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Otolaryngologic Clinics of North America

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https://www.readbyqxmd.com/read/28162242/endoscopic-resection-of-pterygopalatine-fossa-and-infratemporal-fossa-malignancies
#1
REVIEW
Gretchen M Oakley, Richard J Harvey
The endoscopic resection of pterygopalatine and infratemporal fossa malignancies allows excellent visualization and manipulation of tissues in an anatomically complex area compared with open approaches. With less approach morbidity, endoscopic endonasal surgery allows an easier recovery and earlier transition to adjuvant radiotherapy. The endoscopic approach is minimal access but rarely minimally invasive. Surgeons should not hesitate to gain wide surgical exposure of the pterygopalatine, infratemporal fossa, and petrocavernous carotid artery to ensure comfortable maneuverability and easy visualization of the tumor and its normal tissue margins...
February 2, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28162241/transfacial-and-craniofacial-approaches-for-resection-of-sinonasal-and-ventral-skull-base-malignancies
#2
REVIEW
Elizabeth L Perkins, Bryan M Brandon, Satyan B Sreenath, Dipan D Desai, Brian D Thorp, Charles S Ebert, Adam M Zanation
Malignancies of the paranasal sinuses and ventral skull base present unique challenges to physicians. A transfacial or craniofacial approach allows for wide, possibly en bloc resection and is ideal for tumors that involve surrounding soft tissue, the palate, the orbit, anterolateral frontal sinus, and lateral dura. Transfacial approaches include a lateral rhinotomy often combined with a medial, subtotal, or total maxillectomy. Reconstruction is most commonly performed with a pericranial flap to separate the intranasal and intracranial compartments...
February 2, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28162240/endoscopic-resection-of-sinonasal-and-ventral-skull-base-malignancies
#3
REVIEW
Ghassan Alokby, Roy R Casiano
The transnasal endoscopic resection of ventral skull base lesions represents a safe and effective method for the surgical management of sinonasal and ventral skull base malignancies in carefully selected cases. The goal of surgery is complete removal of all tumor with negative resection margins while maintaining the key oncological principles. Careful selection of cases along with the presence of an experienced surgeon and a fully involved multidisciplinary skull base team trained in the management of ventral skull base neoplasm are essential for excellent outcomes...
February 2, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28160998/overview-of-sinonasal-and-ventral-skull-base-malignancy-management
#4
REVIEW
Peter F Svider, Michael Setzen, Soly Baredes, James K Liu, Jean Anderson Eloy
Significant technological advances have fostered a movement toward minimally invasive surgical interventions for the management of ventral skull base malignancies. The care of patients with these lesions ideally involves an interdisciplinary skull base team that includes otolaryngologists, neurologic surgeons, radiation oncologists, and medical oncologists. This overview describes considerations essential for diagnosis, prognosis, and preoperative evaluation. Furthermore, surgical nuances, strategies for skull base reconstruction, and nonsurgical options are briefly discussed...
February 1, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28160997/the-role-of-chemotherapy-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#5
REVIEW
George A Scangas, Jean Anderson Eloy, Derrick T Lin
In most cases of advanced sinonasal and ventral skull base cancer, a multimodal treatment approach provides the best chance for improved outcomes. Depending on the tumor type and extent of disease, systemic chemotherapy has been shown to play an important role in neoadjuvant, concomitant, and adjuvant settings. The lack of randomized trials continues to limit its indications. Further high-quality studies are needed to understand ideal chemotherapeutic regimens and their role and sequential timing in sinonasal and ventral skull base cancer...
February 1, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28160996/survival-morbidity-and-quality-of-life-outcomes-for-sinonasal-and-ventral-skull-base-malignancies
#6
REVIEW
Suat Kilic, Sarah S Kilic, Soly Baredes, James K Liu, Jean Anderson Eloy
Sinonasal and ventral skull base malignancies are a rare, heterogeneous group of cancers. Although prognosis usually depends on many factors, long-term survival rates remain low despite recent advances. Population-based databases are powerful resources for studying survival outcomes. However, institutional retrospective chart-review studies have been able to provide more insight on recurrence patterns, morbidity, and quality-of-life metrics, as well as more details of the treatment information that may affect outcomes...
