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Current Opinion in Otolaryngology & Head and Neck Surgery

Axel Sahovaler, Kevin Fung
PURPOSE OF REVIEW: The current article reviews the most recent publications of computer-assisted reconstruction using bony free flaps, emphasizing on comparative reports using these novel techniques. RECENT FINDINGS: Computer-aided reconstruction has shown some benefits in comparison with traditional techniques and some of the perceived limitations are currently being addressed in the latest reports. Still, there is a lack of appropriate comparative studies and unblinded measurements to establish solid conclusions...
July 19, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Rachael Krager
PURPOSE OF REVIEW: Individuals over the age of 60 are at an increased risk of falls, even if they do not have an isolated dysfunction of the vestibular system. The aim of this article is to review the various vestibular testing currently available and its usefulness in determining the presence of vestibular dysfunction in the elderly population. The primary vestibular tests to be reviewed include: balance function testing, vestibular evoked myogenic potentials (VEMPs), and video head impulse testing (vHIT)...
July 19, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Kevin A Peng, Gregory P Lekovic, Eric P Wilkinson
PURPOSE OF REVIEW: To discuss the use of the middle fossa craniotomy for resection of vestibular schwannomas; to present pearls of and modifications to the approach. RECENT FINDINGS: The middle fossa craniotomy allows for hearing preservation in the resection of intracanalicular vestibular schwannomas. Over recent years, the approach has been modified to address larger tumors with a limited cerebellopontine angle component. Positive identification of the superior semicircular canal allows for rapid exposure of the internal auditory canal (IAC)...
July 17, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Patrik Pipkorn, Kelsey Rosenquist, Joseph Zenga
PURPOSE OF REVIEW: The treatment of oral cavity cancer may impair speech and swallowing function. Optimizing posttreatment function may lead to significant improvement of quality of life. RECENT FINDINGS: Although oncologic control remains the main goal of treatment for oral cavity cancer, posttreatment function for surviving patients has over the last decades been recognized as an important secondary outcome. Reconstruction of oral cavity defects range from primary closure to advanced microvascular reconstruction, including multiple tissue types...
July 17, 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Noga Lipschitz, Gavriel D Kohlberg, Mario Zuccarello, Ravi N Samy
PURPOSE OF REVIEW: To review the current literature on the extended middle cranial fossa (xMCF) approach and to provide a comprehensive description of the relevant anatomy, indications, surgical technique, results, and complications. RECENT FINDINGS: The xMCF approach expands the surgical exposure provided by the sMCF approach, allowing access to the internal auditory canal, cerebellopontine angle, prepontine cistern, anterior petrous apex, petrous carotid artery, Meckel's cave, cavernous sinus, mid and upper clivus, and posterior lesions approaching the jugular foramen...
June 27, 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
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
Toby O Steele, Amarbir Gill, Travis T Tollefson
PURPOSE OF REVIEW: Characterize indications, perioperative considerations, clinical outcomes and complications for concurrent endoscopic sinus surgery (ESS) and rhinoplasty. RECENT FINDINGS: Chronic rhinosinusitis and septal deviation with or without inferior turbinate hypertrophy independently impair patient-reported quality of life. Guidelines implore surgeons to include endoscopy to accurately evaluate patient symptoms. Complication rates parallel those of either surgery (ESS and rhinoplasty) alone and are not increased when performed concurrently...
August 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Angela Vong, Jamie Funamura
PURPOSE OF REVIEW: Oculo-auriculo-vertebral spectrum (OAVS) is a complex disorder that is represented by wide variations in phenotypic presentation. Recent publications and systematic reviews of the available literature are presented here. RECENT FINDINGS: Treatment strategies vary among craniofacial centers across the country. Advances in presurgical planning, virtual surgical planning, and computer-aided manufacturing have been incorporated in the treatment of patients...
August 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Alan Herford, Isaac Lowe
PURPOSE OF REVIEW: To provide a comprehensive overview of the predisposing factors that contribute to a risk of excess bleeding for surgical therapy in the head and neck regions, provide a thorough overview of techniques and tools for managing blood loss complications, and provide intervention algorithms to help guide clinical decision making. RECENT FINDINGS: With the current landscape of medications and reversal agents, protocols for intervention in a variety of situations, and new tools for blood loss management all rapidly changing and being developed it is critical to stay up to date to provide patients the best care in the most critical of situations...
August 2018: 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...
August 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...
August 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...
August 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...
August 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
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...
June 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...
June 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Johannes J Fagan, Muaaz Tarabichi
No abstract text is available yet for this article.
June 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Jo Frost, H 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...
June 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
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