Analysis of 255 tracheostomies in an otorhinolaryngology-head and neck surgery tertiary care center: a safe procedure with a wide spectrum of indications

Introduction: Corona virus disease 2019 (COVID 19) is an infectious respiratory disease caused by the novel virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Till 31st August 2020, 39460 COVID-19 positive cases confirmed and 228 deaths occurred in Nepal. The surgical activities in the division of ENT and HNS (Ear, Nose, Throat and Head and Neck Surgery) across the world has been affected with many hospitals confining themselves to only emergency or essential surgeries due to implementation of lockdown by many countries. Manipal Teaching Hospital being a tertiary care referral centre in western Nepal has wide array of cases coming from various parts of the country and due to the pandemic the surgical activity of our ENT and HNS unit has undergone profound changes. Methods: A six months prospective study of “ENT and HNS Surgical Activity in Tertiary Care Center during COVID-19 Pandemic” was conducted in the department of ENT and HNS, Manipal college of Medical Sciences, Pokhara, Nepal. Statistical analysis of the study was done for various parameters like age, sex, incidence and types of elective and emergency surgeries and comparing the frequency of surgeries done during the COVID-19 pandemic vs that during the same period in the previous year. Results: This study includes a total of 56 surgery cases out of which 26 were emergency and 30 were elective. Among 26 emergency cases, five were ear, one was nose, nine were throat and 11 were head & neck cases. Similarly, among 30 elective cases, six were ear, eight were nose, 11 were throat and five were head & neck cases. The most commonly performed emergency cases were incision and drainage of abscess followed by repair of wounds and rigid oesophagoscopy and removal of foreign body. Commonly performed elective cases were excision of ENT and HNS lesions followed by Functional endoscopic sinus surgery. Conclusions: The COVID-19 pandemic caused a steep decrease in ENT and HNS surgical activities both the elective and emergency surgery.

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Treatment Outcomes of Laryngeal and Hypopharyngeal Squamous Cell Carcinomas in a Tertiary Care Center of Nepal

Nepalese Journal of ENT Head and Neck Surgery ◽

10.3126/njenthns.v3i2.10154 ◽

2014 ◽

Vol 3 (2) ◽

pp. 10-11

Author(s):

Pallavi Sinha ◽

Bimal Kumar Sinha ◽

Dharma Kanta Baskota ◽

Yogesh Neupane ◽

Kunjan Acharya

Keyword(s):

Head And Neck ◽

Treatment Outcomes ◽

Squamous Cell ◽

Care Center ◽

Tertiary Care ◽

Neck Surgery ◽

Squamous Cell Carcinomas ◽

Head And Neck Surgery ◽

Tertiary Care Center

DOI: http://dx.doi.org/10.3126/njenthns.v3i2.10154 Nepalese Journal of Head and Neck Surgery Vol.3(2) 2012: 10-11

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Experience with Vacuum-Assisted Closure Therapy in Head and Neck Surgery at a Tertiary Care Center

10.1055/s-0041-1727675 ◽

2021 ◽

Author(s):

D Ahmed ◽

S Dommerich ◽

H Olze ◽

P Arens

Keyword(s):

Head And Neck ◽

Care Center ◽

Tertiary Care ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Tertiary Care Center ◽

Vacuum Assisted Closure ◽

Vacuum Assisted Closure Therapy

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Implementation of a Novel Protocol for Preventing Venous Thromboembolism in Otolaryngology Patients

Otolaryngology ◽

10.1177/01945998211024923 ◽

2021 ◽

pp. 019459982110249

Author(s):

Lirit Levi ◽

Galia Spectre ◽

Ofir Nesichi ◽

Avi Leader ◽

Pia Raanani ◽

...

Keyword(s):

Venous Thromboembolism ◽

Head And Neck ◽

Care Center ◽

Tertiary Care ◽

Postoperative Bleeding ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Assessment Model ◽

Sinus Surgery ◽

Secondary Outcome

Objective Venous thromboembolism (VTE) is a preventable cause of postoperative morbidity and mortality. The Caprini risk assessment model (CRAM) is a validated tool for estimating the risk for postoperative VTE. Previous studies demonstrated a low risk of VTE among otorhinolaryngology–head and neck surgery (ORL-HNS). Hence, our objective was to modify the CRAM-based protocol to be applicable for otolaryngology patients and assess protocol efficacy and safety. Study Design Observational pilot study conducted on ORL-HNS patients undergoing surgery. Setting University-affiliated tertiary care center. Methods We constructed a modified protocol based on the CRAM and previous reports in the ORL-HNS literature using a reduced postoperative anticoagulation regimen. Primary end point was symptomatic VTE up to 3 months after surgery. Main secondary outcome was postoperative bleeding. Results A total of 508 patients were enrolled. Of them, 48% underwent head and neck surgery, 18% direct laryngoscopy and transoral robotic surgery, 15% endoscopic sinus surgery, and 11% otology surgery. Adherence to the protocol was 79%. Mean follow-up time was 115 days (range, 30-448 days). Only 1 patient developed deep vein thrombosis, and none developed pulmonary embolism. Two patients had major bleeding not related to the use of anticoagulation. Conclusions Our novel CRAM-based protocol appears to be efficacious and safe for VTE prevention in otolaryngology. A larger-scale study is required to validate these findings. Level of Evidence Level 2b.

