Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Aug 2012
Sentinel node biopsy for head and neck desmoplastic melanoma: not a given.
Determine the frequency of, the characteristics predictive of, and potential associated survival benefit from sentinel lymph node biopsy in a population of patients with desmoplastic melanoma of the head and neck. ⋯ Positive sentinel lymph node biopsies are rare in patients with desmoplastic melanoma of the head and neck. The low (5%) incidence of positive sentinel lymph node biopsy, coupled with the absence of identifiable survival benefit from its use, supports a more selective application of sentinel lymph node biopsy to this group of patients.
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To examine the impact of early tracheotomy in nontrauma patients on duration of mechanical ventilation (MV), intensive care unit (ICU) stay, and overall hospital stay. ⋯ Early tracheotomy in ICU patients is associated with earlier ICU discharge, shorter duration of mechanical ventilation, and decreased length of overall hospital stay without affecting mortality.
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To identify contemporary trends in female authorship in the otolaryngology literature. ⋯ Female authorship has shown significant and steady increases in the otolaryngology literature, particularly in the past decade. Increased rates of publication from female otolaryngologists within most subspecialties have resulted in similar rates of publication across the subspecialties.
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Otolaryngol Head Neck Surg · Jul 2012
Endoscopic nasoseptal flap repair of skull base defects: is addition of a dural sealant necessary?
We compared the incidence of postoperative cerebrospinal fluid (CSF) leaks in patients undergoing endoscopic skull base repair with a pedicled nasoseptal flap (PNSF) with or without the addition of a dural sealant. ⋯ The use of dural sealants when performing endoscopic PNSF repair of high-flow CSF leaks is not supported by our data. In addition, this practice may significantly increase surgical cost. We encountered no postoperative CSF leaks in patients with high-flow CSF leaks treated with PNSF alone without dural sealants. Meticulous surgical technique and proper positioning of the PNSF seem to obviate the need for dural sealants during endoscopic skull base reconstruction of high-flow CSF leaks.
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Otolaryngol Head Neck Surg · Jun 2012
All-cause mortality after tracheostomy at a tertiary care hospital over a 10-month period.
To evaluate perioperative mortality after tracheostomy in intensive care unit (ICU) patients undergoing routine tracheostomy over a 10-month period. ⋯ High rates of mortality after tracheostomy can possibly affect hospital quality ratings for surgical services. There were no deaths directly related to surgery. Despite this, the mortality rate in this population was quite high. This illustrates the significant disease burden in these patients and the need to stratify postoperative mortality as well as to consider comorbidity and age when evaluating patients for tracheostomy.