Complications in otolaryngology-- : head and neck surgery PDF
Preview Complications in otolaryngology-- : head and neck surgery
To our families and friends, who endure our quest to improve our medical and surgical skills on a daily basis, and to all our patients, who we hope will benefit from that quest. Complications in Otolaryngology— Head and Neck Surgery Edited by Manuel Bernal-Sprekelsen, MD, PhD John L. Dornhoffer, MD, FACS Professor Professor and Sam McGill Chair in Otology Research Hospital Clinic University of Arkansas for Medical Sciences Department of Otorhinolaryngology Little Rock, Arkansas, USA University of Barcelona Barcelona, Spain Giorgio Peretti, MD Professor Ricardo L. Carrau, MD, FACS Department of Otorhinolaryngology– Professor Head and Neck Surgery Department of Otolaryngology– University of Brescia Head and Neck Surgery Brescia, Italy The Ohio State University Wexner Medical Center Columbus, Ohio, USA Marc A. Tewfik, MDCM, MSc, FRCSC Assistant Professor Stefan Dazert, MD Department of Otolaryngology, Professor and Chair Head and Neck Surgery Department of Otorhinolaryngology, Royal Victoria Hospital Head and Neck Surgery Montreal, Quebec, Canada Ruhr University Bochum Bochum, Germany Peter-John Wormald, MD Professor Department of Otorhinolaryngology, Head and Neck Surgery Queen Elizabeth Hospital Woodville South, South Australia, Australia With contributions by Hassan Arshad, M. Demir Bajin, José-Luis Blanch, Gabriela P. B. Braga, Roberto Brusati, Miguel Caballero, Rodrigo Cadore Malfado, Giacomo Colletti, Francesca Del Bon, Leo F. S. Ditzel Filho, Richard Douglas, Albert Elmaraghy, Javier Gavilán, Michael B. Gluth, David S. Haynes, Jesús Herranz-González, Heinrich Iro, Arif Janjua, Amin B. Kassam, Karen M. Kost, Danielle de Lara, Andrea F. Lewis, Josep Llach, José Luis Llorente Pendas, Gabriele Materazzi, Paolo Miccoli, Amir Minovi, David A. Moffat, Philippe Monnier, Luc G. T. Morris, Salil B. Nair, Piero Nicolai, Matthew O. Old, Christopher L. Oliver, James P. O’Neill, Bradley A. Otto, Cesare Piazza, Daniel M. Prevedello, Alejandro Rivas, Ashok Rokade, Laura Samarà Piñol, Kishore Sandu, Levent Sennaroğlu, Jatin P. Shah, Ashok R. Shaha, Ralf Siegert, Ryan J. Soose, Carlos Suárez, Holger H. Sudhoff, Theodoros Teknos, Betty S. Tsai, Isabel Vilaseca, Stefan Volkenstein, Ian J. Witterick, Andrew Wood, Johannes Zenk. 361 illustrations Thieme Stuttgart · New York Library of Congress Cataloging-in-Publication Data is avail- Important note: Medicine is an ever-changing science able from the publisher. undergoing continual development. Research and clinical experience are continually expanding our knowledge, in particular our knowledge of proper treatment and drug therapy. Insofar as this book mentions any dosage or application, readers may rest assured that the authors, editors, and publishers have made every effort to ensure that such references are in accordance with the state of knowledge at the time of production of the book. Nevertheless, this does not involve, imply, or express any guarantee or responsibility on the part of the pub- lishers in respect to any dosage instructions and forms of applications stated in the book. Every user is requested to examine carefully the manufacturers’ leaflets accom- panying each drug and to check, if necessary in consul- Illustrator: Dr. Katja Dalkowski, Buckenhof, Germany tation with a physician or specialist, whether the dosage schedules mentioned therein or the contraindications stated by the manufacturers differ from the statements made in the present book. Such examination is particu- larly important with drugs that are either rarely used or have been newly released on the market. Every dosage schedule or every form of application used is entirely at the user’s own risk and responsibility. The authors and publishers request every user to report to the publishers any discrepancies or inaccuracies noticed. If errors in this work are found after publication, errata will