Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
-
Otolaryngol Head Neck Surg · Jul 2019
Clinical Consensus Statement: Balloon Dilation of the Eustachian Tube.
To develop a clinical consensus statement on the use of balloon dilation of the eustachian tube (BDET). ⋯ This panel reached consensus on several statements that clarify diagnosis and perioperative management of OETD. Lack of consensus on other statements likely reflects knowledge gaps regarding the role of BDET in managing OETD. Expert panel consensus may provide helpful information for the otolaryngologist considering the use of BDET for the management of patients with OETD.
-
Otolaryngol Head Neck Surg · Jul 2019
Postoperative Venous Thromboembolism after Extracranial Otologic Surgery.
To determine the incidence of postoperative venous thromboembolism (VTE) in adults undergoing otologic surgery. ⋯ The Caprini risk assessment model may overestimate VTE risk in patients undergoing extracranial otologic surgery. Postoperative VTE following otologic surgery is rare, even in patients traditionally considered moderate or high risk. Chemoprophylaxis guidelines in this group should be balanced against the potential risk of increased intraoperative bleeding and its associated effects on surgical visualization and morbidity.
-
Otolaryngol Head Neck Surg · Jun 2019
Outcomes of Children with Mild Obstructive Sleep Apnea Treated Nonsurgically: A Retrospective Review.
Obstructive sleep apnea (OSA) is characterized by partial or complete obstruction of the upper airway and is commonly caused by adenotonsillar hypertrophy in children. Accordingly, adenotonsillectomy is considered first-line treatment. However, in cases of mild OSA, nonsurgical management has been proposed as an alternative. The purpose of this study was to determine the outcomes of pediatric patients with mild obstructive sleep apnea (OSA) treated without surgical intervention. ⋯ Mild pediatric OSA has approximately equal chances of worsening or improvement over time without surgical intervention, which is useful for counseling parents on treatment options.
-
To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs. ⋯ Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.
-
Otolaryngol Head Neck Surg · Apr 2019
Frailty as a Predictor of Postoperative Outcomes among Patients with Head and Neck Cancer.
To understand measures of frailty among preoperative patients and explain how these can predict perioperative outcomes among patients with head and neck cancer. ⋯ This study demonstrated a significant increase in poor perioperative outcomes and mortality among patients with head and neck cancer and increased frailty, as measured by the modified frailty index.