Abstract：
OBJECTIVE:Microvascular anastomosis is generally performed by attending surgeons or fellows, with published success rates >95%. Since otolaryngology residents do not typically perform microvascular anastomosis, it is unknown if they achieve similar results. The objective of this study is to determine the success rate and complication rate during free flap reconstruction when microvascular anastomosis is performed in part by otolaryngology chief residents. STUDY DESIGN:Multi-institutional retrospective review. SETTING:Academic, tertiary-care referral centers. SUBJECTS AND METHODS:Consecutive patients who underwent microvascular reconstruction by the Department of Otolaryngology from 2004 through 2011. All patients had >50% of the arterial and venous anastomoses performed by the chief resident. RESULTS:The study included 93 consecutive free flaps in 88 patients: 43 radial forearm, 14 anterolateral thigh, and 36 fibula. There were 71 males and 22 females with mean age of 53. The pre-operative diagnosis was squamous cell carcinoma in 78%, with 27% of patients having previously received radiotherapy and 13% of patients having had previous neck surgery. There were no instances when resident-placed sutures required revision, nor was there a perceived need to revise such an anastomosis intraoperatively. Overall flap success rate was 97%. The anastomotic complication rate was 4.3%, with venous thrombosis in three cases and arterial hemorrhage in one case. CONCLUSION:Overall free flap success rate and anastomosis-related complications with residents performing portions of the microvascular anastomosis are comparable to published studies. Otolaryngology chief residents can safely participate in microsuturing, which is a single facet in the broader skill set of a microvascular surgeon.
journal_name
Am J Otolaryngoljournal_title
American journal of otolaryngologyauthors
Patel UA,Lin ACdoi
10.1016/j.amjoto.2013.02.005subject
Has Abstractpub_date
2013-09-01 00:00:00pages
407-10issue
5eissn
0196-0709issn
1532-818Xpii
S0196-0709(13)00049-5journal_volume
34pub_type
杂志文章,多中心研究abstract：:We report a case of chondrosarcoma of the larynx, diagnosed by a percutaneous core-needle biopsy (CNB). Cartilaginous tumors of the larynx are usually diagnosed by biopsy with direct laryngomicroscopy under general anesthesia. However, patients find it difficult to undergo a biopsy under general anesthesia, for physic...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2014.03.013
更新日期：2014-07-01 00:00:00
abstract：OBJECTIVES:Studies suggest that hypercholesterolemia promotes the development of inner ear disorders such as tinnitus. However, the underlying pathomechanisms are still not clearly defined. METHODS:A retrospective study was performed to assess whether a reduction of serum cholesterol by 3-hydroxy-3-methylglutaryl coen...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2009.09.004
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:Pneumocephalus is a rare complication of endoscopic sinus surgery (ESS) and microscopic skull base surgery (MSBS). Postoperatively, patients often present with headache and altered mental status. Unrepaired leaks are associated with an increased risk of ascending meningitis. Standard treatment of pneumocepha...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2009.02.012
更新日期：2010-07-01 00:00:00
abstract：:In a group of patients with unilateral labyrinthine dysfunction, the maximal velocity of the slow component response to caloric stimulation was compared with that to horizontal vestibular rotatory stimulation by a low-frequency stimulus. It was found that the larger the magnitude of the caloric response, the larger we...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/s0196-0709(84)80027-7
更新日期：1984-03-01 00:00:00
abstract：:Divided nevus, which is also known as "kissing nevus," "split ocular nevus" and "panda nevus" is a rare congenital dermatological abnormality that occurs on opposing margins of upper and lower eyelids. There is a paucity of literature on this rare anomaly, with most knowledge from this disease process derived from iso...
