Conservative Management of an Intraoperative Chyle Leak: A Case Report and Literature Review.

Chyle leaks are a rare but potentially fatal complication of head and neck surgery carrying an incidence as high as 8.3%. The development of a chyle leak carries significant morbidity ranging from delayed wound healing to oropharyngeal fistulas.

Use of Parathyroid Hormone Assay after Thyroidectomy: A Survey of US and European Surgeons.

Introduction: Hypocalcemia after thyroidectomy results in prolongation of hospitalization and patient discomfort but can be predicted by PTH assays. However, there is considerable variation in their use.

Methods: This study was undertaken to document current US and European practice patterns regarding the use of this assay.

Prediction of hypocalcemia after using 1- to 6-hour postoperative parathyroid hormone and calcium levels: an analysis of pooled individual patient data from 3 observational studies.

Background: Parathyroid hormone (PTH) levels up to 6 hours postthyroidectomy have been shown to have excellent predictive power in determining hypocalcemia. In this study, we investigate the usefulness of combining calcium and PTH to increase the predictive power.

Methods: Individual patient data were obtained from 3 studies (152 patients) that fulfilled our criteria (using PTH assay within hours postthyroidectomy to predict symptomatic hypocalcemia).

Neurosarcoidosis presenting as complicated sinusitis: a case report and review.

Sarcoidosis is a systemic granulomatous disease with widely variable clinical characteristics, including numerous head and neck manifestations. We describe the case of a 49-year-old man who presented to the emergency department with symptoms consistent with complicated sinusitis. He was ultimately found to have an atypical case of neurosarcoidosis.

Early prediction of hypocalcemia after thyroidectomy using parathyroid hormone: an analysis of pooled individual patient data from nine observational studies.

Background: Monitoring for hypocalcemia after thyroidectomy, using only symptoms and serum calcium levels, can delay the discharge of patients who will remain normocalcemic and can delay the treatment of hypocalcemic patients.

Study Design: We conducted a systematic search for articles describing use of parathyroid hormone (PTH) assay, checked within hours of completing thyroidectomy, to predict postoperative symptomatic hypocalcemia. Studies were excluded if all patients were treated with postoperative calcium, or if early PTH values were used to alter management of the patient.

The use of rapid parathyroid hormone assay in predicting postoperative hypocalcemia after total or completion thyroidectomy.

Purpose: To evaluate the rapid parathyroid hormone assay (rPTH) as a perioperative tool in predicting postoperative symptomatic hypocalcemia following thyroidectomy.

Methods: We conducted a prospective study of 69 patients undergoing total or completion thyroidectomy. Rapid PTH levels were obtained preoperatively, intraoperatively, and postoperatively upon arrival in the postanesthesia care unit (PACU).

Potential applications of the da Vinci minimally invasive surgical robotic system in otolaryngology.

Anatomic constraints and instrumentation design characteristics have limited the exploitation of endoscopic surgery in otolaryngology. The move toward less invasive and less morbid procedures has paved the way for the development and application of robotic and computer-assisted systems in surgery. Surgical robotics allows for the use of new instrumentation in our field.

Da Vinci robot-assisted excision of a vallecular cyst: a case report.

The da Vinci Surgical System is a new and exciting entrant into the field of robotic technology. This system is undergoing considerable research and is being practically applied in general surgery, cardiothoracic surgery, urology, and gynecology. We have previously described our experience with the da Vinci system in the laboratory setting, and we have reviewed its potential applications in otolaryngology.

Revision choanal atresia repair.

Objective: Since the first description of choanal atresia (CA) in 1755, multiple surgical techniques have been proposed to repair the malformation. Today, the transnasal endoscopic method is the most widely accepted repair technique. The bony choanal plates are perforated, the lateral choanae are drilled, and a portion of the vomer removed.