Single, Pauci, and Multi-allergen Testing and Immunotherapy
AbstractPurpose of ReviewAllergy immunotherapy has been a mainstay of treatment of inhalant allergy for years. Controversy still exists regarding best methods of allergy testing and immunotherapy. We aim to review the evidence supporting single-, pauci-, and multi-allergen testing and immunotherapy.Recent FindingsThe efficacy of immunotherapy has been well-established. The majority of research regarding allergy immunotherapy has focused on single-allergen treatment for mono- or poly-sensitized patients. There is a small heterogeneous group of studies that evaluate the efficacy of multi-allergen immunotherapy. There is a ne...
Source: Current Otorhinolaryngology Reports - January 21, 2020 Category: ENT & OMF Source Type: research

Sleep-Disordered Breathing in Geriatric Populations
AbstractPurpose of ReviewThe prevalence of sleep-disordered breathing has greatly increased in the geriatric population.Recent FindingsThe pathophysiology of sleep-disordered breathing for this population varies from younger populations due to consequences of aging such as loss of neuromuscular tone, soft tissue hypertrophy, and tissue laxity. The importance of treating obstructive sleep apnea is obvious as it is linked to detrimental cardiovascular and cerebrovascular risks with additional effects on quality of life.SummaryTreatment of older patients is best met by evaluating their goals of treatment and meeting it with o...
Source: Current Otorhinolaryngology Reports - January 21, 2020 Category: ENT & OMF Source Type: research

Rhinology: Simulation Training (Part 2)
AbstractPurpose of ReviewRecently, there has been an expansion of novel technologies in simulation training. The aim of this review was to examine existing evidence about training simulators in rhinology, their incorporation into real training programmes and translation of these skills into the operating room. The first part focuses on the virtual and augmented reality simulators. The second part describes the role of physical (i.e. non-computer-based) models of endoscopic sinus surgery.Recent FindingsWe learned that an ideal sinus surgery model would score highly in all standard measures of validity whilst maintaining an ...
Source: Current Otorhinolaryngology Reports - January 21, 2020 Category: ENT & OMF Source Type: research

History of Ossicular Chain Reconstruction
AbstractPurpose of ReviewOssicular erosion is a well-known complication of chronic ear disease, particularly when associated with cholesteatoma. Discontinuity of the ossicular chain can result in varying degrees of conductive hearing loss. Surgical correction and rehabilitation through ossiculoplasty has long been described as a successful means of hearing rehabilitation. Since its original description, numerous advancements have been made, particularly in the sector of prosthesis design and development.Recent FindingsSince the original ossicular chain reconstruction (OCR) was first described in 1952, various allografts, a...
Source: Current Otorhinolaryngology Reports - January 17, 2020 Category: ENT & OMF Source Type: research

Oropharyngeal Dysphagia in the Elderly: Evaluation and Prevalence
AbstractPurpose of ReviewSeveral age-related sensory and motor changes impact swallow function in the elderly. Dysphagia is a common and growing concern as the geriatric population expands and is associated with emotional, physical, and financial consequences. However, it is underdiagnosed and undertreated, especially in community-dwelling independent older adults who do not report issues with swallowing.Recent FindingsOtherwise healthy older adults may have senescent swallowing that remains functional until it is disrupted by triggers and becomes dysphagia. Evaluating for dysphagia in the elderly is important, because it ...
Source: Current Otorhinolaryngology Reports - January 17, 2020 Category: ENT & OMF Source Type: research

Brief Immunology Review for Targeted Biologic Therapies in Allergic Disease
This article provides a concise overview of important aspects of immunology related to atopic disorders and the key inflammatory components that biologic agents target.Recent FindingsOver 15  years ago, the first biologic agent for an allergic disease gained FDA approval. Since then, additional attention has been given to elucidating the underlying pathways involved in these inflammatory disorders and identifying other potential targets that may be used to treat these conditions. In th e last 5 years, not only have new biologic agents emerged to treat other atopic conditions, but also currently available agents h...
Source: Current Otorhinolaryngology Reports - January 16, 2020 Category: ENT & OMF Source Type: research

