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Current Opinion in Otolaryngology & Head and Neck Surgery

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https://www.readbyqxmd.com/read/28319482/immunotherapy-for-food-allergy
#1
William R Reisacher, Wesley Davison
PURPOSE OF REVIEW: The current review discusses strategies for administering specific immunotherapy (SIT) for the treatment of food allergy. It focuses on three delivery routes for food allergens, immunomodulatory adjuvants and allergen modifications. RECENT FINDINGS: Interest in SIT for food allergy has been increasing significantly. Sublingual immunotherapy is effective for desensitization with a very favorable adverse event profile. Epicutaneous immunotherapy is also effective, most notably in younger children, with a high rate of local reactions...
March 17, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28319481/application-of-telepractice-for-head-and-neck-cancer-management-a-review-of-speech-language-pathology-service-models
#2
Elizabeth C Ward, Laurelie R Wall, Clare L Burns, Bena Cartmill, Anne J Hill
PURPOSE OF REVIEW: Head and neck cancer (HNC) is a complex and heterogeneous disease, requiring specialist intervention from a multidisciplinary team including speech language pathology (SLP). Unfortunately, multiple patient and service-related challenges exist which currently limit equitable access to SLP support for all individuals. This review highlights the existing evidence for different telepractice models designed to help patients and services optimize management of swallowing and communication disorders arising from HNC...
March 17, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#3
Anne Hurren, Nick Miller
PURPOSE OF REVIEW: A consensus and body of robust evidence has developed regarding optimal laryngeal voice outcome measures. This contrasts with a lack of clarity for equivalent assessments in alaryngeal voice. Addressing this situation would enable clinicians to select the best tools currently available to facilitate research, audit and clinical practice. This is important because of the limited knowledge regarding the optimal surgical or reconstruction techniques and rehabilitation regimes for the laryngectomy population...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28306585/behaviour-change-technique-taxonomy-a-method-of-describing-head-and-neck-cancer-dysphagia-intervention-delivery
#4
Kate Toft, Helen Stringer
PURPOSE OF REVIEW: The purpose of the review is to examine the current state of the art of dysphagia intervention delivery description and to propose use of a new tool to facilitate this: the behaviour change technique taxonomy version 1 (BCTTv1). RECENT FINDINGS: Describing intervention delivery is difficult, and published research in the field of speech and language therapy (SLT) does not include detail on this key aspect of research protocols. Interventions themselves are often poorly delineated, and a way is needed of classifying how these interventions are delivered in practice...
March 16, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28277335/voice-and-swallowing-outcomes-for-adults-undergoing-reconstructive-surgery-for-laryngotracheal-stenosis
#5
Gemma M Clunie, Andrew J Kinshuck, Gurpreet S Sandhu, Justin W G Roe
PURPOSE OF REVIEW: Adult laryngotracheal stenosis is a rare, multifactorial condition which carries a significant physical and psychosocial burden. Surgical approaches have developed in recent years, however, voice and swallowing function can be affected prior to treatment, in the immediate postoperative phase, and as an ongoing consequence of the condition and surgical intervention. In this study we discuss: the nature of the problem; surgical interventions to address airway disorders; optimal patterns of care to maximize voice and swallowing outcomes...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28277334/social-and-quality-of-life-impact-using-a-voice-prosthesis-after-laryngectomy
#6
Lizz Summers
PURPOSE OF REVIEW: This review is intended to give an up-to-date overview of key developments in the evidence base relating specifically to the social and quality of life (QOL) impact of using a voice prosthesis, with reflections on the impact on clinical practice. RECENT FINDINGS: Recent studies have shed light on the role of social support on psychological adjustment after laryngectomy, developing the existing evidence base on psychological sequelae. Investigations into the relationship between voice intensity/intelligibility and voice handicap/QOL may suggest a relationship for some patients, and current tools for measuring these constructs are evaluated...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28277333/voice-outcomes-for-early-laryngeal-cancer
#7
Andrew J Kinshuck, Aditya Shenoy, Terry M Jones
PURPOSE OF REVIEW: Treatment options for early laryngeal cancer are well established with good local control and 5-year survival. The commonest treatments are radiotherapy or transoral laser microsurgery (TLM). There are advantages and disadvantages of the different modalities, but debate continues regarding the voice outcomes posttreatment. This review will focus on early glottic carcinoma and voice outcomes following the different treatments. RECENT FINDINGS: TLM and radiotherapy are both likely to affect voice quality, but the extent of voice change depends on different factors...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28277332/dysphagia-management-in-tracheostomized-patients-where-are-we-now
#8
Diane Goff
PURPOSE OF REVIEW: Tracheostomized patients are medically complex and vulnerable. International attention is now focused on improving the safety and quality of their care. This review summarizes recent evidence in hot-topic areas pertinent to speech and language therapy (SLT) intervention for dysphagia management in tracheostomized patients. RECENT FINDINGS: The management of tracheostomized patients requires a truly multidisciplinary team (MDT) approach. Without this, patients remain tracheostomized and hospitalized for longer and have slower access to MDT members...
