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Otolaryngology anesthesia

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https://www.readbyqxmd.com/read/27901329/comparing-incidence-of-emergence-delirium-between-sevoflurane-and-desflurane-in-children-following-routine-otolaryngology-procedures
#1
Jeremy N Driscoll, Brian M Bender, Carlos A Archilla, Carol M Klim, J Hossain, George Mychaskiw, Julie L Wei
BACKGROUND: Emergence delirium (ED) is a state of aggressive agitation that can occur temporarily in the process of emerging from anesthesia in children exposed to volatile or intravenous anesthetics. Emergence delirium is typically assessed using the published and validated pediatric emergence delirium (PAED) scale. Due to some variation in properties between sevoflurane and desflurane for maintenance of anesthesia after standard sevoflurane induction, we designed a prospective study to examine potential differences in emergence behavior and incidence of ED in children undergoing elective ear-nose-throat (ENT) surgery...
November 30, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27079717/the-effect-of-propofol-versus-isoflurane-anesthesia-on-human-cerebrospinal-fluid-markers-of-alzheimer-s-disease-results-of-a-randomized-trial
#2
Miles Berger, Jacob W Nadler, Allan Friedman, David L McDonagh, Ellen R Bennett, Mary Cooter, Wenjing Qi, Daniel T Laskowitz, Vikram Ponnusamy, Mark F Newman, Leslie M Shaw, David S Warner, Joseph P Mathew, Michael L James
BACKGROUND: Preclinical studies have found differential effects of isoflurane and propofol on the Alzheimer's disease (AD)-associated markers tau, phosphorylated tau (p-tau) and amyloid-β (Aβ). OBJECTIVE: We asked whether isoflurane and propofol have differential effects on the tau/Aβ ratio (the primary outcome), and individual AD biomarkers. We also examined whether genetic/intraoperative factors influenced perioperative changes in AD biomarkers. METHODS: Patients undergoing neurosurgical/otolaryngology procedures requiring lumbar cerebrospinal fluid (CSF) drain placement were prospectively randomized to receive isoflurane (n = 21) or propofol (n = 18) for anesthetic maintenance...
April 15, 2016: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/27062311/successful-intraoperative-electrophysiologic-monitoring-of-the-recurrent-laryngeal-nerve-a-multidisciplinary-approach-the-massachusetts-eye-and-ear-infirmary-monitoring-collaborative-protocol-with-experience-in-over-3000-cases
#3
Alvaro A Macias, Sunil Eappen, Ilya Malikin, Jeremy Goldfarb, Sharon Kujawa, Paul M Konowitz, Dipti Kamani, Gregory W Randolph
BACKGROUND: Although intraoperative nerve monitoring (IONM) is utilized increasingly, the information on the related anesthesia technique is limited. This study presents an up-to-date clinical algorithm, including setup and troubleshooting of an IONM system, endotracheal tube placement, and anesthetic parameters. To our knowledge, this is the first interdisciplinary collaborative protocol for monitored neck surgery based on the published evidence and clinical experience. METHODS: The Departments of Otolaryngology Head and Neck Surgery, Anesthesiology, and Audiology collaboratively developed a protocol for IONM of the recurrent laryngeal nerve (RLN) based on published evidence and our experience with 3000 patients over a 16-year period...
October 2016: Head & Neck
https://www.readbyqxmd.com/read/26976024/endoscopic-adenoidectomy-in-children-with-otitis-media-with-effusion-and-mild-hearing-loss
#4
Pasquale Capaccio, Sara Torretta, Givlia Anna Marciante, Paola Marchisio, Stella Forti, Lorenzo Pignataro
OBJECTIVES: Surgical management of children with chronic otitis media with effusion (OME) includes tympanostomy tube insertion or adenoidectomy, alone or with myringotomy and tube insertion. The aim of this study was to compare the effectiveness of transoral microdebrider endoscopic-assisted adenoidectomy (TOMEA) and traditional adenoidectomy in the management of children with mild hearing loss due to OME and chronic adenoiditis. METHODS: This prospective, double-blind and controlled study involved 120 consecutive patients aged 4-12 years, who were randomised 1:1 to undergo TOMEA or traditional adenoidectomy under general anesthesia...
