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Otolaryngol Head Neck Surg 2021 Apr 13:1945998211004270. Epub 2021 Apr 13.

Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine in St Louis, St Louis, Missouri, USA.

Objective: This is the first database study to assess the effectiveness of prophylactic preoperative antibiotics (PPAs) in mandible fracture repair.

Study Design: Retrospective cohort.

Setting: Database study using US inpatient and outpatient insurance claims submitted from July 2006 to March 2015. Read More

Ophthalmic Plast Reconstr Surg 2021 Jan 19. Epub 2021 Jan 19.

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of New Mexico, Albuquerque, New Mexico, U.S.A. Department of Surgery, Division of Ophthalmology, University of New Mexico, Albuquerque, New Mexico, U.S.A.

Purpose: The use of antibiotic prophylaxis for the prevention of infection in nonoperative orbital fractures is controversial, with limited high-quality evidence and inconsistent recommendations in the current scientific literature. Our primary study objective was to identify the prophylactic antibiotic prescribing pattern at our institution for nonoperative orbital fractures and to determine the effect of antibiotic prophylaxis.

Methods: We retrospectively reviewed 16 years of data from a single institution on patients with acute traumatic fractures of the orbital floor or medial orbital wall. Read More

Int Forum Allergy Rhinol 2020 Dec 19. Epub 2020 Dec 19.

Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear, Boston, MA.

Background: Surgeons commonly prescribe prophylactic antibiotics after endoscopic sinus surgery (ESS), yet minimal data exist to support this practice. In this study we aimed to assess the impact of post-ESS antibiotics on infection, quality of life (QOL), and endoscopic scores.

Methods: This was a randomized, double-blind, placebo-controlled, noninferiority trial comparing amoxicillin-clavulanate vs placebo after ESS (NCT01919411, ClinicalTrials. Read More

J Emerg Med 2021 Feb 7;60(2):144-149. Epub 2020 Nov 7.

Department of Otolaryngology-Head and Neck Surgery, New York University School of Medicine, New York, New York.

Background: There have been few investigations examining the benefits, consequences, and patterns of use for prophylactic antibiotics for nasal packing in the emergency department setting. Given the frequency of epistaxis in the emergency department, it is an ideal setting to study the efficacy and utilization patterns of prophylactic antibiotics in nasal packing.

Objective: Our aim was to assess both rates of utilization and evidence of benefit for prophylactic antibiotics in patients with nasal packing for epistaxis. Read More

Otolaryngol Head Neck Surg 2020 08 23;163(2):275-279. Epub 2020 Jun 23.

Department of Otolaryngology, Head & Neck Surgery, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Objectives: There is limited evidence regarding use of routine perioperative antibiotics for pediatric otolaryngologic procedures. The objectives of this quality improvement study were (1) to characterize the otolaryngology case mix for which antibiotics were delivered and (2) determine the percentage of surgical encounters with appropriate timing of antibiotic administration.

Methods: Pediatric otolaryngology procedures meeting criteria from 2015 to 2019 were evaluated as a component of an institution-wide pediatric surgical antibiotic prophylaxis study using A3 problem solving to identify and roll out interventions for appropriate antibiotic administration. Read More

Turk Arch Otorhinolaryngol 2020 Mar 26;58(1):56-60. Epub 2020 Mar 26.

Department of Otorhinolaryngology Head and Neck Surgery, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, İstanbul, Turkey.

Surgical site infections (SSIs) after thyroidectomy are very rare as it is a clean case surgery, even the patterns for the use of prophylactic antibiotics is disputable. Cutaneous and subcutaneous tissue infections are the most common type of SSIs that develop due to the contamination of the skin flora pathogens during surgical incision. We report the case of a patient who, unlike the reports in the literature, developed necrotizing fasciitis due to Candida infection after total thyroidectomy. Read More

Otol Neurotol 2020 07;41(6):802-805

Department of Otolaryngology/Head and Neck Surgery, Virginia Commonwealth University.

Objective: To determine if the routine use of postoperative antibiotics following percutaneous auditory osseointegrated implant placement reduces skin reactivity.

Study Design: Retrospective matched case-controlled series.

Settings: Tertiary academic medical center. Read More

Adv Ther 2020 04 5;37(4):1360-1380. Epub 2020 Mar 5.

