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Update on the Evaluation and Management of Nasal Valve Collapse
AbstractPurpose of ReviewThis review covers the etiology, diagnosis, and management of nasal valve collapse (NVC). Particular attention is directed toward recent advances in office-based procedural treatment options.Recent FindingsWhile intervention for NVC has traditionally focused on graft and suture maneuvers performed via open functional septorhinoplasty, recent innovations include the use of radiofrequency energy and bioaborbable implants to strengthen the nasal valve and reduce dynamic collapse. Studies have demonstrated comparable long-term outcomes to conventional surgery in properly selected patients.SummaryDynami...
Source: Current Otorhinolaryngology Reports - November 10, 2021 Category: ENT & OMF Source Type: research

Nuances of Facelifting for the Male Patient
AbstractPurpose of ReviewCosmetic procedures, namely rhytidectomy and neck lifting, have become increasingly popular among male patients. However, there are nuances to preoperative evaluation and surgical techniques unique to males that must be considered in order to achieve optimal results. It is critical to not only evaluate the patient properly and master the techniques of these procedures, but to also decrease complications.Recent FindingsMale patients require special attention to facial hair growth patterns, temporal sideburns, and beard growth color and density when determining the type of rhytidectomy incision to pe...
Source: Current Otorhinolaryngology Reports - October 27, 2021 Category: ENT & OMF Source Type: research

Contemporary Management of the Periocular Area
AbstractPurpose of ReviewTo provide the reader with an overview of contemporary management of the periocular area.Recent FindingsThere are various surgical and non-surgical techniques for periocular rejuvenation, with a growing number of minimally invasive approaches. Surgical interventions include blepharoplasty, ptosis repair, browpexy, brow lift, and autologous fat grafting. Non-surgical periorbital rejuvenation techniques include botulinum toxin type A, soft tissue fillers, ablative laser resurfacing, and platelet-rich plasma. Recent surgical techniques focus on volume preservation and enhancement, such as fat repositi...
Source: Current Otorhinolaryngology Reports - October 15, 2021 Category: ENT & OMF Source Type: research

New Technologies in Skin Tightening
This article explores the recent advances in these non-surgical technologies for skin tightening including microcoring, hydroxyapatite fillers, and energy-based devices (lasers, ultrasound, radiofrequency, and plasma).Recent FindingsAdvances in non-surgical skin-tightening devices allow for effective skin tightening. Although fully ablative laser resurfacing devices are often considered the gold standard for non-surgical rejuvenation, important advances in this technology include fractionated energy delivery to decrease risk and shorten treatment recovery. In addition, studies have shown that optimal treatment temperatures...
Source: Current Otorhinolaryngology Reports - October 11, 2021 Category: ENT & OMF Source Type: research

Management of Caudal Septal Deviation: Historic and New Techniques
AbstractPurpose of ReviewSeptoplasty is one of the most commonly performed surgical procedures in otolaryngology. However, correction of the caudal septal deviation is the most difficult part of the septoplasty and a common cause of revision septoplasty. The aim of this paper is to review the various operative techniques described in the literature for caudal septal deviation, as well as surgical outcomes.Recent FindingsMany techniques, such as swinging door method, cross-hatching incision, scoring incision, septal batten graft, horizontal mattress suture, cutting and suture, crossing suture, septal cartilage traction sutu...
Source: Current Otorhinolaryngology Reports - October 9, 2021 Category: ENT & OMF Source Type: research

The Inferior Turbinate: Role in Normal Respiration and Airway Obstruction
AbstractPurpose of ReviewThe understanding of the inferior turbinate (IT) function, role in nasal obstruction, and its management for symptomatic relief has evolved. We aim to provide a comprehensive review of the anatomy, contribution to nasal function and response of the IT to sinonasal disease.Recent FindingsTechniques to study the nasal physiology are expanding; these include the computational flow dynamics that has allowed a better understanding of the function and role of the inferior turbinate in normal respiration and airway obstruction.SummaryThe IT function includes warming, moisturizing, and filtering the air pr...
Source: Current Otorhinolaryngology Reports - September 27, 2021 Category: ENT & OMF Source Type: research

Evolution in Surgical Treatment of Vestibular Schwannomas
This article presents outcomes of modern surgical treatment of VS in the era of radiosurgery and reviews recent published advancements relevant to VS management.Recent FindingsFollowing VS surgery, excellent tumor resection rates and cranial nerve outcomes were achieved in a consecutive series of 572 adult patients with mean postoperative follow up of 4  years. Innovations in surgical technique include endoscopic technique as additional tool to microsurgery, exploration of semi-sitting position for large tumors, and intraoperative use of vasoactive agents as neuroprotective strategy.SummaryDespite great developments in ra...
Source: Current Otorhinolaryngology Reports - September 3, 2021 Category: ENT & OMF Source Type: research

Is There a Perfect Drug for Sedation in DISE?
AbstractPurpose of ReviewDrug-induced sleep endoscopy (DISE) provides additional information about upper airway sites and patterns of narrowing in obstructive sleep apnea. There is a great variability on drugs chosen for DISE in the literature. In this systematic review, we looked for differences in obstruction patterns, as well as cardiovascular, neurological, or respiratory differences between the different drugs.Recent FindingsAll drugs reproduced a similar upper airway collapse on DISE. Propofol and midazolam showed a higher rate of respiratory depression; however, propofol has better pharmacokinetic properties. Dexmed...
Source: Current Otorhinolaryngology Reports - July 26, 2021 Category: ENT & OMF Source Type: research

