Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Jan 2017
Meta AnalysisEfficacy of Perioperative Lumbar Drainage following Endonasal Endoscopic Cerebrospinal Fluid Leak Repair.
Objective Perioperative lumbar drain (LD) use in the setting of endoscopic cerebrospinal fluid (CSF) leak repair is a well-established practice. However, recent data suggest that LDs may not provide significant benefit and may thus confer unnecessary risk. To examine this, we conducted a meta-analysis to investigate the effect of LDs on postoperative CSF leak recurrence following endoscopic repair of CSF rhinorrhea. ⋯ Conclusions There is insufficient evidence to support that adjunctive lumbar drainage significantly reduces postoperative CSF leak recurrence in patients undergoing endoscopic CSF leak repair. Subgroup analysis examining only those patients whose CSF leaks were associated with anterior skull base resections demonstrated similar results. More level 1 and 2 studies are needed to further investigate the efficacy of LDs, particularly in the setting of patients at high risk for CSF leak recurrence.
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Otolaryngol Head Neck Surg · Jan 2017
Is There a Need for Repeat Radiologic Examination of Children with Esophageal Coin Foreign Body?
Objectives To determine factors associated with the passage of coins. To determine the need for repeat preoperative chest x-ray (CXR) for esophageal coin foreign body. Setting Academic tertiary care center. ⋯ Age, type of coin, location of coin at initial x-ray, and length of time are all important considerations to determine if the coin will pass. This information may be used to counsel families about the likelihood of coins to pass and whether repeat x-ray is necessary prior to surgical removal. Additionally, it may be more cost-effective to obtain repeat films in select patients and prevent those from going to the operating theater who are more likely to pass the coin spontaneously.