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Otolaryngologic Clinics of North America

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https://www.readbyqxmd.com/read/29106888/acquired-vascular-tumors-of-the-head-and-neck
#1
REVIEW
Mark Persky, Theresa Tran
Vascular neoplasms of the head and neck present with a wide spectrum of signs and symptoms. Diagnosis requires a high index of suspicion and is usually made after tumors are large enough to be visually apparent or cause symptoms. This article discusses the most common acquired benign and malignant vascular tumors, with an emphasis on their evaluation and treatment.
October 26, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28992951/the-role-of-allergy-in-otologic-disease
#2
REVIEW
Betty Yang, Christopher D Brook
Allergy is commonly associated with conditions such as rhinitis, sinusitis, and asthma, but the relationship between allergy and otologic diseases is less clear. This article examines the evidence for a relationship between allergic disease and several common otologic conditions, including otitis media with effusion, eosinophilic otitis media, and Ménière's disease.
October 6, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28964532/contemporary-pharmacotherapy-for-allergic-rhinitis-and-chronic-rhinosinusitis
#3
REVIEW
Saied Ghadersohi, Bruce K Tan
Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) are chronic conditions causing nasal inflammation. CRS is increasingly recognized as a chronic inflammatory process rather than a chronic infection. Although the primary initiating factors in CRS remain unclear, AR is driven by IgE-mediated hypersensitivity to environmental allergens. Understanding the underlying inflammatory pathways and disease endotypes are driving innovation toward novel pharmacotherapies targeting critical mediators implicated in CRS and AR, including IL-4, IL-13, IL-5, IgE, and epithelial initiators IL-33 and TSLP...
September 27, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28964530/efficacy-and-safety-of-subcutaneous-and-sublingual-immunotherapy-for-allergic-rhinoconjunctivitis-and-asthma
#4
REVIEW
Christopher R Roxbury, Sandra Y Lin
Allergic rhinitis is often associated with asthma and has significant impacts on health care costs and productivity in the United States. Although allergen avoidance and pharmacotherapy are effective, allergen-specific immunotherapy is the only treatment that may lead to improved allergy symptoms even after treatment is discontinued. Subcutaneous immunotherapy has been the mainstay of allergen-specific immunotherapy in the United States for decades, but sublingual immunotherapy has recently become available...
September 27, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28964529/advances-in-food-allergy
#5
REVIEW
Christine B Franzese
Food allergy has been increasing in prevalence for the last few decades, and numerous studies have evaluated ways of improving the allergy practitioner's ability to accurately diagnose patients who are truly food allergic, rather than sensitive but able to tolerate food. Once diagnosed, the current standard treatment is food elimination and avoidance, but other potential treatment options like oral immunotherapy, sublingual immunotherapy, and epicutaneous immunotherapy are becoming promising alternatives. Due the health care costs and potential for life-threatening adverse reactions, much attention has been given to the prevention of food allergies, resulting a shift in recent guideline recommendations...
September 27, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28964528/immunotherapy-treating-with-fewer-allergens
#6
REVIEW
Cecelia Damask
Polysensitization, sensitization to more than one allergen, is a common feature of patients with allergic rhinitis, and may be a risk factor for subsequent development of allergic diseases, especially allergic asthma. However, a polysensitized patient does not necessarily have polyallergy, a documented, causal relationship between exposure to 2 or more specific, sensitizing allergens and the subsequent occurrence of relevant clinical symptoms of allergy. Allergen immunotherapy treatment strategy for the polysensitized patient in Europe is to treat the single or 2 most clinically relevant allergen(s), whereas patients in the United States are usually treated for all potential clinically relevant allergens...
September 27, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29103456/allergy-for-the-otolaryngologist
#7
EDITORIAL
Murugappan Murray Ramanathan, James W Mims
No abstract text is available yet for this article.
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29103455/allergy-as-part-of-the-unified-otolaryngologic-practice
#8
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29103454/management-of-anaphylaxis
#9
REVIEW
Stella E Lee
Anaphylaxis is a severe systemic reaction that can be managed appropriately with expedient diagnosis and treatment. Intramuscular epinephrine continues to be the mainstay of treatment of anaphylaxis; however, it is still underused in the community and in the medical setting. Further education and counseling of patients and health care providers is required to prevent and manage anaphylaxis successfully. In-office management of anaphylaxis includes training of staff, preparedness with the necessary supplies and medication, and an effective action plan...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29103453/clinical-applications-of-sublingual-immunotherapy
#10
REVIEW
Thomas S Edwards, Sarah K Wise
Sublingual immunotherapy (SLIT) is effective for the treatment of allergic rhinitis and allergic asthma in adults and children. In a limited number of studies, SLIT efficacy has been demonstrated for the treatment of food allergy. SLIT has a higher safety profile versus subcutaneous immunotherapy, although some systemic reactions have been reported. Appropriate patient selection, meticulous patient education, and routine follow-up are key for the safe and effective administration of SLIT. With organization and attention to detail, adding SLIT to one's practice can provide a highly valued patient service...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29103452/rational-approach-to-allergy-testing
#11
REVIEW
Michael P Platt, Jacqueline A Wulu
Allergy testing is commonly used when symptoms of allergic rhinitis are refractory to symptoms and there is potential for treatment with institution of avoidance measures or immunotherapy. Once the decision for testing has been made, the method of testing by either in vivo skin testing by prick/puncture or intradermal testing or in vitro testing of serum-specific IgE is dictated by factors in the clinical history and an informed decision by the patient. Because there is no perfect testing method, understanding the benefits and limitations of each method is important in selecting the best testing option for each patient...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28992950/future-horizons-in-allergy
