Golub Justin S, Samy Ravi N
aDepartment of Otolaryngology - Head and Neck Surgery, University of Cincinnati, Cincinnati, Ohio bDepartment of Otolaryngology - Head and Neck Surgery, Columbia University, New York, New York, USA.
Curr Opin Otolaryngol Head Neck Surg. 2015 Oct;23(5):334-40. doi: 10.1097/MOO.0000000000000184.
To discuss effects of smoking on otologic surgery in an era of electronic (e-) cigarettes and proposals for legalization of marijuana. Physiologic mechanisms and clinical outcomes are presented.
Tobacco smoke can cause a variety of tissue effects that may adversely impact otologic surgery outcomes. Results in tympanoplasty using temporalis fascia are inferior in smokers compared with nonsmokers. More recent data show that in cartilage tympanoplasty, graft incorporation rates in smokers may approach those of nonsmokers. However, these results may not be as durable long-term in smokers. Evidence from nonotologic studies suggests that smoking cessation and nicotine replacement therapy may reduce perioperative morbidity. No data are available on electronic cigarettes and otologic outcomes; however, based on the pathophysiologic mechanisms of tobacco smoking, electronic cigarettes are likely a safer alternative. Marijuana smoke also needs to be considered as more states consider legalization.
Cigarette smoking negatively influences otologic surgery results, mostly because of tobacco combustion byproducts. Counseling and, if needed, pharmacologic measures to reduce smoking are recommended. E-cigarettes that deliver nicotine in water vapor may be safer than tobacco smoking. Our review contributes to the discussion of how the trends of e-cigarette use and marijuana legalization will unfold in the future to affect our patients' outcomes.
探讨在电子烟时代吸烟对耳科手术的影响以及大麻合法化的提议。介绍了生理机制和临床结果。
烟草烟雾可导致多种组织效应，可能对耳科手术结果产生不利影响。与不吸烟者相比，吸烟者使用颞肌筋膜进行鼓室成形术的效果较差。最新数据表明，在软骨鼓室成形术中，吸烟者的移植物融合率可能接近不吸烟者。然而，这些结果在吸烟者中长期可能不那么持久。非耳科研究的证据表明，戒烟和尼古丁替代疗法可能会降低围手术期发病率。目前尚无关于电子烟与耳科手术结果的数据；然而，基于吸烟的病理生理机制，电子烟可能是一种更安全的选择。随着越来越多的州考虑大麻合法化，大麻烟雾也需要纳入考量。
吸烟对耳科手术结果有负面影响，主要是由于烟草燃烧的副产品。建议进行咨询，并在必要时采取药物措施减少吸烟。通过水蒸气输送尼古丁的电子烟可能比吸烟更安全。我们的综述有助于讨论电子烟使用趋势和大麻合法化在未来将如何发展以影响我们患者的手术结果。