March 8, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28266945/allergic-laryngitis-unraveling-the-myths
#9
Robert J Stachler, James P Dworkin-Valenti
PURPOSE OF REVIEW: This article provides a thorough review of the literature highlighting the articles that have advanced our knowledge about the sensitivity of the larynx to allergens in the air or ones consumed. This area of inquiry requires continued interest and investigation. As the field of clinical laryngology changes, and more information is discovered about the possible causal association between allergy and vocal pathologies, practicing otolaryngologists, allergists, and other medical professionals may discover more comprehensive methods to evaluate and treat their allergic patients, particularly those who present with complaints of dysphonia, dysphagia, laryngopharyngeal reflux (LPR), and/or dyspnea...
March 4, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28266944/patient-adherence-to-swallowing-exercises-in-head-and-neck-cancer
#10
Mary Wells, Emma King
PURPOSE OF REVIEW: A younger population and improved treatments for head and neck cancer (HNC) mean that more people are now living longer with the consequences of treatment, including long-term swallowing problems (dysphagia). Exercises aim to improve swallowing function, however highly variable adherence rates are currently reported, with no standard measure of adherence. RECENT FINDINGS: Measuring adherence to swallowing exercises depends on the definition of 'adherence', the tools used to measure adherence, and the acceptable threshold that is used to constitute adherence or nonadherence...
March 4, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28234780/biologics-for-asthma-and-allergy
#11
Garry M Walsh
PURPOSE OF REVIEW: The development of monoclonal antibody-based biologics targeted at inhibition of the Th2 cytokines interleukin-4, interleukin-5 and interleukin-13 represent potentially effective treatments for asthma and allergic diseases. This short review is based on English-language original articles in PubMed or MedLine that reported significant clinical findings on the evidence demonstrating the effectiveness or otherwise of the targeting of interleukin-4, interleukin-5 or interleukin-13 in asthma or allergic disease...
February 23, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28234779/assessing-asthma-in-the-otolaryngologist-s-office
#12
Lauren J Luk, Melissa R Rotella, Leisa J Stillman, Sarah K Wise
PURPOSE OF REVIEW: To familiarize otolaryngologists and other practitioners with basic diagnosis and treatment of asthma in adults and children based on current literature. RECENT FINDINGS: Increased fractional excretion of nitrous oxide and sputum eosinophils have been identified in asthmatic patients being evaluated for chronic cough and appear to be more sensitive in diagnosis than traditional spirometry. Both sublingual and subcutaneous immunotherapy modalities are effective in decreasing symptoms and medication use in patients with allergic rhinitis and allergic asthma...
February 23, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28169864/utilization-of-ultrasound-for-diagnostic-evaluation-and-management-of-peritonsillar-abscesses
#13
Michael H Froehlich, Zhen Huang, Brian K Reilly
PURPOSE OF REVIEW: We outlined the management of peritonsillar abscess (PTA) through the use of ultrasound, an imaging modality that continues to emerge as a diverse diagnostic and treatment tool. Our review compares the use of ultrasound to alternative diagnostic modalities, particularly computed tomography (CT). Further, the review evaluates how ultrasound can be used to help facilitate guided drainage of PTA and serve as a suitable alternative to more invasive management options. RECENT FINDINGS: Studies over the past 5 years have demonstrated that the initial management of PTA with ultrasound is a more cost-efficient and lower-risk option than imaging with CT...
February 4, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28169863/supratracheal-partial-laryngectomy-indications-oncologic-and-functional-results
#14
Giovanni Succo, Marco Fantini, Giuseppe Rizzotto
PURPOSE OF REVIEW: To describe current evidence about supratracheal laryngectomies, focusing on indications, contraindications, oncologic results, functional outcomes and side-effects of this 'extreme' function-sparing surgical approach to laryngeal cancer. RECENT FINDINGS: In the latest years, some studies have analyzed oncologic and functional results of open partial supratracheal laryngectomy, a surgical approach whose modern technique was recently described...