March 2016: Clinical and Experimental Otorhinolaryngology
https://www.readbyqxmd.com/read/26658070/comprehensive-emergency-airway-response-team-eart-training-and-education-impact-on-team-effectiveness-personnel-confidence-and-protocol-knowledge
#5
Angela C Tsai, Gintas P Krisciunas, Chris Brook, Krystyne Basa, Mauricio Gonzalez, Janet Crimlisk, Julie Silva, Gregory A Grillone
OBJECTIVE: To evaluate the efficacy and utility of simulation of the Emergency Airway Response Team (EART) at a tertiary care hospital to improve team dynamics and confidence and knowledge in managing an emergency airway. METHODS: This was a descriptive, quantitative performance improvement study. From September 1, 2013, to December 1, 2013, 177 members of the EART from anesthesia, otolaryngology, trauma surgery, emergency medicine, ICU nursing, and respiratory therapy participated in emergency airway simulations...
June 2016: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/26611339/tympanostomy-tube-placement-in-awake-unrestrained-pediatric-patients-a-prospective-multicenter-study
#6
MULTICENTER STUDY
Jacob W Zeiders, Charles A Syms, Mary T Mitskavich, David M Yen, Daniel T Harfe, Ryan D Shields, Brent J Lanier, Andrew R Gould, Jason Mouzakes, C Layton Elliott
OBJECTIVES: Tympanostomy tube (tube) placement is the most common pediatric otolaryngologic surgery in the United States. Most surgeries are performed in an operating-room setting under general anesthesia due to the lack of tolerable and reliable local anesthesia methods suitable for pediatric patients, and concerns regarding myringotomy procedures in a mobile child. This study evaluated the safety and efficacy of an iontophoresis system (IPS) to achieve local anesthesia in combination with a tube delivery system (TDS) for tube placement in pediatric patients in an office setting...
December 2015: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/26457086/trichobezoar-causing-airway-compromise-during-esophagogastroduodenoscopy
#7
Erica Y Kao, Nicholas J Scalzitti, Gregory R Dion, Sarah N Bowe
Objectives. (1) Report the case of a 5-year-old female with trichotillomania and trichophagia that suffered airway compromise during esophagogastroduodenoscopy for removal of a trichobezoar. (2) Provide management recommendations for an unusual foreign body causing extubation and partial airway obstruction. Methods. Case report of a rare situation of airway compromise caused by a trichobezoar. Results. A 5-year-old patient underwent endoscopic retrieval of a gastric trichobezoar (hairball) by the gastroenterology service under general endotracheal anesthesia in a sedation unit...
2015: Case Reports in Medicine
https://www.readbyqxmd.com/read/26388248/the-risk-of-venous-thromboembolism-in-ent-and-head-neck-surgery
#8
Carlos Chiesa Estomba, Teresa Rivera Schmitz, Carla Cristina Ossa Echeverri, Frank Alberto Betances Reinoso, Alejandra Osorio Velasquez, Carmelo Santidrian Hidalgo
OBJECTIVES: Venous thromboembolic disease (VTD) includes deep vein thrombosis (DVT) and pulmonary embolism (PE), thus is one of the most feared postoperative complications developed by patients at any surgical department, because of high morbidity and mortality associated with it. MATERIALS AND METHODS: We performed a retrospective study including all patients operated on at the Otolaryngology Head and Neck Department (tertiary hospital) between January 2009 and December 2013...
2015: Otolaryngologia Polska. the Polish Otolaryngology
https://www.readbyqxmd.com/read/26307580/perioperative-management-of-antithrombotic-therapy-in-common-otolaryngologic-surgical-procedures-state-of-the-art-review
#9
REVIEW
Wayne D Hsueh, Peter H Hwang, Waleed M Abuzeid
OBJECTIVE: The perioperative management of patients undergoing otolaryngologic procedures is increasingly complicated by the use of newer antithrombotic agents. Furthermore, with advances in anesthesia and surgical technique, otolaryngologists are presented with the challenge of operating on patients with advanced comorbid diseases. The objective of this review is to provide evidence-based recommendations on perioperative antithrombotic management for common otolaryngologic procedures...
