Biomedical subjects

Sandra Y Lin

Publications and source records attributed to Sandra Y Lin.

6 recordsLinked to original sources

PubMed2006

Relief of upper airway obstruction with mandibular distraction surgery: Long-term quantitative results in young children.

OBJECTIVE: To evaluate the long-term benefits of mandibular distraction on sleep-related upper airway obstruction in young children with mandibular hypoplasia. DESIGN: Cross-sectional study. Subjects were examined for sleep-disordered breathing using medical history, physical examination results, and a written questionnaire. Subjects underwent standard overnight polysomnography, during which measures of sleep-disordered breathing were collected. SETTING: Tertiary care hospital. PATIENTS: Five children with upper airway obstruction from craniofacial anomalies treated with mandibular distraction, with a minimum follow-up of 12 months. MAIN OUTCOME MEASURES: Apnea-hypopnea index, oxygen saturation nadir, and peak end-tidal carbon dioxide value. RESULTS: Of the 5 children, 3 were cured of upper airway obstruction as documented by polysomnography, with an apnea-hypopnea index of less than 1.5 and no snoring. The fourth child had primary snoring without apnea. The fifth child had severe obstructive sleep apnea, with an apnea-hypopnea index of 20.2. CONCLUSIONS: Most children who undergo mandibular distraction for upper airway obstruction associated with mandibular hypoplasia demonstrate significant clinical improvement of obstructive sleep apnea. However, those children who continue to have symptoms of sleep-disordered breathing after surgery should undergo polysomnography for evaluation of persistent obstructive sleep apnea.

Craniofacial Abnormalities↗

PubMed2006

Allergy practice in the academic otolaryngology setting: results of a comprehensive survey.

OBJECTIVE: To survey academic otolaryngology centers and obtain information regarding their practice of otolaryngic allergy. STUDY DESIGN: A 12-item multiple-choice survey was sent to all academic otolaryngology department chairmen and program directors, as well as all academic liaisons known to the American Academy of Otolaryngic Allergy. RESULTS: Representatives of 71 of 102 (69.6%) accredited otolaryngology programs responded; 52 of 84 respondents reported an active otolaryngic allergy practice at their institution. The testing method most widely employed by those surveyed is intradermal dilutional testing (IDT). The majority of respondents (74.5%) felt that the addition of allergy increased referrals to their department, and a similar majority (72%) were operating at a profit. The most common reasons cited for adding allergy services were to meet educational and residency requirements. CONCLUSIONS: The majority of academic otolaryngology programs in the United States currently offer otolaryngic allergy services. The primary reason cited for adding these services is for educational purposes, but there appear to be potential financial benefits as well. EBM RATING: C-4.

Academic Medical Centers↗

PubMed2004

Severe tracheobronchial stenosis in the X-linked recessive form of chondrodysplasia punctata.

The X-linked recessive form of chondrodysplasia punctata, characterized by chondrodysplasia and punctate calcification of cartilage, is caused by a defect in the vitamin K-dependent enzyme arylsulfatase E. We herein describe a male infant with chondrodysplasia punctata and stenosis and calcification of the entire trachea and main bronchi. To our knowledge, this is the first case of chondrodysplasia punctata reported in the English literature with such extensive airway manifestations.

Bronchial Diseases↗

PubMed2004

Current practice patterns in tonsillectomy and perioperative care.

OBJECTIVES: Tonsillectomy is one of the most commonly performed otolaryngologic procedures in the United States. Many options and controversies exist regarding techniques and peri-operative management. The purpose of the study was to examine current practice patterns among otolaryngologists regarding tonsillectomy. METHODS: A 13 question survey regarding tonsillectomy techniques and peri-operative management was mailed to 10% of randomly selected board certified otolaryngologists of the AAO-HNS in the spring of 2002. Four hundred and eighteen anonymously completed questionnaires were returned, for a response rate of 58.5%. Statistical analysis of survey data was performed by means of cross tabulation and Pearson Chi-Square Calculation. RESULTS: Monopolar electrocautery was the most common technique used among those surveyed (53.5%). There was a significant correlation between choice of monopolar electrocautery and the cited reason for choice of technique being decreased blood loss (P < 0.001). There was no relationship between pediatric fellowship training and choice of technique. 97.7% routinely admitted sleep apnea patients for post-operative observation. There was no significant correlation between practice setting (tertiary versus community) and type of post-operative monitoring for sleep apnea patients, with patients most commonly admitted to an intermediate care setting. CONCLUSION: In our survey, the most common surgical technique for tonsillectomy was monopolar electrocautery, chosen for the reason of decreased blood loss.

Anesthesia, Local↗

PubMed2003

Postoperative hemorrhage with nonsteroidal anti-inflammatory drug use after tonsillectomy: a meta-analysis.

OBJECTIVE: To use standard meta-analysis techniques to determine the risk of postoperative hemorrhage associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs) after tonsillectomy. DATA SOURCES: The MEDLINE database (1966-2001) restricted to the English language was searched using the keywords tonsillectomy, hemorrhage, analgesics, and NSAID in various combinations. Additionally, published articles were cross-referenced. To ensure completeness, the search was rerun using the Science Citation Index database. STUDY SELECTION: Of the 110 articles identified, 7 were selected. Selected studies were prospective trials comparing the effects of an NSAID and a control drug on posttonsillectomy pain and hemorrhage in pediatric and/or adult patients. In all cases, the NSAID or control was administered through an enteric route in the postoperative period. Patients were monitored for early and delayed hemorrhage. DATA EXTRACTION: Data were extracted independently by 2 investigators. DATA SYNTHESIS: A random effects model was used to compute a pooled odds ratio. For the 1368 patients included in analysis, the pooled odds ratio of posttonsillectomy hemorrhage with NSAIDs compared with controls was 1.29 and was not statistically significant (95% confidence interval, 0.85-1.73; P>/=.05). A subgroup analysis revealed an odds ratio of 0.93 (95% confidence interval, 0.44 -1.95; P>/=.05) for the nonaspirin NSAID group, while the aspirin group had a statistically significant odds ratio of 1.94 (95% confidence interval, 1.09-3.42; P =.02). CONCLUSIONS: There is an increased risk of posttonsillectomy hemorrhage with the use of aspirin after tonsillectomy; however, there appears to be no significant increased risk of bleeding for nonaspirin NSAIDs in this meta-analysis.

Adolescent↗

PubMed2003

Hot versus cold tonsillectomy: a systematic review of the literature.

OBJECTIVE: We systematically reviewed the literature comparing monopolar electrocautery versus cold knife dissection tonsillectomy. METHODS: The MEDLINE database was searched using the key words "tonsillectomy," "hot," "cold," "sharp," "bleeding," and "cautery." Selection criteria included prospective trials comparing electrodissection versus cold knife dissection on posttonsillectomy pain and hemorrhage. Six of the 815 articles met the selection criteria. RESULTS: Pooled data for the paired studies showed significantly more patients with pain worse on the electrodissection side (148 of 293 = 51%) than the cold knife side (33 of 293 [11%]; P = 0.001) on postoperative days 4 to 10. There were significantly more analgesic doses after surgery with electrodissection (means 26.7 versus 19.2; P = 0.028) and higher pain scores for adults undergoing electrodissection (means, 2.6 versus 0.8; significance could not be determined). There were no differences in hemorrhage rates. CONCLUSIONS: Electrodissection increases pain in comparison to sharp dissection for tonsillectomy. Postoperative hemorrhage rates are not significantly different when comparing the 2 methods.

Adolescent↗