February 4, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28141602/genetic-signature-and-profiling-of-head-and-neck-cancer-where-do-we-stand
#15
Julia Paczkowska, Krzysztof Szyfter, Maciej Giefing, Malgorzata Wierzbicka
PURPOSE OF REVIEW: To focus on two novel aspects of head and neck squamous cell carcinoma (HNSCC) genetics of special interest: the epithelial-mesenchymal transition (EMT) process, an initial step in tumor progression that finally leads to metastasis formation, by explaining how genes as well as epigenetic factors control this process, and the new diagnostic options based on the analysis of circulating tumor cells (CTCs) and cell-free DNA (cfDNA) that could revolutionize diagnosis in the coming years...
January 30, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28141601/is-p16-an-adequate-surrogate-for-human-papillomavirus-status-determination
#16
Lauri Jouhi, Jaana Hagström, Timo Atula, Antti Mäkitie
PURPOSE OF REVIEW: In head and neck cancer management, immunoexpression of protein p16 is widely used as a surrogate marker for human papillomavirus (HPV) positivity due to challenges of direct HPV testing. Previously p16 has been reported to have good sensitivity but only moderate specificity in HPV-status determination. The aim of this review is to evaluate the existing information on sensitivity and specificity of p16 immunohistochemistry (IHC) in HPV-status determination among the recent studies...
January 30, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28106661/swallowing-after-transoral-surgery-for-oropharyngeal-cancer-comparison-with-primary-chemoradiotherapy-outcomes
#17
Nicholas Dawe, James O'Hara
PURPOSE OF REVIEW: Survival equipoise is recognized between the contemporary surgical and oncological approaches to oropharyngeal squamous cell carcinoma treatment. Primary transoral surgery (TOS) options have emerged that utilize either laser or robotic techniques. Our review presents an overview of the evidence available for swallowing outcomes following TOS approaches and compares these with outcomes following primary oncological management. RECENT FINDINGS: Meta-analysis of swallow outcomes following TOS or (chemo)radiotherapy is not possible given the heterogeneity of the available data...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28106660/different-branching-patterns-of-the-spinal-accessory-nerve-impact-on-neck-dissection-technique-and-postoperative-shoulder-function
#18
Boštjan Lanišnik
PURPOSE OF REVIEW: Despite nerve-sparing surgery, postoperative shoulder morbidity remains high and significantly impacts patient's quality of life. This review will focus on recent findings of anatomical nuances of the cranial nerve XI (CN XI) along its course in the neck and possible reasons for postoperative morbidity. RECENT FINDINGS: The most recent studies identified three different branching patterns of the CN XI in the neck. In type 1 (66%), the branch for trapezius muscle exits at the posterior border of the sternocleidomastoid muscle (mSCM)...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28106658/transoral-surgery-vs-intensity-modulated-radiotherapy-for-early-supraglottic-cancer-a-systematic-review
#19
Mark S Swanson, Garren Low, Uttam K Sinha, Niels Kokot
PURPOSE OF REVIEW: To provide clinicians with a critical review of outcomes for endolaryngeal surgery and intensity-modulated radiation therapy (IMRT) for early-stage supraglottic cancer. RECENT FINDINGS: A total of 971 potential articles were reviewed, with inclusion of 14 studies comparing IMRT with transoral surgery. One study analyzed IMRT, one transoral robotic surgery, and the remaining were transoral laser microsurgery studies. A weighted average and 95% confidence interval of all surgery patients showed a local control of 90...
January 18, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28059901/conservative-surgery-for-laryngeal-chondrosarcoma-a-review-of-the-most-recently-proposed-approaches
#20
Cesare Piazza, Alberto Paderno, Piero Nicolai
PURPOSE OF REVIEW: The aim of this study was to describe the most recent technical nuances for resection and reconstruction of Grade 1 and 2 laryngeal chondrosarcomas, with a special emphasis on those located at the level of the cricoid plate, which is the site of origin of the vast majority of these rare tumours. RECENT FINDINGS: Even though inherently based on retrospective small clinical series or anecdotal case reports, a number of studies have been recently published focusing on conservative transoral and open-neck surgical procedures aimed at an oncologically sound removal of the tumour together with organ and function preservation...
January 3, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
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