October 2015: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/26159800/clinical-features-of-patients-treated-with-endoscopic-sinus-surgery-for-posttraumatic-paranasal-sinus-mucocele
#10
Yusuke Kojima, Kenzo Tsuzuki, Yoriko Yukitatsu, Hideki Oka, Hironori Takebayashi, Masafumi Sakagami
AIM: The purpose of this study was to analyze the clinical features of patients with posttraumatic paranasal sinus mucocele (PSM). SUBJECTS AND METHODS: Between 2009 and 2013, we performed endoscopic sinus surgery (ESS) on 68 patients with PSM at the Department of Otolaryngology - Head and Neck Surgery at Hyogo College of Medicine. Five male patients (age range, 45-76 years) with posttraumatic PSM were analyzed retrospectively. Diagnosis was based on the history of injury and radiological findings...
2015: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/26142485/comparison-of-rigid-and-flexible-endoscopy-for-removing-esophageal-foreign-bodies-in-an-emergency
#11
Chia-Chen Tseng, Tzu-Yu Hsiao, Wei-Chung Hsu
BACKGROUND/PURPOSE: Despite the effectiveness of endoscopies in removing ingested foreign bodies (FBs) impacted in the esophagus, the merits and limitations of flexible endoscopy (FE) and rigid endoscopy (RE) remain unclear. Therefore, this study compares the advantages and disadvantages of both endoscopic procedures from a clinical perspective. METHODS: A retrospective review was made of 273 patients suspected of esophageal FBs in emergency consultations of a tertiary medical referral center from March 2010 to March 2014...
August 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/25999002/predictors-of-difficult-intubation-and-the-otolaryngology-perioperative-consult
#12
REVIEW
Karla O'Dell
Airway management is one of the most important aspects of anesthesia care. Although the incidence of difficult intubation is low, predicting a potentially difficult airway can ensure that necessary staff and equipment are available. A preoperative airway evaluation should include a history and physical examination focusing on elements that can cause problems with intubation. When indicated, flexible fiberoptic laryngoscopy can add valuable information regarding the upper aerodigestive anatomy. Specific patient and situational factors should be considered...
June 2015: Anesthesiology Clinics
https://www.readbyqxmd.com/read/25937600/incidence-and-outcomes-of-intraoperative-vascular-surgery-consultations
#13
Rachel C Danczyk, Jake Coleman, Jordan Allensworth, Amir F Azarbal, Erica L Mitchell, Timothy K Liem, Gregory J Landry, Gregory L Moneta
OBJECTIVE: Vascular surgeons may aid in primarily nonvascular procedures. Such activity has not been quantified, and hospital administrators may be unaware of the importance of vascular surgeons to support other hospital-based surgical programs. This study reviewed intraoperative consultations by vascular surgeons to support other surgical services. METHODS: Intraoperative vascular consultations were reviewed from January 2006 to January 2014 for consulting service, indication, and whether consultation occurred with advanced notice...
July 2015: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/25842630/difficult-intubation-resulting-in-surgical-repair-of-esophageal-and-hypopharyngeal-perforation
#14
Karen Erika Wastler
Although rare, perilous injury of the aerodigestive tract due to traumatic endotracheal intubation can have devastating consequences for patient and provider. Resulting serious complications of injury may involve esophageal perforation, pneumomediastinum, mediastinitis, retropharyngeal abscess, vocal cord paralysis, arytenoids dislocation, and hypopharyngeal pseudodiverticulum. Morbidity, mortality, and legal and financial consequences can be enormous. Early identification and treatment of suspected injury will promote patient recovery and thwart life-threatening progression of injury...
February 2015: AANA Journal
https://www.readbyqxmd.com/read/25786199/unconscious-race-and-social-class-bias-among-acute-care-surgical-clinicians-and-clinical-treatment-decisions
#15
Adil H Haider, Eric B Schneider, N Sriram, Deborah S Dossick, Valerie K Scott, Sandra M Swoboda, Lia Losonczy, Elliott R Haut, David T Efron, Peter J Pronovost, Pamela A Lipsett, Edward E Cornwell, Ellen J MacKenzie, Lisa A Cooper, Julie A Freischlag
IMPORTANCE: Significant health inequities persist among minority and socially disadvantaged patients. Better understanding of how unconscious biases affect clinical decision making may help to illuminate clinicians' roles in propagating disparities. OBJECTIVE: To determine whether clinicians' unconscious race and/or social class biases correlate with patient management decisions. DESIGN, SETTING, AND PARTICIPANTS: We conducted a web-based survey among 230 physicians from surgery and related specialties at an academic, level I trauma center from December 1, 2011, through January 31, 2012...
