Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
-
Otolaryngol Head Neck Surg · Dec 2014
Observational StudyPredictors of perioperative complications in higher risk children after adenotonsillectomy for obstructive sleep apnea: a prospective study.
Retrospective studies have limitations in predicting perioperative risk following adenotonsillectomy in children with obstructive sleep apnea syndrome (OSAS). Few prospective studies exist. We hypothesized that demographic and polysomnographic (PSG) variables would predict respiratory and general perioperative complications. ⋯ Thus, PSG predicted perioperative respiratory, but not nonrespiratory, complications in children with OSAS. Age <3 years or black race are high-risk factors. Present guidelines have limitations in determining the need for postoperative admission.
-
Otolaryngol Head Neck Surg · Dec 2014
Comparative StudyIncreased intracranial pressure in spontaneous CSF leak patients is not associated with papilledema.
Spontaneous cerebrospinal fluid (CSF) leaks typically present in patients with undiagnosed idiopathic intracranial hypertension (IIH) secondary to pressure erosion of the skull base. Despite elevated intracranial pressure (ICP) on lumbar puncture or ventriculostomy, patients with spontaneous CSF leaks rarely complain of visual disturbances. The objective of this study is to correlate the presence of preoperative papilledema with opening ICP in patients undergoing endoscopic repair of spontaneous CSF leaks. ⋯ Subjects with spontaneous CSF leaks had postclamping average ICP identical to controls with IIH and papilledema. Such evidence suggests that a CSF leak in this patient population provides sufficient pressure diversion to avoid the development of papilledema.
-
Otolaryngol Head Neck Surg · Nov 2014
Randomized Controlled TrialPreemptive submucosal infiltration with ropivacaine for uvulopalatopharyngoplasty.
To evaluate the preemptive analgesic effect of submucosal infiltration of ropivacaine for uvulopalatopharyngoplasty. ⋯ Preemptive submucosal infiltration with 0.33% ropivacaine effectively controlled pain after uvulopalato-pharyngoplasty.
-
Otolaryngol Head Neck Surg · Nov 2014
Comparative StudyCost analysis of mandibular distraction versus tracheostomy in neonates with Pierre Robin sequence.
To evaluate costs associated with surgical treatment for neonates with Pierre Robin sequence (PRS). ⋯ For patients with severe PRS, mandibular distraction provides significant cost savings over tracheostomy ($300,000 per patient over 3 years). Increased costs with tracheostomy come from greater hospital-related charges, more frequent airway procedures, a higher incidence of gastrostomy tube feeds, and home trach care costs. A careful examination of long-term outcomes will be critical as mandibular distraction continues to gain acceptance for treatment of PRS.