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A total of 4506 articles were identified; 2351 duplicates were removed; and 2155 titles and abstracts were independently reviewed. Reference review was also performed. Eligible manuscripts described surgical fires involving patients undergoing otolaryngologic procedures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Seventy\u2010two articles describing 87 otolaryngologic surgical fire cases were identified. These occurred during oral cavity or oropharyngeal procedures (11%), endoscopic laryngotracheal procedures (25%), tracheostomies (36%), \u201cother\u201d general anesthesia procedures (3%), and monitored anesthesia care or local procedures (24%). Oxidizing agents consisted of oxygen alone (n = 63 of 81, 78%), oxygen and nitric oxide (n = 17 of 81, 21%), and room air (n = 1 of 81, 1%). The fractional inspired oxygen delivered was &gt;30% in 97% of surgical fires in non\u2013nitrous oxide general anesthesia cases (n = 35 of 36). Laser\u2010safe tubes were used in only 12% of endoscopic laryngotracheal cases with endotracheal tube descriptions (n = 2 of 17). Eighty\u2010six percent of patients experienced acute complications (n = 76 of 87), including 1\u00a0intraoperative death, and 22% of patients (n = 17 of 77) experienced long\u2010term complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Surgical fires in otolaryngology persist despite aggressive multi\u2010institutional efforts to curb their incidence. Guideline recommendations to minimize the concentration of delivered oxygen and use laser\u2010safe tubes when indicated were not observed in many cases. Improved institutional fire safety practices are needed nationally and internationally.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817746926","type":"journal-article","created":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T09:55:16Z","timestamp":1516787716000},"page":"598-616","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Surgical Fires in Otolaryngology: A Systematic and Narrative Review"],"prefix":"10.1002","volume":"158","author":[{"given":"Andrew T.","family":"Day","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery UT Southwestern Medical Center Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erika","family":"Rivera","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Keck School of Medicine University of Southern California Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice L.","family":"Farlow","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine University of Michigan Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine G.","family":"Gourin","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Johns Hopkins Medical Institutions Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Nussenbaum","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery School of Medicine Washington University in Saint Louis Saint Louis Missouri USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,1,23]]},"reference":[{"key":"e_1_2_10_2_1","first-page":"314","article-title":"New clinical guide to surgical fire prevention: patients can catch fire\u2014here's how to keep them safer","volume":"38","author":"ECRI Institute","year":"2009","journal-title":"Health Devices"},{"key":"e_1_2_10_3_1","first-page":"293","article-title":"Eliminating surgical fires: a team approach","volume":"72","author":"Pollock GS","year":"2004","journal-title":"AANA J"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2009.11.004"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0b013e31827773d2"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.aorn.2009.12.023"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(05)31067-1"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2014.09.024"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_10_10_1","first-page":"75","volume-title":"Fire Engineering's Handbook for Firefighter I and II NFPA 921: Guide for Fire and Explosion Investigations","author":"Naylis J"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2010.01.005"},{"key":"e_1_2_10_12_1","first-page":"77","volume-title":"Principles of Fire Behavior and Combustion","author":"Gann RG"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-199493030-00010"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4243-5"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.anclin.2010.07.006"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e31821d420b"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e31820dff18"},{"key":"e_1_2_10_18_1","unstructured":"Anesthesia Patient Safety Foundation.ASPF resources: fire safety video.http:\/\/www.apsf.org\/resources\/fire\u2010safety\/. 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