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Current Opinion in Otolaryngology & Head and Neck Surgery

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https://www.readbyqxmd.com/read/28525400/big-data-in-facial-plastic-and-reconstructive-surgery-from-large-databases-to-registries
#1
Aaron M Smith, Scott R Chaiet
PURPOSE OF REVIEW: There are many limitations to performing clinical research with high levels of evidence in facial plastic and reconstructive surgery (FPRS), such as randomization into surgical groups and sample size recruitment. Therefore, additional avenues for exploring research should be explored using big data, from databases to registries. Other organizations have developed these tools in the evolving landscape of outcomes measurement and value in healthcare, which may serve as models for our specialty...
May 17, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28509672/update-on-injectables-in-the-nose
#2
Leo L Wang, Oren Friedman
PURPOSE OF REVIEW: The use of injectable fillers for nonsurgical rhinoplasty has increased tremendously over the past decade. This review describes the most commonly used fillers and their indications in the context of recent reports of both their successes and failures. RECENT FINDINGS: Hyaluronic acid and calcium hydroxylapatite are the two most commonly used fillers for injection. Recent studies have found that most injectable fillers are met with success and patient satisfaction, but vascular complications are still a serious problem of which physicians should be wary...
May 13, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28509671/complications-in-facial-mohs-defect-reconstruction
#3
Angelique M Berens, Sarah R Akkina, Sapna A Patel
PURPOSE OF REVIEW: To review the recent literature in regards to complications after reconstruction of Mohs defects, outline common pitfalls and to discuss the literature on avoiding complications as outlined per aesthetic subunit. RECENT FINDINGS: Complications in facial Mohs reconstruction commonly consist of infection, wound necrosis and dehiscence, hematoma and suboptimal scarring. However, site-specific complications such as hairline or eyebrow distortion, eyelid retraction or ectropion, nasal contour abnormality, alar retraction, nasal valve compromise, significant facial asymmetry or even oral incompetence must also be considered...
May 13, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28509670/pediatric-nasal-surgery-timing-and-technique
#4
Celeste C Gary
PURPOSE OF REVIEW: Timing of pediatric nasal surgery has always been a controversial topic. Concern over disrupting growing parts of the face and causing permanent facial deformity has led to a primarily conservative approach. Many surgeons feel that it is prudent to wait until the patient has completed nasal growth after puberty to pursue nasal surgery. RECENT FINDINGS: Recently, this attitude has been challenged with evidence that not only is nasal surgery in the pediatric age group not a detriment to facial growth, but failure to correct significant nasal deformity may actually cause dysmorphic facial growth secondary to obligate mouth breathing...
May 13, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28504987/secondary-reconstruction-of-maxillofacial-trauma
#5
Jaime Castro-Núñez, Joseph E Van Sickels
PURPOSE OF REVIEW: Craniomaxillofacial trauma is one of the most complex clinical conditions in contemporary maxillofacial surgery. Vital structures and possible functional and esthetic sequelae are important considerations following this type of trauma and intervention. Despite the best efforts of the primary surgery, there are a group of patients that will have poor outcomes requiring secondary reconstruction to restore form and function. The purpose of this study is to review current concepts on secondary reconstruction to the maxillofacial complex...
May 12, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28504986/cosmetic-bone-contouring
#6
Regina Rodman
PURPOSE OF REVIEW: In recent years, cosmetic bone contouring surgery has become increasingly popular, especially in East Asian countries. These procedures are also being requested by patients in the United States at an increasing rate. The purpose of this study is to provide an overview of what is involved with these procedures and their potential complications. RECENT FINDINGS: In some cultures, a wide jaw and a square face are aesthetically unpleasing, whereas an ovoid or 'melon seed face' is thought to be feminine, delicate and beautiful...
May 12, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28504985/current-opinion-in-otolaryngology-and-head-and-neck-surgery-frontal-sinus-fractures
#7
Robert J Chouake, Brett A Miles
PURPOSE OF REVIEW: The purpose of this manuscript is to review the current literature regarding the management of frontal sinus fractures and offer the authors opinion on the current management of these traumatic injuries. We evaluate recently proposed management algorithms as well as novel surgical approaches reported within the last few years. RECENT FINDINGS: Patient selection for sinus sparing treatment modalities is balanced between fracture severity, involved structures, and reliable patient surveillance...
May 12, 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/28459759/managing-dysphagia-in-trachesotomized-patients-where-are-we-now
#9
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...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28459758/speech-and-swallowing-outcomes-following-oral-cavity-reconstruction
#10
Camilla Dawson, Laith Al-Qamachi, Timothy Martin
PURPOSE OF REVIEW: This review explores speech and swallowing outcomes following oral cavity reconstruction for treatment of head and neck cancer, with focus on articles published within 2015-2016. RECENT FINDINGS: There is limited recent evidence that explores functional outcomes following oral cavity surgery in the literature; therefore, an overview of the literature describing surgical interventions and their associated functional outcomes is timely. SUMMARY: We discuss the challenges associated with achieving adequate surgical margins, alongside optimal functional outcomes...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28426527/us-antibiotic-stewardship-and-penicillin-allergy
#11
Kara J Wada, Karen H Calhoun
PURPOSE OF REVIEW: The purpose of this review is to improve otolaryngologists' antibiotic stewardship by detailing current approaches to penicillin allergy. RECENT FINDINGS: Although up to 15% of hospitalized patients in the United States have a penicillin allergy recorded on their charts, fewer than 10% of these have a true penicillin allergy. SUMMARY: Using a combination of a detailed allergy history, skin testing and graded-dose administration, many patients whose charts say 'penicillin-allergic' can safely be treated with penicillin and cross-reacting antibiotics...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28368872/diagnostic-challenges-the-evaluation-of-antibiotic-allergy
#12
Andrew O'Keefe, Moshe Ben-Shoshan
PURPOSE OF REVIEW: Antibiotic allergy is commonly reported and often challenging to evaluate. This review highlights recent developments in our understanding of antibiotic allergy, primarily surrounding evaluation, and diagnosis of antibiotic allergy. We provide historical context to establish a framework, lending relevance to the latest studies. RECENT FINDINGS: Clinicians have typically employed skin testing as a first step in the diagnosis of drug allergy, reserving drug provocation challenge, the gold standard for diagnosis, for those with negative skin tests...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28319482/immunotherapy-for-food-allergy
#13
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...
June 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
#14
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...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28306586/voice-outcomes-post-total-laryngectomy
#15
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...
June 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
#16
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...
June 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
#17
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...
June 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
#18
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...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28277333/voice-outcomes-for-early-laryngeal-cancer
#19
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...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28266945/allergic-laryngitis-unraveling-the-myths
#20
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...
June 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
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