Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Adenotonsillectomy is generally safe surgery, but surgeons should be cognizant of potential complications and be prepared to manage them. Postoperative hemorrhage usually responds to local measures or cautery but can be life-threatening. Preoperative screening of coagulation profiles appears unnecessary. ⋯ Sore throat, otalgia, fever, dehydration, and uvular edema are more common postoperative complaints. Less common complications include atlantoaxial subluxation, mandible condyle fracture, infection, eustachian tube injury, and psychological trauma. The prevalence, management, and strategies for avoidance of these are discussed.
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Otolaryngol Head Neck Surg · Jan 1998
Case ReportsFatal meningitis and brain abscess resulting from foreign body-induced otomastoiditis.
Herein we report what we believe to be the only published case of an intracranial complication of otomastoiditis resulting from foreign-body material. The presence of a foreign body must be ruled out in any chronically draining ear, and all foreign material must be removed. ⋯ Fever, malodorous ear drainage, and the presence of granulation tissue are warming findings. A high index of suspicion of infectious complications must be maintained in evaluating all patients with ear disease.
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Otolaryngol Head Neck Surg · Dec 1997
Value of preoperative prothrombin time/partial thromboplastin time as a predictor of postoperative hemorrhage in pediatric patients undergoing tonsillectomy.
Hemorrhage after tonsillectomy is a potentially lethal complication. Preoperative assessment consisting of prothrombin time (PT) and activated partial thromboplastin time (PTT) has been used to identify patients at risk for hemorrhage after tonsillectomy and adenoidectomy. We sought to assess the value of PT/PTT screening as a predictor of posttonsillectomy hemorrhage. ⋯ Preoperative PT/PTT provides no additional information than does a bleeding history for the general pediatric population undergoing tonsillectomy. This should only be done in selective cases where warranted by history.
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Otolaryngol Head Neck Surg · Dec 1997
Obstructive sleep apnea surgery: risk management and complications.
Hypoxemia, hypertension, airway obstruction, and death have been associated with surgery for obstructive sleep apnea syndrome (OSAS). Patient analysis was undertaken to identify potential factors that could affect risk-management outcome. ⋯ Intraoperative airway risks can be reduced by use of fiberoptic intubation in patients with increased neck circumference and skeletal deficiency. Patients with OSAS are at a significantly increased risk for hypertension. Nasal continuous positive airway pressure eliminated the postoperative risk of hypoxemia, which allowed the use of adequate parenteral or oral analgesics.