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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 29, 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 21, 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 2, 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 al., Ann Dermatol...
Source: Current Otorhinolaryngology Reports - June 21, 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 13, 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 2, 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 23, 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 16, 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 13, 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 6, 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 2, 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 how to ...
Source: Current Otorhinolaryngology Reports - May 1, 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 29, 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 25, 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 21, 2019 Category: ENT & OMF Source Type: research