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Neoplasms of the Ear Canal
Primary EAC neoplasms include benign and malignant lesions of bony, glandular or cutaneous origin. Small, benign slow growing bony neoplasms are often asymptomatic, diagnosed incidentally and might not require intervention. Both malignant and benign neoplasms of cutaneous and glandular origin can present with symptoms of chronic otitis externa, leading to delays in diagnosis. Prompt biopsy of soft tissue lesions associated with non-resolving otitis externa are warranted. Local and regional imaging is helpful to understand disease extent and origin, but even early-stage malignant neoplasms require aggressive surgical treatm...
Source: Otolaryngologic clinics of North America - July 24, 2023 Category: ENT & OMF Authors: Mallory Raymond Source Type: research

The External Auditory Canal Should Not Be, but Is, Often Overlooked
Discussions about the ear usually focus on the pinna and jump to the tympanic membrane (TM) and middle and inner ear, traversing but ignoring the external auditory canal (EAC), similar to the way that sound waves traverse the ear canal to reach the TM. However, disorders of the EAC, which is also referred to as the external auditory meatus or EAM, affect a significant percentage of the population of all ages, resulting in great physical, monetary, and even emotional costs. A majority of pathologic conditions affecting the EAC require office-based and medical treatment; only a small minority will need surgical intervention....
Source: Otolaryngologic clinics of North America - July 23, 2023 Category: ENT & OMF Authors: Sujana S. Chandrasekhar Tags: Foreword Source Type: research

Skull Base Osteomyelitis
SBO is a life-threatening disease that requires a high index of suspicion based on these patients complex underlying medical co-morbidities and clinician ’s acumen. Once a diagnosis is made, is it critical to communicate and work closely with other multidisciplinary teams (neuroradiology for appropriate choice of imaging study and interpretation; infectious disease for appropriate medical treatment and duration; internist to properly manage their u nderlying medical co-morbidities). Despite advances in imaging, the diagnosis is first made based on clinical judgment, appropriate culture, and tissue biopsy. (Source: Otolar...
Source: Otolaryngologic clinics of North America - July 19, 2023 Category: ENT & OMF Authors: Mickie Hamiter, Valerianna Amorosa, Katherine Belden, Paul W. Gidley, Suyash Mohan, Brian Perry, Ana H. Kim Source Type: research

Pediatric Head and Neck Trauma
The pediatric patient population has unique anatomic characteristics that bring challenges and increased risk to management. The purpose of this article is to guide the head and neck trauma surgeon in decision making for the treatment of pediatric head and neck trauma with an emphasis on facial fracture management. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - July 15, 2023 Category: ENT & OMF Authors: Sara Bressler, Lisa Morris Source Type: research

Management of Complications and Secondary Deformity After Fractures of the Midface, Orbit, and Upper Third of the Maxillofacial Skeleton
Craniomaxillofacial trauma is a challenging entity to manage effectively and often necessitates serial evaluation and treatment. A multidisciplinary team is best served to evaluate and treat these complex injury patterns with the use of necessary adjuncts, such as neuronavigation, intraoperative imaging, custom implant use, and virtual surgical planning. Complications of facial trauma can present at a spectrum of time points and manifest in a variety of manners and as such patients should be observed closely and longitudinally. Although not all complications and secondary deformities can be avoided, this article highlights...
Source: Otolaryngologic clinics of North America - July 11, 2023 Category: ENT & OMF Authors: Nima Vahidi, Peter Kwak, Dimitrios Sismanis, Theodore Schuman, Daniel Hawkins, Thomas S. Lee Source Type: research

Laryngeal Trauma
Laryngeal trauma is rare but potentially fatal. Initial evaluation includes efficient history and physical examination, imaging, bedside flexible laryngoscopy, and if necessary, operative endoscopic evaluation. Multiple classification systems exist for laryngeal trauma, and each has its merits. We recommend a patient-centered approach, rather than using the classification alone. Secure airways are the primary goal of acute management, with awake tracheostomy more often indicated over oral intubation compared with traumas not involving the larynx. More severe injuries typically require surgical intervention. Early intervent...
Source: Otolaryngologic clinics of North America - July 11, 2023 Category: ENT & OMF Authors: Claude Nganzeu, Antoinette Esce, Sara Abu-Ghanem, Duncan A. Meiklejohn, H. Steven Sims Source Type: research

Dermatologic Conditions of the External Ear
Cutaneous diseases of the ear encompass a wide range of symptoms, complaints, and factors that negatively impact patients ’ well-being. These observations are frequently encountered by otolaryngologists and other physicians who treat individuals with ear-related issues. In this document, we aim to offer up-to-date information on diagnosing, predicting outcomes, and treating commonly occurring ear diseases. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - July 7, 2023 Category: ENT & OMF Authors: Rebecca Leibowitz, Jenna E. Koblinski, Latrice M. Hogue, Justin T. Cheeley, Travis W. Blalock Source Type: research

