Long‐term Trends in Head and Neck Surgery Outcomes

Mowery, Alia; Light, Tyler; Clayburgh, Daniel

doi:10.1177/0194599818785157

Cited by 9 publications

(12 citation statements)

References 18 publications

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“…In our study population, we demonstrated minimal complications including hematomas, seromas, infections, and ED visits, and none of these were associated with the drain removal process. These complication rates are in line with overall complication rates for these head and neck surgeries 14–16 . In the future, a case–control or randomized trial study would definitively confirm this.…”

Section: Discussionsupporting

confidence: 71%

Patient‐Directed Home Drain Removal in Head and Neck Surgery

et al. 2021

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Objectives/Hypothesis The purpose of this study was to evaluate the efficacy and safety of at home drain removal in head and neck surgery patients. Methods The study population included patients who underwent head and neck surgery at an academic tertiary care center between February 2020 and November 2020 and were discharged with one to four drains with instructions for home removal. Prior to discharge, patients received thorough drain removal education. Patients were prospectively followed to evaluate for associated outcomes. Results One hundred patients were evaluated in the study. There was record for ninety‐seven patients receiving education at discharge. The most common methods of education were face‐to‐face education and written instructions with educational video link provided. Of 123 drains upon discharge, 110 drains (89.4%) were removed at home while 13 (10.6%) were removed in office. Most drains were located in the neck (86.4%). There was one seroma, two hematomas, two drain site infections, and five ED visits; however, none of these complications were directly associated with the action of drain removal at home. Calculated cost savings for travel and lost wages was $259.82 per round trip saved. Conclusions The results demonstrate that home drain removal can provide a safe and efficacious option for patients following head and neck surgery. This approach was safe and associated with patient cost savings and better utilization of provider's time. Furthermore, patients and healthcare providers avoided additional in‐person encounters and exposures during the COVID‐19 pandemic. Our findings warrant further investigation into cost savings and formal patient satisfaction associated with home drain removal. Level of Evidence 4 Laryngoscope, 131:2471–2477, 2021

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Section: Discussionsupporting

confidence: 71%

Patient‐Directed Home Drain Removal in Head and Neck Surgery

et al. 2021

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“…Head and neck oncologic surgical procedures range from small local resections to extensive, surgeries such as neck dissection or pharyngolaryngoesophagectomy with many also necessitating reconstructive surgery. Postoperative morbidity, mortality and expected LOS is known to vary depending on the complexity of the procedure along with other factors such as tumor location, stage, and salvage surgery 3,4 . Unfortunately, it was not possible to evaluate and perform sensitivity analysis for specific head and neck cancers or surgeries using the available data which limits the conclusions that may be definitively drawn from this meta‐analysis.…”

Section: Discussionmentioning

confidence: 99%

“Age is just a number”; frailty as a marker of peri‐operative risk in head and neck surgery: Systematic review and meta‐analysis

2022

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Background: Frailty refers to a patient's reduced capacity to withstand stressors due to a reduction in physiologic reserves. We assessed the impact of frailty on outcomes following head and neck surgery.Methods: We performed a systematic review in accordance with the PRISMA guidelines. Meta-analysis was performed using the Mantel-Haenszel method.Results: Fourteen studies incorporating 182 059 patients were included in qualitative synthesis with 15 953 (8.8%) of patients deemed as frail. Metaanalysis incorporating nine studies demonstrated that frailty is associated with an increased 30 day postoperative morbidity (OR 2.74; 95% CI 1.98-3.80; p < 0.01) and meta-analysis with six studies suggested increased 30-day mortality (OR 2.94; 95% CI 2.62-3.31; p < 0.01). Preliminary meta-analyses between two and five studies suggested that frail patients had reduced overall survival and were more likely to be discharged to a nonhome location or readmitted within 30 days.Conclusions: Frailty appears to be associated with poor short-term outcomes following head and neck surgery and may improve understanding of an individual patient's peri-operative risk.

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“…Traditional clinical treatments for maxillofacial tumours include surgery, radiotherapy, and chemotherapy. Unfortunately, current clinical therapies are destructive to hosts, resulting in unsatisfactory therapeutic outcomes as follows: (1) Physiological dysfunction [10][11][12] , including issues with chewing, speech, swallowing, sucking, and breathing, owing to the lack of maxillofacial bone and radiation and chemotherapeutic drug damage; (2) Psychological damage resulting from the impairment of normal physiological functions and maxillofacial deformity 13,14 , which could lead to depression and misanthropy in patients; and (3) Frequent tumour recurrence due to cancer cells that survive surgery, inaccessibility of tumours during operations, unpredictable variation and constantly increasing drug resistance. Some novel methods, such as immunotherapy 15,16 , have shown strong potential, particularly biomaterial-mediated therapies (including targeted chemotherapy, magnetic-mediated hyperthermia (MMT), photodynamic therapy (PDT), and photothermal therapy (PTT)), which have demonstrated high anticancer efficiency, specific tumour targeting properties, excellent biocompatibility and low invasiveness.…”

Section: Introductionmentioning

confidence: 99%

Biomaterial-based strategies for maxillofacial tumour therapy and bone defect regeneration

et al. 2021

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Issues caused by maxillofacial tumours involve not only dealing with tumours but also repairing jaw bone defects. In traditional tumour therapy, the systemic toxicity of chemotherapeutic drugs, invasive surgical resection, intractable tumour recurrence, and metastasis are major threats to the patients’ lives in the clinic. Fortunately, biomaterial-based intervention can improve the efficiency of tumour treatment and decrease the possibility of recurrence and metastasis, suggesting new promising antitumour therapies. In addition, maxillofacial bone tissue defects caused by tumours and their treatment can negatively affect the physiological and psychological health of patients, and investment in treatment can result in a multitude of burdens to society. Biomaterials are promising options because they have good biocompatibility and bioactive properties for stimulation of bone regeneration. More interestingly, an integrated material regimen that combines tumour therapy with bone repair is a promising treatment option. Herein, we summarized traditional and biomaterial-mediated maxillofacial tumour treatments and analysed biomaterials for bone defect repair. Furthermore, we proposed a promising and superior design of dual-functional biomaterials for simultaneous tumour therapy and bone regeneration to provide a new strategy for managing maxillofacial tumours and improve the quality of life of patients in the future.

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Long‐term Trends in Head and Neck Surgery Outcomes

Cited by 9 publications

References 18 publications

Patient‐Directed Home Drain Removal in Head and Neck Surgery

Patient‐Directed Home Drain Removal in Head and Neck Surgery

“Age is just a number”; frailty as a marker of peri‐operative risk in head and neck surgery: Systematic review and meta‐analysis

Biomaterial-based strategies for maxillofacial tumour therapy and bone defect regeneration

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