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Current Opinion in Otolaryngology & Head and Neck Surgery

Isabelle Magro, Susan D Emmett, James Saunders
PURPOSE OF REVIEW: Cost-effectiveness of cochlear implants is a major concern for expanding these services to low-income and middle-income developing countries. RECENT FINDINGS: Recent studies have applied appropriate methodology to make determination of cost-effectiveness for cochlear implants in developing countries. In addition, important parameters that effect cost-effectiveness have been reviewed in a systematic way. The combination of these new studies along with existing reports of cochlear implant programmes in developing countries allows for a discussion of cost and outcomes determinants that drive cost-effectiveness in these environments...
March 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Jemma Haines, James H Hull, Stephen J Fowler
PURPOSE OF REVIEW: Many aspects of inducible laryngeal obstruction (ILO) are still poorly understood. However, in recent years there have been advances made and an international consensus has achieved a standardized taxonomy. This review will synthesize recent research; specifically, relating to clinical presentation, assessment, and therapeutic interventions. RECENT FINDINGS: The evidence base is growing but still limited for ILO and mostly comprises retrospective reviews, case studies, and anecdotal reports...
March 6, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Max J H Witjes, Rutger H Schepers, Joep Kraeima
PURPOSE OF REVIEW: This review describes the advances in 3D virtual planning for mandibular and maxillary reconstruction surgical defects with full prosthetic rehabilitation. The primary purpose is to provide an overview of various techniques that apply 3D technology safely in primary and secondary reconstructive cases of patients suffering from head and neck cancer. RECENT FINDINGS: Methods have been developed to overcome the problem of control over the margin during surgery while the crucial decision with regard to resection margin and planning of osteotomies were predetermined by virtual planning...
February 20, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Chloe Walton, Paul Carding, Kieran Flanagan
PURPOSE OF REVIEW: Unilateral vocal fold paralysis (UVFP) is a common cause of neurogenic dysphonia resulting in glottal insufficiency. To restore glottal sufficiency and reduce the presenting dysphonia, treatment involving either surgical intervention, voice therapy or a combination of the two is typically provided. Currently, there is no consensus for the most effective voice treatment for UVFP. This results in an inability to compare current studies, and a lack of treatment effectiveness for the management of UVFP...
February 19, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
José G Vartanian, Ronaldo N Toledo, Thiago Bueno, Luiz P Kowalski
PURPOSE OF REVIEW: Review the recent literature regarding the management of orbital invasion in sinonasal malignant tumors. RECENT FINDINGS: There is a recent trend in preserving the orbit in cases of minimal invasion of periosteum and limited periorbit involvement, as well as in presence of good response to neoadjuvant chemotherapy, mainly in squamous cell carcinoma and neuroendocrine histologies. SUMMARY: The decision about orbital exenteration in cases of sinonasal malignancies is facilitated if the patient already has clear clinical signs of intraconal invasion such as visual loss, restriction of ocular mobility or infiltration of the eyeglobe...
February 19, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Ann Edwards, Elspeth Froude, Gabriella Sharpe
PURPOSE OF REVIEW: This review examines the recent literature concerning the development of VFSS analysts. RECENT FINDINGS: Face-to-face and blended methods of training improve reliability and accuracy of VFSS analysis. However, with the exception of the literature describing the MBSImP training, most studies investigate relatively brief training for specific VFSS rating tools. The influence of training mode and trainee factors has received limited attention. SUMMARY: There is a lack of controlled studies investigating the influences of training methods for VFSS analysis...
February 15, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Gerhard F Huber, Joseph C Dort
PURPOSE OF REVIEW: To review the development and the benefits of enhanced recovery after surgery (ERAS) protocols in non-head and neck disciplines and to describe early implementation efforts in major head and neck surgeries. RECENT FINDINGS: Several groups have adopted ERAS protocols for major head and neck surgery and demonstrated its feasibility and effectiveness. SUMMARY: There is growing evidence that clinical and financial outcomes for patients undergoing major head and neck surgery rehabilitation can be significantly improved by standardizing preoperative, intraoperative, and postoperative treatment protocols...
February 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Vittorio Rampinelli, Marco Ferrari, Piero Nicolai
PURPOSE OF REVIEW: Intestinal-type adenocarcinoma (ITAC) is one of the most frequent sinonasal tumors, especially in European countries. The purpose of this article is to review the most recent literature, with special emphasis on biological and genetic profile and treatment guidelines. RECENT FINDINGS: Results on large series support transnasal endoscopic surgery as the technique of choice in the large majority of patients with ITAC. Adjuvant radiotherapy is recommended in advanced-stage and high-grade lesions...
January 30, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Martine Hendriksma, Bas J Heijnen, Elisabeth V Sjögren
PURPOSE OF REVIEW: To give an overview of the laryngeal preservation and functional outcomes of patients treated with transoral CO2 laser microsurgery (TLM) or radiotherapy for T2 glottic carcinoma. This information supports physicians and patients in treatment counselling and choices. RECENT FINDINGS: A recent systematic review showed that local control rates at 5-year did not differ between radiotherapy and TLM for T2 glottic tumours. However, there is a lack of comparative data on laryngeal preservation as well as functional outcomes in T2 glottic carcinoma...
January 30, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Ivana Fiz, Jan Constantin Koelmel, Christian Sittel
PURPOSE OF REVIEW: Summarize recent findings regarding the impact of margin status on oncologic outcomes and organ preservation, as well as evaluate possible management policies of close and positive margins after transoral laser microsurgery (TLM) for Tis-T2 glottic carcinomas. RECENT FINDINGS: Impact of margin status on survival rates remains controversial, whereas some authors found close and positive margins to be independent risk factors for recurrence and poorer survival rates, others did not find any significant variations compared with negative ones...
