Mark Rowe

Disinfection of Flexible Fiberoptic Laryngoscopes After In Vitro Contamination With Staphylococcus aureus and Candida albicans

OBJECTIVE To determine the efficacy of various cleaning and disinfective methods in reducing bacterial and fungal load on flexible fiberoptic laryngoscopes (FFLs). DESIGN In vitro model. SUBJECTS Flexible fiberoptic laryngoscopes contaminated with Staphylococcus aureus and Candida albicans. INTERVENTIONS Contamination with S aureus and C albicans was separately induced on FFLs, which were then disinfected with different protocols: 20-, 15-, 10-, and 5-minute soaks in ortho-phthalaldehyde (Cidex OPA; Johnson & Johnson) with or without presoaking in an enzymatic soap solution for 5 minutes; an isolated 5-minute soak in an enzymatic soap solution; a 30-second wipe with antibacterial soap and water; a 30-second wipe with isopropyl alcohol; a 30-second wipe with antibacterial soap, followed by a 30-second scrub with isopropyl alcohol; and a 30-second wipe with germicidal cloth, all accompanied by previous rinsing with 30 seconds of running tap water. RESULTS All protocols except the isolated 5-minute soak in enzymatic soap solution were successful in completely disinfecting the FFLs after experimental contamination with S aureus or C albicans. CONCLUSION Various different cleaning methods appeared to properly disinfect FFLs after inoculation with S aureus and C albicans in an in vitro model.

Electrocautery versus cold knife technique adenotonsillectomy: A cost analysis

OBJECTIVE: Much has been written about the merits of various techniques of adenotonsillectomy. Proponents of each technique tout many virtues over one another. However, cost remains one variable that has not been thoroughly addressed. In this study, we compared the surgery time, anesthesia time, bleeding, and cost between 2 well-established techniques. Electrocautery tonsillectomy/adenoid ablation was compared against traditional cold knife dissection with adenoid curette. STUDY DESIGN AND SETTING: A retrospective chart review of 275 patients in a large tertiary teaching hospital. RESULTS: The electrocautery group had overall savings of 8, 8, and 9 minutes in surgery, anesthesia, and operating room times, respectively. In terms of cost, the variable cost of the electrocautery group was 19% less than the cold knife dissection group. CONCLUSION/SIGNIFICANCE: This study demonstrated that cautery ablation of adenoids, when employed as part of adenotonsillectomy, enables the surgical team to save significant amount of time, and substantial cost for patients. EBM rating: B-3.

Disk Battery Aspiration in a Young Child: A Scarcely Reported Phenomenon

Disk (or button) battery ingestion is not uncommon, with an estimated US incidence of 2 to 8 per million annually.(1) Reported serious adverse sequelae include esophageal stenosis, tracheoesophageal fistula, vocal cord paralysis, massive bleeding, and death.(1,2) There are, however, surprisingly few reports of aspirated batteries in the searchable literature; we found only 2. We present the diagnostic workup and treatment of a previously healthy 4-year-old boy with an aspirated disk battery in the bronchus.

Pediatric melanoma of the head and neck: a single institutions experience.

Objectives: The objectives of this study were to review our experience with pediatric melanoma of the head and neck and discuss proper diagnostic protocols and suggest a possible treatment algorithm.

S171 – Head and Neck Microvascular Reconstruction: Changing Trends:

Objectives The practice of head and neck reconstruction has been evolving over the past 15 years with the introduction of new surgical techniques, and increasing options for tissue harvest. We sought to investigate corresponding trends in the disciplines performing head and neck microvascular reconstruction. Methods 2 specialties for the proportion of head and neck microvascular reconstruction were compared: those performed by otolaryngologists and those done by plastics surgery. A 3-part study was performed to evaluate these trends: 1) Total case number of microvascular cases of otolaryngology residents and plastic surgery residents over the last 4 years was evaluated through the ACGME national data; 2) A poll of the percentage of otolaryngology residency programs that have their own microvascular reconstructive surgeon, and if that surgeon was hired within the last 5 years; and 3) The number of scientific articles published relating to microvascular head and neck reconstruction were systematically queried for 2 timeframes, (1995–2000) and (2002–2007). Results The national number of cases has steadily increased in the last 5 years. It has slowly increased compared to plastic surgery, but when all flaps are evaluated, it is not significant. We also found that the number of peer-reviewed articles relating to microvascular free flaps authored by otolaryngologists has increased. The data from the polls are still pending. Conclusions There is an increasing trend emerging in the practice of head and neck microvascular reconstruction, with an increase number of articles being authored and increased number of surgeries being performed by otolaryngolo-gists, compared to plastic surgeons.