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1.
J Laryngol Otol ; 135(3): 212-216, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33641688

RESUMO

OBJECTIVE: To describe our management of implantable hearing device extrusion in cases of previous cervicofacial surgery. METHODS: A review was conducted of a retrospectively acquired database of surgical procedures for implantable hearing devices performed at our department between January 2011 and December 2019. Cases of device extrusion and previous cervicofacial surgery are included. Medical and surgical management is discussed. RESULTS: Four cases of implant extrusion following cervicofacial surgery were identified: one involving a Bonebridge system and three involving cochlear implants. In all cases, antibiotic treatment was administered and surgical debridement performed. The same Bonebridge system was implanted in the middle fossa. The three cochlear implants were removed, and new devices were implanted in a more posterior region. CONCLUSION: Previous cervicofacial surgery is a risk factor for hearing implant extrusion. The middle fossa approach is the best option for the Bonebridge system. Regarding the cochlear implant, it is always suitable to place it in a more posterior area. An inferiorly based fascio-muscular flap may be a good option to reduce the risk of extrusion.


Assuntos
Migração de Corpo Estranho/etiologia , Reação a Corpo Estranho/etiologia , Auxiliares de Audição , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Implantação de Prótese/efeitos adversos , Idoso , Condução Óssea , Bases de Dados Factuais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Necrose/etiologia , Desenho de Prótese , Reoperação/efeitos adversos , Estudos Retrospectivos
2.
J Laryngol Otol ; 135(2): 168-172, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33517925

RESUMO

OBJECTIVE: The coronavirus disease 2019 pandemic resulted in the cessation of elective surgery. The continued provision of complex head and neck cancer surgery was extremely variable, with some UK centres not performing any cancer surgery. During the pandemic, Guy's and St Thomas' NHS Foundation Trust received high numbers of coronavirus disease 2019 admissions. This paper presents our experience of elective complex major head and neck cancer surgery throughout the pandemic. METHODS: A head and neck cancer surgery hub was set up that provided a co-ordinated managed care pathway for cancer patients during the pandemic; the Guy's Cancer Centre provided a separate, self-enclosed coronavirus-free environment within the hospital campus. RESULTS: Sixty-nine head and neck cancer patients were operated on in two months, and 13 patients had a microvascular free tissue transfer. Nosocomial infection with coronavirus disease 2019 was detected in two cases (3 per cent), neither required critical care unit admission. Both patients made a complete recovery and were discharged home. There were no deaths. CONCLUSION: Performing major head and neck surgery, including free flap surgery, is possible during the pandemic; however, significant changes to conventional practice are required to achieve desirable patient outcomes.


Assuntos
/epidemiologia , Infecção Hospitalar/epidemiologia , Neoplasias de Cabeça e Pescoço/cirurgia , Procedimentos Cirúrgicos Otorrinolaringológicos , Complicações Pós-Operatórias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Retalhos de Tecido Biológico , Hospitalização , Humanos , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória , Hemorragia Pós-Operatória/epidemiologia , Infecção da Ferida Cirúrgica/epidemiologia , Reino Unido/epidemiologia , Adulto Jovem
3.
J Laryngol Otol ; 135(2): 176-178, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33599574

RESUMO

BACKGROUND: Peritonsillar abscess, or quinsy, is one of the most common emergency presentations to ENT departments, and is the most common deep tissue infection of the head and neck. In the UK, junior members of the ENT team are regularly required to independently assess, diagnose and treat patients with peritonsillar aspiration or incision and drainage. ISSUE: Inexperienced practitioners can stumble at several obstacles: poor access due to trismus; poor lighting; difficulty in learning the therapeutic procedure; and difficulty in accurately documenting findings and treatment. SOLUTION: To counter these and other difficulties, the authors describe the routine use of video endoscopy as a training tool and therapeutic adjunct in the management of quinsy.


