General anaesthetic vs local anaesthetic myringoplasties: a systematic review and meta-analysis

Kaleva, A; Raithatha, Amit; Tomasoni, Michele; Borsetto, Daniele; Vijendren, Ananth

doi:10.1007/s00405-022-07734-8

Cited by 2 publications

(1 citation statement)

References 45 publications

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“…Ear, nose, and throat (ENT) procedures are increasingly being performed in the office [33,34]. Lerner et al conducted a systematic review of 25 papers, 40 years, and 29 504 patients, and found no difference in mortality or bleeding for in-office esophageal dilation under general GA or conscious sedation [35 ]. They reported bleeding, perforation, and mortality rates of 2%, 3%, and 2%, respectively.…”

Section: Ear Nose and Throat Surgerymentioning

confidence: 99%

Office-based anesthesia: a contemporary update on outcomes, incentives, and controversies

Young,

Osman,

Shapiro

2023

Current Opinion in Anaesthesiology

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Purpose of review The volume of office-based surgery (OBS) has surged over the last 25–30 years, however patients with increasing comorbidities are being considered for procedures in office locations. This review focuses on office-based surgery outcomes, financial incentives driving this change, and controversies. Recent findings Healthcare economics appear to drive the push towards OBS with improved reimbursements, but there are rising out-of-pocket costs impacting patients. Plastic surgery has low complications, but procedures like buttock augmentation are associated with mortality. In ophthalmology, emerging controversial literature investigates the impact of anesthesia type on and whether anesthesia providers impact ophthalmology outcomes. Dental anesthesia continues to suffer occasional wrong-sided surgeries. Vascular interventions are being driven towards offices due to reimbursements, and may be safely performed. Meta-analyses of ear, nose, and throat in-office surgeries have low complication rates. Summary The reported safety supports the proper selection of patients for the proper procedure in the right location. Anesthesiologists need to develop and implement safe and efficient systems to optimize patient outcomes in outpatient office settings. Further research and uniform standardized outcomes tracking are needed in the emerging specialties performing office-based surgery.

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Section: Ear Nose and Throat Surgerymentioning

confidence: 99%

Office-based anesthesia: a contemporary update on outcomes, incentives, and controversies

Young,

Osman,

Shapiro

2023

Current Opinion in Anaesthesiology

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Local Anesthesia-Based Modified Cartilage “Inlay” Graft Myringoplasty for Repairing Large Perforation

Wu,

Lou

2023

Ear Nose Throat J

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Objective: The objective of this study was to evaluate the graft success rate and hearing outcome of modified cartilage inlay graft technique for repairing large perforations under local anesthesia. Study Design: Prospective case series. Methods and Materials: We performed a prospective study in 31 patients with large perforations who underwent endoscopic local anesthesia-based modified cartilage inlay graft technique with no raising of the squamous epithelium and no rimming of the perforation margins. The graft outcomes and complications were evaluated at 6 and 24 months postoperatively. Results: Thirty-one patients (31 ears) were included in this study. The mean operation time was 42.3 ± 2.6 (ranged 36-51) minutes. The visual analog scale pain scores at intraoperative and 2 and 48 hours postoperatively were, respectively, 2.6 ± 0.6, 1.4 ± 0.2, and 0.6 ± 0.1. The graft success rate was 100.0% (31/31) at 6 months after surgery. However, only 25 (80.6%, 25/31) patients completed a 2-year follow-up and performed a temporal bone CT examination; re-perforation was seen in 2 patients, the graft success rate was 92.0% (23/25). CT revealed the well-developed pneumatization of the mastoids and middle ear in all the patients. Nevertheless, 1 (1/25, 8.0%) patient developed a graft epithelial inclusion cyst, which was removed by endoscope in the outpatient setting. The mean preoperative air bone gap (ABG) was 23.1 ± 4.3 dB, while the mean postoperative ABG after 6 months was 14.9 ± 2.6 dB; the difference between these values was significant ( P < .05; Wilcoxon’s signed-rank test), and the functional success rate was 93.5% (29/31). Conclusion: Endoscopic modified cartilage “inlay” graft technique with no raising the squamous epithelium and no rimming the perforation is a minimally invasive technique with a short operative time and satisfying success rate for closure of large perforations under local anesthesia.

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General anaesthetic vs local anaesthetic myringoplasties: a systematic review and meta-analysis

Cited by 2 publications

References 45 publications

Office-based anesthesia: a contemporary update on outcomes, incentives, and controversies

Office-based anesthesia: a contemporary update on outcomes, incentives, and controversies

Local Anesthesia-Based Modified Cartilage “Inlay” Graft Myringoplasty for Repairing Large Perforation

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