Anesthesia for Ears, Nose, and Throat Surgery
Otorhinolaryngologic procedures are among the most common surgeries performed in children worldwide. Technological advances have enabled the evolution of minimally invasive surgical techniques with an associated reduction in patient discomfort and expedited postoperative recovery. Nevertheless, these surgeries should not be considered trivial. They may involve a shared, partially obstructed or soiled airway, and include surgeries that have among the highest incidence of postoperative nausea, emesis, and emergence delirium. While the most otorhinolaryngologic procedures have a common surgical goal, there exists much inter-institutional variation in the preferred surgical technique and the anesthetic strategy used to accomplish the procedural objective. Here we will present a range of head and neck surgical topics for consideration from the perspective of a pediatric anesthesiologist. We emphasize that as is often the case in anesthesiology, some of the solutions may work well in a specific clinical context dependent on surgeon, institutional resources and culture, but may not transpose universally to all contexts.
KeywordsOtorhinolaryngology Tonsillectomy Obstructive sleep apnea Lasers Cochlear implant Nasal surgeries Laryngeal clefts Supraglottoplasty Bronchoscopy Epiglottitis
Conflict of Interest: None.
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