February 1, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28160995/the-making-of-a-skull-base-team-and-the-value-of-multidisciplinary-approach-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#7
REVIEW
Carl H Snyderman, Eric W Wang, Juan C Fernandez-Miranda, Paul A Gardner
The management of sinonasal and ventral skull base malignancies is best performed by a team. Although the composition of the team may vary, it is important to have multidisciplinary representation. There are multiple obstacles, both individual and institutional, that must be overcome to develop a highly functioning team. Adequate training is an important part of team-building and can be fostered with surgical telementoring. A quality improvement program should be incorporated into the activities of a skull base team...
February 1, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28104275/anatomic-considerations-for-sinonasal-and-ventral-skull-base-malignancy
#8
REVIEW
Thomas J Willson, Juan C Fernandez-Miranda, Cristian Ferrareze Nunes, Stefan Lieber, Eric W Wang
Malignancies of the sinonasal region and ventral skull base include a varied group of uncommon tumors that are a challenge to treat. These malignancies, with few exceptions, often present late because of their insidious growth and bland symptomatology. As with malignancies of other sites, the primary goal in surgical management is complete resection with negative margins. This presents a unique surgical challenge in that these lesions lie within a region of densely populated anatomic real estate. This fact reinforces the importance of complete preoperative work-up and a sound anatomic understanding...
January 16, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28104274/the-role-of-radiation-therapy-in-the-management-of-sinonasal-and-ventral-skull-base-malignancies
#9
REVIEW
Kyle Wang, Adam M Zanation, Bhishamjit S Chera
Sinonasal and ventral skull base malignancies are rare tumors that arise in a complex anatomic location juxtaposed with critically important normal tissues. The standard treatment paradigm for most histologies has been surgery followed by postoperative radiation therapy. Because of their propensity to present at an advanced stage and the presence of nearby critical structures, patients are at risk for severe radiation-induced long-term toxicity. Recent advances in radiotherapy technique have improved the therapeutic ratio between tumor control and normal tissue toxicity...
January 16, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888920/refractory-chronic-rhinosinusitis
#10
EDITORIAL
Abtin Tabaee, Edward D McCoul
No abstract text is available yet for this article.
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888919/chronic-rhinosinusitis-a-simple-complex-condition
#11
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888918/systemic-and-odontogenic-etiologies-in-chronic-rhinosinusitis
#12
REVIEW
Edward C Kuan, Jeffrey D Suh
Systemic and odontogenic etiologies of chronic rhinosinusitis, although rare, are an integral consideration in the comprehensive management of patients with sinonasal disease. Proper knowledge and timely recognition of each disease process, with referrals to appropriate consultants, will facilitate treatment, because many of these conditions require both local and systemic therapy. In some instances, medical therapy plays a pivotal role, with surgery being a supplemental treatment technique. We review the most commonly encountered systemic etiologies of chronic rhinosinusitis and odontogenic sinusitis, including clinical presentation, diagnosis, management, and treatment outcomes...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888917/aspirin-exacerbated-respiratory-disease
#13
REVIEW
Evan S Walgama, Peter H Hwang
Aspirin-exacerbated respiratory disease (AERD) is characterized by the triad of asthma, sinonasal polyposis, and aspirin intolerance. The hallmark of the disease is baseline overproduction of cysteinyl leukotrienes via the 5-lipoxygenase pathway, exacerbated by ingestion of aspirin. Patients with AERD have high rates of recidivistic polyposis following sinus surgery, although the improvement in quality of life following surgery is similar to aspirin-tolerant patients. The diagnosis is secured by a positive aspirin provocation test, usually administered by a medical allergist...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888916/refractory-chronic-rhinosinusitis-with-nasal-polyposis
#14
REVIEW
Benjamin P Hull, Rakesh K Chandra
