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Otolaryngologic Clinics of North America

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https://www.readbyqxmd.com/read/28527523/advances-in-radiation-oncology-what-to-consider
#1
REVIEW
John V Hegde, Allen M Chen, Robert K Chin
Treatment of squamous cell carcinoma of the head and neck is rapidly evolving due to changing patient populations, an emphasis on quality of life-related outcomes, and advances in radiotherapy concepts and techniques to meet these new demands. This review includes recent and ongoing studies that are potentially practice changing, including improvements in intensity-modulated radiotherapy planning, the use of deintensified regimens in the human papilloma virus-related setting, and adjuvant therapy after transoral robotic surgery...
May 17, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28527522/precision-medicine-genomic-profiles-to-individualize-therapy
#2
REVIEW
Oscar E Streeter, Phillip J Beron, Prashant Natarajan Iyer
Precision medicine is the application of genotypic and Omics biomarkers to determine the most appropriate, outcome-driven therapy for individual patients. To determine the best choice of therapy, institutions use significant information technology-enabled data from imaging, electronic medical records, sensors in the clinic/hospitals, and wearable sensors to determine treatment response. With genomic profiling, targets to affect a disease course are continuing to be developed. As clonal mutational prevalence continues to be understood, information can be communicated to patients to inform them that resistance is common, requiring collection of more genetic mutations from patients with further biopsies or blood collection...
May 17, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28389018/topical-drug-therapies-for-chronic-rhinosinusitis
#3
REVIEW
Lauren J Luk, John M DelGaudio
Chronic rhinosinusitis is recognized as an inflammatory syndrome involving the nose and paranasal sinuses of multifactorial etiology. Research has demonstrated a complex interplay between host factors, microbiota, environmental exposures, and epigenetics resulting in chronic mucosal inflammation. The mainstay of medical therapy addresses this inflammation. In previously operated sinuses this includes topical saline and corticosteroids, reserving antibiotics for culture-directed acute exacerbations. Topical antiinflammatory therapies allow increased local concentration of drugs while minimizing side effects...
April 4, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28372814/endoscopic-skull-base-reconstruction-an-evolution-of-materials-and-methods
#4
REVIEW
Aaron C Sigler, Brian D'Anza, Brian C Lobo, Troy Woodard, Pablo F Recinos, Raj Sindwani
Endoscopic skull base surgery has developed rapidly over the last decade, in large part because of the expanding armamentarium of endoscopic repair techniques. This article reviews the available technologies and techniques, including vascularized and nonvascularized flaps, synthetic grafts, sealants and glues, and multilayer reconstruction. Understanding which of these repair methods is appropriate and under what circumstances is paramount to achieving success in this challenging but rewarding field. A graduated approach to skull base reconstruction is presented to provide a systematic framework to guide selection of repair technique to ensure a successful outcome while minimizing morbidity for the patient...
March 31, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28372813/innovations-in-balloon-catheter-technology-in-rhinology
#5
REVIEW
Brian D'Anza, Raj Sindwani, Troy D Woodard
Since being introduced more than 10 years ago, balloon catheter technology (BCT) has undergone several generations of innovations. From construction to utilization, there has been a myriad of advancements in balloon technology. The ergonomics of the balloon dilation systems have improved with a focus on limiting the extra assembly. "Hybrid" BCT procedures have shown promise in mucosal preservation, including treating isolated complex frontal disease. Multiple randomized clinical trials report improved long-term outcomes in stand-alone BCT, including in-office use...
March 31, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28372812/advances-in-microdebrider-technology-improving-functionality-and-expanding-utility
#6
REVIEW
Dennis Tang, Brian C Lobo, Brian D'Anza, Troy Woodard, Raj Sindwani
Since its application in nasal surgery, the microdebrider has revolutionized the practice of endoscopic sinus surgery. As the demands and breadth of procedures performed endoscopically have increased, so has the need for improvement in the microdebrider and related technologies. This article addresses how use of the microdebrider has impacted endonasal surgery and discusses current advances, which include creation of specialty hand pieces and blades, increases in instrument rotational speed, incorporation of navigation and energy, adaptation for intracranial use, and disposable instrumentation designed for in office use...