January 25, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Emmanuel D'heygere, Jeroen Meulemans, Vincent Vander Poorten
PURPOSE OF REVIEW: The review puts new information on geno- and phenotype of salivary duct carcinoma (SDC) in the perspective of the updated 2017 WHO classification. RECENT FINDINGS: The proportion of SDC is increasing. This may be because of a true rise in incidence, but certainly to better diagnostic tests and changed WHO definitions. In this light, a substantial proportion of carcinoma expleomorphic adenoma is now attributed to the category of SDC. 'Low-grade SDC' and 'SDC in-situ' of the former WHO classification, are now named low-grade and high-grade intraductal carcinoma (IDC), respectively...
January 25, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Ross Elledge, Satyesh Parmar
PURPOSE OF REVIEW: To review recent literature on the subject of free tissue transfer options in paediatric head and neck surgery, with a particular emphasis on highlighting the advantages and disadvantages of different reconstructions in the paediatric patient. RECENT FINDINGS: Free tissue transfer in paediatric patients is predictable and applicable for a wide range of congenital and acquired defects in the head and neck. The free fibula flap is a mainstay of mandibular reconstruction and allows excellent implant-supported prosthodontic rehabilitation and growth potential at the recipient site with little or no donor site morbidity...
January 22, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Alberto Paderno, Alessandro Gronchi, Cesare Piazza
PURPOSE OF REVIEW: To present the current state of knowledge concerning the role of conservative surgery in the treatment of synovial sarcomas of the upper aero-digestive tract (UADT). RECENT FINDINGS: The wider experience on synovial sarcomas involving the extremities and the results of retrospective reports focused on head and neck synovial sarcomas tend to justify a conservative surgical approach when dealing with tumors involving the UADT. SUMMARY: UADT synovial sarcomas is an extremely rare clinical entity (only around 50 cases reported in the literature, with four more herein presented from our own surgical series), with no clear guidelines concerning its treatment...
January 11, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Patrick J Bradley
PURPOSE OF REVIEW: Recurrent pleomorphic adenoma (RPA) is uncommon. Treatment selection is based on the likely possibility of minimizing the risk of tumour recurrence, avoiding local functional and cosmetic sequelae, and eradicates the possibility of metastatic or malignant transformation. Much has changed since the topic was reviewed in 2001, and this manuscript comments on clinical progress and discusses patient treatment options. RECENT FINDINGS: Surgery is the preferred treatment for head and neck pleomorphic adenoma...
December 22, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
Peter A Pellionisz, Karam W Badran, Warren S Grundfest, Maie A St John
PURPOSE OF REVIEW: The quantity of tissue removed during an oncologic surgical procedure is not standardized and there are numerous reports of local recurrence despite histologically adequate resection margins. The oral cavity is one of the sites in the head and neck with high chances of recurrence following negative margins. To address this need, this article reviews the recent applications of Dynamic Optical Contrast Imaging (DOCI) towards both oral screening and the intraoperative evaluation of tumor margins in head and neck surgery...
April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
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April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Salvatore Alfieri, Stefano Cavalieri, Lisa Licitra
PURPOSE OF REVIEW: In the last decade, after cetuximab (anti-epidermal growth factor receptor), none of the novel investigated compounds has demonstrated benefit in head and neck squamous cell cancers (HNSCC), both in advanced and curative settings. Therefore, prognosis of recurrent/metastatic (R/M) HNSCC patients remains dismal, especially in platinum-refractory cohort. In the last few years, a new important class of drugs has affirmed its role. HNSCC, even if less 'immunogenic' than other malignancies (e...
April 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Madeleine R Schaberg
PURPOSE OF REVIEW: To review the literature on quality of life (QOL) in endoscopic approaches to anterior and central intracranial skull-base disease. As endoscopic surgical techniques have gained widespread acceptance and complications and morbidity remain low and comparable with microscopic and open approaches, a shift to focusing on patients' perception of their own well being as an important outcome parameter has been made. In addition to the traditional measurements of surgical outcomes (extent of resection, recurrence rate, morbidity, survival, and complication rate), the success of a surgery can now be assessed using QOL measures...
February 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Sandro H de Paiva Leite, Richard G Douglas
PURPOSE OF REVIEW: The current article reviews the literature on the distribution of nasal irrigation in the treatment of chronic sinusitis, especially in how sinus surgery and irrigation techniques affect its delivery to the nasal cavity and paranasal sinuses. RECENT FINDINGS: Nasal irrigation has become a useful tool in the treatment of chronic sinusitis. Used after endoscopic surgery of the paranasal sinuses, irrigation has shown to be effective in improving edema and removing crusts and secretions in that place...
February 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Aman Khanna, Anshul Sama
PURPOSE OF REVIEW: The article reviews the advancements in instrumentation in the operating room that augment the speed, safety or outcomes of endoscopic sinus surgery (ESS). The article aims to update the Rhinologist on recent perioperative instruments that may benefit their practice. RECENT FINDINGS: The greatest advancements in the recent years have been in the field of visualization and optics. The introduction of high definition and ultra high definition 4K camera and screens supported by improvements with three-dimensional and variable angled endoscopes have greatly enhanced the quality and range of the visual information available to the sinus surgeon...
February 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
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