be posted at www.thieme.com on the product description page. © 2013 Georg Thieme Verlag KG, Rüdigerstrasse 14, 70469 Stuttgart, Germany http://www.thieme.de Some of the product names, patents, and registered Thieme Medical Publishers, Inc., 333 Seventh Avenue, designs referred to in this book are in fact registered New York, NY 10001, USA trademarks or proprietary names even though specific http://www.thieme.com reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation Cover design: Thieme Publishing Group by the publisher that it is in the public domain. Typesetting by Prepress Projects, Perth, UK Printed in China by Everbest Co. Ltd This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation, ISBN 978-3-13-160531-3 without the publisher’s consent, is illegal and liable to prosecution. This applies in particular to photostat repro- Also available as an e-book: duction, copying, mimeographing, preparation of micro- eISBN 978-3-13-173281-1 films, and electronic data processing and storage. Editors Senior Editor Manuel Bernal-Sprekelsen, MD, PhD Professor Hospital Clinic Department of Otorhinolaryngology University of Barcelona Barcelona, Spain Section I Otology and Lateral Skull Base John L. Dornhoffer, MD, FACS Stefan Dazert, MD Professor and Sam McGill Chair in Otology Research Professor and Chair University of Arkansas for Medical Sciences Department of Otorhinolaryngology, Head and Neck Little Rock, Arkansas, USA Surgery Ruhr University Bochum Bochum, Germany Section II Rhinology and Anterior Skull Base Peter-John Wormald, MD Marc A. Tewfik, MDCM, MSc, FRCSC Professor Assistant Professor Department of Otorhinolaryngology, Head and Neck Department of Otolaryngology, Head and Neck Surgery Surgery Royal Victoria Hospital Queen Elizabeth Hospital Montreal, Quebec, Canada Woodville South, South Australia, Australia Section III Complications of Head and Neck Surgery Giorgio Peretti, MD Ricardo L. Carrau, MD, FACS Professor Professor Department of Otorhinolaryngology–Head and Neck Department of Otolaryngology–Head and Neck Surgery Surgery The Ohio State University Wexner Medical Center University of Brescia Columbus, Ohio, USA Brescia, Italy Contributors Hassan Arshad, MD Rodrigo Cadore Malfado, MD Richard Douglas, MD, FRACS, FRACP, Assistant Professor Research Fellow MRCP Department of Head and Neck Department of Neurosurgery Department of Surgery Surgery/Plastic and Reconstructive The Ohio State University Wexner University of Auckland Surgery Medical Center Auckland, New Zealand Roswell Park Cancer Institute Columbus, Ohio, USA Buffalo, New York, USA Albert Elmaraghy, MD, FAAP Ricardo L. Carrau, MD, FACS Department of Pediatric M. Demir Bajin, MD Professor Otolaryngology Assistant Professor Department of Otolaryngology– Nationwide Children’s Hospital Department of Otolaryngology Head and Neck Surgery The Ohio State University Wexner Hacettepe University Faculty of The Ohio State University Wexner Medical Center Medicine Medical Center Columbus, Ohio, USA Ankara, Turkey Columbus, Ohio, USA Javier Gavilán, MD Manuel Bernal-Sprekelsen, MD, PhD Giacomo Colletti, MD Professor and Chairman Professor Department of Maxillo-Facial Department of Otolaryngology Hospital Clinic Surgery La Paz University Hospital Department of Otorhinolaryngology University of Milan Madrid, Spain University of Barcelona San Paolo Hospital Barcelona, Spain Milan, Italy Michael B. Gluth, MD Director José-Luis Blanch, MD, PhD Stefan Dazert, MD Comprehensive Listening Center Hospital Clinic Professor and Chair Division of Otolaryngology– Section of Oncologic ENT Surgery Department of Otorhinolaryngology, Head and Neck Surgery Barcelona, Spain Head and Neck Surgery University of Chicago Ruhr University Bochum Chicago, Illinois, USA Gabriela P. B. Braga, MD Bochum, Germany Assistant Professor David S. Haynes, MD, FACS Otology Neurotology Francesca Del Bon, MD Professor of Otolaryngology, Santa Casa de Misericórdia do Rio de Department of Neurosurgery, and Hearing