Dataset Information

Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery.

ABSTRACT:

Importance

Postoperative packing in nasal surgery often results in nasal obstruction and discomfort. Commercially available silicone intranasal airways (IAs) serve as dual-nasal airway tubes aimed at alleviating this process, but the safety and efficacy of these devices are unknown.

Objective

To evaluate the safety and efficacy of an intraoperatively placed IA device in rhinoplasty and nasal surgery.

Design, setting, and participants

In this retrospective record review, the medical records of patients undergoing nasal surgery with insertion of the IA at a single institution from 2012 to 2017 were reviewed. After review of over 200 patients, a questionnaire was developed to assess device efficacy.

Exposures

Use of the IA device. The IA is 12 cm long, anchored across the columella, extends distally along the nasal floor, and has a proximal external portion used for cleaning and maintaining patency. Placed intraoperatively, the device aims to support air flow postoperatively in the face of edema, hemorrhage, and packing.

Results

A total of 302 operations in 300 patients were analyzed, including primary and revision septorhinoplasty. A total of 24 (7.9%) patients self-removed or inadvertently dislodged the IA. Minor acute postoperative complications not unique to airway insertion included cellulitis in 4 (1.3%) participants and epistaxis in 6 (2%). Postoperatively, 1 (0.3%) patient developed dehiscence along transcolumellar incisions. A total of 59 patients (100% compliance) completed the efficacy questionnaire. The mean breathing score was between good and average (2.9 of 5), comfort scores between comfortable and average (2.9 of 5), and mean ease of irrigation score was between very easy and easy (1.96 of 5). The device was irrigated on average 3.57 times per day. A total of 43 (76%) particpiants had full patency or only partial obstruction, compared with 13 (24%) patients with total obstruction. In all patients, with or without obstruction, the effect lasted an average of 4 days.

Conclusions and relevance

The device is safe and well-tolerated for maintaining patency of the nasal airway in patients undergoing rhinoplasty and nasal reconstruction without increased risk of incisional dehiscence.

Level of evidence

SUBMITTER: Tripathi PB

PROVIDER: S-EPMC6439732 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery.

Tripathi Prem B PB Majd Pejman P Ngo Tuan T Gu Jefferey T JT Sharma Giriraj K GK Badger Christopher C Bhandarkar Naveen D ND Wong Brian J F BJF

JAMA facial plastic surgery 20190101 1

<h4>Importance</h4>Postoperative packing in nasal surgery often results in nasal obstruction and discomfort. Commercially available silicone intranasal airways (IAs) serve as dual-nasal airway tubes aimed at alleviating this process, but the safety and efficacy of these devices are unknown.<h4>Objective</h4>To evaluate the safety and efficacy of an intraoperatively placed IA device in rhinoplasty and nasal surgery.<h4>Design, setting, and participants</h4>In this retrospective record review, the ...[more]

PMID: 30193353

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Project description:ObjectivesAlthough the flexible laryngeal mask airway (FLMA) provides considerable advantages in head and neck procedures, little is known about its safety and efficacy in functional endoscopic sinus surgery (FESS). We conducted a retrospective study to evaluate the success rate of FLMA and relevant airway complications in FESS under general anaesthesia.MethodsA retrospective review of consecutive patients who underwent FESS for chronic rhinosinusitis was performed from 2015 to 2019. All patients scheduled for FLMA ventilation were identified. Patient characteristics, length of the surgery, FLMA size, failed FLMA cases requiring endotracheal intubation, immediate adverse airway events and delayed airway injuries were recorded. The primary outcomes included the FLMA success rate, which was defined as primary success after induction and final success after the whole surgical procedure. The secondary outcomes were specific clinical factors associated with FLMA failure and airway complications related to FLMA usage.ResultsOf the 6661 patients included in our study, primary success was achieved in 6572 (98.7%), and final success was achieved in 6512 (97.8%). Failure occurred in 89 patients (1.3%) during induction, in 14 (0.2%) during surgical preparation and in 46 (0.7%) during the intraoperative procedure. All patients with failed FLMA ventilation were successfully switched to endotracheal intubation. Male sex, advanced age, higher American Society of Anesthesiologists grade (ASA) and higher body mass index (BMI) were independent risk factors associated with failed FLMA. Immediate adverse respiratory events were observed in 0.85% of the patients, and delayed airway injuries associated with use of FLMA were observed in 0.07%.ConclusionThis retrospective study demonstrates a high success rate for FLMA (97.8% in 6661 patients undergoing FESS). Adverse airway events and injuries associated with FLMA are rare, but clinicians should remain vigilant so that early diagnosis and prompt treatment can be provided.

Dataset Information

Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery.

Importance

Objective

Design, setting, and participants

Exposures

Results

Conclusions and relevance

Level of evidence

Publications

Evaluation of Safety and Efficacy for an Intranasal Airway Device in Nasal Surgery.

Similar Datasets

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