Search Our Scientific Publications & Authors

Int Forum Allergy Rhinol 2022 Jun 9. Epub 2022 Jun 9.

Department of Otolaryngology, Head and Neck Surgery, University of California Irvine, Orange, California, USA.

Background: Postoperative management strategies for endoscopic skull base surgery (ESBS) vary widely because of limited evidence-based guidance.

Methods: The PubMed, EMBASE, and Cochrane databases were systematically reviewed from January 1990 through February 2022 to examine 18 postoperative considerations for ESBS. Nonhuman studies, articles written in a language other than English, and case reports were excluded. Read More

Otolaryngol Head Neck Surg 2022 May 24:1945998221100801. Epub 2022 May 24.

Department of Otolaryngology-Head and Neck Surgery, Washington University School of Medicine, St Louis, Missouri, USA.

Objective: To assess for differences in surgical site infection (SSI) rates and bacterial load after major mucosal head and neck surgery between patients who received topical antimicrobial prophylaxis and those who did not.

Data Sources: Ovid Medline, Embase, SCOPUS, Cochrane Library, and ClinicalTrials.gov from inception to May 20, 2021, with cross-referencing of retrieved studies per PRISMA guidelines. Read More

Ear Nose Throat J 2022 Apr 9:1455613221092208. Epub 2022 Apr 9.

Department of Otolaryngology, Head and Neck Surgery, 73819Tohoku University Hospital, Japan.

Actinomycosis is a bacterial infection caused by actinomyces. Although almost 50% of cases are related to the head and neck region, those in the nose and paranasal sinuses (PNS) are rare. Actinomycosis of the PNS is presumed to be typically caused by dental caries, dental manipulation, and maxillofacial trauma, which facilitate the penetration of oral pathogens into the sinus, and should thus be treated by the combination of surgical removal and potent antibiotics for at least two months. Read More

Iran J Otorhinolaryngol 2021 Nov;33(119):375-381

Department of Community Medicine, Faculty of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.

Introduction: Rational surgical antibiotic prophylaxis is suggested for some selected surgical processes. However, inappropriate utilization of antimicrobial prophylaxis reduces benefits and increases costs and risks, such as antibiotic resistance. This study aimed to evaluate the current practice of antibiotics prescribed by surgeons in common otologic surgeries. Read More

OTO Open 2022 Jan-Mar;6(1):2473974X211073306. Epub 2022 Feb 8.

Division of Otolaryngology-Head and Neck Surgery, Cooper University Hospital, Camden, New Jersey, USA.

Objective: Malignant fungating wounds (MFWs) are unfortunate and underreported manifestations of some advanced head and neck cancers. The management of MFWs is complex and challenging. MFWs are often mistaken for infectious processes/abscesses and treated indiscriminately with oral or intravenous antibiotics. Read More

J Otol 2022 Jan 29;17(1):25-30. Epub 2021 Oct 29.

Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, the Netherlands.

Introduction: This study aims to describe the occurrence of postoperative complications related to cholesteatoma surgery and to determine factors influencing the most common complication, i.e. postoperative surgical site infection (SSI) in cases with and without mastoid obliteration. Read More

Otolaryngol Head Neck Surg 2022 02;166(2):189-206

American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA.

Objective: This executive summary of the guideline update provides evidence-based recommendations for patient selection and surgical indications for managing tympanostomy tubes in children. The summary and guideline are intended for any clinician involved in managing children aged 6 months to 12 years with tympanostomy tubes or children being considered for tympanostomy tubes in any care setting as an intervention for otitis media of any type. The target audience includes specialists, primary care clinicians, and allied health professionals. Read More

Otolaryngol Head Neck Surg 2022 02;166(1_suppl):S1-S55

American Academy of Otolaryngology-Head and Neck Surgery Foundation, Alexandria, Virginia, USA.

Objective: Insertion of tympanostomy tubes is the most common ambulatory surgery performed on children in the United States. Tympanostomy tubes are most often inserted because of persistent middle ear fluid, frequent ear infections, or ear infections that persist after antibiotic therapy. All these conditions are encompassed by the term (middle ear inflammation). Read More

Open Forum Infect Dis 2022 Jan 24;9(1):ofab590. Epub 2021 Nov 24.

Department of Infectious Diseases, University of Melbourne at the Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia.

