Unilateral and Bilateral Laryngeal Pacing for Bilateral Vocal Fold Paralysis
AbstractPurpose of ReviewPresent the state-of-the-art overview of laryngeal pacing for treatment of bilateral vocal fold paralysis. A minimally invasive unilateral pacing system and a fully implantable bilateral pacing system are currently in clinical trials. The relative advantages and disadvantages of each are discussed.Recent FindingsResearch in functional electrical stimulation for the reanimation of the posterior cricoarytenoid muscle has successfully translated from animal models to human clinical trials for unilateral pacing and bilateral pacing. Current findings suggest unilateral pacing in humans significantly imp...
Source: Current Otorhinolaryngology Reports - September 3, 2020 Category: ENT & OMF Source Type: research

Botulinum Toxin Injection in Facial Paralysis and Other Neuromuscular Conditions
AbstractPurpose of ReviewBotulinum toxin A (BTX-A) has long been used for the management of the sequelae of facial paralysis and other neuromuscular conditions. Evidence is limited in its efficacy and outcomes, and there is a lack of standardisation in its use.Recent FindingsBoth objective and subjective outcomes in BTX-A injections for facial paralysis are favourable. Differences are seen depending on type of botulinum toxin used, but most studies recommend OnabotulinumtoxinA.SummaryBTX-A injection is an effective method in the treatment of these disorders, improving patient outcomes through a minimally invasive approach....
Source: Current Otorhinolaryngology Reports - September 3, 2020 Category: ENT & OMF Source Type: research

Metabolic, Radiation, and Medication Induced Sialadenitis
AbstractPurpose of ReviewThis review will cover clinical presentations for sialadenosis, radiation-related sialadenitis, and medication-induced salivary disorders.Recent FindingsPresentation of metabolic disorder –related sialadenosis or gland enlargement is gradual and progressive without obstructive salivary symptoms. In contrast, radioactive iodine therapy can induce acute and chronic sialadenitis due to salivary gland dysfunction and duct damage with subsequent duct stenosis. Obstructive symptoms assoc iated with fluctuating gland swelling and pain can be treated with sialendoscopy and dilation of the main saliva...
Source: Current Otorhinolaryngology Reports - September 1, 2020 Category: ENT & OMF Source Type: research

Botulinum Toxin for Headache: a Comprehensive Review
AbstractPurpose of ReviewHeadache disorders are among the most prevalent disorders of mankind. They incur huge costs in terms of disability, days loss to work, and quality of life. In recent years, usage of botulinum toxin (BTX-A) has been extended to the management of various headaches. This review sets out to examine the evidence and role of BTX-A in the different headache disorders.Recent FindingsBTX-A is effective in reducing the frequency of chronic migraine days per month, with statistically significant improvement in quality of life. No difference was seen in patients with episodic migraine. The evidence of BTX-A on...
Source: Current Otorhinolaryngology Reports - August 25, 2020 Category: ENT & OMF Source Type: research

Clinical Entities that Mimic Salivary Inflammatory Disease
AbstractPurpose of ReviewSialadenitis due to salivary obstruction is associated with characteristic intermittent pain and swelling of the affected gland. Common etiologies of adult salivary obstruction include salivary duct stones or duct stenosis. However, various pathologic processes can mimic obstructive salivary gland symptoms. This is a case-based review of pathologies that may present similar to the signs and symptoms of salivary obstruction with gland inflammation.Recent FindingsMultiple cases with pathologies mimicking inflammatory salivary gland disease have been reported and described. This review uses a case-bas...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

The Role of Botulinum Toxins in Wound Management and Scar Revision
This article reviews advances focusing on the use of BoTA in wound management and scar revision.Recent FindingsSeveral prospective randomized controlled trials provide evidence that BoTA has a positive effect on wound healing and scar formation. This effect extends beyond its chemodenervative properties to include reducing pro-fibrotic factors and minimizing fibroblast growth and differentiation to better prevent pathological scarring.SummaryBotulinum toxin is a safe and efficacious adjunct to other interventions intended to optimize scar appearance in traumatic or surgical wounds. Questions remain regarding the optimal te...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

