Introduction: Tracheostomy is a commonly performed procedure in Otolaryngology and can be performed in different settings. We evaluate patient characteristics and cost efficacy of tracheostomy at the bedside versus operating room (OR).
Materials And Methods: Retrospective chart review was performed for adult intensive care unit (ICU) patients who underwent tracheostomy from 2020 to 2023.
Unlabelled: Management of Enlarging tracheoesophageal fistula (TEF) with Voice Prosthesis in Laryngectomized Head and Neck Cancer Patients.
Objectives: An enlarging TEF following voice prosthesis placement impacts patient quality of life, risks airway compromise, and can lead to aspiration pneumonia. Pharyngoesophageal strictures have previously been reported to be associated with TEF enlargement and leakage.
Purpose: Office-based procedures in otolaryngology are increasingly utilized to increase efficiency, reduce cost, and eliminate risks associated with surgery. Gland-preserving surgical management of sialadenitis and sialolithiasis are often performed in the operating room, although many surgeons are moving this practice to clinic. We aim to determine the difference in patient charges and perioperative outcomes for salivary gland procedures performed in the clinic versus the OR.
View Article and Find Full Text PDFBackground: Head and neck osteosarcoma (HNOS) is a rare primary bone tumor with limited data to guide treatment approaches.
Methods: The NCDB was used to identify patients diagnosed with HNOS. Kaplan-Meier and Cox multivariate regression were used to examine the impact of each treatment on overall survival (OS).
The aim of this study is to evaluate the impact of transoral robotic surgery (TORS) compared to nonrobotic surgery (NRS) on overall survival in oropharyngeal squamous cell carcinoma (OPSCC). We performed a retrospective study of patients with HPV+ and HPV- OPSCC undergoing TORS or NRS with neck dissection using the National Cancer Database from the years 2010-2016. Among patients with OPSCC in our cohort, 3167 (58.
View Article and Find Full Text PDFObjectives: To determine the prevalence of Sensorineural Hearing Loss (SNHL) attributable to Sickle Cell Disease (SCD) in the global pediatric population and to identify factors contributing to its severity.
Study Design: Meta-analysis.
Methods: We performed a comprehensive literature search for scientific articles in PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library that reported the incidence of hearing loss in populations under 18 years of age with excluding studies analyzing patients on iron chelation therapy, adults, or those without objective audiological analysis.
Int J Pediatr Otorhinolaryngol
December 2020
Introduction: Rhabdomyosarcoma (RMS) is the most common soft tissue head and neck sarcoma in children. Stringent analysis of survival data is imperative to optimize treatment.
Methods: The National Cancer Database (NCDB, 2004-2016) and the Surveillance, Epidemiology, and End Results Program (SEER, 1975-2016) were queried for patients ages 0-19 with RMS of the head and neck.
Objectives And Main Outcome Measures: To determine the prevalence of sensorineural hearing loss (SNHL) attributable to sickle cell disease (SCD) in the global adult population and to identify factors contributing to its severity.
Study Design: Systematic Review and Meta-analysis.
Methods: We performed a comprehensive literature search for scientific articles in PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library that reported the incidence of hearing loss in populations over 18 years of age with SCD.
Objectives: To determine the historical origins of the usage of the salt restriction diet as an intervention for Menière's disease (MD).
Methods: Articles on MD and salt restriction were identified using Pubmed and Google scholar. Original manuscripts from 19th and 20th century as well as selected otological textbooks in English, German, and French were also reviewed.
Objectives: Though the role of chronic kidney disease (CKD) has been studied previously in primary arthroplasty procedures of the hips and knees, there is a paucity of literature analyzing CKD's impact on surgical outcomes in revision total knee arthroplasty (rTKA) patients. As the number of patients with CKD requiring revision surgery increases, more vigilant pre-operative and post-operative measures can be taken to ensure successful outcomes. This retrospective study sought to 1) determine differences in demographics and preoperative comorbidities of patients with normal or mild CKD and those with moderate/severe CKD and 2) establish moderate/severe CKD as an independent risk factor for complications in the 30-day postoperative period in patients undergoing rTKA.
View Article and Find Full Text PDFInt J Pediatr Otorhinolaryngol
February 2020
Objectives: Single-stage laryngotracheal reconstruction (SS-LTR) requires a period of post-operative intubation, during which time adequate sedation is needed to ensure graft healing. Commonly used agents include benzodiazepines, opioids, and more recently, dexmedetomidine, a centrally-acting α adrenoreceptor. This study aims to compare withdrawal outcomes between various sedation regimens following SS-LTR.
