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Chiesa-Estomba CM, Suarez JAS, Ninchritz-Becerra E, Soriano-Reixach M, González-García JA, Larruscain E, Altuna X. Transoral Carbon Dioxide Microsurgery of the Larynx as a Day-Case Outpatient Procedure: An Observational, Retrospective, Single-Center Study. EAR, NOSE & THROAT JOURNAL 2020; 100:100S-104S. [PMID: 32804574 DOI: 10.1177/0145561320951049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Despite good results of transoral laser CO2 microsurgery (CO2TOLMS) of the larynx, a lack of data related to the safety of this technique as a day-case procedure across the literature is evident. MATERIALS AND METHODS An observational, retrospective, non-randomized study. RESULTS One hundred four (62.6%) patients met the inclusion criteria, 96 (92.3%) patients were male, and 8 (7.7%) patients were female. The mean age of the study group was 66 ± 11 years (min: 34/max: 90). All the patients underwent CO2TOLMS were treated as an outpatient procedure. The glottis was the most common location affecting 97 (93.3%) patients, regarding the need of readmission, just 4 (3.8%) patients needed to be readmitted after surgery due to dyspnea secondary to laryngeal edema in 2 cases by laryngeal bleeding, and cervical emphysema in one case, respectively. Being just necessary to reintubate 1 patient (<1%) to control the bleeding. We didn't find any statistical correlation between variables and the need for readmission of reintubation. CONCLUSION According to our results, CO2TOLMS of the larynx can be safely performed as an outpatient procedure. To establish a proper protocol and to perform a careful preoperative assessment are essential to increase our success rate and to prevent any potential complication.
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Affiliation(s)
- Carlos M Chiesa-Estomba
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - Jon A Sistiaga Suarez
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - Elisabeth Ninchritz-Becerra
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - Maria Soriano-Reixach
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - Jose A González-García
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - Ekhiñe Larruscain
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
| | - Xabier Altuna
- Department of Otorhinolaryngology-Head and Neck Surgery, 16650Hospital Universitario Donostia, Donostia-San Sebastian, Spain
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Onal M, Colpan B, Elsurer C, Bozkurt MK, Onal O, Turan A. Is it possible that direct rigid laryngoscope-related ischemia-reperfusion injury occurs in the tongue during suspension laryngoscopy as detected by ultrasonography: a prospective controlled study. Acta Otolaryngol 2020; 140:583-588. [PMID: 32223688 DOI: 10.1080/00016489.2020.1743353] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: Tongue-related complications can be seen in suspension laryngoscopy (SL) procedures.Aims/objectives: This study aimed to detect tongue edema associated with the pressure exerted by a rigid direct laryngoscope by measuring the tongue area using ultrasonography (USG) in patients undergoing SL procedures.Material and methods: The study group included 31 patients and the control group consisted of 33 patients. Submental USG examinations of the tongue in the coronal plane were performed. In the study and control groups, the first examination (TA1) was done immediately after intubation and the second examination (TA2) was done after the surgery procedure but before extubation. The USG results regarding tongue area for both the groups were compared.Results: The study and control groups significantly differed in terms of the postoperative tongue area measurements (TA2), as well as tongue edema (based on the TA2 - TA1) values.Conclusions and significance: Direct rigid laryngoscopes may cause tongue edema in SL procedures which was demonstrated by the USG. This tongue edema can be a result of ischemia-reperfusion injury in the tongue due to the pressure exerted by a direct rigid laryngoscope. This study is the first to demonstrate the possible role of USG examination in determining the side effects of SL procedures on the tongue. Trial Registration ClinicalTrials.gov Identifier: NCT04205253.
