Postoperative Cervical Soft Tissue Hemorrhage with Acute Upper Airway Obstruction

Quick, Esther; Byard, Roger W.

doi:10.1111/1556-4029.12026

Cited by 21 publications

(17 citation statements)

References 9 publications

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“…The incidence of hematoma was 1.9% in our study, which is in accordance with previous reports (0.2-2.4%) [5,6,9,10]. History of hypertension was a risk factor for hematoma formation, and this nding was consistent with that of Palumbo, who mentioned that the surgical stress reaction and anesthesia could cause increased arterial blood pressure, especially in hypertensive patients [11].…”

Section: Discussionsupporting

confidence: 92%

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Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study

Zhou

Quan

He³

et al. 2020

Preprint

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Background We aim to explore the risk factors independently associated with postoperative wound hematoma in patients who have undergone anterior cervical spine surgery. Methods The clinical data of patients with cervical spondylosis or cervical disc herniation who underwent anterior cervical spine surgery by the senior author from January 2011 to December 2017 were evaluated. Multivariate logistic regression was conducted to compare the hematoma group and the no-hematoma group to determine which factors were independently associated with hematoma formation in patients who need evacuation. The Mann-Whitney U test was conducted to compare the Neck Disability Index score in the two groups. Results A total of 678 patients met the criteria and underwent anterior cervical spine surgery. Thirteen patients undergone hematoma evacuation. Multivariate logistic regression analysis identified that history of hypertension (p = 0.039 OR = 4.42 95% CI 1.08–18.07) and therapeutic heparin use (p = 0.020 OR = 4.58 95% CI 1.27–16.59) were independent risk factors for hematoma formation. The t-test showed no significant differences between the hematoma group and the no-hematoma group in terms of APTT or PT levels (p > 0.05). The Mann-Whitney U test indicated that there was no difference in NDI scores between the two groups(p > 0.05). Conclusion History of hypertension and therapeutic heparin use are risk factors for hematoma formation. Meticulous hemostasis, moderate muscle subtraction, and perioperative airway management are critical for avoiding hematoma development. The Neck Hematoma Scores can quickly determine the severity of a hematoma in the absence of radiographic image evidence.

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Section: Discussionsupporting

confidence: 92%

“…To date, several studies have investigated the risk factors for wound hematoma formation and the results are differ [6][7][8]. Therefore, the present research explores the effects of risk factors and the bleeding sites of wound hematoma formation, in order to minimize the occurrence of this dangerous complication.…”

Section: Introductionmentioning

confidence: 99%

Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study

Zhou

Quan

He³

et al. 2020

Preprint

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“…Postoperative complications may prohibit healing, extend the length of hospital stays, and be life-threatening [1][2][3][4][5]. Notably, the causes of airway obstruction include postoperative hematoma, pharyngolaryngeal edema, and morphological changes of the airway; thus, appropriate airway management is required [6,7]. There are three methods of postoperative airway management: 1) extubation, 2) endotracheal intubation under sedation, and 3) tracheostomy.…”

Section: Introductionmentioning

confidence: 99%

Assessment of the degree of agreement between the judgment of tracheotomy score and the clinician: a retrospective analysis

Abe

Kurita

Ito

et al. 2020

Preprint

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Background: In oral cancer surgery, the decision to tracheotomize is often determined based on the experience of the surgeon. Sometimes, tracheotomy may be performed for cases that may not necessarily require tracheotomy. For such cases, safety is achieved by airway management, but the patients are exposed to tracheotomy-related complications. Several evaluation methods have been reported to predict the need for selective tracheotomy in patients with oral cancer. In this study, we investigated the competency of clinical scoring systems in identifying patients who require tracheotomy among the oral malignancy cases treated with surgery in our department, and examined the degree of agreement between the surgeon’s decision and the scores of various scoring systems. Methods: This study was conducted on 110 patients with oral cancer who were treated with surgery under general anesthesia in the Department of Oral and Maxillofacial Surgery, Nagoya Ekisaikai Hospital, between January 2007 and April 2018. Among them, 67 patients (44 male and 23 female), who were managed by resection and reconstruction, were retrospectively analyzed. To derive the score, we evaluated the endpoint of these indices from clinical records and images. We divided the patients, based on the Cameron and Gupta scores, into two groups: tracheotomy and no tracheotomy groups, and evaluated the degree of agreement by calculating the κ coefficient. Results: After the assessment, the κ coefficients of the Gupta and Cameron scores were 0.61 (95% CI, 0.4-0.82) and 0.6 (95% CI, 0.38-0.82), respectively. The clinical evaluation of the κ coefficient indicated that the Gupta and Cameron scores agreed substantially. Discussion: These score matched the decision of the surgeon and confirmed that it was able to be applied to the decision of the airway management. However, these values are affected by prevalence. When unilateral total neck dissection and resection of the primary lesion were performed, though it was high-risk, the score was low, and an evaluation contradicted it. Conclusions: In this study, the Cameron and Gupta scores agreed with the decision of the experienced surgeon to some extent, and were confirmed to adapt to the clinical judgment.

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“…Mechanical loads to the collapsible segments of the retropalatal and retropharyngeal UA (e.g. postoperative hematoma 89 , 90 , peripharyngeal inflammation, and edema, e.g. due to fluid overload and rostral fluid shift 91 – 94 ) lead to physical compression of the airway.…”

Section: Why Does Osa Occur and How Can The Perioperative Setting Affmentioning

confidence: 99%

Perioperative sleep apnea: a real problem or did we invent a new disease?

2016

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Depending on the subpopulation, obstructive sleep apnea (OSA) can affect more than 75% of surgical patients. An increasing body of evidence supports the association between OSA and perioperative complications, but some data indicate important perioperative outcomes do not differ between patients with and without OSA. In this review we will provide an overview of the pathophysiology of sleep apnea and the risk factors for perioperative complications related to sleep apnea. We also discuss a clinical algorithm for the identification and management of OSA patients facing surgery.

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Postoperative Cervical Soft Tissue Hemorrhage with Acute Upper Airway Obstruction

Cited by 21 publications

References 9 publications

Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study

Risk factor analysis and severity assessment of wound hematoma after anterior cervical spine surgery: A retrospective study

Assessment of the degree of agreement between the judgment of tracheotomy score and the clinician: a retrospective analysis

Perioperative sleep apnea: a real problem or did we invent a new disease?

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