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Current Opinion in Otolaryngology & Head and Neck Surgery

Minna Kääriäinen, Elina Halme, Jussi Laranne
PURPOSE OF REVIEW: Flap failure in microvascular reconstruction is a costly complication with total flap loss being the worst-case scenario. With the aim to rapidly identify a postoperative circulatory problem, some susceptible flaps can be saved by careful clinical monitoring or by various technical monitoring methods. In head and neck surgery, where the flaps are often buried and difficult to monitor clinically, a reliable technical monitoring method would be useful. A broad range of different techniques are in use varying according to practical and personal preferences among clinics and surgeons...
May 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Tom Shokri, Jessyka G Lighthall
PURPOSE OF REVIEW: The aim of this study was to review and discuss recent literature regarding perioperative use of antibiotics in the context of facial plastic surgery. RECENT FINDINGS: Despite research efforts, there continues to be insufficient evidence in support of, or against, the use of antimicrobial prophylaxis. SUMMARY: Current available evidence regarding antibiotic use in facial plastic surgery procedures fails to demonstrate routine benefit...
May 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Yiu Yan Leung, Karen Kar Yan Lai
PURPOSE OF REVIEW: This article reviews the current literature on the use of distraction osteogenesis as a treatment for patients with obstructive sleep apnoea (OSA). We reviewed the indications, surgical protocols and outcomes for distraction osteogenesis in paediatric and adult OSA cases described in the literature. RECENT FINDINGS: There is evidence that distraction osteogenesis is effective in treating children with OSA as a result of underdevelopment of jaws such as those with craniofacial syndromes...
May 9, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Dörte Ohrmann, Paa Ekow Hoyte-Williams, Philip Kuo-Ting Chen
PURPOSE OF REVIEW: To give an update on recent publications and tendencies concerning complications in cleft orthognathic surgery. RECENT FINDINGS: Cleft-specific changes after orthognathic surgery and their impact on surgical outcomes are discussed. Focus lays on the causes and mechanisms of cleft-related surgical complications and strategies to prevent or minimize these complications. Bimaxillary surgery is seen as a safe procedure for cleft patients. Maxillary distraction, total or segmental, is pointed out as an alternative method to improve outcomes...
May 8, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Catherine Y Liu, Priyanka Chhadva, Pete Setabutr
PURPOSE OF REVIEW: To review recent advances on the mechanisms and management of acquired aponeurotic blepharoptosis. RECENT FINDINGS: Recent advances over the past year have focused on refining well known methods of ptosis repair, expanding and modifying techniques to treat difficult and more severe conditions, and uncovering the biomechanical and neurostimulatory mechanisms of ptosis and its repair. SUMMARY: Innovations in ptosis repair are discussed in the context of current treatment paradigms...
May 4, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Ayham Al Afif, H Kendal Uys, S Mark Taylor
PURPOSE OF REVIEW: Tremendous advancements have been made in head and neck reconstruction following oncologic resection. Despite this, many patients are left with disfiguring postoperative changes. The focus of this review highlights various techniques aimed at improving aesthetic outcomes following head and neck cancer therapy, with a focus on liposuction and fat augmentation. RECENT FINDINGS: Over the past decade, the use of liposuction in treating lymphedema after head and neck cancer therapy has showed promising results...
May 2, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Blake S Raggio, Ryan Winters
PURPOSE OF REVIEW: Despite recent advances in radiotherapy, osteoradionecrosis (ORN) remains a common and difficult complication of radiation therapy in head and neck cancer patients. Available treatment options are complementary to its complex pathophysiology and the currently available theories of ORN development. The efficacy of hyperbaric oxygen therapy has recently been questioned, and therapies targeting the fibroatrophic process have become a focus of ORN treatment. The objective of this review is to evaluate the literature regarding ORN of the mandible, with a focus on available treatment options...
April 30, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Raghunandhan Sampath Kumar, Mohan Kameswaran
PURPOSE OF REVIEW: The overall prevalence of deafness in India is 0.2%, but the prevalence in the southern state of Tamil Nadu is much higher (around 0.6%) because of consanguinity. Especially in India, establishing cochlear implantation as a treatment modality for hearing loss has been a daunting task, but in the last decade, the cochlear implantation program has emerged as an unqualified success in many states, with over 20 000 cochlear implantations done till date. Several states are sponsoring free implants to children under the age of 6 years and below poverty line...
April 24, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Johannes J Fagan, Muaaz Tarabichi
No abstract text is available yet for this article.
March 16, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Jo Frost, Fiona Robinson, Judi Hibberd
PURPOSE OF REVIEW: Dysphagia in adults arises from a range of causes including acquired neurological disorders and some cancers. Previous research has suggested that treatment using neuromuscular electrical stimulation (NMES) when used in conjunction with conventional therapy is effective. This review describes the recent literature and a small prospective case series carried out in the United Kingdom. This study contributed to support National Institute of Clinical Excellence (NICE) guidance for clinicians who wish to include NMES in a rehabilitation programme for dysphagic patients, specifically with reference to safety and the impact on swallowing function of this intervention...
March 16, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Ricardo F Bento, Fayez Bahmad, Miguel A Hippolyto, Sady S Da Costa
PURPOSE OF REVIEW: Effective hearing rehabilitation with cochlear implantation is challenging in developing countries, and this review focuses on strategies for childhood profound sensorineural hearing loss care in South America. RECENT FINDINGS: Most global hearing loss exists in developing countries; optimal cost-effective management strategies are essential in these environments. This review aims to assess and discuss the challenges of cochlear implantation effectiveness in South America...
March 15, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Tessa Goldsmith, Marlene C Jacobson
PURPOSE OF REVIEW: Late dysphagia has a profound impact on quality of life in patients treated with chemoradiation therapy for advanced head and neck cancer and the number of survivors is growing. Traditional treatment methods are not uniformly successful in reducing the swallow impairment in these patients. RECENT FINDINGS: Manifestations of late dysphagia are complex and do not follow a uniform trajectory. Patient's experience of eating and engagement in treatment is critical given the complex, variable nature of late dysphagia...
June 2018: 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...
June 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...
June 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...
June 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...
June 2018: 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
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...
April 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...
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
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