Ossiculoplasty for Tympanosclerosis
AbstractPurpose of ReviewThe utility of surgery for tympanosclerosis has been a controversial topic among otologic surgeons for many decades. Knowing the variations in tympanosclerotic involvement, different aspects of surgical technique, and audiologic outcomes data can help inform the discussion of optimal management between surgeon and patient.Recent FindingsTympanosclerosis can involve all structures in the middle ear, and the distribution of that involvement determines the likelihood of surgical success in hearing improvement. Most recent studies indicate that having a mobile stapes is a key prognostic factor and incr...
Source: Current Otorhinolaryngology Reports - January 15, 2020 Category: ENT & OMF Source Type: research

Mucosal Barrier Defects: What Have We Learned from Atopic Dermatitis, Asthma, and Allergic Rhinitis?
AbstractPurpose of the ReviewThis review covers recent findings describing roles for tight junction proteins in the mucosal barrier and their dysfunction in atopic diseases.Recent FindingsMucosal barrier dysfunction is commonly associated with chronic inflammation. Changes in tight junction protein expression and localization can be indicators of disease progression in allergic rhinitis. In addition, alterations in tight junctions may have a role in the initial onset of asthma. Lastly, polymorphisms in tight junction genes can be early predictors for atopic dermatitis risk and severity.SummaryTight junctions play a vital r...
Source: Current Otorhinolaryngology Reports - January 11, 2020 Category: ENT & OMF Source Type: research

Malleostapedotomy: Recent Innovations and Surgical Outcomes
This article presents outcomes with a self-crimping angulated malleostapedotomy piston and reviews recent published advancements relevant to MS surgery.Recent FindingsExcellent results are reported with a self-crimping angulated nitinol piston including AB gap closure
Source: Current Otorhinolaryngology Reports - January 10, 2020 Category: ENT & OMF Source Type: research

Endoscopic Ossiculoplasty
AbstractPurpose of ReviewTo review contemporary literature on audiometric and functional outcomes of endoscopic ossicular chain reconstruction (OCR) and to contrast this with outcomes using traditional microscopic OCR.Recent FindingsAudiometric outcomes of endoscopic OCR (including benchmark outcome of percentage of cases with air-bone gap (ABG) closure to
Source: Current Otorhinolaryngology Reports - December 3, 2019 Category: ENT & OMF Source Type: research

Transoral Robotic Surgery for Obstructive Sleep Apnea
AbstractPurpose of ReviewThe review briefly explores the history of sleep surgery and the advent of transoral robotic surgery (TORS) in the treatment of patients intolerant to continuous positive airway pressure (CPAP).Recent FindingsTORS for obstructive sleep apnea demonstrates increased effectiveness compared to single-level surgery in the treatment of the CPAP-intolerant patient. However, recent studies on newer therapies (upper airway stimulation) have demonstrated improved efficacy and fewer complications.SummaryTORS of the airway to treat OSA is an effective means of lowering the sequela of untreated sleep apnea in p...
Source: Current Otorhinolaryngology Reports - November 29, 2019 Category: ENT & OMF Source Type: research

Transoral Robotic Surgery (TORS) —Inside Out Anatomy and Exposure of the Operating Field
AbstractPurpose of ReviewTo optimize operating field exposure and improve understanding of surgical anatomy from the “inside out” perspective for transoral robotic surgery (TORS).Recent FindingsIn the last decade, TORS has become a common surgical technique for the management of early stage oropharyngeal cancers. Recent anatomic studies have focused on understanding the landmarks specific to each oropharynx subsite from the “inside out” perspective of a transoral surgeon.SummaryTechnical, anatomic, and oncologic factors should be considered pre-operatively to optimize surgical set-up, as exposure an...
Source: Current Otorhinolaryngology Reports - November 26, 2019 Category: ENT & OMF Source Type: research

Revision Ossiculoplasty
AbstractPurposeTo critically evaluate the literature as it pertains to revision ossiculoplasty and to distill it so that the reader may garner useful tips and strategies.Recent FindingsWe discuss reasons for failure in primary ossiculoplasty and discuss recent developments in the field, notably transcanal endoscopic ear surgery and various alloplastic materials.SummaryOssicular chain reconstruction remains a technically challenging procedure with numerous biophysical factors to take into account. In heeding certain guiding principles, otologic surgeons may optimize their outcomes. (Source: Current Otorhinolaryngology Reports)
Source: Current Otorhinolaryngology Reports - November 23, 2019 Category: ENT & OMF Source Type: research

