Arch Otolaryngol
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Meta Analysis
Postoperative hemorrhage with nonsteroidal anti-inflammatory drug use after tonsillectomy: a meta-analysis.
To use standard meta-analysis techniques to determine the risk of postoperative hemorrhage associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) after tonsillectomy. ⋯ There is an increased risk of posttonsillectomy hemorrhage with the use of aspirin after tonsillectomy; however, there appears to be no significant increased risk of bleeding for nonaspirin NSAIDs in this meta-analysis.
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To analyze possible etiological factors of spontaneous cerebrospinal fluid (CSF) rhinorrhea and to assess the outcomes of endonasal endoscopic repair. ⋯ Possible etiological factors of this disease include obesity, congenital malformations of the skull base, an overpneumatized sphenoid sinus (particularly in its lateral extensions), and the empty sella syndrome. Endoscopic endonasal repair of spontaneous CSF rhinorrhea appears to be a safe and successful procedure. However, techniques for endoscopic closure of CSF fistulas in the lateral part of the sphenoid sinus need further perfecting.
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Office-based evaluation of the lower airway in adults with only topical anesthetics has been well documented. This study was performed to assess the feasibility of performing office-based lower airway endoscopy in a pediatric population. ⋯ With the use of only topical anesthesia, flexible endoscopy of the lower airway in children can be performed in the office setting and can be used effectively to evaluate abnormalities of the lower airway.
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Randomized Controlled Trial Clinical Trial
Three-dose vs extended-course clindamycin prophylaxis for free-flap reconstruction of the head and neck.
Twenty-four hours of perioperative antibiotics provides effective prophylaxis for most head and neck cancer resections. Many reconstructive surgeons have been hesitant to apply this standard to free-flap reconstruction of the head and neck. This prospective clinical trial compared short-course and long-course clindamycin prophylaxis for wound infection in patients with head and neck cancer undergoing free-flap reconstruction. ⋯ Short-course clindamycin is as effective as long-course clindamycin in preventing wound infections after free-flap surgery for head and neck ablative defects.
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The indications for surgical treatment of patients with head and neck cancer can be limited by the risk of perioperative complications. Prediction of outcome is important in disease stratification and the subsequent decision-making process. ⋯ The POSSUM and APACHE II scores were useful in predicting perioperative morbidity for patients with oral or oropharyngeal cancer, serving as objective methods to assist the surgeon in classifying patients into risk groups with different probabilities of perioperative complications. The poorer results achieved with the ASA classification are possibly because this system is primarily based on subjective clinical judgments.