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What Are The Potential Complications of a Tracheostomy?
Discussion In the past, indications for tracheostomy were often because of infection, but today are more often due to need for chronic airway support and/or ventilation. Many more children and infants are having tracheostomies placed. Decannulation rates for these children are low due to concomitant complex chronic disease such as neurological, pulmonary and congenital heart diseases. Co-morbidies are common with 3-4 being average, and frequently also including chronic technology such as gastrostomy tubes or ventriculoperitoneal shunts. Approximately 8% of children do not survive the hospitalization where the tracheostomy ...
Source: PediatricEducation.org - January 7, 2019 Category: Pediatrics Authors: pediatriceducationmin Tags: Uncategorized Source Type: news

Intranasal tissue necrosis associated with opioid abuse: Case report and systematic review
ConclusionIntranasal opioid abuse is a prevalent condition associated with chronic pain and tissue necrosis that is clinically concerning for invasive fungal disease. Whereas IFRS must be excluded, even in patients without known immunodeficiency, complete resolution of symptoms can be expected following surgical debridement with cessation of opioid abuse. Laryngoscope, 2017
Source: The Laryngoscope - December 27, 2017 Category: ENT & OMF Authors: Danielle A. Morrison, Sarah K. Wise, John M. DelGaudio, Naweed I. Chowdhury, Joshua M. Levy Tags: Allergy/Rhinology Source Type: research

Elimination of pain improves specificity of clinical diagnostic criteria for adult chronic rhinosinusitis
ConclusionClinical diagnostic criteria overestimate the prevalence of chronic rhinosinusitis. Removing facial pain, ear pain, dental pain, and headache increased specificity without a concordant loss in sensitivity. Given the high prevalence of sinusitis, improved clinical diagnostic criteria may assist primary care providers in more accurately predicting the presence of inflammation, thereby reducing inappropriate antibiotic use or delayed referral for evaluation of primary headache syndromes. Level of Evidence4. Laryngoscope, 2017
Source: The Laryngoscope - January 5, 2017 Category: ENT & OMF Authors: Scott D. Hirsch, Evan R. Reiter, Laurence J. DiNardo, Wen Wan, Theodore A. Schuman Tags: Allergy/Rhinology Source Type: research

Balloon dilation of sinus ostia in the Department of Defense: Diagnoses, actual indications, and outcomes
ConclusionsBalloon dilation of sinus ostia has an expanding role in treating sinus disease. In the studied population, BCD is often utilized for alternate indications for which there is currently no evidence of efficacy. Future studies are needed to evaluate the efficacy of this technology in treating these alternate indications. Level of Evidence4. Laryngoscope, 2016
Source: The Laryngoscope - September 23, 2016 Category: ENT & OMF Authors: Adrienne M. Laury, Sarah N. Bowe, Joshua Stramiello, Kevin C. McMains Tags: Allergy/Rhinology Source Type: research

Product comparison model in otolaryngology: Equivalency analysis of absorbable hemostatic agents after endoscopic sinus surgery
ConclusionCareful and deliberate consideration should be taken when choosing products to assist our surgical endeavors. Subjectively, patients treated with MPH showed near‐significant increases in pain and obstruction. In objective measures, CMC gel nearly reaches significance for more postoperative debridement, with increased crusting and inflammation. Product choice could consider these factors, although it remains at the discretion of the surgeon. This model of comparison allows careful product comparison and should be applied to other hemostatics, as well as other materials in use in otolaryngology. Level of Evidence...
Source: The Laryngoscope - October 28, 2015 Category: ENT & OMF Authors: Jastin L. Antisdel, Annika Meyer, Brett Comer, David Jang, Jose Gurrola, Eyad Khabbaz, Kara Christopher, Stilianos Kountakis Tags: Allergy/Rhinology Source Type: research

Comorbidities in patients with all‐positive symptoms on sinonasal outcomes test quality‐of‐life instrument
ConclusionThe SNOT‐20 questionnaire assists clinicians to monitor outcomes in patients treated for CRS. However, clinicians should suspect other underlying chronic conditions in SNOT‐20 pan‐positive patients. Level of Evidence3B. Laryngoscope, 2015
Source: The Laryngoscope - July 7, 2015 Category: ENT & OMF Authors: Alexander Caten, Christopher Johnson, David Jang, Jose Gurrola, Stilianos Kountakis Tags: Allergy/Rhinology Source Type: research

The EQ‐5D: A new tool for studying clinical outcomes in chronic rhinosinusitis
ConclusionThe EQ‐5D is a general health measure with sensitivity to clinical change in rhinosinusitis that support its use for monitoring patient outcomes. The limited response burden and ability to directly calculate health utility make it an attractive tool for rhinosinusitis outcomes research. Level of Evidence2c. Laryngoscope, 2014
Source: The Laryngoscope - June 10, 2014 Category: ENT & OMF Authors: Aaron K. Remenschneider, Laura D'Amico, Stacey T. Gray, Eric H. Holbrook, Richard E. Gliklich, Ralph Metson Tags: Allergy/Rhinology Source Type: research

Primary care and upfront computed tomography scanning in the diagnosis of chronic rhinosinusitis: A cost‐based decision analysis
ConclusionsIn all scenarios, confirming diagnosis with CT scanning prior to treatment or referral is more cost‐efficient than presuming a diagnosis of CRS based on symptoms alone. Level of Evidence2c. Laryngoscope, 2013
Source: The Laryngoscope - August 5, 2013 Category: ENT & OMF Authors: Randy M. Leung, Rakesh K. Chandra, Robert C. Kern, David B. Conley, Bruce K. Tan Tags: Allergy/Rhinology Source Type: research