State of the Art: Reconstruction with Synthetic PORP and TORP
AbstractPurpose of ReviewThe purpose of this review article is to present salient pearls of successful ossiculoplasty, with particular attention paid to reconstructive strategies with synthetic partial ossicular prostheses and total ossicular prostheses.Recent FindingsA refined level of dexterity and an appropriate attention to detail are needed to optimize audiometric outcomes in ossiculoplasty, as is a fundamental understanding of middle ear mechanics and the consistent anatomical relationships that exist in the middle ear, but perhaps the most important determinant of long-term hearing outcomes in ossiculoplasty is the ...
Source: Current Otorhinolaryngology Reports - November 22, 2019 Category: ENT & OMF Source Type: research

Remote Access Surgery for Thyroid Disease
This article reviews the most commonly embraced remote access approaches to the thyroid compartment.Recent FindingsAfter initial enthusiasm, the trend towards remote access thyroid surgery has been tempered. Preference in the USA is given to techniques involving familiar cervical dissection planes. Extracervical remote access thyroid surgery is generally not considered to be minimally invasive surgery.SummaryRemote access thyroid surgery may be offered to a special subset of patients with high motivation towards absence of a visible cervical scar. The procedure should probably be done in specialized centers where adequate ...
Source: Current Otorhinolaryngology Reports - November 18, 2019 Category: ENT & OMF Source Type: research

Nerve Monitoring for Transoral Thyroid Surgery: Why, How, and What to Expect
AbstractPurpose of ReviewWe primarily describe technical tips, and attempt to demonstrate the value of using intermitted neural monitoring (IONM) during transoral endoscopic thyroidectomy vestibular approach (TOETVA), with emphasis and respect given to nerve monitoring standards described by the International Neural Monitoring Study Group (INMSG).Recent FindingsAny modifications to the established operative technique for TOETVA should result in similar or improved patient outcomes with lower rates of complications. TOETVA is a new technique that demands full protection of RLN function during the cranial to caudal thyroid a...
Source: Current Otorhinolaryngology Reports - August 2, 2019 Category: ENT & OMF Source Type: research

Relevant Anatomy for the Transoral Vestibular Approach to the Thyroid and Parathyroid Glands
AbstractPurpose of ReviewThis paper highlights the key anatomical considerations for the surgeon to appreciate in order to carry out a safe and effective transoral vestibular approach to the central neck for thyroid and parathyroid dissection.Recent FindingsThe transoral, vestibular approach for thyroidectomy and parathyroidectomy avoids external, visible scarring altogether.SummaryThis approach requires additional understanding of intraoral and cervical anatomy from an altered viewpoint compared with open central neck surgery as the surgeon creates a working space from the mouth to the neck and views the thyroid and parat...
Source: Current Otorhinolaryngology Reports - July 30, 2019 Category: ENT & OMF Source Type: research

Transoral Endoscopic Thyroidectomy (TOETVA)
AbstractPurpose of ReviewSince the nineteenth century, the surgical methods used to perform open cervical thyroidectomy have improved significantly, resulting in substantially reduced rates of mortality and morbidity. The most up-to-date techniques today now focus on the need to limit the extent of any visible scarring, which requires that surgeons make their incisions in locations which minimize their likelihood of being noticed.Recent FindingsDuring the past two decades, several remote access approaches have been developed for use in the field of endoscopic and robotic thyroidectomy, and these have proved a popular alter...
Source: Current Otorhinolaryngology Reports - July 22, 2019 Category: ENT & OMF Source Type: research

Transoral Robotic Thyroidectomy: the New Era of Remote-Access Surgery for Thyroid Disease
We present a comprehensive overview on the development of robotic transoral thyroidectomy, and highlight major challenges in adoption.Recent FindingsTransoral robotic thyroidectomy (TORT) is the newest remote access approach to remove the thyroid gland and draws attention because of its cosmetic excellence. The principal advantage of TORT is that the flap dissection area is comparatively small to other remote-access methods and the lip wounds disappear over time resulting in excellent cosmesis.SummaryTORT could be done safely in the patients with appropriate selection by an experienced surgeon in robotic thyroidectomy. It ...
Source: Current Otorhinolaryngology Reports - July 3, 2019 Category: ENT & OMF Source Type: research