Applied Anatomy for Botulinum Toxin Injection in Cosmetic Interventions
AbstractPurpose of ReviewTo provide the reader with a clear overview of facial anatomy as it relates to injection of botulinum toxin.Recent FindingsThe review suggests the presentation of multiple combinations of facial musculature, with the forehead, glabellar, and nasal base areas as particular areas of variation. Differences in musculature result in different wrinkling patterns; with age, these changes first become apparent in the upper face, particularly in the forehead and glabellar area.SummaryBotulinum toxin is well suited to achieve the optimal outcome: it is popular, safe, and non-invasive and presents with few ad...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

The Therapeutic Use of Botulinum Toxin Injections for Conditions Affecting the Head and Neck
This article presents a summary of the wide range of uses in the laryngeal, pharyngeal, cervical, oromandibular and facial muscles.Recent FindingsAs well as the uses discussed in this article, botulinum toxin has also been used more recently for a newly recognized condition: retrograde cricopharyngeus dysfunction. The condition and its treatment are discussed.SummaryBotulinum toxin is a safe and generally successful treatment for spasmodic dysphonia, Meige syndrome and oromandibular and cervical dystonia; neurological conditions, such as multiple system atrophy and migraine; and finally the oropharynx, post-laryngectomy, c...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

Botulinum Toxin for the Head and Neck: a Review of Common Uses and Recent Trends
We present a narrative summary of the pharmacology and commercial preparations; principles of use; cautions, contraindications and adverse effects; common cosmetic applications; common non-cosmetic applications; and recent cosmetic trends in the use of BoNT type A.SummaryThe cosmetic and non-cosmetic applications of BoNT in the head and neck have rapidly expanded in recent years, with excellent outcomes and considerable demand from patients. It is essential for ENT surgeons to have a good awareness of BoNT and its applications to complement their practices for the benefit of their patients. This narrative review provides a...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

Botulinum Toxin in the Management of Hyperhidrosis and Other Salivary Conditions
AbstractPurpose of ReviewThe aim of this review is to summarise the most up-to-date literature on the application of botulinum toxin in hyperhidrosis and other salivary conditions, including sialorrhea, salivary leak and Frey ’s syndrome. Surgeons performing this procedure should stay updated with the most recent evidence of its effectiveness for appropriate treatment planning and patient consultation.Recent FindingsThe use of botulinum toxin in hyperhidrosis provides symptom relief in most patients, with satisfaction rates of 80 –100% in the majority of patients. Accidental infiltration of local musculature is...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

Novel Cosmetic Uses of Botulinum Toxin in the Head and Neck
AbstractPurpose of ReviewInjection of botulinum toxin is the most commonly performed nonsurgical cosmetic procedure worldwide. New applications and formulations of botulinum toxin have become available for clinical use. This review presents recent advancements, applications, and new formulations of botulinum toxin. We also discuss issues regarding brand uniformity, safety, and patient satisfaction.Recent FindingsNovel cosmetic uses for botulinum toxin include the treatment of androgenic alopecia, oily skin, and others. Two new toxin formulations include daxibotulinumtoxinA, with a duration of 6  months, and botulinum ...
Source: Current Otorhinolaryngology Reports - August 18, 2020 Category: ENT & OMF Source Type: research

Advances in Inner Ear Therapeutics for Hearing Loss in Children
AbstractPurpose of ReviewHearing loss is a common congenital sensory disorder with various underlying causes. Here, we review and focus on genetic, infectious, and ototoxic causes and recent advances in inner ear therapeutics.Recent FindingsWhile hearing aids and cochlear implantation are the mainstay of treatment for pediatric hearing loss, novel biological therapeutics are being explored. Recent preclinical studies report positive results in viral-mediated gene transfer techniques and surgical approaches to the inner ear for genetic hearing loss. Novel pharmacologic agents, on the other hand, show promising results in re...
Source: Current Otorhinolaryngology Reports - July 6, 2020 Category: ENT & OMF Source Type: research