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Affiliation(s)
- Merih Onal
- Department of Otolaryngology, Selcuk University, Konya, Turkey
| | - Bahar Colpan
- Department of Otolaryngology, Selcuk University, Konya, Turkey
| | - Cagdas Elsurer
- Department of Otolaryngology, Selcuk University, Konya, Turkey
| | | | - Ozkan Onal
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA
- Department of Anesthesiology and Reanimation, Selcuk University, Konya, Turkey
| | - Alparslan Turan
- Department of Outcomes Research, Cleveland Clinic, Cleveland, OH, USA
- Department of General Anesthesia, Cleveland Clinic, Cleveland, OH, USA
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Vigier S, Tassin C, Romero G, Girodet D, Zrounba P, Deneuve S. Day-care unit for rigid panendoscopy of the upper aerodigestive tract: A study of 436 procedures. Eur Ann Otorhinolaryngol Head Neck Dis 2017; 134:393-397. [PMID: 28552504 DOI: 10.1016/j.anorl.2017.05.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To assess the role of day-care management of upper aerodigestive tract (UADT) panendoscopy and to study criteria for conventional hospital admission and reasons for conversion. PATIENTS AND METHODS Retrospective study, from January 2011 to May 2013. Inclusion criteria UADT panendoscopy for carcinoma assessment. Study variables, age, gender, tumor location, reason for panendoscopy, TNM stage, previous external radiotherapy, home-to-hospital distance and Apfel, Detsky and ASA scores. A day-care and a conventional admission group were compared using Fisher's test for ASA score, student's test for age and Pearson's chi2 test for the other variables. RESULTS Four hundred and thirty-six panendoscopies were performed: 252 in day-care, including 4 cases of conversion and 184 with conventional admission. There were no significant differences between groups for age, gender, tumor location, TNM stage, reason for panendoscopy, previous external radiotherapy, home-to-hospital distance or Apfel score. A significant difference was observed for ASA score (P<0.0001) and Detsky score (P=0.03). In 39% of cases, the reason for hospital admission without criteria defined by the French Society of Anesthesia and Intensive Care Medicine (SFAR) and French Health Authority (HAS) was the patient's refusal of day care. In 10% of conventional admissions, day-care was not implemented because of psychosocial factors. CONCLUSION Day-care management is appropriate for UADT panendoscopy in selected patients. The reasons for the high rate of patient refusal should be studied.
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Affiliation(s)
- S Vigier
- Département de chirurgie oncologique, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - C Tassin
- Département d'anesthésie réanimation, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - G Romero
- Département d'anesthésie réanimation, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - D Girodet
- Département de chirurgie oncologique, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - P Zrounba
- Département de chirurgie oncologique, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France
| | - S Deneuve
- Département de chirurgie oncologique, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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Tessema B, Sulica L, Yu GP, Sessions RB. Tongue Paresthesia and Dysgeusia following Operative Microlaryngoscopy. Ann Otol Rhinol Laryngol 2016; 115:18-22. [PMID: 16466095 DOI: 10.1177/000348940611500103] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: This study was performed to assess the overall incidence and duration of alterations in tongue sensation and taste after operative microlaryngoscopy, and the relation of these symptoms to operative time. Methods: We performed a retrospective review of information regarding tongue symptoms in patients who completed standard post-microlaryngoscopy follow-up at 1 week, 1 month, and 3 months. Results: One hundred patients (54 male and 46 female; mean age, 46 years; age range, 14 to 83 years) met the inclusion criteria. Eighteen patients had positive findings at 1 week: 15 complained of paresthesia and 3 of dysgeusia. The symptoms decreased over time without treatment (4% of patients at 1 month and 1% of patients at 3 months). Only 1 case of dysgeusia persisted past 3 months. Gender was found to be a significant independent risk factor for the development of symptoms (odds ratio, 5.63; 95% confidence interval, 1.36 to 31.29; p = .013). Patients whose operations lasted longer than 1 hour were almost 4 times more likely to develop tongue-related symptoms than those with an operative time less than 30 minutes, although these findings did not achieve statistical significance (odds ratio, 3.91; 95% confidence interval, 0.62 to 30.95; p = .182). Conclusions: Alterations in tongue sensation and taste, most likely due to lingual nerve injury, are common after microlaryngoscopy, especially in female patients. They also tend to be associated with longer operative times. Although transient in nearly every case, lingual paresthesia and dysgeusia should form part of the preoperative discussion with the patient.
