Abstract:
BACKGROUND:Salivary fistulas remain a significant problem in patients undergoing major head and neck reconstructive surgery. Surgical sealants have become increasingly used in cutaneous and non-cutaneous wound closure, providing a barrier to fluids/gases and promoting healing. The purpose of this study was to determine the efficacy of a common surgical sealant, 2-Octyl Cyanoacrylate (2-OCA, Dermabond®), in the prevention of salivary fistulas following free flap reconstruction of the oral cavity. METHODS:In this non-randomized, single arm prospective trial, patients undergoing free flap reconstruction of gravity-dependent oral cavity defects were recruited. Application of 2-OCA was performed along flap inset suture lines at the time of surgery. Prospectively collected trial data were propensity score matched to a control cohort to compare outcomes. Data collected include demographics, medical co-morbidities, previous treatments, primary tumor site, and subsites reconstructed. The primary outcome measure was rate of salivary fistula formation. Secondary outcomes were time to development of leak and percentage of patients tolerating oral feeding at one month post-operatively. RESULTS:In the 46 propensity score matched pairs, eight (17.4%) out of 46 patients in the 2-OCA prospective cohort and seven (15.2%) out of 46 patients in the control cohort developed postoperative salivary fistulas within the one-month study interval (p = 1.00). The average time to postoperative leak in the 2-OCA group was 12.5 days versus 7.1 days in the control cohort (p = 0.10). In the 2-OCA group, 30 (65.2%) patients were tolerating regular diet at one month post-operatively compared to 33 (71.7%) in the control cohort (p = 0.65). CONCLUSION:Salivary fistula rates after application of a 2-OCA surgical sealant were not improved compared to a control cohort in this single institutional trial. There are several surgical sealants available, each with varying elasticity and adhesiveness. Future studies are needed to identify surgical sealants that are able to provide sufficient strength and adhesion to seal closures and combat corrosive saliva, but elastic enough to handle motion related tension during swallowing and post-operative movements in the head and neck.
journal_name
Am J Otolaryngoljournal_title
American journal of otolaryngologyauthors
Roof SA,Perez ER,Villavisanis DF,Khan MN,Ferrandino RM,Chouake RJ,Pacheco CW,Yao M,Teng MS,Genden EM,Miles BAdoi
10.1016/j.amjoto.2020.102552subject
Has Abstractpub_date
2020-01-01 00:00:00pages
102552issue
5eissn
0196-0709issn
1532-818Xpii
S0196-0709(20)30246-5journal_volume
41pub_type
临床试验,杂志文章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
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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
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/0196-0709(91)90119-z
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
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abstract::The bacteriology of acute otitis media in 18 children eight to 17 years of age was investigated through the use of culture of middle ear exudate obtained by tympanic membrane puncture. Equal numbers of children had either Hemophilus influenzae (six) or Streptococcus pneumoniae (six) in the middle ear exudate. Acute ot...
journal_title:American journal of otolaryngology
pub_type: 杂志文章
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abstract::Melanotic neuroectodermal tumor of infancy is a rare condition that is most commonly found within the head and neck regions. We present a 4-month-old boy with a melanotic neuroectodermal tumor of infancy of his maxilla. Because of the fairly high recurrence rate, the operating microscope was used after surgical excisi...
journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1053/ajot.2001.20696
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journal_title:American journal of otolaryngology
pub_type: 杂志文章,评审
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journal_title:American journal of otolaryngology
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journal_title:American journal of otolaryngology
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/j.amjoto.2008.07.003
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journal_title:American journal of otolaryngology
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/j.amjoto.2006.09.006
更新日期:2007-09-01 00:00:00
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/0196-0709(95)90047-0
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/j.amjoto.2006.01.010
更新日期:2006-11-01 00:00:00
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/s0196-0709(85)80090-9
更新日期:1985-05-01 00:00:00
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/j.amjoto.2008.08.007
更新日期:2009-11-01 00:00:00
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journal_title:American journal of otolaryngology
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doi:10.1053/ajot.2001.24822
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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journal_title:American journal of otolaryngology
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journal_title:American journal of otolaryngology
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/0196-0709(91)90067-p
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/j.amjoto.2013.04.006
更新日期:2013-09-01 00:00:00
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
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更新日期:2014-11-01 00:00:00
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journal_title:American journal of otolaryngology
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
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journal_title:American journal of otolaryngology
pub_type: 杂志文章,评审
doi:10.1016/j.amjoto.2010.05.001
更新日期:2011-07-01 00:00:00
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
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更新日期:2013-09-01 00:00:00
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journal_title:American journal of otolaryngology
pub_type: 杂志文章
doi:10.1016/j.amjoto.2012.05.001
更新日期:2012-09-01 00:00:00