Radiofrequency Ablation in the Neck for Thyroid Diseases: the Surgical Perspective
This report reviews the current data regarding the advantages of radiofrequency ablation for treating recurrent well-differentiated thyroid cancer.Recent FindingsThe literature favors early ablation of small recurrent lesions, providing the best results while offering decreased incidence of complications when compared to repeated surgical procedures. Nonetheless, recent studies have demonstrated promising results in larger advanced recurrent nodules extending to the neck or with tracheal invasion.SummaryMinimally invasive thermal ablation is carving out its role in the treatment of well-differentiated thyroid cancer. As ne...
Source: Current Otorhinolaryngology Reports - July 22, 2021 Category: ENT & OMF Source Type: research

A Thoughtful Approach to IONM Outcomes Reporting
AbstractPurpose of ReviewTo explore how the different types of intraoperative neuromonitoring (IONM) —namely intermittent (I-IONM) and continuous (C-IONM)—differ from each other and to examine how these differences can affect expected outcomes from IONM.Recent FindingsIntraoperative neuromonitoring (IONM) is an important surgical tool for assessment of nerve functional status during surgical procedures where a particular nerve is at risk of injury. IONM has evolved especially in the thyroid/parathyroid surgical space. Accurate use of IONM is dependent on correct set-up of the monitoring equipment and on the surgeon ’...
Source: Current Otorhinolaryngology Reports - July 22, 2021 Category: ENT & OMF Source Type: research

Holistic Treatment Outcomes in OSA: Clinical Evidence for the SLEEP GOAL
AbstractPurpose of ReviewObstructive sleep apnea (OSA) is a systemic disease that is due to upper airway collapse and obstruction during sleep, resulting in frequent hypoxia, sympathetic overdrive, tachycardia, nocturnal hypertension, and oxidative metabolic stress. Daytime 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; nighttime symptoms include loud snoring, choking at night, gasping for air, frequent arousals, witnessed apneas, and nocturia. OSA can lead to systemic diseases ...
Source: Current Otorhinolaryngology Reports - July 3, 2021 Category: ENT & OMF Source Type: research

Intermittent Neuromonitoring of the Recurrent Laryngeal and Vagus Nerves: the Ins and Outs
AbstractPurpose of ReviewIntermittent intraoperative nerve monitoring has remained a controversial topic in endocrine neck surgery as several studies have produced nonuniform results. Although continuous intraoperative nerve monitoring is a newer technology, intermittent monitoring is still a useful adjunct in safe thyroid surgery when used correctly. This work summarizes the benefits, limitations, setup, and troubleshooting techniques for this technology.Recent FindingsThere are randomized controlled trials and meta-analyses supporting the use of intermittent neuromonitoring in thyroid surgery, but it has not been consist...
Source: Current Otorhinolaryngology Reports - June 19, 2021 Category: ENT & OMF Source Type: research

Palatal Anatomy and Phenotypes for the Treatment of OSA
AbstractPurpose of ReviewThe purpose of the review is to provide background on palatal anatomy and phenotypes to better model the complex upper airway structure.Recent FindingsReview of the literature identifies limited data on upper airway phenotypes and the associated palatal anatomy. The majority of literature evaluates sites of obstruction based on sedated endoscopy without describing the pharyngeal lumen and its characteristics.SummaryUpper airway anatomy is associated with different patterns and airway configurations. These can be described and may represent specific phenotypes. Additional research is needed to assoc...
Source: Current Otorhinolaryngology Reports - June 11, 2021 Category: ENT & OMF Source Type: research

Pediatric OSA: Evidence-Based Review of Treatment Results
AbstractPurpose of ReviewReview current evidence-based treatment outcomes and future management directions for children with obstructive sleep apnea (OSA).Recent FindingsEffective medical therapies include weight loss, leukotriene modifiers, nasal corticosteroids, oral appliances, and positive airway pressure. The first randomized controlled trials for adenotonsillectomy in childhood OSA show improved polysomnography results but no postoperative change in neurocognitive outcomes when compared to watchful waiting. Factors have been identified (e.g., craniofacial disorders and obesity) which can lead to decreased adenotonsil...
Source: Current Otorhinolaryngology Reports - June 9, 2021 Category: ENT & OMF Source Type: research

Tongue Surgery That Works in OSA
AbstractPurpose of ReviewTo describe the current knowledge about tongue base surgery (TBS) in obstructive sleep apnea (OSA). Diagnostic tools and surgical techniques developed during the last years will be illustrated.Recent FindingsTongue base (TB) obstruction can be objectively assessed in a multidisciplinary way through polysomnography, DISE, imaging studies, and measurements of tongue strength. Transoral approaches for TBS include midline glossectomy, radiofrequency TB reduction, coblation TB reduction/resection, and TORS. Transcervical approaches include TB suspension techniques and the newly described upper airway st...
Source: Current Otorhinolaryngology Reports - June 8, 2021 Category: ENT & OMF Source Type: research