JAMA otolaryngology-- head & neck surgery
-
JAMA Otolaryngol Head Neck Surg · Dec 2014
Patients undergoing total laryngectomy: an at-risk population for 30-day unplanned readmission.
Patients undergoing total laryngectomy are at high risk for hospital readmission. Hospital readmissions are increasingly scrutinized because they are used as a metric of quality care and are subject to financial penalties. ⋯ Patients undergoing total laryngectomy are an at-risk patient population with a high rate of unplanned readmission within 30 days of discharge. By identifying the risk factors that predict 30-day unplanned readmission, these data can be used to design and implement quality-improvement interventions to decrease readmissions.
-
JAMA Otolaryngol Head Neck Surg · Dec 2014
Epidemiology and treatment of lacrimal gland tumors: a population-based cohort analysis.
Primary tumors of the lacrimal gland are rare and are associated with substantial morbidity and mortality. The literature regarding these tumors is limited to case series and case reports. ⋯ Our study demonstrates that ACC is the most common malignant epithelial neoplasm of the lacrimal gland. Determinants of survival for tumors of the lacrimal gland include age at diagnosis and surgical therapy. Radiation therapy is associated with improved DSS in SCC but not in ACC.
-
JAMA Otolaryngol Head Neck Surg · Dec 2014
Transoral robotic surgery for obstructive sleep apnea: perioperative management and postoperative complications.
Patients who undergo surgery for obstructive sleep apnea (OSA) have acceptable perioperative morbidity that is similar to that seen in other sleep-related surgical procedures. ⋯ Transoral robotic surgery can be safely performed in patients with OSA with an acceptable complication rate. Complications are similar to those seen with other surgical treatments of OSA and were only predicted by ASA score and number of procedures performed.
-
JAMA Otolaryngol Head Neck Surg · Nov 2014
Observational StudyClinical features and surgical outcomes following closed reduction of arytenoid dislocation.
Arytenoid dislocation is a rare condition characterized by vocal fold immobility and is easily mistaken as recurrent laryngeal nerve paralysis. ⋯ These data represent the largest clinical series on arytenoid dislocation with complete vocal function data and follow-up at 6 months after CR. These findings also corroborate existing evidence for early surgical intervention.
-
JAMA Otolaryngol Head Neck Surg · Nov 2014
Chemoprophylaxis for venous thromboembolism in otolaryngology.
Venous thromboembolism (VTE) causes significant morbidity and mortality in surgical patients. Despite strong evidence that thromboprophylaxis reduces the incidence VTE, guidelines for prophylaxis in otolaryngology are not well established. Key to the development of VTE prophylaxis recommendations are effective VTE risk stratification and evaluation of the benefits and harms of prophylaxis. ⋯ Effectiveness and safety of VTE chemoprophylaxis differed between patient subgroups, defined by Caprini risk score and by procedure. Effectiveness was most evident in patients with high Caprini risk scores and microvascular free tissue reconstruction. Bleeding complications were associated with VTE chemoprophylaxis administered in close proximity to potent antiplatelet therapy. The Caprini risk assessment model appears to be an effective tool to stratify otolaryngology patients by risk for VTE. Patients undergoing free tissue reconstruction merit further study before developing recommendations for VTE prophylaxis because of their higher risk of both VTE and bleeding.