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Affiliation(s)
- Belachew Tessema
- Department of Otolaryngology, The New York Eye and Ear Infirmary, New York, New York, USA
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Allen CT, Lee CJ, Meyer TK, Hillel AD, Merati AL. Risk stratification in endoscopic airway surgery: is inpatient observation necessary? Am J Otolaryngol 2014; 35:747-52. [PMID: 25097181 DOI: 10.1016/j.amjoto.2014.06.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Accepted: 06/30/2014] [Indexed: 11/19/2022]
Abstract
PURPOSE To compare post-operative complication rates between inpatient and outpatient endoscopic airway surgery in patients with laryngotracheal stenosis. Secondary objectives included characterization of a cohort of patients with this disease. METHODS Retrospective review of patients with laryngotracheal stenosis in a tertiary care laryngology practice over a 5-year period. RESULTS Ninety-one patients underwent 223 endoscopic airway surgeries. Of 114 outpatient interventions, 1 patient (0.8%) sought emergent medical care following discharge for respiratory distress. Of 109 procedures resulting in admission, no patients required transfer to a higher level of care, endotracheal intubation or placement of a surgical airway. There was no statistically significant difference in complication rates between patients treated as outpatients or inpatients (p=0.33, chi square). There were no cardiopulmonary events. There were no pneumothoraces despite frequent use of jet ventilation. The most common etiologic category was idiopathic (58%), followed by granulomatosis with polyangiitis (16%) and history of tracheotomy (12%). Most patients with idiopathic disease were female (p<0.001, Fisher's exact test). CONCLUSION Patients undergoing endoscopic surgery for airway stenosis rarely have post-operative complications, and outpatient surgery appears to be a safe alternative to post-operative admission and observation.
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Affiliation(s)
- Clint T Allen
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA.
| | - Chia-Jung Lee
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA
| | - Tanya K Meyer
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA
| | - Allen D Hillel
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA
| | - Albert L Merati
- Division of Laryngology, Department of Otolaryngology-Head and Neck Surgery, University of Washington School of Medicine, 1959 NE Pacific St, Box 356515, Seattle, WA
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Phase I/II Study of Intrapleural Administration of a Serotype rh.10 Replication-Deficient Adeno-Associated Virus Gene Transfer Vector Expressing the Human α1-Antitrypsin cDNA to Individuals with α1-Antitrypsin Deficiency. HUM GENE THER CL DEV 2014; 25:112-33. [DOI: 10.1089/humc.2014.2513] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
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Schwartz SR, Cohen SM, Dailey SH, Rosenfeld RM, Deutsch ES, Gillespie MB, Granieri E, Hapner ER, Kimball CE, Krouse HJ, McMurray JS, Medina S, O'Brien K, Ouellette DR, Messinger-Rapport BJ, Stachler RJ, Strode S, Thompson DM, Stemple JC, Willging JP, Cowley T, McCoy S, Bernad PG, Patel MM. Clinical Practice Guideline: Hoarseness (Dysphonia). Otolaryngol Head Neck Surg 2009; 141:S1-S31. [DOI: 10.1016/j.otohns.2009.06.744] [Citation(s) in RCA: 203] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2009] [Accepted: 06/26/2009] [Indexed: 12/27/2022]
Abstract
Objective: This guideline provides evidence-based recommendations on managing hoarseness (dysphonia), defined as a disorder characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication or reduces voice-related quality of life (QOL). Hoarseness affects nearly one-third of the population at some point in their lives. This guideline applies to all age groups evaluated in a setting where hoarseness would be identified or managed. It is intended for all clinicians who are likely to diagnose and manage patients with hoarseness. Purpose: The primary purpose of this guideline is to improve diagnostic accuracy for hoarseness (dysphonia), reduce inappropriate antibiotic use, reduce inappropriate steroid use, reduce inappropriate use of anti-reflux medications, reduce inappropriate use of radiographic imaging, and promote appropriate use of laryngoscopy, voice therapy, and surgery. In creating this guideline the American Academy of