JAMA otolaryngology-- head & neck surgery
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JAMA Otolaryngol Head Neck Surg · Jun 2013
Disinfection of rigid nasal endoscopes following in vitro contamination with Staphylococcus aureus, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae.
If not adequately cleaned, rigid nasal endoscopes (RNEs) have the potential to cause iatrogenic cross-contamination. ⋯ Most cleaning methods used in our trials appear to properly disinfect RNEs after in vitro inoculation with S aureus, S pneumoniae, and H influenzae. However, it appears that disinfectants may be less effective in cleaning rigid scopes experimentally inoculated with P aeruginosa. There is a paucity of published data regarding cross-contamination during rigid nasal endoscopy, and these results should guide future studies and to some extent practice to avoid iatrogenic spread of contamination.
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JAMA Otolaryngol Head Neck Surg · May 2014
Case ReportsImplications of carotid sinus hypersensitivity following preoperative embolization of a carotid body tumor. An indication for prophylactic intraoperative cardiac pacing.
IMPORTANCE Carotid body tumors are rare neoplasms of neural crest origin that are both highly vascularized and locally invasive. Treatment options for these tumors often include surgery with preoperative embolization, which can pose major cardiovascular risk to patients. As demonstrated by this case report, hemodynamic instability following preoperative embolization of a carotid body tumor may indicate severe carotid sinus hypersensitivity and the need for temporary cardiac pacing. ⋯ Following a negative cardiac workup, a temporary pacemaker was implanted, and surgical resection of the tumor was successfully completed. CONCLUSIONS AND RELEVANCE Carotid sinus hypersensitivity is a rare but serious risk of preoperative embolization of carotid body tumors. Postembolization bradycardia or hypotension should be assessed as potential harbingers of carotid sinus hypersensitivity, and the need for temporary intraoperative cardiac pacing should be strongly considered.
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JAMA Otolaryngol Head Neck Surg · Jan 2014
Treatment of severe porcine tracheomalacia with a 3-dimensionally printed, bioresorbable, external airway splint.
The study demonstrates use of a novel intervention for severe tracheobronchomalacia (TBM). ⋯ A multidisciplinary effort producing a computer-aided designed, computer-aided manufactured bioresorbable tracheobronchial splint was tested in a porcine model of severe TBM and was found to extend survival time. Mortality in the splinted group was ascribed to the TBM model based on the lack of respiratory distress in splinted pigs, long-term survival in animals implanted with the splint without TBM, and necropsy findings.
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JAMA Otolaryngol Head Neck Surg · Feb 2013
The significance of Streptococcus anginosus group in intracranial complications of pediatric rhinosinusitis.
To assess the significance of the Streptococcus anginosus group in intracranial complications of pediatric patients with rhinosinusitis. ⋯ Rhinosinusitis associated with the S anginosus group should be considered a more serious infection relative to those caused by other pathogens. Streptococcus anginosus group bacteria are significantly more likely than other bacteria to cause more severe intracranial complications and neurologic deficits and to require neurosurgical intervention. A low threshold for intervention should be used for infection caused by this pathogen.