journal_title：American journal of otolaryngology
pub_type： 杂志文章,评审
doi：10.1016/j.amjoto.2013.01.004
更新日期：2013-05-01 00:00:00
abstract：:The cartilaginous columellar strut is a well established, commonly used graft in rhinoplasty which provides support and stability to the nasal base. The risk of such a graft is related to grafts designs, whereby the posterior aspect can cause clicking with movement across the anterior nasal spine. We present an additi...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2012.12.008
更新日期：2014-01-01 00:00:00
abstract：:Thromboses in Trousseau's syndrome are typically confined to the vascular system of the extremities and viscera. The authors report a case of sequential bilateral internal and external jugular-vein thromboses secondary to this paraneoplastic hypercoagulable state. The etiologies of commonly encountered head and neck v...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/s0196-0709(85)80019-3
更新日期：1985-09-01 00:00:00
abstract：PURPOSE:To find a correlation between increasing levels of serum bilirubin and auditory brainstem responses (ABR) and to find the use of ABR as a bilirubin neurotoxicity marker. MATERIAL AND METHODS:A prospective study of 60 neonates in which ABR of hyperbilirubinemic neonates was compared with the normal neonates. Al...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/s0196-0709(98)90123-5
更新日期：1998-07-01 00:00:00
abstract：PURPOSE:To further enhance and assess the ability to characterize middle ear effusion (MEE) using non-invasive ultrasound technology. MATERIALS AND METHODS:This is a prospective unblinded comparison study. Fifty-six children between the ages of 6 months and 17 years scheduled to undergo bilateral myringotomy with pres...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2012.08.005
更新日期：2013-01-01 00:00:00
abstract：INTRODUCTION:Sir Charles Bell is renowned and revered as an outstanding surgeon, anatomist, clinician and teacher and his many contributions to various medical fields have been amply described. What are less well-known are his contributions to the field of laryngology. METHODS:Selected clinical and physiological publi...
journal_title：American journal of otolaryngology
pub_type： 传,历史文章,杂志文章,评审
doi：10.1016/j.amjoto.2017.04.011
更新日期：2017-01-01 00:00:00
abstract：:A choristoma is a nonneoplastic proliferation of histologically normal tissue that forms at an abnormal site. It is extremely uncommon in the middle ear space. It appears to be a developmental abnormality and may be associated with abnormalities of adjacent structures. It usually occurs with unilateral conductive hear...
journal_title：American journal of otolaryngology
pub_type： 杂志文章,评审
doi：10.1016/s0196-0709(00)85011-5
更新日期：2000-03-01 00:00:00
abstract：PURPOSE:Laryngeal papillomatosis is the most common benign tumor of the larynx of children. It is characterized by the development of exophytic proliferative lesions in the mucosa of the airways. Human papillomavirus (HPV) has been recognized as a causal agent among which HPV types 6 and 11 are the most frequently impl...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2019.02.003
更新日期：2019-01-01 00:00:00
abstract：PURPOSE:To determine survival and factors influencing survival for parotid gland cancer. METHODS:Cases of parotid gland malignancy were extracted from the SEER database for 1988 to 1998. Kaplan-Meier survival analysis was conducted for the most common tumor histologies. Cox proportional hazards modeling was conducted ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2004.06.017
更新日期：2005-01-01 00:00:00
abstract：:Perineural invasion of cranial nerves, including the facial nerve by squamous cell carcinoma of the skin, is a poor prognostic factor for recurrent disease and disease-specific mortality. We discuss 2 patients who presented to the Otolaryngology/Head and Neck Surgery service with complete facial nerve paralysis and a ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2005.07.017
更新日期：2006-03-01 00:00:00
abstract：:Merkel cell carcinoma is a rare malignant tumor of the skin. The face and extremities are the most common locations. We present a case of Merkel cell carcinoma of the auricle in a 93-year-old man subsequently treated with surgery and radiotherapy. The clinical features, prognosis, and treatment of the Merkel cell carc...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2005.01.013
更新日期：2005-09-01 00:00:00
abstract：PURPOSE:The aim of this study was to compare the efficacy and safety of moxifloxacin with that of amoxicillin/clavulanate for the treatment of acute bacterial sinusitis in adults. MATERIALS AND METHODS:Five hundred seventy-five patients from Latin American countries were randomized to receive oral moxifloxacin 400 mg ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjoto.2006.06.016
更新日期：2007-03-01 00:00:00
abstract：OBJECTIVES:The aim of the study was to report a recent case of mucoepidermoid carcinoma (MEC) of the thyroid, review the pertinent literature, and highlight the importance of multimodal treatment in this potentially aggressive malignancy. STUDY DESIGN:The study comprise a case report and a review of literature. METHO...
