Operative Techniques in Otolaryngology - Head and Neck Surgery This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Coblation Intracapsular Tonsillectomy in Pediatric Patients
Coblation intracapsular tonsillectomy (IT) is a relatively new technique in pediatric tonsillectomy and represents a significant step forward in quality and safety in the treatment of pediatric tonsillar hypertrophy. Studies, and our own clinical experience, suggest that it has equivalent efficacy to total tonsillectomy (TT) in the treatment of sleep-disordered breathing and even recurrent tonsillitis1. Furthermore, children who undergo IT have been shown to experience less pain, have increased PO intake, and be more active than those who undergo TT, particularly by POD 52. (Source: Operative Techniques in Otolaryngology -...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 31, 2020 Category: ENT & OMF Authors: Steven M. Chau, Gurpreet S. Ahuja, Kevin C. Huoh, Nguyen S. Pham Source Type: research

Preoperative assessment of the difficult airway in otolaryngology – implications for operative technique and airway management
Despite a plethora of articles describing airway assessment, there is no magic bullet for difficult airway evaluation. Statistical validation of scoring systems and radiological evaluations appear to be elusive. The reason for our inability to reliably assess every airway is complex. Every airway has a subset of subtly different anatomical variables and when taken in totality may result in difficult bag mask ventilation or difficult intubation. Simply looking at 5-12 risk factors may not be relevant or adequate for an individual. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 14, 2020 Category: ENT & OMF Authors: Analee Milner Source Type: research

Preoperative assessment of the difficult airway in otolaryngology- implications for operative technique and airway management
Despite a plethora of articles describing airway assessment, there is no magic bullet for difficult airway evaluation. Statistical validation of scoring systems and radiological evaluations appear to be elusive. The reason for our inability to reliably assess every airway is complex. Every airway has a subset of subtly different anatomical variables and when taken in totality may result in Difficult Bag Mask ventilation (DBMV) or Difficult Intubation (DI). Simply looking at five to 12 risk factors may not be relevant or adequate for an individual. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 14, 2020 Category: ENT & OMF Authors: Analee Milner Source Type: research

The Difficult Airway in Severe Facial Trauma
Consideration of the airway is paramount in management of facial fractures in both the acute setting and delayed repair. As experts in laryngotracheal surgery, otolaryngologists often play a key role in airway management in both settings. On presentation, soft tissue edema and prolapse or presence of blood in the airway may complicate placement of an endotracheal tube and may necessitate emergent intervention. During planned fracture repair, surgeons and anesthesiologists must collaborate to determine a precise airway plan due to the inherent conflict of a need for a secure airway and a need for surgical access. (Source: O...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 9, 2020 Category: ENT & OMF Authors: Danielle Kumpf, Robert Saadi, Jessyka G. Lighthall Source Type: research

A multidisciplinary approach for managing the infraglottic difficult airway in the setting of the Coronavirus pandemic
Management of a difficult airway caused by pathology below the glottis is high-risk and requires a shared approach to airway planning and surgical treatment. Access to the trachea requires a careful assessment of the airway since the end-point of laryngoscopy for infraglottic airway management is not visualization of the larynx for tube placement, but access to the laryngotracheal complex in cases where intubation may not be feasible or may preclude surgical access.This work provides a common framework for creating multidisciplinary shared-airway management plans and presents devices and strategies that have in recent year...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: S.A.R. Nouraei, M. Girgis, J. Shorthouse, K. El-Boghdadly, I. Ahmad Source Type: research

A multidisciplinary approach for managing the infraglottic difficult airway in the settings of the Coronavirus pandemic
Management of a difficult airway caused by pathology below the glottis is high-risk and requires a shared approach to airway planning and surgical treatment. Access to the trachea requires a careful assessment of the airway since the end-point of laryngoscopy for infraglottic airway management is not visualization of the larynx for tube placement, but access to the laryngotracheal complex in cases where intubation may not be feasible or may preclude surgical access.This work 23 provides a common framework for creating multidisciplinary shared-airway management plans and presents devices and strategies that have in recent y...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: S.A.R. Nouraei, M. Girgis, J. Shorthouse, K. El-Boghdadly, I. Ahmad Source Type: research

Multidisciplinary airway response teams: Concept, structure, & implementation
Airway management challenges encompass the anticipated (eg, airway pathology, history of difficult intubation, bleeding) and the unanticipated. Challenging airway situations also occur in patients with existing in situ tracheostomy tubes and laryngectomy stomas or in intubated patients around the time of planned or unplanned extubation. Preparedness to handle difficult airway scenarios requires a structured approach to patient assessment, identification, and planning. Preparedness also necessitates an organized, disseminated, and predefined process to deliver appropriate resources efficiently to the bedside in an emergency...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Joshua H. Atkins, Christopher H. Rassekh Source Type: research