and Janeiro Otorhinolaryngology–Head and Speech Sciences II Enfermaria de Neck Surgery Neurotology Division/Fellowship Otorrinolaringologia University of Brescia Program/Cochlear Implant Program Rio de Janeiro, Brazil Brescia, Italy Director Vanderbilt University Medical Roberto Brusati, MD Leo F. S. Ditzel Filho, MD Center Professor Clinical Fellow Nashville, Tennessee, USA Department of Maxillo-Facial Department of Neurosurgery Surgery The Ohio State University Wexner Jesús Herranz-González, MD, PhD University of Milan Medical Center Complexo Hospitalario Universitario San Paolo Hospital Columbus, Ohio, USA A Coruña Milan, Italy Department of Otorhinolaryngology John L. Dornhoffer, MD, FACS University of Santiago de Miguel Caballero, MD, PhD Professor and Sam McGill Chair in Compostela Hospital Clinic Otology Research Santiago de Compostela, Spain Department of Otorhinolaryngology University of Arkansas for Medical University of Barcelona Sciences Barcelona, Spain Little Rock, Arkansas, USA V Contributors Heinrich Iro, MD, PhD José Luis Llorente Pendas Piero Nicolai, MD Professor and Medical Director Department of Otorhinolaryngology Professor and Chairman Hospital Clinic Hospital Universitario Central de Department of Department of Asturias Otorhinolaryngology–Head and Otorhinolaryngology–Head and University of Oviedo Neck Surgery Neck Surgery Oviedo, Spain University of Brescia Friedrich-Alexander University Brescia, Italy Hospital Erlangen-Nuremberg Gabriele Materazzi, MD Erlangen, Germany Department of Surgery Matthew O. Old, MD University of Pisa Assistant Professor Arif Janjua, MD, FRCSC Pisa, Italy Department of Otolaryngology– Endoscopic Sinus and Skull Base Head and Neck Surgery Surgery Paolo Miccoli, MD The Ohio State University Wexner Vancouver General Hospital and Department of Surgical Pathology Medical Center St. Paul’s Hospital University of Pisa Columbus, Ohio, USA Division of Otolaryngology– Pisa, Italy Head and Neck Surgery Christopher L. Oliver, MD University of British Columbia Amir Minovi, MD, PhD, MHA Otolaryngology, Head and Neck Vancouver, British Columbia, Canada Department of Otorhinolaryngology, Surgery Head and Neck Surgery Colorado Head and Neck Specialists Amin B. Kassam, MD Ruhr University Bochum Centura Health Professor and Chair Bochum, Germany Denver, Colorado, USA Department of Neurosurgery University of Ottawa David A. Moffat, BSc (Hons), MA James P. O’Neill, MB, MRCSI, MD, Ottawa, Ontario, Canada (Hon Cantab), MB BS, PhD, FRCS MBA, MMSc Hunterian Professor of Surgery Otolaryngology, Head and Neck Karen M. Kost, MD, FRCSC University of Cambridge Surgery Associate Professor Consultant in Neuro-Otology and The Royal College of Surgeons in Department of Otolaryngology, Skull Base Surgery Ireland Head and Neck Surgery Addenbrooke’s Cambridge Dublin, Ireland Montreal General Hospital University Teaching Hospital Montreal, Quebec, Canada Cambridge, UK Bradley A. Otto, MD Assistant Professor Danielle de Lara, MD Philippe Monnier, MD Department of Otolaryngology– Research Fellow Department of Otorhinolaryngology Head and Neck Surgery Department of Neurosurgery –Head and Neck Surgery The Ohio State University Wexner The Ohio State University Wexner Centre Hospitalier Universitaire Medical Center Medical Center Vaudois – CHUV Columbus, Ohio, USA Columbus, Ohio, USA Lausanne, Switzerland Giorgio Peretti, MD Andrea F. Lewis, MD Luc G. T. Morris, MD Professor Assistant Professor Head and Neck Service Department of Department of Otolaryngology and Department of Surgery Otorhinolaryngology–Head and Communicative Sciences Memorial Sloan–Kettering Cancer Neck Surgery University of Mississippi Medical Center University of Brescia Center New York, New York, USA Brescia, Italy Jackson, Mississippi, USA Salil B. Nair, MD, FRCS (ORL-HNS) Cesare Piazza, MD Josep Llach, MD, PhD Consultant Rhinologist Spedali Civili of Brescia Hospital Clinic Department of Otorhinolaryngology Department of Endoscopic Unit IMDiM