Otolaryngology—Head and Neck Surgery Foundation selected a panel representing the fields of neurology, speech-language pathology, professional voice teaching, family medicine, pulmonology, geriatric medicine, nursing, internal medicine, otolaryngology–head and neck surgery, pediatrics, and consumers. Results The panel made strong recommendations that 1) the clinician should not routinely prescribe antibiotics to treat hoarseness and 2) the clinician should advocate voice therapy for patients diagnosed with hoarseness that reduces voice-related QOL. The panel made recommendations that 1) the clinician should diagnose hoarseness (dysphonia) in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces voice-related QOL; 2) the clinician should assess the patient with hoarseness by history and/or physical examination for factors that modify management, such as one or more of the following: recent surgical procedures involving the neck or affecting the recurrent laryngeal nerve, recent endotracheal intubation, radiation treatment to the neck, a history of tobacco abuse, and occupation as a singer or vocal performer; 3) the clinician should visualize the patient's larynx, or refer the patient to a clinician who can visualize the larynx, when hoarseness fails to resolve by a maximum of three months after onset, or irrespective of duration if a serious underlying cause is suspected; 4) the clinician should not obtain computed tomography or magnetic resonance imaging of the patient with a primary complaint of hoarseness prior to visualizing the larynx; 5) the clinician should not prescribe anti-reflux medications for patients with hoarseness without signs or symptoms of gastroesophageal reflux disease; 6) the clinician should not routinely prescribe oral corticosteroids to treat hoarseness; 7) the clinician should visualize the larynx before prescribing voice therapy and document/communicate the results to the speech-language pathologist; and 8) the clinician should prescribe, or refer the patient to a clinician who can prescribe, botulinum toxin injections for the treatment of hoarseness caused by adductor spasmodic dysphonia. The panel offered as options that 1) the clinician may perform laryngoscopy at any time in a patient with hoarseness, or may refer the patient to a clinician who can visualize the larynx; 2) the clinician may prescribe anti-reflux medication for patients with hoarseness and signs of chronic laryngitis; and 3) the clinician may educate/counsel patients with hoarseness about control/preventive measures. Disclaimer: This clinical practice guideline is not intended as a sole source of guidance in managing hoarseness (dysphonia). Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. The guideline is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and may not provide the only appropriate approach to diagnosing and managing this problem.
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Anaesthesia for direct laryngoscopy with propofol and fentanyl or sufentanil. Indian J Otolaryngol Head Neck Surg 2008; 60:314-6. [PMID: 23120572 DOI: 10.1007/s12070-008-0106-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
UNLABELLED AIM #ENTITYSTARTX00026; OBJECTIVE To find if direct laryngoscopy (DL) could be done without using succinylcholine and secondly, to acertain the appropriate anesthetic regimen. PATIENTS AND METHODS In a double blind placebo controlled study 67 patients aged 40-75 years of age, of both sex requiring direct laryngoscopy (DL) either for diagnosis or for biopsy were enrolled. The patients were randomly divided in three groups. The patients in group F and S received Fentanyl or Sufentanil respectively along with Propofol, whereas those in group N received normal saline (placebo) and propofol. The conditions of laryngoscopy, hemodynamic parameters and any adverse events were recorded. Good or fair conditions for laryngoscopy were achieved in 91% (21), 87% (19) and 73% (16) of patients in groups F, S and N respectively (p < 0.05) in favor of group F and S. During DL arterial pressure and pulse rate changes were minimal when propofol was administered along with opioids, (group F and S) compared to group N where only propofol was used. RESULTS No serious side effects were seen in the three groups. Hence by these findings we concluded that better conditions of DL are achieved during anesthesia with propofol and fentanyl and sufentanil alone. The opioids provided additional benefit of stable hemodynamics.