Transoral Endoscopic Parathyroidectomy Vestibular Approach (TOEPVA) —Choosing the Right Patient
AbstractPurpose of ReviewParathyroidectomy is the surgical treatment for primary hyperparathyroidism. A single parathyroid adenoma is the most common cause of primary hyperparathyroidism (PHPT) making it amenable to a focused surgery whereby the putative hyperfunctional parathyroid gland is excised.Recent FindingsParathyroid surgery, like thyroid surgery, is typically performed through a cervical incision usually measuring 4 –5 cm. Though most surgical scars heal well over time, the presence of a scar may affect a patient’s quality of life (Goldfarb and Casillas, Thyroid. 26(7):923–32,2016; Choi et a...
Source: Current Otorhinolaryngology Reports - June 22, 2019 Category: ENT & OMF Source Type: research

Hypoglossal Nerve Stimulation: An Update on the Latest Evidence
AbstractPurpose of ReviewObstructive sleep apnea (OSA) is a common disease in which narrowing of the upper airway occurs during sleep. Hypoglossal nerve stimulation represents a new therapy option for patients who are noncompliant with standard-treatment continuous positive airway pressure (CPAP) therapy. This review provides an overview of the latest evidence regarding this technique.Recent FindingsVarious devices have been investigated for hypoglossal nerve stimulation in recent years. A breathing cycle-dependent selective hypoglossal nerve stimulation system has been shown to be effective in clinical routine over many y...
Source: Current Otorhinolaryngology Reports - June 14, 2019 Category: ENT & OMF Source Type: research

Modern Challenges Managing Chronic Cough in Otolaryngology
AbstractPurpose of ReviewCough is an increasingly important public health concern, and otolaryngologists play a critical role in these patients. Despite advances in best practice, there remain opportunities to improve coordination of care, as well as fostering a systematic approach to improve outcomes.Recent FindingsThe standard challenge is appreciating the multifactorial nature of chronic cough, primarily upper respiratory, lower respiratory, and upper gastrointestinal tract (e.g., gastric reflux and oropharyngeal swallowing disorders), in addition to tobacco use and angiotensin-converting enzyme inhibitors. Beyond the b...
Source: Current Otorhinolaryngology Reports - June 3, 2019 Category: ENT & OMF Source Type: research

Starting a Transoral Thyroid and Parathyroid Surgery Program
AbstractPurpose of ReviewTo describe the necessary steps to facilitate safe implementation of a transoral thyroid and parathyroid surgery program.Recent FindingsTransoral vestibular approaches to the central neck have been demonstrated to be safe and feasible, while avoiding the morbidity of a cutaneous scar. As operative volume expands from a select few high-volume centers, a framework for implementation has been recommended to allow the evidence-based outcomes to translate into clinical practice for new adopters of these techniques. These include securing institutional support, choosing the appropriate candidate (both pa...
Source: Current Otorhinolaryngology Reports - May 24, 2019 Category: ENT & OMF Source Type: research

Combined Supra- and Infra-Tentorial Retro-Labyrinthine Pre-sigmoid Approach
AbstractPurpose of ReviewThis chapter describes the background, indications and key aspects of the combined supra- and infra-tentorial retro-labyrinthine pre-sigmoid approach. This approach is most commonly used for petrous apex meningiomata and vascular pathologies of the mid and upper basilar trunk.Recent FindingsOur pre-operative evaluation includes MRI, CT to assess pneumatisation of the petrous bone and vascular imaging where necessary. Audiology and ophthalmology baseline assessments are performed if appropriate.SummaryThe nuances of the operative technique are discussed with an emphasis on avoidance of complications...
Source: Current Otorhinolaryngology Reports - May 17, 2019 Category: ENT & OMF Source Type: research

Commentary: Forward to the Special Issue on Cough in Current Otorhinolaryngology Reports
(Source: Current Otorhinolaryngology Reports)
Source: Current Otorhinolaryngology Reports - May 14, 2019 Category: ENT & OMF Source Type: research

The Larynx as a Target for Treatment in Chronic Refractory Cough
AbstractPurpose of ReviewChronic cough is a common and debilitating problem that remains refractory to medical treatment. Laryngeal dysfunction frequently occurs in chronic cough. The goal of this review was to explore new developments in the mechanism treatment of chronic cough particularly those that target laryngeal function.Recent FindingsTreatments for chronic cough that target laryngeal sensation and motor function have include speech pathology, neuromodulators, botulinum toxin, trigger reduction and vocal fold augmentation.SummarySpeech pathology treatment for chronic cough can be successful; however, the mechanism ...
Source: Current Otorhinolaryngology Reports - May 7, 2019 Category: ENT & OMF Source Type: research