Assuntos
Drenagem/métodos , Laringoscópios , Laringoscopia/métodos , Abscesso Peritonsilar/cirurgia , Endoscopia/educação , Endoscopia/métodos , Humanos , Laringoscopia/educação , Orofaringe , Procedimentos Cirúrgicos Otorrinolaringológicos/educação , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
5.
Laryngoscope ; 131(1): E307-E313, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33405253

RESUMO

OBJECTIVE: To investigate whether modified uvulopalatopharyngoplasty (UPPP) for treatment of obstructive sleep apnea (OSA) remained effective after 8 years. METHODS: Prospective intervention study. Sixty-five patients with OSA were offered re-evaluation with polysomnography and the Epworth Sleepiness Scale (ESS) 8 years after UPPP. Results were compared with baseline and with a previous 2-year follow-up. Baseline predictors were analyzed with regression analyses. RESULTS: The dropout rate at the 8-year follow-up was 28%. The mean decrease in apnea-hypopnea index (AHI) between baseline and the 8-year follow-up was significant, 14.0 events/hour (from 52.9 to 38.9), 27% (P < .001). The mean increase in AHI between the 2-year and the 8-year follow-up was significant, 14.7 events/hour (from 24.2 to 38.9), 61% (P < .0001). Overweight at baseline predicted an AHI at the 8-year follow-up that was 22.9 events higher compared to patients with normal weight (P = .015). An increase in body mass index (BMI) of 1 kg/m2 between baseline and the 8-year follow-up predicted a mean AHI increase of 3.8 events/hour (P = .015). The median decrease in ESS between baseline and the 8-year follow-up was significant, 7 (from 13.0 to 6.0), 54% (P < .0001). The median increase in ESS between the 2-year and the 8-year follow-up was not significant, 1.0 (from 5.0 to 6.0), 20%. CONCLUSION: Modified UPPP was effective as a long-term treatment for OSA in selected patients, although the effect on AHI decreased over time. Daytime sleepiness remained improved even in the long term. High BMI at baseline and an increase in BMI predicted a reduced long-term respiratory outcome. LEVEL OF EVIDENCE: 3 Laryngoscope, 131:E307-E313, 2021.


Assuntos
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Apneia Obstrutiva do Sono/cirurgia , Adulto , Índice de Massa Corporal , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Palato Mole/cirurgia , Faringe/cirurgia , Polissonografia , Estudos Prospectivos , Apneia Obstrutiva do Sono/diagnóstico , Fatores de Tempo , Resultado do Tratamento , Úvula/cirurgia , Adulto Jovem
6.
J Laryngol Otol ; 135(1): 57-63, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33487190

RESUMO

OBJECTIVE: The incidence of recurrent stenosis after cricotracheal resection is 3-9.5 per cent. Management of such patients is challenging. This study aimed to review our experience in revision cricotracheal resection. METHODS: The study was conducted in the Otorhinolaryngology Department, Mansoura University Hospitals, Egypt, on nine patients with recurrent stenosis following cricotracheal resection. Revision cricotracheal resection was performed in all patients. Surgiflo was applied on the site of anastomosis to enhance healing. RESULTS: No intra-operative complications were recorded. Minor post-operative complications occurred in two patients (surgical emphysema and temporary choking); no major complications were reported. Re-stenosis occurred in one patient. Successful decannulation was achieved in eight of the nine patients. CONCLUSION: Revision cricotracheal resection is the definitive curative treatment for recurrent stenosis after previous unsuccessful resection. It has high success rates, provided that careful pre-operative assessment and meticulous operative technique are performed.


Assuntos
Cartilagem Cricoide/cirurgia , Traqueia/cirurgia , Estenose Traqueal/cirurgia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Recidiva , Reoperação , Estudos Retrospectivos , Adulto Jovem
7.
Curr Opin Allergy Clin Immunol ; 21(1): 38-45, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33369568

RESUMO

PURPOSE OF REVIEW: The WHO announced the coronavirus disease 2019 (COVID-19) outbreak as a pandemic in February 2020 with over 15 million confirmed cases of COVID-19 globally to date. Otolaryngologists are at a high risk of contracting COVID-19 during this pandemic if there is inadequate and improper personal protective equipment provision, as we are dealing with diseases of the upper-aerodigestive tract and routinely engaged in aerosol-generating procedures. RECENT FINDINGS: This article discusses the background and transmission route for severe acute respiratory syndrome coronavirus 2, its viral load and temporal profile as well as precaution guidelines in outpatient and operative setting in otorhinolaryngology. SUMMARY: As it is evident that COVID-19 can be transmitted at presymptomatic or asymptomatic period of infections, it is essential to practice ear, nose, and throat surgery with high vigilance in a safe and up-to-standard protection level during the pandemic. This article provides a summary for guidelines and recommendations in otorhinolaryngology.


