The Impact of Smoking on Ossiculoplasty Outcomes

Cox, Matthew D.; Anderson, Shane; Russell, James S.; Dornhoffer, John L.

doi:10.1097/mao.0000000000001059

Cited by 8 publications

(6 citation statements)

References 17 publications

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“…Smoking negatively affects outcomes in all surgical fields 1 . In otology specifically, smoking has a negative impact on outcomes, particularly in tympanoplasties 2–7 . When compared with nonsmokers, smokers have worse hearing outcomes, more grafts failures, and more extensive middle ear disease processes 3 …”

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confidence: 99%

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Association between Smoking and 30‐Day Outcomes in Otologic Surgery

Kay‐Rivest

Mascarella

Sewitch

et al. 2019

Otolaryngol.--head neck surg.

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Objective To determine the effect of current smoking status on 30-day postoperative adverse events in patients undergoing otologic surgery. Study Design Retrospective cohort study. Setting Database of the American College of Surgeons National Surgical Quality Improvement Program from 2006 to 2016. Subjects and Methods Adult patients undergoing middle ear and mastoid surgery were included. Preoperative smoking status was determined, and adverse events within 30 days of surgery were recorded. Descriptive statistics were used to characterize the study sample. Multivariable logistic regression was performed to identify the association between sociodemographic and clinical variables and postoperative adverse events. Population-attributable fractions were then calculated. Results A total of 10,684 patients who underwent otologic surgery were included, of whom 2036 (19.1%) were smokers. The most commonly performed surgery was tympanoplasty with and without ossicular chain reconstruction, followed by canal wall up tympanomastoidectomy. Adverse events occurred in 221 (2.1%) patients; the most common was superficial wound infections (n = 99, 0.9%). In smokers, the odds ratio for any adverse event was 1.97 (95% CI, 1.42-2.71). The odds ratios (95% CIs) for superficial wound infections, wound dehiscence, and 30-day readmission among smokers were 1.89 (1.32-2.86), 3.92 (1.26-11.60), and 1.84 (1.15-2.87), respectively. The population-attributable fraction for any adverse event in smokers was 15.5%. Conclusions In patients undergoing otologic surgery, smokers are more likely than nonsmokers to have postoperative adverse events—in particular, wound infections, wound dehiscence, and readmission to hospital.

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confidence: 99%

“…1 In otology specifically, smoking has a negative impact on outcomes, particularly in tympanoplasties. [2][3][4][5][6][7] When compared with nonsmokers, smokers have worse hearing outcomes, more grafts failures, and more extensive middle ear disease processes. 3 Cigarette smoking contributes to poorer outcomes by several mechanisms of action.…”

mentioning

confidence: 99%

Association between Smoking and 30‐Day Outcomes in Otologic Surgery

Kay‐Rivest

Mascarella

Sewitch

et al. 2019

Otolaryngol.--head neck surg.

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“…Clinically, otolaryngologists are very familiar with the deleterious effects that smoke and tobacco can have on the upper airway. Within otology, the effects of tobacco and nicotine have also been well documented, though with varying conclusions as to the outcome consequences (13)(14)(15)(16).…”

Section: Discussionmentioning

confidence: 99%

Tobacco Use and Skin Reactivity in Patients With Percutaneous Auditory Osseointegrated Implants

Gardiner¹,

Lavallee

Šíma

et al. 2021

Otology &Amp; Neurotology

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Objectives: To determine if there is an association between tobacco use and the development of postoperative skin reactions in patients undergoing percutaneous osseointegrated auditory implant (pOAI) surgery. Study Design: Single surgeon retrospective cohort study. Setting: Academic medical center. Subjects and Methods: Retrospective chart review was performed on all patients who underwent pOAI. Smoking status (current and former users versus never-users) was recorded as were numerous demographic and surgical variables. The primary outcome measure was skin reactivity as measured by Holgers score. Secondary outcomes studied included total number of problem visits, minor interventions, and major interventions. Results: 126 patients, 73 with no tobacco history (NT) and 53 with a positive smoking tobacco history (T) underwent pOAI surgery in this study. The T group was found to have higher rates of first postoperative visit soft tissue reactions compared with the NT group (24.5% versus 6.8%, p 1/4 0.011, odds ratio [OR] 4.42, 95% confidence interval [CI]: 1.5, 13.3), but not at long-term follow-up. When former smokers were eliminated from analysis, differences were also found at long-term follow-up (40.9% versus 19.2%, p 1/4 0.037, OR 2.92, 95% CI [1.0 -8.1]). There were no differences in total number of problem visits or total number of minor or major interventions. Conclusions: Patients with a history of tobacco use have a significantly higher rates of skin reactivity compared with patients without, though smoking cessation may partially mitigate long-term risks. Surgeons should be aware of the risks of early skin reactivity and should counsel patients accordingly.

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“…and Becvarovski and Kartush. 8,16,24 Coelho and Peng found a greater proportion of smokers required revision surgery for persistent cholesteatoma, conductive hearing loss and tympanic membrane perforation compared with non-smokers ( n = 6 (13.3 per cent) and n = 4 (4.7 per cent), respectively). 21 In an assessment of 30-day post-operative outcomes following otological surgery, smokers have also been found to have increased odds of soft tissue complications including 89 per cent increased odds of superficial wound infections (95 per cent CI, 1.32–2.86) and almost 300 per cent increased odds of wound dehiscence (95 per cent CI, 1.26–11.60).…”

Section: Cigarettes and Middle-ear Disease And Surgerymentioning

confidence: 99%

“…Trialists with increased success rates amongst smokers have attributed this to use of cartilage grafts rather than temporalis fascia owing to its metabolic properties and resistance to retraction, atelectasis and perforation. 21,24,25 In one trial utilising both graft tissues, a 75 per cent failure was reported amongst smokers when temporalis fascia was used compared with similar success rates between smokers and non-smokers (88.9 per cent and 76.8 per cent, respectively) when cartilage grafts were used, further advocating the use of cartilage as routine in smokers. 19…”

Section: Cigarettes and Middle-ear Disease And Surgerymentioning

confidence: 99%

A systematic review of the impact of cigarettes and electronic cigarettes in otology

2020

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BackgroundThe detrimental systemic effects of cigarette smoking are well established. Though less pronounced in the field of otology, they are proposed to contribute to the global burden of unaddressed hearing loss. Recently, in efforts to stop smoking, individuals have used electronic cigarettes of which the long-term safety data are largely unknown. This study aimed to conduct a systematic review of cigarette smoking and electronic cigarette effects in the field of otology.MethodRelevant articles were identified by a National Institute for Health and Care Excellence healthcare database literature search and by scanning the references of relevant articles and reviews.ResultsA total of 473 articles were identified, with 43 articles included in the review after trials were excluded.ConclusionCigarette smoking is associated with recurrent otitis media, otitis media with effusion and sensorineural hearing loss in children exposed to second-hand smoke. In adults, it is associated with active and aggressive chronic suppurative otitis media, worse tympanoplasty success rates, increased post-operative complications and sensorineural hearing loss that is more pronounced in the long term and at high frequencies. The effects of e-cigarettes in otology are largely unknown.

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The Impact of Smoking on Ossiculoplasty Outcomes

Cited by 8 publications

References 17 publications

Association between Smoking and 30‐Day Outcomes in Otologic Surgery

Association between Smoking and 30‐Day Outcomes in Otologic Surgery

Tobacco Use and Skin Reactivity in Patients With Percutaneous Auditory Osseointegrated Implants

A systematic review of the impact of cigarettes and electronic cigarettes in otology

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