Auckland City Hospitals Otorhinolaryngology–Head and University of Barcelona Auckland, New Zealand Neck Surgery Barcelona, Spain University of Brescia Brescia, Italy VI Contributors Daniel M. Prevedello, MD Ashok R. Shaha, MD, FACS Betty S. Tsai, MD Associate Professor Professor of Surgery Assistant Professor Department of Neurosurgery Memorial Sloan–Kettering Cancer Department of Otorhinolaryngology The Ohio State University Wexner Center The University of Oklahoma Health Medical Center New York, New York, USA Sciences Center Columbus, Ohio, USA Oklahoma City, Oklahoma, USA Ralf Siegert, MD Alejandro Rivas, MD Professor and Director Isabel Vilaseca, MD, PhD Assistant Professor Department of Otorhinolaryngology, Hospital Clinic Department of Otology and Head and Neck Surgery Department of Otorhinolaryngology Neurotology Prosper Hospital University of Barcelona Vanderbilt University Medical Academic Teaching Hospital, Barcelona, Spain Center Ruhr University Bochum Nashville, Tennessee, USA Recklinghausen, Germany Stefan Volkenstein, MD Department of Otorhinolaryngology, Ashok Rokade, MD, FRCS (ORL-HNS) Ryan J. Soose, MD Head and Neck Surgery Rhinology Fellow Director Ruhr University Bochum Royal Hampshire County Hospital Division of Sleep Surgery Bochum, Germany Winchester, UK Assistant Professor Department of Otolaryngology Ian J. Witterick, MD, MSc, FRCSC Laura Samarà Piñol, MD University of Pittsburgh School of Professor and Chair Hospital Clinic Medicine Department of Otolaryngology– Department of Otorhinolaryngology Pittsburgh, Pennsylvania, USA Head and Neck Surgery University of Barcelona University of Toronto Barcelona, Spain Carlos Suárez, MD, PhD Toronto, Ontario, Canada Department of Otorhinolaryngology Kishore Sandu, MD Hospital Universitario Central de Andrew Wood, BA, BM BCh Head of Department Asturias; Department of Surgery Otorhinolaryngology, Head and Instituto Universitario de Oncología The University of Auckland Neck Surgery del Principado de Asturias Auckland, New Zealand Valais State Hospital – Centre University of Oviedo Hospitalier du Centre du Valais Oviedo, Spain Peter-John Wormald, MD Romand – CHCVR Professor Sion and Holger H. Sudhoff, MD, PhD, FRCS, Department of Otorhinolaryngology, Centre Hospitalier Universitaire FRCPath Head and Neck Surgery Vaudois – CHUV Klinikum Bielefeld Queen Elizabeth Hospital Lausanne, Switzerland Department of Otorhinolaryngology, Woodville South, South Australia, Head and Neck Surgery Australia Levent Sennaroğlu, MD Bielefeld, Germany Professor Johannes Zenk, MD, PhD Department of Otolaryngology Theodoros Teknos, MD Professor and Deputy Medical Hacettepe University Faculty of Professor and Vice-Chairman Director Medicine Division of Head and Neck Oncologic Hospital Clinic Ankara, Turkey Surgery Department of Department of Otolaryngology– Otorhinolaryngology–Head and Jatin P. Shah, MD, PhD (Hon), FACS, Head and Neck Surgery Neck Surgery FRCS (Hon), FDSRCS (Hon), FRACS The Ohio State University Wexner Freidrich-Alexander University (Hon) Medical Center Hospital Erlangen-Nuremberg Chief Columbus, Ohio, USA Erlangen, Germany Head and Neck Service Department of Surgery Marc A. Tewfik, MDCM, MSc, FRCSC Memorial Sloan–Kettering Cancer Assistant Professor Center Department of Otolaryngology, New York, New York, USA Head and Neck Surgery Royal Victoria Hospital Montreal, Quebec, Canada VII Foreword I Having finished my residency training and military ser- technique in the operating room, the reality was that this vice, I did a fellowship with Dr. John Conley, the world’s was a multifactorial problem. preeminent head and neck surgeon in 1967. I had very I soon came to realize that the prevention of complica- little training in head and neck surgery during my resi- tions begins the first time the patient is seen in the office. dency, and this year was meant to be a “remedial” year For instance, although it was easy to identify the patients for me so that I could be well rounded in all