Assuntos
/prevenção & controle , Otolaringologia/métodos , Pandemias , Aerossóis , Instituições de Assistência Ambulatorial , Infecções Assintomáticas , /transmissão , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Nasofaringe/virologia , Orofaringe/virologia , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equipamento de Proteção Individual , Exame Físico , Carga Viral
8.
Ann Acad Med Singap ; 49(11): 897-901, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33381783

RESUMO

The COVID-19 pandemic has had a major impact in healthcare systems across the world, with many hospitals having to come up with protocols and measures to contain the spread of the virus. This affects various specialties' clinical practices in many ways. Since early 2020 in Singapore, the Department of Otorhinolaryngology at Tan Tock Seng Hospital had to rapidly adapt to this pandemic as we provided services to the main healthcare facility combating the virus in our country. We had to design new workflows and also remain flexible in view of the ever-changing situation. There are 6 important domains for an otolaryngology department or any clinical department in general to consider when making adjustments to their practices in an outbreak: (1) clinical work, (2) education, (3) research, (4) safety of patients and staff, (5) morale of medical staff and (6) pandemic frontline work. We hope that the sharing of our experiences and the lessons learnt will be useful for both our local and international colleagues.


Assuntos
/epidemiologia , Assistência à Saúde/métodos , Otolaringologia/métodos , Assistência Ambulatorial , Pesquisa Biomédica , Educação Médica , Procedimentos Cirúrgicos Eletivos , Mão de Obra em Saúde , Humanos , Moral , Otolaringologia/educação , Procedimentos Cirúrgicos Otorrinolaringológicos , Equipamento de Proteção Individual , Admissão e Escalonamento de Pessoal , Singapura/epidemiologia , Fluxo de Trabalho
9.
J Otolaryngol Head Neck Surg ; 49(1): 76, 2020 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-33106189

RESUMO

The novel Coronavirus (COVID-19) has created a worldwide deadly pandemic that has become a major public health challenge. All semi-urgent and elective medical care has come to a halt to conserve capacity to care for patients during this pandemic. As the numbers of COVID-19 cases decrease across Canada, our healthcare system also began to reopen various facilities and medical offices. The aim for this document is to compile the current evidence and provide expert consensus on the safe return to clinic practice in Otolaryngology - Head & Neck Surgery. These recommendations will also summarize general precaution principles and practical tips for office across Canada to optimize patient and provider safety. Risk assessment and patient selection are crucial to minimizing exposure to COVID-19. Controversial topics such as COVID-19 mode of transmission, duration of exposure, personal protective equipment, and aerosol-generating procedures will be analyzed and discussed. Practical solutions of pre-visit office preparation, front office and examination room set-up, and check out procedures are explored. Specific considerations for audiology, pediatric population, and high risk AGMPs are also addressed. Given that the literature surrounding COVID-19 is rapidly evolving, these guidelines will serve to start our specialty back into practice over the next weeks to months and they may change as we learn more about this disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Otolaringologia , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Equipamento de Proteção Individual/normas , Pneumonia Viral/epidemiologia , Sociedades Médicas , Canadá/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Pandemias , Pneumonia Viral/transmissão
10.
Medicine (Baltimore) ; 99(42): e22835, 2020 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-33080763

RESUMO

Even being equipped with advanced surgical navigation systems, thorough analysis of patient's imaging diagnosis before procedures is still of great necessity for the operators. This study aimed to explore the morphological changes of sphenoid sinus lesions as observed on computed tomography (CT), and further carry out the fenestration of sphenoid sinus under guidance of the CT.A retrospective analysis of the characteristics of CT images was performed. The outcomes of three kinds of nasal endoscopic surgeries on benign lesions of sphenoid sinuses were investigated. For the 128 patients included, nasal-cavity-olfactory cleft pathway was performed in 64 patients, the Messerklinger pathway was adopted in 54 patients, while Wigand pathway was performed in the rest 10 patients.After follow-up visit, the drainage at the fenestration site of sphenoid sinus was found to be smooth, the symptoms were completely controlled, and no severe complication was reported during or after the surgery. No significant difference was observed in the curative effects among the 3 groups.CT of the paranasal sinus can guide the procedures of sphenoid sinus fenestration. No statistically significant differences were exhibited in terms of the amount of bleeding, surgical time and days of hospitalization among the 3 groups.