Salivary Gland Neoplasms
AbstractPurpose of ReviewTo give an overview of diagnosis and treatment of salivary gland neoplasms and highlight the contribution of recent literature.Recent FindingsThe newly adapted Milan classification system for cytologic diagnosis provides risk of malignancy and clinical management strategies for parotid neoplasms with high PPV and NPV. Reconstruction for partial parotidectomy and total parotidectomy defects continues to advance toward greater cosmesis and facial symmetry.SummaryNew diagnostic advances will aid in clinical decision making and patient management. Surgically based therapy continues to be favored in bot...
Source: Current Otorhinolaryngology Reports - July 4, 2020 Category: ENT & OMF Source Type: research

The Aging Voice
AbstractPurpose of ReviewAge-related dysphonia in the elderly is more common than appreciated because it is an under-reported symptom. Perceptually, the presbyphonic voice is characterized negatively as sounding weak, breathy, tremulous, and unstable. The frequent association with hearing impairment in this group may lead to social isolation and depression, with a significant impact on quality of life. Although several anatomical and physiological alterations are known to contribute to presbyphonia, singing prevents, in large part, many of the perceptual changes. Vocal exercises, with vocal fold augmentation or thyroplasty...
Source: Current Otorhinolaryngology Reports - July 2, 2020 Category: ENT & OMF Source Type: research

Recommended Imaging for Salivary Gland Disorders
AbstractPurpose of ReviewImaging modalities useful in the contemporary evaluation of salivary gland disorders are discussed.Recent FindingsSalivary gland ultrasound —due to its wide applicability, versatility, availability, and low cost—is supported as a frontline evaluation and is frequently done as an in-office procedure by the treating surgeon. Contrast-enhanced CT may be as accurate as non-contrast CT in detecting sialolithiasis. Although conventional s ialography (fluoroscopic salivary gland evaluation with ductal dilation and radiocontrast insufflation) was initially designed as a diagnostic procedure, mo...
Source: Current Otorhinolaryngology Reports - June 25, 2020 Category: ENT & OMF Source Type: research

Upper Motor Neuron Diseases and Laryngeal Presentations
AbstractPurpose of ReviewThe purpose of this manuscript is to review laryngeal manifestations of upper motor neuron disease. A review of the relevant neuroanatomy is performed as well as a description of common laryngeal signs of upper motor neuron disease and the disease entities that cause them.Recent FindingsUpper motor neuron lesions must occur in the brainstem or in the bilateral cerebral hemisphere in order to cause signs and symptoms in the larynx.SummaryThe presence of bilateral vocal fold paralysis or paresis with concurrent signs of myoclonus, tremor, rigidity, hyperactive gag reflex, and/or laryngospasm episodes...
Source: Current Otorhinolaryngology Reports - June 18, 2020 Category: ENT & OMF Source Type: research

What Is New in Laryngeal Dystonia: Review of Novel Findings of Pathophysiology and Novel Treatment Options
AbstractPurpose of ReviewThe aim of this review is to present the current literature on pathophysiology, evaluation, and management of laryngeal dystonia.Recent FindingsRecent evidence suggests loss of cortical inhibition, and sensory dysfunction plays an important role in the pathophysiology of laryngeal dystonia. New treatments addressing these changes include electrical stimulation for neuromodulation of the larynx, vibrotactile therapy, and sodium oxybate. Preliminary investigations are promising and these may impact the future of care for laryngeal dystonia patients.SummaryThe current literature emphasizes a new under...
Source: Current Otorhinolaryngology Reports - June 15, 2020 Category: ENT & OMF Source Type: research

