Role of Peri- and Postoperative Antibiotics in Microscopic Laryngeal Surgery

Pasick, Luke J.; Valentino, William L.; Paknezhad, Hassan; Sataloff, Robert T.

doi:10.1016/j.jvoice.2019.10.014

Cited by 2 publications

(4 citation statements)

References 12 publications

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“…7 Additionally, two studies examining a range of direct laryngoscopy and microlaryngoscopy procedures have shown no significant difference in SSI related to presence or absence of perioperative antibiotic use. 8,9 Our analysis demonstrated inconsistency at our institution between best practice guidelines and perioperative antibiotic use in low-risk head and neck procedures. Almost one-third of these patients received unnecessary perioperative antibiotics.…”

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…5,6 However, there are certain otolaryngology (ENT) procedures with low surgical site infection (SSI) risk for which there is negligible benefit from perioperative antibiotic administration. [7][8][9] The objective of this evaluation was to describe antibiotic use and adherence to best practices in lowrisk head and neck procedures for which antibiotic prophylaxis is not indicated within our institution.…”

Section: Introductionmentioning

confidence: 99%

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Rethinking Perioperative Antibiotic Prophylaxis for Low-Risk Head and Neck Procedures

Nelson,

Baur,

Lew

et al. 2024

Ann Otol Rhinol Laryngol

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Objective: For true clean-contaminated head and neck procedures, the literature supports ≤24 hours of perioperative antibiotics. However, there are certain otolaryngology procedures with low surgical site infection (SSI) risk for which there is negligible benefit from antibiotic prophylaxis. The objective of this evaluation was to describe antibiotic use and adherence to evidence-based institutional guidelines in low-risk head and neck procedures. Methods: This was a single-center, retrospective cohort study of patients undergoing low-risk clean-contaminated head and neck procedures wherein antibiotic prophylaxis was not indicated, based on evidence-based institutional guidelines. Results: Among the 291 included patients, perioperative antibiotics were unnecessarily administered in 29% of patients. Among patients who received antibiotics, 76% received preoperative antibiotics and 41% received postoperative antibiotics, for a median duration of 7 days. There were no significant differences in SSIs, mortality, and length of stay for those receiving perioperative antibiotics versus those not receiving perioperative antibiotics. Conclusion: These data highlight the need for antibiotic stewardship interventions and partnerships between antibiotic stewardship teams and surgical services.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rethinking Perioperative Antibiotic Prophylaxis for Low-Risk Head and Neck Procedures

Nelson,

Baur,

Lew

et al. 2024

Ann Otol Rhinol Laryngol

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“…Another matter of concern could be that voice rest as a part of sick leave alone might outweigh the financial burden of the surgery itself [ 3 ]. Adjuvant medical treatment options following surgery, such as antibiotics or proton pump inhibitors, do not seem to benefit patients in terms of healing time and voice outcomes [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Platelet-Rich Plasma Injection on Short Term Vocal Outcomes Following Phonosurgery—A Pilot Study

et al. 2022

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Background and Objectives: The efficiency and optimal voice rest period following phonosurgery remains debatable. Platelet-rich plasma (PRP) is a safe and cheap alternative to many bioactive agents being studied on animal models, and is already in use in many medical areas. We investigate the short-term effects of PRP and voice rest on voice outcomes following phonosurgery as an alternative to voice rest alone. Materials and Methods: A prospective single-blinded pilot study was conducted. Sixteen patients with a diagnosis of vocal fold cyst and polyps were included, forming equal groups (PRP and voice rest vs. voice rest alone). Voice analysis was carried out on the preoperative day, day three, and week three following surgery. The measured parameters were fundamental frequency (F0), noise–signal ratio (NSR), harmonic poverty (HP), attack alteration (AL), pitch instability (PI), and amplitude instability (AI).VHI(Voice Handicap Index)-30 questionnaires were carried out before surgery and three weeks following surgery to assess the impact of subjective voice change on quality of life. PRP was obtained using commercial kits with separator gel. Results: An average 3.68-fold increase in platelets was obtained with PRP. No side effects were noted after injection. All voice parameters improved on day three and week three following surgery. Statistical significance was noted only in the fundamental frequency of male patients (p = 0.048) in favor of the PRP-voice rest group. In addition, the VHI- 30 questionnaire results between preoperative and postoperative assessments showed statistically significant differences in total VHI score (p = 0.02) as well as the physical (p = 0.05) and emotional (p = 0.02) scale in favor of the PRP-voice rest group. Conclusions: PRP presents short term safety in patients who undergo phonosurgery, although long-term outcomes are unknown. PRP and voice rest are superior to voice rest alone when considering subjective assessment of the voice. When analyzing acoustic parameters, PRP and voice rest are not superior to voice rest alone.

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Role of Peri- and Postoperative Antibiotics in Microscopic Laryngeal Surgery

Cited by 2 publications

References 12 publications

Rethinking Perioperative Antibiotic Prophylaxis for Low-Risk Head and Neck Procedures

Rethinking Perioperative Antibiotic Prophylaxis for Low-Risk Head and Neck Procedures

The Effect of Platelet-Rich Plasma Injection on Short Term Vocal Outcomes Following Phonosurgery—A Pilot Study

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