Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P177
between groups (92% ASC and 86% hospital, P = .490). There
was no significant difference between groups for needing further
surgical intervention (6% ASC and 5% hospital, P = 1.00). Total
time patients were at the facility was higher in the hospital group
(2.5 hours longer, P < .0001). Turnover time at the hospital was
41.5 minutes compared with 30.3 minutes at an ASC. Medicare's
average payment for procedure at an ASC varied from $146 to
$968 based on the complexity of the procedure, whereas $2231
was paid for a hospital regardless of complexity.
Conclusions: Performing sialendoscopy in an ASC produced
no difference in successful outcomes compared with a hospital, while significantly decreasing cost and total time in hospital. Our data and experience suggest that although not all
sialendoscopies are suitable for an ASC, it is safe and more
efficient in the majority of cases.
Anatomical Variation of Right and Left
Vagus Nerves: A Cadaveric Study
Matthew Neil Spence (Presenter); James B. Tansey, MD;
Darryl Weiman, MD; Michael Herr, PhD
Objectives: A consensus does not currently exist on the anatomical positioning of the vagus nerve (VN) within the carotid
sheath (CS). Understanding the VN pathway is essential for
surgery of the head and neck because damage to the VN may
lead to significant consequences. This study uses a cadaveric
approach to explore VN anatomy within the CS, specifically
at the bifurcation of common carotid artery.
Methods: Right and left VN were located in the CS after
retraction of the sternocleidomastoid muscle and blunt dissection in 35 cadavers. Nerve position was characterized as either
anterior or posterior to the common carotid artery just inferior
to its bifurcation into internal and external carotid arteries
(figures available).
Results: The VN on both the right and left side were predominantly located posterior to the common carotid artery
just inferior to its bifurcation. On the right side, the VN was
located posteriorly in 31 (89%) of cadavers. On the left side,
the VN was located posteriorly in 30 (86%) of cadavers. Only
3 (9%) cadavers had both right and left VN positioned anterior
to the carotid artery. Three cadavers had contralateral differences. In 2 of these, the right VN was posterior to the carotid
artery and the left VN was anterior.
Conclusions: The VN is most commonly located posteriorly
within the CS. Although they are often symmetric, location of the
VN on one side of the neck does not always confer symmetrical
findings on the contralateral side. Careful dissection should be
undertaken after 1 VN has been exposed to avoid damage.
Anterior Spinal Hardware Erosion of the
Pharyngoesophagus Requiring Reconstruction:
Approach and Swallowing Outcomes
Nithin S. Peddireddy, MD (Presenter); Andrew J. Rosko, MD;
Matthew E. Spector, MD
Objectives: The objectives of this work are to describe pharyngoesophageal perforation repair due to anterior spinal
P177
hardware erosion and to describe fistula closure rate and swallowing outcomes after repair.
Methods: We performed a retrospective case series of patients
with radiographically or endoscopic confirmed esophageal erosion secondary to anterior spinal hardware from 2013 to 2019
who underwent reconstruction at a tertiary care hospital performed by a single surgeon. Data collected included indication
for spinal intervention and operation, history of radiation,
reconstruction type, fistula closure rate, need for reoperation,
and postoperative oral intake.
Results: Nine subjects were included. Four subjects had a history of radiation. Three subjects underwent anterior cervical discectomy and fusion (ACDF) after trauma. Pharyngoesophageal
perforations were repaired primarily in 8 cases, with 2 cases not
requiring further free-tissue overlay and 6 cases requiring free
tissue overlay (3 radial forearm, 2 anterolateral thigh, and 1 parascapular flap). One subject did not undergo primary closure
because of poor tissue quality, and a sternocleidomastoid flap
was used for carotid coverage. Three patients required postoperative diverticulectomy, and 1 patient had a residual fistula.
Eight patients were able to take all nutrition orally, and 1 patient
with a history of radiation for larynx cancer used a G-tube for
nutrition with some oral trial.
Conclusions: A variety of reconstructive options can be used
for fistula closure due to anterior spinal hardware erosion with
excellent swallowing outcomes. A customized approach must be
used for each patient based on their indication for ACDF, stability of the spine with hardware removal, their previous exposure
to radiation, and their extent of pharyngoesophageal erosion.
Are Anesthesia Screens a Barrier to
Communication Practices in the Operating
Room?
Alexandra Bourdillon (Presenter); Heather A. Edwards, MD
Objectives: Breakdowns in communication are the most
common cause of adverse surgical events, and teamworkrelated practices are central aspects of many tools for surgical
safety and teamwork evaluation. An ether screen is a (typically
opaque) drape hung between the sterile surgical field and the
nonsterile anesthesia area. Because of its variable use in the
context of otolaryngology, the goal of our preliminary study
was to evaluate the association between use of the ether screen
and frequencies in verbal interactions in the operating room.
Methods: Twenty-five otolaryngologic procedures (ranging
from 15 to 215 minutes) were observed in full by a trained medical student who recorded key time points and verbal exchanges
between anesthesia and scrubbed surgical staff. The procedures
were selected to capture a spectrum of ope-rating teams and procedures under 4 hours. Verbal exchanges were also categorized
by those their relation to patient management.
Results: Altogether 13 procedures with and 12 without ether
screens were included. Communication was more frequent
among procedures without ether screens (7.17 exchanges per
hour) compared with those with ether screens (2.23 exchanges
per hour). Differences in rates of exchanges between
Head and Neck
Poster Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Table of Contents for the Digital Edition of Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Contents
Accreditation Information
2020 President Duane J. Taylor, MD
2020 Annual Meeting Program Committee
2020 Star Reviewers
2020 Distinguished Service Award Recipients
2020 Honor Award Recipients
Honorary Guest Lecturers 2020
Panel Presentations
Oral Presentations
Poster Presentations
Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Intro
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A1
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A2
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Contents
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A5
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - A6
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Accreditation Information
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 President Duane J. Taylor, MD
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Annual Meeting Program Committee
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P4
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Star Reviewers
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - 2020 Honor Award Recipients
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P7
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Honorary Guest Lecturers 2020
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P9
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Panel Presentations
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P11
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P12
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Oral Presentations
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Poster Presentations
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Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P274
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P275
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P276
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P277
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P278
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P279
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P280
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P281
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P282
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P283
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P284
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P285
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P286
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P287
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P288
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P289
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P290
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P291
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P292
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P293
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P294
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P295
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P296
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P297
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P298
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P299
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P300
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P301
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P302
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P303
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P304
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P305
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P306
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P307
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P308
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P309
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P310
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P311
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P312
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Author Index
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P316
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P317
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P318
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P319
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P320
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P321
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P322
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P323
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P324
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P325
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P326
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P327
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P328
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P329
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P330
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P331
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P332
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover3
Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - Cover4
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