Implications of Concurrent Vestibular Dysfunction in Pediatric Hearing Loss
AbstractPurpose of the ReviewIt is known that the prevalence of vestibular impairment in children with sensorineural hearing loss (SNHL) is high and can lead to balance deficits. In this review, we look beyond balance and consider the impact of this multisensory deficit on neurocognitive function and navigation with the aim of explaining some of the variability in outcomes seen in cochlear implant populations, considering how to ameliorate these outcomes with targeted rehabilitative strategies.Recent FindingsCongenital or early acquired vestibular impairment associated with SNHL impacts multiple cognitive domains including...
Source: Current Otorhinolaryngology Reports - June 9, 2020 Category: ENT & OMF Source Type: research

Unilateral Hearing Loss and Single-Sided Deafness in Children: an Update on Diagnosis and Management
AbstractPurpose of ReviewThis review highlights our current understanding of the impact of unilateral hearing loss and single-sided deafness in children, offering insight into diagnosis and management.Recent FindingsChildren with unilateral hearing loss develop an aural preference toward their better hearing ear, leading to difficulties with spatial navigation, balance, speech/language skills, and quality of life when compared with typical hearing peers. Cochlear nerve aplasia and cytomegalovirus are among the most common etiologies for unilateral hearing loss, which has important implications for treatment. Hearing rehabi...
Source: Current Otorhinolaryngology Reports - June 8, 2020 Category: ENT & OMF Source Type: research

Vocal Fold Paresis 2020
AbstractPurpose of ReviewAlthough the clinical significance of vocal fold paresis is generally acknowledged among specialists, details of evaluation and diagnosis remain highly debated.Recent FindingsMany studies evaluating vocal fold paresis have been performed in the last two decades; most are retrospective and fraught with methodological concerns. Diagnosis and management of paresis remain founded primarily on experience and opinion with little high-quality evidence to support clinical practice.SummaryUniversally agreed-upon standards for diagnosis remain elusive. Most laryngologists diagnose paresis by laryngoscopic or...
Source: Current Otorhinolaryngology Reports - June 4, 2020 Category: ENT & OMF Source Type: research

Surgical Considerations for Laryngeal Reinnervation and Future Research Directions
AbstractPurpose of ReviewThis paper examines the history, current use, and future directions of laryngeal reinnervation surgery.Recent FindingsNonselective laryngeal reinnervation has been refined as a surgical technique for use in unilateral vocal fold paralysis.Selective laryngeal reinnervation is a viable surgical option for bilateral vocal fold paralysis. The use of laryngeal pacing devices, nimodipine, stem cells, and manipulation of the cellular and chemical microenvironment are future areas of study for laryngeal reinnervation.SummaryWhile both thyroplasty and injection laryngoplasty are highly effective and remain ...
Source: Current Otorhinolaryngology Reports - June 4, 2020 Category: ENT & OMF Source Type: research

Laryngeal Electromyography: Present and Future
The objective of this review is to present recent advances in LEMG.Recent FindingsThe addition of quantitative analysis and adductor synkinesis testing to the traditional qualitative analysis has improved the accuracy of LEMG and provide opportunities for future research.SummaryEstablishing a team as well as having a standardized testing and reporting protocol will contribute greatly to the clinical value and research utility of LEMG. (Source: Current Otorhinolaryngology Reports)
Source: Current Otorhinolaryngology Reports - June 3, 2020 Category: ENT & OMF Source Type: research

Update on Auditory Neuropathy/Dyssynchrony in Children
This article is meant to update clinicians on best practices for diagnosis and management of AN/AD.Recent FindingsExciting advances in genetics present opportunities for additional evidence to classify AN/AD based on site of lesion, and may lead to additional understanding of the pathophysiology as well as prognosis. Cochlear implantation continues to be a highly effective intervention for managing AN/AD in pediatric patients.SummaryAN/AD can be a challenging condition to manage given the heterogeneity of its presentation and variety of options for management. Ultimately, clinicians must tailor treatment to the individual ...
Source: Current Otorhinolaryngology Reports - June 3, 2020 Category: ENT & OMF Source Type: research

