberg, Maryam Jowza, Trevor Hackman, Adam Zanation
OBJECTIVE: To assess the effect that implementation of a multimodal analgesic plan has on opioid requirements and pain control in head and neck (H&N) surgery patients. STUDY DESIGN: Prospective cohort. SETTING: Tertiary academic hospital. SUBJECTS AND METHODS: An institutional review board (IRB)-approved quality improvement initiative was undertaken to implement a multimodal analgesic protocol for all admitted H&N surgery patients starting November 2017...
April 9, 2019: Otolaryngology—Head and Neck Surgery
Lyndy J Wilcox, Claudia Schweiger, Catherine K Hart, Alessandro de Alarcon, Nithin S Peddireddy, Michael J Rutter
OBJECTIVE: This study documents the growth and course of repaired complete tracheal rings over time after slide tracheoplasty. STUDY DESIGN: Case series with review. SETTING: Tertiary pediatric academic medical center. SUBJECTS/METHODS: Medical records of pediatric patients with confirmed tracheal rings on bronchoscopy who underwent slide tracheoplasty between January 2001 and December 2015 were reviewed. Patients who had operative notes documenting tracheal sizing over time were included...
April 9, 2019: Otolaryngology—Head and Neck Surgery
Mark A Ellis, Katherine R Sterba, Terry A Day, Courtney H Marsh, Stacy Maurer, Elizabeth G Hill, Evan M Graboyes
OBJECTIVE: To promote patient-centered oncology care through an in-depth analysis of the patient experience of body image disturbance (BID) following surgery for head and neck cancer (HNC). STUDY DESIGN: Qualitative methods approach using semistructured key informant interviews. SETTING: Academic medical center. SUBJECTS AND METHODS: Participants with surgically treated HNC underwent semistructured key informant interviews and completed a sociodemographic survey...
April 9, 2019: Otolaryngology—Head and Neck Surgery
Evan A Jones, Andrew G Shuman, Brian L Egleston, Jeffrey C Liu
OBJECTIVE: To highlight common pitfalls observed in scientific research derived from national cancer registries, predominantly the Survival, Epidemiology, and End Results Program and the National Cancer Database. DATA SOURCES: Literature review and expert opinion. REVIEW METHODS: This state-of-the-art review consolidates the literature with editorial experiences describing how and why statistically flawed studies are usually rejected for publication, highlighting common errors in submitted articles employing national cancer registries...
April 2, 2019: Otolaryngology—Head and Neck Surgery
Monica C Azmy, Juanita Pinto, Nirali M Patel, Aparna Govindan, Evelyne Kalyoussef
OBJECTIVES: To identify risk factors of perioperative blood transfusions (PBTs) for neck dissection and identify the association of PBTs with other postoperative outcomes. METHODS: This is a retrospective study of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. The database was queried for neck dissection procedures performed by otolaryngologists from 2006 to 2014. Multivariable logistic regression was used to determine associations between demographic and preoperative factors, mortality, unplanned reoperation, and unplanned readmission with PBTs...
April 2, 2019: Otolaryngology—Head and Neck Surgery
Lauren A Bohm, Jessa E Miller, Noëlle Morrell, James D Sidman, Brianne B Roby
This study aimed to compare outcomes of concomitant palatoplasty and sphincter pharyngoplasty with pharyngeal flap and sphincter pharyngoplasty alone for the treatment of velopharyngeal insufficiency in patients with 22q11.2 deletion syndrome. Thirty-one cases were identified for inclusion in the study. Patients were separated into 3 surgical groups: combined palatoplasty and sphincter pharyngoplasty (n = 11), pharyngeal flap (n = 7), and sphincter pharyngoplasty (n = 13). Outcome measures included perceptual speech analyses, surgical complications, and revision rates...