International Head and Neck Scientific Group, Padua, Italy.

Background: The optimal evidence-based prophylactic antibiotic regimen for surgical site infections following major head and neck surgery remains a matter of debate.

Methods: Medline, Cochrane, and Embase were searched for the current best evidence. Retrieved manuscripts were screened according to the PRISMA guidelines. Read More

Trials 2019 Dec 9;20(1):683. Epub 2019 Dec 9.

Department of Otolaryngology, Kilimanjaro Christian Medical Centre, Kilimanjaro, Tanzania.

Background: Adenotonsillectomy is the most frequently performed operation in children worldwide. For decades, prophylactic antibiotics have been prescribed to limit postoperative complications. The effect of this antibiotic use has been refuted in a Cochrane Review. Read More

Am J Otolaryngol 2019 Nov - Dec;40(6):102276. Epub 2019 Aug 14.

Department of Otolaryngology, University of Florida, Gainesville, FL, USA; University of Florida Health Cancer Center, Gainesville, FL, USA. Electronic address:

Objective: Recent evidence supports the use of ampicillin-sulbactam as a favored choice for antibiotic prophylaxis following head and neck free flap reconstructive surgery. However, there is a paucity of evidence guiding the optimal duration of antibiotic prophylaxis. The aim of this study is to compare the infection rates of short courses of ampicillin-sulbactam versus extended courses of various antibiotics in head and neck free flap reconstructive surgery. Read More

Ann Otol Rhinol Laryngol 2020 Jan 8;129(1):5-11. Epub 2019 Aug 8.

Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel.

Objectives: Intranasal septal splints are often used in nasal septal surgeries. Routine use of postoperative antibiotics is an accepted practice, although data regarding its efficacy in preventing postsurgical complications are limited. This study aimed to examine bacterial colonization on septal splints following prophylactic antibiotic therapy and the association with postoperative infections. Read More

Ear Nose Throat J 2019 Jul 28;98(6):362-365. Epub 2019 May 28.

1 Otorhinolaryngology-Head & Neck Surgery Department, Hospital Universitario Donostia, San Sebastian, Donosti, Guipuzkoa, Basque Country, Spain.

Introduction: Surgical site infection (SSI) is a common complication in surgery. In head and neck surgeries, different rates are reported in the indexed literature. Nowadays, this indiscriminate use of antibiotics is associated with increased cost and risks for patients. Read More

J Med Case Rep 2019 May 24;13(1):162. Epub 2019 May 24.

Department of Head and Neck Surgery, Japan Community Health Care Organization Kyushu Hospital, 1-8-1 Kishinoura, Yahatanishi-ku, Kitakyushu City, Fukuoka, 806-8501, Japan.

Background: Patients with head and neck carcinoma are considered to be at high risk of developing tuberculosis, since the risk of morbidity due to tuberculosis in these patients is 2.86 to 16 times the risk in the general population.

Case Presentation: This case series describes an 83-year-old Japanese man, a 60-year-old Japanese man, and a 69-year-old Japanese man who developed active pulmonary tuberculosis while being treated for head and neck carcinoma. Read More

Int J Pediatr Otorhinolaryngol 2019 Jun 25;121:26-28. Epub 2019 Feb 25.

Department of Otolaryngology Head and Neck Surgery, Rabin Medical Center and Schneider Children's Hospital, Petah Tikva, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Background: Recurrent periorbital cellulitis (RPOC) associated with rhinosinusitis is rarely noted and scarcely discussed in the literature. The aim of our study was to analyze the characteristics and disease course of a group of pediatric patients with RPOC.

Methods: The medical records of all pediatric patients with a diagnosis of RPOC treated in a tertiary children's hospital were retrieved. Read More

Acta Otorhinolaryngol Ital 2019 Jun 28;39(3):139-144. Epub 2018 Dec 28.

Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì and degli Infermi Hospital, Faenza, Azienda USL della Romagna, Italy.

Neurosurgery 2020 01;86(1):19-29

Department of Neurosurgery, Ronald Regan UCLA Medical Center, Los Angeles, California.