Management of Congenital Cytomegalovirus-Related Hearing Loss
AbstractPurpose of ReviewThe aim of this report is to review the current literature regarding the diagnosis, treatment, management, and rehabilitation of congenital cytomegalovirus (cCMV) –associated sensorineural hearing loss (SNHL).Recent FindingsHearing-targeted CMV screening is successful in identifying cases of cCMV-related hearing loss. However, a significant number of children who develop cCMV-related SNHL may not be detected on newborn hearing screening, and it may be cost-effective to implement a universal CMV screening program. We also broadly review the management and audiologic rehabilitation of cCMV-asso...
Source: Current Otorhinolaryngology Reports - May 29, 2020 Category: ENT & OMF Source Type: research

A Practical Approach to Genetic Testing for Pediatric Hearing Loss
We present the most recent research in the field followed by our recommended diagnostic algorithm incorporating genetic testing. We then provide case examples of commonly encountered patient presentations as further guidance.Recent FindingsGenetic testing has the highest diagnostic yield of any single test in the evaluation of children with congenital bilateral severe-to-profound hearing loss. For unilateral or asymmetric hearing loss, imaging is typically more informative initially than genetic testing. Recent data show that syndromic forms of hearing loss are more common than previously appreciated.SummaryA thorough and ...
Source: Current Otorhinolaryngology Reports - May 26, 2020 Category: ENT & OMF Source Type: research

Classification of Salivary Gland Disorders
AbstractPurpose of ReviewTo offer a fresh perspective on the evolving management of salivary gland disease by introducing a sequence of articles organized by a classification system grouping disorders by etiology.Recent FindingsSialendoscopy has been successful in improving the management of salivary gland disease. This endoscopic approach to imaging and instrumentation of the salivary duct system has been a focal point of recent discussion. The overall management of salivary pain and swelling as well as xerostomia and sialorrhea has improved through additional treatment options including increased application non-surgical...
Source: Current Otorhinolaryngology Reports - May 26, 2020 Category: ENT & OMF Source Type: research

Updates to the Current Understanding of the Relationship Between Allergy and Chronic Sinusitis
AbstractPurpose of ReviewTo examine the relationship of chronic rhinosinusitis (CRS) and atopic disease.Recent FindingsCRS with nasal polyps (CRSwNP) has been shown to be associated with high aeroallergen sensitivity and local allergic response, but with no difference in imaging, symptomatic severity, or disease recurrence rates in atopic vs. non-atopic individuals. There is conflicting evidence for CRS without nasal polyps (CRSsNP) with regard to the relationship with atopic disease. There may, however, be differential molecular profiles between atopic and non-atopic patients with CRSsNP.SummaryThere is no consensus as to...
Source: Current Otorhinolaryngology Reports - April 14, 2020 Category: ENT & OMF Source Type: research

Biologic Therapeutics and Their Role in Allergic Disease of the Unified Airway
AbstractPurpose of ReviewRecent advances have been made in the use of biologic therapies for chronic inflammatory diseases of the unified airway. The purpose of this review is to summarize the current state of knowledge for biologic therapies in chronic airway disease, including indications for use, mechanisms of action, and future needs for research.Recent FindingsThere are currently four classes of FDA-approved biologic therapies for treatment of inflammatory airway diseases: Dupilumab (anti-IL-4R α) is approved for both moderate to severe allergic asthma and chronic rhinosinusitis with nasal polyps, including aspi...
Source: Current Otorhinolaryngology Reports - April 8, 2020 Category: ENT & OMF Source Type: research

Setting up an Office Allergy Practice: Current Recommendations for Sterility and Supervision
AbstractPurpose of ReviewDiscuss optimal conditions for the office delivery of allergy immunotherapy with regard to medical personnel supervision and techniques for sterility of antigen vial preparation and delivery.Recent FindingsThe revised USP 797 pharmaceutical compounding guidelines, combined with allergen extract preparation directions provide clear instructions for the general supervision and oversight of allergen preparation for immunotherapy.SummarySterility of antigen vial preparation and supervision of office personnel delivering and preparing allergy immunotherapy are critical points of competency allowing for ...
Source: Current Otorhinolaryngology Reports - April 3, 2020 Category: ENT & OMF Source Type: research

