Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Oct 2010
Randomized Controlled TrialPreoperative treatment with topical corticoids and bleeding during primary endoscopic sinus surgery.
To find out whether the constant preoperative use of a topical corticoid (mometasone furoate [MF]) could really improve the operative field quality and decrease bleeding during endoscopic sinus surgery (ESS). ⋯ The use of topical corticoid (MF) in the preoperative period can improve endoscopic vision, reduce bleeding, and decrease operation time in CRS patients with and without polyps undergoing ESS, but our sample size cannot exclude small, and possibly trivial, group differences.
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Otolaryngol Head Neck Surg · Sep 2010
Sinogenic orbital and subperiosteal abscesses: microbiology and methicillin-resistant Staphylococcus aureus incidence.
To assess the current bacteriology and the incidence of methicillin-resistant Staphylococcus aureus in orbital and subperiosteal abscesses of paranasal sinus disease origin. ⋯ Abscess cultures grew a mixture of bacteria, including gram-positive cocci, gram-negative bacilli, and anaerobes. Although streptococci were the most common genus of bacteria isolated, S. aureus was the single most common pathogen recovered and one fourth of these cases were methicillin-resistant S. aureus. Given the significant morbidity that may result from inadequate treatment, an antibiotic active against methicillin-resistant S. aureus should be included in the initial broad-spectrum antimicrobial treatment regimen of orbital and subperiosteal abscesses of sinusitis origin until culture results are available.
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Otolaryngol Head Neck Surg · Sep 2010
Obstructive sleep apnea surgery practice patterns in the United States: 2000 to 2006.
To determine obstructive sleep apnea (OSA) surgical volume, types, costs, and trends. To explore whether specific patient and hospital characteristics are associated with the performance of isolated palate versus hypopharyngeal surgery and with costs. ⋯ Surgical treatment is performed in 0.2 percent of all adults with OSA annually. Validation of the exploratory findings concerning procedure type and cost requires additional studies, ideally including adjustment for clinical factors.
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Otolaryngol Head Neck Surg · Jul 2010
Multicenter StudyPreliminary NSQIP results: a tool for quality improvement.
To utilize National Surgical Quality Improvement Program (NSQIP) data to evaluate patient outcomes in otolaryngology-head and neck surgery. ⋯ NSQIP reports form the basis for quality improvement with targeted interventions in areas of concern that result in changes in patient care processes. The reports are composed of outcomes-based, risk-adjusted data that are submitted by participating hospitals and have recently included data for otolaryngology-head and neck surgery. Actions taken based on NSQIP data demonstrate improvements in patient morbidity and mortality, decreased length of stay, and decreased hospital costs. In a time of increased scrutiny of health care costs and outcomes, NSQIP is an important tool for surgeons to improve quality and decrease costs.
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To determine the scope of wrong-site sinus surgery. ⋯ Approximately 10 percent of survey respondents know of a case of wrong-site sinus surgery occurring; the majority of respondents are concerned about a wrong-sinus or wrong-sided surgery occurring in their practice. Otolaryngologists should be vigilant regarding the potential for inverted computed tomography images; there should be national efforts to address this latent systems defect. Surgeons should be trained in understanding the role of and engaging in disclosure and in other techniques that are of greatest support to the patient. Consideration of sinus-specific checklists should be led by the societies representing sinus surgeons.