#12
REVIEW
Michael J Marino, Amber U Luong
There are several advances in diagnosis and management for the otolaryngologist treating allergy. These include new technologies and the refinement of current techniques, and reflect overall trends in health care toward personalized medicine. Local immunoglobulin, urinary leukotriene E4, lipidomics, microRNA within extracellular vesicles, and optical rhinometry all offer to improve the diagnostic accuracy of allergy and related nonallergic conditions. New delivery systems for intranasal steroids and antihistamines, recombinant allergens, advances in allergen immunotherapy delivery, and biologics will improve current management options...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28988815/advancements-and-dilemmas-in-the-management-of-allergy
#13
REVIEW
James W Mims
Recent advances in the diagnosis and management of allergic disease also lead to new clinical decisions for providers. Advances in component (or molecular) diagnostic testing for allergy continue to build in the literature, but diagnosing inhalant allergy remains largely unchanged clinically. Prevention of allergy has been demonstrated by preventing peanut allergy in high-risk infants by intentional oral exposure to promote tolerance. Immunotherapy options have increased, with literature supporting sublingual drops, sublingual tablets, and subcutaneous immunotherapy...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28988814/the-role-of-the-sinonasal-epithelium-in-allergic-rhinitis
#14
REVIEW
Nyall R London, Murugappan Ramanathan
The sinonasal epithelial barrier is comprised of tight and adherens junction proteins. Disruption of epithelial barrier function has been hypothesized to contribute to allergic disease such as allergic rhinitis through increased passage of antigens and exposure of underlying tissue to these stimuli. Several mechanisms of sinonasal epithelial barrier disruption include antigen proteolytic activity, inflammatory cytokine-mediated tight junction breakdown, or exacerbation from environmental stimuli. Mechanisms of sinonasal epithelial barrier stabilization include corticosteroids and nuclear erythroid 2-related factor 2 (Nrf2) cytoprotective pathway activation...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28988813/asthma-management-for-the-otolaryngologist
#15
REVIEW
John H Krouse
Asthma is a chronic inflammatory disease that will frequently be encountered by otolaryngologists as they manage their patients with upper respiratory diseases. Symptoms such as cough should alert otolaryngologists to consider more broadly the potential role of asthma in the differential diagnosis. It is critical for otolaryngologists to appreciate that patients with allergic rhinitis and chronic rhinosinusitis will often have asthma, and that many of them may not be diagnosed at the time of presentation. Appropriate diagnosis of the patient with asthma, as well as effective treatment for its symptoms, will improve patient function and enhance quality of life...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28967389/manifestations-of-inhalant-allergies-beyond-the-nose
#16
REVIEW
Julie P Shtraks, Elina Toskala
The upper and lower airways are linked epidemiologically and pathophysiologically. The upper and lower airways are considered a single, functional unit characterized by shared immunologic mechanisms, often referred to as the unified airway. Upper and lower airway inflammatory disease frequently coexist in the same patient. Allergic rhinitis and rhinosinusitis are associated with asthma. Treatment of both diseases impacts asthma outcomes. The otolaryngologist may be the first physician to suspect and diagnose asthma in patients with upper airway complaints...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28964531/the-role-of-allergy-in-chronic-rhinosinusitis
#17
REVIEW
Ashleigh A Halderman, Laura J Tully
The role of allergy in chronic rhinosinusitis (CRS) has long been debated and remains controversial. The 2 diseases frequently co-occur; however, direct causality has never been proved. The literature is largely mixed as to the manner and degree by which allergy contributes to CRS and this is in large part due to heterogeneity in the definitions of allergy and of CRS. In this review, the potential role of allergy in the disease processes of CRS without polyps, CRS with polyps, and allergic fungal rhinosinusitis is discussed...
December 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28915950/improving-team-performance-through-simulation-based-learning
#18
REVIEW
Mark S Volk
American health care is facing an epidemic of medical errors. A major cause of these errors is poor teamwork. Crisis resource management (CRM) is a set of teamwork principles derived from the airline industry. Medical simulation is an educational tool that affords health care providers a means of improving teamwork by learning and practicing CRM. This article (1) discusses the case for teaching team training, (2) reviews the principles of medical simulation as they pertain to team training, (3) provides practical guidelines for using medical simulation in otolaryngology education, (4) discusses current evidence for the efficacy of medical simulation...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28915949/assessment-of-surgical-skills-and-competency
#19
REVIEW
Nasir I Bhatti
Evaluation of surgical skills and competency are important aspects of the medical education process. Measurable and reproducible methods of assessment with objective feedback are essential components of surgical training. Objective Structured Assessment of Technical Skills (OSATS) is widely used across the medical specialties and otolaryngology-specific tools have been developed and validated for sinus and mastoid surgery. Although assessment of surgical skills can be time-consuming and requires human and financial resources, new evaluation methods and emerging technology may alleviate these barriers while also improving data collection practices...
October 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28915948/the-economics-of-surgical-simulation
#20
REVIEW
Noel Jabbour, Carl H Snyderman
There are massive hidden costs in the current paradigm of surgical training related to increased operative times for procedures with resident involvement and costs of medical errors. Shifting procedural training outside of the operating room through use of simulation has the potential to improve patient safety, minimize learning time to achieve competency, and increase operative efficiency. Investment in surgical simulation has the potential to reduce costs to health care systems through improved operating room efficiency and reduction of medical errors...
October 2017: Otolaryngologic Clinics of North America
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