Sinonasal Squamous Cell Carcinoma: Etiology, Pathogenesis, and the Role of Human Papilloma Virus
AbstractPurpose of ReviewSinonasal squamous cell carcinoma (SNSCC) is a rare disease with considerable histologic diversity. Currently, there is a poor understanding of the etiology and pathogenesis of SNSCC. Here, we review recent literature to summarize what is known regarding (1) the etiology of SNSCC, (2) the role of Human Papilloma Virus (HPV) in SNSCC, and (2) the molecular underpinnings of SNSCC.Recent Findings1. High risk HPV appears to play a role in the pathogenesis of a subset of SNSCCs. SNSCCs with high risk HPV have improved survival compared with those without HPV and occur in patients who are younger, simila...
Source: Current Otorhinolaryngology Reports - March 24, 2020 Category: ENT & OMF Source Type: research

Controversies in Skin Testing for Allergic Rhinitis
This article will review different methods of skin testing available for allergic rhinitis, emphasizing controversies and challenges associated with these techniques.Recent FindingsThe utility of quantitative skin testing has been debated in current literature, as has the accuracy of skin versus in vitro testing. Single- and pauci-allergen immunotherapy (AIT) have also shown good outcomes, thus questioning the use of large testing panels. Recent studies further support the use of standardized and recombinant antigens.SummarySkin testing remains a safe and dependable tool in the diagnosis and management of allergic rhinitis...
Source: Current Otorhinolaryngology Reports - March 23, 2020 Category: ENT & OMF Source Type: research

Perioperative Considerations in Endoscopic Skull Base Surgery
AbstractPurpose of the ReviewPresent an overview of perioperative considerations specific to endoscopic skull base surgery necessary to maximize successful outcomes.Recent FindingsThe majority of perioperative considerations for endoscopic skull base surgery lack strong supporting evidence and frequently have varied use or implementation amongst institutions. A notable exception comes from a recent randomized controlled trial demonstrating the benefit of lumbar drainage in high-risk cerebrospinal fluid leaks.SummarySkull base surgeons must consider a multitude of perioperative factors. While many components of perioperativ...
Source: Current Otorhinolaryngology Reports - March 19, 2020 Category: ENT & OMF Source Type: research

Quality of Life Outcomes and Approach-Specific Morbidities in Endoscopic Endonasal Skull Base Surgery
AbstractPurpose of ReviewEndoscopic endonasal skull base surgery (EESBS) has many advantages compared with traditional approaches. Recently, there is an increasing focus on patient-centered, quality of life (QOL), and approach-specific outcomes. This review seeks to illuminate our current understanding and knowledge gaps in EESBS-specific QOL outcomes.Recent FindingsIn an effort to capture the most relevant QOL implications for patients undergoing EESBS, three comprehensive, validated, QOL instruments have been created. These instruments are often supplemented by sinonasal-specific outcome measures, given the potentially s...
Source: Current Otorhinolaryngology Reports - March 19, 2020 Category: ENT & OMF Source Type: research

Open and Endoscopic Skull Base Approaches
AbstractPurpose of ReviewSurgical approaches to the skull base have been evolving at an incredible rate in the past 30  years. The advent of the endoscope has multiplied the available approaches while reducing morbidity. Otolaryngologists and neurosurgeons performing these operations must stay updated in recent trends and techniques to determine the best options for patients.Recent FindingsTwenty years have passed since the adoption of the endoscope in skull base surgery but new techniques are still being introduced on an annual basis. Most notably are the “cross court” techniques utilizing the contralater...
Source: Current Otorhinolaryngology Reports - March 19, 2020 Category: ENT & OMF Source Type: research

