Objective: To evaluate the predictors of prolonged length of stay (LOS) after vestibular schwannoma resection. Study Design: Retrospective chart review. Setting: Tertiary referral center. Patients: Patients who underwent vestibular schwannoma resection between 2008 and 2019. Interventions: Variables of interest included age, body mass index, comorbidities, symptoms, previous intervention, microsurgical approach, extent of resection, operative time, preoperative tumor volume, and postoperative complications. Predictive modeling was done through multivariable linear regression and random forest models with 80% of patients used for model training and the remaining 20% used for performance testing. Main Outcome Measures: LOS was evaluated as the number of days from surgery to discharge.Results: Four hundred one cases from 2008 to 2019 were included with a mean LOS of 3.0 (IQR ¼ 3.0-4.0). Postoperatively, 14 (3.5%) of patients had LOS greater than two standard deviations from the mean (11 days).
Lithium-ion batteries have been used for more than 20 years, most recently to power handheld devices including cellphones and electronic nicotine-delivery systems. They have garnered significant media attention due to thermal-related injuries occurring after spontaneous combustion. Spontaneous combustion of a lithium-ion battery occurs due to a process that is referred to as the thermal runaway effect. Here, we review the case of a 25-year-old female with severe oropharyngeal and upper aerodigestive thermal injuries after spontaneous combustion of a lithium-ion battery in a flashlight. We discuss the associated management and provide a review of the literature detailing similar injuries. Laryngoscope, 2018.
Objectives/Hypothesis
To measure and report noise exposure at urban music venues and assess the risk of noise‐induced hearing loss by comparing these measures to the National Institute of Occupations Safety and Health (NIOSH) guidelines.
Study Design
Observational study.
Methods
A commercially available smartphone and external calibrated microphone were used to measure sound levels at urban music venues. The maximum sound level, equivalent continuous sound level, and statistical noise levels (L10, L50, L75, L90) were recorded.
Results
The average equivalent continuous sound level was 112.0 (±4.9) dBA, and the average maximum sound level was 127.0 (±3.2) dBA. The L90 average (sound levels at or above this loudness for 90% of measured exposure time) was 101.1 (±5.5) dBA, and the L10 average was 115.2 (±5.0) dBA. Based off of NIOSH guidelines, noise exposure duration at the L10 average should not exceed 28 seconds, and those at the L90 average should not exceed 12 minutes.
Conclusions
Smartphone applications using external calibrated microphones can provide useful sound measurements. Data show that randomly sampled music venues may have noise levels that place patrons without hearing protection at risk for noise‐induced hearing loss with prolonged exposure.
Level of Evidence
NA Laryngoscope, 131:25–27, 2021
The SARS-CoV-2 pandemic response utilizes nasopharyngeal swabbing as a prolific testing method for presence of viral RNA. The depth of the swab to the nasopharynx coupled with breakpoints along the shaft leads to a risk for foreign body retention. Here, we present a case of a nasopharyngeal swab that became a retained foreign body during routine swabbing to test for the SARS-CoV-2 virus. Bedside flexible fiberoptic endoscopy was performed and did not reveal a foreign body in the nasopharynx or larynx. Subsequent computed tomography (CT) scan demonstrated the radiopaque retained foreign body at the distal gastroesophageal junction. The patient remained asymptomatic and did not have any upper airway or gastrointestinal symptoms. This unique case demonstrates a potential risk associated with SARS-CoV-2 nasopharyngeal swab testing and highlights management strategies that serve the patient while adequately protecting health care providers. A standardized approach to evaluation optimally includes bedside flexible endoscopy with appropriate personal protective equipment, prompt airway evaluation if aspiration is suspected, and noncontrasted CT imaging if the known foreign body is not identified via other modalities.
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