April 2, 2019: Otolaryngology—Head and Neck Surgery
Hsin-Ching Lin, Chi-Chih Lai, Pei-Wen Lin, Michael Friedman, Anna M Salapatas, Hsueh-Wen Chang, Meng-Chih Lin, Chien-Hung Chin
OBJECTIVE: To identify standard clinical parameters that may predict the presence and severity of obstructive sleep apnea/hypopnea syndrome (OSA). DESIGN: Case series with chart review. SETTING: Tertiary academic medical center. SUBJECTS AND METHODS: A total of 325 adult patients (274 men and 51 women; mean age, 44.2 years) with habitual snoring completed comprehensive polysomnography and anthropometric measurements, including modified Mallampati grade (also known as updated Friedman's tongue position [uFTP]), tonsil size grading, uvular length, neck circumference, waist circumference, hip circumference, and body mass index (BMI)...
April 2, 2019: Otolaryngology—Head and Neck Surgery
Ashton E Lehmann, George A Scangas, Regan W Bergmark, Edward El Rassi, Konstantina M Stankovic, Ralph Metson
OBJECTIVE: To provide a comprehensive overview of the emerging role of periostin, an extracellular matrix protein, as a key component in the development, diagnosis, and treatment of patients with chronic rhinosinusitis. DATA SOURCES: Medline database. REVIEW METHODS: A state of the art review was performed targeting English-language studies investigating the role of periostin in cardiopulmonary, neoplastic, and inflammatory diseases, with emphasis on recent advances in the study of periostin in chronic rhinosinusitis...
April 2, 2019: Otolaryngology—Head and Neck Surgery
Zaid Al-Qurayshi, Jarrett Walsh, Scott Owen, Emad Kandil
OBJECTIVES: To examine trend, prevalence, and outcomes of surgical site infection (SSI) in head and neck surgery. STUDY DESIGN: Retrospective cross-sectional analysis. SETTING: The Nationwide Readmissions Database (2010-2014), which represents 56.6% of all US hospitalization. SUBJECTS: Adult patients (≥18 years) who underwent head and neck surgery. Patients with SSI were compared with controls. METHODS: Analysis included chi-square test and multivariate logistic and linear regression models...
April 2, 2019: Otolaryngology—Head and Neck Surgery
Masafumi Ohki, Shigeru Kikuchi, Sunao Tanaka
OBJECTIVE: To compare surgical outcomes after tympanoplasty without ossiculoplasty for chronic otitis media between transcanal endoscopic ear surgery (TEES) and postauricular microscopic ear surgery (PAMES). STUDY DESIGN: Case-control study. SETTING: Tertiary care university hospital. SUBJECTS AND METHODS: Consecutive patients ( N = 122) who had undergone tympanoplasty without ossiculoplasty for chronic otitis media were enrolled in this retrospective study and divided into 2 groups: TEES (n = 47) and PAMES (n = 75)...
March 26, 2019: Otolaryngology—Head and Neck Surgery
Mustafa G Bulbul, Osama Tarabichi, Rosh K Sethi, Anuraag S Parikh, Mark A Varvares
OBJECTIVES: To compare local recurrence-free survival (LRFS) in early oral cavity cancer (OCC) patients with positive/close frozen section (FS) cleared with further resection (R1 to R0) or positive FS not cleared (R1) to those with negative margins on initial FS analysis (R0). DATA SOURCES: PubMed, EMBASE, and Cochrane. REVIEW METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) for reporting in our study...
March 26, 2019: Otolaryngology—Head and Neck Surgery
Luke T Small, Madison Lampkin, Emre Vural, Mauricio A Moreno
OBJECTIVE: To evaluate outcomes of free flaps in low- versus high-risk American Society of Anesthesiologists (ASA) classes utilizing a standardized perioperative clinical pathway. STUDY DESIGN: Case series with chart review. SETTING: Single tertiary care academic institution. SUBJECTS AND METHODS: Data were collected from 301 patients who underwent 305 free flap reconstructions for head and neck defects from January 2012 to March 2016 by a single surgeon (M...
March 26, 2019: Otolaryngology—Head and Neck Surgery
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