Imaging of Anterior and Central Skull Base Tumors: a Review
AbstractPurpose of ReviewThe aim of this review is to summarize characteristic imaging findings of common skull base lesions. In addition, this study aims to review the literature regarding important and interesting new advancements in imaging of the anterior and central skull base.Recent FindingsImaging techniques including magnetic resonance elastography, indocyanine green fluorescence, Gallium-DOTATATE PET/CT, peptide receptor radionucleotide therapy, and 3D printing are being used to advance the care of patients with skull base pathology.SummaryCharacteristic CT and MRI findings can be used to narrow the differential d...
Source: Current Otorhinolaryngology Reports - March 13, 2020 Category: ENT & OMF Source Type: research

Balance and Dizziness Disorders in the Elderly: a Review
AbstractPurpose of ReviewDizziness and balance disorders affecting the elderly are among the most common causes of medical consultation. In an aging population, the number of cases is expected to increase, proving to be a growing public health concern. This review aims to summarize exciting, new research done on this topic.Recent FindingsVirtual reality and Internet-based vestibular rehabilitation have shown promise in providing low-cost, at-home care for older adults suffering from dizziness and balance disorders. Furthermore, new research has crafted an effective preventative screening guide for falls in the elderly.Summ...
Source: Current Otorhinolaryngology Reports - March 12, 2020 Category: ENT & OMF Source Type: research

Reconstruction Following Endoscopic Endonasal Skull Base Surgery: Options and Technical Considerations
AbstractPurpose of ReviewTo provide a brief overview of the options available for reconstruction of the skull base and to discuss their technical considerations. To review the contemporary literature surrounding adjunctive measures such as acetazolamide and perioperative cerebrospinal fluid (CSF) diversion.Recent FindingsA recent randomized, control trial examining perioperative lumbar drainage following endoscopic skull base surgery has demonstrated that perioperative lumbar drainage is significantly associated with decreased incidence of postoperative CSF leak in specific anatomical subsites.SummaryMany factors must be w...
Source: Current Otorhinolaryngology Reports - March 6, 2020 Category: ENT & OMF Source Type: research

Training and Surgical Simulation in Skull Base Surgery: a Systematic Review
This article presents a review of the available literature specific to training and simulation in endoscopic endonasal skull base surgery.Recent FindingsA systematic review of the literature was performed onsimulation andtraining in endoscopic endonasal skull base surgery. The level of evidence, simulation fidelity, and the level of learning effectiveness (Kirkpatrick scale) were assessed for each available study. Thirty studies were included in the review. One study describes a validated training program for training in skull base surgery. The other included studies of present simulation training using cadaveric models, 3...
Source: Current Otorhinolaryngology Reports - March 6, 2020 Category: ENT & OMF Source Type: research

Endoscopic Stapes Surgery
AbstractPurpose of ReviewStapes surgery is challenging yet rewarding hearing restoration procedure. Endoscopic ear surgery is a relatively new technique for managing otologic pathology. Stapes surgery presents a unique challenge when performed via a transcanal endoscopic approach because the surgeon is confined to using one hand for management of the footplate and placing the prosthesis.Recent FindingsOutcomes have been published for endoscopic stapes surgery, with several studies comparing endoscopic with the traditional microscopic approach. Several authors noted the need for less bone removal and less pain after endosco...
Source: Current Otorhinolaryngology Reports - March 3, 2020 Category: ENT & OMF Source Type: research

Creating a Validated Simulation Training Curriculum in Otolaryngology
This article seeks to review current virtual and non-virtual reality simulation models within the literature and review their validation status.Recent FindingsMany simulation models exist within otolaryngology and are currently being used for education. New models are also continuously being developed; however, validity should be proven for the models before incorporating their use for educational purposes. Validity should be determined by experts and trainees themselves.SummaryA validated simulation curriculum should be incorporated within the otolaryngology training programme. A curriculum based on the current training p...
Source: Current Otorhinolaryngology Reports - February 27, 2020 Category: ENT & OMF Source Type: research

