safety of open surgical tracheotomy performed by otorhinolaryngology residents

Objective: We aimed to clarify the safety of open surgical tracheotomy performed by supervised residents, and the impact of "reason for hospitalization" on complication rates in open surgical tracheotomy technique

Methods: In this retrospective cohort study, the medical files and documents of 277 patients who underwent open surgical tracheotomy [OST] over a period of 12 years from October 2005 to July 2017 were analyzed. Forty four patients were excluded due to emergent tracheotomy and presence of malignancy. Remaining 223 cases were divided into two groups as "OSTs done by supervised residents" and "OSTs done by attending surgeons". Age, gender, reason for hospitalization, observation time and complications were noted. The overall minor and major complication rates and each complication rate were compared with regard to the operating surgeons

Results: No statistically significant difference between two groups was demonstrated in terms of observation time [p=0.127]. Minor complication rate for residents and attending surgeons was 14.7% and 17.5%, whereas major complication rate was 6.3% and 5.0%, respectively. No significant difference was found between two groups both in terms of minor [p=0.58] and major [p=0.43] complication rates. No risk of "reason for hospitalization" on minor and major complications was found [p=0.06, p=0.15]

Conclusion: Open surgical tracheotomy performed by supervised residents is as safer as the ones performed by the attending surgeons. The study also showed that "reason for hospitalization" does not potentiate the occurrence of tracheotomy related complications

Pregnancy rhinitis in Turkish women: do gestational week, BMI and parity affect nasal congestion?

Objective: To determine the cumulative incidence of pregnancy rhinitis along with prevalence in different trimesters and to find out whether gestational age, BMI and parity have any effect on pregnancy related nasal congestion

Methods: In the prospective protocol at the obstetrics outpatient clinic, 167 pregnant women were enrolled consecutively. According to exclusion criteria, 67 of them were excluded. Visual-Analogue-Scale [VAS], Nasal-Obstructive-Symptom-Evaluation [NOSE] scale and Discharge-lnflammation-Polyps/Oedema [DIP] scoring were utilized for diagnosis of pregnancy rhinitis. Besides, weight, length, age, parity and week of pregnancy were recorded

Results: Total prevalence of pregnancy rhinitis was 17.17% and cumulative incidence was 38.89%. Our study revealed significant relation of NOSE score with both gestational week [r=0.474, p=0.001] and BMI [r=0.301, p=0.003]. VAS score was significantly related with gestational week [r=0.409, p=0.001] and BMI [r=0.270, p=0.007]. DIP score was found to be correlated only with gestational week [r=0.375, p=0.001]

Conclusion: Cumulative incidence of pregnancy rhinitis was 38.89%. Nasal congestion was significantly associated with BMI and gestational week. Patients should be informed about unfavorable fetal and maternal outcomes of pregnancy related nasal congestion which is triggered by obesity and excessive weight gain in pregnancy