Otolaryngology Consultation Research Articles

Isolated fungal sphenoid sinusitis with unilateral lateral rectus palsy six years post lung transplant

Rhino-orbital-cerebral mucormycosis (ROCM) infections are rare and usually occur in patients with diabetes, malignancy, or organ transplantation. The most common presenting symptoms include facial pain and swelling, fever, and rhinorrhea. Mortality rates reach nearly 50%. Those with previous organ transplants typically present with sinus symptoms a few weeks to months after transplantation. A 75-year-old man presented with headache. His history was significant for bilateral lung transplantation in 2017. On his fourth presentation, he was admitted to the hospital for work up. Imaging showed small fluid levels within the right maxillary and sphenoid sinuses. Infectious work-up revealed no meningitis. On day three, the patient complained of diplopia on the right. His examination was significant for right lateral rectus palsy. Repeat imaging was performed and showed increasing fluid levels of the right maxillary and sphenoid sinuses, and the otolaryngology consultation service was consulted. Nasal endoscopy was significant for pink, vascularised mucosa with no obvious regions of pallor or necrosis. Endoscopic sinus surgery was performed. There were no findings suggestive of fungus but purulence of the right sphenoid grew Rhizopus. The patient’s nerve palsy did not resolve and progressed to the contralateral orbit. Repeat nasal endoscopy continued to show healthy mucosa while MRI showed enhancement worrisome for meningitis. To our knowledge, this is the only reported case of fungal sphenoid sinusitis resulting in meningitis and death six years after transplant. Current literature documents fungal infection in post-transplant patients up to four years after surgery, with most occurring within the first year. Suspicion for fungal infection should remain high in this patient population. Keywords: mucormycosis, lung transplant, sinusitis, lateral rectus palsy

An International Survey of the Diagnosis and Management of Ménière's Disease Amongst Otolaryngology Consultants.

Ménière's Disease (MD) is a disease that may be difficult to diagnose and manage. Our UK survey showed variability in the practice of UK Otolaryngology consultants. We hence surveyed Otolaryngology consultants internationally, to assess their confidence levels in diagnosing MD, their use of the AAO-HNS guidelines and current diagnostic and treatment modalities. An online questionnaire was distributed internationally over four weeks. The questionnaire asked respondents to anonymously rank their confidence in diagnosing MD, identify the minimum investigations required to make a diagnosis, describe their use of the AAO-HNS criteria, share their preferred treatment modalities for acute attacks, and state their 1st and 2nd-line preventative treatment options. A total of 173 responses were collected with 77% of respondents reporting high levels of confidence in diagnosing MD. Most respondents stated the minimum tests required were "History, Otoscopy, Clinical Vestibular testing, and Pure Tone Audiometry" although some chose as few as 1 test. Regarding the use of the AAO-HNS criteria, responses ranged from "always" (20.2%) to "never" (22.5%). Cinnarizine was the first-line treatment for acute attacks followed by betahistine. Betahistine (30.1%) and dietary restrictions (28.3%) were recommended almost equally as first-line preventative measures. The most popular second-line measure was intratympanic steroids injection (30.1%). Our survey revealed disparities in the diagnosis of MD and its management, like the results of our previously conducted UK survey. This suggests the need for an international consensus regarding the diagnosis and subsequent management strategies for this disease.

Video Otoscopy as a Novel Teaching and Remote Otolaryngology Consultation Tool at an Academic Medical Center.

Assess the use of video otoscopy (VO) as a tool for teaching Emergency Department (ED) residents and remote Otolaryngology consultation. Survey and retrospective chart review. Tertiary care center. Emergency Medicine resident physicians completed an otologic skill self-assessment and pathology followed by an interactive training on VO and postintervention assessment after 9 months of use. Outcomes compared change in pre- to posttraining scores. ED consultations using VO during this time period were reviewed to detect differences between the presumed diagnosis/treatment based only on phone consultation and VO image compared to the final diagnosis/treatment after in-person Otolaryngology consultation. Forty-six (63.1%) ED residents participated. Diagnostic accuracy improved by 20.7% overall. The most improved diagnoses were of a normal ear canal (+75%), tympanosclerosis (+58.4%), and ear canal foreign body (+57.1%); most challenging were external auditory canal cyst (-13.6%), hemotympanum (-11.3%), and cerumen (-1.9%). Cholesteatoma did not improve because all responses were incorrect; neither did tympanic membrane perforation because all were correct. Confidence in the otologic exam and anatomy also increased (P < .01). Thirteen consults used VO and 3 (23.1%) had a change in diagnosis/treatment after in-person Otolaryngology evaluation. Training on the use of VO significantly improves the confidence and diagnostic skills of ED providers for many pathologies. This application suggests the efficacy of an otologic e-consultation model.

