Otolaryngology - Head & Neck Surgery Supplement - 2020 Official Program Abstracts - P51

Impact of Early Tracheostomy in
Non-neurologically Injured Patients:
A Systematic Review and Meta-analysis
Noémie Villemure-Poliquin, MD (Presenter);
Paule Lessard-Bonaventure, MD, MSc, FRCSC;
Olivier Costerousse, PhD; François Lauzier, MD, MSc, FRCPC;
Alexis F. Turgeon, MD, MSc, FRCPC
Objectives: The ideal timing of tracheostomy for mechanically ventilated critically ill patients is still a controversial
issue, especially for non-neurologically injured patients who
are more likely to require prolonged intubation because of
respiratory failure. The primary objective of our systematic
review was to evaluate the effect of early vs late tracheostomy
or prolonged intubation in non-neurologically injured patients.
Methods: We searched MEDLINE, CENTRAL, CINAHL,
Web of Science, and Embase databases for randomized clinical trials (RCTs) comparing early tracheostomy with late tracheostomy or prolonged intubation in non-neurologically
injured patients. We included trials with populations comprising >75% of non-neurologically injured patients. Our primary
outcome was the overall mortality. Secondary outcomes
included hospital and intensive care unit (ICU) length of stay
(LOS), hospital LOS, duration of mechanical ventilation
(MV), and ventilator-associated pneumonia (VAP).
Results: Our search strategy yielded 7023 citations, from
which 8 RCTs (n = 2353) were included in our analysis. We
observed a non-statistically significant reduction in overall
mortality with early tracheostomy compared with late tracheostomy or prolonged intubation (risk ratio = 0.89, 95% CI,
0.80-1.00; P = .05; I2 = 21%). Our results were consistent for
the study population, the timing of outcome assessment, and
the risk of bias of trials. We found no difference in ICU and
hospital LOS, duration of MV, and VAP.
Conclusions: In our systematic review of RCTs, we observed
that early tracheostomy as compared with late tracheostomy
or prolonged intubation decreases or has no effect on the overall mortality in non-neurologically injured patients.
Implications of Electronic Cigarettes on
Postoperative Wound Healing
W. Taylor DeBusk, MD (Presenter); William DeBusk, MD;
Amy Anne D. Lassig, MD
Objectives: To evaluate the clinical and physiologic effects
of electronic cigarettes (e-cigarettes) on in vivo rat wounds.
Methods: Osmotic pumps were implanted in SpragueDawley rats with e-cigarette solution, nicotine solution, or
saline. Three weeks after implantation, pumps were removed,
and dorsal skin flaps were raised and primarily repaired. One
week after dorsal flap elevation, the rats were euthanized and
digital and thermographic images were taken to quantify tissue necrosis and perfusion. Digital image analysis was used
for outcome measures. One-way analysis of variance and nonparametric 1-way Kruskal-Wallis tests were used for statistical analysis; significance of P < .01 accounted for multiple
comparisons.

P51
Results: A total of 38 Sprague-Dawley rats were involved in
the study and divided into 3 groups: e-cigarette (n = 13), nicotine (n = 12), and saline (n = 13). Digital images were analyzed
to objectify tissue necrosis, measured in percentage of black
pixels. The control group had a mean of 30%, the e--cigarette
group had 35.8%, and the nicotine group had 34.4% (P = .894).
Thermography of the skin flap showed an average temperature
(Tavg; °F) in the control group 94.1, the e-cigarette group 92.9,
and the nicotine group 93.5. The control group showed an
increased Tavg throughout the duration of the study compared
with the e-cigarette or nicotine groups (P = .039).
Conclusions: Analysis of skin flap necrosis showed no significant differences among the rats exposed to e-cigarette
solution, nicotine, or saline. This is reassuring in that flap survival is not affected by exposure to these products relative to
control exposure. Thermography showed a delay in the natural inflammatory phase of wound healing in the e-cigarette
and nicotine groups, thus affecting wound integrity.
Incidence and Outcomes of Bell's Palsy With
Severe Presentation
Derek Escalante, MD (Presenter); Aurora G. Vincent, MD;
Zachary Nygren; Kristofer Radcliffe, MD; Scott B.
Roofe, MD; Douglas Ruhl, MD; Marc Hale Hohman, MD
Objectives: To determine the percentage of Bell's palsy
patients who meet electrodiagnostic criteria for facial nerve
decompression and to describe outcomes for Bell's palsy
patients presenting with House-Brackmann (HB) VI paralysis.
Methods: This is a retrospective study reviewing records of
patients with facial weakness from 2013 to 2020. Age, sex,
diagnoses, HB scores, electrodiagnostic studies, and treatments were reviewed. The chi-square test was used to evaluate
difference in outcomes.
Results: A total of 128 patients were evaluated for acute
facial weakness, defined as presentation within 1 month of
symptom onset. Bell's palsy accounted for 81% of cases. All
patients were treated with steroids and antivirals. Twenty percent of Bell's palsy patients presented with HB VI paralysis,
10% of whom met electrodiagnostic criteria for facial nerve
decompression. Of the patients who met criteria for decompression, 1 patient proceeded with surgery and 1 patient
refused. The one who underwent decompression had HB III
weakness at 23 months; the one who did not undergo decompression had HB VI paralysis at 2 weeks. Of the Bell's palsy
patients presenting with HB VI paralysis not meeting decompression criteria, 16% recovered to HB I, 21% HB II, 47% HB
III, 11% HB IV, and 5% HB V. The patients who presented
with HB scores 


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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