Background: External ventricular drain (EVD) placement is essential for the management of many neurocritical care patients. However, ventriculostomy-related infection (VRI) is a serious complication, and there remains no well-established protocol guiding use of perioperative or extended antibiotic prophylaxis to minimize risk of VRI.

Objective: To analyze published evidence on the efficacy of extended prophylactic antimicrobial therapy and antibiotic-coated external ventricular drains (ac-EVDs) in reducing VRI incidence. Read More

Br J Hosp Med (Lond) 2018 Nov;79(11):643-647

Consultant in Anaesthetics and Critical Care, Department of Anaesthetics and Critical Care, University College Hospital, London.

Background:: Antibiotic prophylaxis is crucial in head and neck surgery to prevent infection from clean contaminated wounds. Scottish Intercollegiate Guidelines Network (SIGN) guidance, the gold standard of practice, recommends that administration of broad spectrum antibiotics is discontinued after 24 hours post-operation. A three-audit cycle quality improvement project was conducted to assess clinical practice against SIGN guidance at a large London teaching hospital. Read More

Clin Otolaryngol 2018 12 14;43(6):1508-1512. Epub 2018 Aug 14.

Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petach Tikva, Israel affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

Objective: Antibiotic prophylaxis is not indicated for clean head and neck surgery. However, its role in revision cases is not known. The objective was to prospectively test whether antibiotics are useful in this patient group. Read More

Oncotarget 2018 Apr 10;9(27):18970-18984. Epub 2018 Apr 10.

Department of Otorhinolaryngology-Head and Neck Surgery, Keio University School of Medicine, Shinjuku, Tokyo, Japan.

Background: Febrile neutropenia (FN) is the most serious hematologic toxicity of systemic chemotherapy. However, accurate prediction of FN development has been difficult because the risk varies largely depending on the chemotherapy regimen and various individual factors.

Methods: We retrospectively analyzed diverse clinical factors including pretreatment hematological parameters to clarify the reliable predictors of FN development during chemotherapy with a docetaxel, cisplatin, and fluorouracil (TPF) regimen in patients with head and neck squamous cell carcinoma. Read More

Ann Otol Rhinol Laryngol 2018 Apr 11;127(4):266-269. Epub 2018 Feb 11.

1 Depatment of Otolaryngology/Head and Neck Surgery, Section of Otology/Neurotology, Virginia Mason Medical Center, Seattle, Washington, USA.

Objective: Evaluate whether prophylactic antibiotics administered following cochlear implant (CI) surgery impact short-term infection rates.

Design: Retrospective, concurrent, case-control.

Setting: Tertiary referral center. Read More

J Cancer Res Clin Oncol 2018 Feb 8;144(2):389-401. Epub 2017 Dec 8.

Translational Radiobiology Group, Division of Cancer Sciences, Manchester Academic Health Science Centre, NIHR Manchester Biomedical Research Centre, The Christie NHS Foundation Trust, University of Manchester, Wilmslow Road, Manchester, England, M20 4BX, UK.

Purpose: The benefit of adding docetaxel, cisplatin and 5-fluorouracil (TPF) induction chemotherapy to chemoradiotherapy (CRT) in head and neck squamous cell carcinoma (HNSCC) remains uncertain. We aimed to investigate whether ICT is well tolerated when given with prophylactic treatment against predicted adverse effects and which patients benefit most.

Methods: A single-centre audit identified 132 HNSCC patients with stage IVa/b neck node-positive disease, prescribed TPF followed by CRT. Read More

Head Neck 2018 02 30;40(2):417-427. Epub 2017 Oct 30.

Department of Otolaryngology - Head and Neck Surgery, University of Colorado, Boulder, Colorado.

Background: Optimal antibiotic prophylaxis duration in head and neck clean-contaminated free-flap cases is unknown.

Methods: A systematic review/meta-analysis was conducted using PubMed/MEDLINE, Cochrane Library, Web-of-Science, and Scopus databases.

Results: Of the 3755 searched articles, 5 articles were included for a total of 861 patients. Read More

Clin Otolaryngol 2018 02 21;43(1):291-299. Epub 2017 Sep 21.

Department of Otorhinolaryngology, Head and Neck Surgery, Berlin Institute of Health, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Campus Benjamin Franklin, Berlin, Germany.