Rigid bronchoscopy: a consultant survey.

Inhalation of foreign bodies represents a potentially fatal emergency in both adults and children. Chest x-ray, in isolation, is neither sensitive nor specific. Rigid bronchoscopy represents the gold standard to diagnose and retrieve paediatric foreign bodies. Cases are encountered infrequently, creating anxieties about their management. Little is known about the confidence in, and maintenance of, rigid bronchoscopy skills by ear, nose and throat teams. A 15-question survey was completed by 50 practising otolaryngology consultants in England. Results show that almost 40% of otolaryngology consultants covering rigid bronchoscopy have not performed bronchoscopy in more than 5 years. Consultants raised concerns about the anaesthetic support and the speed of equipment assembly. Questions on clinical practice showed disparities in practice in the same scenario. The authors advocate addressing many of the issues raised by the study with a greater availability of simulation courses and regular scheduled intradepartmental teaching days for all professionals involved. National guidelines on criteria for transfer to tertiary centres would improve the consistency of practice.

Periodontitis associated with risk of obstructive sleep apnea in Peruvian adult patients: A cross-sectional study.

Patients at high risk for obstructive sleep apnea (OSA) are characterized by intermittent transient hypoxias and upper respiratory tract collapse, with reactive oxygen production and oxidative imbalance which causes an inflammatory cascade. This can generate negative effects on the periodontium, causing severe tooth attachment loss. This study aimed to determine the association between periodontitis and the risk of OSA in adults who attend outpatient otolaryngology consultations. A cross-sectional observational study was carried out with 118 patients seen in the otolaryngology service of the Hospital Victor Lazarte Echegaray-ESSALUD in Trujillo (Peru), between September and October 2023. The presence and severity of periodontitis were determined using the Page and Eke criteria, and the presence and severity of OSA risk were determined using the STOP-BANG questionnaire. The results were analyzed using Chi-square, Spearman correlation and logistic regression tests, considering a significance level of p<0.05. An association was found between periodontitis and risk of OSA (p=0.000), obtaining a positive relationship with rs=0.527. In addition, there was an association between periodontitis and DM2 (p=0.028) and bronchial asthma (0.017). No association was found between periodontitis and sex (0.503) or age (0.741). There is an association between periodontitis and the risk of OSA in Peruvian adult patients who attended outpatient otolaryngology consultations. This association was also found according to age, sex, smoking, DM2 and asthma. In addition, an association was found between periodontitis and DM2 and asthma, but not with sex and age.

Treatment, Management, and Otolaryngology Consultation for Epistaxis in the Emergency Room: An Institutional Experience.

Epistaxis is a common reason for emergency department (ED) visits, accounting for approximately 1 of every 200 ED visits in the United States annually and up to one-third of all otolaryngology (ENT)-related ED encounters. To detail reasons for ENT consultation for epistaxis in the ED, understand how consultation impacts patient care, assess follow-up patterns after emergency care, and study patient care after transfer or referral into the ED. Retrospective chart review of 592 adult patients with epistaxis managed in a tertiary care ED setting between 2017 and 2018. Patients with known follow-up, ENT consult in the ED, or admission were included, while patients with trauma, recent head and neck surgery, or abnormal anatomy were excluded. The most common reasons for ENT consultation for epistaxis were for advanced management, referral to the ED from an outside facility or provider, and recent head and neck surgery. In total, 48.2% of patients treated for epistaxis in the ED received an ENT consultation. ENT consultation was associated with a higher likelihood of receiving absorbable or nonabsorbable packing (92.4% vs 36.1%). In total, 40.4% of patients referred into the ED from an outside facility or provider had no change in their management after receiving an ENT consult. Patients referred to the ED and White patients were significantly more likely to receive an ENT consult. Secondary analyses revealed that more White patients had an established outpatient ENT provider than patients of other races. On multivariate analysis, patients who received an ENT consult spent 75.2 min longer in the ED. The high percentage of patients referred or transferred to the ED for epistaxis management with no change in interventions after ENT consultation indicates a continued need to develop more precise clinical care pathways. Additionally, there may be gaps between White and non-White patients in access to ENT care.