Chronic rhinosinusitis with nasal polyposis (CRSwNP) represents a subset of chronic sinusitis with various causes. Some forms of the disease are driven by allergy, often in association with asthma. Refractory CRSwNP can be associated with cystic fibrosis and other clinical syndromes. More recent literature is presented regarding roles of innate immunity and superantigens. Effective treatment of CRSwNP requires careful endoscopic sinus surgery followed by an individualized treatment plan that often includes oral and topical steroids...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888915/biofilm-and-osteitis-in-refractory-chronic-rhinosinusitis
#15
REVIEW
Yi Chen Zhao, Peter-John Wormald
Our understanding of chronic rhinosinusitis (CRS) show biofilm and osteitis play a role in the disease's pathogenesis and refractory. Studies point to its role in pathogenesis and poor prognosis. Outside the research laboratory, biofilm detection remains difficult and specific treatment remains elusive. It is believed that osteitis is a nidus of inflammation and occurs more commonly in patients with refractory CRS. However, osteitis may be exacerbated by surgery and a marker of refractory disease, not a causative agent...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888914/bacterial-pathogens-and-the-microbiome
#16
REVIEW
Thad W Vickery, Vijay R Ramakrishnan
Bacterial pathogens and microbiome alterations can contribute to the initiation and propagation of mucosal inflammation in chronic rhinosinusitis (CRS). In this article, the authors review the clinical and research implications of key pathogens, discuss the role of the microbiome, and connect bacteria to mechanisms of mucosal immunity relevant in CRS.
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888913/a-practical-approach-to-refractory-chronic-rhinosinusitis
#17
REVIEW
Edward D McCoul, Abtin Tabaee
Patients with refractory chronic rhinosinusitis, by definition, have persistent, poorly controlled symptoms and objective inflammatory findings despite prior medical and surgical therapy. These patients represent a diagnostic and treatment challenge given the complexity of the underlying disease factors and the limitations in available management options. This article presents a practical framework for clinical evaluation and treatment. Germane to discussion are emerging concepts in refractory chronic rhinosinusitis that will likely have important implications in the near future...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888912/extended-endoscopic-and-open-sinus-surgery-for-refractory-chronic-rhinosinusitis
#18
REVIEW
Jean Anderson Eloy, Emily Marchiano, Alejandro Vázquez
This review discusses extended endoscopic and open sinus surgery for refractory chronic rhinosinusitis. Extended maxillary sinus surgery including endoscopic maxillary mega-antrostomy, endoscopic modified medial maxillectomy, and inferior meatal antrostomy are described. Total/complete ethmoidectomy with mucosal stripping (nasalization) is discussed. Extended endoscopic sphenoid sinus procedures as well as their indications and potential risks are reviewed. Extended endoscopic frontal sinus procedures, such the modified Lothrop procedure, are described...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888911/revision-functional-endoscopic-sinus-surgery
#19
REVIEW
Corinna G Levine, Roy R Casiano
Refractory chronic rhinosinusitis can be challenging to treat. Initial treatment focuses on medical and nonsurgical treatments. If these treatments fail, revision endoscopic sinus surgery is an option. A plan for revision surgery must address anatomic factors contributing to recurrence. Preoperative imaging and sinonasal endoscopy are systematically reviewed; areas of disease and "danger" zones are identified. Traditional anatomic landmarks are often obscured or absent; thus, a set of consistent landmarks (unchanged despite prior surgery) are used to navigate the revision endoscopic sinus surgery...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888910/genetic-and-immune-dysregulation-in-chronic-rhinosinusitis
#20
REVIEW
Ashleigh Halderman, Andrew P Lane
Chronic rhinosinusitis (CRS) is a prevalent condition that is heterogeneous in disease characteristics and multifactorial in cause. Although sinonasal mucosal inflammation in CRS is often either reversible or well-managed medically and surgically, a significant proportion of patients has a refractory form of CRS despite maximal therapy. Two of the several described factors thought to contribute to disease recalcitrance are genetic influences and dysfunction of the host immune system. Current evidence for a genetic basis of CRS is reviewed, as it pertains to putative abnormalities in innate and adaptive immune function...
February 2017: Otolaryngologic Clinics of North America
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