Background: Patients who have granulomatosis with polyangiitis (GPA, syn. M. Wegener) often develop an external nose deformity which may have devastating psychological effects. Read More

Lancet Oncol 2017 07;18(7):e405-e413

Department of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA. Electronic address:

Head and neck cancer surgery is often a complex multi-step procedure that includes major resections, vascularised tissue reconstruction, and extensive neck dissection. The upper aerodigestive tract mucosal lining is often disrupted during surgery, which requires the management of a clean-contaminated field and the need to reconstruct the mucosal lining. With bacterial contamination, surgical site infections (SSI) are a serious complication that can result in delayed wound healing, wound breakdown, fistula formation, and compromised tissue reconstruction. Read More

J Craniomaxillofac Surg 2017 Jul 20;45(7):1078-1082. Epub 2017 Apr 20.

Department of Oral and Maxillofacial Surgery, RWTH Aachen University, Pauwelsstraße 30, 52074 Aachen, Germany.

Objectives: The adequate perioperative antibiotic prophylaxis in head and neck cancer surgery is an important and easy applicable tool to decrease nosocomial morbidity and mortality by reducing the rate of infections. In the study a strictly perioperative antibiosis is compared with an extended postoperative prophylactic antibiosis. We aim to clarify the value of postoperative prophylactic antibiosis for the recovery and clinical course of patients. Read More

Am J Otolaryngol 2017 Mar - Apr;38(2):204-207. Epub 2017 Jan 19.

Department of Otolaryngology - Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA. Electronic address:

Purpose: Many head and neck surgical procedures are considered clean-contaminated wounds and antibiotic prophylaxis is recommended. Despite prophylaxis, the incidence of surgical site infections remains significant - especially in the setting of free tissue transfer. The antibiotic course is often of a longer duration after free tissue transfer than the recommended 24hour post-operatively. Read More

J Laryngol Otol 2016 May;130(S2):S13-S22

Department of Anaesthesia,Freeman Hospital,Newcastle upon Tyne NHS Foundation Trust,Newcastle upon Tyne,UK.

This is the official guideline endorsed by the specialty associations involved in the care of head and neck cancer patients in the UK. This paper provides recommendations on the pre-treatment clinical assessment of patients presenting with head and neck cancer. Recommendations • Comorbidity data should be collected as it is important in the analysis of survival, quality of life and functional outcomes after treatment as well as for comparing results of different treatment regimens and different centres. Read More

J Neurol Surg B Skull Base 2016 Oct 2;77(5):419-29. Epub 2016 Jun 2.

Department of Otolaryngology-Head and Neck Surgery, University of California Davis Medical Center, Sacramento, California, United States.

Traumatic injury to the temporal bone can lead to significant morbidity or mortality and knowledge of the pertinent anatomy, pathophysiology of injury, and appropriate management strategies is critical for successful recovery and rehabilitation of such injured patients. Most temporal bone fractures are caused by motor vehicle accidents. Temporal bone fractures are best classified as either otic capsule sparing or otic capsule disrupting-type fractures, as such classification correlates well with risk of concomitant functional complications. Read More

Ulus Travma Acil Cerrahi Derg 2016 Jul;22(4):402-4

Department of Otolaryngology-Head and Neck Surgery, Erciyes University Faculty of Medicine, Kayseri-Turkey.

Pharyngeal foreign bodies are commonly encountered in otolaryngological practice. However, in certain instances, particularly in cases of penetrating injuries, major vascular damage leads to severe morbidity and mortality. Management of these cases includes airway protection, bleeding control, imaging of major vascular injury, and prophylactic antibiotics. Read More

Int Forum Allergy Rhinol 2017 01 23;7(1):30-36. Epub 2016 Aug 23.

Department of Internal Medicine, Division of Immunology, University of Iowa Carver College of Medicine, Iowa City, IA.

Background: Patients with primary antibody deficiencies have an increased frequency of sinonasal and pulmonary infections. Immunoglobulin (Ig) replacement is a standard therapy for common variable immunodeficiency (CVID) and other antibody deficiency diseases. Although there is convincing evidence that Ig replacement reduces pulmonary infections, there is little evidence that it reduces sinus infections or abates chronic rhinosinusitis (CRS). Read More