Wpływ pandemii COVID-19 na diagnostykę pacjentów z rakiem krtani

IntroductionPatients’ access to public healthcare has been limited during the COVID-19 pandemic. The psychological factor – the fear of patients and medical staff of infection, especially before the introduction of vaccinations – had also a negative impact on the diagnostic and therapeutic procedures.AimThe aim of the study was to assess the impact of the COVID-19 pandemic on the degree of advancement of laryngeal cancer in patients referring for diagnosis and treatment to a IV-level clinical referral hospital.Material and methodsThe medical documentation of patients presenting to IVth level reference clinical hospital was retrospectively analyzed in pre-, during and post-pandemic period of time. The total number of patients presenting to the emergency department (ED), inclusive of those receiving otolaryngological consultation, patients diagnosed with laryngeal cancer and advancement stage of disease was assessed. Additionally the comprehensive count of diagnostic and therapeutic procedures pertaining to the larynx and trachea, during the three above mentioned periods of time was performed.Results and discussionThe study revealed a significant decrease in the number of patients presenting to the ED during the pandemic, with a more pronounced drop among otolaryngological patients. The number of patients with laryngeal tumor treated in our hospital as well as the number of laryngeal diagnostic and therapeutic procedures remained stable throughout analysed periods of time. During pandemic period significant drop of patients with early-stage (T1) laryngeal cancers was observed.ConclusionsDespite maintained surgical activity in level IV reference hospital, fewer patients with early stage of laryngeal cancer (T1) were diagnosed and treated during pandemic.

Gun shot injuries to the temporal bone: Anatomic predictors of mortality

PurposeTo explore anatomic predictors of mortality from gunshot wounds involving the temporal bone. MethodsA retrospective search of radiology reports was performed for all patients with CT reports suggestive of gunshot wounds (GSW) to the TB (2000–2020). All cases were reviewed by the senior author to confirm injury to the temporal bone. Detailed demographic and radiographic data were collected. Main findingsA total of 120 patients met inclusion criteria. The majority of patients were male (n = 101) and the average age was 32.9. The squamosa was the most commonly involved subsite (n = 90), followed by the mastoid (n = 43). Squamosal entry site had the highest associated mortality (89.7 %). For those with known disposition, 65.8 % (79 of 120) expired on the same hospital admission. Inpatient otolaryngology consultation was noted in 18.3 % (n = 22) of patients, with poor outpatient follow-up. ConclusionsThis series represents the largest survey of GSW to the temporal bone to date. Although associated mortality is high and outpatient follow-up poor, otolaryngologists should be aware of associated morbidities to facilitate both inpatient and subsequent outpatient management.

The Use of Point of Care Ultrasound in Diagnosis of Peritonsillar Abscess

The use of point of care ultrasound (POCUS) for diagnosis and treatment of peritonsillar abscess (PTA) is increasing [1]. Proven advantages include improved diagnostic accuracy and treatment success rates as well as decreased otolaryngology consultation, computed tomography (CT) usage, return visits to the emergency department (ED), and length of stay [1]. We present a case of a patient with a PTA that was diagnosed and successfully treated utilizing POCUS, avoiding the need for otolaryngology consultation and CT.

Metagenomic insights into microbial contamination in critical healthcare environments and the efficacy of a novel "HLE" disinfectant.

Bacterial contamination on inanimate clinical surfaces is directly linked to severe health problems, especially those caused by multidrug resistant (MDR) pathogens. Here, we evaluated the microbial burden in these environments and tested the efficacy of a novel HLE disinfectant solution. Microbial contamination of healthcare surfaces [Intensive Care Unit (ICU), Long Period Hospitalization Room (LPHR) and Otolaryngology Consultation (OC)] and the efficacy of HLE disinfectant solution were determined analyzing the viable counts on general and selective media, and also by molecular studies focused on metagenomic and specific qPCR. Different contamination loads were detected with LPHR showing the highest contamination. Treatment with the HLE disinfectant solution curbed the spread of well-adapted pathogens on touched surfaces (ICU, LPHR and OC). Metagenomic analysis of microbial diversity of the Patient Table (most contaminated surface in LPHR) revealed the presence of mainly A. johnsonii and P. putida. Furthermore, functional annotation of toxin, virulence and antibiotic resistance sequences showed a high diversity of Acinetobacter spp. and Pseudomonas spp. In this context, specific qPCR analysis confirmed the efficacy of HLE disinfectant solution against the most prevalent and critical pathogens Pseudomonas sp. and Acinetobacter sp. achieving their complete eradication. Given the persistence of detrimental resistant pathogens, the application of HLE disinfection solution could be a highly beneficial and effective option -used either alone or in combination-for infection prevention and control with the aim to eliminate microbial pathogens and their genes from contaminated contact-surfaces and thus limit the spread to humans and other ecological niches.