Radiotherapy-induced Pathology of the Ear
Acute radiotherapy (RT)-induced external ear soft tissue changes start with erythema and dry desquamation and may progress to moist desquamation and epidermal ulceration. Chronic RT-induced changes include epithelial atrophy and subcutaneous fibrosis. Although RT-induced radiation dermatitis has been well studied, interventions for soft tissue disease involving the external auditory canal (EAC) warrant investigation. Medical management includes topical steroid treatment for EAC radiation dermatitis and topical antibiotic therapy for suppurative otitis externa. Hyperbaric oxygen and pentoxifylline –vitamin E therapy have ...
Source: Otolaryngologic clinics of North America - July 4, 2023 Category: ENT & OMF Authors: Kaitlyn A. Brooks, Jennifer H. Gross Source Type: research

Perioperative Management of Patients with Craniomaxillofacial Trauma
Successful surgical management of patients with facial fractures requires a detailed preoperative evaluation and postoperative management that differs from elective surgical patients. This review presents evidence-based recommendations from the surgical and anesthesiology literature that address many of the clinical questions that arise during the perioperative management of this group of patients. Surgeons and anesthesiologists must work together at numerous points and make joint decisions, especially where airway and pain management challenges may arise. The multidisciplinary nature of the decision-making process is emph...
Source: Otolaryngologic clinics of North America - July 4, 2023 Category: ENT & OMF Authors: Tzu-Hsuan Cheng, Matthew Mendelsohn, Radhika Patel, Samrat Worah, Sydney C. Butts Source Type: research

Temporal Bone Trauma
Temporal bone trauma represents a potentially underrecognized condition during head injuries and remains an important consideration during the evaluation of these patients. The temporal bone contains many critical neurovascular structures in addition to the primary organs of the auditory and vestibular systems that may be violated during these injuries. Despite the lack of consensus guidelines on the management of these injuries, this review highlights the current literature regarding the diagnosis and management of temporal bone trauma and its potential complications. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - June 28, 2023 Category: ENT & OMF Authors: James Dixon Johns, Corinne Pittman, Selena E. Briggs Source Type: research

Current Trends in Head and Neck Trauma
The practicing otolaryngologist frequently encounters consultation for injuries in the head and neck. Restoration of form and function is essential to normal activities of daily living and quality of life. This discussion intends to provide the reader with an up-to-date discussion of various evidence-based practice trends related to head and neck trauma. The discussion focuses on the acute management of trauma with minor emphasis on secondary management of injuries. Specific injuries related to the craniomaxillofacial skeleton, laryngotracheal complex, vascularity, and soft tissues are explored. (Source: Otolaryngologic cl...
Source: Otolaryngologic clinics of North America - June 27, 2023 Category: ENT & OMF Authors: Gregory I. Kelts, Travis R. Newberry Source Type: research

Enhanced Recovery After Surgery for Head and Neck Oncologic Surgery Requiring Microvascular Reconstruction
It has been demonstrated since the 1990 ’s that surgical outcomes can be improved through protocolized perioperative interventions. Since then, multiple surgical societies have engaged in adopting Enhanced Recovery After Surgery (ERAS) Societal recommendations to improve patient satisfaction, decrease the cost of interventions, and impr ove outcomes. In 2017, ERAS released consensus recommendations detailing the perioperative optimization of patients undergoing head and neck free flap reconstruction. This population was identified as a high resource demand, oftentimes burdened with challenging comorbidity, and poorly des...
Source: Otolaryngologic clinics of North America - June 27, 2023 Category: ENT & OMF Authors: Curtis Hanba, Carol Lewis Source Type: research

Improving Quality and Value in Head and Neck Reconstruction
Multiple advances in surgical techniques, technology, and perioperative patient care have revolutionized head and neck reconstruction over the last 40  years. Concurrent with these advances, health systems, patients, and payers have become increasingly focused on value and quality, owing in part to rapidly increasing health care costs. However, there is no consensus on how to define value and quality in the realm of head and neck reconstruction. This review focuses on the past, present, and future of quality improvement efforts in head and neck reconstruction. (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - June 27, 2023 Category: ENT & OMF Authors: Kiran Kakarala, Matthew Mifsud, Peter Dziegielewski Source Type: research

Reconstruction Options in Otolaryngology
OTOLARYNGOLOGIC CLINICS OF NORTH AMERICA (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - June 27, 2023 Category: ENT & OMF Authors: Jayne R. Stevens, Kiran Kakarala Source Type: research

Copyright
Elsevier (Source: Otolaryngologic clinics of North America)
Source: Otolaryngologic clinics of North America - June 27, 2023 Category: ENT & OMF Source Type: research