“Cannot Intubate, Cannot Oxygenate” (CICO) rescue by emergency Front of Neck Airway (eFONA)
In airway management, a ``Cannot Intubate, Cannot oxygenate ” emergency, or simply ``CICO” (IPA: kaɪkəʊ), is an inability to restore alveolar oxygenation by means of any non-surgical lifeline (facemask, endotracheal tube, or supraglottic airway device). With ``CICO,” hypoxic brain damage and death will result unless there is rapid resolution. The ab ility of an airway team member to swiftly establish an emergency Front of Neck Airway as a CICO rescue is currently deemed to be an essential skill for everyone that performs tracheal intubations. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Wayne Pearce, Jeremy Barr, Kasra Ziai, Neerav Goyal Source Type: research

Contemporary approach to the difficult airway management
A difficult airway can arise as a primary emergent or urgent one, or during an elective procedure, with unexpected and rapid deterioration in oxygenation. Both scenarios may be handled differently. However, open communication and planning between airway specialists involved are critical for a good outcome. Depending on the underlying causes of difficult airway situations, different approaches and management algorithms obtain. The Otolaryngologist-Head and Neck Surgeon (OHNS) should be familiar and comfortable with difficult airway situations, have an open dialogue with the rest of the airway team, and always plan for failu...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Dana Goldenberg, Sonia Vaida Source Type: research

Two curves and three columns –A reappraisal of direct laryngoscopy
Airway management requires an assessment of the 2 curves of the airway and how these are affected by pathology within the head and neck region. The changes in airway curvature due to head and neck positioning as well as regional pathology are correlated with the effects of different airway devices to enable the operator to predict the success or failure of airway management. Airway device groups are not mutually exclusive to specific airway pathologies but may function successfully in a variety of scenarios. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Keith B. Greenland Source Type: research

Nasal Dermoid Cyst Excision with a Lateral Rhinotomy Approach through the Nasal Alar Sulcus
Congenital midline nasal masses are uncommon, occurring anywhere from 1 in 20,000 to 1 in 40,000 births.[1] They result from anomalies in neural tube closure between the 3rd and 4th week of gestation.[2] Pediatric nasal midline masses of ectodermal origin include nasal dermoids (ND) and nasal dermoid sinus cysts (NDSC). NDSCs are characterized by intracranial extension whereas NDs are limited to the nasal dorsum, medial canthus, or glabella.[3] NDs are the most common congenital midline nasal mass and develop as a result of failed involution of the neuroectomderm in the prenasal space. (Source: Operative Techniques in Otol...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: John W. Lally, Alexandra Ortiz, Jon Robitschek, Michael Demarcantonio Source Type: research

Introduction
It is an honor to serve as an anesthesiologist as a guest editor for this issue on the difficult airway of Operative Techniques in Otolaryngology, especially at a time of unprecedented world-wide interprofessional collaboration in the elaboration of guidelines and strategies to prevent airway complications. Today there are calls for reorganizing care in hospitals by establishing local multidisciplinary airway safety teams responsible for all aspects of advanced airway management, and in particular invasive airway management, that would “take note of current concepts, techniques and existing guidelines from relevant speci...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Wayne Pearce Source Type: research

Contemporary approach to the difficult airway
A difficult airway can arise as a primary emergent or urgent one, or during an elective procedure, with unexpected and rapid deterioration in oxygenation. Both scenarios may be handled differently. However, open communication and planning between airway specialists involved are critical for a good outcome. Depending on the underlying causes of difficult airway situations, different approaches and management algorithms obtain. The Otolaryngologist-Head and Neck Surgeon (OHNS) should be familiar and comfortable with difficult airway situations, have an open dialogue with the rest of the airway team, and always plan for failu...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Dana Goldenberg, Sonia Vaida Source Type: research

Two Curves and Three Columns – a reappraisal of direct laryngoscopy
Airway management requires an assessment of the two curves of the airway and how these are affected by pathology within the head and neck region.  The changes in airway curvature due to head and neck positioning as well as regional pathology are correlated with the effects of different airway devices to enable the operator to predict the success or failure of airway management. Airway device groups are not mutually exclusive to specific air way pathologies but may function successfully in a variety of scenarios. (Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Keith B. Greenland Source Type: research

‘Cannot Intubate, Cannot Oxygenate’ (CICO) rescue by emergency Front of Neck Airway (eFONA)
In airway management, a ‘Cannot Intubate, Cannot oxygenate’ emergency, or simply ‘CICO’ (IPA: kaɪkəʊ), is an inability to restore alveolar oxygenation by means of any lifeline (facemask, endotracheal tube or supraglottic airway device) through the upper airway. With ‘CICO’, hypoxic brain damage and death wil l result unless there is rapid resolution. The ability of an airway team member to swiftly establish an emergency Front of Neck Airway (eFONA) as a CICO rescue is currently deemed to be an essential skill for everyone that performs tracheal intubations. (Source: Operative Techniques in Otolaryngology - H...
Source: Operative Techniques in Otolaryngology - Head and Neck Surgery - May 2, 2020 Category: ENT & OMF Authors: Wayne Pearce, Jeremy Barr, Kasra Ziai, Neerav Goyal Source Type: research