Promoting interprofessional education in surgery: development and evaluation of a clinical curriculum

PurposeInterprofessional collaboration is essential in surgery, but health professions students have limited opportunities for interprofessional education (IPE) during training in authentic patient-care settings. This report describes the development and evaluation of a clinical interprofessional elective in otolaryngology for medical (MD) and nurse practitioner (NP) students.MethodsMD and NP students were paired together on an inpatient otolaryngology consult service for one- or two-week rotations designed to promote interprofessional learning objectives. Students worked with different professions essential to the care of patients with voice, airway, and swallowing conditions, including surgeons, advanced practice providers, speech-language pathologists, nurses, and respiratory therapists. Students completed written daily reflections about their experiences and pre- and post-rotation surveys to assess comfort with course learning objectives. Paired t-tests and Cohen’s d effect sizes were used to compare pre/post responses, and thematic analysis was used to analyze all narrative data.ResultsFourteen students (8 MD, 6 NP) students completed the rotation. All participants reported significant improvements on all learning objectives (p < 0.05) with large effect sizes (Cohen’s d range: 1.2–2.9), including their understanding of the responsibilities of each interprofessional team member. Participants described three overarching themes that characterized their learning experiences and supported the learning objectives: appreciation for interprofessional patient care, benefits of learning with an interprofessional peer, and clinician role modeling of effective interprofessional communication.ConclusionsIPE can be successfully integrated into a clinical surgical rotation and enhance students’ understanding of the benefits of and strategies for effective interprofessional collaboration. The elective can serve as a model for IPE rotations in other surgical subspecialties and be extended to include students across the continuum of health professions education.

The Effects of COVID-19 Surges on Otolaryngology Consults.

Objectives We aimed to evaluate the effects COVID-19 surges had on an otolaryngology service'sconsultation data. Methods After obtaining Upstate University Hospital institutional review board exemption to perform this research, a retrospective review analyzing otolaryngology consults at a single institution during COVID-19 surges in the years 2020 to 2021 was performed. The total consult volume and emergency department, inpatient, pediatric, adult, weekday, night, and weekend consults were assessed.Statistical analysis was used to compare these findings to the otolaryngology consult volumes and characteristics during the same time frames as the COVID-19 surges in the years 2014 to 2019. Results Based on bivariate analysis, an upward trend in otolaryngology consult volume was found over the study period.Although there was not a significant difference in consult volume during COVID-19 surges compared to historical data (p = 0.718, p = 0.695), both surge periods had significantly lower proportions of emergency department and pediatric consults (p < 0.001 for both). Conclusion Our study demonstrated that despite increasing cases of COVID-19 infection, otolaryngology consult volume remained high during surges. It was found that there has been an increase in otolaryngology consult volume at our academic center from the year 2014 to the present, a finding that was also seen in previous studies from our institution. Interestingly, consult parameters that changed when compared to the historical data included a decreased percentage of emergency department and pediatric consults during COVID-19 surges. The summation of these findings can be used to provide insight into how hospitals and otolaryngology services can prepare for the anticipated fluctuations in COVID-19 cases and associated hospitalizations.

Upper airway and tracheostomy management in patients with COVID-19: A long-term acute care hospital (LTACH)

ObjectiveDescribe the tracheostomy and ventilation management of patients admitted due to COVID-19 as facilitated by speech language pathologists (SLPs) and otolaryngologists within the long-term acute care hospital (LTACH) setting. Study designRetrospective cohort study. SettingLong-term acute care hospital. Subjects and methodsA retrospective chart review was conducted on all patients admitted to RML Specialty Hospital for respiratory failure secondary to COVID-19 from April 1, 2020 to November 30, 2021. Demographic information, laryngeal findings, and tracheostomy management was reviewed. Descriptive statistics and chi-square analysis were performed. ResultsAmongst the 213 subjects, 80.0 % arrived on mechanical ventilation. 23.0 % required otolaryngology consultation during LTACH stay due to poor Passy Muir Valve (PMV) or tracheostomy capping tolerance. 35 (71.4 %) of those consulted had abnormal laryngeal findings on exam with subglottic/tracheal stenosis and laryngeal edema being most common at 38.8 % and 20.4 %, respectively. 28.6 % of those with laryngeal findings were decannulated by discharge. Mechanical ventilator weaning and decannulation success were 86.6 % and 62.5 %, respectively. No association (p > 0.05) between number of intubations and abnormal laryngeal findings were found. No association (p > 0.05) between number of intubations or prone-positioning and decannulation success at discharge were found. ConclusionLTACHs can serve a specific role in upper airway rehabilitation and tracheostomy care in the post COVID-19 period. SLPs and otolaryngologists should be involved in the care of these patients to help facilitate decannulation and return to normal laryngeal function.

