Postoperative antibiotic care after functional endoscopic sinus surgery.

BACKGROUND: Antibiotics are used routinely in the postoperative care of functional endoscopic sinus surgery (FESS), but their efficacy has not been well evaluated. METHODS: Patients with chronic rhinosinusitis who underwent FESS were enrolled in this study. They were randomly divided into two groups: a study group and a control group. In the study group, patients took amoxicillin/clavulante for 3 weeks after FESS. In the control group, no antibiotic was given after FESS. Before FESS, all patients filled out a symptom questionnaire and received nasal endoscopy. Swab specimens were taken from the middle meati for bacterial cultures. These procedures were done again 3 weeks after FESS. RESULTS: Seventy-one patients completed the study. Thirty-one patients were in the study group, and 40 patients were in the control group. The symptom scores significantly decreased after surgery in both groups, but bacteria identified before and after FESS were statistically different in both groups. There were no differences in the symptom and endoscopic scores, rates of bacterial culture, and drug sensitivity to amoxicillin/clavulante between the two groups after FESS. CONCLUSION: This study showed that postoperative care with amoxicillin/clavulante did not improve the short-term outcome of FESS on chronic rhinosinusitis or decrease bacterial growth 3weeks after FESS, although the long-term influence was not evaluated in this study.

Visual screening of oral cavity cancer: The role of otolaryngologists.

OBJECTIVES: Because most screening was done by dentists, the purpose of this prospective cohort study was to evaluate the effectiveness of oral visual screening by otolaryngologists. In addition, we wanted to determine which group of enrolled patients was at potential risk of contracting oral cancer. METHODS: All male patients age > or =18 years who visited our clinic received oral mucosal screening. Basic data, including personal habits, were also obtained. A multivariate logistic regression model was devised to determine relevant risk factors for developing oral cancer. RESULTS: A total of 5,825 patients were enrolled in this study. Positive findings were found in 226 patients (3.9%). One hundred seventy-two patients received biopsy and 131 patients were proven to have oral cancer (sensitivity rate: 76.2%). The results showed that those who smoked, consumed alcohol, and chewed betel quid on a regular basis were most likely to contract oral cancer (odds ratio = 49.81, 95% confidence interval = 29.38-84.42). CONCLUSIONS: The otolaryngologists involved in this study successfully performed the oral screening. The sensitivity and specificity rates were both satisfactory. We suggest that those who are habitual cigarette smokers, alcohol consumers, and betel quid chewers should receive oral mucosal screening regularly so that potential oral cancer can be detected as early as possible.