New Options in Pediatric Obstructive Sleep Apnea
AbstractPurpose of ReviewTo describe the current literature pertaining to the evaluation and management of obstructive sleep apnea (OSA) in children.Recent FindingsNewer diagnostic modalities, such as drug-induced sleep endoscopy (DISE) and cine MRI, may be utilized to determine anatomic locations of upper airway obstruction contributing to OSA. Pharmacologic and non-pharmacologic treatments have been studied as primary therapy for OSA or as adjuvant therapy for residual disease after adenotonsillectomy. Surgical therapy for persistent moderate to severe OSA following adenotonsillectomy may be considered for patients who a...
Source: Current Otorhinolaryngology Reports - May 3, 2019 Category: ENT & OMF Source Type: research

Therapeutic Targets for the Treatment of Chronic Cough
AbstractPurpose of ReviewChronic cough, defined in adults as one lasting longer than 8  weeks, is among the commonest clinical problems encountered by doctors both in general practice and in hospital. It can exist as a distinct clinical problem or as a prominent and troublesome symptom for patients with common pulmonary conditions including asthma, chronic obstructive pulmonary disea se and idiopathic pulmonary fibrosis.Recent FindingsChronic cough impacts considerably on patients ’ daily-life activities and many patients are left frustrated by what they see as a complete lack of awareness among their doctors as...
Source: Current Otorhinolaryngology Reports - May 2, 2019 Category: ENT & OMF Source Type: research

Endoscopic Intraconal Orbit Surgery
AbstractPurpose of ReviewEndoscopic approaches to the orbit have significantly expanded from endoscopic orbital decompression and dacryocystorhinostomy to use in resection of orbital tumors. Within the compact space of the orbit, there are critical neurovascular structures and important considerations regarding the management and treatment of pathologies in this region. This review will outline the anatomy of the orbit from an endoscopic perspective and how it can be accessed for tumor extirpation through the nasal corridor using endoscopic sinus surgery. It will discuss the various advancements in approach and visualizati...
Source: Current Otorhinolaryngology Reports - April 30, 2019 Category: ENT & OMF Source Type: research

Occupational and Environmental Exposures and Their Role in Chronic Cough
AbstractPurpose of ReviewTo review the mechanisms by which occupational and environmental factors can contribute to chronic cough and to discuss the approach to diagnosis and management of these patients with review of recent publications in this area.Recent FindingsAn Expert Panel Report from the American College of Chest Physicians in 2016 addressed this topic. Recent publications improve understanding of mechanisms of effects.SummaryInhaled dust, fumes, gases, and vapor can cause an irritant or inflammatory response in upper and lower airways leading to cough. Physico-chemical properties, exposure conditions, and host f...
Source: Current Otorhinolaryngology Reports - April 26, 2019 Category: ENT & OMF Source Type: research

Endoscopic Dacryocystorhinostomy
AbstractPurpose of the ReviewEndoscopic dacryocystorhinostomy (DCR) is a recognized procedure performed to treat epiphora caused by anatomical or functional obstruction of the nasolacrimal apparatus. The purpose of this review is to discuss our experience with the endoscopic approach to DCR.Recent FindingsNasolacrimal duct dysfunction has many different etiologies. The diagnosis is clinical, so a thorough clinical history and physical exam are required to confirm the diagnosis of epiphora. The etiology is confirmed with further exams including the dye disappearance test, Jones tests, endoscopic evaluation, and imaging when...
Source: Current Otorhinolaryngology Reports - April 22, 2019 Category: ENT & OMF Source Type: research

Endoscopic Orbital Decompression for Thyroid Eye Disease
This article will cover the latest developments in endoscopic management of thyroid eye disease while reviewing the pathophysiology of the disease, patient selection, proper surgical technique, postoperative outcomes, and complications.Recent FindingsEndoscopic surgeons have modified the technique over the past several years in order to reduce the incidence of certain complications, in particular diplopia. The implementation of “balanced” decompression, along with preservation of orbital struts and/or periorbital slings, has improved postoperative outcomes.SummaryEndoscopic orbital decompression remains a safe ...
Source: Current Otorhinolaryngology Reports - April 17, 2019 Category: ENT & OMF Source Type: research