View Article and Find Full Text PDFInt J Pediatr Otorhinolaryngol
December 2019
Objectives: Velopharyngeal insufficiency (VPI) may be due to functional or anatomic causes, and can lead to speech deficits, communication difficulty, and emotional strain on patients and their caregivers. The VPI Effects on Life Outcomes (VELO) instrument quantifies quality of life outcomes in VPI patients both before and after VPI surgery. This study aims to identify pre-operative patient characteristics associated with better post-operative quality of life.
View Article and Find Full Text PDFJBJS Essent Surg Tech
March 2019
Background: Genicular nerve radiofrequency ablation (GNRFA), including conventional, cooled, and pulsed techniques, has been used in the management of symptomatic knee osteoarthritis (OA). This new and innovative treatment option has the capacity to decrease pain and improve function and quality of life in certain patients. GNRFA is reserved for patients with symptomatic knee OA who have had failure of conservative treatment and have had failure of or are poor candidates for surgery.
View Article and Find Full Text PDFImportance: Objective quantification of small fiber neuropathy in patients with human immunodeficiency virus (HIV)-associated sensory neuropathy (HIV-SN) is difficult but needed for diagnosis and monitoring. In vivo corneal confocal microscopy (IVCCM) can quantify small fiber damage.
Objective: To establish whether IVCCM can identify an abnormality in corneal nerve fibers and Langerhans cells in patients with and without HIV-SN.
Highly imbalanced data sets are those where the class of interest is rare. In this paper, we compare the performance of several common data mining methods, logistic regression, discriminant analysis, Classification and Regression Tree (CART) models, C5, and Support Vector Machines (SVM) in predicting the discharge status (alive or deceased, with "deceased" being the class of interest) of patients from an Intensive Care Unit (ICU). Using a variety of misclassification cost ratio (MCR) values and using specificity, recall, precision, the F-measure, and confusion entropy (CEN) as criteria for evaluating each method's performance, C5 and SVM performed better than the other methods.
View Article and Find Full Text PDFBackground: Surgical scheduling is complicated by both naturally occurring and human-induced variability in the demand for surgical services. Surgical demand time series are decomposed into periodic, lagged, and linear trends with frequent occurrences of nonconstant variations in mean and variance. The authors used time series methods to model surgical demand time series in order to improve the scheduling of scarce surgical resources.
View Article and Find Full Text PDFEscitalopram is the recently marketed S-enantiomer of the widely used antidepressant citalopram. Data from intentional overexposure to this medication are limited. Twelve-lead electrocardiogram (ECG) effects from racemic citalopram have been described; however, the present report is the first, to the best of the authors' knowledge, that describes all the reported abnormalities in a single patient receiving escitalopram.
View Article and Find Full Text PDFLeft ventricular (LV) contraction dyssynchrony is not easily quantified. We previously described a model for quantifying LV dyssynchrony that referenced regional amplitude and phase angles to global LV systole using esmolol-induced regional dyskinesis. We tested the hypothesis that our sine wave model and phase angle analysis of regional dyssynchrony in a canine model could also assess dyssynchrony of contraction during regional ischemia.
View Article and Find Full Text PDFThis research describes a constraint-based heuristic model of capacity segmentation for outpatient facilities used to estimate the effect of segmentation constraints on stakeholders. Growth of free-standing ambulatory surgery centres has been dramatic in recent years with institutions being urged by governments and insurers to segment inpatients (IP) and outpatients (OP) to reduce costs and improve services. Critics of segmentation argue it is a false economy to separate inpatients and outpatients since pooling of patients in large IP facilities offers economies of scale and opportunities for parallel processing, not to mention elimination of infrastructure.
View Article and Find Full Text PDFWe present an empirical study of methods for estimating the location parameter of the lognormal distribution. Our results identify the best order statistic to use, and indicate that using the best order statistic instead of the median may lead to less frequent incorrect rejection of the lognormal model, more accurate critical value estimates, and higher goodness-of-fit. Using simulation data, we constructed and compared two models for identifying the best order statistic, one based on conventional nonlinear regression and the other using a data mining/machine learning technique.
View Article and Find Full Text PDFBackground: Variability inherent in the duration of surgical procedures complicates surgical scheduling. Modeling the duration and variability of surgeries might improve time estimates. Accurate time estimates are important operationally to improve utilization, reduce costs, and identify surgeries that might be considered outliers.
View Article and Find Full Text PDFUnlabelled: We studied the effect of systemic dobutamine infusion (4 microg. kg(-1). min(-1) IV) on regional wall motion abnormalities (RWMAs) in eight anesthetized open-chested dogs.
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