March 31, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28347482/robotics-in-sinus-and-skull-base-surgery
#7
REVIEW
Sanjeet Rangarajan, Ralph Abi Hachem, Enver Ozer, Andre Beer-Furlan, Daniel Prevedello, Ricardo L Carrau
Transoral robotic surgery (TORS) has been proven to be safe and to yield acceptable oncological and functional outcomes for surgery of the oropharynx, hypopharynx, supraglottis, and glottis. TORS has been successful at reducing morbidity, improving quality of life, and providing access to areas that previously required mandibulotomy or other more radical approaches in the past. This has changed the paradigm of management of tumors in these anatomic locations. In this article, the authors review the recent literature discussing the role of robotic surgery in managing sinonasal and skull base pathology and discuss its current advantages and limitations...
March 24, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28325634/emerging-roles-of-coblation-in-rhinology-and-skull-base-surgery
#8
REVIEW
Garret W Choby, Peter H Hwang
Coblation is a technology that incorporates bipolar radiofrequency energy to ablate tissue at relatively low temperatures. Its use for sinonasal surgery is actively being investigated, including applications for turbinate reduction, sinus surgery, skull base surgery, and adenoidectomy. Potential benefits include reduction in blood loss, improved endoscopic surgical visualization, and reduction in postoperative pain. The main drawbacks are its relatively high cost, potential adverse effects on functional epithelium, and relative paucity of long-term outcomes...
March 18, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28325633/trends-in-the-use-of-stents-and-drug-eluting-stents-in-sinus-surgery
#9
REVIEW
Leah J Hauser, Justin H Turner, Rakesh K Chandra
Stenting has long been used in the paranasal sinuses with the goals of maintaining a patent sinus cavity during the postoperative healing process and preventing restenosis from inflammation or scarring. More recently, drug-eluting stents have been introduced. Steroid-impregnated dressings and implants appear to be safe, although likely have increased systemic absorption compared with topical nasal steroid sprays and rinses. There is evidence to support the use of steroid-releasing implants in the ethmoid cavity in the postoperative period; however, more study is needed to truly define the role of these implants...
March 18, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28318535/organism-and-microbiome-analysis-techniques-and-implications-for-chronic-rhinosinusitis
#10
REVIEW
Ashleigh A Halderman, Andrew P Lane
Modern advances in DNA sequencing have allowed for the development of culture-independent techniques with application to infectious and inflammatory conditions, such as rhinosinusitis. Although paradigm-changing discoveries have resulted from molecular microbiologic methods for a number of diseases, insights provided into the role of bacteria in chronic rhinosinusitis have yet to be fully understood to the point of impacting clinical diagnosis and management. As culture-independent techniques continue to evolve and become more refined, it is likely that a better understanding will emerge of how the microbiome influences chronic rhinosinusitis pathogenesis and response to therapy...
March 16, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28284452/advances-in-absorbable-biomaterials-and-nasal-packing
#11
REVIEW
Conner J Massey, Ameet Singh
Nasal biomaterials have been developed to improve postoperative outcomes after functional endoscopic sinus surgery (FESS). These products have been designed to overcome certain common complications in FESS, and to maximize patient comfort. This article evaluates the performance of nonabsorbable and absorbable packing with respect to these outcomes. The collected trials suggest superior performance of bioabsorbable packs compared with absorbable packs with respect to patient comfort. For hemostasis and wound healing, variation in performance metrics makes interstudy comparison difficult...
March 9, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28502533/harnessing-technology-at-the-edges-of-otolaryngology
#12
EDITORIAL
Sujana S Chandrasekhar
No abstract text is available yet for this article.