The Spectrum of Non-asthmatic Airway Diseases Contributing to Cough in the Adult
AbstractPurpose of ReviewCough becomes a pathologic reflex when the airways are inflamed and overwhelmed with excessive mucus. The goal of this review is to discuss acute and chronic cough syndromes caused by non-asthmatic airway diseases.Recent FindingsAcute cough syndrome is short-lived and self-limited. Acute bronchitis and diffuse acute infectious bronchiolitis (DAIB) are examples. The former is usually caused by a viral illness; the latter byMycoplasma pneumoniae, influenza, andHaemophilus influenzae. Causes of chronic cough in the adult include chronic bronchitis, non-infectious bronchiolitis, and non-cystic fibrosis...
Source: Current Otorhinolaryngology Reports - April 17, 2019 Category: ENT & OMF Source Type: research

Endoscopic Optic Nerve Decompression: Indications, Technique, Results
AbstractPurpose of ReviewFor decades, treatment of compressive optic nerve neuropathy was conservative and involved the intravenous application of high-dose corticoids, which was combined with nerve growth factors in later years. If surgery was considered, transcranial and transfacial access to the orbital apex and the optic nerve were achieved using classical approaches. Over the past decade, endonasal endoscopic procedures have increasingly come into force, based on favorable experiences with functional endoscopic sinus surgery and as a result of innovative developments in endoscopy and image guidance. The purpose of thi...
Source: Current Otorhinolaryngology Reports - April 17, 2019 Category: ENT & OMF Source Type: research

Transorbital Endoscopic Surgery
AbstractPurpose of ReviewEndoscopic surgery of the orbit and the creation of transorbital portals to access lesions involving the orbit, sinuses and skull base is now being performed in multiple centres across the world since being popularised by Kris Moe in 2010. This review focuses on the current knowledge base with regard to transorbital endoscopic surgery.Recent FindingsNumerous publications show favourable outcomes in the management of orbital, skull base and intracranial lesions using endoscopic transorbital surgery when compared to traditional surgical approaches. Previously inaccessible or difficult-to-access lesio...
Source: Current Otorhinolaryngology Reports - April 3, 2019 Category: ENT & OMF Source Type: research

Managing Complications and Revisions in Sinus Surgery
AbstractPurpose of ReviewTo discuss strategies to avoid, identify and deal with both minor and major complications, as well as indications for revision sinus surgery.Recent FindingsComplication rates from endoscopic sinus surgery are low and have improved with increased surgical experience and new technology. Early extensive surgery in patients with complex sinonasal disease can improve long-term outcomes.SummaryA majority of patients undergoing endoscopic sinus surgery have a positive outcome. The surgeon must be competent in recognising and dealing with potential complications, as well as approaching complex revision cas...
Source: Current Otorhinolaryngology Reports - April 3, 2019 Category: ENT & OMF Source Type: research

Update in Temporal Bone Resection Outcomes
AbstractPurpose of ReviewSurgical outcomes data related to temporal bone malignancy can be challenging to interpret and apply to a specific patient population due to the overall rarity of the disease and the heterogeneity of disease types often studied in aggregate in this anatomic region. Large institutional series are commonly composed of a diverse patient cohort, with numerous pathologic entities studied in aggregate despite known differences in biologic behavior.Recent FindingsOur current aim is to provide a review of recent literature on surgical resection of primary, untreated squamous cell carcinoma of the temporal ...
Source: Current Otorhinolaryngology Reports - March 2, 2019 Category: ENT & OMF Source Type: research

Endoscopic Endonasal Approach to Selected Lesions of the Petrous Apex
We report our experience and review the literature highlighting current indications and limits in the management of benign and malignant lesions with special focus on the endoscopic approaches.Recent FindingsOver the last years, indications and limits of the extended endonasal approaches range from inflammatory disease of the paranasal sinuses to the management of various diseases involving the skull base such as CSF leak, pituitary tumors, ethmoid tumors, petrous apex lesions, and purely intracranial lesions thanks to the development of dedicated surgical instrumentation, the improvement of skull base reconstruction techn...
Source: Current Otorhinolaryngology Reports - February 14, 2019 Category: ENT & OMF Source Type: research