Assuntos
Endoscopia/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Seios Paranasais/diagnóstico por imagem , Seio Esfenoidal/diagnóstico por imagem , Seio Esfenoidal/cirurgia , Cirurgia Assistida por Computador , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Adulto Jovem
11.
Otolaryngol Clin North Am ; 53(6): 1171-1174, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32951900

RESUMO

Although the majority of attention to the health care impact of COVID-19 has focused on adult first responders and critical care providers, the pandemic has had a profound effect on the entire health care industry, including the pediatric otolaryngology community. This article highlights the unique ramifications of COVID-19 on pediatric otolaryngology, with a focus on the immediate and potential long-term shifts in practice. Specifically, the article is divided into 3 sections (care for the patient, care for the practitioner, and care for the practice) and details the unique effects of the pandemic on the pediatric otolaryngology specialty.


Assuntos
Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/métodos , Feminino , Humanos , Masculino , Saúde do Trabalhador , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Pandemias/estatística & dados numéricos , Segurança do Paciente , Pediatria/métodos , Pneumonia Viral/epidemiologia , Estados Unidos
12.
Am J Otolaryngol ; 41(6): 102737, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32979667

RESUMO

PURPOSE: Surgeons resuming elective procedures during the COVID-19 pandemic should consider strategies to mitigate risk of exposure. For otolaryngologists performing surgery on children, unique vulnerability to SARS-CoV-2 results from a regular interface with the upper respiratory tract mucosa. A growing interest in perioperative application of povidone­iodine (PVP-I) to the nasopharynx and oropharynx has emerged. The purpose of this review is to provide an evidence-based assessment of PVP-I in pediatric oral, nasal and pharyngeal surgery. METHODS: A contemporary literature review with algorithmic approach to the potential use of PVP-I in pediatric mucosal surgery. RESULTS: Several formulations of PVP-I have shown rapid in vitro virucidal activity against SARS-CoV-2. Antisepsis using 1.0% PVP-I mouthwash and 0.45% PVP-I throat spray can occur after 30 seconds of contact time. To date, in vivo effectiveness of PVP-I against SARS-CoV-2 has yet to be established and possible risks of its direct use on upper aerodigestive mucosa of children must be weighed. CONCLUSION: Further research is required prior to strongly recommending PVP-I use in preparation for nasal, oral or pharyngeal surgery in children.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Infecções por Coronavirus/prevenção & controle , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Procedimentos Cirúrgicos Otorrinolaringológicos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Povidona-Iodo/administração & dosagem , Betacoronavirus , Criança , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Humanos , Nasofaringe , Orofaringe , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão
13.
Dermatol Online J ; 26(8)2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32941709

RESUMO

Dermatologic surgeons are at increased risk of contracting SARS-COV-2. At time of writing, there is no published standard for the role of pre-operative testing or the use of smoke evacuators, and personal protective equipment (PPE) in dermatologic surgery. Risks and safety measures in otolaryngology, plastic surgery, and ophthalmology are discussed. In Mohs surgery, cases involving nasal or oral mucosa are highest risk for SARS-COV-2 transmission; pre-operative testing and N95 masks should be urgently prioritized for these cases. Other key safety recommendations include strict control of patient droplets and expanded pre-clinic screening. Dermatologic surgeons are encouraged to advocate for appropriate pre-operative tests, smoke evacuators, and PPE. Future directions would include national consensus guidelines with continued refinement of safety protocols.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Dermatologistas , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Gestão da Segurança/métodos , Técnicas de Laboratório Clínico/métodos , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Procedimentos Cirúrgicos Eletivos , Humanos , Cirurgia de Mohs/efeitos adversos , Cirurgia de Mohs/métodos , Doenças Profissionais/epidemiologia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Equipamento de Proteção Individual , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Cuidados Pré-Operatórios , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fumaça/prevenção & controle
14.
S Afr Med J ; 110(7): 601-604, 2020 06 02.
Artigo em Inglês | MEDLINE | ID: mdl-32880329