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28502532/retraction
#13
(no author information available yet)
No abstract text is available yet for this article.
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28502531/technological-advances-in-sinus-and-skull-base-surgery
#14
EDITORIAL
Raj Sindwani
No abstract text is available yet for this article.
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28502530/the-operating-room-of-the-future-versus-the-future-of-the-operating-room
#15
REVIEW
Amin B Kassam, Richard A Rovin, Sarika Walia, Srikant Chakravarthi, Juanita Celix, Jonathan Jennings, Sammy Khalili, Lior Gonen, Alejandro Monroy-Sosa, Melanie B Fukui
Technological advancement in the operating room is evolving into a dynamic system mirroring that of the aeronautics industry. Through data visualization, information is continuously being captured, collected, and stored on a scalable informatics platform for rapid, intuitive, iterative learning. The authors believe this philosophy (paradigm) will feed into an intelligent informatics domain fully accessible to all and geared toward precision, cell-based therapy in which tissue can be targeted and interrogated in situ...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28392038/the-emerging-role-of-3-dimensional-printing-in%C3%A2-rhinology
#16
REVIEW
Janalee K Stokken, John F Pallanch
Nasal septal perforations, particularly those that are large and irregular in shape, often present as challenging surgical dilemmas. New technology has allowed us to develop techniques using computed tomography imaging and 3-dimensional (3D) printers to design custom polymeric silicone septal buttons. These buttons offer patients an option that avoids a surgical intervention when standard buttons do not fit well or are not tolerated. Preliminary data suggest that buttons designed by 3D printer technology provide more comfort than standard commercially available or hand-carved buttons with equivalent reduction of symptoms...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28392037/next-generation-surgical-navigation-systems-in-sinus-and-skull-base-surgery
#17
REVIEW
Martin J Citardi, William Yao, Amber Luong
Over the past 25 years, rhinologists have adopted surgical navigation technology for endoscopic sinus and skull base procedures. Navigation systems often produce a wide target registration error (TRE). Ideally, next-generation systems will include a leap in target registration error reduce TRE through innovative hardware and software. Incorporation of microsensors will be another important innovation. Future systems are likely to include augmented reality, which can project overlays of critical anatomy on real-world endoscopic images...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28389019/evolution-in-visualization-for-sinus-and-skull-base-surgery-from-headlight-to-endoscope
#18
REVIEW
Omar H Ahmed, Sonya Marcus, Richard A Lebowitz, Joseph B Jacobs
Rhinoscopy became a formal field of study in the mid-nineteenth century as improvements in nasal specula were made and the potent vasoconstrictive effects of cocaine on the intranasal tissues were discovered. Since then, a multitude of advances in visualization and illumination have been made. The advent of the Storz-Hopkins endoscope in the mid-twentieth century represents a culmination of efforts spanning nearly 2 centuries, and illumination has evolved concomitantly. The future of endoscopic sinus surgery may integrate developing technologies, such as 3-dimensional endoscopy, augmented reality navigation systems, and robotic endoscope holders...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28372815/application-of-ultrasonic-aspirators-in-rhinology-and-skull-base-surgery
#19
REVIEW
Dominic Vernon, Brian C Lobo, Jonathan Y Ting
Ultrasonic aspirators (UAs) are increasingly being used in rhinology and skull base surgery. The use of ultrasonic vibration for the removal of bony tissue transfers minimal heat to surrounding tissues and is relatively atraumatic to nearby soft tissue structures. This article details the development and application of this technology in septoturbinoplasty, endoscopic dacryocystorhinostomy (DCR), and skull base surgery. The benefits and limitations of UAs compared with conventionally powered instruments are discussed...
June 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28314409/sinonasal-and-ventral-skull-base-malignancies
#20
EDITORIAL
Jean Anderson Eloy, Michael Setzen, James K Liu
No abstract text is available yet for this article.
April 2017: Otolaryngologic Clinics of North America
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