Adequacy of antibiotic prophylaxis and incidence of surgical site infections in neck surgery.

Health care-related infections are frequent and among them surgical site infection (SSI) are the most frequent in hospitals. The objective was to evaluate the adequacy of antibiotic prophylaxis in patients undergoing neck surgery and its relationship with the incidence of surgical site infection (SSI). Prospective cohort study. The adequacy of antibiotic prophylaxis in patients undergoing neck surgery was evaluated. Antibiotic prophylaxis was considered adequate when it conformed to all items of the protocol (antibiotic used, time of administration, administration route, dose and duration). The cumulative incidence of SSI was calculated, and the relationship between SSI and antibiotic prophylaxis adequacy was determined using adjusted relative risk (RR). Antibiotic prophylaxis was administered in 63 patients and was adequate in 85.7% (95% CI 75.0-92.3) of them. The cumulative incidence of SSI was 6.4% (95% CI 3.4-11.8). There was no significant relationship between antibiotic prophylaxis inadequacy and the incidence of SSI (RR = 2.4, 95% CI 0.6-10.6). Adequacy of antibiotic prophylaxis was high and it did not affect the incidence of SSIs.

[Presurgical preparation and surgical site infection in neck surgery. The effect of the protocol adequacy in the improvement of the health care quality]. / Impacto de la adecuación del protocolo de preparación prequirúrgica en la incidencia de infección de localización quirúrgica en cirugía cervical.

BACKGROUND: Surgical wound infection is one of the leading causes of healthcare-associated infections. One of the most common measures for its reduction is the pre-surgical preparation. The aim of this study was to evaluate the adequacy to the pre-surgical protocol in patients undergoing neck surgery and the relationship with the incidence of surgical wound infection. MATERIAL AND METHODS: Observational cohort study, conducted from January 2011 to December 2017. Variables related to patient, pre-surgical preparation and infection were collected. Infection rate was calculated after a maximum period of 30days after surgery. The effect of the pre-surgical preparation's adequacy and infection was evaluated. RESULTS: The study included 131 patients. The global adequacy of the pre-surgical protocol was 84.7%, being the main cause of inadequacy the application of the mouthwash (7.6% of the interventions). The overall incidence of surgical wound infection during the follow-up period was 4.6% (95%CI: 1.0%-8.2%). No relationship between the adequacy to the protocol and the presence of infection was found (P=.59). CONCLUSIONS: Adequacy of the pre-surgical preparation in our hospital was high and the incidence of surgical wound infection was low, and no relationship was found between the two. The results show a high safety culture in this surgery. However, there is still room for improvement in the quality of care of our patients.

[Kikuchi-Fujimoto disease: report of two cases]. / Enfermedad de Kikuchi-Fujimoto: descripción de dos casos.

Kikuchi-Fujimoto disease, described for the first time in 1972, is an unusual diagnosis that is characterized by lymph node enlargement and fever. Cervical lymph nodes are affected so often that ENT specialists should be aware of this entity during differential diagnosis. The diagnosis was done by histological features, necrotizing lymphadenitis. The disease is self-limited and it has good prognosis. We have reviewed two cases in our hospital. We report an aseptic meningoencephalitis as a rare complication.

Enfermedad de Kikuchi-Fujimoto: descripción de dos casos / Kikuchi-Fujimoto disease: report of two cases

La enfermedad de Kikuchi-Fujimoto (EKF) fue descrita en el año 1972 y se caracteriza por la aparición de fiebre y adenopatías preferentemente cervicales. Es un diagnóstico raro y entra dentro del diagnóstico diferencial de las adenopatías cervicales. El diagnóstico definitivo de la enfermedad es anatomopatológico. La enfermedad es autolimitada y casi siempre tiene una evolución favorable. Revisamos dos casos diagnosticados en nuestro hospital. Uno de los casos cursó con una meningitis aséptica que es una complicación muy rara

Kikuchi-Fujimoto disease, described for the first time in 1972, is an unusual diagnosis that is characterized by lymph node enlargement and fever. Cervical lymph nodes are affected so often that ENT specialists should be aware of this entity during differential diagnosis. The diagnosis was done by histological features, necrotizing lymphadenitis. The disease is self-limited and it has good prognosis. We have reviewed two cases in our hospital. We report an aseptic meningoence-phalitis as a rare complication

Somnoplastia: tratamiento del ronquido crónico mediante radiofrecuencia sobre el paladar / Somnoplasty: treatment of chronic snoring by radiofrequency of the soft palate

El objetivo de este trabajo es evaluar la eficacia y seguridad de la reducción de volumen de tejidos mediante la aplicación de radiofrecuencia sobre el paladar para el tratamiento de la roncopatía crónica. Cincuenta y tres pacientes fueron incluidos en el estudio. Ocho de ellos (15 por ciento) eran pacientes con SAOS de carácter moderado. Todos ellos fueron tratados con multilesiones, liberando alrededor de 2.500 julios/sesión. El 75 por ciento fue sometido a dos sesiones. En cada sesión se liberó la misma cantidad de energía. El seguimiento fue hasta de 29 meses con una media de 20 meses. Se analizó el resultado del ronquido (usando escala visual analógica), así como el dolor post-op y la satisfacción del paciente y de su entorno. Los peores resultados se obtienen en pacientes con SAOS y obesos. El éxito del tratamiento disminuye con el tiempo, sin embargo dada la buena tolerancia y la ausencia de efectos adversos, el procedimiento puede repetirse según la necesidad (AU)

