Dr Ohlms has satisfied the editor's requirements in her article for "Clinical Challenges in Otolaryngology" and is to be commended for her review of a very practical subject. She has included a pertinent and current bibliography on this subject. Her review giving the "pros" and "cons" of the subject is concise yet thorough. The advantages of less intraoperative bleeding and possible ease of dissection are clearly supported, while the desired advantage of postoperative pain management does not seem to be supported. The complications referenced certainly encourage the surgeon to weigh the benefit-risk ratio closely..
Gibson, Jr WS. Concerns With Bupivacaine Injection. Arch Otolaryngol Head Neck Surg. 2001;127(10):1280. doi:10.1001/archotol.127.10.1280