Background: Adherence to guidelines for antibiotic prophylaxis is often poor and is an important target for antimicrobial stewardship programs. Prescribing audits that suggested poor adherence to guidelines in a plastic surgery department led to a targeted education program to bring antibiotic prescriptions in line with hospital guidelines. We reviewed whether this intervention was associated with changed perioperative prescribing and altered surgical outcomes, including the rate of surgical site infections, specifically looking at clean-contaminated head and neck tumor resections with free flap reconstruction. Read More

Cureus 2021 Nov 17;13(11):e19675. Epub 2021 Nov 17.

Otolaryngology - Head and Neck Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, GBR.

Diphtheria is a highly contagious and potentially life-threatening infection. Cases in the United Kingdom are rare due to widespread vaccination. However, in recent years, there has been a notable increase in cases in the United Kingdom. Read More

J Infect Chemother 2022 Mar 6;28(3):401-405. Epub 2021 Dec 6.

Department of Otorhinolaryngology Head and Neck Surgery, Wakayama Medical University, 811-1 Kimiidera, Wakayama-shi, Wakayama, 641-8510, Japan. Electronic address:

Objectives: In 2016, Japanese Society of Chemotherapy and Japan Society for Surgical Infection presented the practical guideline for appropriate usage of antimicrobial agents to prevent postoperative infections. This study aims to exhibit the validity of the guideline as a series of effective strategies for prevention of surgical site infections (SSIs) during reconstructive surgery of the head and neck cancer.

Methods: We retrospectively evaluated patients who underwent head and neck reconstructive surgery with free or pedicle flaps in a single institute in Japan between July 2010 and July 2020. Read More

Open Access Emerg Med 2021 2;13:527-533. Epub 2021 Dec 2.

Department of Emergency Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

We performed a narrative review of epistaxis management in the emergency department. First, we examined the pathophysiology, the current types of treatment that are available to emergency clinicians. When nasal packing is indicated, we examined the efficacy of nasal packing in addition to other topical treatment such as tranexamic acid and the evidence of prophylactic antibiotics. Read More

Clin Otolaryngol 2022 03 16;47(2):287-294. Epub 2021 Dec 16.

Department of Surgery, School of Clinical Sciences, Monash University, Melbourne, Vic, Australia.

Objectives: To determine the effectiveness of ciprofloxacin .3% antibiotic eardrops in preventing clinically significant postoperative otorrhoea and tube obstruction following grommet insertion in children.

Design: Three-arm parallel assessor-blinded randomised controlled trial. Read More

Am J Otolaryngol 2022 Jan-Feb;43(1):103266. Epub 2021 Oct 21.

School of Medicine, Chang Gung University, Taoyuan, Taiwan; Department of Otorhinolaryngology & Head and Neck Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan. Electronic address:

Background: Otitis media with effusion (OME) is a condition where non-infective fluid builds up in the middle ear. Long-term OME can cause damage to the middle ear and hearing impairment. Ventilation tube insertion (VTI) is an efficient procedure to drain persistent OME. Read More

Clin Otolaryngol 2022 01 21;47(1):174-180. Epub 2021 Nov 21.

Department of Otorhinolaryngology - Head and Neck Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Objectives: Postoperative infection is the most common complication after septoplasty. Pre- or postoperative prophylactic antibiotics are commonly used, although no official guidelines exist.

Design: We retrospectively collected data on postoperative infections from 772 septoplasties performed in 2015, 2016 and 2018, and classified the infections according to surgical site infection (SSI) criteria by the Centers for Disease Control and Prevention (CDC). Read More

Eur Arch Otorhinolaryngol 2022 Jul 15;279(7):3449-3458. Epub 2021 Oct 15.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, P.O. Box 263, 00029 HUS, Helsinki, Finland.

Purpose: One of the most common complications after septoplasty is a postoperative infection. We investigated the number of postoperative infections and unplanned postoperative visits (UPV) in septoplasties with and without additional nasal surgery at our institution and evaluated the role of antibiotic prophylaxis.

Methods: We collected data of all consecutive 302 septoplasty or septocolumelloplasty patients operated during the year 2018 at the Department of Otorhinolaryngology-Head and Neck Surgery, HUS Helsinki University Hospital (Helsinki, Finland). Read More

Otolaryngol Head Neck Surg 2021 12 13;165(6):798-808. 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 Sep-Oct 01;37(5):462-464

Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, 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 2021 07 19;11(7):1047-1055. 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