May 2015: JAMA Surgery
https://www.readbyqxmd.com/read/25625257/hypoglossal-nerve-palsy-after-airway-management-for-general-anesthesia-an-analysis-of-69-patients
#16
REVIEW
Aalap C Shah, Christopher Barnes, Charles F Spiekerman, Laurent A Bollag
Isolated hypoglossal nerve palsy (HNP), or neurapraxia, a rare postoperative complication after airway management, causes ipsilateral tongue deviation, dysarthria, and dysphagia. We reviewed the pathophysiological causes of hypoglossal nerve injury and discuss the associated clinical and procedural characteristics of affected patients. Furthermore, we identified procedural factors potentially affecting HNP recovery duration and propose several measures that may reduce the risk of HNP. While HNP can occur after a variety of surgeries, most cases in the literature were reported after orthopedic and otolaryngology operations, typically in males...
January 2015: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/25558573/epistaxis-in-geriatric-patients
#17
Alper Yüksel, Hanifi Kurtaran, Ekrem Said Kankiliç, Nebil Ark, Kadriye Serife Uğur, Mehmet Gündüz
AIM: Epistaxis is a common emergency in otolaryngology. The aim of this study is to analyze the etiology, management, and accompanying disorders of epistaxis in geriatric patients by reviewing the literature MATERIALS AND METHODS: Data of 117 patients 65 years old and older who presented to the Department of Otorhinolaryngology with active epistaxis between 2004 and 2010 were retrospectively reviewed. Records were evaluated for age, sex, accompanying disorders, drug medication, detailed otorhinolaryngological findings, and management of epistaxis...
2014: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/25473812/interdisciplinary-pediatric-aerodigestive-care-and-reduction-in-health-care-costs-and-burden
#18
Joseph M Collaco, Angela D Aherrera, Karla J Au Yeung, Maureen A Lefton-Greif, Jeannine Hoch, Margaret L Skinner
IMPORTANCE: Children with complex respiratory and gastrointestinal disorders frequently require care from multiple pediatric subspecialists. Interdisciplinary pediatric aerodigestive clinic centers have been established at several pediatric tertiary care centers in the United States. Their effectiveness is unknown. OBJECTIVE: To determine whether an interdisciplinary approach to pediatric aerodigestive disorders reduces health care costs and burden. DESIGN, SETTING, AND PARTICIPANTS: Retrospective medical record review for the first 125 unique pediatric patients (median age, 1...
February 2015: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/25458165/improving-outcomes-in-a-high-output-pediatric-otolaryngology-practice
#19
John M Carter, Charles Riley, Ashwin Ananth, J Lindhe Guarisco, Kimsey Rodriguez, Ronald Amedee
OBJECTIVES: To identify factors associated with efficient operating room work flow on high volume pediatric otolaryngology days and the effects on provider and perceived parent satisfaction. METHODS: Retrospective review was performed of a sample of 20 days with greater than 10 cases per day performed by a pediatric otolaryngologist operating in 2 rooms. Turnover time and complications were the main outcome measures. Providers from otolaryngology and anesthesia that participated in these days were surveyed regarding efficiency, safety, and satisfaction...
December 2014: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/25455523/the-pediatric-sedation-unit-a-prospective-analysis-of-parental-satisfaction
#20
Matthew P Connor, Gregory R Dion, Matthew Borgman, Stephen Maturo
UNLABELLED: As financial pressures drive health care to be more cost-effective and efficient, performing procedures outside the main operating room (MOR) is becoming more common. Pediatric sedation units (PSU) have proven both effective and safe at providing anesthesia for children. However, there is limited data available regarding the PSU and its potential application in pediatric otolaryngology. OBJECTIVE: To evaluate the experience of performing pediatric outpatient procedures in a PSU through a parental satisfaction survey...
December 2014: International Journal of Pediatric Otorhinolaryngology
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