Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
-
Otolaryngol Head Neck Surg · Jul 2015
Multicenter StudyOropharyngeal Contamination Predisposes to Complications after Neck Dissection: An Analysis of 9462 Patients.
While neck dissection is important in the treatment of head and neck cancer, there is a paucity of studies evaluating outcomes. We sought to compare preoperative variables and outcomes between clean and contaminated neck dissections, using the 2006-2011 American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) data sets. ⋯ Using the ACS-NSQIP data set, this study found an increased risk of surgical complications in the setting of contaminated neck dissections. These data should be used for patient risk stratification, informed consent, and to guide further research.
-
Otolaryngol Head Neck Surg · Jun 2015
Multicenter Study Comparative StudyAmbulatory thyroidectomy: a multistate study of revisits and complications.
Determine rates and reasons for revisits after ambulatory adult thyroidectomy. ⋯ In carefully selected patients, ambulatory thyroidectomy demonstrates a good postoperative morbidity and mortality profile. Common reasons for revisits included hypocalcemia and bleeding/seroma/hematoma, which occurred with relatively high frequencies as late as a week after surgery. Quality improvement measures should be targeted at lowering revisit rates and safely managing complications.
-
Otolaryngol Head Neck Surg · Dec 2014
Multicenter Study Observational StudyLong-term dizziness handicap in patients with vestibular schwannoma: a multicenter cross-sectional study.
(1) To characterize long-term dizziness following observation, microsurgery, and stereotactic radiosurgery (SRS) for small to medium-sized vestibular schwannoma (VS) using a validated self-assessment inventory; and (2) to identify clinical variables associated with long-term dizziness handicap. ⋯ At a mean of approximately 8 years following treatment, over half of patients with VS reported ongoing dizziness. The authors have identified several baseline features that may help predict the risk of lasting dizziness. Treatment modality does not appear to influence long-term DHI score. We found a strong association between posttreatment headache and poor dizziness handicap. Future study is needed to further define this relationship.
-
Otolaryngol Head Neck Surg · Dec 2014
Multicenter StudyAssociations between socioeconomic status and race with complications after tonsillectomy in children.
To determine if disparities exist for revisits and complications after pediatric tonsillectomy. ⋯ Significant disparities, particularly with respect to household income, exist in the incidence of revisits and complications after pediatric tonsillectomy. The disparate burden of increased revisits and acute pain diagnoses after tonsillectomy deserve further attention.
-
Otolaryngol Head Neck Surg · May 2014
Multicenter StudyDexamethasone and risk of bleeding in children undergoing tonsillectomy.
To determine whether dexamethasone use in children undergoing tonsillectomy is associated with increased risk of postoperative bleeding. ⋯ In a real-world practice setting, dexamethasone use was associated with a small absolute increased risk of revisits for bleeding. However, the upper bound of this risk increase does not cross published thresholds for a minimal clinically important difference. Given the benefits of dexamethasone in reducing postoperative nausea and vomiting and the larger body of evidence from trials, these results support guideline recommendations for the routine use of dexamethasone.