Otolaryngology consultations requested by palliative care services: a five-year analysis

Introduction: Otolaryngologists are required to possess the knowledge, skills, and confidence necessary to manage consultations requested by palliative care services. However, the inclusion of palliative care needs in otolaryngology residency training is limited. The goal of this study was to enhance awareness of otolaryngologists' palliative care knowledge and skills by evaluating otolaryngology consultations requested by tertiary palliative care services between 2016 and 2021. Methods: This retrospective cross-sectional study included patients who consulted the otolaryngology department from the palliative care service of Kutahya Health Sciences University between January 1, 2016 and September 31, 2021. A total of 80 otolaryngology consultations were requested between 2016 and 2021. Patients were evaluated for age, gender, diagnosis of palliative admission, reason for consultation, date of consultation, interventions, and additional investigations. Results: There were 27 female patients (33.7%) and 53 male patients (66.2%). The mean age was 65.0 (range: 22-97) years. It was found that the volume of consultations did not increase significantly over a five-year period (p=0.502) and 78.8 % of consultations were requested during working hours (08:00-16:00). In addition, the response time (minutes) for consultations during working hours (08:00-16:00) was significantly lower than outside working hours (16:01-07:59) (p&amp;lt;0.001). The reasons for requesting a consultation and the procedures performed were significantly different between patients under and over 65 years of age (p=0.019 and p=0.008, respectively). Conclusions: This is the first study to evaluate otolaryngology consultations requested by a tertiary palliative care service. Awareness of these consultations may provide guidance for the assessment and management of patients in palliative care services. Keywords: consultation, otolaryngology, tracheotomy, palliative care

Intratympanic Steroid Use for Sudden Sensorineural Hearing Loss: Current Otolaryngology Practice in the Kingdom of Saudi Arabia

Abstract Objectives: Sudden sensorineural hearing loss (SSNHL) is commonly defined as a hearing loss of more than 30 decibels in three consecutive frequencies that occurs within 72 h. In most cases, it is considered idiopathic, and an evidence-based strategy to treat it is still debated. We aim to analyze the current practice of intratympanic steroid injection (ITSI) for SSNHL in the Kingdom of Saudi Arabia (KSA) and compare it to the published data from the United Kingdom (UK), the United States (US), and continental Europe. Methodology: A survey of 28 questions was distributed among Otolaryngology Consultants and Specialists of KSA. It includes questions about demographics, indications for IT treatment, procedure, follow-up, and outcomes. Results: We received 75 responses. Around 66% of them indicated that they use ITSI to treat idiopathic SSNHL (ISSNHL). Forty-six percent (n = 23) did not use ITSI as a primary therapy. Forty percent (n = 20) used it in combination with other treatments, including oral steroids, and 14% (n = 7) used it as a primary monotherapy. The majority (36%, n = 18) considered using ITSI for up to 1 month. The commonly used course of treatment for our ear, nose, and throat (ENT) doctors was three injections (50% n = 25), with a weekly dose being the most frequent interval (42% n = 21). Conclusion: This study showed wide variability in practice among Saudi ENT clinicians. This variation has been found across countries, in the UK, US, and continental Europe, which tells us that this is a global issue and there is not yet one unified protocol to be followed in the treatment of ISSNHL.

Allergic rhinitis facts from an Irish pediatric population.

Assessing the main allergens in the pediatric population from the largest urban area in the country. Clinical letters of patients referred with possible allergic rhinitis (AR) were retrospectively reviewed over the past 5 years. Five hundred and fifty-five patients were included. Males suffer twice as often with AR than females and have high titers of allergens. House dust mites (44.7%) and grass pollen (29%) were the main allergens in our area, with 48% of patients sensitized to both allergens. Half of the patients had the diagnosis of AR confirmed with positive allergen-specific tests. For the other half, the diagnosis was based on a clinical assessment performed by a pediatric otolaryngologist. Half of suspected AR children have environmental allergen sensitivity confirmed by testing, and a large number had a clinical diagnosis of AR after an otolaryngology consultation. Our findings can help clinicians to initiate AR treatment considering the most problematic allergens in the area.