RESUMO

Cancelling elective clinical consultations and surgical procedures was instrumental in assisting hospitals prepare for the COVID-19 crisis. Essential bed space was made available, and it allowed mobilisation of health workers and enforced social distancing. A shift in patient-centred ethics to public health ethics was required to provide a utilitarian approach to the crisis. However, at some point, clinicians need to start becoming patient centred again, and this needs to happen within the utilitarian framework. Children only account for 1 - 5% of confirmed COVID-19 cases, and they present with a much milder disease spectrum than adults. Consequently, paediatric units may be at the forefront of implementing reintroduction of patient-centred elective clinical and surgical procedures. The following recommendations provide a framework to do this in a way that minimises risk to patients and clinicians. They are the first paediatric guidelines in the literature to propose a strategy to reintroduce elective surgical procedures.


Assuntos
Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/métodos , Procedimentos Cirúrgicos Otorrinolaringológicos/normas , Pandemias/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Adulto , Criança , Pré-Escolar , Infecções por Coronavirus/prevenção & controle , Países em Desenvolvimento , Procedimentos Cirúrgicos Eletivos/normas , Feminino , Humanos , Masculino , Inovação Organizacional , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Avaliação de Resultados em Cuidados de Saúde , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Saúde Pública , África do Sul
15.
Eur Ann Otorhinolaryngol Head Neck Dis ; 137(4): 269-271, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32807696

RESUMO

PURPOSE: The purpose of this study was to assess the impact of the COVID-19 pandemic on the surgical volume of three ENT departments in Ile-de-France, a region severely affected by the epidemic. MATERIALS AND METHODS: The number and nature of surgeries was collected from three university hospital ENT departments from 17/03/2020 to 17/04/2020 and from 18/03/2019 to 18/04/2019. Centre 1 is a general adult ENT department specialized in otology, centre 2 is a general adult ENT department specialized in cancer and centre 3 is a paediatric ENT department. Comparative analysis of the decreased surgical volume was conducted between 2019 and 2020. OBJECTIVE: To analyse the reduction of ENT surgical volume. RESULTS: The three centres operated on 540 patients in 2019, versus 89 in 2020, i.e. an 84% decrease: 89% in Centre 1, 61% in Centre 2, and 95% in the paediatric centre. Otological surgery decreased by 97%, endonasal surgery decreased by 91%, head and neck surgery decreased by 54%, plastic surgery decreased by 82%, and transoral surgery decreased by 85%. The number of surgical operations for skin cancer decreased (24 vs. 9), while the total number of head and neck cancer surgeries remained stable (18 vs. 22). The number of planned tracheostomies increased from 8 to 22. CONCLUSION: The number of ENT surgeries decreased by 84% during the first month of the COVID-19 epidemic. This decreased surgical volume mainly concerned functional surgery, while the level of cancer surgery remained stable. Hospital units will need to absorb a marked excess surgical volume after the epidemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Adulto , Feminino , França/epidemiologia , Humanos , Masculino , Pandemias , Estudos Retrospectivos
16.
Plast Reconstr Surg ; 146(2): 205e-216e, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740598

RESUMO

LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe normal ear anatomy and development, and evaluate the patient's ears for differences in shape, size, prominence, and symmetry. 2. Identify common congenital ear deformities, including prominent ear, macrotia, Stahl ear, cryptotia, constricted ear, and lobule anomalies. 3. Describe both early nonoperative management and operative techniques for correction of these ear deformities. 4. Be aware of advantages and disadvantages of common and emerging techniques for correction of pediatric ear deformities. SUMMARY: Whereas severe ear malformations such as microtia/anotia are rare, other ear deformities, such as prominent ear, Stahl ear, and cryptotia, are common. Although these ear deformities result in minimal physiologic morbidity, their psychological and cosmetic impact can be significant. Identifying these common deformities and understanding how they differ from normal ear anatomy is critical to their management. In cases where a deformity is identified in neonatal life, ear molding may obviate the need for surgery. Although various surgical techniques have been described for correction of common ear deformities, the surgeon should follow a careful stepwise approach to address the auricular deformity or deformities present. By using such an approach, complications may be minimized and predictable aesthetic outcomes achieved.