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Chen WT, Soong WJ, Lee YS, Jeng MJ, Chang HL, Hwang B. The safety of aerodigestive tract flexible endoscopy as an outpatient procedure in young children. J Chin Med Assoc 2008; 71:128-34. [PMID: 18364264 DOI: 10.1016/s1726-4901(08)70004-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Flexible endoscopy (FE) for the pediatric aerodigestive tract is an invasive and complicated procedure; therefore, it is usually performed under an inpatient setting. We investigated whether FE could be a safe procedure for outpatient young children (< 5 years old) and analyzed the findings. METHODS Outpatient FE records were retrospectively reviewed between 1996 and 2003. Patients aged less than 5 years were enrolled and allocated to 3 age groups: group A (<or=3 months), group B (4-12 months), and group C (1-5 years). Patients with or without previously known major airway anomalies were also grouped for analysis. RESULTS A total of 728 children (479 boys, 249 girls) who underwent 834 FE procedures were collected. Of those without previously known airway anomalies, stridor was the most common symptom in group A (60.2%), and snoring in group B (34.1%) and group C (74.2%). Laryngomalacia was the most common FE finding in group A (60.2%) and group B (34.1%), and nasal adenoid hypertrophy in group C (69.6%). After FE, there were 57 admissions (6.8%), and higher in those aged less than 1 year or in those with major airway anomalies. Seven (0.7%) were complication-associated admissions. CONCLUSION From this study, we conclude that FE is a safe, effective and tolerable outpatient procedure in the majority of young children, and serious complications were uncommon.
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Affiliation(s)
- Wan-Teh Chen
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C
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Extubation difficile : critères d’extubation et gestion des situations à risque. ACTA ACUST UNITED AC 2008; 27:46-53. [DOI: 10.1016/j.annfar.2007.10.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Altuna Mariezkurrena X, Henríquez Alarcón M, Camacho Arrioaga JJ, Algaba Guimerá J. [Laser cordectomy without hospitalization. Is it a safe intervention?]. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2004; 54:635-41. [PMID: 14992117 DOI: 10.1016/s0001-6519(03)78460-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To evaluate the safety of the CO2 Laser Cordectomy in the treatment of glottic carcinoma as a day-case procedure. MATERIAL AND METHODS Retrospective study of a cohort of 30 patients with glottic carcinoma treated with CO2 Laser Cordectomy at our institution between 1999-2001 as a day-case procedure. RESULTS There were no major complications and no patients required re-intubation. 90% of the patients were discharged the same day of the procedure. There were three unplanned admissions to the hospital but none of them were, in our opinion, the direct result of Cordectomy. These patients were discharged the next day. 100% of the patients answered that they would repeat the experience. CONCLUSIONS CO2 Laser Cordectomy of the glottic carcinoma can be safely performed as an outpatient procedure if patients are selected according to specific day-case criteria.
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Affiliation(s)
- X Altuna Mariezkurrena
- Servicio de Otorrinolaringología, Hospital Donostia, Edificio Aranzazu, Po. Doctor Beguiristain, s/n, 20014 San Sebstián, Guipúzcoa.
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Klussmann JP, Knoedgen R, Wittekindt C, Damm M, Eckel HE. Complications of suspension laryngoscopy. Ann Otol Rhinol Laryngol 2002; 111:972-6. [PMID: 12450169 DOI: 10.1177/000348940211101104] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Although suspension laryngoscopy (SL) is routinely used in operative laryngology, no prospectively gathered data on the complications of this procedure have so far been available. We prospectively analyzed 339 consecutive procedures for intervention-related complications. The survey included preoperative dental status and assessment of postoperative dental, mucosal, and nerve injuries. Minor mucosal lesions were found in 75% of all patients. All healed spontaneously within a few days. Dental injuries occurred in 6.5% of all patients. These were more frequent in therapeutic laryngoscopy than in diagnostic procedures (6.8% versus 6.0%). Highly significant correlations were found between dental injury rate and preoperative dental disease (p < .04) and grade of periodontitis (p <.001). Temporary nerve lesions were observed in 13 patients (9 of the lingual nerve and 4 of the hypoglossal nerve). Although minor complications frequently occur during SL, it is a relatively safe procedure with a low risk of significant morbidity.
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Affiliation(s)
- Jens Peter Klussmann
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Cologne, Cologne, Germany
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A prospective evaluation of the feasibility of daycase microlaryngeal surgery. The Journal of Laryngology & Otology 1998. [DOI: 10.1017/s0022215100142938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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