Inpatient Otolaryngology Consultations and COVID-19: The Surge and Lasting Effects at an Urban, Academic Institution.

Objective: This study aims to examine the lasting effects of the coronavirus disease 2019 (COVID-19) pandemic on inpatient otolaryngology consultations. Methods: In a retrospective analysis, inpatient otolaryngology consultations at an urban, academic tertiary care center were reviewed over the course of 2 years (Jun 2019-Jun 2021). The consultations were categorized by time period based on the local data for COVID-19 hospitalizations and deaths as follows: pre-COVID (Jun 2019-Feb 2020), Surge 1 (Mar 2020-May 2020), Surge 2 (Oct 2020-Jan 2021), and Post Surge (Mar 2021-Jun 2021). Results: A total of 897 patients undergoing an inpatient otolaryngology consultation across all 4 time periods were included for analysis. The average consultations per day was 1.67 ± 0.24 in pre-COVID times, and dropped acutely to 0.86 ± 0.33 consultations per day during Surge 1. The consultation volume was not statistically different from pre-COVID levels during Surge 2 (1.33 ± 0.35) and Post Surge (1.60 ± 0.20). Reason for consultation and procedures performed did not vary significantly between pre-COVID times and Post Surge, except that consultation for postoperative complaint was less frequent in Post Surge (4.8% vs 1.0%, P = .02). More patients had been screened with rapid antigen COVID testing in Post Surge versus Surge 1 (20.1% vs 7.6%, P = .04). Conclusions: Inpatient otolaryngology consultation volumes, indications, and procedures performed at an urban, academic institution returned to pre-COVID levels after being significantly impacted during Surge 1.

Otolaryngologic manifestations of Mpox: the Atlanta outbreak

Background In 2022, Mpox (MPX) has become clinically relevant as otolaryngologists are evaluating this exotic disease process due to its many otolaryngologic manifestations. Aims/Objective To characterize our cohort of otolaryngology-relevant MPX confirmed cases. Materials and methods A descriptive case series was performed via retrospective review. Adult patients who underwent inpatient or emergency department otolaryngology consultation at an Emory University-affiliated tertiary care level hospital for MPX were included. Results Seven patients (age 18–58 years; median 32 years) were identified. All patients were male. Six patients (86%) were black and six patients (86%) were HIV positive with varied immunocompetence. Otolaryngology was consulted for lymphadenopathy (n = 2), pharyngeal involvement (n = 1), and airway evaluation (n = 4). All 6 patients with active MPX developed the classic rash, which developed after oropharyngeal symptoms in 3 patients. Three patients had laryngeal involvement. Conclusion MPX manifests with symptoms requiring otolaryngology expertise, especially when the airway is involved. Infectious disease consultation is key. Mpox can be identified with a specific constellation of demographic identifiers and physical exam findings, which is key to determining appropriate treatment and protection for the consulting otolaryngologist. Significance This is the first otolaryngologic study of Mpox and first description of Mpox laryngeal involvement.

Editorial introductions.

Editorial introductions.

Preoperative evaluation characteristics of bimaxillary surgery patients: A retrospective study in which prominent findings were evaluated with the literature review

In this study, we aimed to share our experience in preoperative anaesthesia evaluation for patients undergoing bimaxillary surgery in our hospital and review the relevant literature. We retrospectively evaluated 139 patients with ASA (American Society of Anesthesiology) physical status 1 and 2 who underwent bimaxillary surgery. Data were collected on demographic characteristics, ASA physical status, mallampati scores, systemic diseases, allergy history, consultation request status, consulted departments, smoking, alcohol or drug use, and previous exposure to general anaesthesia. The preoperative evaluation of bimaxillary surgery patients revealed several notable findings, including a relatively high rate of cardiovascular problems (48% rate among those with additional systemic disease), the need for otolaryngology (ENT) consultation being the most frequent (44% rate among all consultations), and a relatively high rate of active smoking (23.7%). Our findings suggest that the bimaxillary surgery patient group should be carefully evaluated, particularly regarding cardiovascular disease and difficult airway management