Assuntos
Orelha Externa/anormalidades , Estética , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Complicações Pós-Operatórias/prevenção & controle , Procedimentos Cirúrgicos Reconstrutivos/métodos , Fatores Etários , Criança , Desenvolvimento Infantil , Pré-Escolar , Orelha Externa/crescimento & desenvolvimento , Orelha Externa/cirurgia , Humanos , Lactente , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Complicações Pós-Operatórias/etiologia , Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos , Tempo para o Tratamento , Adesivos Teciduais , Resultado do Tratamento
17.
Int Forum Allergy Rhinol ; 10(11): 1201-1208, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-32735062

RESUMO

BACKGROUND: It has become clear that healthcare workers are at high risk, and otolaryngology has been theorized to be among the highest risk specialties for coronavirus disease 2019 (COVID-19). The purpose of this study was to detail the international impact of COVID-19 among otolaryngologists, and to identify instructional cases. METHODS: Country representatives of the Young Otolaryngologists-International Federation of Otolaryngologic Societies (YO-IFOS) surveyed otolaryngologists through various channels. Nationwide surveys were distributed in 19 countries. The gray literature and social media channels were searched to identify reported deaths of otolaryngologists from COVID-19. RESULTS: A total of 361 otolaryngologists were identified to have had COVID-19, and data for 325 surgeons was available for analysis. The age range was 25 to 84 years, with one-half under the age of 44 years. There were 24 deaths in the study period, with 83% over age 55 years. Source of infection was likely clinical activity in 175 (54%) cases. Prolonged exposure to a colleague was the source for 37 (11%) surgeons. Six instructional cases were identified where infections occurred during the performance of aerosol-generating operations (tracheostomy, mastoidectomy, epistaxis control, dacryocystorhinostomy, and translabyrinthine resection). In 3 of these cases, multiple operating room attendees were infected, and in 2, the surgeon succumbed to complications of COVID-19. CONCLUSION: The etiology of reported cases within the otolaryngology community appear to stem equally from clinical activity and community spread. Multiple procedures performed by otolaryngologists are aerosol-generating procedures (AGPs) and great care should be taken to protect the surgical team before, during, and after these operations.


Assuntos
Infecções por Coronavirus/epidemiologia , Otorrinolaringologistas/estatística & dados numéricos , Pneumonia Viral/epidemiologia , Sistema de Registros/estatística & dados numéricos , Cirurgiões/estatística & dados numéricos , Adulto , Aerossóis , Idoso , Idoso de 80 Anos ou mais , Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Saúde do Trabalhador , Procedimentos Cirúrgicos Otorrinolaringológicos/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Inquéritos e Questionários
18.
Am J Otolaryngol ; 41(6): 102676, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32836042

RESUMO

OBJECTIVES: The current study aims at assessing the effectiveness of the guidelines set up by our clinic for the protection of patients and staff which enabled us to proceed with urgent and oncological surgery after the outbreak of the Covid-19 pandemic. MATERIAL AND METHODS: Our ENT department devised specific equipment to be worn by the staff for personal protection when dealing with Covid-19 patients both in aerosol generating and non-generating procedures. Moreover, restrictive measures were enforced both for the outpatient department and for the ward where only urgent practices were carried out and visitors were not allowed, while non-urgent elective surgery was postponed. A codified scheme was followed to perform tracheostomy procedure in Covid-19 positive testing patients on the part of 3 specific teams of 2 surgeons each, while the resident educational program was reorganized to limit the spread of the infection. RESULTS: In about a couple of months (from March 8th to May 3rd) a relevant amount of medical tests and surgical procedures were carried out on non COVID-19 patients and a certain number of tracheostomies were performed on COVID-19 patients. Consequently, all the ENT personnel were checked and found negative. Also, all the patients in the ward were swab tested and chest X-rayed, only one had a positive outcome and was adequately handled and treated. CONCLUSION: Our ENT guidelines regarding personal protection equipment and multiple simultaneous diagnostic procedures have proved to be an essential instrument for the management of patients with both known and unknown COVID-19 status.