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The impact of COVID-19 in the attendance of patients to the otolaryngology clinic: a retrospective review

The Egyptian Journal of Otolaryngology ◽

10.1186/s43163-021-00147-0 ◽

2021 ◽

Vol 37 (1) ◽

Author(s):

Kanachai Boonpiraks ◽

Yanin Nawachartkosit ◽

Dhave Setabutr

Keyword(s):

Head And Neck ◽

Retrospective Review ◽

Care Center ◽

Tertiary Care ◽

Neck Surgery ◽

Head And Neck Surgery ◽

Patient Specific ◽

One Year ◽

Surgery Department ◽

The Impact

Abstract Background To evaluate the impact of the COVID-19 outbreak on patient management at an Otolaryngology Head and Neck Surgery Department at a tertiary care center in Southeast Asia. This is a retrospective review. Patient load and diagnosis at the Outpatient Division of the Otolaryngology Head and Neck Surgery Department were reviewed at the height of the initial wave of the COVID-19 pandemic. Patient-specific data was then compared during the same timeframe one year prior. Patients were then grouped into an additional subspecialty subgroup based upon their diagnosis. Descriptive statistics were analyzed. Results A total of 819 cases were identified in 2019 during the study period. At the peak of the first wave, cases fell to 483, constituting a 41% decrease between the years (p value = 0.083). The largest decrease was in Otology cases with a drop by 53% (p value = 0.047), with the smallest decrease noted in General cases. Laryngology visits overall showed an increase in cases by 41.7%. Moreover, new visits decreased by 35.5%, with the largest decrease in new Laryngology visits and new Head and Neck Oncology cases. New visits for general issues had the smallest drop in patients, decreasing by only 21% (p value = 0.006) Conclusions The COVID-19 pandemic caused a significant decrease in overall cases in the Otolaryngology Head and Neck Surgery outpatient department. Thus, in anticipation of future outbreaks, interventions may be tailored according to these trends.

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Schwere Epistaxis stoppen – Klinischer Behandlungspfad zahlt sich aus

Gesundheitsökonomie & Qualitätsmanagement ◽

10.1055/s-0043-117328 ◽

2017 ◽

Vol 22 (04) ◽

pp. 178-179

Author(s):

Maria Weiß

Keyword(s):

Head And Neck ◽

Care Pathway ◽

Clinical Care ◽

Care Center ◽

Tertiary Care ◽

Neck Surgery ◽

Successful Implementation ◽

Tertiary Care Center ◽

Klinischer Behandlungspfad ◽

Clinical Care Pathway

Vosler PE et al. Successful Implementation of a Clinical Care Pathway for Management of Epistaxis at a Tertiary Care Center. Otolaryngology – Head and Neck Surgery 2016; 155: 879–885 Die meisten Fälle von Nasenbluten lassen sich leicht in den Griff bekommen – schwere Blutungen aus der Arteria sphenopalatina (SPA) oder unter Antikoagulation können aber eine Herausforderung darstellen. US-amerikanische HNO-Ärzte haben jetzt einen klinischen Behandlungspfad zum Management der schweren Epistaxis entwickelt, den sie in einem Tertiär-Krankenhaus evaluierten.

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Head and Neck Cancer—A Clinicopathological Study in a Tertiary Care Center

Journal of the National Medical Association ◽

10.1016/s0027-9684(15)31343-2 ◽

2008 ◽

Vol 100 (6) ◽

pp. 690-697 ◽

Cited By ~ 20

Author(s):

Bukola F Adeyemi ◽

Lola V Adekunle ◽

Bamidele M Kolude ◽

Effiong E.U. Akang ◽

Jonathan O. Lawoyin

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Clinicopathological Study

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P-40 Radiotherapy with curative intent in head and neck cancer – Experience from a tertiary care center

Oral Oncology ◽

10.1016/s1368-8375(21)00328-6 ◽

2021 ◽

Vol 118 ◽

pp. 2

Author(s):

André Laranja ◽

Diana Moreira ◽

Isabel Reis ◽

Isabel Rodrigues ◽

Fausto Sousa ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Care Center ◽

Tertiary Care ◽

Tertiary Care Center ◽

Curative Intent ◽

Cancer Experience

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Trans-oral Extra Tonsillar Approach of Styloidectomy for Treatment of Eagle’s Syndrome among Operated Cases of the Department of Otolaryngology-Head and Neck Surgery at a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Journal of Nepal Medical Association ◽

10.31729/jnma.6756 ◽

2021 ◽

Vol 59 (240) ◽

Author(s):

Deepak Regmi ◽

Rachana Baidhya ◽

Ashik Rajak ◽

Sangita Shrestha ◽

Meera Bista

Keyword(s):

Head And Neck ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Neck Surgery ◽

Cross Sectional Study ◽

Head And Neck Surgery ◽

Care Hospital ◽

Sectional Study ◽

Eagle’S Syndrome ◽

Cross Sectional

Introduction: Eagle’s syndrome is a poorly understood clinical entity that has variable presentations like recurrent throat pain or foreign body sensation, dysphagia, or facial pain. With a confirmed diagnosis, a surgical approach is considered appropriate for its treatment. This study aims to find out the prevalence of trans-oral extra tonsillar approach of styloidectomy among the operated cases of Department of Otolaryngology-Head and Neck Surgery at a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among 1,475 who underwent surgery at the Department of Otolaryngology-Head and Neck Surgery in a tertiary care center of Nepal between July 2018 to September 2020 after receiving the ethical clearance from the Institutional Review Committee (Reference number: 0106201802). Convenience sampling was done and data was entered in Statistical Package for the Social Sciences version 20. Point estimate at 95% confidence interval was calculated along with frequency and proportion for binary data. Results: Among 1,475 patients enrolled in the study, 24 (1.62%) patients (95% Confidence Interval= 0.97-2.26) underwent trans-oral extra tonsillar approach of surgery for Eagle’s syndrome during the study duration. Conclusions: The prevalence of styloidectomy among the operated cases of our study is low in comparison to other studies done in similar settings. Transoral extra tonsillar approach can be considered as a novel approach for surgical removal of the styloid process in Eagle’s Syndrome.

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