Non-technical Skills Simulation Training
AbstractPurpose of Review“Non-technical skills” are critical to patient safety and form an important part of a surgeon’s competency. Inter-disciplinary team training is now considered essential to train these valuable skills. This review discusses the importance of non-technical skills, and the role these skills have in simulation training within Otolaryngology.Recent FindingsOtolaryngologists are uniquely positioned to encounter airway emergencies. Consequently, team-based training in crisis scenarios is especially important. Simulation can occur in situ or in the simulated setting, with “boot-camp...
Source: Current Otorhinolaryngology Reports - February 7, 2020 Category: ENT & OMF Source Type: research

Age-related Hearing Loss: Recent Developments in Approaching a Public Health Challenge
AbstractPurpose of ReviewAge-related hearing loss is highly prevalent and increasingly recognized as a public health priority. The purpose of this review is to summarize developments in understanding the role hearing plays in aging and new approaches to hearing health care.Recent FindingsGrowing evidence from large epidemiologic studies documents an association between hearing loss and the development of incident dementia, accelerated cognitive decline, depression, decreased quality of life, and falls, as well as increased risk of hospitalizations, health care utilization, and expenditures. Recent advances in legislation a...
Source: Current Otorhinolaryngology Reports - January 28, 2020 Category: ENT & OMF Source Type: research

Evidence and Practicalities of Aqueous Sublingual Immunotherapy, Tablet Sublingual Immunotherapy, and Oral Mucosal Immunotherapy for Allergic Rhinitis and Allergic Asthma
AbstractPurpose of ReviewAllergen immunotherapy (AIT) is the only disease-modifying treatment for allergic rhinitis (AR). Multiple modalities of AIT dosed via sublingual or oral routes are becoming available. This review discusses current evidence and practicalities of aqueous and tablet sublingual immunotherapy (SLIT) and oral mucosal immunotherapy (OMIT) in the treatment of AR and allergic asthma.Recent FindingsSeveral large-scale studies demonstrate the efficacy and safety of SLIT. These studies have led to the United States Food and Drug Administration (USFDA) approval of tablet SLIT against grass, ragweed, and house d...
Source: Current Otorhinolaryngology Reports - January 25, 2020 Category: ENT & OMF Source Type: research

Rhinology: Simulation Training (Part 1)
AbstractPurpose of ReviewRecently, there has been an expansion of novel technologies in simulation training. Different models target different aspects of 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 FindingsVirtual reality simulators are still evolving and facing challenges ...
Source: Current Otorhinolaryngology Reports - January 24, 2020 Category: ENT & OMF Source Type: research

Sinonasal Disorders in Elderly Patients
AbstractPurpose of ReviewAge-related changes of the sinonasal region can have a significant impact on the quality of life. Knowing the effect of aging on sinonasal physiology and understanding the impact of sinonasal disorders on this specific group of patients can help in providing them with better care.Recent FindingsSignificant research in approaching rhinosinusitis, smell disorders, and functional nasal surgery has appeared in the literature in recent years. Medical and surgical treatment options for common sinonasal disorders should be tailored in the geriatric population to take into consideration the presence of com...
Source: Current Otorhinolaryngology Reports - January 23, 2020 Category: ENT & OMF Source Type: research

Frailty and Polypharmacy in Older Patients: Critical Issues for Otolaryngologists
AbstractPurpose of ReviewFrailty and polypharmacy are conditions commonly encountered in older otolaryngology patients and impact their symptoms as well as treatment decision-making.Recent FindingsA number of frailty assessment tools are available and in active use. Retrospective studies of large cohorts of patients identify a close correlation between measures of frailty and outcomes. Prospective assessment to inform decision-making remains challenging in clinical practice. The definition of “too many” medications, often termed polypharmacy, remains controversial. Management can be considered a form of “...
Source: Current Otorhinolaryngology Reports - January 22, 2020 Category: ENT & OMF Source Type: research

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