Assuntos
Infecções por Coronavirus/prevenção & controle , Controle de Infecções/organização & administração , Salas Cirúrgicas/organização & administração , Otolaringologia , Ambulatório Hospitalar/organização & administração , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Departamentos Hospitalares , Humanos , Itália/epidemiologia , Procedimentos Cirúrgicos Otorrinolaringológicos , Equipamento de Proteção Individual , Pneumonia Viral/epidemiologia , Traqueostomia/métodos
19.
J Laryngol Otol ; 134(6): 553-557, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32624009

RESUMO

BACKGROUND: ENT presentations are prevalent in clinical practice but feature little in undergraduate curricula. Consequently, most medical graduates are not confident managing common ENT conditions. In 2014, the first evidence-based ENT undergraduate curriculum was published to guide medical schools. OBJECTIVE: To assess the extent that current UK medical school learning outcomes correlate with the syllabus of the ENT undergraduate curriculum. METHOD: Two students from each participating medical school independently reviewed all ENT-related curriculum documents to determine whether learning outcomes from the suggested curriculum were met. RESULTS: Sixteen of 34 curricula were reviewed. Only a minority of medical schools delivered teaching on laryngectomy or tracheostomy, nasal packing or cautery, and ENT medications or surgical procedures. CONCLUSION: There is wide variability in ENT undergraduate education in UK medical schools. Careful consideration of which topics are prioritised, and the teaching modalities utilised, is essential. In addition, ENT learning opportunities for undergraduates outside of the medical school curriculum should be augmented.


Assuntos
Currículo/normas , Educação de Graduação em Medicina/métodos , Otolaringologia/educação , Procedimentos Cirúrgicos Otorrinolaringológicos/educação , Cauterização/métodos , Cauterização/estatística & dados numéricos , Competência Clínica , Currículo/estatística & dados numéricos , Educação Médica/estatística & dados numéricos , Humanos , Laringectomia/educação , Laringectomia/estatística & dados numéricos , Procedimentos Cirúrgicos Otorrinolaringológicos/estatística & dados numéricos , Faculdades de Medicina/normas , Faculdades de Medicina/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Ensino/normas , Traqueostomia/educação , Traqueostomia/estatística & dados numéricos , Reino Unido/epidemiologia
20.
Saudi Med J ; 41(7): 715-719, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32601639

RESUMO

OBJECTIVES: To analyze the data of patients with otorhinolaryngological foreign bodies and to evaluate the management and outcomes of foreign bodies to prevent complications. METHODS: A retrospective study was conducted over 8 years at Aseer Central Hospital to examine all admitted cases with foreign bodies in the ear, nose, throat, esophagus and bronchus during the period from January 2011 to January 2019. Patient demographic data, type of foreign body, and most common site were analyzed. RESULTS: A total of 184 patients were admitted, including 72 (39.1%) males and 112 (60.9%) females. The age range was from one year old to 70 years old; the mean±standard deviation of age was 10.6±12.55 years. Foreign bodies were most commonly located in the esophagus (n=97, 52.7%), followed by the bronchus (n=55, 29.9%). A statistically significant difference was found, with a p-value of 0.00001. The most common site in children was the bronchus (n=39, 21%); the most common site in adults was the esophagus (n=18, 72%). CONCLUSION: Otorhinolaryngological foreign bodies are found most frequently in preschool-aged children. The most common site in children was the bronchus, and the most common site in adults was the esophagus. Prevention measures are essential to reduce the risk of ingestion and admission, which can be challenging.


Assuntos
Brônquios , Orelha , Endoscopia/métodos , Esôfago , Corpos Estranhos/cirurgia , Nariz , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Faringe , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Feminino , Corpos Estranhos/prevenção & controle , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
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