The Transpetrosal Approaches System in Posterior Fossa Meningiomas Surgery: Rationale and Results
AbstractPurpose of ReviewThis is a retrospective review of 90 patients with a posterior fossa meningioma (PFM) treated between 1996 and 2017 in our two tertiary skull base centers. Patients underwent surgical resection via different approaches. We aimed to show how different surgical approaches may help to reach gross total resection (GTR) and low morbidity, especially on facial nerve function.Recent FindingsPFM is a real surgical challenge with high morbidity and mortality due to the surrounding structures, their common large size at diagnosis, and their potentially invasive behavior. Total resection is the only way to cu...
Source: Current Otorhinolaryngology Reports - February 1, 2019 Category: ENT & OMF Source Type: research

Technical Challenges in Temporal Bone Paraganglioma Surgery: a Clinical Review
AbstractPurpose of the ReviewTemporal bone paragangliomas have always presented the otologist with their ultimate challenge. Surgical management is difficult, dangerous and demanding. It is also often associated with increased cranial nerve deficits and decreased quality of life for the patient. Management protocols for patients with temporal bone paragangliomas are changing as a result of advances in knowledge and technical developments. Multi-disciplinary care is now recommended for most patients with surgical intervention becoming restricted for the most difficult tumours.Recent FindingsPreviously considered unresponsiv...
Source: Current Otorhinolaryngology Reports - January 24, 2019 Category: ENT & OMF Source Type: research

Reconstructive Ladder for Transoral Resections of Oropharyngeal Cancers
The objective of this manuscript is to discuss the most recent advances and options available after resection with TORS.Recent FindingsThe latest research provides a common framework for surgeons to classify the type of oropharyngeal defect. A variety of reconstructive options described include secondary intent, modifications to existing local and regional flaps, and advances utilizing robotic assistance in free flap reconstruction.SummaryThere exists a multitude of reconstructive options with appropriate considerations for a stepwise approach based on patient-specific factors, surgeon capability, and the extent of the oro...
Source: Current Otorhinolaryngology Reports - January 24, 2019 Category: ENT & OMF Source Type: research

Consumer Technology for Sleep-Disordered Breathing: a Review of the Landscape
AbstractPurpose of ReviewThe consumer market for devices that quantify sleep is quickly evolving. We conducted a review of the consumer technology available for sleep disorders, including its potential and limitations to screen obstructive sleep apnea (OSA).Recent FindingsThere are many commercial devices claiming to objectively measure sleep, but only a few are tested rigorously in research. We critically review the technology available, including its overall ability to provide objective measures of sleep (total sleep time (TST), sleep efficiency (SE), sleep latency (SL), wake after sleep onset (WASO)), and to estimate ap...
Source: Current Otorhinolaryngology Reports - January 22, 2019 Category: ENT & OMF Source Type: research

Clinical Outcomes in OSA —SLEEP GOAL—a More Holistic Approach
AbstractPurpose of ReviewObstructive sleep apnea (OSA) is a systemic disease that is due to a narrow upper airway that collapses and obstructs during sleep, which results in frequent nocturnal hypoxemia, sympathetic overdrive, tachycardia, nocturnal hypertension, and oxidative metabolic stress. Symptoms include unrefreshed sleep, daytime tiredness, loss of memory, irritability, lack of concentration, poor work productivity, poor quality of life (QOL), mood swings, and even depression. This upper airway disorder can lead to systemic diseases such as hypertension, cardiovascular events, myocardial infarct, and fatal arrhythm...
Source: Current Otorhinolaryngology Reports - January 21, 2019 Category: ENT & OMF Source Type: research

Drug-Induced Sleep Endoscopy as a Tool for Surgical Planning
AbstractPurpose of ReviewTo review whether drug-induced sleep endoscopy (DISE) aids in obstructive sleep apnea surgical planning, if it changes the initial proposal, and if so, does it contribute to increased surgical success or unnecessary morbidity?Recent FindingsA DISE and surgical outcomes multicenter cohort study (n = 275) reported no association for surgical outcomes with velopharyngeal and epiglottic collapse. Oropharyngeal and tongue base collapse on the other hand were associated with lower odds of surgical response.SummaryDISE changes surgical planning mainly in regard to the approach of the tongue ba...
Source: Current Otorhinolaryngology Reports - January 21, 2019 Category: ENT & OMF Source Type: research

