ABSTRACT
PURPOSE: Postoperative laryngeal edema (PLE) is a common complication in patients undergoing head and neck surgery, leading to symptoms such as odynophagia, dysphagia, or potential airway obstruction. However, the prevalence and risk factors of PLE in patients undergoing neck dissection (ND) have not been well investigated. METHODS: A retrospective analysis was conducted in three steps. Initially, a pilot study of 50 consecutive ND patients revealed a preliminary PLE prevalence of 0.34. Then, the medical records of an additional 295 ND patients were reviewed to estimate the prevalence of PLE with a total width of 95% confidence interval (CI) of ± 5%. Finally, multivariable logistic regression analyses were performed to identify risk factors for PLE (n = 343). RESULTS: PLE occurred in 29.4% [95%CI 24.4-34.4%] of patients undergoing any type of ND, with the most common symptoms of odynophagia (75.0%) and dyspnea (11.1%). Hospital stay was just one day longer in PLE patients, responding well with short-term steroid treatment (p = 0.0057). In multivariable analyses, no significant association was found between PLE occurrence and airway management. However, body mass index and the American Society of Anesthesiologists classification correlated with PLE. More importantly, surgery for oro-hypopharynx or supraglottis tumors (odds ratio, OR = 3.019, [95%CI 1.166-7.815]) and lymph node level 2(3) ND (OR = 4.214 to 5.279, [95%CI 1.160-20.529]) were significant risk factors for PLE. CONCLUSIONS: PLE developed in approximately 30% of ND patients, causing uncomfortable symptoms. Early diagnosis and intervention of PLE in high-risk patients can improve patient care and outcomes.
Subject(s)
Laryngeal Edema , Neck Dissection , Postoperative Complications , Humans , Male , Female , Neck Dissection/adverse effects , Risk Factors , Middle Aged , Retrospective Studies , Laryngeal Edema/epidemiology , Laryngeal Edema/etiology , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Prevalence , Aged , Adult , Pilot Projects , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/epidemiologyABSTRACT
Crystal splitting and enhanced photocatalytic activities caused by implied dislocations were observed in hierarchical TiO(2) nano-architectures prepared by one-pot hydrothermal synthesis in concentrated HCl. Microstructural observation revealed that the nanowires formed by continuous splitting of TiO(2) nano-belts, which is caused by a lattice misorientation of about 6°, were generated by an array of dislocations. In addition, the larger amount of dislocations implied in TiO(2) nano-architectures induces higher photocatalytic activities under ultra-violet illumination.