journal_title：American journal of otolaryngology
pub_type： 杂志文章,评审
doi：10.1016/j.amjoto.2004.08.014
更新日期：2005-03-01 00:00:00
abstract：:Detection and identification of bacteria in middle ear effusions from patients with otitis media with effusion requires sensitive bacteriologic techniques. Direct microscopic examination is very important in this respect. Three staining methods--Gram, Giemsa and the fluorescent acridine orange stain--were evaluated an...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/s0196-0709(85)80083-1
更新日期：1985-05-01 00:00:00
abstract：PURPOSE:To present a prospective temporal bone fracture database, and study facial and cochleovestibular sequelae and their impact on quality of life. MATERIALS AND METHODS:Prospective study of consecutive cases of 39 patients with 45 temporal bone fractures over 11-month period in a university tertiary referral cente...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2014.12.011
更新日期：2015-05-01 00:00:00
abstract：:Carotid body tumors constitute the third commonest group of parapharyngeal tumors. Newer diagnostic modalities such as computed tomography scan, magnetic resonance imaging, and Doppler ultrasound are commonly used for diagnosing lesions at this site. However, simple technique of fine-needle aspiration (FNA) cytology i...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2005.02.012
更新日期：2005-09-01 00:00:00
abstract：OBJECTIVE:Describe current practices and challenges in personal protective equipment (PPE) use among US otolaryngologists during the COVID-19 pandemic. STUDY DESIGN:Online survey. SETTING:Academic and non-academic healthcare institutions. SUBJECTS AND METHODS:Subjects included US otolaryngology physicians. Emails we...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2020.102735
更新日期：2020-01-01 00:00:00
abstract：:There have been recent reports of sarcoid-like granulomatosis development following the administration of tumor necrosis factor (TNF) inhibitors. To date, only four cases of neurosarcoidosis have been reported in association with TNF inhibitors, two of which were attributed to etanercept. We present the first case of ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2015.09.012
更新日期：2016-05-01 00:00:00
abstract：:A detailed light and electron microscopic study of the development of the middle ear lining epithelium of the rat was undertaken in order to determine whether a portion of the middle ear lining is normally derived from a condensation of mesenchymal connective tissue. We learned that pharyngeal epithelium outpouches ea...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/s0196-0709(80)80002-0
更新日期：1980-02-01 00:00:00
abstract：:The endometrial small cell carcinoma (ESCC) is a rare and aggressive malignancy with an estimated prevalence of less than 1% of endometrial carcinomas. Endometrial small cell carcinoma is frequently diagnosed at an advanced stage and has a poor prognosis. Although the most common presenting sign of ESCC is definitely ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2006.09.011
更新日期：2007-07-01 00:00:00
abstract：INTRODUCTION:Hypopharyngeal squamous cell carcinoma (SCC) is rare, but highly aggressive. Due to the advanced stage of this cancer at the time of diagnosis, radical surgery with reconstruction of pharynx is the standard care with high morbidity and mortality rate. A safer partial pharyngectomy could also be used for in...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2020.102505
更新日期：2020-01-01 00:00:00
abstract：:Wegener granulomatosis is an immune-mediated, systemic vasculitis with unknown etiology that can be seen in almost any anatomical site. Positivity for antineutrophil cytoplasmic antigene, which is a serological marker, and presence of granulomatous vasculitis in histopathologic specimens from the lesions are accepted ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2007.04.007
更新日期：2008-03-01 00:00:00
abstract：PURPOSE:Facial nerve monitoring is often used to predict postoperative facial function after acoustic neuroma tumor removal. In this study, three methods of predicting facial nerve function were compared. These methods used various parameters of the evoked electromyographic monitoring. MATERIALS AND METHODS:Thirty-fou...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/s0196-0709(98)90103-x
更新日期：1998-03-01 00:00:00
abstract：:The purpose of this study was to quantify any age-related change in the components of Schwann cells associated with vestibular ganglion cells: adperikaryonal Schwann cell cytoplasm, myelin bubbles, compact myelin, Schwann cell lipofuscin, or mitochondria in addition to extracellular intraganglionic space. Studies were...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/0196-0709(90)90082-7
更新日期：1990-07-01 00:00:00
abstract：PURPOSE:The type of allergy and other diagnostic procedures were analyzed in a group of elderly seasonal allergic rhinitis (SAR) patients and were compared with young SAR people and a control group. MATERIALS AND METHODS:Study group consisted of 248 patients with mean age 64.1 ± 4.2 years. They were compared with 289 ...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2009.11.002
更新日期：2011-03-01 00:00:00
abstract：PURPOSE:In this study, we aimed to determine the function of the cochlea and peripheral and central auditory pathways with migraine. MATERIALS AND METHODS:Fifty-eight patients with migraine and 40 healthy subjects were assessed using routine diagnostic audiometry along with transient evoked otoacoustic emissions (TOAE...
journal_title：American journal of otolaryngology
pub_type： 杂志文章
doi：10.1016/j.amjoto.2011.10.008
更新日期：2012-07-01 00:00:00
