Evidence map›Paper›PMID 35902904›Full record

ArticleJournal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale2022

Development of a management protocol for internal carotid artery injury during endoscopic surgery: a modified Delphi method and single-center multidisciplinary working group.

Amr F Hamour, Frederick Laliberte, Vikram Padhye, Eric Monteiro, Ronit Agid, John M Lee, Ian J Witterick, Allan D Vescan

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Amr F HamourDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada.ORCID http://orcid.org/0000-0001-9345-4500
Frederick LaliberteDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada.
Vikram PadhyeDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada.
Eric MonteiroDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada.
Ronit AgidDivision of Neuroradiology, Joint Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, ON, Canada.
John M LeeDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada.
Ian J WitterickDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada.
Allan D VescanDepartment of Otolaryngology - Head and Neck Surgery, Temerty Faculty of Medicine, University of Toronto, Mount Sinai Hospital, 600 University Ave, Suite 401, Toronto, ON, M5G 1X5, Canada. allan.vescan@sinaihealth.ca.
Mount Sinai Hospital · CAUniversity Health Network · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntra-operative internal carotid artery (ICA) injury during transnasal endoscopic surgery is a potentially catastrophic event. Such an injury is life-threatening in the immediate setting, with a reported peri-operative mortality rate of 10%. Nasal packing, muscle patches, direct vessel closure, and endovascular techniques have been described as useful strategies for managing ICA bleeds. The objective of this study was to develop a formalized management protocol for intra-operative ICA injury through engagement with a multi-disciplinary panel.

methodsA modified Delphi method including literature review, iterative rounds of stakeholder feedback, and expert panel discussions was used to develop a management protocol for ICA injury during transnasal endoscopic surgery. The 10-person multi-disciplinary panel included otolaryngologists, neurosurgeons, interventional neuroradiologists, anesthesiologists, and operating room nursing staff.

resultsAfter three rounds of stakeholder engagement with the expert panel, consensus was reached on important elements to include within the protocol. The protocol was divided in three categories: Alert, Control, and Transfer. 'Alert' focusses on early communication with anesthesia and nursing staff. 'Control' focusses on techniques to expose the injury and obtain hemostasis or adequate tamponade. Lastly, 'Transfer' describes the process of contacting neuro-interventional radiology and safely transferring the patient. A one-page handout of the protocol was developed for placement in operating theatres.

conclusionDue to the life-threatening nature of ICA injury, it is imperative that endoscopic sinus and skull base surgeons are prepared to manage this complication. Using a modified Delphi method with a multidisciplinary expert panel, a protocol for management of intra-operative ICA injury was developed.

Indexed as

Carotid Artery InjuriesCarotid Artery, InternalDelphi TechniqueEndoscopyHumansSkull BaseComplicationsEndoscopic surgeryEndovascular treatmentRhinologySkull base

Identifiers

PMID35902904
PMCPMC9331087
OpenAlexW4288084307

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.