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Otolaryngologic Clinics of North America

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https://www.readbyqxmd.com/read/30029923/surgical-management-of-turbinate-hypertrophy
#1
REVIEW
Regan W Bergmark, Stacey T Gray
Inferior turbinate reduction is a common technique used to improve nasal breathing in patients with inferior turbinate hypertrophy. Subjective nasal breathing improves for the majority of patients with most surgical techniques, but effectiveness often diminishes over time. Inferior turbinate reduction techniques typically have low complication rates. Empty nose syndrome is a rare complication associated most classically with total or subtotal inferior turbinate reduction. Most techniques attempt to preserve the turbinate mucosa for the purposes of preserving normal mucociliary clearance and sensation...
July 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30025848/techniques-in-septoplasty-traditional-versus-endoscopic-approaches
#2
REVIEW
Janki Shah, Christopher R Roxbury, Raj Sindwani
This article provides a review of modern techniques in the surgical management of the deviated septum with emphasis on the comparison of traditional versus endoscopic septoplasty approaches. Relevant anatomy and physiology of the nasal septum are discussed. A brief history of the evolution of the surgical approaches for the correction of a deviated septum is provided. Traditional and endoscopic septoplasty techniques are reviewed; the indications, advantages, and limitations of each approach are highlighted...
July 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30017096/nasal-obstruction-considerations-in-cosmetic-rhinoplasty
#3
REVIEW
Douglas Sidle, Katherine Hicks
Cosmetic rhinoplasty is an increasingly popular procedure in the United States. There are critical aspects of preoperative planning and intraoperative execution that facilitate successful rhinoplasty. Thorough preoperative assessment of the structures comprising the internal and external nasal valves and identification of potential at-risk areas for static or dynamic compromise must be done before surgery. Thoughtful maneuvers and meticulous surgical technique must be used. Postoperative counseling ranges from simple reassurance to medical therapy to procedural efforts to alleviate a patient's concerns...
July 12, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30017095/office-based-procedures-for-nasal-airway-obstruction
#4
REVIEW
Nadim Bikhazi, James H Atkins
Treatment of common rhinologic problems with in-office surgical procedures has increased dramatically in response to patient preference, evolving insurance patterns, and changes in coding and reimbursement. Because this is an emerging practice, there is not a lot of evidence published about how to best perform these techniques. This article provides practical advice from experienced surgeons related to logistics and anesthetic techniques for conducting in-office surgical treatment of nasal airway obstruction; an overview of office set-up and necessary equipment; and specific procedural considerations...
July 12, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/30017094/surgical-management-of-nasal-valve-collapse
#5
REVIEW
Sheena Samra, Jeffrey T Steitz, Natalia Hajnas, Dean M Toriumi
Nasal valve collapse has multiple causes, including congenital, traumatic, and, unfortunately, iatrogenic. Recognition of the causes of nasal valve collapse and the methodology for treatment is paramount not only for the otolaryngologist but also for any physician managing the nasal airway. This article focuses on the cause and surgical management of internal and external nasal valve collapse.
July 12, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29941182/anatomy-and-physiology-of-nasal-obstruction
#6
REVIEW
David W Hsu, Jeffrey D Suh
Nasal obstruction is a common presenting symptom to clinicians and affects up to one-third of the population. There are several factors that cause nasal obstruction, including anatomic, physiologic, and pathophysiologic factors. The anatomy and physiology of nasal obstruction is complicated and is influenced by patency of nasal passages, mucociliary function, airflow receptors, autonomic function, and degree of mucosal inflammation. Common anatomic causes include internal nasal valve stenosis/collapse, septal deviation, and turbinate hypertrophy...
June 22, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29941181/treatment-paradigm-for-nasal-airway-obstruction
#7
REVIEW
Theodore A Schuman, Brent A Senior
Nasal airway obstruction (NAO) is a common otolaryngic complaint with many potential causes, frequently structural or inflammatory in nature. Patients typically have multiple coexisting factors leading to symptoms. Good patient outcomes require careful preoperative evaluation, including nasal endoscopy, to accurately identify sources of obstruction and tailor intervention appropriately. Common structural causes of NAO include inferior turbinate hypertrophy, nasal septal deviation, and narrowing or collapse of the internal or external nasal valves...
June 22, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29937066/measuring-nasal-obstruction-outcomes
#8
REVIEW
Emily Spataro, Sam P Most
Methods of measuring nasal obstruction outcomes include both objective anatomic and physiologic measurements, as well as subjective patient-reported measures. Anatomic measurements include acoustic rhinometry, imaging studies, and clinician-derived examination findings. Physiologic measures include rhinomanometry, nasal peak inspiratory flow, and computational fluid dynamics. Patient-reported outcome measures (PROMs) are self-reported assessments of disease-specific quality-of-life outcomes. Several studies attempted correlation of these outcome measures; however, few show strong correlation...
June 21, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29937065/surgical-management-of-nonallergic-rhinitis
#9
REVIEW
Carol H Yan, Peter H Hwang
Nonallergic rhinitis (NAR) describes chronic symptoms of nasal congestion, obstruction, and rhinorrhea unrelated to a specific allergen based on skin or serum testing. Vasomotor rhinitis is the most frequent subtype of NAR. Although medical management is the first-line treatment of NAR, there is a role for surgical therapy when medications fail to improve symptoms. Surgical options for NAR include inferior turbinate reduction and botulinum toxin injection as well as more directed targeting of the autonomic nerve supply to the nasal cavity through vidian neurectomy, posterior nasal neurectomy, and cryoablation of the posterior nerve...