The goal of this study is to evaluate the efficacy and the safety of tissue reduction of the palate by means of radiofrequency for the treatment of snoring. Fifty-three patients were evaluated. Eight of them (15%) met criteria for mild OSAS. All of them underwent RF energy treatment with several ablation sites and the mean total energy administered was about 2500 J per treatment session. 40 patients (75%) underwent an additional RF treatment and the energy administered in the second session was the same as in the first one. We evaluated postoperative pain, snoring and the satisfaction of the patient and his enviroment. After a mean follow-up of 20 months no adverse effect was reported. The success diminishes with time as happens other surgical procedures (UPPP or LAUP) but the absence of serious adverse side-effects and the minimal postoperative pain support the use of RF as an effective procedure for reducing snoring (AU)

[Somnoplasty: treatment of chronic snoring using radiofrequency irradiation of the palate]. / Somnoplastia: tratamiento del ronquido crónico mediante radiofrecuencia sobre el paladar.

The goal of this study is to evaluate the efficacy and the safety of tissue reduction of the palate by means of radiofrequency for the treatment of snoring. Fifty-three patients were evaluated. Eight of them (15%) met criteria for mild OSAS. All of them underwent RF energy treatment with several ablation sites and the mean total energy administered was about 2500 J per treatment session. 40 patients (75%) underwent an additional RF treatment and the energy administered in the second session was the same as in the first one. We evaluated postoperative pain, snoring and the satisfaction of the patient and his enviroment. After a mean follow-up of 20 months no adverse effect was reported. The success diminishes with time as happens other surgical procedures (UPPP or LAUP) but the absence of serious adverse side-effects and the minimal postoperative pain support the use of RF as an effective procedure for reducing snoring.

Alteraciones del olfato en la consulta ORL general / Olfaction disturbances in general ORL practice

Revisión de las alteraciones olfatorias de los pacientes de una consulta de ORL en un hospital general cuando éste es el motivo fundamental de consulta. Es un estudio retrospectivo y descriptivo. Incluimos en el estudio todos los pacientes con alteraciones del olfato como principal motivo de consulta. La muestra recogida fueron 38 pacientes. Definimos las etiologías de las alteraciones del olfato: viral, idiopática, postraumática, tóxica, medicamentosa e inflamatoria. Los estudios realizados en cada paciente fueron: anamnesis, endoscopia nasal y exploración de imagen. Las alteraciones del olfato son más frecuentes en mujeres (2:1), a partir de los 55 años y la causa más frecuente es la viral (55,3 per cent). La endoscopia nasal fue normal en la mayoría de los casos (68,4 per cent). El estudio de imagen más utilizado en nuestra consulta es la TC (68,4 per cent). La recuperación es mayor en pacientes jóvenes y en aquellas lesiones reversibles (AU)

Analysis of smell disturbances in the ENT outpatients department of in a General Hospital. A retrospective and descriptive study. We include all patients with olfactory alterations as the main reason for consultation. The sample was 38 patients. Viral, postraumatic, toxic, drug-induced and inflammatory. We performed anamnesis, nasal endoscopic and scan images on all patients. Olfactory disturbances were more frequent in women older than 55 (2:1). The viral cause was the most frequent aethiology (55.3%). Nasal endoscopic exploration was normal in 68.4% patients. The CT scan was the main imaging study used (68.4%). The younger patients recovered better than the older ones. Smell disorders provoked by virus, toxic and medical drugs do have a better (AU)

[Olfaction disturbances in general ORL practice]. / Alteraciones del olfato en la consulta ORL general.

Analysis of smell disturbances in the ENT outpatients department of in a General Hospital. A retrospective and descriptive study. We include all patients with olfactory alterations as the main reason for consultation. The sample was 38 patients. Viral, postraumatic, toxic, drug-induced and inflammatory. We performed anamnesis, nasal endoscopic and scan images on all patients. Olfactory disturbances were more frequent in women older than 55 (2:1). The viral cause was the most frequent aethiology (55.3%). Nasal endoscopic exploration was normal in 68.4% patients. The CT scan was the main imaging study used (68.4%). The younger patients recovered better than the older ones. Smell disorders provoked by virus, toxic and medical drugs do have a better.

[Thromboembolic prophylaxis in patients with head and neck carcinomas: a risk-benefit study]. / Profilaxis tromboembólica en pacientes con carcinomas de cabeza y cuello: un estudio riesgo-beneficio.

Thromboembolism is a risk in major surgical procedures on the head and neck for cancer in predisposed patients. This study was designed to determine if preoperative administration of low-molecular-weight heparin is safe or if it increases the risk of postoperative complications. Preoperative administration of low-molecular-weight heparin was the most important factor in complications such as pharyngo-cutaneous fistula, wound infection, suture dehiscence, or seroma. The second most important factor was surgical technique, and the third factor was neck dissection. Low-molecular-weight heparin did not reduce the risk of thromboembolism. In fact, one patient died suddenly from thromboembolism after surgery.