aspects of who were malnourished, we never again gave much our specialty and could become a member of an academic thought to nourishment being a big factor in healing. faculty. However, I soon realized its importance and we began Dr. Conley’s practice was complex in many ways. It to improve the patients nourishment prior to treatment. was a private practice populated by surgical oncologists We knew that smoking was a biohazard in that it caused from Memorial Sloan–Kettering Hospital, except for Dr. cancer, but we did not think so much about the effect on Conley, an otolaryngologist. Our outpatient office was small vessels and the negative impact on healing. quite a distance from St. Vincent’s Hospital, which is After going through the analytical process, I organized where the surgery took place. Some of the complex cases many new ways of preventing complications, many of that Dr. Conley saw were with far-advanced neglected which admittedly had to do with surgical technique. After cancers, many of which had already been treated with a few months our life was made easier by the introduc- surgery and radiation. Those were the days prior to che- tion of the deltopectoral flap by Dr. Bakamjian, which motherapy so we did not have to worry about that aspect. allowed us the luxury of immediate reconstruction of This was before the intensive care unit was invented and these wounds whereas previously we had made oropha- before nondelayed pedicle flaps had been introduced. ryngostomas to allow the neck to heal before closing the The surgeon assumes fundamental responsibility for wound. all factors that might influence the success of his or her The realization that most complications are prevent- craft and so, in general, complications were accepted as able is the concept that I carried throughout my entire part of head and neck surgery at that time. Most of the 40-year surgical career. While it is not possible to go wound breakdowns and the fistulas we had to contend through such an extended period of time with no com- with, particularly in the patients who had been radiated, plications, I must say that we ended up with the bare were blamed on the patient as having “poor protoplasm.” minimum. I had the opportunity to train more than 150 I assisted on these cases and watched Dr. Conley and, residents and countless fellows in head and neck surgery later in the fellowship, I did the cases with Dr. Conley’s in how to prevent complications rather than having to assistance. I found myself spending more and more time treat them. in the hospital packing the wounds, taking care of the I congratulate Professor Manuel Bernal-Sprekelsen and complications and making sure that the patients medical the remarkable group of experts that he has recruited problems, as well as their surgical complications, were into the writing and editing of this comprehensive book. I looked after. am impressed with their courage in undertaking the pro- I had the primary responsibility for the patients post- digious task of covering complications across the many operative care. In an effort to improve the lot of these subspecialty areas of our field. Although the main feature unfortunate patients and a bit in self defense motivated of this book will be diagnosis and management of compli- by the desire to see my family, I undertook an indepth cations, I am sure that there will be an emphasis on Ben- study of complications. jamin Franklin’s observation that “an ounce of prevention I became quite analytical about these problems and I is worth a pound of cure.” found this experience to be a provocative and educational I wish the editors and authors the best of success for process. I spent long hours analyzing each case to see this very important contribution to the literature in head how we could have done better and soon realized that, and neck surgery. although the complications had been blamed on errors in Eugene N. Myers VIII
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