June 21, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29934201/nasal-obstruction-considerations-in-sleep-apnea
#10
REVIEW
Mahmoud I Awad, Ashutosh Kacker
Obstructive sleep apnea (OSA) is a highly prevalent condition in the context of the global obesity epidemic with significant medical comorbidities and psychosocial implications. The first-line treatment of OSA is continuous positive airway pressure (CPAP). There is evidence to demonstrate an association between nasal obstruction and OSA. Therefore, medications and surgical interventions to address nasal obstruction may play a role in the treatment of OSA. In addition, surgical correction of nasal obstruction has been shown to improve CPAP tolerance and compliance...
June 19, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29914725/medical-treatment-of-nasal-airway-obstruction
#11
REVIEW
Daniel R Cox, Sarah K Wise
Nasal obstruction is a common, and potentially debilitating, problem. It is caused by a combination of structural factors and/or mucosal swelling/inflammation. The medical treatment of nasal obstruction is aimed at decreasing mucosal inflammation and edema and is generally guided by the underlying cause. Several different drug classes are commonly used in the treatment of nasal obstruction, each with different indications, and pros and cons to their use. This article discusses the most commonly used therapies for nasal obstruction...
June 16, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29803531/vertigo-and-dizziness-understanding-and-managing-fall-risk
#12
REVIEW
Jennifer C Alyono
Vertigo and dizziness are common conditions among older adults. They are closely associated with fall risk and portend major implications for geriatric injury and disability. Management can be particularly challenging, because symptoms are often nonspecific and may reflect multiple etiologies. Chronic dizziness can reflect dysfunction in the vestibular, somatosensory, or visual systems or in their central integration. Systemic processes, such as postural hypotension, arrhythmias, heart failure, medication use, and lower extremity weakness or frailty, also contribute...
May 24, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29801920/head-and-neck-cancer-and-the-elderly-patient
#13
REVIEW
Brian P Cervenka, Shyam Rao, Arnaud F Bewley
Management of head and neck cancer in the elderly patient is particularly challenging given the high morbidity associated with treatment. Surgery, radiotherapy, and chemotherapy have all been demonstrated as effective in older patients; however, older patients are more susceptible to treatment-induced toxicity, which can limit the survival benefits of certain interventions. This susceptibility is better associated with the presence of multiple comorbidities and decreasing functional status than with age alone...
May 22, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29789139/medical-and-preoperative-evaluation-of-the-older-adult
#14
REVIEW
Audrey Chun
Because of age, increased rates of multimorbidity, polypharmacy, functional changes, and cognitive impairment, older adults are at higher risk for perioperative complications. Identifying modifiable risk factors and educating patients and families about what to expect can improve surgical outcomes and satisfaction. Comprehensive preoperative evaluation assesses these potential factors and should include recommendations for risk reduction. The optimal preoperative evaluation for older adults should address medical conditions and other areas pertinent to the care of older adults including assessments of cognition, capacity, delirium risk, function, frailty, nutrition, medications, and treatment preferences...
May 19, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779618/aging-in-the-united-states-opportunities-and-challenges-for-otolaryngology-head-and-neck-surgery
#15
REVIEW
Brandon L Chiu, Jayant M Pinto
The number of Americans over the age of 65 has been growing much faster than the overall population's growth rate. These changes can be largely attributed to the improvement in life expectancy. This demographic shift yields a unique and exciting opportunity to provide both expedient and cost-efficient care to a growing patient population.
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779617/dysphagia-in-the-older-patient
#16
REVIEW
Samia Nawaz, Ozlem E Tulunay-Ugur
Dysphagia in older adults is a challenging problem and necessitates a team approach. The key to effective management is recognition. Patients tend to dismiss their symptoms as normal aging; therefore, early diagnosis depends on the diligence of the primary care doctors. No diagnostic technique can replace the benefits of a thorough history, with a detailed understanding of nutritional status and aspiration risk. Although one of the main goals in management is to ensure safe swallowing, the impact of a nonoral diet on the quality of life of patients should not be underestimated...
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779616/sleep-apnea-and-sleep-disordered-breathing
#17
REVIEW
Jiahui Lin, Maria Suurna
Older adults undergo gradual changes in their sleep patterns. It is important to differentiate normal age-related sleep changes from sleep disorders. Because sleep disorders can impact an older adult's day-to-day life and contribute to various comorbidities, these patients should be carefully screened by using a detailed medical history, combined with a detailed sleep history. There is a high prevalence of undiagnosed and untreated sleep apnea in the elderly. Early identification and appropriate management of this disorder may not only provide improvement in quality of life but also decrease disease-associated morbidity and mortality...
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779615/treating-the-elderly-with-science-and-dignity
#18
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779614/the-emerging-field-of-geriatric-otolaryngology
#19
REVIEW
David Eibling, Karen Kost
Sub-specialization within otolaryngology, like other specialties, is driven by accumulation of new knowledge and technology. For a variety of reasons, the establishment of a new subspecialty of geriatric otolaryngology is unlikely. Education of all otolaryngologists in the basic principles of gerontology and geriatric otolaryngology is achievable and represents a preferred strategy.
May 17, 2018: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/29779613/facial-plastic-surgery-in-the-geriatric-population
#20
REVIEW
Ian Newberry, Eric W Cerrati, J Regan Thomas
Greater life expectancy with advancements in technology and medicine has led to an increasing interest in facial rejuvenation. Facial aging is an inevitable process that largely results from soft tissue descent and volumetric deflation. However, a comprehensive knowledge of the aging process and precise assessment of the exact pathologies yielding the patient's senescent appearance is essential to produce the best cosmetic outcome. The surgeon must evaluate each region independently and the aging face as a whole to ensure a pleasing, natural appearance...
May 17, 2018: Otolaryngologic Clinics of North America
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