Role of Frailty and Comorbidity in Determination of Operability for Patients With Oral and Oropharyngeal Squamous Cell Carcinoma
AbstractPurpose of ReviewTo review the role of frailty and comorbidities in determining operability and associated outcomes in patients with oral and oropharyngeal squamous cell carcinoma.Recent FindingsFrailty and comorbidity have been linked to multiple adverse outcome measures including risk of mortality, surgical complications, length of stay, intensity of care needs, discharge disposition, risk of readmission, and cost of healthcare delivery. There are diverse objective and validated measures of comorbidity and frailty. Addition of comorbidity and objective frailty measurements has been demonstrated to improve predict...
Source: Current Otorhinolaryngology Reports - January 19, 2019 Category: ENT & OMF Source Type: research

Optimising Medical Management in CRS
AbstractPurpose of ReviewWe assess the literature on different medical treatment options and their effectiveness in chronic rhinosinusitis (CRS).Recent FindingsAlthough there is significant overlap in the management of CRS, not all therapies are equally effective within CRS phenotypes.SummaryCRS is one of the most common chronic health problems affecting a large proportion of adult population and generating significant economic implications. Despite an unclear pathophysiology of this complex disorder, it is widely recognised that surgery alone does not resolve the chronic inflammation and that ongoing medical treatment rem...
Source: Current Otorhinolaryngology Reports - January 18, 2019 Category: ENT & OMF Source Type: research

Patient Phenotyping in OSA
AbstractPurpose of ReviewOSA treatment paradigms are evolving from a “one treatment for all” philosophy to personalised therapeutic options based on anatomical and physiological phenotypes. Understanding these different phenotypes will become vital for clinicians as OSA testing and treatment become more targeted.Recent FindingsPhenotyping of the pharynx and upper airway is vital to inform anatomical treatment options such as surgery and mandibular advancement splints. Manipulated CPAP testing allows determination of traits such as arousal threshold, muscular responsiveness and ventilatory control. Targeted ther...
Source: Current Otorhinolaryngology Reports - January 12, 2019 Category: ENT & OMF Source Type: research

Paralytic Lagophthalmos: Comprehensive Approach to Management
AbstractPurpose of ReviewFacial paralysis can lead to lagophthalmos, loss of corneal protection, and devastating ocular consequences like corneal ulcers or even blindness. The purpose of this review is to discuss the importance of comprehensive and early eye care.Recent FindingsTreatment of paralytic lagophthalmos should be individualized to each patient ’s situation; depending on the severity of the problem and the prognosis for recovery, treatment modalities are broad and include lubrication, selective chemodenervation, filler injection, fat augmentation, and surgical procedures like canthopexy and tarsorrhaphy.Sum...
Source: Current Otorhinolaryngology Reports - November 8, 2018 Category: ENT & OMF Source Type: research

Management of the Neck for Non-melanoma Skin Cancer
AbstractPurpose of ReviewTo summarize the current management of the neck lymph node basin for head and neck non-melanoma skin cancers.Recent FindingsOver the last 5  years, there have been updates to staging for cSCC and MCC. T classification of the AJCC staging system has been changed to match the UICC staging system. MCC staging has been updated based on data from the National Cancer Data Base. Sentinel lymph node biopsy, while established in MCC, is playing a growing role in the management of high-risk N0 cSCC.SummaryThe optimal management of N0 neck varies by metastatic potential. In low-risk malignancy, no workup...
Source: Current Otorhinolaryngology Reports - October 27, 2018 Category: ENT & OMF Source Type: research

Management of Squamous Cell Carcinoma Involving the Temporal Bone
AbstractPurpose of ReviewTo examine contemporary management of squamous cell carcinoma (SCC) involving the temporal bone.Recent FindingsThe modified Pittsburgh criteria have gained acceptance by many institutions for staging, planning treatment and comparing outcomes. Often primary SCC as well as secondary cutaneous SCC involving the temporal bone can be managed in a similar fashion.SummaryT1 tumours should undergo lateral temporal bone resection (LTBR) due to the higher risk of positive margins and recurrence rates with lesser surgical procedures. T2 tumours require LTBR and superficial parotidectomy. T3 and T4 tumours of...
Source: Current Otorhinolaryngology Reports - October 25, 2018 Category: ENT & OMF Source Type: research