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Current Opinion in Otolaryngology & Head and Neck Surgery

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https://www.readbyqxmd.com/read/28617692/update-on-the-supraclavicular-flap
#1
Nicholas E Wirtz, Samir S Khariwala
PURPOSE OF REVIEW: The purpose of this study is to describe the supraclavicular flap and its utility in head and neck reconstruction in the context of recent studies. RECENT FINDINGS: Current literature regarding the supraclavicular flap has described its expanded uses in a variety of head and neck reconstructive settings. Its reliability and limited morbidity have been well demonstrated, and it has been cited as a reasonable alternative to other reconstructive options including, in some situations, free tissue transfer...
June 14, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28604404/perioperative-care-of-head-and-neck-free-flap-patients
#2
Michael R Kinzinger, Arnaud F Bewley
PURPOSE OF REVIEW: This article reviews the recent literature on the perioperative care of head and neck surgical patients undergoing free tissue transfer. RECENT FINDINGS: As the overall success of head and neck free flaps has plateaued above 95%, recent literature on perioperative flap management has focused on minimizing complications, length of stay, and cost of treatment. Current areas of research include preoperative risk stratification, preoperative and postoperative nutrition, intraoperative fluid management, postoperative level of care, postoperative antibiotic prophylaxis, defining the impact of comorbidities, and developing comprehensive evidence-based perioperative care protocols...
June 9, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28604403/latest-advances-in-the-management-of-facial-synkinesis
#3
Jeffrey Markey, Myriam Loyo
PURPOSE OF REVIEW: To provide an overview of the treatment options for nonflaccid facial paralysis including physical rehabilitation, botulinum toxin injection and surgical intervention. To also describe recent technique advances regarding facial synkinesis in each zone of facial movement. RECENT FINDINGS: Physical therapy and neuromodulation with botulinum toxin continues to be the main treatment strategy for facial synkinesis. Treating the orbicularis oculi, mentalis and platysma muscles with neurotoxin has been well described...
June 9, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28562372/masseteric-to-buccal-branch-nerve-transfer
#4
Sinehan B Bayrak, J David Kriet, Clinton D Humphrey
PURPOSE OF REVIEW: To review recent literature pertaining to the use of masseteric-facial nerve neurorrhaphy (MFNN) for facial reanimation in patients with facial paralysis. RECENT FINDINGS: First, MFNN effectively restores some midface tone and function, including the ability to smile. Second, use of the masseteric nerve minimizes synkinesis, dysarthria, and dysphagia that frequently occur after hypoglossal-facial nerve neurorrhaphy. Third, concurrent cable grafting to the zygomatic branch from an intact proximal facial nerve remnant - when available - can restore dynamic eye closure...
May 29, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28548998/zygomaticomaxillary-complex-fractures-diagnosis-and-treatment
#5
Nicholas Peretti, Stephen MacLeod
PURPOSE OF REVIEW: To provide an overview of zygomaticomaxillary complex (ZMC) fractures and their treatment. Aspects of anatomy, diagnosis, and treatment objectives of these common fractures will be reviewed including recent literature. RECENT FINDINGS: Advances in technology such as guided surgery have allowed for better outcomes and a reduction in surgeon variability with regard to postoperative results. The use of titanium and bioresorbable mini screws and plates have expanded the ability to achieve stable and predictable results...
May 25, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28538022/surgical-orthodontics
#6
Alexis M Strohl, Lauren Vitkus
PURPOSE OF REVIEW: The article reviews some commonly used orthodontic treatments as well as new strategies to assist in the correction of malocclusion. Many techniques are used in conjunction with surgical intervention and are a necessary compliment to orthognathic surgery. Basic knowledge of these practices will aid in the surgeon's ability to adequately treat the patient. RECENT FINDINGS: Many orthodontists and surgeons are eliminating presurgical orthodontics to adopt a strategy of 'surgery first' orthodontics in orthognathic surgery...
May 22, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28538021/global-surgery-current-evidence-for-improving-surgical-care
#7
Jennifer C Fuller, David A Shaye
PURPOSE OF REVIEW: The field of global surgery is undergoing rapid transformation, owing to several recent prominent reports positioning it as a cost-effective means of relieving global disease burden. The purpose of this article is to review the recent advances in the field of global surgery. RECENT FINDINGS: Efforts to grow the global surgical workforce and procedural capacity have focused on innovative methods to increase surgeon training, enhance international collaboration, leverage technology, optimize existing health systems, and safely implement task-sharing...
May 19, 2017: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/28525400/big-data-in-facial-plastic-and-reconstructive-surgery-from-large-databases-to-registries
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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/28459759/managing-dysphagia-in-trachesotomized-patients-where-are-we-now
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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